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To make predictions about the carbon cycling consequences of rising global surface temperatures, Earth system scientists rely on mathematical soil biogeochemical models (SBMs). However, it is not clear which models have better predictive accuracy, and a rigorous quantitative approach for comparing and validating the predictions has yet to be established. In this study, we present a Bayesian approach to SBM comparison that can be incorporated into a statistical model selection framework. We compared the fits of linear and nonlinear SBMs to soil respiration data compiled in a recent meta-analysis of soil warming field experiments. Fit quality was quantified using Bayesian goodness-of-fit metrics, including the widely applicable information criterion (WAIC) and leave-one-out cross validation (LOO). We found that the linear model generally outperformed the nonlinear model at fitting the meta-analysis data set. Both WAIC and LOO computed higher overfitting risk and effective numbers of parameters for the nonlinear model compared to the linear model, conditional on the data set. Goodness of fit for both models generally improved when they were initialized with lower and more realistic steady-state soil organic carbon densities. Still, testing whether linear models offer definitively superior predictive performance over nonlinear models on a global scale will require comparisons with additional site-specific data sets of suitable size and dimensionality. Such comparisons can build upon the approach defined in this study to make more rigorous statistical determinations about model accuracy while leveraging emerging data sets, such as those from long-term ecological research experiments.

Introduction: The research on cancer patients returning to work in China is still in its infancy, and there is no research and discussion on the adaptability to return-to-work for cancer patients. It is critical to develop the Adaptability to Return-to-Work Scale (ARTWS) for cancer patients and evaluate its psychometric properties., Methods: The items of the initial scale were compiled based on the theoretical model and literature review results. Through two rounds of Delphi expert consultation ( N = 15) and a pilot survey ( N = 40), the initial scale was further checked and revised. Conduct a large sample survey ( N = 376) and the construct validity and reliability of the ARTWS were assessed by confirmatory factor analysis (CFA) and exploratory factor analysis (EFA)., Results: The final ARTWS consisted of 24 items. "Focusing on rehabilitation," "Rebuilding Self-efficiency," and "Adjusting plans" as common factors in determining adaptability to return to work for cancer patients, and the cumulative variance contribution rate for these three factors was 66.6%. The S-CVI of the total scale was 0.979. The Cronbach's α coefficient was 0.937 and the 2-week test-retest reliability was 0.814., Discussion: ARTWS has good correlation validity and can be used as a tool to measure the adaptability of cancer patients' return to work. The presentation of the manuscript in Research Square (https://doi.org/10.21203/rs.3.rs-2323264/v1)., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Guo, Xue, Gu, Su, Li, Kuai, Xu, Xie and Han.)

Objective: To analyze factors influencing the underestimation of noise-induced permanent threshold shift (NIPTS) among manufacturing workers, providing baseline data for revising noise exposure standard., Design: A cross-sectional study was designed with 2702 noise-exposed workers from 35 enterprises from 10 industries. Personal noise exposure level(L Aeq,8h ) and noise kurtosis level were determined by a noise dosimeter. Questionnaires and hearing loss tests were performed for each subject. The predicted NIPTS was calculated using the ISO 1999:2013 model for each participant, and the actual measured NIPTS was corrected for age and sex. The factors influencing the underestimation of NIPTS were investigated., Results: The predicted NIPTS at each test frequency (0.5, 1, 2, 3, 4, or 6kHz) and mean NIPTS at 2, 3, 4, and 6kHz (NIPTS 2346 ) using the ISO 1999:2013 model were significantly lower than their corresponding measured NIPTS, respectively (P < 0.001). The ISO model significantly underestimated the NIPTS 2346 by 12.36 dB HL. The multiple linear regression analysis showed that noise exposure level, exposure duration, age, and kurtosis could affect the degree of underestimation of NIPTS 2346 . The generalized additive model (GAM) with (penalized) spline components showed nonlinear relationships between critical factors (age, exposure duration, noise level, and kurtosis) and the underestimated NIPTS 2346 .The underestimated NIPTS 2346 decreased with an increase in exposure duration (especially over ten years). There was no apparent trend in the underestimated NIPTS 2346 with age. The underestimated NIPTS 2346 decreased with the increased noise level [especially > 90 dB(A)]. The underestimated NIPTS 2346 increased with an increase in noise kurtosis after adjusting for the noise exposure level and exposure duration and ultimately exhibiting a linear regression relationship., Conclusions: The ISO 1999 predicting model significantly underestimated the noise-induced hearing loss among manufacturing workers. The degree of underestimation became more significant at the noise exposure condition of fewer than ten years, less than 90 dB(A), and higher kurtosis levels. It is necessary to apply kurtosis to adjust the underestimation of hearing loss and consider the applying condition of noise energy metrics when using the ISO predicting model., (© 2023. The Author(s).)

Objective: To establish reference values for carotid intima-media thickness (CIMT) of adult dwellers in Shenzhen City. Methods: The study was conducted based on the Shenzhen heart failure epidemiological survey from 2021 to 2022. In this survey, residents aged 18 years and above in Shenzhen were selected by using a multi-stage stratified random sampling method. General information, cardiovascular disease (CVD) related behavior and carotid ultrasound examination and etc. were collected from the participants. People with CVD factors, a history of atherosclerotic cardiovascular disease, carotid plaque or having no carotid ultrasound examination results were excluded. The parameter regression model based on fractional polynomial was used to establish the reference values of CIMT by age and sex. Results: A total of 2 163 healthy individuals were enrolled in the final analysis, including 576 males (26.6%) and 1 587 females (73.4%). The fractional polynomial regression of the CIMT mean and standard deviation was obtained. For men, the regression was mean CIMT =0.324 7+0.006 9×age and SD CIMT =0.076 9+0.001 2×age. For women, the regression was mean CIMT =0.354 9+0.005 4×age and SD CIMT =0.041 6+0.002 0×age. Conclusion: The age and sex reference values for CIMT of adult people in Shenzhen established in this study could provide the latest reference standards for early screening of subclinical CVD.

Unified pixel-based (PB) beamforming has been implemented for ultrasound imaging, offering significant enhancements in lateral resolution compared to the conventional dynamic focusing. However, it still suffers from clutter and off-axis artifacts, limiting the contrast resolution. This paper proposes an efficient method to improve image quality by integrating filtered delay multiply and sum (F-DMAS) into the framework. This hybrid strategy incorporates the spatial coherence of the received data into the beamforming process to improve contrast resolution and clutter rejection in the generated image. We also integrate a Wiener filter to suppress the spatiotemporal spreading using signals echoed from a single scatterer at the transmit focus as a kernel for the deconvolution. The Wiener filter is applied to the received waveforms before performing the hybrid strategy. The Wiener filter is shown to reduce interference due to the interaction between the excitation pulse and the transfer functions of the transducer elements, thus benefiting the axial resolution of the generated images. We validate the proposed method and compare it with other beamforming strategies through a series of experiments, including simulation, phantom, and in vivo studies. The results show that our approach can substantially improve both spatial resolution and contrast over the unified PB algorithm, while still maintaining the good features of this beamformer. The simplicity and good performance of our method show its potential for use in clinical applications., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Pixel-based beamforming generates focused data by assuming that the waveforms received on a linear transducer array are composed of spherical pulses. It does not take into account the spatiotemporal spread in the data from the length of the excitation pulse or from the transfer functions of the transducer elements. As a result, these beamformers primarily have impacts on lateral, rather than axial, resolution. This paper proposes an efficient method to improve the axial resolution for pixel-based beamforming. We extend our field pattern analysis and show that the received waveforms should be passed through a Wiener filter before being used in the coherent pixel-based beamformer. This filter is designed based on signals echoed from a single scatterer at the transmit focus. The beamformer output is then combined with a coherence factor, that is adaptive to the signal-to-noise ratio, to improve the image contrast and suppress artifacts that have arisen during the filtering process. We validate the proposed method and compare it with other beamforming strategies using a series of experiments, including simulation, phantom and in vivo studies. It is shown to offer significant improvements in axial resolution and contrast over coherent pixel-based beamforming, as well as other spatial filters derived from synthetic aperture imaging. The method also demonstrates robustness to modeling errors in the experimental data. Overall, the imaging results show that the proposed approach has the potential to be of value in clinical applications., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Objective: To study the effect of occupational exposure to non-steady state noise on hearing loss in the general equipment manufacturing industry, and to explore the feasibility of applying kurtosis index to evaluate hearing loss caused by non-steady state noise. Methods: A total of 233 workers exposed to non-steady state noise in 6 general equipment manufacturing enterprises were selected as the observation group, and 237 workers exposed to steady noise in 4 textile enterprises were selected as the control group between 2012 and 2018. Personal normalized continuous A-weighted sound pressure level equivalent to an 8 h-working-day (L(Aeq, 8 h)) was determined by a noise dosimeter. Cumulation noise exposure (CNE) was calculated from L(Aeq, 8 h) and related working age, and the CNE was adjusted by using noise kurtosis (CNE' after adjustment) . Meanwhile, questionnaires and hearing loss tests were performed for all subjects. The changes in the threshold of high-frequency hearing and the incidence of high-frequency hearing loss caused by noise in the two groups were compared before and after the adjustment of the kurtosis of CNE. The correlation between CNE and the incidence of high-frequency hearing loss before and after kurtosis adjustment was analyzed. Results: There was an difference between the 3000-8000 Hz hearing threshold of workers in different CNE groups ( P <0.05) . logistic regression analysis showed that CNE was a risk factor of high-frequency hearing loss for workers in the observation group ( OR =1.189, P <0.05) , and trend Chi-square test showed that the incidence of high-frequency hearing loss increased with CNE levels (χ(2)(trend)=34.415, P <0.05) .Before the kurtosis adjustment, in the CNE 95~<110 dB (A) ·year level group, the incidence of high-frequency hearing loss and the high-frequency hearing threshold in the observation group were significantly higher than those in the control group ( P <0.05) . After kurtosis adjustment, there was no significant difference in the incidence of high-frequency hearing loss between the observation group and the control group in each level group ( P >0.05) . The correlation between CNE after kurtosis adjustment and the incidence of high-frequency hearing loss was better than that before adjustment (after R (2) adjustment >before R (2) adjustment) . Conclusion: The effect of non-steady state noise on high-frequency hearing loss of workers in general equipment industry increases with the increase of CNE, and the effect of non-steady state noise on high-frequency hearing loss of workers is greater than that of steady noise. CNE' can be used to evaluate the hearing loss caused by non-steady state noise.

Objective: To investigate the occupational noise exposure characteristics and distribution of workers in wood furniture manufacturing industry and textile industry, so as to provide the basis for the establishment of noise source database and the prevention and control of noise hazards in China. Methods: In March 2020, a total of 653 workers in wood furniture manufacturing industry and textile industry were selected by cluster sampling method. A general questionnaire survey was conducted to measure the characteristics of noise exposure and analyze the changes of 8 h equivalent A-level (L(Aeq, 8 h)) and kurtosis of different industries and types of work. Results: The noise exposure L(Aeq, 8 h) of workers was (91.2±6.9) dB (A) , the median kurtosis and mean kurtosis were 37.0 and 105.0, respectively. 84.1% (549/653) of the workers had L(Aeq, 8 h)≥85 dB (A) , 49.0% (320/653) and 68.5% (447/653) of the workers had median kurtosis and mean kurtosis >10. The L(Aeq, 8 h) level of the textile industry was higher than that of the wooden furniture manufacturing industry, while the median and mean of kurtosis levels of the textile industry was lower than the wooden furniture manufacturing industry ( P <0.01) . The L(Aeq, 8 h) levels of spinners and weavers were higher, and the median and mean of kurtosis of nailers were higher ( P <0.05) . The mean and median of kurtosis were highly correlated among workers of two industries ( r =0.80, P <0.01) . The L(Aeq, 8 h) was positively correlated with mean and median of kurtosis among workers of wooden furniture manufacturing industry ( r =0.33 and 0.35, P <0.01) , while it was negatively correlated with mean and median of kurtosis among workers of textile industry ( r =-0.45 and -0.40, P <0.01) . Conclusion: Indicators for noise exposure characteristics, such as L(Aeq, 8 h) and kurtosis vary greatly by industries and type of works. Multi-indicator joint measurement is conducive to comprehensive assessment of noise exposure and its health effects.

Objective: To analyse the dose-response relationships between the kurtosis metric of noise and noise-induced hearing loss (NIHL) and study the role of kurtosis in the evaluation of NIHL associated with non-Gaussian noise. Methods: From January 2012 to December 2017, a total of 1869 workers in seven manufacturing industries were selected as the study subjects. The basic data of the workers were investigated by questionnaire, personal noise waveform was collected for a long time, and pure tone hearing threshold was tested. The 8-hour continuous equivalent A sound level (L(Aeq, 8 h)) , cumulative noise exposure (CNE) and kurtosis structure indexes were calculated. The dose-response relationships between kurtosis and NIHL were analyzed by stratification analysis method, which controlled the influence of CNE, L(Aeq, 8 h), exposure duration, age and sex on hearing loss using high-frequency noise-induced permanent threshold shift (NIPTS(346)) and high-frequency noise-induced hearing loss (HFNIHL) as outcome indicators. Results: When CNE was <90 dB (A) ·year and ≥100 dB (A) ·year, NIPTS(346) in the extremely high kurtosis group was significantly greater than that in the Gaussian kurtosis, low kurtosis and medium kurtosis group ( P <0.05) . In the workers exposed to L(Aeq, 8 h)<85 dB (A) and ≥94 dB (A) , NIPTS(346) in the extremely high kurtosis group was significantly greater than that in the Gaussian kurtosis group ( P <0.05) . Among workers under the age of 50 or male workers, NIPTS(346) in the extremely high kurtosis group was significantly greater than that in the Gaussian kurtosis, low kurtosis and medium kurtosis group ( P <0.05) . Kurtosis was positively correlated with NIPTS(346) ( r =0.121, P <0.05) . When CNE was <100 dB (A) ·year, the detection rate of HFNIHL increased with the increase of kurtosis level ( P <0.01) . Logistic regression analysis showed that kurtosis was an important influencing factor for HFNIHL ( OR =1.321) . Conclusion: Kurtosis has a dose-response relationship with the detection rate of HFNIHL in noise exposed workers, and noise kurtosis is an influencing factor of NIHL.

Background: Colorectal cancer (CRC), one of the most common malignancies worldwide, is associated with poor survival and has a high mortality rate. Taxol is a chemotherapeutic agent that has been clinically applied as a first-line drug against diverse cancers. Yet, development of drug resistance has become the major challenge for anti-cancer treatments. F-box and WD40 domain protein 7 ( Fbxw7 ) is a known tumor suppressor which is frequently downregulated in cancers. However, the biological roles and mechanisms of Fbxw7 in Taxol resistance are still under investigation., Methods: We report that Fbxw7 is significantly inactivated in CRC tumors and cell lines compared with normal tissues and colon cells. Expressions of Fbxw7 and Nox1 were detected from human colon tumors and cells by qRT-PCR and Western blot. Glycolysis rate was assessed by glucose uptake and lactate product assay. Interactions between Fbxw7 and Nox1 were determined by co-immunoprecipitation (Co-IP). Chemosensitivity and resistance of colon cancer cells were determined by MTT assay and Annexin V-FITC assay., Results: Overexpression of Fbxw7 sensitized colon cancer cells to Taxol. Moreover, we observed a negative correlation between Fbxw7 and glucose metabolism. From the established Taxol-resistant (TR) cell line from HCT-116, Fbxw7 was found to be markedly downregulated in HCT-116 TR cells. We detected that NADPH oxidase 1 ( Nox1 ), a superoxide-generating NADPH oxidase, is negatively regulated by Fbxw7 . The Co-IP assay showed that Fbxw7 interacted with Nox1 , which was observed to be significantly upregulated in CRC tissues. Nox1 therefore promotes the Taxol resistance and glucose metabolism of colon cancer cells. Finally, rescue experiments demonstrated that the Fbxw7 -promoted Taxol sensitivity was partially through the Nox1 -glycolysis axis. Restoration of Nox1 in Fbxw7 -overexpressed TR colon cancer cells significantly recovered the Taxol resistance, which could be further overridden by glycolysis inhibition., Conclusions: Collectively, this study uncovered that targeting the Fbxw7 - Nox1 -glucose metabolism axis could be an effective strategy against chemoresistant colon cancer., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm-21-2076). The authors have no conflicts of interest to declare., (2021 Annals of Translational Medicine. All rights reserved.)

The evolution of taste perception is usually associated with the ecology and dietary changes of organisms. However, the association between feeding ecology and taste receptor evolution is unclear in some lineages of vertebrate animals. One example is the sweet taste receptor gene Tas1r2 Previous analysis of partial sequences has revealed that Tas1r2 has undergone equally strong purifying selection between insectivorous and frugivorous bats. To test whether the sweet taste function is also important in bats with contrasting diets, we examined the complete coding sequences of both sweet taste receptor genes ( Tas1r2 and Tas1r3 ) in 34 representative bat species. Although these two genes are highly conserved between frugivorous and insectivorous bats at the sequence level, our behavioral experiments revealed that an insectivorous bat ( Myotis ricketti ) showed no preference for natural sugars, whereas the frugivorous species ( Rousettus leschenaultii ) showed strong preferences for sucrose and fructose. Furthermore, while both sweet taste receptor genes are expressed in the taste tissue of insectivorous and frugivorous bats, our cell-based assays revealed striking functional divergence: the sweet taste receptors of frugivorous bats are able to respond to natural sugars whereas those of insectivorous bats are not, which is consistent with the behavioral preference tests, suggesting that functional evolution of sweet taste receptors is closely related to diet. This comprehensive study suggests that using sequence conservation alone could be misleading in inferring protein and physiological function and highlights the power of combining behavioral experiments, expression analysis, and functional assays in molecular evolutionary studies., Competing Interests: The authors declare no competing interest., (Copyright © 2021 the Author(s). Published by PNAS.)

Objective: To study the effect of p38 mitogen-activated protein kinase (MAPK) gene silencing on expression of apoptotic genes and oncogenes in hepatocytes treated with PM(2.5). Methods: From June to September 2019, according to the p38MAPK gene mRNA sequence provided by GenBank, three interfering sequences were designed and synthesized, ligated into PLVX-shRNA2-puro after annealing, and the recombinant lentiviral vector was transfected into L02 hepatocytes. The p38MAPK silencing cells were identified by real-time fluorescent quantitative PCR and western blotting. The normal L02 cells and p38MAPK silencing cells were treated with 50 μg/mL PM(2.5) water soluble solution, 10 μmol/L positive control Cr(6+), and a blank control group was set up, the treatment time was 24 h. The mRNA levels of oncogenes (c-fos, c-myc, k-ras) , tumor suppressor gene (p53) and apoptotic genes (Caspase-3, Caspase-8, Caspase-9) were detected by real-time PCR. The protein levels of oncogenes and apoptotic genes were detected by Western blotting. Results: The expression levels of p38MAPK mRNA and protein in p38MAPK gene silencing cells were significantly lower than those in L02 hepatocytes ( P <0.05) , and the p38MAPK gene silencing cell line was successfully constructed. Compared with the blank control group, the expression levels of the oncogenes c-fos, c-myc, k-ras and the apoptosis genes Caspase-3, Caspase-8 and Caspase-9 increased, the expression level of tumor suppressor gene p53 decreased in the L02 hepatocyte group treated with PM(2.5) water soluble matter, and the differences were statistically significant ( P <0.05) . Compared with the L02 hepatocytes group treated with PM(2.5) water soluble matter, the expression levels of the oncogenes c-fos, c-myc, k-ras and apoptosis genes Caspase-3, Caspase-8 and Caspase-9 decreased, the expression level of tumor suppressor gene p53 increased in the p38MAPK gene silencing cells group treated with PM(2.5) water soluble matter, and the differences were statistically significant ( P <0.05) . Conclusion: PM(2.5) has effects on the expression of oncogenes, tumor suppressor genes and apoptotic genes in L02 hepatocytes, while p38MAPK gene silencing can inhibit the effects of PM(2.5) on L02 hepatocytes.

Objective: To explore the daily dietary behaviors of girls under precocious puberty and provide targeted measures for the prevention of precocious puberty. Methods: A case control study was conducted in a hospital in Shenzhen between September 2016 and December 2018. Girls with diagnosed precocious puberty were selected as case group. A 1∶1 matching was conducted. The control group was from 26 primary schools in Shenzhen. Dietary survey was conducted in parents, completing a self-administered questionnaire. Frequencies of 12 kinds of food intakes were investigated and dietary patterns were analyzed. Conditional logistic regression was used to analyze the relationship between dietary patterns and precocious puberty. Results: A total of 568 girls were included in the study. Among them, those aged 8-year-old accounted for highest proportion (43.8%). The median of age was same in both case group and control group (8 years-old). There was no significant difference in ethnic group between two groups ( P >0.05). The medians of height, weight and BMI of case group were 135.0 cm, 30.2 kg and 16.6 kg/m(2), respectively, which were all higher than those of the control group (129.2 cm, 25.0 kg and 15.3 kg/m(2)), the differences were significant ( P <0.05). There was significant difference in nutritional assessment result between two groups ( P < 0.05). Three dietary patterns were defined, i.e. balanced pattern, high calorie and fat pattern and high protein diet pattern. The cumulative rate of variance contribution of the three dietary patterns was 0.541 2. The differences in the prevalence of three dietary patterns between two groups were significant ( χ (2)=4.41, χ (2)=49.24, χ (2)=39.68, P <0.05 respectively). Data from the multivariate regression analysis showed that both balanced dietary pattern ( OR =0.633, 95% CI : 0.504-0.769) and high protein diet pattern ( OR =0.622, 95% CI : 0.498-0.776) were protective factors for precocious puberty, while high calorie and fat pattern was risk factors ( OR =1.850, 95% CI : 1.461-2.342). Conclusions: Balanced dietary pattern was common in school-aged girls. High calorie and fat pattern was risk factor for precocious puberty. Children should be encouraged to develop a balanced dietary habit and increasing the intake of legumes and fish since they are beneficial to normal growth and development.

Purpose: We aimed to document the time of onset of ultrasonographic and histologic changes in the testes of a rat model following testicular torsion., Methods: Twenty-five Sprague-Dawley rats were divided into four groups. All animals underwent preoperative Doppler ultrasonography. Groups 1, 2, and 3 underwent unilateral surgical torsion of the testis lasting for 72, 24, and 6 hours, respectively. Group 4 underwent a sham operation. The animals were followed with Doppler ultrasonography at 6, 24, 48, and 72 hours postoperatively. Histologic examinations were performed at the designated final time point for each group., Results: After torsion, enlargement of the epididymal head and thickening of the spermatic cord over time were noted. Based on the ultrasonographic dimensions, the ratio of the epididymal volume increased with time following torsion (p=0.002). The torsed testes had an average weight gain of 0.27 g at 6 hours compared to the control testes, but an average weight loss of 0.22 g at 72 hours (P=0.006). Changes in testicular echotexture were noted as soon as 6 hours after torsion, but there was no consistent pattern of echotexture change thereafter. Histologically, viable tubules were seen 6 hours after torsion, while extensive hemorrhagic necrosis was found at 72 hours., Conclusion: In evaluating testicular torsion, the enlargement ratio of the epididymis and thickening of the spermatic cord on Doppler ultrasonography may be useful for determining the urgency of immediate surgery. Changes in testicular echotexture may not be a reliable indicator of the time of onset.

Diet is a key factor in determining and structuring animal diversity and adaptive radiations. The mammalian fossil record preserves phenotypic evidence of many dietary shifts, whereas genetic changes followed by dietary diversification in mammals remain largely unknown. To test whether living mammals preserve molecular evidence of dietary shifts, we examined the trehalase gene (Treh), which encodes an enzyme capable of digesting trehalose from insect blood, in bats and other mammals with diverse diets. Bats represent the largest dietary radiation among all mammalian orders, with independent origins of frugivory, nectarivory, carnivory, omnivory, and even sanguivory in an otherwise insectivorous clade. We found that Treh has been inactivated in unrelated bat lineages that independently radiated into noninsectivorous niches. Consistently, purifying selection has been markedly relaxed in noninsectivorous bats compared with their insectivorous relatives. Enzymatic assays of intestinal trehalase in bats suggest that trehalase activity tends to be lost or markedly reduced in noninsectivorous bats compared with their insectivorous relatives. Furthermore, our survey of Treh in 119 mammal species, which represent a deeper evolutionary timeframe, additionally identified a number of other independent losses of Treh in noninsectivorous species, recapitulating the evolutionary pattern that we found in bats. These results document a molecular record of dietary diversification in mammals, and suggest that such molecular signatures of dietary shifts would help us understand both historical and modern changes of animal diets., (© The Author(s) 2019. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.)

Introduction: The flavonoid kurarinone suppresses CD4+ T-cell-mediated chronic inflammatory dermatitis. However, kurarinone's effects upon autoimmune central nervous system (CNS) disease remain unknown. We investigated the potential therapeutic effects and molecular mechanism(s) of kurarinone in an experimental autoimmune encephalomyelitis (EAE) murine model of multiple sclerosis (MS)., Materials and Methods: Myelin oligodendrocyte glycoprotein (MOG 35-55 ) peptide-induced EAE was constructed in wild-type mice. Effects of kurarinone (100 mg/kg/day) upon clinical scores were assessed based on physical traits and signs. Spinal cord sections were extracted to assess inflammation, demyelination, and mRNA expression of key pro-inflammatory cytokines and chemokines. CNS-infiltrating mononuclear cells (MNCs) and splenocytes were harvested; flow cytometry was then applied to determine CD4+ and CD8+ T-cell percentages as well as Th1/Th2/Th17 subset percentages. Purified naïve CD4+ T-cells underwent in vitro T-cell polarization and proliferation to assess kurarinone's effects., Results: Prophylactic and treatment regimens of kurarinone significantly improved clinical scores in the MOG 35-55 peptide-induced EAE model (P < 0.05). Kurarinone significantly lowered CNS inflammation and demyelination (61% and 83% decreases, respectively; P < 0.05), significantly decreased MNC infiltration into CNS tissue (42% decrease; P < 0.05), and significantly inhibited levels of several pro-inflammatory cytokines and chemokines (P < 0.05). Kurarinone significantly lowered CD4+ and CD8+ CNS T-cell counts (51% and 80% decreases, respectively; P < 0.05) and significantly reduced CNS Th1 and Th17 cell percentages (24% and 44% decreases, respectively; P < 0.05). Kurarinone significantly inhibited in vitro Th1, Th2, and Th17 cell differentiation and proliferation (P < 0.05)., Conclusions: Kurarinone significantly inhibits the clinical progression of EAE through the inhibition of Th1 and Th17 cell differentiation and proliferation. Kurarinone may show promise as an immunomodulatory therapeutic agent in treating MS., (Copyright © 2018. Published by Elsevier B.V.)

Objective: To observe the effect of "Xingnao Kaiqiao" acupuncture(acupuncture technique for restoring consciousness) combined with hyperbaric oxygen in patients with hypoxic ischemic encephalopathy and assess its influence on blood rheology., Methods: Forty patients with hypoxic ischemic encephalopathy were randomly divided into treatment group and control group with 20 cases in each group. The treatment group received "Xingnao Kaiqiao" acupuncture combined with hyperbaric oxygen, and the control group received hyperbaric oxygen only. The two groups of patients were treated once per day for 6 consecutive days, which consisted of one course of treatment, and the total treatment lasted for four courses. Before and after treatment, the patients underwent the mini mental state examination (MMSE) to evaluate cognitive function and the barthel index score for activities of daily living. The changes of whole blood viscosity, plasma viscosity, and erythrocyte aggregation index were determined., Results: After treatment, both the treatment and control groups showed improvements in cognitive function，activities of daily living, and blood rheology compared with those before treatment ( P <0.05). However, these improvements in the treatment group were significantly greater than those in the control group ( P <0.05)., Conclusions: Application of "Xingnao Kaiqiao" acupuncture combined with hyperbaric oxygen in patients with hypoxic ischemic encephalopathy can result in an integrated curative effect, a significant improvement in the blood rheology indexes, and promote the recovery of brain cells.

Taking super hybrid rice variety 'Wufengyou T025' as test material, the effects of different irrigation methods and water layer depth on physiological characteristics and yield in double-season late rice under low temperature conditions during heading and flowering stage were investigated. Three treatments were set, i.e., draining during day and containing 4-5 cm water layer during night (H 1 ), draining during day and containing 8-10 cm water layer during night (H 2 ), and containing 8-10 cm water layer day and night (H 3 ), with the 0-1 cm water layer day and night was as the control (CK). The results showed that rice leaf temperature, soil layer temperature and canopy temperature under the different irrigation treatments were higher than that of CK, and the warming effect of treatment H 2 was the best during the low temperature period. Leaf chlorophyll content, net photosynthetic rate, transpiration rate, leaf stomatal conductance and intercellular CO 2 concentration of rice plants decreased gradually under the low temperature, while the smallest reduction occurred in H 2 . The increase ranges of malondialdehyde and proline content in H 2 were lower, while its soluble protein content was the highest compared with other irrigation treatments. The increase ranges for the activities of superoxide dismutase and peroxidase in H 2 were lower, while its decrease range for the activity of catalase was the lowest. Irrigation for heat preservation could increase the yield, and H 2 performed best. Yield of H 2 at the second sowing date in 2014 and 2015 encountering low temperature increased by 12.9% and 13.5% respectively compared to CK. The yield components including the effective panicle numbers per plant, panicle length, seed setting rate and 1000-grain mass were improved in all irrigation treatments compared to CK. Draining during day and containing 8-10 cm water layer during night (H 2 ) was the most effective agronomic measure to enhance the tolerance to low temperature during heading and flowering stage for double-season hybrid late rice.

Super hybrid early rice variety Ganxin 203 was used as test material, and four foliar spraying treatments were set using clear water as the control group (CK), and 3 concentrations of potassium dihydrogen phosphate (KH 2 PO 4 ) with 0.1% (P1), 0.3% (P3), 0.5% (P5) and po-tash (MH). The effects of spraying P and K fertilizers on the leaf temperature, yield and physiolo-gical characteristics in double-season early rice under low temperature conditions during panicle primordium differentiation stage were studied. The results showed that during the low temperature period 6:00-18:00, rice leaf temperature under the different treatments with potassium dihydrogen phosphate and potash was higher than that of CK. Leaf chlorophyll content and net photosynthetic rate (P n ) of rice plants decreased gradually with the treatments under low temperature, while the reduction range was the smallest in treatment P3. The activities of the antioxidative enzymes varied to different extents, and the increase range for the activities of superoxide dismutase (SOD) and peroxidase (POD) in treatment P3 were higher than those in the other treatments. The decrease range of the activity catalase (CAT) in treatment P3 was lower than that in the other treatments. At the end of low temperature treatment, malondialdehyde (MDA) content was the highest in CK. Under low temperature, foliar spraying of potassium dihydrogen phosphate or potash could improve dry matter accumulation to varying degrees and achieve the purpose of slowing down the yield decrease, among which treatment P3 was the best. It could be found from the yield components that the total grains per panicle, seed setting rate and 1000-grain mass were significantly improved for all treatments compared to CK. The application of foliar spraying of 0.3% potassium dihydrogen phosphate was the most effective agronomic measure to enhance the resistance to low temperature during panicle primordium differentiation stage for double-season super hybrid early rice.

OBJECTIVE Therapeutic neovascularization is a promising strategy for treating patients after an ischemic stroke; however, single-factor therapy has limitations. Stromal cell-derived factor 1 (SDF-1) and vascular endothelial growth factor (VEGF) proteins synergistically promote angiogenesis. In this study, the authors assessed the effect of combined gene therapy with VEGF 165 and SDF-1 in a rat model of cerebral infarction. METHODS An adenoviral vector expressing VEGF 165 and SDF-1 connected via an internal ribosome entry site was constructed (Ad- VEGF 165 -SDF-1). A rat model of middle cerebral artery occlusion (MCAO) was established; either Ad- VEGF 165 -SDF-1 or control adenovirus Ad- LacZ was stereotactically microinjected into the lateral ventricle of 80 rats 24 hours after MCAO. Coexpression and distribution of VEGF 165 and SDF-1 were examined by reverse-transcription polymerase chain reaction, Western blotting, and immunofluorescence. The neurological severity score of each rat was measured on Days 3, 7, 14, 21, and 28 after MCAO. Angiogenesis and vascular remodeling were evaluated via bromodeoxyuridine and CD34 immunofluorescence labeling. Relative cerebral infarction volumes were determined by T2-weighted MRI and triphenyltetrazolium chloride staining. Cerebral blood flow, relative cerebral blood volume, and relative mean transmit time were assessed using perfusion-weighted MRI. RESULTS The Ad- VEGF 165 -SDF-1 vector mediated coexpression of VEGF 165 and SDF-1 in multiple sites around the ischemic core, including the cortex, corpus striatum, and hippocampal granular layer. Coexpression of VEGF 165 and SDF-1 improved neural function, reduced cerebral infarction volume, increased microvascular density and promoted angiogenesis in the ischemic penumbra, and improved cerebral blood flow and perfusion. CONCLUSIONS Combined VEGF 165 and SDF-1 gene therapy represents a potential strategy for improving vascular remodeling and recovery of neural function after cerebral infarction.

Objective: To investigate the characteristics of superior petrosal vein (SPV) and its influence on the surgical field in microvascular decompression (MVD) for trigeminal neuralgia (TN), and to analyze the effect of the surgical treatment of SPV on the surgical approach, indication and prognosis. Methods: The clinical data of 280 patients with trigeminal neuralgia between Jan. 2013 and Jun. 2016 were collected, including the trunks and the branches of SPV, intraoperative electrocoagulation status, the surgery outcome and complications. Results: The petrosal vein during the operation was fully preserved in 152 cases (54.29%). The SPV were completely sectioned in 25 cases (8.92%), while some branches of SPV were sectioned in 103 cases (36.79%). We found that SPV have 1 to 3 trunks, accounted for 67 cases (23.90%), 168 cases (60%), and 45 cases (16.10%), while the SPV with 1 to 4 branches accounted for 17 cases (6.07%), 112 cases (40%), 136 cases (48.57%), and 15 cases (5.36%). The SPV was identified as offending vessel in 17 cases (6.07%). One patient with cutoff SPV trunk encountered cerebellar infarction and recovered completely at 2 weeks after MVD by using intravenous medication. Conclusions: MVD is the recommended treatment method for PTN, mostly SPV is unnecessary to be sectioned completely and small branches of SPV could be sacrificed. Very few patients may develop cerebellar infarction or hematoma.

Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose.

It has been shown that the same canonical cortical circuit model with mutual inhibition and a fatigue process can explain perceptual rivalry and other neurophysiological responses to a range of static stimuli. However, it has been proposed that this model cannot explain responses to dynamic inputs such as found in intermittent rivalry and rivalry memory, where maintenance of a percept when the stimulus is absent is required. This challenges the universality of the basic canonical cortical circuit. Here, we show that by including an overlooked realistic small nonspecific background neural activity, the same basic model can reproduce intermittent rivalry and rivalry memory without compromising static rivalry and other cortical phenomena. The background activity induces a mutual-inhibition mechanism for short-term memory, which is robust to noise and where fine-tuning of recurrent excitation or inclusion of sub-threshold currents or synaptic facilitation is unnecessary. We prove existence conditions for the mechanism and show that it can explain experimental results from the quartet apparent motion illusion, which is a prototypical intermittent rivalry stimulus.

Objective: To test a kurtosis-adjusted cumulative noise exposure (CNE) metric for use in evaluating the risk of hearing loss among workers exposed to industrial noises. Specifically, to evaluate whether the kurtosis-adjusted CNE (1) provides a better association with observed industrial noise-induced hearing loss, and (2) provides a single metric applicable to both complex (non-Gaussian [non-G]) and continuous or steady state (Gaussian [G]) noise exposures for predicting noise-induced hearing loss (dose-response curves)., Design: Audiometric and noise exposure data were acquired on a population of screened workers (N = 341) from two steel manufacturing plants located in Zhejiang province and a textile manufacturing plant located in Henan province, China. All the subjects from the two steel manufacturing plants (N = 178) were exposed to complex noise, whereas the subjects from textile manufacturing plant (N = 163) were exposed to a G continuous noise. Each subject was given an otologic examination to determine their pure-tone HTL and had their personal 8-hr equivalent A-weighted noise exposure (LAeq) and full-shift noise kurtosis statistic (which is sensitive to the peaks and temporal characteristics of noise exposures) measured. For each subject, an unadjusted and kurtosis-adjusted CNE index for the years worked was created. Multiple linear regression analysis controlling for age was used to determine the relationship between CNE (unadjusted and kurtosis adjusted) and the mean HTL at 3, 4, and 6 kHz (HTL346) among the complex noise-exposed group. In addition, each subject's HTLs from 0.5 to 8.0 kHz were age and sex adjusted using Annex A (ISO-1999) to determine whether they had adjusted high-frequency noise-induced hearing loss (AHFNIHL), defined as an adjusted HTL shift of 30 dB or greater at 3.0, 4.0, or 6.0 kHz in either ear. Dose-response curves for AHFNIHL were developed separately for workers exposed to G and non-G noise using both unadjusted and adjusted CNE as the exposure matric., Results: Multiple linear regression analysis among complex exposed workers demonstrated that the correlation between HTL3,4,6 and CNE controlling for age was improved when using the kurtosis-adjusted CNE compared with the unadjusted CNE (R = 0.386 versus 0.350) and that noise accounted for a greater proportion of hearing loss. In addition, although dose-response curves for AHFNIHL were distinctly different when using unadjusted CNE, they overlapped when using the kurtosis-adjusted CNE., Conclusions: For the same exposure level, the prevalence of NIHL is greater in workers exposed to complex noise environments than in workers exposed to a continuous noise. Kurtosis adjustment of CNE improved the correlation with NIHL and provided a single metric for dose-response effects across different types of noise. The kurtosis-adjusted CNE may be a reasonable candidate for use in NIHL risk assessment across a wide variety of noise environments.

Genotoxic stress activates checkpoint signaling pathways that activate the checkpoint kinases ATM and ATR, halt cell cycle progression, and promote DNA repair. A number of proteins act in concert with ATR to phosphorylate Chk1, including RAD17, the RAD9-RAD1-HUS1 complex, ATR/ATRIP and TopBp1. However, how these proteins involved act in concert with one another to propagate and maintain the checkpoint response is not well understood. Here, we reported that upregulation of RAD9 protein increased the quantity of ATRIP, suggesting that RAD9 activation will induce more efficient accumulation of ATRIP in vivo. Furthermore, the DNA damage-induced ATRIP foci formation was faster in the mRad9-/- ES cells. Also, ATRIP interacts specifically with RAD9, but not HUS1 and RAD1. Taken together, we suggested that RAD9 could affect both the ATRIP protein levels and DNA damage-induced ATRIP foci formation. Thus, we propose a role of RAD9 in the ATR-Chk1 pathway that is necessary for successful formation of the damage-sensing complex and DNA damage checkpoint signaling.

Background: Recent studies have demonstrated that long non-coding RNAs (lncRNAs) were present in the blood of cancer patients and have shown great potential as powerful and non-invasive tumor markers. However, little is known about the value of lncRNAs in the diagnosis of esophageal squamous cell carcinoma (ESCC). We hypothesized that ESCC-related lncRNAs might be released into the circulation during tumor initiation and could be utilized to detect and monitor ESCC., Methods: Ten lncRNAs (HOTAIR, AFAP1-AS1, POU3F3, HNF1A-AS1, 91H, PlncRNA1, SPRY4-IT1, ENST00000435885.1, XLOC&#95;013104 and ENST00000547963.1) which previously found to be differently expressed in esophageal cancer were selected as candidate targets for subsequent circulating lncRNA assay. A four-stage exploratory study was conducted to test the hypothesis: (1) optimization of detected method to accurately and reproducibly measure ESCC-related lncRNAs in plasma and serum; (2) evaluation of the stability of circulating lncRNAs in human plasma or serum; (3) exploration the origin of ESCC-related lncRNAs in vitro and in vivo; (4) evaluation the diagnostic power of circulating lncRNAs for ESCC., Results: ESCC-related lncRNAs were detectable and stable in plasma of cancer patients, and derived largely from ESCC tumor cells. Furthermore, plasma levels of POU3F3, HNF1A-AS1 and SPRY4-IT1 were significantly higher in ESCC patients compared with normal controls. By receiver operating characteristic curve (ROC) analysis, among the three lncRNAs investigated, plasma POU3F3 provided the highest diagnostic performance for detection of ESCC (the area under the ROC curve (AUC), 0.842; p < 0.001; sensitivity, 72.8%; specificity, 89.4%). Moreover, use of POU3F3 and SCCA in combination could provide a more effective diagnosis performance (AUC, 0.926, p < 0.001, sensitivity, 85.7%; specificity, 81.4%). Most importantly, this combination was effective to detect ESCC at an early stage (80.8%)., Conclusions: Plasma POU3F3 could serve as a potential biomarker for diagnosis of ESCC, and the combination of POU3F3 and SCCA was more efficient for ESCC detection, in particular for early tumor screening.

Objectives: To present time-efficiency data during our initial experience with intracorporeal urinary diversion and technical tips that may shorten operative time early in the learning curve., Patients and Methods: Data were analyzed in the initial 37 consecutive patients undergoing robotic radical cystectomy and intracorporeal urinary diversion in whom detailed stepwise operative time data were available. Median age was 65 years and median body mass index was 27. Neoadjuvant chemotherapy was administered in 6 patients and 11 patients had clinical evidence of T3 or lymph node-positive disease. Each component of the operation was subdivided into specific steps and operative time for each step was prospectively recorded. Peri-operative and follow-up data up to 90 days and final pathological data were recorded., Results: All procedures were completed intracorporeally and robotically without need for conversion to open surgery or extracorporeal diversion. Median total operative time was 387 vs 386 minutes (p=0.2) and median total console time was 361 vs 295 minutes (p<0.007) for orthotopic neobladder and ileal conduit, respectively. Median time for radical cystectomy was 77 minutes, extended pelvic lymph node dissection was 63 minutes, and diversion was 111 minutes (ileal conduit 92 minutes and orthotopic neobladder 124 minutes). Median estimated blood loss was 250 mL, and median hospital stay was 9 days. High grade (Clavien grade 3-5) complications at 30 and 90 days follow-up were recorded in 6 (16%) and 9 (24%) patients, respectively. Over a median follow-up of 16 months, 12 (32%) patients experienced disease recurrence and 9 (24%) died from bladder cancer. These correspond to 1-year recurrence-free and overall survival of 64% and 70%, respectively., Conclusions: Intracorporeal urinary diversion following robotic radical cystectomy can be safely performed and reproducible in a time-efficient manner even during the early learning curve.

Background: The objective of this article was to investigate the operation outcome, complications, and the patient's quality of life after surgical therapy for central gyrus region meningioma with epilepsy as the primary symptom., Methods: All patients get at least 6 months of follow-up (range, 6-34 mo) after surgery. They underwent preoperative magnetic resonance imaging and video electroencephalography, and their clinical manifestations, imaging characteristics, microsurgical methods, and prognosis were retrospectively analyzed., Results: The meningioma was located in the front and back of the central sulcus vein in 3 and 2 patients, respectively; in the compressed precentral gyrus and central sulcus vein in 3 patients; and in the precentral gyrus and postcentral gyrus each in 1 patient; beside the right sagittal sinus and invaded a thick draining vein on the brain surface in 1 patient and beside the right sagittal sinus and close to the precentral gyrus in 2 patients; invaded the superior sagittal sinus in 8 patients; crossed the cerebral falx and compressed cortex gyrus veins in 1 patient; invaded duramater and irritated skull hyperplasia in 3 patients; invaded duramater and its midline infiltrated into the superior sagittal sinus, was located behind the precentral gyrus, and enveloped the central sulcus vein. They were resected and classified by Simpson standards: 17 of the 26 patients had grade I, 6 patients had in grade II, and 3 patients had in grade III., Conclusions: Resection of central gyrus region meningioma by microsurgical technique avoids injury to the cerebral cortex, central sulcus vein, and other draining veins. Microsurgery improves the total resection rate, reduces recurrence rate, and lowers disability or death rate.

LncRNA SPRY4-IT1 has been shown to promote the progression of melanoma. However, the role of lncRNA SPRY4-IT1 in human esophageal squamous cell carcinoma (ESCC) remains unclear. The purpose of this study is to investigate the clinical significance and biological functions of SPRY4-IT1 in ESCC. The expression levels of lncRNA SPRY4-IT in 92 ESCC patients and 8 ESCC cell lines were evaluated by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR). The prognostic significance was evaluated using Kaplan-Meier and Cox regression analyses. Small interfering RNA (siRNA) was used to suppress SPRY4-IT1 expression in ESCC cell lines. Both in vitro and in vivo assays were performed to further explore its role in tumor progression. SPRY4-IT1 levels were significantly higher in ESCC tissues and cells than in corresponding adjacent noncancerous tissues and nontumorigenic esophageal epithelial cells, and the ESCC patients with higher SPRY4-IT1 expression had an advanced clinical stage and poorer prognosis than those with lower SPRY4-IT1 expression. The multivariate analysis revealed that SPRY4-IT1 expression level is an independent prognostic factor in ESCC patients. In vitro assays demonstrated that knockdown of SPRY4-IT1 reduced cell proliferation, invasiveness, and migration. In vivo assays demonstrated that knockdown of SPRY4-IT1 decreases cell growth. SPRY4-IT1 is a novel molecule involved in ESCC progression, which may provide a potential prognostic biomarker and a potential target for therapeutic intervention.

Background: Recent studies revealed that long noncoding RNAs (lncRNAs) play critical regulatory roles in cancer biology. PlncRNA-1 is one of lncRNAs that is associated with cell apoptosis and proliferation of prostate cancer., Aim: This study aimed to assess the potential role of PlncRNA-1 in the pathogenesis of esophageal squamous cell carcinoma (ESCC)., Materials and Methods: Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the expression level of PlncRNA-1 in 73 pairs of ESCC and their matched normal tissues. The correlation of PlncRNA-1 with clinicopathological features and clinical stages was also analyzed. Cancer cell proliferation and apoptosis were assessed following knock-down of PlncRNA-1 by MTT, colony formation assay, and flow cytometry., Results: The expression of PlncRNA-1 was significantly higher in human ESCC compared with the adjacent noncancerous tissues (69.8 %, p < 0.05), and the high level of PlncRNA-1 expression was significantly correlated with advanced clinical stage (p < 0.01) and lymph node metastasis (p < 0.05). Furthermore, knockdown of PlncRNA-1 reduced cell proliferation and increased the apoptosis in vitro., Conclusions: PlncRNA-1 plays an important role in ESCC cell proliferation. Overexpression of PlncRNA-1 is correlated with advanced tumor stage and lymph node metastasis, and may serve as a potential prognostic marker and therapeutic target for ESCC.

Objective: To compare the outcome difference between the heat-sensitive and non-sensitive moxibustion stimulation of Yifeng (TE 17) in the treatment of peripheral facial palsy., Methods: A total of 43 patients with peripheral facial paralysis were divided into heat-sensitive moxibustion (n = 21) and non-sensitive moxibustion (n = 22) groups in accordance with their reactions to moxa-heat stimulation. Mild moxibustion was applied to bilateral Yifeng (TE 17) for 45 minutes, followed by mild acupuncture stimulation of Cuanzhu (BL 2), Yangbai (GB 14), Sibai (ST 2), Hegu (LI 4), etc. Moxibustion treatment was conducted once daily for 10 days, and acupuncture treatment given once daily for 20 days (with 2 days interval between every 10 days). Following moxibustion, if the patient felt regional heat penetrating to the deep tissue, extending peripherally, or propagating to other part of the body, or felt mild warm in the stimulated region but warmer in the slightly distant part, or felt mild warm on the skin surface but warmer in the deep tissue, it was considered to be heat-sensitivity. Patients with occurrence of heat-sensitivity being equal to and more than 3 times during the 10 sessions of treatment were assigned to heat-sensitive group, and those with occurrence of heat-sensitivity being equal to or less than 2 times assigned to non-sensitive moxibustion group. According to Portmann Scale (including movement and resting posture) for the voluntary movement state of the face, forehead, winkles eye closure, open mouth smile, snarl, and pucker; points 0, 1, 2 and 3 indicate no muscular movement, marked asynersis, asynersis and normal, respectively. In the light of resting posture of the eye, the nasolabial fold and mouth corner, 0, 1, and 2 points indicate severe, mild dissymmetry and normal, separately. In evaluation of the therapeutic effect, twenty points (at most) indicate cured, 17-19 points marked improvement; 14- 16 points improved, and < or = 13 points failure., Results: Compared with pre-treatment, Portmann scores of both heat-sensitive moxibustion and non-sensitive moxibustion groups were significantly increased after the treatment (P < 0.001), and the score of the heat-sensitive moxibustion group was markedly higher than that of the non-sensitive moxibustion group (P < 0.05). Of the 21 and 22 facial palsy patients in the heat-sensitive moxibustion and non-sensitive moxibustion groups, 8 and 5 cases were cured, 10 and 7 were markedly effective, 3 and 10 were improved, with the markedly effective rates being 85.71% and 54.55%, respectively. The therapeutic effect of the heat-sensitive moxibustion group was statistically better (P < 0.05)., Conclusion: Heat-sensitive moxibustion is significantly superior to non-sensitive moxibustion in improving symptoms of peripheral facial palsy patients, suggesting a necessity for paying attention to patients' reactions during moxibustion treatment.

Objective: To observe the clinical effect of moxibustion of different acupoints undergoing heat-sensitive state and resting state in the treatment of knee osteoarthritis (KOA) patients., Methods: A total of 60 cases of KOA patients were enrolled in the present trial. They were divided into heat-sensitive moxibustion (heat-sensitive) group and non-sensitive moxibustion group (resting group). Moxibustion was applied to Neixiyan (EX-LE 4), Waixiyan (i.e. Dubi, ST 35) and Heding (EX-LE 2) for about 45 min, once daily for 20 days. The heat-sensitive state was evaluated according to the patient's feeling. After moxibustion stimulation at the acupoint area, if the patient feels the heat penetrating from the skin surface to the deep tissue, or/and extending peripherally around the moxibustion site, or/and transmitting toward a certain direction, it is considered to be heat sensitization state. The therapeutic effect was evaluated by using visual analogue scale (VAS) for pain severity changes and by Guiding Principles for Clinical Trials of New Drugs of Chinese Materia Medica for evaluating functional activity of the knee-joint., Results: After 20 sessions of treatment and after a half year's follow-up, the total integrated scores of VAS in the heat-sensitive group were all lower than those of the resting group (P < 0.01). Following 20 sessions of treatment, of the two 30 KOA patients in the heat-sensitive group and resting group, 14 (46.67% )and 5 (16.67%) experienced a marked improvement, 10 (33.33%) and 9 (30.00%) were effective, 6 (20.00%) and 16 (53.33%) were invalid, with the effective rates being 80.00% and 46.67 , respectively. Half-year's follow-up showed that the effective rates of the heat-sensitive group and resting group were 79.17% (19/24) and 42.86% (6/14), respectively, suggesting a better therapeutic effect of heat-sensitive moxibustion., Conclusion: The clinicaln effect of heat-sensitive moxibustion is significantly superior to that of non-sensitive moxibustion in the treatment of KOA patients, being worthy of clinical application.

Recent studies of the individual functionalities of long non-coding RNAs (lncRNAs) in the development and progression of cancer have suggested that HOX transcript antisense RNA (HOTAIR) is capable of reprogramming chromatin organization and promoting cancer cell metastasis. In order to ascertain the expression pattern of the lncRNA HOTAIR and assess its biological role in the development and progression of esophageal squamous cell carcinoma (ESCC), HOTAIR expression in ESCC tissues and adjacent noncancerous tissues were collected from 78 patients and measured by real-time reverse transcription-polymerase chain reaction (RT-PCR). HOTAIR correlation with clinicopathological features and prognosis was also analyzed. Suppression of HOTAIR using siRNA treatment was performed in order to explore its role in tumor progression. Notably elevated HOTAIR expression levels were observed in cancerous tissues compared to adjacent noncancerous tissues (96%, P < 0.01), showing a high correlation with cancer metastasis (P < 0.01), elevated TNM (2009) stage classification (P < 0.01), and lowered overall survival rates (P = 0.003). Multivariate analysis revealed that HOTAIR expression (P = 0.003) is also an independent prognostic factor for comparison of TNM stage (P = 0.024) and lymph node metastasis (P = 0.010). Furthermore, in vitro assays of the ESCC cell line KYSE30 demonstrated that knockdown of HOTAIR reduced cell invasiveness and migration while increasing the response of cells to apoptosis. Thus, HOTAIR is a novel molecule involved in both ESCC progression and prognosis. Full elucidation of HOTAIR functionality relevant to ESCC may open avenues for the use of lncRNAs in identification of novel drug targets and therapies for ESCC and other prevalent cancers., (© 2012 Wiley Periodicals, Inc.)

Objective: To observe the synchronism difference of brain region activities in response to acupuncture stimulation of Zusanli (ST 36) in healthy volunteer subjects with different acupuncture analgesia sensitivity, so as to study the central factors influencing acupuncture intervention outcomes., Methods: Forty-five healthy volunteer subjects with different constitutions (different sensitivities in response to needling stimulation) were divided into insensitive group, normal group and sensitive group (n = 15). The pressure pain threshold (PPT) of the Zusanli (ST 36) region before and after acupuncture stimulation of ST36 was assessed using visual analog scale (VAS). Two weeks later after acupuncture stimulation of ST 36, resting-state fMRI images were acquired by using a nuclear magnetic resonance imaging system and analyzed by using DPARSFV 2.1 software package, software SPM 8 and REST 1.7. The cerebral regional homogeneity (ReHo) of the subjects was then calculated by Resting-State fMRI Data Analysis Toolkit (REST)., Results: Compared with pre-acupuncture, PPT levels of the normal and sensitive groups were significantly increased after acupuncture of ST 36 (P < 0.05), and that of the insensitive group had no significant change (P > 0.05). Following acupuncture stimulation of ST 36, the insensitive group only showed a significant decreased ReHo in the left fusiform gyrus, left inferior temporal gyrus, bilateral postcentral gyrus, and left anterior central gyrus. In the normal group, a significantly increased ReHo was found in left brainstem, the right cerebellum posterior lobe, right parahippocampa gyrus, right fusiform gyrus, left angular gyrus, temporal lobe and the left frontal lobe; and a significantly decreased ReHo in the occipital lobes and the right superior temporal gyrus after acupuncture stimulation of ST 36. In the sensitive group, a markedly increased ReHo was found in the left brainstem, bilateral cerebellum posterior lobes, left inferior temporal gyrus, basal ganglia, the left insular lobe, anterior cingutate, frontal lobe, inferior parietal lobule, and the right supplementary motor area, and an obviously decreased ReHo found in the bilateral occipital lobes, fusiform gyrus, posterior central gyrus, the right posterior cingutate, the left temporal lobe and the left paracentral lobule, etc. after acupuncture of ST 36., Conclusion: Constitution-associated needling sensation may be an important influential factor for acupuncture analgesia in normal subjects. The change of ReHo in different cerebral areas is probably responsible for the difference of acupuncture analgesia in different constitution people.

The present study was aimed to investigate the effect of electroacupuncture (EA) on learning-memory of rats with low estrogen-induced cognitive impairment and the possible mechanism. The rat model was established by ovariectomy, which resulted in low estrogen-induced cognitive impairment. EA was applied continuously for 3 months 2 weeks after ovariectomy. Morris water maze was used to test the ability of spatial learning and memory. Enzyme-linked immunosorbent assay (ELISA) and real-time quantitative RT-PCR were used to detect the concentration of serum estradiol (E2) and relative expression of choline acetyltransferase (ChAT) mRNA in hippocampus, respectively. The result showed that, compared with the sham group, the ovariectomy model group exhibited longer escape latency, reduced number of platform-crossing, lower concentration of serum E2, and decreased expression of ChAT mRNA in hippocampus. EA shortened the escape latency and increased the number of platform-crossing in the ovariectomy model group. Moreover, the concentration of serum E2 and the hippocampal expression of ChAT mRNA in the ovariectomy model group were significantly elevated by EA treatment. These results suggest EA is capable of improving learning and memory in ovariectomized rats, and the mechanism involves the up-regulation of the expression of ChAT mRNA in hippocampus induced by the increase of the serum concentration of estrogen.

Objective: To observe the effect of acupuncture stimulation of scalp- and body-acupoints on limb function in subacute stroke patients., Methods: A total of 110 stroke inpatients were randomly and equally divided into acupuncture group and control group. Patients of the acupuncture group were treated by acupuncture stimulation of scalp acupoint Dingnie Qianxiexian (MS 6) and body acupoints Neiguan (PC 6), Jianyu (LI 15), Sanyinjiao (SP 6), etc. once daily for 20 days and routine neurological therapies, including drugs for controlling blood pressure, blood sugar, water-electrolyte balance, anticoagulation, encephaledema reduction, intracranial pressure reduction, anti-inflammation, neurofunction protection, etc. The stroke patients of the control group were treated with the routine neurological therapies only. The Fugl-Meyer assessment (FMA), US National Institutes of Health Stroke Scale (NIHSS) were used to assess the patients' limb function and nerve functional lesion severity before and after the treatment, and the ratio of mortality/disability and recurrence rate were used to assess the efficacy of acupuncture at the end of 3 and 6 months' follow-up., Results: After the treatment, the FMA scores were increased significantly and NIHSS scores decreased considerably in both groups (P < 0.01), and the effects of acupuncture group were obviously superior to those of the control group (P < 0.05). There were no significant differences between two groups in the ratios of mortality/disability and recurrence rates at the end of 3 and 6 months' follow-up (P > 0.05)., Conclusion: Scalp acupuncture combined with body acupuncture can evidently improve limb movement function and reduce the nerve function damage in stroke patients.

Background: Robotic radical cystectomy (RC) for cancer is beginning to gain wider acceptance. Yet, the concomitant urinary diversion is typically performed extracorporeally at most centers, primarily because intracorporeal diversion is perceived as technically complex and arduous. Previous reports on robotic, intracorporeal, orthotopic neobladder may not have fully replicated established open principles of reservoir configuration, leading to concerns about long-term functional outcomes., Objective: To illustrate step-by-step our technique for robotic, intracorporeal, orthotopic, ileal neobladder, urinary diversion with strict adherence to open surgical tenets., Design, Setting, and Participants: From July 2010 to May 2012, 24 patients underwent robotic intracorporeal neobladder at a single tertiary cancer center. This report presents data on patients with a minimum of 3-mo follow-up (n=8)., Surgical Procedure: We performed robotic RC, extended lymphadenectomy to the inferior mesenteric artery, and complete intracorporeal diversion. Our surgical technique is demonstrated in the accompanying video., Outcome Measurements and Statistical Analysis: Baseline demographics, pathology data, 90-d complications, and functional outcomes were assessed and compared with patients undergoing intracorporeal ileal conduit diversion (n=7)., Results and Limitations: Robotic intracorporeal urinary diversion was successfully performed in 15 patients (neobladder: 8 patients, ileal conduit: 7 patients) with a minimum 90-d follow-up. Median age and body mass index were 68 yr and 27 kg/m2, respectively. In the neobladder cohort, median estimated blood loss was 225 ml (range: 100-700 ml), median time to regular diet was 5 d (range: 4-10 d), median hospital stay was 8 d (range: 5-27 d), and 30- and 90-d complications were Clavien grade 1-2 (n=5 and 0), Clavien grade 3-5 (n=2 and 1), respectively. This study is limited by small sample size and short follow-up period., Conclusions: An intracorporeal technique of robot-assisted orthotopic neobladder and ileal conduit is presented, wherein established open principles are diligently preserved. This step-wise approach is demonstrated to help shorten the learning curve of other surgeons contemplating robotic intracorporeal urinary diversion., (Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.)

Background: This study was designed to investigate the effect of nesiritide, a recombinant B-type natriuretic peptide (BNP), on plasma aldosterone and vascular remodelling following balloon-induced endothelial injuries to the iliac arteries., Methods: Twenty-four male New Zealand rabbits were divided into nesiritide (0.1mg/kg/day, sc, for 4 weeks, n=12) and saline-treated control group (n=12). A balloon catheter was inserted to the right iliac artery to induce endothelia injuries. Plasma aldosterone was measured before and 28 days after the treatment by radioimmunoassay., Results: The area under internal elastic membrane (657.1±129.6 vs 486.7±124.0μm(2), P=0.02) and the area under external elastic membrane (1506.2±188.3.9 vs 1185.0±202.9μm(2), P=0.02) in the nesiritide group were greater than in the control group. The stenosis ratio in the nesiritide group was lower than in the control group (20.1±6.2% vs 39.6±9.5%, P=0.01). The plasma levels of aldosterone (2.03±0.31 vs 3.00±0.29ng/L, P<0.01) in the nesiritide group was lower than in the control group. Pearson's correlation analysis showed a positive correlation between the levels of plasma aldosterone and the stenosis ratio of the injured right iliac arteries (r=0.622, P=0.002)., Conclusion: Nesiritide treatment reduced stenosis ratio of the rabbit iliac artery following balloon-induced endothelial injuries, and the reduced stenosis ratio was associated with a reduction in the plasma aldosterone concentrations., (Crown Copyright © 2012. Published by Elsevier B.V. All rights reserved.)

Objective: To find a way to discriminate operative reason from anaesthesia reason for the changes of intraoperative transcranial magnetic motor evoked potentials (MEPs)., Methods: In 26 patients under Etomidate/Fentanyl anesthesia from February 2001 to June 2004, MEPs elicited by transcranial magnetic stimulation were recorded from tibialis anterior muscles, simultaneously bispectral index (BIS) and train-of-four stimulation (TOF) were used to monitor the anesthesia depth and neuromuscular blockade respectively. MEP, BIS and measurements of TOF at different anesthesia depth and muscular relaxation were recorded synchronously, statistical analysis of this data set was done in order to find the inherent relationship between these variables., Results: Under anesthesia, MEP amplitude was always positively correlated with the corresponding BIS and TOF value. A regression equation could be built, with which the MEP amplitude could be reckoned based on realtime BIS and T(1)/T(c). In case of spinal cord injury, the measured amplitude value would significantly deviate from predicted one, which suggested that the change of MEP was because of the operation, but not the anaesthesia or neuromuscular blockade. Each patient had his or her own regression equation, which was different from each other., Conclusions: The establishment of regression equation from MEPs, BIS and TOF is very useful to distinguish reasons of the changes of transcranial magnetic MEPs during surgery, and with this technique, the intraoperative MEP monitoring should be more reliable and practicable.

Background: The combination of 1,3-dichloropropene (1,3-D) and dazomet (DZ) offers a potential alternative to methyl bromide (MB) for soil disinfection. MB is scheduled to be withdrawn from routine use by 2015 in developing countries. Combination treatments of 1,3-D + DZ were evaluated in a laboratory study and in two commercial cucumber fields., Results: Laboratory studies found that nearly all of the tested combinations of 1,3-D and DZ displayed positive synergistic activity on root-knot nematodes (Meloidogyne spp.), two major soilborne fungi (Fusarium spp. and Phytophthora spp.) and the seeds of two major weed species (Digitaria sanguinalis and Abutilon theophrasti). Field trials revealed that the combination of 1,3-D and DZ (at 10 + 25 g m(-2) ) successfully suppressed Meloidogyne spp. root galling, sharply reduced Fusarium spp. and Phytophthora spp. and maintained high cucumber yields. The combination treatment of 1,3-D + DZ was more effective than 1,3-D or DZ alone and provided results similar to methyl bromide with respect to pest control, plant mortality, plant height, yield and income. All of the treatments were significantly better than the non-treated control., Conclusion: The results indicate that the tested combination of 1,3-D and DZ offers an efficient alternative to methyl bromide for cucumber production., (Copyright © 2012 Society of Chemical Industry.)

Objective: To observe the clinical efficacy of acupuncture of five Shu-points of the Liver Meridian plus bloodletting for depression patients and its effect on hemorheology., Methods: Thirty depression outpatients were randomly and equally divided into medication and acupuncture + bloodletting groups. Patients of the medication group were treated with Fluoxetine (20 mg/d, PO. in the morning) and those of the acupuncture + bloodletting group treated by acupuncture of Xingjian (LR 2), Taichong (LR 3), Zhongfeng (LR 4) and Ququan (LR 5) first, followed by pricking Dadun (LR 1) to let a little bit of blood out. The treatment was given once every other day, two months altogether. The therapeutic effect was assessed by using Hamilton Depression Rating Scale (HAMD) and the Clinical Global Impression Scale for Severity of Illness (CGI-SI) before and 1, 2, 4, 6, and 8 weeks after the treatment, respectively. Changes of hemorheology were detected by using a blood rheology detector., Results: Of the 15 outpatients in both medication and acupuncture + bloodletting groups, 6 (40.00%) and 6 (40.00%) were cured basically, 5 (33.34%) and 4 (26.67%) experienced marked improvement, 2 (13.33%) and 3 (20.00%) were improved, and 2 (13.33%) and 2 (13.33%) invalid, respectively. No significant difference was found between the two groups in the therapeutic effect (P > 0.05). On the 6th and 8th weeks of the treatment, the CGI-SI score of the acupuncture + bloodletting group was significantly lower than that of the medication group (P < 0.05), suggesting a better therapeutic effect of the acupuncture + bloodletting group. The low and high shear viscosity of whole blood, erythrocyte aggregation index and rigidity index, and fibrinogen levels of the two groups were decreased significantly after the treatment (P < 0.05). No significant difference was found between the two groups in the changes of hemorheology indexes following the treatment (P > 0.05)., Conclusion: Acupuncture of the five Shu-points of the Liver Meridian combined with bloodletting is effective in relieving depression symptoms and improving blood rheology in depression patients.

Objective: To verify the clinical efficacy of heat-sensitive moxibustion in treatment of knee osteoarthritis (KOA)., Methods: Sixty cases of KOA were randomly divided into a heat-sensitive moxibustion group and a conventional moxibustion group, 30 cases in each one. Dubi (ST 35), Yanglingquan (GB 34), Zusanli (ST 36) and Heding (EX-LE 2) on the affected side were selected in two groups. In heat-sensitive moxibustion group, the techniques of circling moxibustion, sparrow-pecking moxibustion, moving moxibustion and mild moxibustion were applied. In conventional moxibustion group, the mild moxibustion was used, 2 to 3 cm far from the skin of the acupoints selected. Lysholm scale for the assessment of knee joint function was adopted to evaluate the efficacy. The scores of joint pain, morning stiffness, joint swelling and walking ability were compared before and after treatment in two groups., Results: The scores of joint pain, morning stiffness, joint swelling and walking ability after treatment were all apparently improved as compared with those before treatment in either group (all P < 0.05). The improvement in the above-mentioned indices in heat-sensitive moxibustion group was much more apparent as compared with that in conventional moxibustion group (all P < 0.01). The effective rate was 90.0% (27/30) in heat-sensitive moxibustion group and was 73.3% (22/30) in conventional moxibustion group. The effective rate in heat-sensitive moxibustion group was obviously superior to that in conventional moxibustion group (P < 0.01)., Conclusion: The efficacy of heat-sensitive moxibustion is superior to that of conventional moxibustion in the treatment of KOA. This therapy can more significantly improve the symptoms and physical signs of the patients with KOA.

Objective: To explore the mechanism of depression treatment by needling at Taichong (LV3) and the correlation between the liver meridian and the frontal lobe., Methods: Forty-two patients with moderate depression at the first attack in line with Diagnostic and Statistical Manual of Mental Disorders (4th ed) by American Psychiatric Association were assigned to the fluoxetine group, the needling + fluoxetine group, and the needling group, 14 in each. The therapeutic course for them all was one month. Resting fMRI scanning was performed before and after treatment using 3.0 T magnetic resonance. Data were analyzed using fractional amplitude of low frequency fluctuations (fALFF). Paired t-test was used for comparison. Correlation analysis was performed in the fALFF images after treatment and Hamilton's depression scale., Results: Compared with before treatment, fALFF values in the left frontal lobe (BA6, BA9, BA48), the right frontal lobe (BA4, BA46), the bilateral inferior parietal lobules (BA40, BA48), the precuneus (BA7), the posterior cingutate (BA31), the left occipital lobe (BA17), and the right occipital lobe (BA18) of the needling +fluoxetine group were lowered (P<0.05). fALFF values in the right inferior parietal lobule (BA40) and the right occipital lobe (BA17) of the fluoxetine group were lowered (P<0.05). fALFF values in the left frontal lobe (BA10), the right frontal lobe (BA45), the left occipital lobe (BA19), the right occipital lobe (BA17), the left precuneus (BA7), and the posterior cingutate (BA31) were lowered in the needling group (P<0.05). Hamilton's depression scale was positively correlated with the fALFF value in the left frontal lobe of the needling +fluoxetine group and the needling group, while Hamilton's depression scale was positively correlated with the fALFF value in the left middle frontal gyrus, the left parietal lobe, and the left occipital lobe in the fluoxetine group., Conclusions: Combination of needling and antidepressive agents was superior to needling or antidepressive agents alone. Changes of the frontal lobe functions were correlated with the severity of depression. More extensive correlation existed between the liver meridian and the frontal lobe, which might be the antidepressive mechanism of needling Taichong (LV3).

Objective: To evaluate the utility of neuronavigation in the microsurgery for cerebral cavernous malformations., Methods: In a retrospective study, 47 patients with cavernous malformations were involved from January 1995 to December 2010. Fourteen cases admitted into hospital from January 1995 to December 2002 were treated without neuronavigation (conventional group), the focus localization was based on magnetic resonance imaging (MRI) images, anatomic landmarks, and the experiences of the neurosurgeon. In the other 33 cases admitted after February 2002 to December 2010, surgeries were performed with neuronavigation using the Medtronic Stealth Station TREON or TRIA system (neuronavigation group). Excision of the cavernomas were all performed microsurgically, surrounding gliotic rim and hemosiderin stained tissue were resected in the case of epilepsy, and a few patients underwent extended hippocampal resection or multiple subpial transection., Results: With the use of neuronavigation, the extent of craniotomy reduced from 5.2 cm to 3.6 cm (P < 0.01), and deeper cavernoma focuses could be treated surgically. There were no changes with regard to the mean size of the cavernomas, the mean time of surgery and hospital stay (P > 0.05), but the mean time of anaesthesia was prolonged from 164 min to 197 min (P < 0.01). Cavernomas were resected completely in all 47 cases, which was confirmed by postoperative MRI recheck. The conditions of all patients were improved or remain unchanged, and no significant differences in the clinical outcome could be evaluated between the two groups., Conclusions: Application of neuronavigation-assisted microsurgery of intracranial cavernous malformations surgery, helps reduce the surgical trauma, and has security and reliability.

Objective: To analyze the characteristics of pneumoconiosis cases in Zhejiang province and to provide the evidence for pneumoconiosis control and prevention measures in Zhejiang province., Methods: The data of new pneumoconiosis cases were from national surveillance system of occupational disease in Zhejiang province during 2006-2009, and were analyzed for distribution, age, exposure duration, pneumoconiosis phases and enterprise types., Results: During 2006-2009, 819 new pneumoconiosis cases (173, 157, 209 and 280 cases, respectively) were reported, 86.9% cases suffered from silicosis. Most of pneumoconiosis cases were distributed in Ningbo, Wenzhou areas and in building materials, machinery, coal, geological and mining, light industries and construction enterprise. The average ages of new pneumoconiosis cases were (47.8 +/- 10.0), (52.5 +/- 13.1), (55.5 +/- 11.2) and (55.9 +/- 12.2) years old, respectively and showed a significant increase trend (P<0.05). The average exposure duration of new pneumoconiosis cases were (12.4 +/- 8.6), (12.9 +/- 9.4), (12.4 +/- 8.6) and (15.7 +/- 10.0) years. The average exposure duration of phase I, phase II, phase III new pneumoconiosis cases were (14.3 +/- 9.87), (12.4 +/- 8.7) and (11.4 +/- 7.1) years, respectively and there were significant differences (P<0.05)., Conclusion: New pneumoconiosis cases in Zhejiang province are increasing year by year, the main type of pneumoconiosis is silicosis, the distribution of pneumoconiosis cases is associated with the areas and enterprises, and the exposure duration of new pneumoconiosis cases is relatively shorter.

Re-stenosis or remodeling of coronary and peripheral arteries remains a major complication following balloon-angioplasty or stenting. This study was designed to investigate the effect of nesiritide, a recombinant B-type natriuretic peptide (BNP), on vascular remodeling following balloon-induced endothelial injuries. Twenty-eight male New Zealand rabbits were divided into nesiritide-treated (0.1 mg/kg/day, sc, for 4 weeks, n = 10), saline-treated control (n = 10) and sham-operated groups (n = 8). In the nesiritide and control groups, a balloon catheter was inserted to the right iliac artery to induce injuries. Vascular endothelial growth factor (VEGF) was measured by immunohistochemistry. The area under internal elastic membrane of the arterial wall (643.2 ± 134.1 vs 493.7 ± 139.3 µm(2), p < 0.05) and the area under external elastic membrane (1495.1 ± 204.9 vs 1265.9 ± 232.6 µm(2), p < 0.05) in the nesiritide group were greater than those in the control group, but were smaller than those in the sham-operated group (p < 0.05). The stenosis ratio was lower in the nesiritide group than in the control group (18.7 ± 7.7% vs 38.0 ± 8.3%, p < 0.01). Importantly, the VEGF expression rate was significantly lower in the nesiritide group than in the control group (42.2 ± 8.8% vs 56.1 ± 13.1%, p < 0.05), while there were no signs of VEGF expression in the non-injured arteries of the three groups. In conclusion, nesiritide treatment reduces the stenosis of the rabbit iliac artery following balloon-induced endothelial injuries probably by decreasing VEGF expression.

Objective: To explore the approach and efficacy of microsurgery for tuberculum sellae meningiomas., Methods: The clinical data of 56 patients with tuberculum sellae meningiomas treated at our department from 1991 - 2009 were analyzed retrospectively. There were 20 males and 36 females with an age range of 32 - 65 years old (mean: 46). All patients underwent microsurgery through pterional, unilateral subfrontal, orbitozygomatic or supraorbital keyhole approach., Results: Among these patients, there were total resection (n = 51) and subtotal resection (n = 5). Postoperatively, 53 patients recovered well, 2 had a mild disability, 1 suffered a severe disability and there was no mortality., Conclusion: Most cases of tuberculum sellae meningiomas can be removed safely and totally. Several approaches may be employed to achieve the best outcomes. Microsurgery can markedly boost the total resection rate of tuberculum salle meningiomas and lower the postoperative complications and mortality.

Objective: To evaluate the practicability and validity of transcranial magnetic motor evoked potential monitoring (TMS-MEP) during spinal surgery., Methods: From February 2001 to June 2004, 37 patients undergoing spinal surgery were involved, anaesthesia was maintained with volatile anesthetics in 11 operations and etomidate in 26. Analgesia was provided with fentanyl, and non-depolarizing muscle relaxant was given intermittently. MEPs elicited with transcranial magnetic stimulations were recorded from tibialis anterior muscles, simultaneously bispectral index (BIS) and train-of-four stimulation (TOF) were used to monitor the anesthesia depth and neuromuscular blockade respectively. The variety of MEP and its effect on surgical operation at different anesthesia depth and muscular relaxation were observed, and the muscle strength of the patients before and after operation were compared., Results: The 11 cases anesthetized with isoflurane or enflurane gave no response to TMS, the other 26 cases in which anaesthesia was maintained with etomidate and fentanyl gave satisfactory TMS-MEPs, but with significantly attenuated amplitudes and prolonged latencies (P < 0.05). Intraoperative MEP showed a grossly unchanged waveform, and its amplitude and latency had little fluctuation when anaesthesia and neuromuscular blockade maintained stable. When T(1) value of TOF at 40% - 60%, a steady MEP could be acquired and the muscular contraction after TMS should not interfere the operation.Seven of 26 cases had a MEP amplitude drop up to 50% or more during the operation, the surgical team was notified to avoid further spinal injury, at last only 1 case had a worsen muscle power after operation., Conclusions: Myogenic TMS-MEP is a valid and practicable technique for intraoperative monitoring, and the etomidate + fentanyl technique is adequate for its anesthesia. BIS and TOF monitoring are helpful to maintain the steadiness of the anesthesia and MEPs, which is very important for monitoring the changes of the MEPs.

Objective: To explore the method and efficacy of microsurgery for anterior clinoidal meningiomas., Methods: The clinical data of 53 patients with anterior clinoidal meningiomas treated from 1991-2009 were analyzed retrospectively. There were 15 males and 38 females. The age range was 33 - 65.5 years old (mean: 45.5). All patients underwent microsurgery through pterional, extended pterional, frontotemporal, frontotemporal and orbitozygomatic approaches., Results: Of 53 patients, total, subtotal and partial resections were performed in 38, 10 and 5 cases respectively. Postoperatively, 48 patients recovered well, 4 had mild disability, 1 severe disability and no dead case., Conclusion: Most anterior clinoidal meningiomas can be removed safely and effectively. Several approaches may be used to achieve the best results. Microsurgical operation can offer a great aid in an effective resection of anterior clinoidal meningiomas and reduce the postoperative complications and mortality. Postoperative radiotherapy should be carried out for the residual tumor invading cavernous sinus or internal carotid artery.