Pan-cancer efficacy and safety of anlotinib plus PD-1 inhibitor in refractory solid tumor: A single-arm, open-label, phase II trial.

The combination of immunotherapy and antiangiogenic agents for the treatment of refractory solid tumor has not been well investigated. Thus, our study aimed to evaluate the efficacy and safety of a new regimen of anlotinib plus PD-1 inhibitor to treat refractory solid tumor. APICAL-RST is an investigator-initiated, open-label, single-arm, phase II trial in patients with heavily treated, refractory, metastatic solid tumor. Eligible patients experienced disease progression during prior therapy without further effective regimen. All patients received anlotinib and PD-1 inhibitor. The primary endpoints were objective response and disease control rates. The secondary endpoints included the ratio of progression-free survival 2 (PFS2)/PFS1, overall survival (OS) and safety. Forty-one patients were recruited in our study; 9 patients achieved a confirmed partial response and 21 patients had stable disease. Objective response rate and disease control rate were 22.0% and 73.2% in the intention-to-treat cohort, and 24.3% and 81.1% in the efficacy-evaluable cohort, respectively. A total of 63.4% (95% confidence interval [CI]: 46.9%-77.4%) of the patients (26/41) presented PFS2/PFS1 >1.3. The median OS was 16.8 months (range: 8.23-24.4), and the 12- and 36-month OS rates were 62.8% and 28.9%, respectively. No significant association was observed between concomitant mutation and efficacy. Thirty-one (75.6%) patients experienced at least one treatment-related adverse event. The most common adverse events were hypothyroidism, hand-foot syndrome and malaise. This phase II trial showed that anlotinib plus PD-1 inhibitor exhibits favorable efficacy and tolerability in patients with refractory solid tumor.

Dark2Light: multi-stage progressive learning model for low-light image enhancement.

Due to severe noise and extremely low illuminance, restoring from low-light images to normal-light images remains challenging. Unpredictable noise can tangle the weak signals, making it difficult for models to learn signals from low-light images, while simply restoring the illumination can lead to noise amplification. To address this dilemma, we propose a multi-stage model that can progressively restore normal-light images from low-light images, namely Dark2Light. Within each stage, We divide the low-light image enhancement (LLIE) into two main problems: (1) illumination enhancement and (2) noise removal. Firstly, we convert the image space from sRGB to linear RGB to ensure that illumination enhancement is approximately linear, and design a contextual transformer block to conduct illumination enhancement in a coarse-to-fine manner. Secondly, a U-Net shaped denoising block is adopted for noise removal. Lastly, we design a dual-supervised attention block to facilitate progressive restoration and feature transfer. Extensive experimental results demonstrate that the proposed Dark2Light outperforms the state-of-the-art LLIE methods both quantitatively and qualitatively.

Acquired EML4-ALK fusion and EGFR C797S in cis mutation as resistance mechanisms to osimertinib in a non-small cell lung cancer patient with EGFR L858R/T790M.

The epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) dramatically improve the clinical outcomes of non-small cell lung cancer (NSCLC) patients harboring EGFR -sensitive mutations. Despite the remarkable efficacy of first-and second-generation EGFR TKIs, disease relapse is inevitable. EGFR T790M mutation is a primary contributor to the acquired resistance to first- and second-generation EGFR TKIs. Osimertinib, which is an irreversible third-generation EGFR TKI, was designed for EGFR -activating mutations as well as the EGFR T790M mutation in patients with advanced NSCLC and has demonstrated a convincing efficacy. However, acquired resistance to osimertinib after treatment inevitably occurs. The acquired resistance mechanisms to osimertinib are highly complicated and not fully understood, encompassing EGFR -dependent as well as EGFR -independent mechanisms. Treatment approaches for patients progressing from osimertinib have not been established. We present a case of a stage IV lung adenocarcinoma patient harboring EGFR L858R, acquired T790M after treatment with first-line gefitinib. She then acquired a new EML4-ALK gene fusion after treatment with osimertinib. A combination targeted therapy of osimertinib plus alectinib was initiated, with a progression-free survival of 5 months without any serious adverse reaction. After disease progression, EGFR C797S in cis was detected with a loss of the EML4-ALK fusion by targeted next-generation sequencing. Then therapy was changed to pemetrexed combined with bevacizumab plus camrelizumab, but no obvious effect was observed. The patient had achieved an overall survival of 31 months. As far as we know, this was the first reported case that an EGFR -mutant NSCLC patient-acquired ALK fusion mediating resistance to osimertinib, and sequential EGFR C797S mutation mediating resistance to combined targeted therapy with osimertinib and alectinib. Our case shows that EML4-ALK fusion is a rare but critical resistance mechanism to osimertinib, and C797S mutation in cis may be an underlying mechanism of acquired resistance mutation in double TKIs therapy. Furthermore, molecular detection and rebiopsy play important roles in the selection of therapeutic strategies when the disease progresses.

Decreased GDF9 and BMP15 in follicle fluid and granulosa cells and outcomes of IVF-ET among young patients with low prognosis.

PURPOSE: To analyze the level of growth differentiation factor 9 (GDF9) and bone morphogenetic protein 15 (BMP15) in follicle fluid (FF) and granulosa cells (GCs) derived from young patients with low prognosis for in vitro fertilization and embryo transfer (IVF-ET) treatment. METHODS: A prospective cohort study was carried out by enrolling 52 young patients with low prognosis according to the POSEIDON classification group 3 (low prognosis group) and 51 young patients with normal ovarian reserve (control group). The concentration of the GDF9 and BMP15 proteins in FF was determined by enzyme-linked immunosorbent assay. The mRNA level of the GDF9 and BMP15 in the GCs was measured by quantitative real-time PCR. RESULTS: The concentration of GDF9 (1026.72 ± 159.12 pg/mL vs. 1298.06 ± 185.41 pg/mL) and BMP15 (685.23 ± 143.91 pg/mL vs. 794.37 ± 81.79 pg/mL) in FF and the mRNA level of GDF9 and BMP15 in the GCs and the live birth rate per treatment cycle started (30.77% vs. 50.98%) and oocytes retrieved (4.25 ± 1.91 vs.12.04 ± 4.24) were significantly lower, whereas the canceled cycle rate was significantly higher (9.62% vs. 0) in the low prognosis group compared with the control group (P < 0.05). The expression of GDF9 and BMP15 in the ovary was positively correlated with live birth (P < 0.05). CONCLUSION: The expression of GDF9 and BMP15 in the ovary was decreased in young patients with low prognosis accompanied by a poorer outcome of IVF-ET treatment. TRIAL REGISTRATION: ChiCTR1800016107 (Chinese Clinical Trial Registry), May 11, 2018. ( http://www.chictr.org.cn/edit.aspx?pid=27216&htm=4 ).

Mechanism of subchronic vinyl chloride exposure combined with a high-fat diet on hepatic steatosis.

Vinyl chloride (VC) is a common industrial organic chlorine and environmental pollutant. In recent years, the dietary structure of residents especially Chinese has gradually shifted to western dietary patterns. VC aggravates dietary fatty acid-induced hepatic steatosis, but its mechanism is still unclear. And if the risk factors for steatosis persist, more severe diseases such as fibrosis and cirrhosis will occur. Therefore, we studied the effects and mechanisms of VC (160 and 800 mg/m3 ) and its metabolite (chloroacetaldehyde, 2.25, 4.5, and 9 µM) on hepatic steatosis of high-fat diet (HFD)-fed mice and palmitic acid (PA, 100 µM) treated HepG2 cells. Liver and serum biochemical indicators and pathological staining of the liver showed that the hepatic steatosis of VC combined with HFD groups was more severe than that of single-exposure groups (HFD group, low-dose VC group, and high-dose VC group). Moreover, VC enhanced HFD-induced oxidative stress (OS) and endoplasmic reticulum stress (ERS) and further upregulated the expression of sterol regulatory element-binding protein 1 (SREBP-1) and FAS. Besides, antioxidants and ERS inhibitors reduced the steatosis of HepG2 cells induced by VC metabolites and PA. These results suggest that VC exposure can enhance the degree of hepatic steatosis in HFD-fed mice. VC combined with HFD led to OS and ERS and upregulated the expression of de novo lipogenesis-related proteins, which may be related to the occurrence of hepatic steatosis. And the increased expression of CYP2E1 induced by VC combined with HFD may be the cause of OS.

Migrant adolescents' behavioral problems compared to host adolescents and adolescents in their region of origin: a longitudinal study.

BACKGROUND: Since the 1990s, families from the ecologically hostile mountainous southern areas of Ningxia Province, China, have been migrating to the northern areas of the province. This study compared the prevalence of behavioral problems among migrant adolescents to those among host adolescents (adolescents from the northern areas) and adolescents in the region of origin (adolescents from the southern areas), to determine whether ecological migration is related to adolescent behavioral problems, and possible changes in such problems over time. METHODS: We used the Children and Adolescents Ecological Migration Survey on Mental Health, administered to 4805 students aged 12-16 years and their parents between 2012 and 2014 (W1), of whom 1753 students and their parents completed the follow-up between 2014 and 2017 (W2). Parents answered questions related to adolescent behavioral problems, main source of family income, parents' desire to reverse migrate, improved standard of living, and parents' educational attainment, while children completed the Eysenck Personality Questionnaire and a classroom environment questionnaire. RESULTS: The prevalence of behavioral problems among the migrant adolescents (28.04%) was significantly higher than among host adolescents (21.59%) or adolescents in the region of origin (24.37%; p < 0.001) at W1. After adjusting for gender and age, parents' work outside the home was the main source of family income (OR = 1.42, 95% CI = 1.13-1.78), and adolescents' learning burden (OR = 1.04, 95% CI = 1.01-1.06) in school negatively influenced behavioral problems. Strong student-teacher relationships (OR = 0.97,95% CI = 0.94-0.99) and parents who had no intention to move back to the original residence (OR = 0.70, 95% CI = 0.52-0.94) exerted a protective effect at W1; at W2, a protective effect was associated with improved living conditions (OR = 0.39-0.55, 95% CI = 0.25-0.84). The extent of behavioral problems among migrant adolescents significantly decreased after two years. CONCLUSION: Ecological migration will increase children's behavioral problems in the early stage, with various factors influencing the extent of these problems.

Role of endoplasmic reticulum stress and oxidative stress in vinyl chloride-induced hepatic steatosis in mice.

Vinyl chloride (VC) is a common industrial organochlorine, shown to cause hepatic angiosarcoma and hepatic steatosis. However, the role of endoplasmic reticulum stress (ERS) and oxidative stress (OS) in hepatic steatosis after subchronic exposure to VC in mice, is unclear. Based on body weight, forty healthy SPF male C57BL/6 J mice were randomly divided into a control group and three VC exposure groups (57.3, 286.7, and 1433.6 ppm) (n = 10 each). VC was administered by static inhalation in a 50 L sealed plexiglass inhalation chamber for 2 h per day, five days per week for 16 weeks. Serum and liver tissues were analyzed for liver enzymes and lipids. Hepatic cytochrome P450 2E1 (CYP2E1) and OS related indicators malondialdehyde (MDA), glutathione (GSH), and superoxide dismutase (SOD) were measured. The mRNA expressions of ERS downstream genes, including glycoregulatory protein-78 (GRP-78), sterol regulatory element binding protein-1 (SREBP-1), Acetyl-CoA carboxylase (ACC), and fatty acid synthase (FAS) were detected by real-time PCR (RT-PCR) and their protein levels examined by western blotting. The CYP2E1 levels increased after VC administration in a dose-dependent manner. MDA levels increased (P < .05) and SOD and GSH levels decreased (P < .05) in the liver of each group with the increase in the dose of VC. ERS and expressions of downstream genes (GRP-78, SREBP-1, ACC, and FAS) were enhanced after VC administration. These results suggested that OS and ERS could be induced by VC, which may lead to an increase in fatty acid synthesis in the liver, further aggravating hepatic steatosis.

[Particulate Matters and Non-accidental Emergency Visits in West China Hospital: a Time-Series Study].

OBJECTIVE: To determine the short-term effect of particulate matter of <2.5 µm (PM2.5) and particulate matter of <10 µm (PM10) on non-accidental emergency visits. METHODS: A time-series study analysis with generalized additive model was performed to establish the associations between air pollution (indicated by PM2.5 and PM10) and non-accidental emergency visits in the West China Hospital of Sichuan University over the period from 2014 to 2016, categorized by age (<65 and ≥65 yr.). RESULTS: From January 1, 2014 to November 30, 2016, the Chengdu urban area had an annual average concentration of 66.47 µg/m3 PM2.5 and 109.35 µg/m3 PM10, respectively. The peak short-term effect of particulate matters on non-accidental emergency visits appeared one day after the exposure, with a daily increase of 10 µg/m3 for PM2.5 and PM10 resulting in an increase of 0.634% (95%CI: 0.273%-0.997%) and 0.413% (95%CI: 0.166%-0.660%) non-accidental emergency visits, respectively. For those ≥65 yr., a daily increase of 10 µg/m3 for PM2.5 and PM10 resulted in 1.439% (95%CI:0.599%-2.287%) and 1.150% (95%CI:0.566%-1.738%) increase in non-accidental emergency visits, respectively, after adjustment for all gaseous pollution. CONCLUSION: High levels of PM2.5 and PM10 are associated with increased non-accidental emergency visits. Older people (over 65 years) are more sensitive to the acute health damage associated with PM2.5 and PM10.

[Systematic review of Chuankezhi injection for treating acute exacerbation of chronic obstructive pulmonary disease].

To evaluate the inflammatory factors, the pulmonary function, the efficiency and the safety of Chuankezhi injection for treating acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The randomized controlled trials (RCTs) on Chuankezhi injection for treating AECOPD were collected from 7 databases (PubMed, CNKI, et al) between inception to November 2016. Two reviewers independently screened literature and extracted the data according to the inclusion and exclusion criteria, and assessed methodological quality of included studies according to the criteria from Cochrane Reviewer's Handbook 5.3. Then, Meta-analysis was conducted by using RevMan 5.3 software. A total of 13 RCTs involving 1 016 patients were included. Meta-analysis results indicated that Chuankezhi group was superior to the control group in the clinical effectiveness [RR=1.15, 95% CI(1.06, 1.23), P=0.000 3], improved pulmonary functions including forced expiratory volume in one second (FEV1) [MD=0.21, 95% CI (0.15, 0.27), P<0.000 01], forced vital capacity (FVC) [MD=0.36, 95% CI（0.15, 0.56）, P=0.000 6], the first seconds breathing volume percentage of forced vital capacity (FEV1/FVC) [MD=6.85, 95% CI（4.68, 9.02）, P<0.000 01] and decreased the level of inflammatory factors including interleukin-6 (IL-6) [MD=-6.35, 95% CI (-8.23, -4.47), P<0.000 01], IL-8 [MD = -2.00, 95% CI ( -3.13, 0.87), P=0.000 5], tumor necrosis factor-α (TNF-α) [ MD=-2.79, 95% CI (-4.61,-0.97), P=0.003]. Besides, there were no frequently happened or serious adverse reactions observed in Chuankezhi group. The results showed that Chuankezhi injection could improve the efficiency and the pulmonary function, reduce inflammation for AECOPD with a high safety on the basis of routine symptomatic treatment. However, due to limited quantity and quality of the included studies, the conclusion above should be further verified by conducting more high quality RCTs.

Identification, diagnosis, and early intervention of children with developmental language disorder in Ningxia.

Background: It is reported that the incidence of language development disorder in children at the age of 2 is as high as 17.0%. Timely discovery of the high-risk factors of language development disorder in children and early intervention can greatly reduce the incidence of language development disorder and shorten the course and condition of the patients with language development disorder. Therefore, in order to facilitate prompt diagnosis and early interventions for children with language development disorder (DLD) and improve their language ability, this study explored the influence of perinatal factors on the language development of children in Ningxia and identified the unfavorable and favorable factors that influenced language development. Methods: Children diagnosed in the General Hospital of Ningxia Medical University during 2018-2021 who met the screening criteria for DLD and practical pediatric diagnostic criteria for DLD were enrolled in this study. Perinatal factors (gestational age, weight, sex, delivery mode, maternal age, presence of intrauterine infection, asphyxia) were retrospectively analyzed. The perinatal factors affecting language development were assessed using a one-way analysis of variance (ANOVA). Results: Among 1,500 children aged 0-3, 240 cases (16.00%) had language delay. Of these, 122 were male and 118 were female. There were 115 cases of comprehension and expression disorder, 30 cases of articulation disorder, and 90 cases of mixed manifestation. And there were 194 cases with definite intrauterine and perinatal high-risk factors or neonatal diseases, accounting for 80.83% of the total number of children with language delay. Conclusions: In Ningxia, factors in the neonatal period are the main cause of DLD, followed by fetal and maternal factors. Ischemic encephalopathy is the most common factor.

Ant sting-induced whole-body pustules in an inebriated male: A case report.

BACKGROUND: Many ant species can harm humans; however, only a few cause life-threatening allergic reactions. Normally, reactions caused by ants occur in patients who come into contact with ant venom. Venom contains various biologically active peptides and protein components, of which acids and alkaloids tend to cause anaphylaxis. Ant venom can cause both immediate and delayed reactions. The main histopathological changes observed in ant hypersensitivity are eosinophil recruitment and Th2 cytokine production. CASE SUMMARY: A 70-year-old man was bitten by a large number of ants when he was in a drunken stupor and was hospitalized at a local hospital. Five days later, because of severe symptoms, the patient was transferred to our hospital for treatment. Numerous pustules were observed interspersed throughout the body, with itching and pain reported. He had experienced fever, vomiting, hematochezia, mania, soliloquy, sleep disturbances, and elevated levels of myocardial enzymes since the onset of illness. The patient had a history of hypertension for more than 1 year, and his blood pressure was within the normal range after hypotensive drug treatment. He had no other relevant medical history. Based on the clinical history of an ant bite and its clinical manifestations, the patient was diagnosed with an ant venom allergy. The patient was treated with 60 mg methylprednisolone for 2 d, 40 mg methylprednisolone for 3 d, and 20 mg methylprednisolone for 2 d. Oral antihistamines and diazepam were administered for 12 d and 8 d, respectively. Cold compresses were used to treat the swelling during the process. After 12 d of treatment, most pustules became crusts, whereas some had faded away. No symptoms of pain, itching, or psychological disturbances were reported during the follow-up visits within 6 mo. CONCLUSION: This case report emphasizes the dangers of ant stings.

Prognostic value of tumor mutation burden in patients with advanced gastric cancer receiving first-line chemotherapy.

Background: Tumor mutation burden (TMB) is a promising biomarker positively associated with the benefit of immunotherapy and that might predict the outcome of chemotherapy. We described the prognostic value of TMB in advanced gastric cancer and explored the underlying mechanism. Methods: We enrolled 155 TMB-evaluated advanced gastric cancer patients and analyzed the relationship between clinicopathological characteristics and both overall survival (OS) and progression-free survival (PFS) among 40 patients treated with first-line chemotherapy. We further verified the distribution of TMB and analyzed the potential mechanism underlying the prognosis based on The Cancer Genome Atlas (TCGA) database. Results: Among the 155 patients, 29 (18.7%) were TMB-high (TMB ≥ 10), roughly the same as the proportion in the TCGA data. Of the 40 patients receiving first-line chemotherapy, the median OS (7.9 vs. 12.1 months; HR 3.18; p = 0.0056) and PFS (4.4 vs. 6.2 months; HR 2.94; p = 0.0099) of the tissue-tested TMB (tTMB)-high patients were inferior to those of the tTMB-low patients. Similarly, unfavorable median OS (9.9 vs. 12.1 months; HR 2.11; p = 0.028) and PFS (5.3 vs. 6.5 months; HR 2.49; p = 0.0054) were shown in the blood-tested TMB (bTMB)-high than in the bTMB-low patients. The Cox analysis demonstrated that both tTMB-high and bTMB-high were significant independent predictors of dreadful OS and PFS. The differentially expressed genes (DEGs) according to TMB status were most significantly enriched in the downregulated metabolic pathway among the TMB-high patients. Conclusions: TMB-high advanced gastric cancer patients accounted for around one-sixth and had a poorer prognosis than TMB-low patients when treated with first-line chemotherapy. The potential mechanism might be the downregulated metabolic activity in TMB-high patients.

Status Quo and Analysis of the Cardiovascular Clinical Practice Guidelines/Expert Consensuses of Chinese and Integrative Medicine: A Systematic Review.

OBJECTIVE: To describe and analyze the status quo of cardiovascular clinical practice guidelines or expert consensuses including both Chinese medicine (CM) and integrative medicine, through systematic literatures searching and quality assessment. METHODS: Data bases including Chinese Biomedical Literature Database, the China National Knowledge Infrastructure, Wanfang Data, China Science and Technology Journal Database were searched for published CM or integrative cardiovascular clinical practice guidelines or expert consensuses. The website www. medlive.cn was also retrieved as supplementary. The clinical practice evaluation tool AGREE II was used to assess the quality of included guidelines or consensuses. RESULTS: A total of 31 relevant clinical practice guidelines or expert consensuses were included, covering diagnosis, treatment, Chinese patent and patient fields. Common cardiovascular diseases like coronary heart diseases, heart failure and arrhythmia were also involved. Through analysis it was found that both the quantity and quality of included guidelines have been improved year by year. A total of 4 evidence-based clinical practice guideline has been found, one of which was a guideline project plan. Except that, the remaining 27 reports were all consensus-based guidelines. The scores of each field, from highest to lowest, were clarity of presentation (58%), scope and purpose (54%), stakeholder involvement (28%), rigor of development (21%), applicability (13%) and editorial independence (8%). CONCLUSIONS: Although clinical practice guidelines in cardiovascular domain of Chinese have gained increasing concern, with both quantity and quality improved, there is still huge gap in methodology and reporting standards between CM guidelines and international ones. On the one hand, it is essential to improve and standardize the methodology of developing CM guidelines. On the other hands, the evaluation system of evidence and recommendation with CM characters should be developed urgently.

[Characteristics of Nitrogen and Phosphorus Output and Loss Flux in the Shipanqiu Watershed, Three Gorges Reservoir Area].

As the source of non-point pollution in the Three Gorges Reservoir Area, small watershed is a key control object in alleviating deterioration of water quality. In the Three Gorges Reservoir Area, the Shipanqiu small watershed with various land-use types was selected as the research object, and the water quantity and quality of the outlet section of the watershed were continuously monitored. We carried out analysis of the small watershed runoff loss and nitrogen and phosphorus pollutants with concentration, analyzed the morphology change characteristics of runoff erosion, calculated the small watershed of pollutant emission flux, and analyzed the nitrogen and phosphorus nutrient loss and main human and natural factors, especially in the Three Gorges Reservoir Area of agriculture where nonpoint source pollution research has important practical significance. The results showed that the rainfall in the watershed varied significantly with the seasons, and the rainfall was mainly distributed from April to June, which was the main output period of nitrogen and phosphorus loss in the small watershed, accounting for 58.94% and 67.60% of the total nitrogen and phosphorus load, respectively, in the whole year. The total annual runoff in the Shipanqiu small watershed was 8.02×104 m3, and the annual total nitrogen loss flux was 5.04 kg·hm-2, of which nitrate nitrogen (2.54 kg·hm-2) was the main part. The total phosphorus output was 0.534 kg·hm-2, and the soluble total phosphorus (0.422kg·hm-2) accounted for 79.00% of the total phosphorus flux. The loss flux of total nitrogen was 9.51 times that of total phosphorus, and the non-point source pollution risk of nitrogen was much greater than that of phosphorus. Therefore, for the Shipanqiu small watershed, it is especially important to prevent nitrogen loss in paddy fields when fertilization and rainfall coincide.

Relative Telomere Length in Peripheral Blood Cells and Hypertension Risk among Mine Workers: A Case-Control Study in Chinese Coal Miners.

Hypertension is a common chronic disease in middle-aged and elderly people and is an important risk factor for many cardiovascular diseases. Its pathogenesis remains unclear. Epidemiological studies have found that the loss of telomere length in peripheral blood cells can increase the risk of coronary heart disease, myocardial infarction, and other diseases. However, a correlation between loss of telomere length and hypertension has not been established. In this study, we aimed to explore the association between telomere length and the risk of essential hypertension (EH) in Chinese coal miners. A case-control study was performed with 215 EH patients and 222 healthy controls in a large coal mining group located in North China. Face-to-face interviews were conducted by trained staff with the necessary medical knowledge. Relative telomere length (RTL) was measured by a quantitative real-time PCR assay using DNA extracted from peripheral blood. In the control group, the age-adjusted RTL was statistically significantly lower in miners performing hard physical labour compared with nonphysical labour (P = 0.043). A significantly shorter age-adjusted RTL was found in the control group of participants who consumed alcohol regularly compared with those who do not consume alcohol (P = 0.024). Age-adjusted RTL was negatively correlated with body mass index (BMI) and alcohol consumption. Hypertension was also found to be significantly correlated with factors such as age, BMI, alcohol consumption, smoking, and tea consumption. Our results suggest that RTL is associated with hypertension in coal miners.

Effect of Chinese Medicine on No or Slow Reflow after Percutaneous Coronary Intervention in Myocardial Infarction Patients: A Systematic Review and Meta-Analysis.

OBJECTIVE: To systematic review the effect of Chinese medicine (CM) on no or slow reflow after percutaneous coronary intervention (PCI) in myocardial infarction (MI) patients. METHODS: The PubMed, EMBASE databases, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, China National Knowledge Infrastructure (CNKI), Chinese BioMedical Literature Database (CBM), Wanfang Knowledge Service Platform (Wanfang Database) and Chinese Scientific Journal Database (VIP) were searched up to December 2017. Randomized controlled trials (RCTs) which evaluated the effect of CM therapies on no or slow reflow after PCI in MI patients were included. The primary outcome was the effect of reperfusion. Secondary outcomes were left ventricular ejection fraction, incidence of major adverse cardiovascular events and adverse effect. RESULTS: Ten RCTs covering 814 patients were included. Two studies revealed that the incidence of no or slow reflow was less in Shenmai Injection () group than in the control group measured by thrombolysis in myocardial infarction (TIMI) ⩽ 2 (risk ratio=0.55, 95% confidence interval 0.38 to 0.81, P=0.003, I2=37%). Two studies indicated that Salvianolate Injection showed no additional benefit on no or slow reflow measured by corrected TIMI frame count compared with the conventional treatment (mean difference -4.24, 95% confidence interval -13.03 to 4.54, P=0.34, I2=86%). In addition, Tongxinluo Capsules (), Danhong Injection () and Xuesaitong Injection () may have the potential to reduce no or slow reflow measured during or after PCI in individual studies. CONCLUSIONS: Current evidence from RCTs are not sufficient to evaluate the effect of CM adjuvant therapies on no or slow reflow after PCI for MI patients. The included studies are limited by small sample size and unclear baseline conditions. Further rigorously designed researches and verification studies with sufficient number of patients are warranted.

Poloxamer modified florfenicol instant microparticles for improved oral bioavailability.

Surfactants can improve the hydrophobicity of poorly water-soluble drugs and increase the stability of microparticles by reducing surface tension. This study describes that surfactant-engineered florfenicol instant microparticles (FIMs) increase bioavailability through a micellar solubilization mechanism. The FIMs were prepared by a modified emulsification method, and the optimal prescription was obtained by a combination of single factor investigation and response surface methodology. The microparticles prepared in this study reduce the polymer materials while increasing the drug content. FIM has a smaller particle size and modification of poloxamer, resulting in better solubility and higher bioavailability. The in vitro solubility of FIM is 1.43 times higher than that of the bulk drug, and the dissolution equilibrium can be achieved in 10 minutes. Compared with florfenicol, FIM showed a decrease in Tmax in the plasma concentration curve, with a peak concentration of 1.43 times and an area of 1.41 times. Considering the advantages of in vitro/in vivo performance and ease of preparation, FIMs may have great application prospects in pharmacy research.

[Characteristics of Soil Organic Carbon and Mineralization with Different Stands in Jinyun Mountain].

Soil organic carbon (SOC) is the largest organic carbon stock on land, and slight changes in SOC can significantly affect the atmospheric CO2 concentration, among which forest soil carbon reservoir accounts for approximately 70% of the global soil carbon stock. Therefore, the implementation of efficient management for SOC stock in the forest ecosystem has become a popular research subject. The mineralized characteristics of SOC in different soil layers (0-20, 20-40,40-60, and 60-100 cm) were analyzed in five typical stands of Jinyun Mountain:broadleaf forest, coniferous forest, coniferous and broadleaf mixed forest, bamboo forest, and 15a abandoned grassland (control soils) in the study area. The results showed that forest type, cultivation duration, and soil depth had significant effects on the SOC mineralization rate. The mineralization rate of SOC in different forest stands decreased with the deepening soil layer, among which the mineralization rate at the 0-20 cm soil layer[11.97-25.12 mg·(kg·d)-1] was significantly higher than that of other soil layers (P<0.05), and there were no significant differences between the mineralization rates of other soil layers[4.79-6.51 mg·(kg·d)-1]. The accumulated mineralization of SOC in the five forests decreased with the deepening soil layer. The accumulated mineralization of SOC in the bamboo forest and broadleaf forest in the 0-20 cm soil layer was the highest at 177.66 mg·kg-1 and 120.38 mg·kg-1, respectively. With the deepening soil layer in the 60-100 cm soil layer, the accumulated SOC mineralization in the coniferous forest reached the highest (46.96 mg·kg-1). The SOC mineralization process in the different stands of Jinyun Mountain can be well fitted by the double reservoir first-level kinetic equation. The content of easily decomposable SOC in different forest stands decreased with the deepening soil layer. Coniferous forest soil exhibited a stronger mineralization ability and higher utilization degree of refractory organic carbon stock, while bamboo forest and broadleaf forest soils had higher microbial activity, which could effectively promote the carbon cycle and improve the soil carbon fixation ability.

Association between methylation of DNA damage response-related genes and DNA damage in hepatocytes of rats following subchronic exposure to vinyl chloride.

In the present study, we investigated the association between methylation of DNA damage response-related genes such as cyclin-dependent kinase inhibitor (CDKN)2A, Ras association (RalGDS/AF-6) domain family member (RASSF)1A, O6-methylguanine DNA methyltransferase (MGMT), Kirsten rat sarcoma viral oncogene homolog (KRAS), and spleen-associated tyrosine kinase (SYK) and DNA damage in hepatocytes of rats following subchronic exposure to vinyl chloride (VC). Sixty-four healthy rats were randomly divided into three VC exposure groups (5, 25, and 125 mg/kg) and an untreated negative control group (n = 16 each). VC was administered by intraperitoneal injection every other day for a total of three times a week. Eight randomly selected rats from each group were sacrificed at the end of 6 and 12 weeks, and liver tissue was harvested for the comet assay and for assessment of DNA methylation level and mRNA expression of related genes by PCR. Overall methylation levels in the genome of hepatocytes in VC-exposed rats were higher than those in the control group at 6 and 12 weeks (P < 0.05), although no differences were observed with regarding to dose (P > 0.05). After 12 weeks of exposure, differences in the methylation of RASSF1A and MGMT promoter regions were observed between the high-dose group and other groups (P < 0.05), whereas no differences were observed for the KRAS, SYK, and CDKN2A promoters (P > 0.05). These results suggest that DNA damage and increased genome-wide methylation are biomarkers for VC exposure and that RASSF1A and MGMT promoter methylation is related to the carcinogenic mechanism of VC.

[Effects of Mushroom Residue Application Rates on Net Greenhouse Gas Emissions in the Purple Paddy Soil].

China is the leading country for production of edible mushrooms and also outputs numerous mushroom residues. The recycling of mushroom residue can solve environmental pollution problems, provide nutrients for the farmland, and play an important role in reducing greenhouse gas emissions and increasing soil carbon sequestration capacity. In order to investigate the effects of mushroom residue amounts on net greenhouse gas emissions in purple paddy soil, potted experiments using static opaque chamber and gas chromatography methods were used to study the changes of greenhouse gases, soil carbon sequestration, and net greenhouse gas emissions (NGHGE) in the paddy soil with five treatments: no fertilizer (CK), conventional fertilization (NPK), 9 t·hm-2 mushroom residue+NPK (LM), 18 t·hm-2 mushroom residue+NPK (MM), and 36 t·hm2 mushroom residue+NPK (HM) from March 2017 to September 2017.The results showed that: ① The greenhouse gas emissions (including CH4, CO2, and N2O) increased with increasing additions of mushroom residue. The emissions of CH4 from highest to lowest followed: HM > MM > LM≈NPK > CK. The HM treatment significantly increased the CH4 emission flux (P<0.01) more than the other treatments and showed an obvious single peak curve, while the CH4 emission flux with the LM treatment showed a bimodal curve, and the MM treatment showed a multiple peak curve. The CO2 emission flux followed: MM > NPK≈LM > HM > CK; and the curves for the LM, MM, and HM treatments were a single peak curve, bimodal curve, and multiple peak curve, respectively. The N2O cumulative emission from the NPK treatment was significantly higher than with the other treatments. The N2O emission flux of the NPK treatment was a bimodal curve and that of the HM treatment was a single peak curve, while the N2O emission flux of treatments LM and MM showed multiple peak curves. ② The carbon sequestration capacity with the LM treatment was lower than that of the other treatments and that from the MM treatment was the highest. The carbon sequestration capacity of the MM treatment increased by 59.2% compared to that of the NPK treatment and increased by 87.79% and 65.65% compared to that of the LM and HM treatments. The LM treatment has the highest carbon sequestration capacity, which was higher than that of the NPK and MM treatments and about 2.1 times greater than the CK treatment and HM treatment. ③ The minimum NGHGE value was -490.29 kg·hm-2 for the whole rice production period, and 18 t·hm-2 mushroom residue applied to the soil was the best way to reduce net greenhouse gas emissions in purple paddy soil.