[Two cases of Dent disease type 1 with Bartter-like phenotype and literature review].

The clinical presentation, treatment, and follow-up of two boys with type 1 Dent disease who exhibited a Bartter-like phenotype were retropectively analysed. The related literature of pediatric patients with type 1 Dent disease who had hypokalemia and metabolic alkalosis was screened through databases such as PubMed, CNKI, and Wanfang until February 1, 2024, and common features among these patients were summarized through literature review. A total of 7 literatures were included, and 9 children were included in the analysis. All patients were male, presenting with significant low molecular weight proteinuria and hypercalciuria. Other prominent characteristic phenotypes included short stature (7/8), hypophosphatemia (8/9), and rickets (6/8). Seven previously reported patients had missense or nonsense mutations, while 2 patients in this study carried possible pathogenic mutations in the CLCN5 gene, c.315+2T>A (p.?) and c.584dupT (p.I196Yfs*6), respectively. Five patients were able to maintain blood potassium levels around 3 mmol/L with oral potassium chloride solution combined with non-steroidal anti-inflammatory drugs (ibuprofen or indomethacin). The follow-up showed that 2 patients developed chronic kidney disease stage 4 and stage 3 at the age of 13 and 21 years, respectively. The phenotypic overlap between Dent disease and Batter syndrome is considerable,with the distinguishing feature being the presence of significant low molecular weight proteinuria. Patients with type 1 Dent disease presenting with the Bartter-like phenotype have a high prevalence of short stature, hypophosphatemia, and rickets. Non-steroidal anti-inflammatory drugs can be used to correct hypokalemia in patients under periodic renal function assessment.

[Role of mitochondrial autophagy and the curative effect of rehmannia glutinosa leaves total glycoside capsules on nucleos(t)ide drug-induced renal injury].

Objective: To study the curative effect of rehmannia glutinosa leaves total glycoside capsules and the role of mitochondrial autophagy on nucleos(t)ide drug-induced renal injury. Methods: Adefovir dipivoxil (ADV) was used to construct a hepatitis B virus (HBV) transgenic mouse model for renal injury. Renal function was measured in each group at one and two weeks of modeling. Mitochondrial autophagy indicators were measured at two weeks of modeling in renal tissue. Transmission electron microscopy was used to detect mitochondrial autophagy phenomena in renal tissue. The model was established for two weeks. Mouse with renal injury were treated with rehmannia glutinosa leaves total glycoside capsules or isotonic saline for eight weeks by intragastric administration. Renal function was measured. Renal tissue morphology was observed. Mitochondrial autophagy indicators were detected in renal tissue. The protective effect of different concentrations of verbascoside (the main active ingredient of rehmannia glutinosa capsule) was observed on HK-2 cell damage induced by ADV. HK-2 cells were divided into control, ADV, and ADV plus verbascoside groups. The effects of verbascoside at different times and concentrations were observed on the HK-2 mitochondrial autophagy indicators. Fifty patients with chronic hepatitis B were collected who presented with renal injury after treatment with nucleos(t)ide analogs. The random number method was used to divide 29 cases into a control group that received conventional treatment. The treatment group of 21 cases was treated with rehmannia glutinosa leaves total glycoside capsules on the basis of the control group. Serum creatinine (Scr) and urinary protein were detected at eight weeks.The χ(2) test or t-test was used for statistical analysis. Results: Compared with the control group, two weeks of modeling in the ADV group induced renal function injury in HBV mice. The expression of autophagy indicators was higher in the renal tissue of the ADV group than that of the control group. Transmission electron microscopy had revealed mitochondrial autophagy in the renal tissue of the ADV group. Compared with the control group, the renal function of HBV mice treated with rehmannia glutinosa leaves total glycoside capsules improved for two months, and the expressions of autophagy indicators were down-regulated.Verbascoside promoted proliferation in ADV-damaged HK-2 cells, and the expression of autophagy indicators was down-regulated compared with the ADV alone group. In 50 patients with renal function injury, the urinary protein improvement was significantly superior in the treatment group than that in the control group, with eighteen and three cases being effective and ineffective in the treatment group and 12 and 17 cases being effective and ineffective in the control group, with a statistically significant difference (χ(2) = 9.975 0, P = 0.001 6). Serum creatinine was decreased in the treatment group compared with the control group, with 11 and 10 cases being effective and ineffective in the treatment group and 12 and 17 cases being effective and ineffective in the control group, with no statistically significant difference (χ(2) = 0.593 5, P = 0.441 1). Conclusion: Rehmannia glutinosa leaves total glycoside capsule can improve the nucleos(t)ide drug-induced renal function injury in chronic hepatitis B, possibly playing a role via inhibiting PINK1/Parkin-mediated mitochondrial autophagy.

Measurement of the Positive Muon Anomalous Magnetic Moment to 0.20 ppm.

We present a new measurement of the positive muon magnetic anomaly, a_{µ}≡(g_{µ}-2)/2, from the Fermilab Muon g-2 Experiment using data collected in 2019 and 2020. We have analyzed more than 4 times the number of positrons from muon decay than in our previous result from 2018 data. The systematic error is reduced by more than a factor of 2 due to better running conditions, a more stable beam, and improved knowledge of the magnetic field weighted by the muon distribution, ω[over ˜]_{p}^{'}, and of the anomalous precession frequency corrected for beam dynamics effects, ω_{a}. From the ratio ω_{a}/ω[over ˜]_{p}^{'}, together with precisely determined external parameters, we determine a_{µ}=116 592 057(25)×10^{-11} (0.21 ppm). Combining this result with our previous result from the 2018 data, we obtain a_{µ}(FNAL)=116 592 055(24)×10^{-11} (0.20 ppm). The new experimental world average is a_{µ}(exp)=116 592 059(22)×10^{-11} (0.19 ppm), which represents a factor of 2 improvement in precision.

Deep learning for predicting the risk of immune checkpoint inhibitor-related pneumonitis in lung cancer.

AIM: To develop and validate a nomogram model that combines computed tomography (CT)-based radiological factors extracted from deep-learning and clinical factors for the early predictions of immune checkpoint inhibitor-related pneumonitis (ICI-P). MATERIALS AND METHODS: Forty ICI-P patients and 101 patients without ICI-P were divided randomly into the training (n=113) and test (n=28) sets. The convolution neural network (CNN) algorithm was used to extract the CT-based radiological features of predictable ICI-P and calculated the CT score of each patient. A nomogram model to predict the risk of ICI-P was developed by logistic regression. RESULTS: CT score was calculated from five radiological features extracted by the residual neural network-50-V2 with feature pyramid networks. Four predictors of ICI-P in the nomogram model included a clinical feature (pre-existing lung diseases), two serum markers (absolute lymphocyte count and lactate dehydrogenase), and a CT score. The area under curve of the nomogram model in the training (0.910 versus 0.871 versus 0.778) and test (0.900 versus 0.856 versus 0.869) sets was better than the radiological and clinical models. The nomogram model showed good consistency and better clinical practicability. CONCLUSION: The nomogram model that combined CT-based radiological factors and clinical factors can be used as a new non-invasive tool for the early prediction of ICI-P in lung cancer patients after immunotherapy with low cost and low manual input.

Rasch analysis of the Jefferson Teamwork Observation Guide to improve student reflection after interprofessional education.

Interprofessional education is expanding and emerging as a focus of health profession education. The development of instruments to identify competency of students is needed to improve interprofessional collaboration in patient care. Our purpose was to investigate the individual Jefferson Teamwork Observation Guide (JTOG) to determine its psychometric properties. Health profession student data (814 surveys) were analyzed using Rasch Modeling to determine the item and person statistics, unidimensionality, scaling performance, and local independence. The psychometric properties of the instrument were strong, but the current model produced a significant ceiling effect. Adaptations to the instrument were recommended to improve the instruments ability to identify competency and provide individual feedback on performance using a Rasch model. The adapted JTOG has strong psychometric properties to help facilitate reflection and to promote collaborative practice competency.

[A clinical application study of digital manufacturing simple intraoral Gothic arch-tracing device in determining the centric relation of complete dentures].

OBJECTIVE: To verify the consistency between the digital manufacturing simple intraoral Gothic arch-tracing device and the traditional intraoral Gothic arch-tracing device in determining the centric relation of complete dentures restoration. METHODS: Ten outpatients with edentulous jaws were selec-ted, and the centric relation of the patients was determined by digital manufacturing of simple intraoral Gothic arch-tracing device (T1) and traditional intraoral Gothic arch-tracing device (T2); the difference of clinical operation time between the two methods was recorded; the upper and lower edentulous jaw plaster models were scanned with two kinds of centric relation, the Standard Triangle Language (STL) files imported into Geomagic studio software to apply the best fitting of multiple points of the both upper jaw models, the fitted STL files imported into the 3 shape viewer software, and the maximum position deviations of the vertical, labial (buccal) and lingual directions of the mandibular midline area and molar areas in T1 and T2 groups measured. During the clinical complete dentures try-in, we observed whether there was midline deviation in the mouth of T1 group and T2 group, and whether the occlusion of posterior teeth was stable or not. RESULTS: The mean time spent on determining the centric relation of T1 and T2 groups was (41.90±2.64) min, (57.50±2.37) min respectively. Paired t test was conducted in the two groups, P < 0.01 with significant statistical difference; The mean maximum position deviation between T1 group and T2 group of the midline mandibular region in labial lingual direction was (0.32±0.14) mm, that was (0.40±0.23) mm in vertical direction; the mean maximum position deviation of molar area in buccal lingual direction was (0.35±0.23) mm and that was (0.33±0.20) mm in vertical direction. In the vertical and horizontal directions, the maximum position deviation of mandibles between group T1 and group T2 was controlled within 0.5 mm. In the process of clinical complete dentures try-in, there was no deviation from the center line of dentures. There was not warping, swinging and other poor stability phenomena in T1 and T2 groups. CONCLUSION: The digital manufacturing of simple intraoral Gothic arch-tracing device can be used to determine the centric relation of complete dentures, which can not only save time of clinical operation, but also ensure the accuracy of the centric relation.

[Interventional effect and mechanism of fermentation liquid of Dendrobium officinale leaves on alcoholic hepatitis mice].

Objective: To explore the intervention effect and mechanism of Dendrobium officinale leaf fermentation liquid on alcoholic hepatitis (AH) mice. Methods: Seventy inbred C57BL/6J male mice aged 6-8 weeks were selected and randomly divided into normal group (NG), model group (MG), liquid feed control group (CG), silybum group (SI), low-dose group (DL), medium-dose group (DM), and high-dose group (DH) of Dendrobium officinale fermentation liquid, with 10 mice in each group. NG group was given common feed, CG group was given control feed (LB alcoholic liquid control feed), SI group was given LB alcoholic liquid feed and silybum by gavage, DL, DM and DH groups were given LB alcoholic liquid feed and 25%, 50% and 100% concentration of Dendrobium officinale leaf fermentation liquid by gavage. An AH model was established by feeding LB alcoholic liquid feed for 8 weeks.At week 8, alanine Transaminase (ALT), triglyceride (TG), transferrin (TRF), interleukin (IL)-6, IL-10, and IL-1ß, tumor necrosis factor-α(TNF-α), interferon-γ(IFN-γ) were detected in eye blood of mice. Liver tissues were stained with HE, Oil Red O, Prussian blue and immunofluorescence ROS. The contents of glutathione(GSH) and malondialdehyde (MDA) in liver tissue homogenate were detected. To analyze the intervention effect and mechanism of Dendrobium officinale leaf fermentation solution on AH mice, the mRNA and protein relative expression levels of adenylate activated protein kinase (AMPK), AMPKß1, phosphorylated AMPKß1 (p-AMPKß1), tumor suppressor gene p53 (p53), solsolic vector family 7 member 11 (SLC7A11), glutathione peroxidase 4 (GXP4) were detected by polymerase chain reaction (PCR) and Western blot. Results: Compared with MG group, the serum ALT and TG levels in the DL, DM, and DH groups were all reduced [ALT: (45.94±19.85), (45.73±22.62), and (41.68±7.13) vs (75.51±17.76) U/L, respectively; TG: (0.90±0.23), (0.69±0.22) and (0.41±0.20) vs (1.28±0.19) mmol/L, respectively, all P<0.05]; IL-6, IL-1ß, TNF-α, IFN-γ were decreased (all P<0.05). The serum TRF and IL-10 levels in the DM and DH groups were increased (all P<0.05). Compared with MG group, the liver tissue MDA of mice in DL, DM and DH groups was decreased [(0.41±0.05), (0.40±0.03), and (0.43±0.14) vs (0.64±0.06)µmol/g, respectively], GSH was increased (all P<0.05). Compared with MG, mRNA expression levels of AMPK (1.36±0.11, 1.61±0.17, 1.68±0.11 vs 0.80±0.12, respectively), SLC7A11 (0.91±0.12, 0.97±0.12, 0.99±0.13 vs 0.60±0.14, respectively) and GPX4 (0.51±0.11, 0.63±0.17, 0.83±0.15 vs 0.42±0.14, respectively) in the liver tissue of DL, DM and DH groups were all increased (all P<0.05). Compared with MG group, DL, DM and DH groups showed the relative expression levels of AMPKß1, p-AMPKß1, SLC7A11 and GPX4 were increased in the liver tissue of mice, while the relative expression levels of p53 protein were decreased (all P<0.05). Compared with MG group, DL, DM and DH groups reduced the degree of hepatic steatosis and inflammation in the lobules, while the iron and ROS staining in the liver tissue became lighter. Conclusion: Dendrobium officinale leaf fermentation liquid can alleviate the severity of AH in mice, and its mechanism may be related to the up-regulation of AMPK to inhibiting the p53/SLC7A11/GPX4 mediated Ferroptosis pathway.

[Long term results of central hole type posterior chamber intraocular lens in the correction of moderate to high myopia].

Objective: To evaluate the long-term safety,effectiveness,predictability and stability of ICL V4c implantation for moderate to high myopia. Methods: In this retrospective case series study, 95 eyes from 50 patients with moderate to severe myopia who were treated in 2015 underwent central hole type posterior chamber intraocular lens (ICL V4c) implantation at Eye & ENT Hospital of Fudan University. The patients were followed up for a period of five years, during which we assessed various parameters including uncorrected visual acuity (UDVA), corrected visual acuity (CDVA), refractive error, axial length, intraocular pressure, endothelial cell density (ECD), vault, and complications. We used the paired t-test and repeated measures one-way ANOVA in SPSS statistical software to analyze the data. Results: The mean spherical equivalent refraction (SE) decreased significantly from (-12.16±3.04) D preoperatively to (-0.19±0.55) D at one month and (-1.14±0.84) D at five years postoperatively. The safety indices (postoperative CDVA/preoperative CDVA) were 1.24±0.27 and 1.13±0.27, respectively, and the efficacy indices (postoperative UDVA/preoperative CDVA) were 1.14±0.25 and 0.87±0.26 at one month and five years postoperatively. At one month after surgery, 80.00% of the eyes were within ±0.50 D of the expected correction, and 96.84% were within ±1.00 D. There was no significant difference in IOP between preoperative and postoperative measurements. The rate of ECD was 3.87%, and the vault decreased by 106.32 µm at five years postoperatively. Conclusion: ICL V4c implantation is safe and effective with good predictability and stability for long term.

[Course of disease and related epidemiological parameters of COVID-19: a prospective study based on contact tracing cohort].

Objective: To analyze the course of disease and epidemiological parameters of COVID-19 and provide evidence for making prevention and control strategies. Methods: To display the distribution of course of disease of the infectors who had close contacts with COVID-19 cases from January 1 to March 15, 2020 in Guangdong Provincial, the models of Lognormal, Weibull and gamma distribution were applied. A descriptive analysis was conducted on the basic characteristics and epidemiological parameters of course of disease. Results: In total, 515 of 11 580 close contacts were infected, with an attack rate about 4.4%, including 449 confirmed cases and 66 asymptomatic cases. Lognormal distribution was fitting best for latent period, incubation period, pre-symptomatic infection period of confirmed cases and infection period of asymptomatic cases; Gamma distribution was fitting best for infectious period and clinical symptom period of confirmed cases; Weibull distribution was fitting best for latent period of asymptomatic cases. The latent period, incubation period, pre-symptomatic infection period, infectious period and clinical symptoms period of confirmed cases were 4.50 (95%CI:3.86-5.13) days, 5.12 (95%CI:4.63-5.62) days, 0.87 (95%CI:0.67-1.07) days, 11.89 (95%CI:9.81-13.98) days and 22.00 (95%CI:21.24-22.77) days, respectively. The latent period and infectious period of asymptomatic cases were 8.88 (95%CI:6.89-10.86) days and 6.18 (95%CI:1.89-10.47) days, respectively. Conclusion: The estimated course of COVID-19 and related epidemiological parameters are similar to the existing data.

Pregnancy and COVID-19: pharmacologic considerations.

In this review, we summarize evidence regarding the use of routine and investigational pharmacologic interventions for pregnant and lactating patients with coronavirus disease 2019 (COVID-19). Antenatal corticosteroids may be used routinely for fetal lung maturation between 24 and 34 weeks' gestation, but decisions in those with critical illness and those < 24 or > 34 weeks' gestation should be made on a case-by-case basis. Magnesium sulfate may be used for seizure prophylaxis and fetal neuroprotection, albeit cautiously in those with hypoxia and renal compromise. There are no contraindications to using low-dose aspirin to prevent placenta-mediated pregnancy complications when indicated. An algorithm for thromboprophylaxis in pregnant patients with COVID-19 is presented, which considers disease severity, timing of delivery in relation to disease onset, inpatient vs outpatient status, underlying comorbidities and contraindications to the use of anticoagulation. Nitrous oxide may be administered for labor analgesia while using appropriate personal protective equipment. Intravenous remifentanil patient-controlled analgesia should be used with caution in patients with respiratory depression. Liberal use of neuraxial labor analgesia may reduce the need for emergency general anesthesia which results in aerosolization. Short courses of non-steroidal anti-inflammatory drugs can be administered for postpartum analgesia, but opioids should be used with caution due to the risk of respiratory depression. For mechanically ventilated pregnant patients, neuromuscular blockade should be used for the shortest duration possible and reversal agents should be available on hand if delivery is imminent. To date, dexamethasone is the only proven and recommended experimental treatment for pregnant patients with COVID-19 who are mechanically ventilated or who require supplemental oxygen. Although hydroxycholoroquine, lopinavir/ritonavir and remdesivir may be used during pregnancy and lactation within the context of clinical trials, data from non-pregnant populations have not shown benefit. The role of monoclonal antibodies (tocilizumab), immunomodulators (tacrolimus), interferon, inhaled nitric oxide and convalescent plasma in pregnancy and lactation needs further evaluation. © 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Immune profiling of lupus miliaris disseminatus faciei and successful management with anti-tumour necrosis factor therapy.

Lupus miliaris disseminatus faciei (LMDF) is a chronic inflammatory dermatosis of unknown aetiology, most often seen in young adults. Although many treatments for LMDF exist, treatment guidelines have not been developed, and response to therapy is generally unpredictable. We present the results of transcriptomic analysis of LMDF lesional skin, which revealed a variety of differentially expressed genes linking LMDF to alterations in innate and adaptive T helper 1 immunity. Immunohistochemical analysis was also performed, identifying similar changes in T-cell immune responses. Given evidence for increased tumour necrosis factor (TNF) pathway activity, our patient, who had previously been refractory to multiple treatments, was initiated on TNF inhibitor therapy with excellent response. This characterization of the LMDF immune response may lead to improved treatment of this condition.

Physicochemical and functional properties of goat milk whey protein and casein obtained during different lactation stages.

During lactation, goat milk contains colostrum, transitional milk, mature milk, and end milk. The protein present in goat milk during different lactation periods has different characteristics. This study aimed to characterize the protein profile of goat milk samples obtained at different lactation stages and to identify changes in the physicochemical and functional properties of whey protein and casein from goat milk collected at 1, 3, 15, 100, and 200 d after calving. The results demonstrated that the lactation period had a great influence on the physicochemical and functional properties of goat milk whey protein and casein, especially the protein properties of colostrum on the first day after delivery. The denaturation temperature, hydrophobicity, and turbidity of whey protein were significantly higher on the first day postpartum than at other lactation periods. Correspondingly, the colostrum whey protein also had better functional properties, such as emulsification, oil holding capacity, and foaming properties on the first day postpartum than at other lactation periods. For casein, the turbidity, particle size, water holding capacity, and foaming properties on the first day after delivery were significantly higher than those at other lactation periods, whereas the denaturation temperature, oil holding capacity, and emulsification followed the opposite trend. For both whey protein and casein, the 2 indicators of emulsifying properties, namely, emulsifying activity index and the emulsion stability, also followed an opposite trend relative to lactation stage, whereas the changes in foaming capacity with the lactation period were completely consistent with the change of foaming stability. These findings could provide useful information for the use of goat milk whey protein and casein obtained during different lactation stages in the dairy industry.

[Effects of intestinal flora on the degree of infiltration of tumor-infiltrating lymphocytes in breast cancer].

Objective: To investigate whether the abundance or diversity of intestinal flora in breast cancer (BC) patients effects on the degree of tumor infiltration lymphocytes in breast cancer tissues. Methods: Between March 2017 and October 2017, a total of 80 biopsy-confirmed female patients with BC were enrolled in the present study at the Breast Center of the Fourth Hospital of Hebei Medical University (Shijiazhuang, China), age distribution ranged from 37 to 74 years, which were divided into three groups based on the infiltration of tumor-infiltrating lymphocytes, as follows: high infiltration of TILs (TIL-H) 25 cases, medium infiltration of TILs (TIL-M) 34 cases and low infiltration of TILs (TIL-L) 21 cases. DNA of the intestinal flora was determined by Illumina sequencing and taxonomy of 16S ribosomal RNA genes. Compare the differences in the abundance or diversity of intestinal flora between these three groups. The relationship between tumor-infiltrating lymphocytes and clinical characteristics was analyzed by χ2 tested, and the relationship with intestinal flora was analyzed by ß diversity. Results: There were 3, 174, 2, 996, and 2, 877 different OUTs in the TIL-H, TIL-M, and TIL-L groups. The ß-diversity distribution was statistically significant (weighted UniFrac, P<0.01; unweighted UniFrac, P<0.01) when comparing the three groups (TIL-H vs. TIL-M vs. TIL-L), the differences between TIL-L and TIL-H groups were greatest. Conclusions: The infiltration level of tumor-infiltrating lymphocytes in breast cancer patients was closely related to the diversity of intestinal flora.

[Application of diffusion-weighted magnetic resonance imaging in evaluating the efficacy of radiotherapy and chemotherapy for esophageal cancer].

This study was a prospective single arm trial conducted in Zhejiang Jinhua Guangfu hospital from February 2018 to June 2020. A total of 39 patients (32 males and 7 females) with esophageal cancer, aged from 44 to 82 (69±9) years were enrolled. Diffusion weighted magnetic resonance imaging(MR-DWI) was implemented to evaluate the changes of apparent diffusion coefficient(ADC) value before and after chemoradiotherapy. The results showed that the ADC value after chemoradiotherapy was higher than that before treatment[(2.03±0.42)×10⁻³ mm 2/s vs (1.60±0.28)×10⁻³ mm2/s], and there was a positive correlation between the increase of ADC value and the prognosis of patients.

[The association between shift work and lower extremity osteoarthritis among retired workers].

Objective: To investigate the association between shift work and the risk of lower extremity osteoarthritis. Methods: The study population came from the Dongfeng-Tongji cohort established in 2008. In September 2008, the Dongfeng Motor Company in Hubei Province was to recruit all retired workers who voluntarily participated in the survey as the research objects. During the follow-up conducted from April to October 2013, a total of 14 438 retired workers, i.e. all of the participants who underwent physical examination were investigated about demographic characteristics, lifestyles, occupation history, and lower extremity joint-related medical history, and additionally completed lower extremity joint examinations. After excluding individuals with missing data regarding lower extremity osteoarthritis, with the history of lower extremity joint trauma, or with history of rheumatoid arthritis (N=532), data from 13 906 participants was analyzed in the study. Multivariate logistic regression models were used to estimate the association between shift work and lower extremity osteoarthritis. After stratified by the duration of shift work, multivariate logistic regression models were used to analyze the relationship between the duration after leaving from shift work and lower extremity osteoarthritis. Results: Finally, a total of 13 906 retired employees included 7 560 (54.4%) females with a mean age of 64.74 (standard deviation 8.23) years old. 5 537 (39.8%) workers had ever engaged in shift work, including 2 004 (14.4%) workers with 1-9 years of shift work and 3 533 (25.4%) workers with ≥ 10 years of shift work. The prevalence of lower extremity osteoarthritis was 7.0%, while the prevalence of knee osteoarthritis and hip osteoarthritis were 6.7% and 0.7%, respectively. Compared with daytime workers, shift workers showed a 22% increase in the risk of lower extremity osteoarthritis (OR=1.22, 95%CI:1.06-1.40). Each 5-year increase in the duration of shift work was associated with a 4% increase in the risk of lower extremity osteoarthritis (OR=1.04, 95%CI:1.01-1.08). With the extension of the duration after leaving from shift work, the risk of lower extremity osteoarthritis decreased. Similar relationships were found between shift work and the risk of knee osteoarthritis, as well as hip osteoarthritis. Conclusion: Shift work was associated with the increased risk of lower extremity osteoarthritis.

[Adrenocortical oncocytic tumors: a clinicopathological analysis of 44 cases].

Objective: To study the clinicopathological features of adrenocortical oncocytic tumors (ACOT) and to compare the diagnostic values of Lin-Weiss-Bisceglia (LWB) score and Helsinki score. Methods: Forty-four cases of ACOT diagnosed at Beijing Friendship Hospital, China from March 2008 to July 2019 were histologically analyzed to evaluate their malignant potential (benign versus malignant) according to two scoring criteria. Immunohistochemical studies (EnVision method) were also used. Results: There were 23 males and 21 females with an average age of 46 years. Histologically, the tumor cells were arranged in trabecular, chrysanthemum-shaped, glandular and microcapsule structures, while clear cells were rare or absent. Most of the tumor cells were moderately atypical, and intranuclear inclusion bodies were conspicuous. Immunohistochemical staining showed that tumor cells were positive for Melan A, inhibin, Syn and calretinin. The average proliferation index was 3% in benign ACOT, about 5% in ACOT of malignant potential, and>20% in malignant ACOT. According to the LWB score, 61.4% (27/44) of the tumors were on the left side and had multiple lesions. The percentage of benign ACOT was 59.1% (26/44), malignant potential 6.8% (3/44), malignant 34.1% (15/44), respectively. Among the 15 malignant ACOT, the mitotic figures>5/50 HPF were found in 13 cases, necrosis in 11 cases and capsule invasion in 10 cases. According to the Helsinki score, 65.9% (29/44) of the tumors were benign, and 34.1% (15/44) were malignant. There was no significant difference between the two scoring standards (P>0.05). During the follow-up of 9 to 144 months, 31 patients survived without disease and 13 patients relapsed or had metastasis. Conclusions: ACOT more likely be benign than malignant. The left side is more common. Malignant tumors are prone to recurrence and metastasis. The morphological parameters (high mitotic index, necrosis, and capsular invasion) in the LWB scoring standards combined with immunohistochemical parameters (Ki-67) in the Helsinki score are helpful for the diagnosis of malignant ACOT and are important predictors of poor prognosis.

[Exploring effects of natural hyperoxic environment on liver lipid metabolism based on the bile acid-farnesoid X receptor pathway in sub-healthy rats].

Objective: To investigate the effect of natural hyperoxic environment on liver lipid metabolism and liver function based on the bile acid-farnesoid X receptor pathway in sub-healthy rats. Methods: Forty adult male Wistar rats were randomly divided into control group (n = 10) and sub-healthy model group (n = 30). The control group was fed a normal diet, and the model group was fed a high-fat-sugar diet with limited daily activities for 5 weeks. The sub-healthy model was successfully established and the feeding conditions were restored. The hyperoxic intervention group (healthy group) were placed in a natural hyperoxic environment for 7 days. The rats feeding status in the spontaneous recovery group were unchanged. The appearance and exhaustive swimming time were compared before and after in healthy rats. Peripheral blood was collected for biochemical measurement. The fluorescence intensity of FXR and peroxisome proliferator activated receptor α (PPAR α) in liver tissue was detected by fluorescence double staining. Real-time fluorescent semi-quantitative PCR and Western blot were used to detect the RNA and protein expression condition of bile acid-FXR signaling pathway related indicators (FXR, PPARα, and SREBP-1c) in liver tissues. Results: Compared with the control group, the model group had gained body weight, and the vitality was decreased, while triglycerides [TG, (1.18 ± 0.20) mmol/L vs. (0.65 ± 0.12) mmol/L] and total cholesterol [TC, (1.23 ± 0.29) mmol/L vs. (1.00 ± 0.25) mmol/L] level was increased, (P < 0.05), which suggests the presence of hepatic steatosis. TG and TC level in the healthy group and spontaneous recovery group were lower than the model group, and the differences between the healthy group and the model group were statistically significant (P < 0.05). Compared with the model group, the expression of FXR and PPARα in the liver of the healthy and the spontaneous recovery group was enhanced, while the expression of the sterol regulatory element binding protein 1c (SREBP-1c) was decreased. FXR and PPARα mRNA levels in the healthy group and the model group were (9.27 ± 0.26 vs. 6.77 ± 0.20), and (9.71 ± 0.21 vs. 7.09 ± 0.24), P < 0.01, respectively. Compared with the model group, spontaneous recovery group mRNA levels were 7.99 ± 0.30 and 8.44 ± 0.28, P < 0.05, respectively. FXR and SREBP-1c protein levels between the healthy group and the model group were (1.30 ± 0.19 vs.0.43 ± 0.28), and (1.56 ± 0.22 vs. 2.43 ± 0.19), P < 0.01, respectively. Compared with the model group, the FXR and SREBP-1c protein levels of the spontaneous recovery group were 0.81 ± 0.33 vs. 2.10 ± 0.38, P < 0.05, respectively. In addition, natural hyperoxic environment had enhanced liver lipid metabolism and improved lipid disorders. Conclusion: The natural hyperoxic environment have the ability to regulate liver lipid metabolism and can improve mild hyperlipidemia to a certain extent.

[Survival analysis of silicosis patients in Wuxi City].

Objective: To analyze the living condition and influencing factors of silicosis patients in Wuxi City form 1975 to 2019. Methods: Through the monitoring of death causes of residents, the paper-based materials and online report system of diagnosis over the years, and the combination of public security and human social system to obtain 3721 cases of silicosis patients as subjects form August to December 2019. And the combination of Kaplan Meier method and life table method were used to carry out single factor survival analysis. Through Cox regression model to analyze the factors affecting the survival time of patients. Results: From 1975 to 2019, 3721 cases of silicosis and 1274 deaths have been reported in Wuxi City, with a mortality rate of 34.24% and a median survival time of 30.9 years. With the development of diagnosis time, the mortality decreased significantly (χ(2)=747.75, P<0.05) . Compared with the first stage silicosis patients, the risk of decreased survival time of the third stage silicosis patients increased (HR=1.486, P<0.05) . Compared with the non-smoking patients, the risk of decreased survival time of the smoking patients increased (HR=1.136, P<0.05) . Compared with the patients who were less than 30 years old, the risk of decreased survival time of patients with 40-49 years old, 50-59 years old and more than 60 years old were increased (HR=9.641, 13.650, 26.794, P<0.05) . Compared with the patients who received industrial and commercial insurance, the risk of decreased survival time of patients who received compensation from employers, basic medical insurance for urban and rural residents, other social compensation and no compensation were increased (HR=3.137, 3.119, 5.129, 8.442, P<0.05) . Conclusion: The survival time of silicosis patients is related to the stage of silicosis, smoking condition, age of onset and social compensation. We should focus on controlling the above risk factors so as to improve the quality of life of patients and prolong their lives.

[A clinical and pathological report of delayed encephalopathy after heat stroke].

Objective: To explore the clinical manifestations, dynamic neuroimaging changes and brain histopathologic characteristics of a patient with delayed encephalopathy after heat stroke. Methods: In October 2019, the clinical manifestations, electroencephalogram, cerebrospinal fluid, imaging changes and brain histopathological characteristics of a patient with brain damage caused by heat stroke were retrospectively analyzed. Results: The patient was a 40-year-old male who suddenly appeared dizziness, unconscious, high fever when working in the high temperature environment. The EEG showed diffuse slow wave activity. Early CT was normal, and abnormal signals gradually appeared in the basal ganglia region of the thalamus after a few days. In the late, the MRI found a large area of abnormal signals under the cerebral cortex, and white matter was involved. Pathological examination of brain biopsy showed that cortical neuron loss, loose white matter changes, and significant demyelination changes, while no inflammatory cell infiltration was observed in subarachnoid space, meninges, and dermal white matter. Conclusion: Imaging examination dynamic changes of the delayed encephalopathy is important in the heat stroke, and the main pathological manifestation is demyelination.

Epigenetic modulations and lineage plasticity in advanced prostate cancer.

Prostate cancer is the most common cancer and second leading cause of cancer-related death in American men. Antiandrogen therapies are part of the standard of therapeutic regimen for advanced or metastatic prostate cancers; however, patients who receive these treatments are more likely to develop castration-resistant prostate cancer (CRPC) or neuroendocrine prostate cancer (NEPC). In the development of CRPC or NEPC, numerous genetic signaling pathways have been under preclinical investigations and in clinical trials. Accumulated evidence shows that DNA methylation, chromatin integrity, and accessibility for transcriptional regulation still play key roles in prostate cancer initiation and progression. Better understanding of how epigenetic change regulates the progression of prostate cancer and the interaction between epigenetic and genetic modulators driving NEPC may help develop a better risk stratification and more effective treatment regimens for prostate cancer patients.