Predictors of stricture after endoscopic submucosal dissection of the esophagus and steroids application.

BACKGROUND: Endoscopic submucosal dissection (ESD) is a reliable method to resect early esophageal cancer. Esophageal stricture is one of the major complications after ESD of the esophagus. Steroid prophylaxis for esophageal strictures, particularly local injection of triamcinolone acetonide (TA), is a relatively effective method to prevent esophageal strictures. However, even with steroid prophylaxis, stenosis still occurs in up to 45% of patients. Predicting the risk of stenosis formation after local TA injection would enable additional interventions in risky patients. AIM: To identify the predictors of esophageal strictures after steroids application. METHODS: Patients who underwent esophageal ESD and steroid prophylaxis and who were comprehensively assessed for lesion- and ESD-related factors at Southeast University Affiliated Zhongda Hospital between February 2018 and March 2023 were included in the study. The univariate and multivariate regression analyses were conducted to identify the predictors of stricture among patients undergoing steroid prophylaxis. RESULTS: A total of 120 patients were included in the analysis. In the oral prednisone and oral prednisone combined with local tretinoin injection groups, the stenosis rates were 44/53 (83.0%) and 56/67 (83.6%), respectively. Among them, univariate analysis showed that the lesion circumference (P = 0.01) and submucosal injection solution (P = 0.04) showed significant correlation with the risk of stenosis formation. Logistic regression analyses were then performed using predictors that were significant in the univariate analyses and combined with known predictors from previous reports, such as additional chemoradiotherapy and tumor location. We identified a lesion circumference < 5/6 (OR = 0.19; P = 0.02) and submucosal injection of sodium hyaluronate (OR = 0.15; P = 0.03) as independent predictors of on esophageal stricture formation. CONCLUSION: Steroid prophylaxis effectively prevents stenosis. Moreover, the lesion circumference and submucosal injection of sodium hyaluronate were independent predictors of esophageal strictures. Additional interventions should be considered in high-risk patients.

Hyperacusis questionnaire and event-related potential correlation in migraine patients.

This study aims to investigate auditory hypersensitivity and cortical function in migraine patients using the Hyperacusis Questionnaire and the Event-Related Potential (ERP) technique. The study analyzes alterations in the latency and amplitude of the event-related potentials MMN and P300 components. The findings contribute to a better understanding of the physiological relationship between migraine and auditory hypersensitivity. Seventeen migraine patients were admitted to the outpatient clinic of the Department of Otorhinolaryngology-Head and Neck Surgery at Peking University People's Hospital from June 2023 to September 2023. Nineteen matched healthy subjects were also selected. All participants underwent the pure tone audiometry and the auditory brainstem response test to determine hearing thresholds, the Hyperacusis Questionnaire, the Tinnitus Handicap Inventory, and an ERP examination. The Oddball classical paradigm was used as the stimulation task, and electroencephalography signals were recorded synchronously. The scores of the Hyperacusis Questionnaire, latency and amplitude of MMN and P300 component were compared between the migraine group and the control group, and their correlation was analyzed. The latency of MMN at the Fz and Cz sites in migraine patients was significantly shorter than that in the control group (P < 0.05), and the amplitudes were significantly higher than those in the control group (P < 0.05). The variances in latency and amplitude of P300 at Cz and Pz sites in migraine patients were not statistically significant when compared with the control group. (P > 0.05). The Hyperacusis Questionnaire was negatively correlated with MMN latency, with a correlation coefficient of - 0.374 (P = 0.025), and positively correlated with MMN amplitude, with a correlation coefficient of 0.378 (P = 0.023). There was no significant similarity between the Hyperacusis Questionnaire and P300 latency and amplitude (P > 0.05). Overall, auditory hypersensitivity was enhanced in individuals with migraines compared to healthy individuals, leading to faster information processing, while there may be less impairment in cognitive function.

scHybridBERT: integrating gene regulation and cell graph for spatiotemporal dynamics in single-cell clustering.

Graph learning models have received increasing attention in the computational analysis of single-cell RNA sequencing (scRNA-seq) data. Compared with conventional deep neural networks, graph neural networks and language models have exhibited superior performance by extracting graph-structured data from raw gene count matrices. Established deep neural network-based clustering approaches generally focus on temporal expression patterns while ignoring inherent interactions at gene-level as well as cell-level, which could be regarded as spatial dynamics in single-cell data. Both gene-gene and cell-cell interactions are able to boost the performance of cell type detection, under the framework of multi-view modeling. In this study, spatiotemporal embedding and cell graphs are extracted to capture spatial dynamics at the molecular level. In order to enhance the accuracy of cell type detection, this study proposes the scHybridBERT architecture to conduct multi-view modeling of scRNA-seq data using extracted spatiotemporal patterns. In this scHybridBERT method, graph learning models are employed to deal with cell graphs and the Performer model employs spatiotemporal embeddings. Experimental outcomes about benchmark scRNA-seq datasets indicate that the proposed scHybridBERT method is able to enhance the accuracy of single-cell clustering tasks by integrating spatiotemporal embeddings and cell graphs.

Age-, season- and gender-specific reference intervals of serum 25-hydroxyvitamin D3 for healthy children (0 ~ 18 years old) in Nanning area of China.

Establishing specific reference intervals (RIs) of serum 25-hydroxyvitamin D3 [25(OH)D] for children is essential for improving the accuracy of diagnosis and prognosis monitoring of diseases such as rickets and growth retardation. The study including 6,627 healthy children was conducted to establish specific RIs of 25(OH)D for children in Nanning area of China. The results showed that there were statistically significant differences among age, season, and gender of serum 25(OH)D levels, and the age-specific RIs of serum 25(OH)D were 20.3 ~ 53.6 ng/mL for 0 ~ ≤ 1 year and 18.9 ~ 49.6 ng/mL for 2 ~ ≤ 3 years. The age-, season-specific RIs of serum 25(OH)D for 4 ~ ≤ 6 years in spring-summer and autumn-winter were 15.8 ~ 42.6 ng/mL and 15.2 ~ 37.7 ng/mL, respectively. The age-, gender-specific RIs of serum 25(OH)D for 7 ~ ≤ 18 years for males and females were 12.1 ~ 36.1 ng/mL and 10.8 ~ 35.3 ng/mL, respectively. This study successfully established the RIs of serum 25(OH)D, which may help to improve disease diagnosis and monitoring for children in the Nanning area of China.

Periodontitis promotes the progression of diabetes mellitus by enhancing autophagy.

Objective: This study aims to identify the periodontitis factor that activates excessive autophagy in pancreatic ß cells, resulting in organic lesions of pancreatic islet tissues and diminished insulin secretion, thereby accelerating the progression of diabetes mellitus (DM). Methods: Sprague-Dawley (SD) rats were induced with periodontitis (PD), type 2 diabetes mellitus (T2DM), or the combination of T2DM and PD (DP) through a high-sugar/high-fat diet and ligation of the tooth neck with silk thread. Alveolar bone resorption was assessed using Micro-CT, blood glucose levels were measured with a blood glucose meter, pancreatic tissue pathology was examined through HE staining, and the expression of autophagy-related proteins Beclin1 and LC3II/LC3I was analyzed using Western blotting. Results: Micro-CT results revealed more pronounced alveolar bone resorption and root bifurcation exposure in the PD and DP groups compared to the control group, with the DP group exhibiting the most severe condition. HE staining demonstrated the formation of periodontal pockets, severe alveolar bone destruction, and abnormal pancreatic islet tissue morphology in the PD and DP groups. The serum levels of IL-6, TNF-α, and IL-1ß increased sequentially in the control, DM, PD, and DP groups (P < 0.05). Relative expressions of GCK and GLUT-2 mRNA decreased in the PD group compared to the control group (P > 0.05), while the mRNA expressions in the DP and DM groups increased (P < 0.05), with the DP group exhibiting higher levels than the DM group (P < 0.05). Western blot results indicated increased expression levels of autophagy proteins Beclin1 and LC3II/LC3I in the DM and DP groups compared to the control group (P < 0.05), with the DP group exhibiting higher levels than the DM group (P < 0.05). Conclusion: The findings demonstrate that periodontal inflammatory factors may promote the enhancement of pancreatic cell autophagy in diabetic rats.

Preparation, stability, and in vitro transport of soybean protein-based diosgenin nanoemulsions.

Soybean protein isolate (SPI)-stabilized nanoemulsions (NEs) were formulated to encapsulate diosgenin (DIO) to enhance its water solubility and bioavailability. The influence of DIO concentrations on NEs' properties was investigated, and their environmental stability and cell permeability were also assessed. Results demonstrated that DIO significantly affected all the physicochemical properties of NEs. NEs with 1.0 mg/mL of DIO exhibited smaller droplet size (209 nm), lower polydispersity index (0.17), and higher stability coefficient (95.8 %). Furthermore, DIO-SPI NEs displayed better stability under appropriate pH (<4 or > 5), NaCl concentrations (≤0.3 M), temperatures (≤60 °C), and freeze-thaw cycles (≤2), as well as storage at 4 °C. Moreover, encapsulating DIO in NEs reduced its toxicity towards cells and enhanced its transport efficiency, which reached 3.16 âˆ¼ 4.87 × 10-6. These findings highlight the potential of SPI-based NEs as a promising carrier for the efficient delivery of DIO.

Promoting Access to Innovative Anticancer Medicines: A Review of Drug Price and National Reimbursement Negotiation in China.

Providing universal access to high-cost medications like anticancer drugs is not an easy feat. Although basic medical insurance has covered over 95% of China's population since 2012, reimbursement for high-priced medicines is limited. In 2015, the Chinese government proposed establishing an open and transparent price negotiation mechanism for some patented and expensive drugs, where oncology was among the prioritized areas. In 2016, three drugs (gefitinib, icotinib, and tenofovir disoprox) underwent negotiation with the government, eventually reducing their prices by over 50% so that they could be prioritized during reimbursement processes. Focusing on anticancer medicines, this study comprehensively summarizes the progress in drug price and national reimbursement negotiation in China. Furthermore, we investigated the changes and development regarding negotiated anticancer medicines from quantity negotiated, classification, indication coverage, utilization, and procurement spending. Our findings could provide a reference for follow-up negotiations and reimbursement policies for high-value anticancer medications in other countries. From 2016 to 2021, 82 anticancer medicines were newly incorporated into the national reimbursement drug list (NRDL) via 6 rounds of negotiation. The majority of these were innovative pharmaceutics (ie, protein kinase inhibitors (28) and monoclonal antibodies (13)). Drug pricing and national reimbursement negotiation led to a marked decrease in prices and a sharp increase in the utilization of negotiated anticancer medicines. Following negotiations, the defined daily doses (DDDs) of innovative anticancer medicines experienced remarkable growth. Their proportion in total anticancer drugs DDDs also increased from 3.4% in 2014 to 20.9% in 2019. However, although drug prices decreased substantially after the negotiations, insurance spending still showed an upward trend owing to the significant increase in utilization. This calls for the government to carefully monitor the rational use of these expensive medicines and explore innovative payment models.

Effect of DFIG control parameters on small signal stability in power systems.

The doubly-fed induction generator (DFIG) with virtual inertia control and reactive damping control gives a renewable energy generation system inertia and damping characteristics similar to those of a thermal power plant, and the parameters of the control strategy have a direct impact on the small-signal stability of the system. This paper firstly introduces the operating characteristics and control strategies of DFIG-based damping control and virtual inertia control, establishes a small-signal model of the control-based DFIG integrated interconnected system, and investigates the effects of virtual inertia and reactive damping values on the small-signal stability of the system; then, the maximum damping ratio of the interval oscillation mode in small disturbance analysis is taken as the optimization objective, and the control parameters are the optimization variables. An optimization method of inertia and damping parameters is established for improving the small disturbance stability of the system. The results show that the optimization procedure could improve the damping ratio of the interval oscillation mode while ensuring the system frequency. The effects of virtual inertia and reactive damping values on the small signal stability of the system are investigated, and an optimal allocation model and method for virtual inertia used to improve the small disturbance stability of the system is proposed.

[Spatial and Temporal Distribution and Influencing Factors of Dissolved Trace Metals in Jiulong River Estuary and Xiamen Bay].

Trace metals play an important role in some biogeochemical processes in the marine system. The physical and hydrological conditions in estuaries and coastal seawater are complicated and significantly affected by human activities. Therefore, the biogeochemical behavior and influencing mechanism of trace metals in nearshore water have become a research hotspot. Jiulong River estuary and Xiamen Bay are located in the coastal areas of Fujian Province, which are significantly influenced by Longyan, Xiamen, and Zhangzhou City. In July 2021, November 2021, and January 2022, the trace metals chromium (Cr), manganese (Mn), cobalt (Co), nickel (Ni), copper (Cu), and cadmium (Cd) and environmental factors (water temperature, salinity, pH, dissolved oxygen (DO), suspended particulate matter (SPM), etc.) in Jiulong River estuary and Xiamen Bay were investigated. The results showed that the order of trace metal concentration average values measured in Jiulong River estuary and Xiamen Bay was Mn>Ni>Cu>Cr>Co>Cd. In July 2021, the average values of ρ(Cr), ρ(Mn), ρ(Co), ρ(Ni), ρ(Cu), and ρ(Cd) were 0.159, 47.96, 0.068, 1.56, 1.07, and 0.016 µg·L-1, respectively. In November 2021, the average values were 0.216, 8.48, 0.030, 1.70, 1.92, and 0.019 µg·L-1, respectively. The average concentrations in January 2022 were 0.281, 32.39, 0.062, 2.21, 1.54, and 0.034 µg·L-1, respectively. The concentration of dissolved metals in the estuary was higher than that in the bay area. Principal component analysis showed that the main factors affecting the concentrations of dissolved trace metals were river runoff and anthropogenic activities.

Successful treatment of advanced muscle-invasive bladder cancer with the combined therapy of toripalimab and chemotherapy: a case report.

Bladder cancer is the most common malignancy in the urinary system, and muscle-invasive bladder cancer (MIBC) accounts for 25-30% among all types of bladder cancers. Although MIBC can be treated by surgery and chemotherapy, favorable outcomes can still not be obtained. In recent years, the emergence of immunotherapy represented by programmed death-1 (PD-1)/programmed death ligand-1 (PD-L1) inhibitors and other immune checkpoint inhibitors provides attractive prospects for the treatment of advanced bladder cancer. PD-1/PD-L1 inhibitors can block the binding of PD-1/PD-L1, which can block negative immunomodulatory signals, thereby improving anti-tumor immune activity. In this article, we reported a case of advanced MIBC who achieved complete pathological remission after receiving the combined therapy of toripalimab and chemotherapy, which could provide clinical data for the treatment of bladder cancer with triprizumab.

Determination of components in Radix paeoniae rubra based on QAMS.

The current study aimed to establish simple and quick quality evaluation method of Chishao based on QAMS. Oxypaeoniflorin is used as a marker in the Chishao root. Based on it, the content of other components could be obtained by establishing the mathematical relationship. UPLC method was used to collect data, and the detection wavelengths were 230nm (benzoic acid, paeoniflorin), 263nm (hydroxy paeoniflorin) 274nm (gallic acid, paeoniflorin, catechin), respectively. The stationary phase was an Agilent ZORBAX SB-C18 and the mobile phase was acetonitrile -0.1% formic acid-water. The gradient elution method was adopted at the certain flow rate (0.3 mL/min). The column temperature set 40oC, and the injection volume was 1µL. Multiple reaction monitoring mode was selected for data collection. The linear ranges of benzoic acid, paeoniflorin, hydroxy-paeoniflorin, gallic acid, catechin and paeoniflorinhad good linearity (r ≥0.9995). The UPLC method was established to determine the content of paeoniflorin, benzoic acid, catechin, gallic acid, paeoniflorin, andhydroxy-paeoniflorin in Radix Paeoniae Rubra. In the current study, the method for the chemical components in Radix Paeoniae Rubra to provide the evaluation basis of medicinal effects.

Forest fire risk estimation in a typical temperate forest in Northeastern China using the Canadian forest fire weather index: case study in autumn 2019 and 2020.

China's forest cover has increased by approximately 10% as a result of sustainable forest management since the late 1970s. The forest ecosystem area affected by fire is increasing at an alarming rate of approximately 600,000 ha per year. The northeastern part of China, with a forest cover of 41.6%, has the greatest percentage of acres affected by forest fires. This study combines field and satellite weather data to determine factors that influence dead fuel moisture content (FMC). It assesses the use of the Canadian forest fire weather index to determine the daily forest fire danger in a typical temperate forest in Northeastern China during autumn. Based on the Wilcoxon test for paired samples, the observed and predicted values of FMC showed similar variation in eight of eleven sampling sites (72.7%), with a p value > 0.05. Three sampling plots presented lower predicted values of FMC than observed values (27.3%), with a p value < 0.05. The calculation of fire risk using the Canadian Forest Fire Weather Rating System (CFFDRS) in Maoer Mountain forest ecosystems presented low, medium or high risk; thus, the CFFDRS is suitable for determining fire danger in our study region. Along with these results, this study served to compare the use of FMC-metre field data and China Weather Station data to evaluate fire danger. The results of this study led us to suggest the multiplication of meteorological stations in fire-prone regions.

Differentially expressed circRNA and functional pathways in the hippocampus of epileptic mice based on next-generation sequencing.

Epilepsy is a clinical syndrome caused by the highly synchronized abnormal discharge of brain neurons. It has the characteristics of paroxysmal, transient, repetitive, and stereotyped. Circular RNAs (circRNAs) are a recently discovered type of noncoding RNA with diverse cellular functions related to their excellent stability; additionally, some circRNAs can bind and regulate microRNAs (miRNAs). The present study was designed to screen the differentially expressed circRNA in an acute seizure model of epilepsy in mice, analyze the related miRNA and mRNA, and study their participating functions and enrichment pathways. In order to obtain the differential expression of circRNA in epilepsy and infer their function, we used next-generation sequencing and found significantly different transcripts. CIRI (circRNA identifier) software was used to predict circRNA from the hippocampus cDNA, EdgeR was applied for the differential circRNA analysis between samples, and Cytoscape 3.7.2 software was used to draw the network diagram. A total of 10,388 differentially expressed circRNAs were identified, of which 34 were upregulated and 66 were downregulated. Among them, mm9_circ_008777 and mm9_circ_004424 were the key upregulated genes, and their expression in the epilepsy group was verified using Quantitative real-time PCR (QPCR). The analysis indicated that the extracted gene ontology terms and Kyoto Encyclopedia of Genes and Genomes pathways were closely related to several epilepsy-associated processes. This study determined that mm9_circ_008777 and mm9_circ_004424 are potential biomarkers of epilepsy, which play important roles in epilepsy-related pathways. These results could help improve the understanding of the biological mechanisms of circRNAs and epilepsy treatments.

Situs inversus totalis patients with gastric cancer: Robotic surgery the standard of treatment?-A case report.

INTRODUCTION AND IMPORTANCE: Situs inversus totalis (SIT) is a very rare congenital condition. Situs inversus totalis (SIT) patients who present with gastric cancer have been reported in Japan, China, the United States, and other countries. China has a high incidence of gastric cancer, accounting for 40% of the global annual incidence. Surgical treatment options for situs inversus totalis (SIT) gastric cancer patients are of great concern due to the rare nature of the condition and the anatomical variations. This case aims to demonstrate the utility of robotic surgery in treating situs inversus totalis patients with gastric cancer. CASE PRESENTATION: We report a 69-year-old male situs inversus totalis (SIT) gastric cancer patient who successfully underwent a DaVinci robotic-assisted distal gastrectomy with Roux-en-Y reconstruction. The patient had no complications after the operation and was discharged postoperative day 15. CLINICAL DISCUSSION: Gastric cancer is an aggressive disease that requires timely diagnosis and appropriate intervention. Unfortunately, many patients present late with gastric cancer and do not benefit from surgical or other appropriate interventions. Patients who are eligible for surgery however still need a clean marginal resection to maximize prognosis, which is not always possible due to complex anatomy or variations as seen in situs inversus totalis. DaVinci robotic surgery system is a new generation of minimally invasive operating systems after conventional laparoscopy, and its visual field clarity, operating flexibility, and instrument stability have obvious advantages over conventional laparoscopic surgery and traditional open surgery. CONCLUSION: Robotic surgery for situs inversus totalis (SIT) patients is more advantageous than laparoscopic and traditional surgeries as it offers a broader view of the variant anatomy and allows optimum dexterity and clarity.

Mechanisms of microRNA­142 in mitochondrial autophagy and hippocampal damage in a rat model of epilepsy.

Researchers have confirmed the microRNA (miRNA/miR)­epilepsy association in rodent models of human epilepsy via a comprehensive database. However, the mechanisms of miR­142 in epilepsy have not been extensively studied. In the present study, a rat model of epilepsy was first established by an injection of lithium chloride­pilocarpine and the successful establishment of the model was verified via electroencephalogram monitoring. The levels of miR­142, phosphatase and tensin homolog deleted on chromosome 10 (PTEN)­induced putative kinase 1 (PINK1), marker proteins of mitochondrial autophagy, and apoptosis­related proteins were measured. Additionally, the pathological changes in the hippocampus, the ultrastructure of the mitochondria, and degeneration and the apoptosis of neurons were observed using different staining methods. The malondialdehyde (MDA) content and superoxide dismutase (SOD) activity in the hippocampus, mitochondrial membrane potential (MTP) and reactive oxygen species (ROS) generation were detected. Furthermore, the targeting association between miR­142 and PINK1 was predicted and verified. Consequently, apoptosis increased, and mitochondrial autophagy decreased, in the hippocampus of epileptic rats. Following miR­142 inhibition, the epileptic rats exhibited an increased Bax expression, a decreased Bcl­2 expression, upregulated marker protein levels of mitochondrial autophagy, a reduced MDA content, an enhanced SOD activity, an increased MTP and decreased ROS generation. PINK1 is a target gene of miR­142, and its overexpression protected against hippocampal damage. Taken together, the results of the present study demonstrated that miR­142 inhibition promotes mitochondrial autophagy and reduces hippocampal damage in epileptic rats by targeting PINK1. These findings may provide useful information for the treatment of epilepsy.

Protective roles of liraglutide against brain injury of streptozotocin induced diabetic rats.

Our study aimed to explore the impacts of liraglutide on brain dysfunction of type 2 diabetes mellitus. Rats in liraglutide treatment group were diabetic rats further received daily intraperitoneal administration of liraglutide for continuous 6 weeks. Body weight and blood glucose were measured weekly. Vascular structure changes in brain tissues were evaluated by Periodic acid-Schiff (PAS) staining. Angiopoietin-2 (ANG-2), high-mobility group box 1 (HMGB-1), CD105, NeuN, Oligo-2 in brain tissues were measured by immunohistochemistry staining and ANG-2, HMGB-1, and matrix metalloproteinase-9 (MMP-9) were detected by western blotting. Blood glucose levels of rats in diabetic model group were significantly elevated and blood glucose levels of rats in liraglutide treatment group were reduced to comparable levels with control group. PAS staining showed vascular basement membrane of rats in the diabetic model group was thicker than that of the control group. ANG-2, HMGB1 and MMP-9 were up-regulated in the diabetic model group comparing the control group, while down-regulated after treated with liraglutide (p<0.05). NeuN expressions were significantly higher in liraglutide treatment group. Liraglutide may have protective roles against brain injury of streptozotocin induced diabetic rats by inhibiting HMGB1, which further suppressing the MMP-9 and ANG-2.

Role of Magnetic Resonance Imaging in Predicting Residual Breast Cancer After Vacuum-Assisted Breast Biopsy.

PURPOSE: This study aims to evaluate the effectiveness of breast magnetic resonance imaging (MRI) in detecting residual breast cancer in patients after vacuum-assisted breast biopsy (VABB). METHODS: Between 2012 and 2019, 26 patients with breast cancer who underwent VABB were enrolled. Breast MRI was conducted after VABB. Imaging findings were then compared with the histopathological results. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated. RESULTS: Residual cancer was confirmed histologically in 8 of the 26 patients after VABB. The overall sensitivity, specificity, PPV, NPV, and accuracy of MRI for diagnosing residual cancer were 79.9%, 73.0%, 87.1%, 61.3%, and 77.8%, respectively. The sensitivity and NPV improved to 100%, when the number of biopsy specimens was larger than five. CONCLUSION: Breast MRI showed high sensitivity and NPV in detecting residual breast tumor after VABB.

[Effect of Panax japonicus saponin â £a on alleviating nonalcoholic steatohepatitis by regulating miR-17-5p/MFN2 signaling pathway].

To study the effect of Panax japonicas saponin Ⅳa(SPJ-Ⅳa) on nonalcoholic steatohepatitis(NASH) through miR-17-5 p/MFN2 signaling pathway. The nonalcoholic steatohepatitis model was induced by a high-fat diet combined with CCl_4 in Balb/c male mice. The mouse serum and liver were collected, the body weight and liver weight were measured, the liver index was calculated, and the serum biochemical indicators alanine amino transferase(ALT), triglyceride(TG), and glucose(Glu) were measured. The morphological changes in the liver were detected by HE and Masson staining, Real-time PCR was used to detect lipid metabolism-related genes, inflammation-related genes interleukin-6(IL-6) and interleukin-1ß(IL-1ß), miR-17-5 p and MFN2 expressions, and Western blot was used to detect MFN2 protein expression level. Compared with the normal control group, the liver index in the HFD+CCl_4 group was significantly increased, and the contents of ALT, TG, and Glu were significantly increased; the morphology showed obvious steatosis and collagen fiber deposition; mRNA expression levels of lipid metabolism-related genes, inflammation-related genes and miR-17-5 p increased significantly, the mRNA expression level of MFN2 decreased significantly, and the protein level of MFN2 decreased. After intervention with SPJ-Ⅳa, the levels of ALT, TG and Glu decreased, morphological steatosis decreased, collagen fiber deposition decreased, and mRNA expression levels of lipid metabolism-related genes, inflammation-related genes and miR-17-5 p decreased. The mRNA expression level of MFN2 increased, and the protein level of MFN2 also increased. The results of this study indicated that miR-17-5 p/MFN2 signaling pathway may be involved in the occurrence and development of NASH, and SPJ-Ⅳa had a protective effect on NASH, its mechanism may be related to the regulation of miR-17-5 p/MFN2 signaling pathway.

[Analysis of comorbid psychiatric disorders in patients with chronic otitis media associated tinnitus].

Objective:To analyze the distribution of comorbid psychiatric disorders in patients with chronic otitis media associated tinnitus. Method:The data of patients with chronic otitis media associated tinnitus who accepted surgical treatments from July 2017 to September 2018 were retrospectively analyzed. All patients accepted pure tone audiometry and acoustic conductance examination and were requested to fill the tinnitus history questionnaire, THI, TEQ, SAS, SDS and PSQI scales before operation. When the SAS or/and SDS score ≥50 the patient was judged as having comorbid psychiatric disorders. When the PSQI score>6 the patient was judged as having comorbid sleep disorder, and then all the results were analyzed. Result:Sixty-two patients were included in the study, 43 cases were diagnosed as chronic suppurative otitis media, and 19 cases were diagnosed as middle ear cholesteatoma. The average course of chronic otitis media or middle ear cholesteatoma was（14.38±14.06） years, while the average course of tinnitus was（8.39±11.69） years. There were 32 cases with mild to moderate tinnitus（gradeⅠ-Ⅱ）（51.61%） and 30 cases with moderate to severe tinnitus（grade Ⅲ-Ⅴ）（48.39%）. Before operation, there were 4 cases（6.45%） with normal hearing, 38 cases（61.29%） with conductive hearing loss, and 20 cases（32.36%） with mixed hearing loss. There was no significant difference in tinnitus severity between different hearing loss degrees and types（P>0.05）. The average SAS score was 45.10±11.61, and the average SDS score was 43.48±14.67, both higher than the normal modulus（30 points）, among which 27 cases（44.00%） comorbid psychiatric disorders. The THI score in patients with comorbid psychiatric disorders（57.85±21.1） was significantly higher than that in patients without comorbid psychiatric disorders（29.2±17.39）（P<0.05）. The PSQI score in patients with comorbid psychiatric disorders（8.86±3.47） was significantly higher than that of those without comorbid psychiatric disorders（6.24±2.54）（P<0.05）. Fifty-three patients were followed up for 0.5 to 1.8 years after operation, and in 43 cases the tinnitus was reduced or disappeared after operation（the effective rate was 81.13%）. There were no significant difference between patients in tinnitus relief group and those in tinnitus without relief group in age, sex, course of the disease, type of the disease, with or without comorbid psychiatric disorders and/or sleep disorder, postoperative hearing improvement. Conclusion:Comorbid psychiatric disorders are common in patients with chronic otitis media associated tinnitus and the tinnitus in patients with comorbid psychiatric disorders is significantly more serious than that those without. For the treatment of chronic otitis media associated tinnitus, besides surgery, the complications such as psychiatric and sleep disorders and so on should be evaluated and treated accordingly.

Increased health threats from land use change caused by anthropogenic activity in an endemic fluorosis and arsenicosis area.

Urbanization is conducive to promoting social development and improving living standards. However, the changing land use attributed to urbanization has placed both the environment and humans at risk. Based on the long-term monitoring and the land use change during 2010-2017, we investigated the exposure of fluoride (F) and arsenic (As) in groundwater. We analyzed the temporal and spatial variation of F and As from different land use changes. The study assessed health risk for children by calculating carcinogenic risk and non-carcinogenic risk. Furthermore, we mapped the distribution pattern of F and As using GIS. For the 768 water samples collected from 2010 to 2017, F concentrations ranged between 0.10 and 5.70 mg L-1 (M = 0.68 ± 0.02 mg L-1), As concentrations ranged between 0.50 and 71.50 µg L-1 (M = 4.28 ± 0.28 µg L-1). A concerning result showed that 6.77% of F concentrations larger than 1.5  mg L-1 and 11.46% of As concentrations larger than 10 µg L-1 based on the recommendation by WHO, respectively. Results proved that land use change caused by human activity increased groundwater pollution and placed human health at risk. High F and As risk were found in southern Taiyuan City. In particular, the groundwater of industrial land suffered from more severe pollution, especially at the frontier of urban and suburban areas in the southern part of Taiyuan City. Land use change attributed to industrial land resulted in major increases in the F and As concentrations in groundwater across 2010-2017. Both carcinogenic risk and non-carcinogenic risk in 2016-2017 were higher than that in 2010-2015. Rational land use planning, strict groundwater protection policies and the regular monitoring of pollution levels are necessary in order to prevent the adverse health of residents.