[Clinical data analysis of 117 patients with ruptured abdominal aortic aneurysm].

Objective: To examine the perioperative clinical features and prognosis of patients with ruptured abdominal aortic aneurysms (rAAA) who received surgical repair. Methods: The clinical data of rAAA patients who underwent surgical repair and were admitted to the Surgical Intensive Care Unit of Beijing Anzhen Hospital, Capital Medical University from August 2005 to November 2020 were retrospectively analyzed, including the general clinical features, surgical mode, intraoperative conditions, postoperative complications, and fatality rate. Results: There were 117 patients with rAAA, with a median age of 68 (62,77) years, including 93 men (79.5%) and 24 women (20.5%). The main clinical manifestation was abdominal pain (n=115, 98.3%). Among them, 65 (55.6%) patients underwent endovascular aneurysm repair (EVAR), while 52 (44.4%) underwent open surgical repair (OSR). The common postoperative complications include acute gastrointestinal dysfunction (n=116, 99.1%), shock (n=89, 76.1%), acute respiratory distress syndrome (n=85, 72.6%), pancreatic injury (n=56, 47.9%), coagulation dysfunction (n=55, 47.0%), disseminated intravascular coagulation (n=46, 39.3%), acute kidney injury (n=39, 33.3%), infection/sepsis (n=28, 23.9%), gastrointestinal bleeding (n=17, 14.5%), and abdominal compartment syndrome (n=12, 10.3%). The overall postoperative in-hospital fatality rate was 10.3% (12/117). Preoperative use of vasopressors and inotropes, retroperitoneal hematoma, and postoperative abdominal compartment syndrome, gastrointestinal hemorrhage, acute kidney injury, and diffuse intravascular coagulation significantly increased the fatality rate [5/11, 6/24, 5/16, 6/12, 6/17, 23.1%(9/39), 19.6%(9/46), respectively]. Conclusion: The postoperative mortality of rAAA patients is still high in the era of EVAR, especially in patients with preoperative existence of shock and retroperitoneal hematoma, and with postoperative abdominal compartment syndrome, coagulation dysfunction, and acute kidney injury. It is necessary to strengthen perioperative monitoring and management of these patients to reduce the fatality rate.

[Study on optimization of image processing parameters of pneumoconiosis by DR].

Objective: To explore the effect of different post-processing parameters of digital radiography (DR) on the quality of chest X-ray for pneumoconiosis diagnosis, and to provide suggestions on parameter setting suitable for this kind of DR machine. Methods: From January 1, 2022 to June 30, 2022, the chest films of 35 workers in the department of radiology of Hangzhou occupational disease prevention and treatment hospital were randomly selected and printed after setting different image post-processing parameters. The quality of chest film was evaluated by the measurement of optical densitometer and the combination of subjective and objective by professional physicians. Results: When the density is set to 2 and the contrast/detail contrast is 4.5, the optical density of each area of DR chest film meets the requirements of chest X-ray quality, and the qualified rate of physician quality evaluation is the highest. Conclusion: Reasonable setting of image post-processing parameters can improve the quality of chest radiograph.

Comparative transcriptome profiling of Termitomyces sp. between monocultures in vitro and link-stipe of fungus-combs in situ.

The edible mushroom Termitomyces is an agaric-type basidiomycete fungus that has a symbiotic relationship with fungus-growing termites. An understanding of the detailed development mechanisms underlying the adaptive responses of Termitomyces sp. to their growing environment is lacking. Here, we compared the transcriptome sequences of different Termitomyces sp. samples and link-stipe grown on fungus combs in situ and monocultured in vitro. The assembled reads generated 8052 unigenes. The expression profiles were highly different for 2556 differentially expressed genes (DEGs) of the treated samples, where the expression of 1312 and 1244 DEGs was upregulated in the Mycelium and link-stipe groups respectively. Functional classification of the DEGs based on both Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis revealed an expected shift in fungal gene expression, where stress response genes whose expression was upregulated in link-stipe may adaptively be involved in cell wall hydrolysis and fusion, pathogenesis, oxidation-reduction, transporter efflux, transposon efflux and self/non-self-recognition. Urease has implications in the expression of genes involved in the nitrogen metabolism pathway, and its expression could be controlled by low-level nitrogen fixation of fungus combs. In addition, the expression patterns of eleven select genes on the basis of qRT-PCR were consistent with their changes in transcript abundance, as revealed by RNA sequencing. Taken together, these findings may be useful for enriching the knowledge concerning the Termitomyces adaptive response to in situ fungus combs compared with the response of monocultures in vitro.

[Pancreas multidisciplinary team optimizes the diagnosis and treatment of pancreas-related diseases and improves the prognosis of pancreatic cancer patients].

Objectives: To evaluate the role of pancreas multidisciplinary team(MDT) clinic in the diagnosis of pancreatic diseases,patient compliance with MDT advice,and the impact of MDT on the postoperative survival of patients with pancreatic cancer. Methods: The study included 927 patients(554 males,373 females,aged (58.1±13.3)years (range: 15 to 89 years)) that had visited the pancreas MDT clinic of Zhongshan Hospital from May 2015 to December 2021,and 677 patients(396 males, 281 females, aged (63.6±8.9)years(range: 32 to 95 years)) who underwent radical surgery and with pathologically confirmed pancreatic adenocarcinoma from January 2012 to December 2020,of whom 79 patients had attended the pancreas MDT. The clinical and pathological data were collected and analyzed retrospectively. Diseases were classified in accordance with 2010 WHO classification of tumors of the digestive system and usual clinical practices. The Kaplan-Meier method was used for drawing the survival curve and calculating the survival rate. The univariate analysis was done by Log-rank test and the multivariate analysis was done by COX proportional hazards model. Survival rates were compared using χ2 test. Results: Among the 927 patients that had visited the MDT clinic,233 patients(25.1%) were referred due to undetermined diagnosis. A direct diagnosis was made in 109 cases (46.8%,109/233) by the MDT clinic, of which 98 were consistent with the final diagnosis,resulting in an accuracy of 89.9%(98/109). The direct diagnosis rate in the recent years(36.6%(41/112),from June 2019 to December 2021) decreased compared to that in the previous years(56.2%(68/121),from May 2015 to May 2019),yet the accuracy in the recent years(90.2%,37/41) was basically the same as before (89.7%,61/68). The rate of compliance of the entire cohort was 71.5%(663/927), with the compliance rate in the recent two and a half years(81.4%,338/415) remarkably higher than that in the previous four years(63.4%,325/512). Patients with pancreatic cancer that attended the MDT exhibited a trend toward longer median postoperative survival than patients that did not attend the MDT,but the difference was not statistically significant(35.2 months vs.30.2 months,P>0.05). The 1-year and 3-year survival rates of patients that attended the MDT were significanly higher than patients that did not attend the MDT(88.6% vs. 78.4%,P<0.05;32.9% vs. 21.9%,P<0.05,respectively),but the 5-year survival rate was not statistically different(7.6% vs. 4.8%,P>0.05). Conclusions: The pancreas MDT clinic is an accurate and convenient way to diagnose intractable pancreatic diseases,and in the recent years the patients' compliance rate with MDT advice has increased. Pancreatic cancer patients that have attended the MDT have higher 1-year and 3-year postoperative survival rates,but the long-term survival benefits of MDT still needs to be proved by clinical studies on a larger scale.

[Diagnostic efficacy for predicting intraductal papillary mucinous neoplasms of the pancreas with high grade dysplasia or invasive carcinoma based on the surgery indications in different guidelines].

Objective: To evaluate the performance of the European Evidence-based Guidelines on Pancreatic Cystic Neoplasms (EEGPCN)(2018) and International Association of Pancreatology(IAP) Guideline(Version 2017) in predicting high grade dysplasia/invasive carcinoma-intraductal papillary mucinous neoplasm(HGD/INV-IPMN). Methods: A retrospective analysis of 363 patients,who underwent surgical resection in Changhai Hospital affiliated to Navy Medical University from January 2012 to December 2018 and were pathologically identified as (intraductal papillary mucinous neoplasm, IPMN),was performed. The patients,including 230 males and 133 females,aging (61.7±10.1) years(range:19 to 83 years). The proportion of HGD/INV-IPMN who met with the absolute indication(AI) of EEGPCN and high risk stigma(HRS) of IAP were compared. The binary Logistic regression analysis was used to find the independent risk factors of HGD/INV-IPMN.Eight combinations of risk factors derived from relative indication/worrisome feature or risk factors in this study,were made to evaluate the diagnostic efficacy. The area under curve(AUC) of receiver operating characteristics was used to evaluate the the cutoff value of risk factors(①CA19-9≥37 U/ml,②diameter of main pancreatic duct 5.0-9.9 mm,③enhancing mural nodule<5 mm,④(acute) pancreatiti,⑤acyst diameter ≥40 mm,⑤bcyst diameter ≥30 mm, ⑥thickened or enhancing cyst walls,⑦neutrophile granulocyte to lymphocyte ratio(NLR)≥2, ⑧cyst located in head, uncinate or neck,⑨carcinoembryonic antigen(CEA) ≥5 µg/L) number for predicting HGD/INV-IPMN.The accuracy,sensitivity,specificity,positive predictive value,negative predictive value,true positive,true negative,false positive,false negative,positive likelihood ratio,negative likelihood ratio,Youden index and F1 score were calculated. Results: Ninety-two patients(49.5%) of 186 ones who met AI and 85 patients(48.3%) of 176 ones who met HRS were respectively confirmed as HGD/INV-IPMN. In those patients who were not met AI,tumor location,thickened/enhancing cyst wall,CA19-9 elevated,NLR≥2 and CEA elevated were significantly (P<0.05) correlated with HGD/INV-IPMN. And tumor location(head/uncinate/neck vs. body/tail,OR=3.284,95%CI:1.268-8.503,P=0.014),thickened/enhancement cyst wall (with vs.without,OR=2.713,95%CI:1.177-6.252,P=0.019),CA19-9(≥37 U/L vs.<37 U/L, OR=5.086,95%CI:2.05-12.62,P<0.01) and NLR(≥2 vs.<2,OR=2.380,95%CI:1.043-5.434,P=0.039) were the independent risk factors of HGD/INV-IPMN. Patients with ≥4 risk factors of 9 in combination Ⅷ(①②③④⑤b⑥⑦⑧⑨) were diagnosed as HGD/INV-IPMN with the moderate accuracy(71.0%),moderate sensitivity (62.0%) and moderate specificity (73.0%). Patients with ≥4 risk factors of 9 in Combination Ⅶ(①②③④⑤a⑥⑦⑧⑨) were diagnosed as HGD/INV-IPMN with the highest specificity(83.0%) and patients with ≥3 risk factors of 8 in combination Ⅵ(①②③④⑤b⑥⑧⑨) were diagnosed as HGD/INV-IPMN with the highest sensitivity(74.0%). The AUC for diagnosis of HGD/INV-IPMN in combination Ⅵ,Ⅶ and Ⅷ were 0.72,0.75 and 0.75,respectively. Older patients and younger patients could respectively refer to combination Ⅶ and combination Ⅵ to improve the management of IPMN. Conclusions: Patients who meet AI of EEGPCN should undertake resection, otherwise the method we explored is recommended. The method of improvement for diagnosis of HGD/INV-IPMN is relatively applicable and efficient for decision-making of surgery, especially for younger patients with decreasing of missed diagnosis and elder patients with decreasing of misdiagnosis.

MicroRNA-495 attenuates proliferation and inflammatory response in rheumatoid arthritis fibroblast-like synoviocytes through attenuating ß-catenin pathway.

Fibroblast-like synoviocytes (FLSs) exert a critical effect in the occurrence and progress of rheumatoid arthritis (RA). MicroRNA-495 (miR-495) can regulate many growth behaviors in various cell types. Nevertheless, the role of miR-495 is still unclear in RA-FLS. We aimed to explore the role and molecular mechanism of miR-495 in RA. The FLSs and synovial tissue from normal and RA cases were used in the study. RT-PCR analysis was used to examine the expression of miR-495. Western blot assay was conducted to determine the levels of matrix metalloproteinase-9 (MMP-9), matrix metalloproteinase-2 (MMP-2) and ß-catenin. Cell counting kit-8 (CCK-8) assays were performed to determine the proliferation of RA-FLS in different treatment groups. The results showed that miR-495 is down-regulated in both RA-synovial tissue and RA-FLSs. Overexpression of miR-495 could inhibit RA-FLS proliferation and inflammatory factors of interleukin (IL)-6, IL-11 and tumor necrosis factor alpha (TNF-α), and decrease the protein expression of MMP-9 and MMP-2. In addition, miR-495 could negatively regulate the expression of ß-catenin in RA-FLSs. We also confirmed that the inhibitory role of miR-495 in RA-FLS is through the regulation of ß-catenin expression. Taken together, miR-495 is downregulated in RA-FLS and RA synovial tissue, and miR-495 inhibits proliferation and inflammatory response in RA-FLS, partially via regulating ß-catenin expression. The miR-495/ß-catenin pathway may serve as a new therapeutic target for RA.

[MiR-451 regulates proliferation and migration of colorectal cells by targeting MIF].

Objective: To investigate the effect and mechanism of miR-451 on the proliferation and migration of human colorectal cancer cell SW480 by targeting macrophage migration inhibitory factor (MIF). Methods: Microarray analysis was used to screen differentially expressed microRNAs and messenger RNA in SW480 cells. Real-time quantitative PCR (RT-qPCR) was used to detect the expressions of miR-451 and MIF in SW480 cells before and after transfection. Cell clone formation assay and Transwell assay were used to detect the proliferation and invasion of SW480 cells, respectively. Cell scratch assay was used to detect the migration ability of SW480 cells. The TargetScan database was used to analyze the correlation between miR-451 and MIF. Dual luciferase reporter gene was used to detect the interaction of miR-451 and MIF. MTT assay was used to detect the viability of SW480 cells. Results: Compared with human normal colorectal mucosal cell FHC (1.00), the expression of miR-451 was down-regulated in SW480 cells ( 0.36±0.18, P<0.001). Knockdown of miR-451 promoted proliferation, and migration of SW480 cells. Compared with that in FHC cells, MIF expression was up-regulated in SW480 cells (2.28±0.45, P<0.001). MIF down-regulation inhibited SW480 cell proliferation, invasion and migration. MiR-451 specifically bind to the MIF 3'UTR and regulated the expression of MIF. Overexpression of miR-451 reduced while overexpression of MIF increased the viability of SW480 cells. Overexpression of MIF promoted the proliferation and migration of SW480 cells (P<0.01), reversed the effect of miR-451 suppressed proliferation and migration of SW480 cells. Conclusion: MiR-451 may regulate proliferation and migration of human colorectal cancer cells by targeting MIF.

[Effect of miR-513a-3p targeting MDM2 on proliferation, migration and invasion of gastric cancer cells].

Objective: To investigate the effects of miR-513a-3p on proliferation, migration and invasion of gastric cancer cells and its mechanism. Methods: The miR-NC (miR-negative control mimics), miR-513a-3p (miR-513a-3p mimics), anti-miR-NC, anti-miR-513a-3p, si-NC, si-MDM2 (murine double minute 2), miR-513a-3p+ pcDNA3.1 (co-transfected with miR-513a-3p and pcDNA3.1), miR-513a-3p+ pcDNA3.1-MDM2 (co-transfected with miR-513a-3p and pcDNA3.1-MDM2) were transfected into BGC-823 cells, respectively. The expression of miR-513a-3p was detected by real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR), and the protein expressions of cyclin D1, MMP-2, p21, E-cadherin, MDM2 were detected by western blot. The viability of BGC-823 cells of each group was detected by 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2-H-tetrazolium bromide (MTT) assay. The migration and invasion of each group were detected by Transwell, the targeting relationship between miR-513a-3p and MDM2 was detected by double luciferase reporter gene assay. Results: The expression of miR-513a-3p in gastric epithelial cells GES-1 was 0.76±0.08, significantly higher than 0.21±0.02 in gastric cancer cells BGC-823 and 0.34±0.03 in MGC-803, respectively (P<0.05). The cell viabilities of the miR-NC group at 24 h, 48 h and 72 h were 0.57±0.05, 1.03±0.10, 1.43±0.14, respectively, while those of the miR-513a-3p group were 0.36±0.03, 0.48±0.05, and 0.63±0.06, respectively. The migration and invasion numbers of miR-NC group were 130±11.80 and 117±10.60, respectively, those of miR-513a-3p group were 58±5.64 and 50±5.13, respectively, and the differences were statistically significant (P<0.05). The cell viabilities of the si-NC group at 24 h, 48 h and 72 h were 0.53±0.05, 0.95±0.10, 1.36±0.14, respectively. Those of the si-MDM2 group were 0.39±0.04, 0.57±0.06, and 0.80±0.08, respectively. The cell migration and invasion of the si-NC group were 141±12.02 and 109±10.60, respectively, while those of the MDM2 group were 66±6.67 and 61±6.18, respectively, and the differences were statistically significant (P<0.05). The cell viabilities of the miR-513a-3p+ pcDNA3.1 group at 24 h, 48 h and 72 h were 0.34±0.03, 0.46±0.05, and 0.61±0.06, respectively. Those of miR-513a-3p+ pcDNA3.1-MDM2 group were 0.48±0.05, 0.82±0.08, 1.17±0.12, respectively. The migration and invasion of miR-513a-3p+ pcDNA3.1 group were 56±5.71 and 51±5.16, respectively, while those of miR-513a-3p+ pcDNA3.1-MDM2 group were 113±10.28 and 104±10.02, respectively, and the differences were statistically significant (P<0.05). Conclusion: miR-513a-3p may inhibit the proliferation, migration and invasion of gastric cancer cells through targeting regulation of MDM2, which will provide new targets for the prevention and treatment of gastric cancer.

Screening for syphilis with dual algorithms: analysis of discordant and concordant serology results in a population with a low prevalence of syphilis.

BACKGROUND: Currently, many laboratories have switched the traditional screening algorithm (TSA) to reverse screening algorithm (RSA) for the efficiencies in high-volume syphilis screening. However, confusions have been arisen regarding this paradigm shift. OBJECTIVE: To compare the performance of two algorithms with head-to-head mode. METHODS: Sera screening for syphilis were tested in parallel with chemiluminescence immunoassay (CIA) and toluidine red unheated serum test (TRUST). CIA-reactive sera from the RSA were reflexively tested with TRUST and confirmed with Treponema pallidum particle agglutination assay (TPPA), while the TRUST-reactive serology from the TSA were afterwards tested with TPPA. RESULTS: A total of 110 663 serum samples were screened. The RSA identified 2259 (2.0%) CIA-reactive results, of which 377 (16.7%) showed TPPA nonreactive results, while the TSA identified 934 (0.8%) TRUST-reactive results, of which 67 (7.2%) showed TPPA-nonreactive results. Among the 2259 CIA-reactive results, 1392 (61.6%) were TRUST-nonreactive, of which 350 (25.1%) were TPPA-nonreactive. A total of 182 sera from the 350 TPPA-nonreactive sera were further tested by a second CIA (VITROS Syphilis TPA, VITROS TPA), of which 155 (85.2%) were nonreactive and 27 (14.8%) were reactive. The 27 VITROS TPA-reactive sera were further tested with a treponemal Western blot assay (Euroimmun IgG Western Blot, EuroWB), of which 11 (41%) were indeterminate, 6 (22%) were nonreactive and 10 (37%) were reactive. Among the 10 EuroWB-reactive sera, two seroconverted to TPPA 1:80+/- after 1-year follow-up. Of 867 CIA-reactive/TRUST-reactive results, 27 (3.1%) were TPPA-nonreactive. CONCLUSIONS: The RSA identified more patients with reactive treponemal serology. However, it also yielded an increased likely false-reactive rate compared with the TSA, especially those results with low index values and TRUST-nonreactive serology, were necessary to retest with a second treponemal test. Further testing results with TPPA, VITROS TPA and EuroWB suggested the false-reactive CIA screening results and the likely false-nonreactive TPPA results when the reactive treponemal results screened with RSA were to be identified.

[The value of preoperative CA19-9 combined with platelet-to-lymphocyte ratio in predicting invasive malignancy in intraductal papillary mucinous neoplasms].

Objective: To explore preoperative predictive markers for invasive malignancy in intraductal papillary mucinous neoplasm(IPMN). Methods: The retrospective case-controlled study was adopted.Seventy-nine patients who underwent surgery and with pathologically confirmed IPMN from January 2005 to December 2014 at Department of Pancreatic Surgery, Zhongshan Hospital Fudan University were enrolled.Forty-six patients were male and 33 were female,with an average age of (62.9±8.9)years (range:37-82 years).Tumor sites:56 tumors were located at the head of the pancreas,22 were located at the body and tail of the pancreas,and 1 was located across the whole pancreas.Surgical procedures: 51 patients underwent pancreaticoduodenectomy, 22 patients underwent distal pancreatectomy, 4 patients underwent segmental pancreatectomy and 2 patients underwent total pancreatectomy.IPMNs were classified into non-invasive lesions and invasive carcinomas according to the histopathological findings of the tumor.Thirty-two tumors were non-invasive lesions and 47 were invasive carcinomas.The preoperative findings were compared between patients with non-invasive IPMN and patients with invasive carcinoma by univariate analysis using t test and χ(2) test accordingly,and factors with statistically significance were subsequently submitted to multivariate analysis. Results: Univariate analysis showed that tumor size(P=0.022), carcinoembryonic antigen(P=0.012), CA19-9(P=0.011), lymphocytes(P=0.034), neutrophil-to-lymphocyte ratio(P=0.010)and platelet-to-lymphocyte ratio(PLR)(P=0.004)were predictive markers with statistical significance.Multivariate analysis showed that CA19-9(P=0.012)and PLR(P=0.025) were independent predictive markers for invasive malignancy in IPMN.The area under curve of the combination factor of CA19-9 and PLR(0.864) was larger than that of CA19-9(0.806) or PLR(0.685) alone, and all the authentic indicators of the combination factor were better than those of each alone. Conclusions: CA19-9 and PLR are independent predictive markers for invasive malignancy in IPMN.The combination of CA19-9 and PLR has improved efficacy than each alone.

[Investigation and analysis of the activities of daily living of the aged at home in western China].

OBJECTIVE: To investigate the current situation of the activities of daily living (ADL) of the aged at home in western China, and to analyze its influencing factors so that we can improve the quality of life and pension services of elderly people. METHODS: The elderly people who came from Qinghai Province, Ningxia Autonomous Region, Xinjiang Uygur Autonomous Region, Shanxi Province, Guizhou Province, Guangxi Province, Sichuan Province, Yunnan Province and Chongqing were surveyed by questionnaires. Logistic regression model was used to analyze the influencing factors of ADL. RESULTS: A total of 7 175 aged people living in the western China were surveyed. In the study, 78.86% of the aged at home could independently live. 12.32% of the aged were of mild dysfunction. 6.27% of the aged had moderate dysfunction. And 2.55% of the aged suffered severe dysfunction. Multiple Logistic analyses indicated that age, educational level, economic income, body mass index and disease were the factors that affected their ADL. The risk of decreased ADL in the 60-69 and 70-79year-old groups were 0.221 (95%CI: 0.190-0.258) and 0.353 (95%CI: 0.305-0.409) times that of the elderly over the age of 80. Compared with illiterate seniors,the risks of decline in ADL of primary school, junior high school, secondary or high school, college or undergraduates, postgraduates or above were 0.299 (95%CI: 0.140-0.637), 0.312 (95%CI: 0.146-0.663), 0.238 (95%CI: 0.112-0.510), 0.226 (95%CI: 0.105-0.484), and 0.238 (95%CI: 0.110-0.514) times. The declines in the risk of ADL for elderly people with quite difficult economic conditions, slight difficulty and breaking even were 2.720 (95%CI: 2.015-3.672), 2.344 (95%CI: 1.816-3.027), and 1.542 (95%CI: 1.215-1.957) times of the economically abundant people. Compared with those with a body mass index (BMI)≥28, the risk of ADL reduction for BMI<18.5 was 1.577 (95%CI: 1.142-2.179) times. And the ADL of the elderly with no disease was at the risk of falling 0.685 (95%CI: 0.602-0.779) times that of an elderly person with the disease. CONCLUSION: The activities of daily living of age at home of western China are not high, and affected by many factors, such as age, educational level and so on. With the increasing of the elderly, maintaining and improving the ADL are the problems and challenges that we are faced with.

[Stereotactic biopsy in the accurate diagnosis of lesions in the brain stem and deep brain].

Objective: To investigate the value of stereotactic biopsy in the accurate diagnosis of lesions in the brain stem and deep brain. Methods: A total of 29 consecutive patients who underwent stereotactic biopsy of brainstem and deep brain lesions between May 2012 and January 2018 were retrospectively reviewed. The Cosman-Roberts-Wells (CRW) stereotactic frame was installed under local anesthesia. Thin-layer CT and MRI scanning were performed. Target coordinates were calculated by inputting CT-MRI data into the radionics surgical planning system. The individualized puncture path was designed according to the location of the lesions and the characteristics of the image. Target distributions were as follows: 12 cases of midbrain or pons, 2 cases of internal capsule, 3 cases of thalamus, 12 cases of basal ganglia. The biopsy samples were used for further pathological and/or genetic diagnosis. Results: Twenty-eight of the 29 cases (96.6%) were diagnosed accurately by histopathology and genomic examination following stereotactic biopsy. Pathological results were as follows: 8 cases of lymphoma, 7 cases of glioma, 4 cases of demyelination, 2 cases of germ cell tumor, 2 cases of metastatic tumor, 1 cases of cerebral sparganosis, 1 case of tuberculous granuloma, 1 case of hereditary prion disease, 1 case of glial hyperplasia, 1 case of leukemia. The accurate diagnosis of one case required a combination of histopathology and genomic examination. Undefined diagnosis was still made in 1 cases (3.45%) after biopsy. After biopsy, there were 2 cases (6.9%) with symptomatic slight hemorrhage, 1 case (3.45%) with symptomatic severe hemorrhage, and 1 cass (3.45%) with permanent neurological dysfunction. No one died because of surgery or surgical complications. Conclusions: Stereotactic biopsy is fast, safe and minimally invasive. It is an ideal strategy for accurate diagnosis of lesions in brain stem and deep brain.

Nuclear receptor subfamily 1 group H member 2 (LXRB) is the predominant liver X receptor subtype regulating transcription of 2 major lipogenic genes in goat primary mammary epithelial cells.

In ruminants, recent research has identified a crucial role for liver X receptors (LXR) in regulating lipid metabolism in mammary cells. However, the differences between LXR subtypes in regulating ruminant lipid metabolism are unknown. We used overexpression and knockdown of LXRA and LXRB in goat primary mammary epithelial cells to distinguish subtype-specific regulation of sterol regulatory element binding protein 1c (SREBP1c) and fatty acid synthase (FASN) mRNA expression and their promoter activity. Incubation with siRNA targeting LXR decreased expression of LXRA and LXRB. Knockdown of LXRA and LXRB in cells incubated with dimethyl sulfoxide (DMSO, control) had no effect on the expression of SREBP1c or FASN. Knockdown of LXRB in cells incubated with LXR ligand T0901317 (T09) led to decreased expression of FASN, but not SREBP1c. Overexpression of LXRB plus T09 dramatically upregulated SREBP1c and FASN to levels higher than overexpression of LXRA with T09. Luciferase reporter assays in cells with site-directed mutagenesis of LXR response elements (LXRE; LXRE1 from -286 to -251 bp or LXRE2 from -235 to -219 bp) revealed that the SREBP1c promoter with the wild type or either LXRE mutation in cells supplemented with T09 decreased markedly only when LXRB was knocked down. Knockdown of LXRA and LXRB had no effect on the SREBP1c promoter when cells had a double LXRE mutation. Overexpression of LXRA only in cells incubated with T09 increased the activity of the SREBP1c promoter with the wild type and the LXRE2 mutation. In contrast, compared with each control group, overexpression of LXRB dramatically increased SREBP1c promoter activity, regardless of LXRE mutation. Furthermore, in cells stimulated with T09, knockdown of either LXRA or LXRB did not alter wild-type FASN promoter activity. Knockdown of LXRA increased wild-type and LXRE-site-mutated (LXRE from -677 to -662 bp) FASN promoter activity. Overexpression of LXRB increased wild-type and LXRE-site-mutated FASN promoter activity regardless of treatment with DMSO or T09, but overexpression of LXRA altered LXRE-site-mutated FASN promoter activity only in cells treated with DMSO. Increased activation of SREBP1c or FASN promoters containing LXRE mutations after overexpression of LXRB suggested that LXRB activates endogenous SREBP1c, which can then bind to the promoter of SREBP1c via an auto-loop circuit regulatory mechanism. Collectively, these results highlight an important role for LXRB in the transcriptional regulation of SREBP1c and FASN in goat mammary epithelial cells. Activation of this nuclear receptor controls lipogenesis via different mechanisms.

The safety profile of subcutaneous allergen immunotherapy in children with asthma in Hangzhou, East China.

BACKGROUND: The aim of the current study is to evaluate the prevalence, severity and possible risk factors of systemic reactions (SRs) to subcutaneous allergen immunotherapy (SCIT) in children and adolescents with asthma in Hangzhou, east China's Zhejiang province. METHODS: From January 2011 to December 2016, this survey analysed the SCIT-related SRs involving 429 patients (265 children and 134 adolescents) affected by allergic asthma. Recorded data included demographics, diagnosis, patient statuses, pulmonary function testing results before and after each injection, allergen dosage, and details of SRs. RESULTS: All patients finished the initial phase and six patients withdrew during the maintenance phase. There were 2.59% (328/12,655) SRs in all injections (3.28% in children and 1.47% in adolescents); 15.62% (67/429) patients experienced SRs (18.49% children and 10.98% adolescents). There were 54.57% SRs of grade 1; 42.37% SRs of grade 2; 3.05% SRs of grade 3; and no grades 4 or grade 5 SRs occurred in patients. Most reactions were mild, and were readily controlled by immediate emergency treatment. There was no need for hospitalisation. The occurrence of SRs was significantly higher in children than that in adolescents (p<0.01). A higher ratio of SRs was found among patients with moderate asthma. CONCLUSION: This retrospective survey showed that properly-conducted SCIT was a safe treatment for children and adolescents with asthma in Hangzhou, East China. Children and patients with moderate asthma may be prone to develop SRs.

[The value of different antibodies detection in diagnosis of rheumatism with uveitis].

Objective: To investigate the value of HLA-B27 antigen, antinuclear antibody (ANA), anti-dsDNA and Anti-Neutrophil Cytoplasmic Antibodies (ANCA) detection in diagnosis of rheumatism with uveitis. Methods: Seven hundred and twenty four newly diagnosed patients with non-infection uveitis in Beijing Tongren Hospital from March 2012 to March 2016 who long-term lived in Beijing and its surrounding areas were continuously enrolled. HLA-B27 antigen expressions in peripheral blood lymphocytes and ANA, anti-dsDNA and ANCA levels in serum were tested. The detailed clinical data, imaging examinations and pathological examinations were recorded to define whether the patients had rheumatism and the types of rheumatism. Results: There were 285 patients were diagnosed with rheumatism in 724 patients (39.4%), with 135 male (47.4%) and 150 female (52.6%). The mean age of male (41±14) was lower than that of female (44±14), with statistically significant (t=2.18, P<0.05). There were 176 patients with Spondyloarthropathies, 48 patients with primary systemic vasculitis, 22 patients with systemic lupus erythematosus, 18 patients with primary Sjogren's syndrome, 16 patients with rheumatoid arthritis and 5 patients with juvenile idiopathic arthritis in 285 rheumatism patients. The positive rate of HLA-B27(57.2%), ANA(15.8%), anti-dsDNA (5.3%) and ANCA(9.1%) in rheumatic uveitis patients were obviously higher than those of non-rheumatic uveitis patients [HLA-B27(1.1%), ANA(1.6%), anti-dsDNA (0.0%) and ANCA(0.9%)], with statistically significant (Fisher's exact test, P<0.01). The HLA-B27 positive antigen were mainly in patients with Spondyloarthropathies, rate was 92.1%; the positive ANA were mainly in patients with systemic lupus erythematosus, rate was 95.5%; the positive anti-dsDNA were mainly in patients with systemic lupus erythematosus, rate was 59.1%; the positive ANCA were mainly in patients with primary systemic vasculitis (besides Behcet disease), rate was 57.1%. Conclusions: The detections of HLA-B27 antigen, ANA, anti-dsDNA and ANCA are valuable for primary screening of some rheumatic uveitis. There fore, clinicians should select targeted laboratory examination combine with the patients' clinical manifestations. This will be helpful in the auxiliary diagnosis of some types of rheumatic uveitis.

Active gratings tuned by thermoplasmonics-induced phase transition in vanadium dioxide thin films.

We propose and investigate an active grating of gold metallic structure on vanadium dioxide (VO2) thin film illuminated by an intense light. Nonuniform phase transition in VO2 film is expected due to the thermoplasmonics effect where the plasmonic-induced light absorption features an enhanced local heat generation at nanometer-scale. The spatial profiles of the electric field, the heat generation, and the temperature distribution, as well as the temperature-dependent dielectric parameters in VO2 film, are solved numerically in a self-consistent manner. Our results show that the evolution of the metallic and semiconducting phases of VO2 changes the effective dielectric environment of the grating and modifies its optical response in a controlled way. The interplay of the thermoplasmonics effect and the phase transition processes can thus provide another degree of freedom in designing optical modulators or switches which are remotely tunable via incident light.

Reactivity of patients with maintenance hemodialysis to erythropoietin in the treatment of renal anemia.

To explore the reactivity of patients with renal anemia (MHD) to erythropoietin (EPO) in maintenance hemodialysis (HD), 31 patients were enrolled in this study. According to the level of serum ferritin (SF), they were divided into two groups; one group received treatment using recombinant human erythropoietin (rHuEPO) and the other group was given iron sucrose. Taking terminal EPO dosage, terminal erythropoietin resistance index (ERI) and rate of change of ERI (ΔERII) as target indexes, the influence of SF level on dosage of EPO was evaluated after usage conditions of relevant substances in a 3-month period. The results revealed that differences of dialysis age, albumin (ALB), blood calcium, initial and terminal SF, variable quantity of hemoglobin (Hb), terminal EPO and ERI between two groups had statistical significance. Furthermore, SF level and terminal EPO (r = -0.37, P < 0. 05) as well as SF level and terminal ERI (r = - 0.39, P <0.05) were negatively correlated. Difference of terminal ERI between the two groups had statistical significance. It can therefore be summarized that supplementing an iron agent intravenously to maintain SF level between 500 ng/ml and 1200 ng/ml may improve reactivity of patients with MHD to EPO. In addition, rHuEPO therapy in treating anemia of patients with MHD has the same effect with intravenous drug delivery, less side effects and is easy to administer.

Effects of sodium ferrous chlorophyll treatment on anemia of hemodialysis patients and relevant biochemical parameters.

This study explores the effects of sodium ferrous chlorophyll treatment on the anemia of maintenance hemodialysis (MHD) patients, as well as the relevant biochemical parameters. We selected 72 patients who had received regular MHD treatment two or three times a week for more than 3 months in the Hospital of Traditional Chinese Medicine of Zhengzhou City of Henan Province from March 2014 to March 2016. They were equally divided into a treatment group and a control group. Haemoglobin (HB) and hematocrit (HCT) of the treatment group increased significantly after treatment (p < 0.01), but less in the control group (p < 0.05); Also serum ferritin (SF) and transferrin saturation (TAST) of the treatment group increased significantly after treatment (p < 0.01); SF of the control group also increased significantly (p < 0.01) and TAST of the control group increased (p < 0.05) but less than in the treatment group. No obvious changes of serum creatinine (SCR), blood urea nitrogen (BUN), C-reactive protein (CRP) and superoxide dismutase (SOD) were found in either groups after treatment (p>0.05). Albumin (ALB) dosage of the treatment group increased after treatment (p < 0.05) while hemopoietin (EPO) decreased significantly (p < 0.01). ALB and EPO of the control group had no obvious changes after treatment (p>0.05). ALB level of the treatment group increased more significantly than in the control group (p < 0.05), while EPO dosage decreased more significantly than in the control group (p <0.05). Therefore, the combination of conventional western medicine and sodium ferrous chlorophyll can effectively improve anemia conditions of MHD patients and their quality of life.

Effect of procyanidine on VEGFR-2 expression and transduction pathway in rat endothelial progenitor cells under high glucose conditions.

The protective effect of procyanidine and its oligomers against high glucose-mediated oxidative stress injury in endothelial progenitor cells (EPCs), and effect of procyanidin on vascular endothelial growth factor receptor-2 (VEGFR-2) expression and downstream signal pathway were analyzed in vitro. Rat bone marrow mononuclear cells were isolated, cultured under normal and high glucose (HG) conditions, and the changes in cell morphology observed. The EPCs were identified, and the oxidative stress products produced by EPCs (under normal and HG conditions) were quantified. Subsequently, an appropriate number of EPCs were cultured with and without procyanidin (OPC), and the MDA concentration and relative expression of VEGFR-2, AKT, IκB-α, and nuclear factor (NF)-κB were detected 1, 3, 5, and 7 days post-culture. We observed minor (round, translucent, gradually adhering) and significant (fusiform morphology/pebble distribution) cell morphological changes 3 and 7 days post-culture, respectively. Apoptosis and oxidative stress product release in EPCs cultured with HG increased significantly compared to the control group (P < 0.05). The oxidative stress product generation and relative expression of VEGFR-2, AKT, IkB-α, and NF-κB were not significantly affected by OPC addition in normal glucose conditions (P > 0.05); alternately, products generated as a result of oxidative stress were significantly reduced, the relative expression of VEGFR-2, AKT, and NF-κB protein was upregulated, and that of IκB-α was downregulated (P < 0.05) in HG + OPC EPCs. Therefore, procyanidin may promote cell proliferation by alleviating oxidative damage to EPCs under HG conditions, and upregulating VEGFR-2 expression and its downstream signal pathway.

[Value of MRI in prenatal diagnosis of abnormal fetal kidneys].

Objective: To investigate the value of MRI in the prenatal diagnosis of abnormal fetal kidneys. Methods: From December 2014 to March 2016, 51 women underwent MRI and were confirmed as having fetuses with abnormal fetal kidneys when follow up. Their clinical and MRI profiles were analyzed retrospectively, including MRI manifestation, the fetal kidney signal intensity of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC). The signal intensity of DWI and ADC of the abnormal kidney and the normal opposite kidney, and those of the normal and abnormal kidneys in different individuals were compared. The accuracies of MRI and ultrasound in evaluating abnormal fetal kidneys were also compared. Results: MRI could accurately demonstrate the morphological features of abnormal fetal kidneys. There was no statistically significant difference between DWI signal intensity and ADC value of the abnormal kidney[368 ± 125, (1.516 ± 0.420) × 10-3 mm2/s] and the normal opposite one[410 ± 125, (1.362 ± 0.251) × 10-3 mm2/s], P values were 0.165 and 0.184, respectively. The DWI signal intensity of normal kidneys (401 ± 124) was higher than that of renal cysts (182 ± 40, P <0.01), and the ADC value of normal kidneys[(1.306 ± 0.252) × 10-3 mm2/s] was lower than that of renal cysts[(2.912 ± 0.235) × 10-3 mm2/s] and multicystic dysplastic kidneys[(1.870±0.654) ×10-3 mm2/s], P values were <0.01 and 0.045, respectively. The diagnostic accuracy of MRI and prenatal ultrasound for abnormal fetal kidneys were 94% (63/67) and 85% (57/67), respectively. However, there was no statistical difference between the two methods (P=0.070). Conclusion: MRI have an important role in the prenatal diagnosis and evaluation of abnormal fetal kidneys.