Transthoracic, thoracoabdominal, and transabdominal surgical approaches for gastric cardia adenocarcinomas: a survival evaluation based on a cohort of 7103 patients.

BACKGROUND: This study compared the survival outcomes of different surgical approaches to determine the optimal approach for gastric cardia adenocarcinoma (GCA) and aimed to standardize the surgical treatment guidelines for GCA. METHODS: A total of 7103 patients with GCA were enrolled from our previously established gastric cardia and esophageal carcinoma databases. In our database, when the epicenter of the tumor was at or within 2 cm distally from the esophagogastric junction, the adenocarcinoma was considered to originate from the cardia and was considered a Siewert type 2 cancer. The main criteria for the enrolled patients included treatment with radical surgery, no radio- or chemotherapy before the operation, and detailed clinicopathological information. Follow-up was mainly performed by telephone or through home interviews. According to the medical records, the surgical approaches included transthoracic, thoracoabdominal, and transabdominal approaches. Kaplan-Meier and Cox proportional hazards regression models were applied to correlate the surgical approach with survival in patients with GCA. RESULTS: There were marked differences in age and tumor stage among the patients who underwent the three surgical approaches (P < 0.001). Univariate analysis showed that survival was related to sex, age, tumor stage, and N stage (P < 0.001 for all). Cox regression model analysis revealed that thoracoabdominal approach (P < 0.001) and transabdominal approach (P < 0.001) were significant risk factors for poor survival. GCA patients treated with the transthoracic approach had the best survival (5-year survival rate of 53.7%), and survival varied among the different surgical approaches for different tumor stages. CONCLUSION: Thoracoabdominal approach and transabdominal approach were shown to be poor prognostic factors. Patients with (locally advanced) GCA may benefit from the transthoracic approach. Further prospective randomized clinical trials are necessary.

Accessory hepatic vein recanalization for hepatic vein-type Budd-Chiari syndrome.

PURPOSE: To explore the clinical efficacy and long-term outcomes of accessory hepatic vein (AHV) recanalization as a means of treating hepatic vein (HV)-type Budd-Chiari syndrome (BCS). METHODS: Between January 2011 and December 2018, a total of 46 symptomatic HV-type BCS patients were treated by AHV recanalization in our hospital. The technical and clinical success of this treatment, as well as associated long-term patient prognosis was assessed herein. RESULTS: The AHV recanalization approach was technically successful in 100% of patients, without any instances of complications associated with the operation. This procedure was 95.7% (44/46) clinically successful and resultant. AHV re-obstruction occurred in 12 patients. The cumulative primary one-, two-, and five-year patency rates were 77.3%, 71.7%, and 71.7%, respectively. The secondary cumulative one-, two-, and five-year patency rates were 97.7, 87.1, and 87.1%, respectively. The five-year patency rates did not differ significantly between patients treated with balloons and stents (p = .674). Based on Cox-regression analysis, younger age was an independent predictor of re-obstruction (p = .005). The cumulative one-, two-, and five-year survival rates were 97.7, 92.2, and 92.2%, respectively. CONCLUSIONS: AHV recanalization is a safe and effective treatment for HV-type BCS.

[Transurethral columnar balloon dilation of the prostate for benign prostatic hyperplasia].

OBJECTIVE: To study the clinical effect of transurethral columnar balloon dilation of the prostate (TUCBDP) in the treatment of BPH and introduce the experience with the surgical procedure. METHODS: We retrospectively analyzed the clinical data on 265 cases of BPH treated by TUCBDP from August 2016 to August 2019. RESULTS: Operations were successfully completed in all the cases, with the mean operation time of (24.67 ± 7.6) min and the average intraoperative blood loss of (26.5 ± 21.4) ml, and all the patients had urinary patency after removal of the catheter. Follow-up examinations every 3 months after surgery showed significant improvement over the baseline in IPSS, quality of life score (QOL), maximum urinary flow rate (Qmax), postvoid residual urine (PVR) and other indicators (P < 0.05). Forty-five of the patients with sexual life exhibited no significant difference from the baseline in IIEF-5 and erectile hardness scale (EHS) scores (P > 0.05). Postoperative complications were observed in 53 cases (20%), including 28 cases of transient urinary incontinence (10.56%), 3 cases of hemorrhage (1.13%), 11 cases of urinary tract infection (4.15%), 1 case of urethral stricture (0.37%), and 8 cases of acute urinary retention (3.01%), which were all improved after regular treatment, with no occurrence of true urinary incontinence. Retrograde ejaculation occurred in 2 (4.45%) of the 45 patients with sexual life. CONCLUSIONS: Transurethral columnar balloon dilation of the prostate, with the advantages of short operation time and less intraoperative bleeding, has a significant short-term clinical effect in the treatment of BPH, particularly suitable for the elderly and those who want to retain the sexual function. Intraoperative localization of the protrusion may significantly influence the outcome of surgery, which deserves strengthened studies. Special attention should be paid to the incidence of postoperative transient urinary incontinence.

Protective effects of alpinetin on lipopolysaccharide/d-Galactosamine-induced liver injury through inhibiting inflammatory and oxidative responses.

Alpinetin, a type of novel plant flavonoid derived from Alpinia katsumadai Hayata, has been reported to have anti-inflammatory effects. The aim of this investigation was designed to reveal the protective effects of alpinetin on Lipopolysaccharide (LPS)/d-galactosamine (D-Gal)-induced liver injury in mice. Alpinetin (12.5, 25, 50 mg/kg) were given 1 h before LPS and D-Gal treatment. 12 h after LPS and D-Gal treatment, the liver tissues and serum were collected. Our results showed that alpinetin treatment improved liver histology, indicating a marked decrease of inflammatory cell infiltration and restore hepatic lobular architecture. Alpinetin also inhibited liver myeloperoxidase (MPO) activity and malondialdehyde (MDA) level. Furthermore, LPS/D-Gal-induced tumor necrosis factor-α (TNF-α) and Interleukin-1ß (IL-1ß) production were dose-dependently inhibited by alpinetin. Alpinetin also attenuated LPS/D-Gal-induced expression of phospho-NF-κB p65 and phospho-IκBα. In addition, alpinetin was found to increase the expression of nuclear factor E2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1). In conclusion, these findings suggested that alpinetin inhibited liver injury through inhibiting NF-κB and activating the Nrf2 signaling pathway.

[Analysis of lipophilic components of Salvia miltiorrhiza roots and S. yunnanensis roots by UPLC and LC-MS/MS].

Fingerprints of lipophilic components in the roots of Salvia miltiorrhiza and S.yunnanensis were analyzed by UPLC-DADand UPLC coupled with mass spectroscopy to evaluate the differences and similarities of the lipophilic components in the two kinds of herbs.The UPLC analysis of 18 batches of S.miltiorrhiza and 16 batches of S.yunnanensis was performed on a 25℃Thermo Accucore C_(18)column(2.1 mm×100 mm,2.6µm)by Shimadzu LC-20AD;mobile phase was 0.026%phosphoric acid(A)-acetonitrile(B)with gradient elution;flow rate was 0.4 m L·min~(-1);detection wavelength was set at 270 nm;injection volume was 2µL.The molecular structures of the lipophilic components were analyzed on a 25℃Thermo Accucore C_(18)column(2.1 mm×100 mm,2.6µm)by Thermo U3000 UPLC Q Exactive Orbitrap LC-MS/MS with a mobile phaseconsisting of 0.1%formic acid water(A)and 0.1%formic acidacetonitrile(B).The mass spectrometry was acquired in positive modes using ESI.There are 10 common peaks in the lipophilic components of S.miltiorrhiza.The similarity between the 16 batches of S.miltiorrhiza and their own reference spectra was greater than 0.942,and the average similarity was 0.973.There are 12 common peaks in the lipophilic components of S.yunnanensis.The similarity between the 18 batches of S.yunnanensis and their own reference spectra was greater than 0.937,and the average similarity was 0.976.The similarity between the reference chromatograms of S.miltiorrhiza and S.yunnanensis was only 0.900.There are three lipophilic components in S.yunnanensis,which are not found in S.miltiorrhiza,and one of which isα-lapachone.There is a lipophilic component in S.miltiorrhiza not found in S.yunnanensis,which may be miltirone.The two herbs contain 8 common lipophilic components including dihydrotanshinoneⅠ,cryptotanshinone,tanshinoneⅠ,tanshinoneⅡ_A,nortanshinone in which the content of tanshinoneⅡ_A,dihydrotanshinoneⅠand cryptotanshinone of S.yunnanensisis significantly lower than that of S.miltiorrhiza(P<0.01),and the contents of tanshinoneⅠand nortanshinone are significantly lower than that of S.miltiorrhiza too(P<0.05).There are significant differences in the types and contents of lipophilic components between the roots of S.miltiorrhiza and S.yunnanensis,and the similarity between the fingerprints of interspecies is much lower than that between the same species.Therefore,the roots of S.miltiorrhiza and S.yunnanensis are two kinds of herbs which are quite different in chemical compounds and compositions.

Higher Serum Fibroblast Growth Factor-23 Levels and the Risk of Stroke and Its Subtypes: Evidence From a Meta-Analysis of Prospective Studies.

BACKGROUND: Epidemiologic studies have indicated conflicting associations of fibroblast growth factor-23 (FGF23) with the risk of stroke. To this end, a meta-analysis of prospective studies was conducted to assess the association. METHODS: Relevant studies were identified by searching PubMed and Embase databases to March 23, 2018. Relative risks (RRs) with 95% confidence intervals (CIs) were combined with the fixed-effects model or random-effects model according to the degree of heterogeneity. Moreover, stratified analyses and sensitivity analysis were carried out for further analysis. RESULTS: Seven prospective studies involving 1988 stroke events among 18048 participants were eligible for our meta-analysis. The combined RRs for total stroke were 1.29 (95% CI: 1.10, 1.52) for the highest versus lowest category of FGF23, with low heterogeneity among studies (Pheterogeneity = 0.38, I2 = 6.1%). Stratified analyses showed that the combined RRs for ischemic stroke (IS) and hemorrhagic stroke (HS) risk were 1.12 (95% CI: 0.92, 1.37) and 2.63 (95% CI: 1.61, 4.30), respectively. In the stratification by geographic areas, the association between higher FGF23 and stroke was similar with studies performed in the United States (RR = 1.24, 95%CI: 1.03, 1.49) and Europe (RR = 1.88, 95%CI: 0.77, 4.55); however, only the results in the United States were statistically significant. Sensitivity analysis indicated the combined results were robust. CONCLUSIONS: Our meta-analysis showed that higher FGF23 levels were associated with an increased risk of stroke. The positive association consistently existed in HS rather than in IS. Further studies are required to confirm these causal associations and to investigate the mechanisms.

[Study on Refined Oil Identification and Measurement Based on the Extension Neural Network Pattern Recognition].

There are four major problems related to fuel consumption, "large consumption", "low quality", "lack of front-end clean" and "lack of end emission control", which needs to address urgently for our country. More than 60 percent of the air pollution is due to the burning of coal and oil in our country, so the haze problem depends on how much we can deal with energy issues. We should achieve the identification and measurement of gasoline, diesel, kerosene and other refined oil products rapidly and accurately, which is important for the implementation of air pollution monitoring and controlling. in order to characterize the type information of the refined oil accurately and to improve the efficiency of the network model identification, it is effective to use principal component analysis method which could achieve the data dimension reductionwhile reducing the complexity of the problem. With principal component analysis of the most commonly used three-dimensional fluorescence spectra based on excitation-emission matrix (Excitation-Emission Matrix, EEM) data, we could obtain finer, deeper characteristic parameters. During the process of classification, it could avoid the "over-fitting" phenomenon because of the application of the cross-validation method, A neural network capable of both qualitative and quantitative analysis is designed. The neural network pattern recognition result becomes feedback to the input of the concentration network, together with the relative slope, the comprehensive background parameters, and the relative fluorescence intensity, we could achieve the measurement of the concentration of the corresponding types, then use the extension neural network pattern recognition technology to achieve identification and measurement of kerosene, diesel, gasoline and other refined oil products. The results of the study show that the average recognition rate reaches 0.99, the average recovery rate of concentration reaches 0.95, the average time of pattern recognition is 2.5 seconds and this time is 48.5% of the time used by PARAFAC model analysis method. The method significantly improves the operation speed with ideal application effect . It should be pointed out that, in order to ensure the accuracy and precision of the analysis, we should make corresponding calibration samples for specific analytes in terms of the analysis of complex mixtures such as refined oil, pesticides, tea, etc.

[Exploration of rapidly determining quality of traditional Chinese medicines by (NIR) spectroscopy based on internet sharing mode].

Because of the numerous varieties of herbal species and active ingredients in the traditional Chinese medicine(TCM),the traditional methods employed could hardly satisfy the current determination requirements of TCM.The present work proposed an idea to realize rapid determination of the quality of TCM based on near infrared(NIR)spectroscopy and internet sharing mode. Low cost and portable multi-source composite spectrometer was invented by our group for in-site fast measurement of spectra of TCM samples. The database could be set up by sharing spectra and quality detection data of TCM samples among TCM enterprises based on the internet platform.A novel method called as keeping same relationship between X and Y space based on K nearest neighbors(KNN-KSR for short)was applied to predict the contents of effective compounds of the samples. In addition,a comparative study between KNN-KSR and partial least squares(PLS)was conducted. Two datasets were applied to validate above idea:one was about 58 Ginkgo Folium samples samples measured with four near-infrared spectroscopy instruments and two multi-source composite spectrometers,another one was about 80 corn samples available online measured with three NIR instruments. The results show that the KNN-KSR method could obtain more reliable outcomes without correcting spectrum.However transforming the PLS models to other instruments could hardly acquire better predictive results until spectral calibration is performed. Meanwhile,the similar analysis results of total flavonoids and total lactones of Ginkgo Folium samples are achieved on the multi-source composite spectrometers and near-infrared spectroscopy instruments,and the prediction results of KNN-KSR are better than PLS. The idea proposed in present study is in urgent need of more samples spectra, and then to be verified by more case studies.

Unilateral or bilateral percutaneous vertebroplasty for acute osteoporotic vertebral fracture: a prospective study.

BACKGROUND: Percutaneous vertebroplasty (PVP) has been demonstrated to be effective in the treatment of acute osteoporotic vertebral fracture (AOVF). However, the matter of which surgical approach should be selected remains controversial. This research aims to compare the clinical results of unilateral and bilateral PVP for AOVF. METHODS: From January 2008 to December 2011, 68 patients with AOVF were randomly assigned to the unilateral puncture group (n=36) or the bilateral group (n=32). These patients underwent percutaneous injection of polymethyl methacrylate into posterior pedicle by the unilateral or bilateral puncture approach. Visual analogue scale (VAS) and the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) were recorded on presentation, at 1 week, 3, 6, and 12 months after operation. The cement leakage was measured by x-ray and computed tomography scan. RESULTS: Follow-up data showed there were no significant differences in VAS and QUALEFFO between 2 groups at 1 week after PVP and only significant difference was observed between 2 groups at 3, 6, and 12 months after operation. The cement leakage was 52.7% in the unilateral puncture group and 28.1% in the bilateral group. CONCLUSIONS: Compared with unilateral puncture, use of bilateral approach during PVP may result in more superior long-term outcomes and less cement leakage for patients with AOVF.

[Preliminary study on suitability of ozone sterilization in traditional Chinese medicine and its preparation].

Microbial contamination, growth and reproduction have a great influence on the quality of traditional Chinese medicine (TCM) and its preparation. TCM may be polluted by microbial in the production process due to ambient air, facilities and appliances and operating personnel, which affects the quality and efficacy of the final product. The GMP certification inspection standard of TCM manufacturing enterprises clearly established: "Sterilization methods of Chinese herbal medicine, intermediate products, finished products should follow the principle whether or not to change its quality", "TCM powder that used as medicine directly should follow the principle whether to do microbiological examinations". So it's particularly important for product quality, corporate energy consumption and its efficiency to choose the scientific and effective sterilization techniques and methods. Ozone is a kind of safe, environmentally friendly, efficient and no residue emerging sterilization technology. It has been widely applied in various fields of medical and health care and production and living. This paper mainly analyzed the ozone sterilization technology of TCM, aiming to explore the principle of ozone sterilization, the advantages, application status and existing problems and so on. The management regulations and implementation rules of ozone sterilization were summarized to make sterilization of Chinese medicine in the production, management, quality control and other aspects standardized, reasonable and scientific, and to provide the theoretical reference of the ozone sterilization technology for TCM and its preparation.

[Identification of adulterants in adulterated milks by near infrared spectroscopy combined with non-linear pattern recognition methods].

In the present work, two hundred and eighty seven raw milks collected from pastures in Shanghai and surrounding areas of Shanghai were used as true milk samples and divided into three true milk sets. Five hundred and twenty six adulterated milk samples, which contained dextrin (or starch) mixed with melamine (or urea, or ammonium nitrate), were prepared as six different adulterated milk sets. The concentrations of these adulterants in the adulterated milks were designed to be 0.15%~ 0.45% (starch or dextrin), 700-2,100 mg · kg(-1) (ammonium nitrate), 524-1,572 mg · kg(-1) (urea), and 365.5-1,096.5 mg · kg(-1) (melamine) to guarantee the protein content of adulterated milks detected by Kjeldahl method not lower than 3%. All the near infrared spectra (NIR) of the samples should have a pretreatment of normal variable transformation (SNV) before they were used to build discriminating models. The three true milk sets and six adulterated milk sets were combined in different ways in order to build NIR models for discriminating different kinds of adulterants (i. e. , dextrin, starch, melamine, urea and ammonium nitrate) based on simplified K-nearest neighbor classification algorithm (IS-KNN) and an improved and simplified of support vector machine (ν-SVM) method. The relationship between mass concentration of the adulterants and the rate of correct discrimination was also investigated. The results show that the average discrimination accuracy of IS-KNN and ν-SVM for identifying melamine, urea and ammonium nitrate were in the region of 49.55% to 51.01%, 61.78% to 68.79% and 68.25% to 73.51%, respectively. Therefore within the concentration regions designed in this study, it is difficult to distinguish different kinds of pseudo proteins by NIR spectroscopy. However, the average accuracy of IS-KNN and ν-SVM for identifying starch and dextrin are 92.33% and 93.66%, 77.29% and 85.08%, respectively. Most discrimination results of ν-SVM are better than those of IS-KNN. The correlative analysis between the discrimination accuracy rate and the content levels of the adulterants indicated that near infrared spectroscopy combined with non-linear pattern recognition methods can distinguish dextrin and starch in milks with higher concentration levels (> 0.15%), but do not work well on identifying the adulterants with lower concentrations such as melamine (365.5 to 1,096.5 mg kg(-1)), urea (524 to 1,572 mg · kg(-1)), ammonium nitrate (700 to 2,100 mg · kg(-1)). Therefore near Infrared Spectroscopy is not suitable for identifying the adulterants with concentrations are below 0.1%.

Asymmetric migration dynamics of the tropical Asian and Australasian floras.

The tropical Asian and Australasian floras have a close relationship, and is a vital distribution pattern of seed plants worldwide. As estimated, more than 81 families and 225 genera of seed plants distributed between tropical Asia and Australasia. However, the evolutionary dynamics of two floras were still vague. Here, a total of 29 plant lineages, represented the main clades of seed plants and different habits, were selected to investigate the biotic interchange between tropical Asia and Australasia by integrated dated phylogenies, biogeography, and ancestral state reconstructions. Our statistics indicated that 68 migrations have occurred between tropical Asia and Australasia since the middle Eocene except terminal migrations, and the migration events from tropical Asia to Australasia is more than 2 times of the reverse. Only 12 migrations occurred before 15 Ma, whereas the remaining 56 migrations occurred after 15 Ma. Maximal number of potential dispersal events (MDE) analysis also shows obvious asymmetry, with southward migration as the main feature, and indicates the climax of bi-directional migrations occurred after 15 Ma. We speculate that the formation of island chains after the Australian-Sundaland collision and climate changes have driven seed plant migrations since the middle Miocene. Furthermore, biotic dispersal and stable habitat may be crucial for floristic interchange between tropical Asia and Australasia.

Contrasting range changes of terrestrial orchids under future climate change in China.

Climate change has impacted the distribution and abundance of numerous plant and animal species during the last century. Orchidaceae is one of the largest yet most threatened families of flowering plants. However, how the geographical distribution of orchids will respond to climate change is largely unknown. Habenaria and Calanthe are among the largest terrestrial orchid genera in China and around the world. In this paper, we modeled the potential distribution of eight Habenaria species and ten Calanthe species in China under the near-current period (1970-2000) and the future period (2081-2100) to test the following two hypotheses: 1) narrow-ranged species are more vulnerable to climate change than wide-ranged species; 2) niche overlap between species is positively correlated with their phylogenetic relatedness. Our results showed that most Habenaria species will expand their ranges, although the climatic space at the southern edge will be lost for most Habenaria species. In contrast, most Calanthe species will shrink their ranges dramatically. Contrasting range changes between Habenaria and Calanthe species may be explained by their differences in climate-adaptive traits such as underground storage organs and evergreen/deciduous habits. Habenaria species are predicted to generally shift northwards and to higher elevations in the future, while Calanthe species are predicted to shift westwards and to higher elevations. The mean niche overlap among Calanthe species was higher than that of Habenaria species. No significant relationship between niche overlap and phylogenetic distance was detected for both Habenaria and Calanthe species. Species range changes in the future was also not correlated with their near current range sizes for both Habenaria and Calanthe. The results of this study suggest that the current conservation status of both Habenaria and Calanthe species should be adjusted. Our study highlights the importance of considering climate-adaptive traits in understanding the responses of orchid taxa to future climate change.

Plastome evolution and phylogenomics of Trichosporeae (Gesneriaceae) with its morphological characters appraisal.

Trichosporeae is the largest and most taxonomically difficult tribe of Gesneriaceae due to its diverse morphology. Previous studies have not clarified the phylogenetic relationships within this tribe on several DNA markers, including the generic relationships within subtribes. Recently, plastid phylogenomics have been successfully employed to resolve the phylogenetic relationships at different taxonomic levels. In this study, plastid phylogenomics were used to explore the relationships within Trichosporeae. Eleven plastomes of Hemiboea were newly reported. Comparative analyses, phylogeny and morphological character evolution within Trichosporeae were conducted on 79 species representing seven subtribes. The Hemiboea plastomes range from 152,742 bp to 153,695 bp in length. Within Trichosporeae, the sampled plastomes range from 152,196 bp to 156,614 bp and GC content from 37.2% to 37.8%. A total of 121-133 genes were annotated in each species, including 80-91 protein-coding genes, 34-37 tRNA genes, and 8 rRNA genes. The contraction and expansion of IR borders were not detected, and gene rearrangements and inversions did not occur. The 13 hypervariable regions were proposed as the potential molecular markers for species identification. A total of 24,299 SNPs and 3,378 indels were inferred, and most of the SNPs were functionally missense and silent variations. There were 1968 SSRs, 2055 tandem repeats and 2802 dispersed repeats. The RSCU and ENC values indicated that the codon usage pattern was conserved in Trichosporeae. Both the phylogenetic frameworks based on the whole plastome and 80 CDSs were basically concordant. The sister relationships between Loxocarpinae and Didymocarpinae were confirmed, and Oreocharis was a sister group of Hemiboea with high support. The morphological characters showed a complex evolutionary pattern of Trichosporeae. Our findings may contribute to future research on genetic diversity, morphological evolutionary patterns, and conservation of the tribe Trichosporeae.

[Extraction technology optimization and quality analysis of volatile oil in Rhizoma Curcumae].

OBJECTIVE: To investigate the effect of technologies and conditions on volatile oil yield extracted from Rhizoma Curcumae. METHODS: Water Extraction coupling Rectification (WER) and Steam Distillation (SD) technologies were applied to extract the volatile oils based on orthogonal table L9 (3(3)) to find out optimized condition. RESULTS: Variance and range analysis of orthogonal experiment results showed that the best conditions of WER and SD were as follows: ultrasound 0 h, extract 12 h with 8 (or 12 fold water for SD) fold water amount. Paired T test on the yields of the oils indicated that the oil yields prepared by WER and SD were significantly different. GC-MS analysis characterized 12 common compounds,which occupied 97.19% (SD) and 92.25% (WER) of the ones identified, respectively. Moreover, the relative percentage of the common constituents were almost the same. CONCLUSION: Ultrasound is not good for extracting volatile oil from Rhizoma Curcumae. WER could not only increase the oil yield of Rhizoma Curcumae, but also keep the quality of the oils accord with that extracted by SD.

[A clinico-pathological comparison between Henoch-Schonlein purpura nephritis and IgA nephropathy in children].

OBJECTIVE: To study the difference in clinico-pathological features between IgA nephropathy (IgAN) and Henoch-Schonlein purpura nephritis (HSPN) in children. METHODS: The medical data of 103 children with HSPN and 61 children with IgAN were retrospectively studied. RESULTS: There were no significant differences in age, sex and disease course between the HSPN and IgAN groups (P>0.05). Clinical classification demonstrated that more severe conditions were found in the IgAN group than in the HSPN group and gross hematuria was more common in the IgAN group (P<0.05). Serum creatinine and cholesterol levels were higher in the IgAN group than in the HSPN group (P<0.05). Fibrinogen-related antigen deposition was more common in the HSPN group, while complement 3(C3) deposition was more common in the IgAN group. Interstitial fibrosis, tubular casts and tubular inflammatory infiltration were also more common in the IgAN group (P<0.05). CONCLUSIONS: Significant clinico-pathological differences can be found between HSPN and IgAN in children, and these differences do not support a one disease entity hypothesis.

The complete chloroplast genome of the newly recorded species Tainia acuminata Averyanov (Orchidaceae) from China.

The complete chloroplast genome sequence of Tainia acuminata Averyanov was assembled and the phylogenetic relationship of the species to other taxa in Subtrib. Bletlinae was inferred in this study. The length of the complete chloroplast sequence is 157,603 bp, and it contains a large single-copy (LSC) region of 86,336 bp, a small single-copy (SSC) region of 18,129 bp, and two inverted repeat (IRA and IRB) regions of 26,569 bp. A total of 134 genes were annotated including 89 protein-coding genes, 37 tRNA, and eight rRNA. Phylogenetic analysis showed that T. acuminata was closely related to T. cordifolia, and the genus was closely related to a clade consisting of Calanthe, Phaius, and Cephalantheropsis.

Long-term effect of hospital volume on the postoperative prognosis of 158,618 patients with esophageal squamous cell carcinoma in China.

Background: The impact of hospital volume on the long-term survival of esophageal squamous cell carcinoma (ESCC) has not been well assessed in China, especially for stage I-III stage ESCC. We performed a large sample size study to assess the relationships between hospital volume and the effectiveness of ESCC treatment and the hospital volume value at the lowest risk of all-cause mortality after esophagectomy in China. Aim: To investigate the prognostic value of hospital volume for assessing postoperative long-term survival of ESCC patients in China. Methods: The date of 158,618 patients with ESCC were collected from a database (1973-2020) established by the State Key Laboratory for Esophageal Cancer Prevention and Treatment, the database includes 500,000 patients with detailed clinical information of pathological diagnosis and staging, treatment approaches and survival follow-up for esophageal and gastric cardia cancers. Intergroup comparisons of patient and treatment characteristics were conducted with the X2 test and analysis of variance. The Kaplan-Meier method with the log-rank test was used to draw the survival curves for the variables tested. A Multivariate Cox proportional hazards regression model was used to analyze the independent prognostic factors for overall survival. The relationship between hospital volume and all-cause mortality was assessed using restricted cubic splines from Cox proportional hazards models. The primary outcome was all-cause mortality. Results: In both 1973-1996 and 1997-2020, patients with stage I-III stage ESCC who underwent surgery in high volume hospitals had better survival than those who underwent surgery in low volume hospitals (both P<0.05). And high volume hospital was an independent factor for better prognosis in ESCC patients. The relationship between hospital volume and the risk of all-cause mortality was half-U-shaped, but overall, hospital volume was a protective factor for esophageal cancer patients after surgery (HR<1). The concentration of hospital volume associated with the lowest risk of all-cause mortality was 1027 cases/year in the overall enrolled patients. Conclusion: Hospital volume can be used as an indicator to predict the postoperative survival of ESCC patients. Our results suggest that the centralized management of esophageal cancer surgery is meaningful to improve the survival of ESCC patients in China, but the hospital volume should preferably not be higher than 1027 cases/year. Core tip: Hospital volume is considered to be a prognostic factor for many complex diseases. However, the impact of hospital volume on long-term survival after esophagectomy has not been well evaluated in China. Based on a large sample size of 158,618 ESCC patients in China spanning 47 years (1973-2020), We found that hospital volume can be used as a predictor of postoperative survival in patients with ESCC, and identified hospital volume thresholds with the lowest risk of death from all causes. This may provide an important basis for patients to choose hospitals and have a significant impact on the centralized management of hospital surgery.

Creation of aggregation-defective α-synuclein variants by engineering the sequence connecting ß-strand-forming domains.

The aggregation of α-synuclein (αS), which is implicated in the pathology of Parkinson's disease, produces fibrils in which layers of parallel, in-register ß-sheet-loop-ß-sheets are formed. The effects of sequence variation in the loop-forming region (referred to as the linker region) on αS aggregation have yet to be systematically studied. In the study described here, we created and characterized αS variants containing mutations in the linker regions. Our results indicate that although the physicochemical properties of the linker region, evaluated based on an intrinsic property of a single amino acid, still play a significant role in aggregation, additional factors can also determine aggregation of αS linker mutants. Our analyses suggest that these factors include a pairwise potential for parallel in-register ß-sheet formation. A linker variant displaying significantly reduced self-aggregation interfered with αS aggregation by inhibiting the conversion of αS soluble species to αS insoluble fibrils. We anticipate that linker mutations could serve as a novel method of creating αS variants that are aggregation-defective and/or inhibit αS aggregation.

[The clinical results of minimally invasive transforaminal lumbar interbody fusion for lumbar spinal stenosis with lumbar instability].

OBJECTIVE: To investigate the clinical results of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for lumbar spinal stenosis with lumbar instability. METHODS: Retrospective study was done on 42 cases of lumbar spinal stenosis with lumbar instability treated with bilateral decompression via unilateral approach and MIS-TLIF through an expandable tubular retractor from March 2010 to January 2011. There were 18 males and 24 females, and mean age was 61.7 years (rang, 48 - 79 years). The level of surgery was L(3-4) in 4 patients, L(4-5) in 26 patients, and L(5)-S(1) in 12 patients. All patients had symptoms of intermittent claudication. And 24 patients had symptoms of lower extremity pain and numbness in one side, and 18 patients had same symptoms in both legs. Operation time, intra-operative bleeding, postoperative hospital stay and complications were recorded. Visual analogue scale (VAS) scores for low back pain and leg pain were recorded before and after surgery. Oswestry disability index (ODI) scores were also recorded before and after surgery. The Bridwell criterion was used for evaluating the interbody fusion, and the MacNab criterion was used for assessment after surgery. RESULTS: The mean operative time was 150.4 minutes (range, 120 - 170 minutes), and mean blood loss was 147.1 ml (range, 50 - 400 ml). The hospitalization time after surgery was 5 - 18 d, an average of 8.8 d. All cases were followed-up for 6 - 14 months (average 11 months). VAS score of low back pain before surgery was 7.3 ± 1.0, and were 2.9 ± 0.8 and 2.0 ± 0.8 at three months after surgery and the last follow-up respectively. VAS score of leg pain before surgery was 7.9 ± 0.7, and were 2.0 ± 0.5 and 1.0 ± 0.7 at three months after surgery and the last follow-up respectively. ODI score was 75% ± 6% before surgery, were 16% ± 6% and 12% ± 5% at three months after surgery and the last follow-up respectively. VAS and ODI scores showed statistically significant improvements (t = 3.110 - 56.323, P < 0.01). There were 40 cases were grade I and II, according to the Bridwell criteria. The clinical results were excellent in 16 cases, good in 22 cases and fair in 4 cases to the MacNab criteria at the final follow-up. CONCLUSIONS: MIS-TLIF is an ideal surgical method for single segment lumbar spinal stenosis with lumbar instability, but close attention should be paid to specific patients, surgeons and hospitals.