[Clinical diagnosis and treatment analysis of 21 cases of intrathyroid thymic carcinoma].

Objective: To analyze the clinical efficacy of intrathyroid thymic carcinoma (ITTC). Methods: This study retrospectively analyzed the clinical data of 21 patients with ITTC diagnosed and treated at the First Affiliated Hospital of Zhengzhou University from January 2018 to July 2023, including 9 males and 12 females, with a median age of 52 years (40-60 years old). Results: There is a correlation between the maximum diameter of the tumor (≥40 mm) and lymph node metastasis (P=0.044). Seventeen patients received surgical treatment, and 4 patients only received chemotherapy. During the follow-up period, a total of 4 patients experienced death or progression, with a 2-year mortality or progression free survival rate of 74.8%. Conclusions: The prognosis of ITTC is good, and surgical treatment is the preferred treatment option, lymph node metastasis is significantly correlated with prognosis. The radiotherapy and chemotherapy of ITTC need to be determined based on the patient's condition.

[Development and validation of risk prediction model for new-onset cardiovascular diseases among breast cancer patients: Based on regional medical data of Inner Mongolia].

OBJECTIVE: To develop and validate a three-year risk prediction model for new-onset cardiovascular diseases (CVD) among female patients with breast cancer. METHODS: Based on the data from Inner Mongolia Regional Healthcare Information Platform, female breast cancer patients over 18 years old who had received anti-tumor treatments were included. The candidate predictors were selected by Lasso regression after being included according to the results of the multivariate Fine & Gray model. Cox proportional hazard model, Logistic regression model, Fine & Gray model, random forest model, and XGBoost model were trained on the training set, and the model performance was evaluated on the testing set. The discrimination was evaluated by the area under the curve (AUC) of the receiver operator characteristic curve (ROC), and the calibration was evaluated by the calibration curve. RESULTS: A total of 19 325 breast cancer patients were identified, with an average age of (52.76±10.44) years. The median follow-up was 1.18 [interquartile range (IQR): 2.71] years. In the study, 7 856 patients (40.65%) developed CVD within 3 years after the diagnosis of breast cancer. The final selected variables included age at diagnosis of breast cancer, gross domestic product (GDP) of residence, tumor stage, history of hypertension, ischemic heart disease, and cerebrovascular disease, type of surgery, type of chemotherapy and radiotherapy. In terms of model discrimination, when not considering survival time, the AUC of the XGBoost model was significantly higher than that of the random forest model [0.660 (95%CI: 0.644-0.675) vs. 0.608 (95%CI: 0.591-0.624), P < 0.001] and Logistic regression model [0.609 (95%CI: 0.593-0.625), P < 0.001]. The Logistic regression model and the XGBoost model showed better calibration. When considering survival time, Cox proportional hazard model and Fine & Gray model showed no significant difference for AUC [0.600 (95%CI: 0.584-0.616) vs. 0.615 (95%CI: 0.599-0.631), P=0.188], but Fine & Gray model showed better calibration. CONCLUSION: It is feasible to develop a risk prediction model for new-onset CVD of breast cancer based on regional medical data in China. When not considering survival time, the XGBoost model and the Logistic regression model both showed better performance; Fine & Gray model showed better performance in consideration of survival time.

[Screening for occult cancer in patients with unprovoked venous thromboembolism].

Venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism, is the third most common cardiovascular disease. Unprovoked VTE can be the initial presentation of occult cancer. Up to 10% of patients with unprovoked VTE are diagnosed with cancer within a year. Cancer screening in patients with unprovoked VTE is beneficial for early cancer diagnosis and treatment, which may theoretically reduce cancer-related morbidity and mortality. The epidemiology of occult cancer in patients with unprovoked VTE, screening strategies originated from evidence-based medicine, risk factors of cancer and different models of risk assessment are reviewed in this article.

[Retrospective study on clinical manifestation, thigh MRI and electrophysiology characteristics of immune-mediated necrotizing myopathy].

Objective: To summarize the clinical, thigh magnetic resonance (tMRI) and electromyographic (EMG) characteristics in patients with immune-mediated necrotizing myopathy (IMNM). Methods: A total of 32 IMNM patients who were admitted to the Department of Neurology from April 2019 to April 2021 were enrolled at the First Medical Centre of Chinese PLA General Hospital. According to the type of antibody, the patients were divided into anti-SRP antibody positive (SRP+) group, anti-HMGCR antibody positive (HMGCR+) group and seronegative (SN) group. The gender, age, course of disease, myositis antibodies, extramuscular manifestations, EMG were collected and analyzed among three groups. The characteristics of skeletal muscle were assessed by tMRI inflammatory edema and fat infiltration scores. Analysis of variance, Kruskal-Wallis test and Chi-square test were used to compare the differences in different clinical characteristics and tMRI scores among the three groups. When there was a statistical difference among the three groups, the comparison between the two groups was corrected by the Bonferroni method. Result: (1) Of the 32 patients, 20 were females (62.5%).The median age of onset was 47±14 years, 25 (78.1%) patients had an acute or subacute course.There were 17 (53.1%) with SRP+, 8 (25.0%) with HMGCR+, and 7 (21.9%) with MSAs (myositis specific antibodies) negative. Anti-Ro52 antibody was the most common combined antibody (12/32, 37.5%), among which 10 were in SRP+group.(2) The CK of all patients were elevated, median was 5 948 (4 229, 7 664) U/L. There was no statistical difference of MMT scores among three groups. The proximal limb score was lower than distal limb (P<0.01). The axial muscle score was lower than the distal limb score (P<0.05).(3) Extramuscular manifestations of HMGCR+ group were lower than those of the other two groups (12.5% vs. 71.4% and 76.5%, P<0.017). Rash (60.0% vs.14.3%, P<0.05) and interstitial pulmonary diseases (70.0% vs. 14.3%, P<0.05) were more common in patients with anti-SRP coexistence with anti-Ro52 than those with isolated anti-SRP. Connective tissue disease was more common in SN group (57.1% vs. 11.8% and 0, P<0.017).(4) tMRI showed fascial edema of SN group was more obvious than that of the other two groups (P<0.017). There was no statistical difference in the degree of fat infiltration and inflammatory edema among three groups, but SRP+ group had more cases of early fat infiltration.(5) Myotonic potentials (25.0% vs. 0 and 0, P<0.017) and compound repetitive discharges (CRDs) (50.0% vs. 5.9% and 0, P<0.017) were common in HMGCR+ group. Proteomic analysis found significantly different expressed proteins in skeletal muscle of patients with myotonic potentials or CRDs were associated with cytoskeleton, cell junction and extracellular matrix. Conclusion: IMNM with pure anti-SRP antibody positive and anti-HMGCR positive were mainly affected by skeletal muscles. Those who were co-positive for anti-SRP antibody and anti-Ro52 antibody had more extramuscular manifestations, which might be a special subtype of SRP+ group. This study proposed for the first time that myofascial inflammatory edema is an early sign of SN-IMNM injury. EMG of HMGCR+group were more prone to myotonia potential and CRDs.

Observation of rotational coherence in an excited state of CO.

The vacuum ultraviolet (VUV) radiation is generated in the strong-field-ionized CO molecules through 2+1 resonance excitation with two-color femtosecond laser pulses. When scanning the relative delay between two pump pulses, the rotational-resolved VUV radiations show periodic oscillations lasting as long as 500 ps. Fourier analysis reveals that these oscillations correspond to rotational beat frequencies of the A2Πi state of CO+, which is the result of multi-channel interference during the resonant excitation process. High resolution of Fourier transform spectra up to 0.067cm-1 allows us to obtain the fine energy levels of the A2Πi state. The theoretical calculation is in good agreement with the experimental observation. This work reveals the rotational coherence of the ionic excited state and shows the prospect of rotational coherence spectroscopy in measuring fine structures of molecular ions.

[The study of the association between lung cancer screening and smoking behavior change].

The smoking cessation rate of 1 314 people at high risk of lung cancer in the area of lung cancer screening and early diagnosis and early treatment in Sichuan Province increased from 22.37% at baseline to 41.78% after screening (χ²=227.97, P<0.001), and the smoking amount of persistent smokers decreased from 20 cigarettes per day to 15 cigarettes per day (t=11.76, P<0.001). Those with positive results in lung cancer screening were more likely to quit smoking or continue to quit smoking. Male, younger age or lower education level would increase the risk of continuous smoking or relapse (P<0.05).

[Analysis of the treatment effect of posterior scleral reinforcement on pathological myopia].

Pathological myopia, a blinding eye disease, is the most common cause of visual impairment in Asian countries. The most obvious features of pathological myopia are the elongation of the eye axis, the appearance of posterior scleral staphyloma, and even degenerative changes in the retina and choroid, resulting in corresponding complications and ultimately leading to marked visual impairment. Controlling the elongated eye axis is a key factor in preventing the complications of pathological myopia. Posterior scleral reinforcement is the main surgical method to delay the elongation of the eye axis and treat the posterior scleral staphyloma. Although most studies have confirmed that posterior scleral reinforcement is effective in delaying axial elongation and treating myopia, some scholars hold negative views on this surgery. This article summarizes the relevant research results of posterior scleral reinforcement surgery in the treatment of pathological myopia, concerning patients' vision, refractive power, eye axis, and corneal curvature, and discusses the effectiveness of the surgery. (Chin J Ophthalmol, 2021, 57: 952-957).

[Clinical approach and prognosis of continuous neurological care after intensive care for the patients with severe and refractory anti-N-methyl-D-aspartate receptor encephalitis].

Objective: To study the clinical features, continuous care and prognosis of the patients with severe and refractory anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis after intensive care unit (ICU). Methods: Clinical data of patients with severe and refractory anti-NMDAR encephalitis, who were transferred from ICU to general ward of neurology between December 2015 and October 2019, were retrospectively reviewed and analyzed in the study. Results: Twenty patients (11 females and 9 males) were enrolled in the study. The median course of disease when patients were transferred to general ward was 4.4 (2.0, 6.0) months. Six cases were alert, 6 cases were in a coma, 5 were in the early recovery phase and 3 were in the late recovery phase. Severe malnutrition, pneumonia, urinary tract infections, bedsores and leukocytopenia were common complications. Seven out of 18 patients were tested positive for cerebrospinal fluid anti-NMDAR antibodies with high titers (≥1∶100). During this continuous therapy stage,10 patients were treated with intravenous immunoglobulin (IVIg), 1 with methylprednisolone, 2 with rituximab, 1 with intrathecal methotrexate and 1 received intravenous cyclophosphamide. All Patients were prescribed a long-term immunotherapy (mycophenolate mofetil 1.5-3.0 g/d). Sixteen patients (80%) had good prognosis (modified Rankin Scale (mRS)≤2), and the mortality was 10%, with follow-up time of 17.0 (8.0, 27.0) months. Conclusions: Patients with anti-NMDAR encephalitis, who are transferred from ICU, have severely impaired neurologic function. These patients need long-term individualized immunotherapy and continuous neurological care. Good outcomes can be achieved in most patients.

[Hepatitis B virus X protein regulates lipid metabolism and promotes the proliferation of liver cancer cells via the C/EBPa/SREBP-1 pathway].

Objective: To investigate the role and mechanism of hepatitis B virus (HBV)-encoded X protein (HBx) on the regulation of lipid metabolism and proliferation of human hepatoma cell line HepG2. Methods: HepG2 cells were transiently transfected with HBx expressing plasmid, and the cell proliferation was detected by MTT assay. Lipid droplet accumulation condition was stained by Oil Red O. Western blot was used to detect the protein levels of lipid metabolism-related genes, such as CCAAT/enhancer binding protein α (C/EBPα), sterol regulatory element binding protein-1 (SREBP-1), fatty acid synthetase (FASN) and acetyl-CoA carboxylase (ACC1). Methyl thiazolyl tetrazolium (MTT), Oil Red O staining and western blot were used to detect the effect of HBx on the regulation of lipid metabolism and proliferation of HepG2 cells under the conditions of overexpression and low expression of C/EBPα. Results: HBx had significantly promoted the proliferation of hepatoma cell line HepG2 in dose-and time-dependent manner (F = 32.82, P < 0.001; F = 58.21, P < 0.001). HBx had significantly promoted the lipid accumulation in HepG2 cells (F = 22.65, P < 0.001). Additionally, the protein levels of C/EBPα and SREBP-1 (key regulatory factors of lipid metabolism), and the rate-limiting enzymes FASN and ACC1 were significantly increased. C/EBPα overexpression had further strengthened the effect of HBx on HepG2 cell proliferation, lipid droplet accumulation, and lipid production-related gene expression. On the contrary, C/EBPα low expression had weakened HBx's promotional effect on cell proliferation, lipid droplet accumulation and lipid production-related gene expression. Conclusion: HBx may affect the lipid production and promote the proliferation of human hepatoma cell line HepG2 via the C/EBPa/SREBP-1 signaling pathway.

[Analysis of the level of the core knowledge and related factors of cancer prevention and treatment in the upper gastrointestinal cancer screening area of Sichuan Province in 2018].

Objective: To investigate the level of the core knowledge and related factors of cancer prevention and treatment among residents in the upper gastrointestinal cancer screening areas of Sichuan Province in 2018. Methods: From April to May 2018, a total of 1 386 residents from Chaotian District of Guangyuan, Enyang District of Bazhong, Nanjiang County of Bazhong, Cangxi County of Guangyuan, Shehong County of Suining, Yilong County of Nanchong, Xichong County of Nanchong and Xuanhan County of Dazhou were recruited in this study. A questionnaire survey was conducted to collect basic demographic characteristics and the knowledge of cancer prevention and treatment. The level of the core knowledge of cancer prevention and treatment of different population was analyzed. A multivariate linear regression model was performed to analyze the related factors. Results: In total, 80.9% (1 120) of all subjects was 25-64 years old and 48.0% (665) were male. The total number of questions answered by the subjects was 18 018, of which 12 147 were known, and the overall awareness rate among the respondents was 67.42%. The female respondents, respondentsaged 65 years old and over, with junior college education or above, and worked in government institutions had a good performance of the core knowledge (P<0.05), about 70.11% (6 571/9 373), 69.23% (387/559), 76.05% (6 327/8 320), and 77.09% (5 602/7 267) respectively. The results of multivariate linear regression showed that the older the age [ß=0.871 (95%CI: 0.623-1.119)], the higher the educational level [ß=0.741 (95%CI: 0.540-0.943)], the more questions respondents could know; compared with the workers in government organization and institution, workers in enterprise [ß=-2.913 (95%CI:-3.499--2.327)], farming workers [ß=-0.635 (95%CI:-1.175--0.095)] and other occupation people [ß=-1.126 (95%CI:-1.663--0.589)] could know fewer questions. Conclusion: In 2018, the level of the core knowledge of cancer prevention and treatment among residents in upper gastrointestinal cancer screening areas of Sichuan Province was relatively high. Age, education level and occupation were relevant factors.

[Effect of overexpression of apoptosis-stimulating protein 2 of p53 on activation and apoptosis of hepatic stellate cells induced by transforming growth factor-ß1 and its mechanism].

Objective: To study the effect of apoptosis-stimulating protein 2 of p53 (ASPP2) on the activation and apoptosis of hepatic stellate cells induced by transforming growth factor-ß1 (TGF - ß1), and to explore the role of autophagy in this process. Methods: Mouse hepatic stellate cells were primarily isolated and cultured with green fluorescent protein (GFP) expressing empty vector adenovirus (Ad-GFP) and ASPP2 expressing adenovirus (Ad-ASPP2) for 12 h by transfection kit, and then treated with TGF-ß1 (10ng/ml) for 24 h. The experiments were grouped as follows: control group: green fluorescent protein (GFP) expressing empty vector adeno (Ad-GFP); experimental group 1: transfected with Ad-GFP and added with TGF-ß1; experimental group 2: transfected with Ad-ASPP2 and induced by TGF-ß1. Western blot and quantitative fluorescence PCR were used to detect the expression of ASPP2, α-smooth muscle actin (SMA). At the same time, autophagy was determined by microtubule-associated protein 1 light chain 3-ß (LC3). Autophagy and apoptosis of MHSc were observed by immunocytochemistry and RNA interference (RNAi). Multiple pairwise-comparisons between the mean of groups was performed by one-way ANOVA. Results: The relative expression of α-SMA mRNA in mHSC of TGF-ß1 + Ad-GFP group (16.83 ± 2.41) was significantly higher than Ad-GFP group (3.62 ± 0.56) (P < 0.05), while the relative expression of α-SMA mRNA (4.22 ± 0.48) in TGF-ß1 + Ad-GFP group was significantly lower than TGF-ß1 + Ad-GFP group (P < 0.05). The expression of α-SMA protein in each group was consistent with mRNA expression. The proportion of mHSC autophagy in TGF-ß1 + Ad-GFP group (80%) was significantly higher than Ad-GFP group (35%); however, there was no statistically significant difference between the two groups. The proportion of mHSC autophagy in TGF-ß1 + Ad-ASPP2 group was 42%, which was significantly lower than TGF-ß1 + Ad-GFP group, but the apoptotic rate was significantly increased. Cells were simultaneously treated with autophagy inhibitors 3-MA and TGF-ß1. The level of autophagy was not statistically significantly different from that of TGF-ß1 + Ad-ASPP2 group, but the apoptotic rate was increased. In addition, the RNAi group added with ASPP2 had increased autophagy (LC3-II/LC3-I) than control RNAi group, and the rate of apoptosis was significantly decreased. Conclusion: Overexpression of ASPP2 can alleviate the activation of mHSC and promote the apoptosis of HSC by inhibiting autophagy, so as to alleviate liver fibrosis.

A serine protease homologue Bombyx mori scarface induces a short and fat body shape in silkworm.

Body shape is one of the most prominent and basic characteristics of any organism. In insects, abundant variations in body shape can be observed both within and amongst species. However, the molecular mechanism underlying body shape fine-tuning is very complex and has been largely unknown until now. In the silkworm Bombyx mori, the tubby (tub) mutant has an abnormal short fat body shape and the abdomen of tub larvae expands to form a fusiform body shape. Morphological investigation revealed that the body length was shorter and the body width was wider than that of the Dazao strain. Thus, this mutant is a good model for studying the molecular mechanisms of body shape fine-tuning. Using positional cloning, we identified a gene encoding the serine protease homologue, B. mori scarface (Bmscarface), which is associated with the tub phenotype. Sequence analysis revealed a specific 312-bp deletion from an exon of Bmscarface in the tub strain. In addition, recombination was not observed between the tub and Bmscarface loci. Moreover, RNA interference of Bmscarface resulted in the tub-like phenotype. These results indicate that Bmscarface is responsible for the tub mutant phenotype. This is the first study to report that mutation of a serine protease homologue can induce an abnormal body shape in insects.

Understanding Combustion of H2/O2 Gases inside Nanobubbles Generated by Water Electrolysis Using Reactive Molecular Dynamic Simulations.

This work explored the mechanism of spontaneous combustion of hydrogen-oxygen mixtures inside nanobubbles (which were generated by water electrolysis) using reactive molecular dynamic simulations based on the first-principles derived reactive force field ReaxFF. The effects of surface-assisted dissociation of H2 and O2 gases that produced H and O radicals were examined. Additionally, the ignition outcome and species evolution as a function of the initial system pressure (or bubble size) were studied. A significant amount of hydrogen peroxide (H2O2), 6-140 times water (H2O), was observed in the combustion products. This was attributed to the low-temperature (∼300 K) and high-pressure (2-80 atm) conditions at which the chemical reactions were taking place. In addition, the rate of consumption of H2 and O2 molecules was found to increase with an increase in added H and O radical concentrations and initial system pressure. The rate at which heat was being lost from the combustion chamber (nanobubbles) was also compared to the rate at which heat was being released from the chemical reactions. Only a slight rise in the reaction temperature was observed (∼68 K), signifying that, at such small scales, heat losses dominate. The resulting chemistry was quite different from macroscopic combustion, which usually takes place at a much higher temperatures of above 1000 K.

[Clinical characteristics and outcomes of patients with lung cancer, gastrointestinal cancer and urologic cancer with venous thromboembolism].

Objective: To compare the clinical characteristics and outcomes of patients with lung cancer, gastrointestinal (GI) cancer and urologic cancer with venous thromboembolism (VTE). Methods: From January 2003 to January 2013, 192 lung cancer, GI cancer and urologic cancer patients with VTE were retrospectively evaluated for the clinical characteristics and outcomes. Results: Among 192 patients, 82 cases of lung cancer, 78 cases of GI cancer, 32 cases of urologic cancer were involved. The Eastern Cooperative oncology Group Performance Status score of GI cancer group was significantly higher than those of the lung cancer and urologic cancer groups[(2.4±1.1) vs (2.0±1.4), (1.8±1.0), both P<0.05]. The proportion of smoking patients in lung cancer group was significantly higher than that in GI cancer and urologic cancer groups (79.3% vs 30.8%, 53.1%, both P<0.05), while the proportion of operation was significantly lower than that in the latter two groups (35.4% vs 53.8%, 68.8%, both P<0.05). Pathological types of cancer were mostly adenocarcinoma, and the proportion of adenocarcinoma in lung cancer and GI cancer groups was significantly higher than that in urologic cancer group (76.9%, 73.8% vs 37.9%, both P<0.001). The proportion of moderately and/or poorly differentiated histodifferentiation in the first two groups was significantly higher than that of urologic cancer group (90.0%, 95.7% vs 40.0%, both P<0.001). The proportion of patients with TNM stage Ⅲ-Ⅳ in lung cancer group was significantly higher than that of the urological cancer group (87.0% vs 64.3%, P<0.05). The incidence of VTE in lung cancer group was significantly higher than those of GI cancer and urologic cancer groups within 6 months after tumor diagnosis, chemotherapy and operation (79.3% vs 60.3%, 46.9%; 76.5% vs 48.6%, 36.4%; 92.3% vs 57.9%, 59.1%; all P<0.05). The case fatality rate within one year in lung cancer and GI cancer groups was significantly higher than that in urologic cancer group (51.2%, 52.6% vs 18.8%, both P<0.01). The median survival time of the lung cancer and GI cancer groups was significantly shorter than that of the urological cancer group (P=0.001, 0.010, respectively). Conclusions: Adenocarcinoma, advanced cancer, and poor histodifferentiation are risk factors of VTE in cancer patients. Most events of VTE occur within 6 months after a diagnosis of cancer. The prognosis of lung cancer and GI cancer complicated with VTE is worse than that of urologic cancer with VTE.

[Clinical characteristics and prognosis of overweight and obese patients with pulmonary thromboembolism].

Objective: To investigate the clinical characteristics and outcomes of overweight and obese patients with pulmonary embolism. Methods: This was a retrospective study of patients with pulmonary thromboembolism(PTE) in Beijing Hospital between 2009 and 2017. Data were analyzed and compared based on body mass index (BMI), and patients were classified into normal weight, overweight, and obese. Results: Among 372 patients with PTE, 159 were normal, 143 were overweight and 70 were obese. The mean age was (67.8±13.4) years, and 159(47.0%) were males. There was no significant difference in age, sex, smoking ratio, and underlying disease between the 3 groups (all P>0.05). Chest pain was less frequent in the obese group than the overweight group (P<0.05), and swollen of lower limbs was more prevalent in the obese group than the first 2 groups (all P<0.05). The levels of hemoglobin and hematocrit in the obese group were significantly higher than those in the normal group(P<0.05), while the serum uric acid levels were significantly higher than that in the normal group (P<0.05). Anticoagulation was more frequent in the overweight than the normal group(P<0.05) and Warfarin use was more frequent in the overweight and the obese than the normal group(both P<0.05). The mortality rate was higher in the normal group than those in the overweight and the obese groups (both P<0.01). Multiple logistic regression analysis after adjusting for age and sex showed that malignancy (OR=3.716, 95%CI: 1.733-7.972, P=0.001) and high risk PTE (OR=13.815, 95%CI: 4.093-46.624, P<0.001) were predictors of mortality, whereas anticoagulation (OR=0.155, 95%CI: 0.056-0.428, P<0.001), BMI≥24 (OR=0.142, 95%CI: 0.045-0.446, P=0.001) and BMI≥28 (OR=0.272, 95%CI: 0.085-0.872, P=0.029) were the predictors of survival. Conclusions: Proportion of hypertension, diabetes, coronary heart disease and hyperlipidemia were not significantly different in patients with overweight and obesity compared to patients with normal weight. Obese patients had higher levels of uric acid and hemoglobin than normal weight. Overweight and obese patients had a better survival.

[Retinal image quality in northern rural Chinese adult population].

Objective: To assess the retinal image quality of the normal northern rural Chinese adult population. Methods: A normal population-based, cross-sectional study. From Oct, 2012 to Jan 2013, a clustered, random sampling procedure was used to select normal population who visual acuity≤ 0(LogMAR) and 30-69 years old from 2 villages. All eligible subjects were invited to undergo a comprehensive eye examination, and the retinal image quality related index were examined with pupil 4 mm using objective optical quality analysis systemⅡ(OQAS Ⅱ, Visiometrics, Spain), including MTFcutoff, VA20, VA9, PSF50, PSF10, OSI, SR. And describe the retinal image quality of different age group, including 30-39y, 40-49y, 50-59y, 60-69y. Results: Among 1 108 participants (61.9%) that completed examinations in our center, 681 participants (1 362 eyes) were recruited. There were 146, 586, 440 and 190 eyes in each group. The spherical equivalent refraction of each group was (-0.35±0.84), (-0.19±0.50), (-0.03±0.54) and (0.20±0.71) D. The best corrected vision acuity of each group was -0.02±0.04, -0.01±0.03, -0.01±0.02 and -0.00±0.01. The MTFcutoff of each group was (37.06±9.31), (36.69±8.93), (36.52±9.05) and (32.61±10.08) c/deg. Retinal imaging parameters were significantly different(MTFcutoff: MD=4.45, SR:MD=0.03, PSF50: MD=-0.45, PSF10: MD=-2.87, VA20:MD=0.13, A9:MD=0.09, OSI:MD=-0.41, P<0.001)between aged 30-39 group and aged 60-69 group. Objective scattering index (OSI) were significantly different(MD=-0.13, P=0.004)between aged 30-39 group and aged 50-59 group. Retinal imaging parameters were significantly different(MTFcutoff:MD=4.45, SR:MD=0.03, PSF50:MD=-0.45, PSF10:MD=-2.87, VA20:MD=0.13, VA9: MD=0.09, OSI: MD=-0.41, P<0.001)between aged 40-49 group and aged 60-69 group. Retinal imageing parameters were significantly different(MTFcutoff: MD=4.45, SR: MD=0.03, PSF50: MD=-0.45, PSF10: MD=-2.87, VA20:MD=0.13, VA9:MD=0.09, OSI:MD=-0.41,P<0.001)between aged 50-59 group and aged 60-69 group. Conclusion: Retinal image quality was gradually worse over time in the northern rural Chinese adult population. (Chin J Ophthalmol, 2018, 54:593-598).

Evaluation of tolerance and safety of conversion from mycophenolate mofetil to enteric-coated mycophenolic acid in renal transplant recipients.

This study was designed to evaluate the curative effect of conversion from mycophenolate mofetil (MMF) to enteric-coated mycophenolate sodium tablets (EC-MPS) and its safety. One hundred and twenty renal transplant recipients who developed MMF-associated chronic diarrhea were selected as research subjects and treated with EC-MPS. The patients were followed up for 12 months to compare the improvement of gastrointestinal symptoms and the indexes such as carbon dioxide combining power (CO2CP), serum sodium, serum potassium, serum creatinine (Scr) and 24-h urine protein before and after conversion treatment. One hundred and ten of the 120 patients tolerated the conversion treatment and the dose increment of EC-MPS at week 28. After initiating the conversion treatment, the improvement rate of diarrhea within 2 weeks was 95% (114/120). Indexes, such as CO2CP, serum sodium, serum potassium, after conversion treatment were higher than those before treatment (P less than 0.05). No acute rejection reactions were observed in the 12-month follow-up. Indexes of Scr and 24-h urine protein had significant improvement after conversion treatment compared to before conversion treatment (P less than 0.05). Compared to before treatment, the average values of indexes in gastrointestinal symptom rating scale in the 12th month remained stable, except for the increase of dose. For renal transplant recipients who received suboptimal EC-MPS treatment due to gastrointestinal symptoms, conversion from MMF to EC-MPS can significantly lower gastrointestinal symptom load, improve quality of life, relieve electrolyte disturbance and improve the injured functions of transplanted kidney, without increasing the risks of acute rejection reactions.

Selective-releasing-affected lubricant mechanism of a self-assembled MoS2/Mo-S-C nanoperiod multilayer film sliding in diverse atmospheres.

A self-assembled MoS2/Mo-S-C multilayer film prepared by r.f. co-sputtering of MoS2 and graphite targets was tribotested in diverse sliding atmospheres, and the lubricant mechanism and its correlations to the selective releasing behavior of non-lubricant component were analyzed in detail. Based on the analysis of composition and structural transformation of transferred materials by Raman and HRTEM characterizations, selective releasing behavior according to the sliding atmospheres were found to be particularly apparent in vacuum and dry inert atmospheres. Under these conditions, a-C in graphitic form was selectively released outwards from the topmost surfaces of contacts, leaving MoS2 layers finely reordered in (002) orientation playing a lubricant role. Composition and structural transformation were observed not only on the topmost surface of wear track but also on the underlying layer at a thickness of tens of nanometers. Moreover, it was found that the selective releasing of a-C initiated from the center of contacts with higher pressure, and then developed toward the edges, resulting in a gradual change in the composition and microstructure of the transferred materials from the well-aligned MoS2 layers in the center to the graphitic a-C dominant composites at the edges. The short running-in periods and low-friction performance in all the tribotests suggested that the initial preference of MoS2-riched sublayers in (002) orientation may facilitate the formation of shearless tribofilms and therefore provide a feasible way of structural tailoring in the MoS2-based lubricant films for an improved triboactive response.