[Role of innate lymphoid cells in oral squamous cell carcinoma microenvironment].

Oral squamous cell carcinoma (OSCC) is the most common oral malignancy. It has a high incidence, strong invasion ability, easy metastasis, poor curative effect, and poor prognosis. Innate lymphoid cells (ILCs) are an important part of immune cells located in the mucosal barrier, which play an important role in the occurrence, development and outcome of tumors. ILCs are the key cells for decoding the regulatory mechanism of tumor microenvironment and the signatures for tumor progression. This paper reviewed the latest progress on ILCs, summarized the possible characteristics and functions of ILCs in the microenvironment of OSCC, and explored the relationship between ILCs and the occurrence, development and immunotherapy of OSCC.

[Application value of questionnaires in the screening obstructive sleep apnea syndrome in pregnancy across trimesters].

Objective: To evaluate the clinical utility value of questionnaires of Berlin, STOP, STOP-Bang (SBQ), Epworth Sleepiness Scale (ESS) in screening obstructive sleep apnea syndrome (OSAS) in pregnant women of different trimesters. Methods: Consecutive pregnant women at high risk for OSAS were enrolled from January, 2021 to April, 2022 at the obstetric clinic of Peking University People's Hospital. They completed questionnaires of Berlin, STOP, SBQ, ESS and also underwent an overnight polysomnography (PSG). To evaluate the accuracy of questionnaires of Berlin, STOP, SBQ, ESS, sensitivity, specificity, positive predictive values, negative predictive values and the area under the receiver operating characteristics (ROC) curve of these questionnaires in pregnancy across trimesters (Pregnancy 1-15 weeks was the first stage, pregnancy 16-27 weeks was the second stage, and pregnancy 28-40 weeks was the third stage) were calculated. Results: A total of 100 pregnant women [(34.5±4.3) years old (26-46 years old)] were included in this study, including 20, 35 and 45 pregnant women in the first, second and third trimester of pregnancy, respectively. Based on PSG results, 45 (45%) of 100 pregnant women were diagnosed with OSAS. The overall predictive values of the four questionnaires were not good, area under[AUC(95%CI)] the ROC curve ESS, Berlin questionnaire STOP and SBQ were 0.54(0.43, 0.66), 0.59 (0.47, 0.70), 0.62(0.51, 0.73) and 0.61 (0.49, 0.72), respectively, sensitivity was 35.6%, 65.9%, 48.9%, 28.9%, specificity was 71.7%, 52.5%, 73.6%, 92.5%. When categorized according to trimesters, the predicted values of the four questionnaires increased in the first trimester, the AUC (95%CI) of STOP questionnaire was 0.81 (0.61, 1.00), sensitivity was 75.0%, specificity was 87.5%. Conclusion: The overall predictive power of the four screening questionnaires is limited in pregnant women. But predictive value of STOP questionnaire is acceptable in the first trimester.

[Craniofacial anatomical Characteristics of patients with catathrenia].

Objective: To analyze whether the upper airway of patients with catathrenia has obstructive manifestations using nasal resistance, craniofacial, and upper airway imaging methods, which could benefit the exploration of the etiology and treatment options. Methods: From August 2012 to September 2019, a total of 57 patients with catathrenia in the Department of Orthodontics at Peking University Hospital of Stomatology were included in the study, including 22 males and 35 females, aged (31.1±10.9) years, with a body mass index of (21.7±2.7) kg/m2. All the patients were diagnosed by full-night polysomnography at the Sleep Division, Peking University People's Hospital, of which 10 patients were combined with obstructive sleep apnea hypopnea syndrome (OSAHS). The median groaning index of patients was 4.8 (1.8, 13.0) events/h. Nasal resistance and cone-beam CT were conducted on the patients, and measurements were performed on the craniofacial structures, upper airway, and surrounding soft tissues, compared with non-snoring normal occlusion individuals' references published by the same research team (144 college students recruited at Peking University and 100 non-snoring young adults with normal occlusion recruited at six universities in Beijing). Results: The total nasal resistance of patients with catathrenia was (0.26±0.08) Pa·cm-3·s-1. The patients had overall well-developed mandibular hard tissues. However, the patients were found with increased FH/BaN (steep anterior cranial base plane), increased MP/FH (forward rotation of the mandible); increased U1/NA and L1/MP (proclined upper and lower incisors). The sagittal diameter of the velopharynx [(19.2±4.5) mm] was significantly larger than the normal reference (t=8.44, P<0.001), while the sagittal diameter at the hypopharynx [(17.4±6.4) mm] was statistically smaller than the normal reference (t=-2.79, P=0.006). Catarhrenia patients combined with OSAHS presented longer soft palate, tongue, and lower hyoid bone than those with primary catathrenia. Conclusions: In patients with catathrenia, the overall craniofacial characteristics are well-developed skeletal structures, lower nasal resistance, proclined upper and lower incisors, wide upper sagittal development of the upper airway and narrow hypopharynx. Groaning sounds might be related to the narrowing of the hypopharynx during sleep.

[Chronic kidney disease in community: Current state for screening and management].

OBJECTIVE: To understand the current state and problem of screening and management of chronic kidney disease (CKD) in the community, and to explore the improving strategies. METHODS: We established a community-CKD integrated data science platform based on medical information from 79 community health centers, in Xicheng District, Beijing. Patients who referred to 79 community health centers from 21 June 2015 to 20 November 2021 were retrospectively included in this study using the CKD data platform. The monitoring of the indicator of kidney injury, risk factor control, medicine use and device configuration in community were assessed in the study. RESULTS: In the study, 70.6% of the population were identified with high risk of CKD in the total 374 498 individuals who referred to the community health centers. Hypertension (62.3%), coronary heart disease (43.3%) and diabetes (30.4%) were the most common risk factors in high-risk CKD population. Only 17.2% of the patients with high risk of CKD were screened for kidney injury including at least one serum creatine (Scr) or albuminuria test, among which 10 992 (24.2%) individuals were defined as CKD. 22.7% (11 338/49 908) of the total patients with kidney screening in community were defined as CKD, of whom, 42.6% and 46.1% were identified by estimated glomerular filtration rate (eGFR) < 60 mL/(min·1.73 m2) and abnormalities of urinary proteins, respectively. The overall CKD detection rate in the community was 5.2% (19 299/374 498), and the miss-diagnosis rate of CKD was 38.1%. Of the 79 community health centers, 13 (16.5%) were equipped with ACR testing device, and eGFR was reported directly in 66 (83.5%) centers. Altogether 60.3% and 99.7% of the community CKD patients achieved glucose control and blood pressure control, respectively, and 59.3% of the CKD patients who had proteinuria was treated with renin-angiotensin-aldosterone system (RAAS) inhibitors. CONCLUSION: High-risk CKD population account for a substantial proportion of patients who refer to the community. Early screening, prevention and management of CKD in the community are of great importance to improve the prognosis and decrease the burden of CKD. It's essential to establish a screening and monitoring system, strengthen standardized management and clinician training for improving the ability of CKD management in the community.

[Occupational hazard analysis of workers exposed to chromate in a steel plant].

Objective: To investigate the occupational damage to workers exposed to chromate in a steel plant. Methods: In January 2021, a retrospective analysis was used to select 850 workers exposed to chromate (observation group) and 598 workers not exposed to chromate (control group) in a steel plant in Shandong Province from 2016 to 2017 as the investigation. We collected their occupational-related information, blood routine, fasting blood sugar, nasal lesions, skin lesions, chest X-rays and other inspection results, compared the differences in the abnormal detection rate of the two groups of respondents, and analyzed the occupational hazards of chromium workers. Results: Incidence of nasal damage, skin lesion, up-regulation of ALT (Alanine aminotransferase), abnormal chest radiograph, abnormal serum biochemical index, and abnormal serum glucose level were observed higher in the exposed group than those in the control group (χ(2)=125.69, 12.25, 5.82, 10.37, 10.46, 20.66, P=0.000, 0.000, 0.016, 0.001, 0.001, 0.000). Among the symptoms, the incidence of erythra, nasal septum deviation, nasal mucosal congestion, nasal mucosal erosion and rhinitis were more frequent than those in the control group (χ(2)=101.54, 4.07, 13.20, 32.05, P=0.000, 0.044, 0.000, 0.000). There was no significant increase in the incidence of work type, age, length of work and the area of nasal mucosa erosion in the observation group compared with the control table, and the difference was not statistically significant (χ(2)=5.31、0.42、0.28, P=0.505, 0.662, 0.871) . Conclusion: Occupational hazards of long-term exposure to chromate cannot be ignored. Attention should be paid to strengthening occupational protection and health education of workers exposed to chromium, and increasing their attention.

[Establish and application of scoring scale for trial of labor after cesarean section].

Objective: To establish a scoring scale for trial of labor after cesarean section (TOLAC), to explore the evaluation ability of this scoring scale for vaginal delivery after cesarean section (VBAC), and to improve the success rate of TOLAC. Methods: The delivery information of 661 TOLAC pregnant women admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from 2014 to 2017 was retrospectively analyzed, and the TOLAC scoring scale was established by referring to relevant literatures. A prospective cohort study of pregnant women with TOLAC from January 2018 to December 2019 in Zhengzhou Central Hospital was conducted, including 440 pregnant women who were excluded from contraindications in trial labor. According to TOLAC scoring scale, pregnant women were divided into 3 groups, 0-6 group (94 cases), 7-9 group (234 cases) and 10-15 group (112 cases). The success rate of trial labor, failure reasons and incidence of maternal and neonatal complications were compared among the three groups. Results: (1) The overall success rate of TOLAC in 440 pregnant women was 75.0% (330/440). The success rates of 0-6, 7-9 and 10-15 groups were 53.2% (50/94), 76.9% (180/234) and 89.3% (100/112), respectively. The success rate of 10-15 group were significantly higher than those of 0-6 and 7-9 groups (all P<0.05). (2) Among the causes of trial labor failure, there were statistically significant differences between the three groups in terms of threatened uterine rupture and maternal abandonment (all P<0.05). Pairings showed that the incidences of threatened uterine rupture and maternal abandonment in 0-6 group was lower than those in 7-9 and 10-15 groups, and the differences were statistically significant (all P<0.05). (3) Maternal and neonatal complications mainly included postpartum hemorrhage and neonatal asphyxia, but there were no significant difference in the incidence of TOLAC success or failure among the three groups (all P>0.05). There was no uterine rupture in all groups. (4) The main factors affecting TOLAC score of pregnant women in the three groups included natural labor, estimated weight of the fetus at this time, Bishop score of the cervix at admission and gestational age, and the scores of the above indexes in 10-15 group were significantly higher than those in 0-6 group and 7-9 group (all P<0.05). Conclusions: TOLAC scoring scale has more accurate evaluation ability for VBAC, which could improve the success rate of TOLAC and maternal and child safety. The score of 0-6 is not recommended for vaginal trial labor, the score of 7-9 is recommended for vaginal trial labor, and the score of 10-15 is strongly recommended for vaginal trial labor.

[Clinical prognostic analysis of 124 adult patients with hemophagocytic lymphohistiocytosis: a multicenter retrospective study of the Huaihai Lymphoma Working Group].

Objective: Factors influencing the prognosis of hemophagocytic lymphohistiocytosis (HLH) in adults were analyzed based on multicentric data. Methods: Clinical data of 124 adult patients with HLH diagnosed in eight medical centers in the Huaihai Lymphoma Working Group from March 2014 to July 2020 were collected. The optimal truncation value of continuous variables was obtained based on the Maxstat algorithm, X-Tile software, and restricted cubic spline. Cox proportional risk regression model was used to construct the adult HLH risk prediction model, and the visualization of the model was realized through the histogram. The bootstrap resampling method was used to verify the model, C-index and calibration curve was used to verify the histogram, and the prediction accuracy was checked. Kaplan-Meier analysis was used to calculate the survival rate and draw the survival curve. Furthermore, the differences between groups were tested by log-rank. Results: The median age of the 124 patients was 55 (18-84) years, including 61 (49.19%) males. The most common etiology was infection. Serum ferritin increased in 110 cases (88.71%) , hepatosplenomegaly in 57 cases (45.97%) . Of the 124 patients, 77 (62.10%) died, and the median survival time of the patients was 7.07 months. Univariate results showed that the prognosis of adult HLH was influenced by sex, age, fibrinogen, serum creatinine, alanine aminotransferase, and albumin (P<0.05) . The results of multivariate analysis showed that gender, platelet, albumin, alanine aminotransferase, and treatment regimens were independent influencing factors for prognosis. Based on the above five risk factors, the prediction model of the histogram was established, and the C-index of the model was 0.739. Finally, the calibration chart showed good consistency between the observed and predicted values of HLH. Conclusion: The prognosis of the adult hemophagocytic syndrome is influenced by many factors. Gender, platelet, albumin, alanine aminotransferase, and treatment regimens are independent risk factors. Therefore, the established histogram provides a visual tool for clinicians to evaluate the prognosis of adult HLH.

[Endovascular treatment strategies for distal entry tear of Stanford type B aortic dissection].

Currently, thoracic endovascular aortic repair (TEVAR) is the first-line treatment for patients with complicated Stanford type B aortic dissections. However, TEVAR does not occlude the distal entry tear of dissections, and blood flow persists in the false lumen. Dissections might progress in some patients. Studies showed that distal entry tear increased the possibility of late aortic events during follow-up. Thus, treatment of distal entry tear is necessary in some high-risk patients after TEVAR. In this article, the current treatment strategies of distal entry tear are summarized, which include PETTICOAT, STABILISE, covered stent, fenestrated and branched stent-grafts, false lumen embolization, vascular occluder, and Knickerbocker. However, the number of the cases of most approaches is so limited that the indications and effectiveness need to be further studied. Selecting the right treatment for the right patient is of great importance.

[Challenges and opportunities of remote diagnosis and treatment management of sleep disordered breathing under the normalization of epidemic situation].

Since the outbreak of coronavirus disease 2019 (COVID-19), the diagnosis and treatment of diseases has been greatly affected. Obstructive sleep apnea hypopnea syndrome (OSAHS) is a common chronic disease, whose diagnosis and treatment methods have changed dramatically during the epidemic period-from traditional outpatient diagnosis and treatment to online remote diagnosis and treatment based on Internet. The diagnostical capability of major sleep centers has increased instead of decreasing. But with the change of diagnosis and treatment mode, privacy, data security, medical insurance policy and other related issues also emerge as the times require. Under the normalization of epidemic situation, telemedicine not only creates new opportunities, but also faces unprecedented challenges.

[Feasibility study of telemedicine model for diagnosis and treatment of patients with obstructive sleep apnea hypopnea syndrome in China].

Objective: To explore the feasibility of applying telemedicine model in disease management for patients with obstructive sleep apnea hypopnea syndrome (OSAHS) in China. Methods: A total of 24 patients were enrolled with suspected OSAHS who were admitted to the Sleep Center of Peking University People's Hospital from October 2015 to September 2016. Patients were diagnosed by electronic questionnaire assessment and home sleep apnea monitoring (HSAT) and were treated with remote automatic positive airway pressure (APAP). After 1 week, 1 month and 3 months of treatment, the patients were followed up by video. The follow-up questionnaire was completed by the patients through an independent data management platform. The APAP treatment data and compliance data were obtained through a built-in digital card of the APAP device. Linear regression model was used to explore the factors related to patient compliance. One-way repeated-measure analysis of variance was used to compare the changes of APAP duration and apnea hypopnea index (AHI) among patients at different treatment time points. Paired t-test was used to compare the EPWORTH scale (ESS) scores before and after treatment. Results: A total of 22 patients were diagnosed with OSAHS, including 20 males (90.9%), aged (45.6±10.2) years and AHI before treatment was (46.9±20.4) times/h. A total of 20 OSAHS patients received APAP treatment, and the proportion of patients with good compliance after 1 week, 1 month and 3 months of treatment were 15/19, 10/19 and 8/18, respectively. The severity of sleepiness before treatment affected compliance. Each 1-point increase in ESS score was associated with a 6.16% (95%CI: 3.01%, 9.31%) increase in compliance. Age, body mass index and AHI before treatment had no effect on compliance (all P values>0.05). The AHI of the patients who had been treated for 1 week, 1 month and 3 months were (2.5±2.1), (2.2±1.6) and (1.9±1.0) times/h, respectively. (P=0.195). After 3 months of treatment, the ESS score was (7.0±3.3), lower than that before treatment (10.6±3.1) (P=0.079). Conclusion: Telemedicine mode of diagnosis and treatment of OSAHS patients has good therapeutic effect and patient compliance, which is practical and feasible.

[Utility of the type 3 portable monitor for the diagnosis of sleep disordered breathing in patients with stable heart failure].

Objective: To evaluate the utility of a type 3 portable monitor (PM) at home for the diagnosis of sleep disordered breathing (SDB) in patients with stable congestive heart failure (CHF). Methods: Seventy-six consecutive patients with CHF (61 males, 15 females, mean±standard deviation age (57.0±16.9) years) were enrolled from the sleep center of Peking university People's Hospital during January 2016 to January 2019, and underwent overnight, unattended home sleep apnea testing (HSAT) with a portable monitor followed by an overnight simultaneous polysomnogram (PSG) with in-laboratory portable monitor (in-lab PM) recording within one week. The consistency of apnea hypopnea index (AHI), obstructive sleep apnea index (OAI), central sleep apnea index (CAI) between HSAT and PSG as well as the in-lab PM and PSG were analyzed by Bland-Altman plot; the sensitivity and specificity of PM for the diagnosis of SDB in patients with CHF were evaluated. Results: The number of patients included in the final analysis were 65 in HSAT, 63 in in-lab PM and 65 in PSG. AHI [M(Q1,Q3)] was 26.1 (10.9,40.1) events/h by HSAT, 27.9 (11.3,43.2) events/h by in-lab PM, both were not different from AHI 29.0 (10.2,45.0) events/h by PSG (P>0.05). The AHI, OAI and CAI assessed by HSAT correlated significantly with those by PSG (r=0.892, 0.903, 0.831, P<0.05). Bland-Altman analysis of AHI, OAI, CAI by PSG versus HSAT showed a mean difference of 3.1 events/h, 0.8 events/h, 1.2 events/h; limits of consistency were -15.2 to 21.4 events/h, -9.7 to 11.3 events/h, -10.9 to 13.2 events/h, respectively. Based on a threshold of AHI ≥5 events/h, HSAT had 94.6% sensitivity, 75% specificity, compared to PSG. For detecting Cheyne-Stokes respiration (CSR), a sensitivity of 96.4%,a specificity of 97.2% were achieved, compared to PSG. Conclusion: Type 3 PM can be used to diagnose SDB in patients with CHF.

[Effects of L-asparaginase on proliferation, cell cycle and apoptosis of Burkitt lymphoma cell lines].

Objective: To investigate the effect of L-asparaginase on the proliferation, cell cycle, and apoptosis of Burkitt lymphoma cell lines and explore the molecular mechanism. Methods: The effect of L-asparaginase on the cell proliferation of Burkitt lymphoma cell lines was detected using the CCK-8 method. The apoptosis rate and cell cycle were detected using flow cytometry. The expression of related molecules in cell cycle, apoptosis, autophagy, and PI3K/Akt/mTOR signaling pathway was detected and analyzed using qPCR and Western blot assay. Results: L-asparaginase significantly inhibited the proliferation of Burkitt lymphoma cell lines and caused cell cycle arrest at G(0)/G(1) phage. L-asparaginase induced cell apoptosis and autophagy in Burkitt lymphoma cell lines. Further results showed that L-asparaginase inhibited the expression of c-Myc and also inhibited the expression of p-PI3K, p-Akt-S473, p-mTOR, p-70S6K, and p-4E-BP1. Combining PI3K inhibitor LY294002 with L-asparaginase further induced apoptosis. Additionally, L-Asp inhibited STAT and ERK signaling pathways. Conclusion: L-asparaginase inhibited Burkitt lymphoma cell proliferation, arrested cell cycle, activated autophagy, and induced apoptosis by inhibiting the PI3K/Akt/mTOR signaling pathway.

Key aroma compounds identified in Cheddar cheese with different ripening times by aroma extract dilution analysis, odor activity value, aroma recombination, and omission.

To determine the odor-active compounds in Cheddar cheeses with different ripening times (6, 10, and 14 mo), 39 potent odorants of Cheddar cheeses were identified with a flavor dilution factor range between 1 and 512 by aroma extract dilution analysis. To further determine their contribution to the overall aroma profile of Cheddar cheeses, odor activity values of 38 odorants with flavor dilution factors ≥1 were calculated. A Cheddar cheese matrix was developed to determine the concentrations and the odor thresholds of these key aroma compounds. The result of the aroma recombinant experiment prepared by mixing the key aroma compounds in the concentrations in which they occurred in Cheddar cheeses showed that the overall aroma profile of the recombinant sample was very similar to that of Cheddar cheese. The main different compounds in Cheddar cheese with different ripening time were acetic acid, butanoic acid, dimethyl trisulfide, methional, hexanal, (E)-2-nonenal, acetoin, 1-octen-3-one, δ-dodecalactone, furaneol, hexanoic acid, heptanal, and ethyl caproate. This study could provide important information for researching and developing Cheddar cheese-related products.

[Clinical effect of nebulized acetylcysteine inhalation combined with bronchoscopy in the treatment of elderly patients with severe ventilator-associated pneumonia].

Objective: To explore the clinical effect of nebulized acetylcysteine inhalation combined with bronchoscopy in treating elderly patients with severe ventilator-associated pneumonia (VAP). Methods: From January 2016 to December 2017, 80 elderly patients with severe VAP who were hospitalized in Zhejiang Hospital were divided into acetylcysteine+ bronchoscopy group [24 males and 16 females, aged (78±7) years] and bronchoscopy group [26 males and 14 females, aged (80±7) years]using random number table for a prospective cohort study. Patients in bronchoscopy group were treated with bronchoscopy in addition to conventional supportive care of symptoms. Patients in acetylcysteine+ bronchoscopy group received nebulized acetylcysteine inhalation therapy on the basis of the treatment given to patients in bronchoscopy group. Patients in both groups received treatment continuously for 7 days. The simplified clinical pulmonary infection score (CPIS) in both groups was assessed before and after treatment. Venous blood of 10 mL was collected before and after treatment to detect leukocyte count, serum C-reactive protein, and procalcitonin. Arterial blood of 1 mL was collected before and after treatment to detect partial arterial oxygen pressure (PaO(2)), partial arterial carbon dioxide pressure (PaCO(2)), oxygenation index. The inhalation platform pressure (Pplat), dynamic lung compliance (Cdyn), airway resistance, work of breathing, time of antibiotic use, and time of mechanical ventilation of patients in two groups were recorded before and after treatment. Data were statistically analyzed with chi-square test and t test. Results: (1) The simplified CPIS, leukocyte count, serum C-reactive protein, and procalcitonin of patients in acetylcysteine+ bronchoscopy group were significantly lower than those in bronchoscopy group after treatment (t=2.32, 2.15, 6.08, 7.12, P<0.05 or P<0.01). The simplified CPIS, leukocyte count, serum C-reactive protein, and procalcitonin of patients in acetylcysteine+ bronchoscopy group and bronchoscopy group after treatment were significantly lower than those before treatment (t=13.76, 13.60, 12.70, 8.32, 11.44, 14.28, 9.48, 9.50, P<0.01). (2) Compared with bronchoscopy group, patients in acetylcysteine+ bronchoscopy group had significantly higher PaO(2) and oxygenation index (t=4.14, 2.55, P<0.05 or P<0.01) but significantly lower PaCO(2) (t=4.36, P<0.01) after treatment. The PaO(2) and oxygenation index of patients in acetylcysteine+ bronchoscopy group after treatment were significantly higher than those before treatment (t=10.90, 43.72, P<0.01). The PaO(2) and oxygenation index of patients in bronchoscopy group after treatment were also significantly higher than those before treatment (t=6.55, 43.03, P<0.01). The PaCO(2) of patients in both groups after treatment were significantly lower than those before treatment (t=21.54, 21.92, P<0.01). (3) The Cdyn of patients in acetylcysteine+ bronchoscopy group after treatment was significantly higher than that in bronchoscopy group (t=5.41, P<0.01), and Pplat, airway resistance, and work of breathing were significantly lower than those in bronchoscopy group (t=2.18, 5.46, 2.49, P<0.05 or P<0.01). The Cdyn of patients in both groups after treatment were significantly higher than those before treatment (t=16.10, 10.90, P<0.01), and Pplat, airway resistance, and work of breathing were significantly lower than those before treatment (t=21.18, 11.13, 9.32, 15.50, 5.17, 5.97, P<0.01). (4)The time of mechanical ventilation and antibiotic usage of patients in acetylcysteine+ bronchoscopy group were (6.9±1.9)and (8.7±2.8) d, respectively, which were significantly shorter than (10.1±2.2) and (11.6±3.5) d in bronchoscopy group (t=6.85, 4.09, P<0.01). Conclusions: Nebulized acetylcysteine inhalation combined with bronchoscopy can significantly control the degree of lung infection in elderly patients with severe VAP, improve patients' respiratory mechanics parameter and blood gas analysis indicator, and shorten the time for mechanical ventilation and antibiotic usage.

Characterization of the key odorants in kurut with aroma recombination and omission studies.

Kurut is a traditional acid-coagulated cheese from the northwest region of China. Using gas chromatography olfactometry and aroma extract dilution analysis, we identified 21 potent odorants from kurut within the flavor dilution factor range of 8 to 256. We developed a kurut matrix to determine the odor thresholds of key aroma compounds in kurut. The odor activity values of these 21 potent volatile compounds revealed that 18 were present at concentrations above their odor threshold values and therefore contributed to the overall aroma of kurut. The result of aroma recombinant experiments prepared by mixing the 18 most important odorants at the concentrations in which they occurred in kurut showed that the overall aroma profile of the recombinant sample was very similar to that of kurut. Omission experiments indicated that acids, furans, esters, and ketones were the most important volatile compounds in kurut. Some aroma compounds-such as butanoic acid, homofuraneol, ethyl hexanoate, and ethyl butanoate-play the most important roles in the overall flavor profile of kurut. Some odorants with a high flavor dilution factor, such as sulfur compounds, may have little effect. The study of key aroma compounds in kurut could provide important information for researching and developing traditional Chinese cheese products.

Research Progress on Age Estimation Based on DNA Methylation.

ABSTRACT: Age estimation is of great significance in the fields of criminal investigation and forensic identification. It can provide the age information of individuals to judicial departments to facilitate the development of judicial work. In recent years, age estimation methods expanded from the morphological level to the molecular biology level. With the rapid development of epigenetics represented by DNA methylation, and the advancement of DNA methylation detection technology together with the detection platform, many age estimation methods based on DNA methylation biomarkers, or using several biological fluids, such as blood, blood stains, saliva, semen stains, etc. are developed. Currently, researches related to age estimation based on DNA methylation are relatively widely carried out. This paper summarizes the researches on age estimation based on DNA methylation, in order to provide references for related studies and forensic applications.

[The association between the whole blood riboflavin level and the occurrence, development and prognosis of esophageal squamous cell carcinoma].

Objective: To investigate the association between the whole blood riboflavin level and the occurrence, development and prognosis of esophageal squamous cell carcinoma (ESCC) in China. Methods: From March 2014 to September 2018, ESCC patients from three hospitals (the Affiliated Hospital of Medical College of Shantou University, Shantou Central Hospital in Southern Chaoshan area and First Affiliated Hospital of Zhengzhou University in Northern Taihang Mountain) were selected as a case group; non-esophageal patients who had a physical examination were selected as a control group. The case and control group were paired by age (±5 years) and a 1:1 ration. A total of 1 528 subjects were enrolled including 764 patients in the case group and 764 patients in the control group. About 3-5 ml venous blood samples were collected, and the erythrocyte glutathione reductase activity coefficient (GRAC) was measured to assess the whole blood riboflavin level. A multivariate conditional logistic regression model was used to analyze the association between the GRAC and the risk of ESCC. The association between the GRAC and the prognosis of ESCC was analyzed by using Cox proportional risk regression model based on 288 patients with complete survival data. They were divided into two groups, the high GRAC group (GRAC≥7.87) group and the low GRAC group (GRAC<7.87) according to the strongest correlation between the total survival time, survival outcome and GRAC (GRAC=7.87). Results: Among the 1 528 patients, 958 patients were from Southern Chaoshan area, including 479 patients in the case group with an average age about (59.90±9.34) years and 479 patients in the control group with an average age about (59.55±8.77) years. Other 570 patients were from Northern Taihang Mountain area, including 285 patients in the case group with an average age (58.39±5.19) years and 285 patients in the control group with an average age about (58.74±4.57) years. The multivariate conditional logistic regression showed that the OR (95%CI) of the GRAC and the risk of ESCC was 1.009 (0.998-1.019). The Cox proportional hazard regression model analysis showed that the HR (95%CI) of the high GRAC group was 1.712 (1.034-2.824) compared with the low GRAC group in the 50-70 years group. Conclusion: The whole blood riboflavin level might not be associated with the occurrence of ESCC. The high whole blood riboflavin level would be more beneficial to the prognosis of ESCC patients aged 50-70 years.

MiR-203 regulates DJ-1 expression and affects proliferation, apoptosis and DDP resistance of pancreatic cancer cells.

OBJECTIVE: DJ-1 is a negative regulator of PTEN and plays a role in tumorigenesis. Abnormal miR-203 expression is associated with pancreatic cancer. Bioinformatics analysis showed a targeted relationship between miR-203 and DJ-1 3'-UTR. This study investigated whether miR-203 regulates DJ-1 expression and its role in pancreatic cancer cell proliferation, apoptosis, and cisplatin (DDP) resistance. MATERIALS AND METHODS: The Dual-Luciferase reporter gene assay validated the targeted regulation between miR-203 and DJ-1. The DDP-resistant cell line SW1990/DDP was established and divided into miR-NC group and miR-203 mimic group followed by analysis of the expression of DJ-1, PTEN and p-AKT, cell apoptosis, and proliferation. RESULTS: There was a targeted relationship between miR-203 and DJ-1 mRNA. The expression of miR-203 in SW1990/DDP cells was significantly lower than that in SW1990 cells, while the expression of DJ-1 mRNA and protein was significantly higher than that in SW1990 cells. Compared with miR-NC group, the expression of DJ-1 and p-AKT protein in SW1990/DDP cells was significantly decreased in miR-203 mimic transfection group, while the expression of PTEN was significantly increased with increased cell apoptosis and decreased cell proliferation, as well as reduced DDP resistance. CONCLUSIONS: The decreased expression of miR-203 and the increased expression of DJ-1 is associated with drug resistance in pancreatic cancer cells. Elevated miR-203 can inhibit the expression of DJ-1, affect the activity of PTEN-PI3K/AKT pathway, inhibit the proliferation of pancreatic cancer cells, induce cell apoptosis, and reduce DDP resistance of pancreatic cancer cells.