[Effects of biologics on psychological status and quality of life in patients with inflammatory bowel disease: a multicenter study].

Objective: To investigate the effects of biologics on psychological status and quality of life in patients with inflammatory bowel disease (IBD). Methods: A cross-sectional survey was conducted in 42 hospitals in 22 provinces (autonomous regions and municipalities directly under the central government) from September 2021 to May 2022. General clinical information and the use of biologics were obtained from adult patients diagnosed with IBD who voluntarily participated in the study. Psychological status was evaluated using the Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Pittsburgh Sleep Quality Index (PSQI), and Inflammatory Bowel Disease Questionnaire (IBDQ) assessment tools. Counts were analyzed via the Chi-square test, and datasets that were not normally distributed were analyzed via nonparametric tests. P<0.05 was considered statistically significant. Results: A total of 2 478 valid questionnaires were collected. The GAD-7 score of the biologics group was significantly lower than that of the non-use group [6 (2, 9) vs. 7 (3, 10), Z=-3.49, P<0.001]. IBDQ scores [183 (158, 204) vs. 178 (152, 198), Z=-4.11, P<0.001], intestinal symptom scores [61 (52, 67) vs. 58 (49, 65), Z=-5.41, P<0.001], systemic symptom scores [28 (24, 32) vs. 27 (23, 31), Z=-2.37, P=0.018], emotional ability scores [69 (58, 77) vs. 67 (56, 75), Z=-3.58, P<0.001] and social ability scores [26 (22, 29) vs. 25 (22, 29), Z=-2.52, P=0.012] in the biologics group were significantly higher than in the non-use group. GAD-7 scores [5 (2, 9) vs. 6 (3, 10), Z=-3.50, P<0.001] and PSQI scores [6 (4, 9) vs. 6 (4, 9), Z=-2.55, P=0.011] were significantly lower in the group using infliximab than in the group not using it. IBDQ scores were significantly higher in patients using vedolizumab than in those not using it [186 (159, 205) vs. 181 (155, 201), Z=-2.32, P=0.021] and were also significantly higher in the group treated with adalimumab than in the group not treated with adalimumab [187 (159, 209) vs. 181 (155, 201), Z=-2.16, P=0.030]. However, ustekinumab had no significant effect on any of the scores. Conclusion: The use of biologics is strongly associated with improvements in anxiety status and quality of life in IBD patients.

An inguinal hernia 'hard to stomach'.

Inguinal hernias containing the stomach are extremely rare, and have never been described in females. We are reporting the case of a 79 year old female who presented in septic shock with a left inguinal hernia containing the stomach, resulting in gastric perforation and loss of abdominal domain. She underwent emergency exploratory laparotomy with manual reduction of the hernia, wedge resection of the perforated gastric segment, abdominal washout, and closure of the abdominal fascia using biological mesh. She had a complicated but successful postoperative course, and was discharged to a rehabilitation center three weeks after hospital admission.

[Progress in omics research and preclinical models of gallbladder cancer].

Gallbladder cancer(GBC)is one common type of bile tract cancers with poor prognosis. This review summarizes the recent development of studies about somatic mutation, molecular subtype, microenvironment heterogeneity, organoid, orthotopic model, patient-derived xenograft and clinical translation on GBC in aspects of genomic,transcriptome,single cell omics and clinical translation. We expect this review will provide new ideas on dissecting molecular mechanisms underlying the development and emerging chemoresistance of GBC following therapy and promote GBC precision medicine.

Transcriptome dissection of candidate genes associated with lentil seed quality traits.

Lentils provide a rich plant-based protein source and staple food in many parts of the world. Despite numerous nutritional benefits, lentil seeds also possess undesirable elements, such as anti-nutritional factors. Understanding the genetic networks of seed metabolism is of great importance for improving the seed nutritional profile. We applied RNA sequencing analysis to survey the transcriptome of developing lentil seeds and compared this with that of the pod shells and leaves. In total, we identified 2622 genes differentially expressed among the tissues examined. Genes preferentially expressed in seeds were enriched in the Gene Ontology (GO) terms associated with development, nitrogen and carbon (N/C) metabolism and lipid synthesis. We further categorized seed preferentially expressed genes based on their involvement in storage protein production, starch accumulation, lipid and suberin metabolism, phytate, saponin and phenylpropanoid biosynthesis. The availability of transcript profile datasets on lentil seed metabolism and a roadmap of candidate genes presented here will be of great value for breeding strategies towards further improvement of lentil seed quality traits.

Adlay, an ancient functional plant with nutritional quality, improves human health.

Adlay (Coix lacryma-jobi L.), a crop closed related to maize (Zea mays L.) and sorghum (Sorghum bicolor L.), originated in tropical/subtropical regions of Asia and Africa; southwest China primary center of this plant's origin, evolution and migration. Adlay is a traditional high-value minor crop used for both medicinal and dietary purposes. Adlay has anti-tumor, anti-bacterial, anti-inflammatory, analgesic, blood sugar-lowering, and blood lipid-lowering effects. To clarify the main bioactive components and phytochemical compounds and to fully explore their utility, this review summarizes the research done on the main functional ingredients of adlay, including amino acids and proteins, oils, vitamins and minerals, polysaccharides, and polyphenols. This study also highlighted the application of genome sequencing to tailor nutrient-rich adlay cultivars and nutraceutical product development. Additionally, the acquisition of high-density genomic data combined with next-generation phenotypic analysis will undoubtedly improve our understanding of the potential genetic regulation of adlay nutraceutical traits. This review provides new insights and ideas for the research of adlay in comparison and evolutionary genomics, and a useful reference for molecular breeding and genetic improvement of this important minor crop.

Coping with COVID-19 in United Nations peacekeeping field hospitals: increased workload and mental stress for military healthcare providers.

INTRODUCTION: This study aimed to explore the impact of COVID-19 on the United Nations peacekeeping field hospitals where medical supply and manpower are extremely insufficient. METHODS: A level II hospital was deployed in Wau, South Sudan, as the regional referral centre of the United Nations Mission in South Sudan (UNMISS). It had a total strength of 63 personnel with 47 medical staff (average age 38.3±8.0 years, 33 men). A new 'appointment-triage-disinfection' work pattern was adopted to cope with the COVID-19 outbreak in the mission. Data on medical service statistics and workload before/after the outbreak were collected and compared. The mental health of staff was analysed from the quarterly psychological survey, including Perceived Stress Scale (PSS)-10, Generalised Anxiety Disorder (GAD)-7 and Patient Health Questionnaire (PHQ)-9. RESULTS: The number of outpatients decreased slightly after the COVID-19 outbreak (41.9±11.9 to 37.6±11.8 per week, p=0.49), whereas the weekly hospital length of stay of inpatients increased significantly (0.4±1.0 to 3.1±3.9 days, p=0.02). Total weekly working hours increased from 1884.9±34.1 to 2023.5±67.3 hours (p<0.001). Elevated mental stress (PSS-10: 4.3±2.4 in February to 7.5±3.9 in May, p<0.001; GAD-7: 4.0±2.3 to 9.4±4.0, p<0.001; PHQ-9: 2.1±1.2 to 3.2±2.4, p<0.001) was documented among healthcare providers after the outbreak. The threat of COVID-19 infection, delay in rotation and family-related concerns constituted the main stressors. CONCLUSION: COVID-19 imposes a huge pressure on peacekeeping field hospitals. Increased workload and mental stress among frontline healthcare providers deserve the attention of UNMISS officials. Facilitating the rotation of the medical staff might potentially improve the operational readiness of the hospital by bringing in well-trained personnel and sufficient medical supplies.

Medullary Thyroid Cancer in Patients Older than 45-Epidemiologic Trends and Predictors of Survival.

Sporadic medullary thyroid cancer (MTC) can occur anytime in life although they tend to present at a later age (≥45 years old) when the tumors are more easily discernible or become symptomatic. We aimed to identify the factors affecting the survival in patients ≥45 years of age diagnosed with MTC. We analyzed the Surveillance, Epidemiology, and End Results (SEER) registry from 1973-2016 focusing on patients ≥45 years of age with MTC as an isolated primary. A total of 2533 patients aged ≥45 years with MTC were identified. There has been a statistically significant increase of 1.19% per year in the incidence of MTC for this group of patients. The disease was more common in females and the Caucasian population. Most patients had localized disease on presentation (47.6%). Increasing age and advanced stage of presentation were associated with worse survival with HR 1.05 (p < 0.001) and HR 3.68 (p < 0.001), respectively. Female sex and surgical resection were associated with improved survival with HR 0.74 (p < 0.001) and 0.36 (p < 0.001), respectively. In conclusion, the incidence of MTC in patients ≥45 years of age is increasing. Patients should be offered surgical resection at an early stage to improve their outcomes.

Sleep disturbances among medical workers during the outbreak of COVID-2019.

BACKGROUND: The outbreak of Corona Virus Disease-2019 (COVID-19) has posed unprecedented pressure and threats to healthcare workers in Wuhan and the entire country. AIMS: To assess the effect of the COVID-19 outbreak on the sleep quality of healthcare workers in a children's healthcare centre in Wuhan. METHODS: A cross-sectional, anonymized, self-reported questionnaire survey was conducted at the Children's Healthcare Centre of Renmin Hospital, Wuhan University, Wuhan, China. The questionnaire consisted of three parts, including socio-demographic characteristics and COVID-19 epidemic-related factors, the Pittsburgh sleep quality index (PSQI), and Zung's self-rating anxiety scale (SAS) and self-rating depression scale (SDS). RESULTS: In total, 47 out of 123 (38%) participants with PSQI scores > 7 were identified as having sleep disturbance. A logistic regression analysis showed that sleep disturbance was independently associated with being an only child (adjusted odds ratio (OR) and 95% confidence interval (CI) 3.40 (1.21-9.57), P < 0.05), exposure to COVID-19 patients (adjusted OR and 95% CI 2.97 (1.08-8.18), P < 0.05) and depression (adjusted OR and 95% CI 2.83 (1.10-7.27), P < 0.05). CONCLUSIONS: We observed that, during the outbreak of COVID-19, sleep disturbance was highly prevalent among paediatric healthcare workers, and sleep disturbance was independently associated with being an only child, exposure to COVID-19 patients and depression. Therefore, more mental health services are required for front-line paediatric healthcare workers in Wuhan.

[Research progress in surface bonding pretreatment of dental zirconia ceramics].

Yttria stabilized tetragonal zirconia polycrystal ceramics is widely used in the field of dentistry because of its excellent mechanical properties and biocompatibility. However, it has low hydroxyl content and does not contain silica. Therefore micro mechanical retention induced by hydrofluoric acid etching on its surface is not applicable. The bonding of zirconia is a difficult problem. Zirconia surface pretreatment is commonly used to improve bonding strength and durability. This review summarizes surface pretreatment of dental zirconia ceramic including air abrasion, laser etching, acid etching, silica coating, non-thermal plasmas treatment, et al. In addition, it presents advantages and disadvantages of each treatment, provides guidance for application and future research directions.

[A pathological report of three COVID-19 cases by minimal invasive autopsies].

Objective: To investigate the pathological characteristics and the clinical significance of novel coronavirus (2019-nCoV)-infected pneumonia (termed by WHO as coronavirus disease 2019, COVID-19). Methods: Minimally invasive autopsies from lung, heart, kidney, spleen, bone marrow, liver, pancreas, stomach, intestine, thyroid and skin were performed on three patients died of novel coronavirus pneumonia in Chongqing, China. Hematoxylin and eosin staining (HE), transmission electron microcopy, and histochemical staining were performed to investigate the pathological changes of indicated organs or tissues. Immunohistochemical staining was conducted to evaluate the infiltration of immune cells as well as the expression of 2019-nCoV proteins. Real time PCR was carried out to detect the RNA of 2019-nCoV. Results: Various damages were observed in the alveolar structure, with minor serous exudation and fibrin exudation. Hyaline membrane formation was observed in some alveoli. The infiltrated immune cells in alveoli were majorly macrophages and monocytes. Moderate multinucleated giant cells, minimal lymphocytes, eosinophils and neutrophils were also observed. Most of infiltrated lymphocytes were CD4-positive T cells. Significant proliferation of type Ⅱ alveolar epithelia and focal desquamation of alveolar epithelia were also indicated. The blood vessels of alveolar septum were congested, edematous and widened, with modest infiltration of monocytes and lymphocytes. Hyaline thrombi were found in a minority of microvessels. Focal hemorrhage in lung tissue, organization of exudates in some alveolar cavities, and pulmonary interstitial fibrosis were observed. Part of the bronchial epithelia were exfoliated. Coronavirus particles in bronchial mucosal epithelia and type Ⅱ alveolar epithelia were observed under electron microscope. Immunohistochemical staining showed that part of the alveolar epithelia and macrophages were positive for 2019-nCoV antigen. Real time PCR analyses identified positive signals for 2019-nCoV nucleic acid. Decreased numbers of lymphocyte, cell degeneration and necrosis were observed in spleen. Furthermore, degeneration and necrosis of parenchymal cells, formation of hyaline thrombus in small vessels, and pathological changes of chronic diseases were observed in other organs and tissues, while no evidence of coronavirus infection was observed in these organs. Conclusions: The lungs from novel coronavirus pneumonia patients manifest significant pathological lesions, including the alveolar exudative inflammation and interstitial inflammation, alveolar epithelium proliferation and hyaline membrane formation. While the 2019-nCoV is mainly distributed in lung, the infection also involves in the damages of heart, vessels, liver, kidney and other organs. Further studies are warranted to investigate the mechanism underlying pathological changes of this disease.

Passive drainage to gravity and closed-suction drainage following pancreatoduodenectomy lead to similar grade B and C postoperative pancreatic fistula rates. A meta-analysis.

INTRODUCTION: There is no level 1a evidence regarding the impact of passive drainage to gravity (PDG) and closed-suction drainage (CSD) following pancreatoduodenectomy on clinical outcomes. The aim of this meta-analysis was to evaluate the impact of PDG versus CSD on surgical outcomes following pancreaticoduodenectomy in high risk patients who would benefit from pancreatic drainage. METHODS: The Pubmed, EMBASE, and Cochrane Library were systematically searched. Postoperative pancreatic fistula (POPF) rate was the primary endpoint. A subgroup meta-analysis of randomized controlled trials (RCT) was performed in addition to a meta-analysis of all eligible studies. Mantel-Haenszel method (random-effects model) with odds ratios and 95% confidence intervals (OR (95%CI)) as an effect measure was utilized. RESULTS: Six studies, whereof 3 RCTs, involving 1519 patients (806 PDG and 713 CSD) were included. In meta-analysis of all studies, overall [OR (95%CI) = 0.81 (0.42, 1.56); p = 0.53; I2 = 79%; Tau2 = 0.54]; grade A [OR (95%CI) = 0.71 (0.33, 1.53); p = 0.39; I2 = 65%; Tau2 = 0.47]; grade B [OR (95%CI) = 1.23 (0.74, 2.05); p = 0.42; I2 = 0%]; and grade C [OR (95%CI) = 1.08 (0.56, 2.09); p = 0.82; I2 = 5%] POPF rates did not differ. Subgroup analysis of RCTs confirmed the finding that grade B and C POPF rates did not significantly differ with low heterogeneity [OR (95%CI) = 1.55 (0.79, 3.04); p = 0.20; I2 = 0%]. No publication bias was found (t = 0.48; p = 0.64). CONCLUSION: This meta-analysis found no difference in short-term clinical outcomes including, clinically relevant, grade B and C POPF rates between PDG and CSD. Furthermore, postoperative complication rates were similar with the use of either drain.

A novel double-variant RHAG allele leads to Rhmod phenotype.

AIMS/OBJECTIVES: We aimed to analyse the molecular backgrounds and red blood cell (RBC) antigen expression of a male blood donor with Rhmod phenotype and his family members. BACKGROUND: Rh deficiency phenotypes are rarely found worldwide and are characterised by the lack of Rh antigen expression on RBCs. During routine screening, we found a blood donor who seemingly lacked Rh antigens. Therefore, we recruited the donor and his family for further investigation. METHODS: RBC serotyping and antibody screening/identification were performed for each sample. A routine blood examination was also conducted. RHD, RHCE and RHAG were sequenced at the genomic DNA or RNA level. Eleven antigens or proteins associated with Rh complex were tested using flow cytometry analysis. RESULTS: The proband and one of his brothers showed extremely weak D antigen and Rh expression levels but did not manifest anaemia. Most of the expressed RBC antigens of the two Rh-deficient individuals were similar to the previously reported cases but with some exceptions. Molecular analyses demonstrated homozygous expression of a novel RHAG allele, namely, c.[572G>A;707A>C], both in the proband and one of his brothers. CONCLUSIONS: To our knowledge, we identified the second double-variant RHAG allele and the first one related to Rhmod phenotype. The novel allele was also confirmed to be heritable by family analyses.

Down-regulation of miR-320 exerts protective effects on myocardial I-R injury via facilitating Nrf2 expression.

OBJECTIVE: Nuclear factor NF-E2 related factor 2 (Nrf2) plays crucial roles in the regulation of oxidative stress (OS) or myocardial ischemia-reperfusion (I-R) injury. During the process of I-R injury, the miR-320 is down-regulated. Bioinformatics analysis showed complementary binding sites between miR-320 and 3'-UTR of Nrf2 mRNA. Therefore, this study aimed to investigate the role of miR-320 in mediating Nrf2 expression and myocardial I-R injury. MATERIALS AND METHODS: Rat I-R model was established. Fluorescent quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) and Western blot were used to measure the expression of miR-320, Nrf2, HO-1 in myocardial tissues. Contents of malondialdehyde (MDA), superoxide dismutase (SOD) and caspase-3 activity, serum assay of creatine kinase (CK) and lactate dehydrogenase (LDH) activity were evaluated. I-R rat models were transfected with antagomir-320 followed by measuring those proteins. Cultured H9C2 cells were transfected with antagomir-320 to measure miR-320, Nrf2 and heme oxygenase 1 (HO-1) expression, cell apoptosis and reactive oxygen species (ROS) content. RESULTS: Compared to the sham group, I-R rats had significantly lower miR-320 or HO-1 expression in the myocardium, plus higher levels of Nrf2, MDA, CK and LDH, and decreased SOD activity (p<0.05). Antagomir-320 transfection suppressed miR-320 expression, elevated Nrf2 and HO-1 expression, decreased levels of MDA, CK or LDH, and increased SOD activity. In H9C2 cells, antagomir-320 transfection also elevated Nrf2 and HO-1 expression and suppressed myocardial cell apoptosis or ROS production under I-R treatment. CONCLUSIONS: Down-regulation of miR-320 exerts protective effects on myocardial I-R injury. The inhibition of mir-320 expression can enhance OS potency of the myocardium, alleviate I-R injury or reduce cell apoptosis by facilitating Nrf2 expression.

The correlation between estrogen receptor gene polymorphism and osteoporosis in Han Chinese women.

OBJECTIVE: To uncover the role of estrogen receptor gene polymorphism in the onset of osteoporosis in Han Chinese women. PATIENTS AND METHODS: A total of 122 osteoporosis woman patients who were admitted to this hospital between April 2016 and April 2017 were enrolled in this study as the case group, and during the same period, 106 healthy counterparts who took physical examination as the control group. With the genetic samples collected from subjects in two groups, we detected the polymorphisms of Pvu II and Xba I in the estrogen receptor alpha (ERα) gene and the Rsa-I and Aiu-I polymorphisms in the ERß gene by Restriction Fragment Length Polymorphism (RFLP), and the related-alleles frequency in subjects carrying the genotype of Pvu-1I and Xba-I polymorphisms in the ERα gene or the genotype of Rsa-I and Alu-I polymorphisms in the ERß gene in the two groups. RESULTS: Comparison of genotype frequencies pp, Pp, and PP of ERα Pvu-II polymorphisms between the case group and the control group showed the differences were statistically significant (p < 0.05), in which the P allele in the case group had a higher frequency than that in the control group (p < 0.05). However, comparisons of the genotype frequencies of xx, Xx, and XX of ERα Xba-I polymorphisms between the case group and the control group showed no statistically significant differences (p > 0.05), and similar results were also found in comparison of the genotype frequencies of rr, Rr, and RR of Rsa-I polymorphisms (p > 0.05). By the comparison of genotype frequencies of ERß Alu-I and Rsa-I polymorphisms in the case group with those in the control group, and by the comparison of genotype frequencies aa, Aa, and AA of ERß Alu-I polymorphisms in the case group with those in the control group, all the differences were statistically significant (p < 0.05 ). CONCLUSIONS: In Han Chinese women, susceptibility to osteoporosis may be affected by ERα Pvu-II polymorphisms and ERß Alu-I polymorphisms; those carrying genotypes containing A and P alleles may have a higher risk in osteoporosis.

The transcriptional landscape of polyploid wheat.

The coordinated expression of highly related homoeologous genes in polyploid species underlies the phenotypes of many of the world's major crops. Here we combine extensive gene expression datasets to produce a comprehensive, genome-wide analysis of homoeolog expression patterns in hexaploid bread wheat. Bias in homoeolog expression varies between tissues, with ~30% of wheat homoeologs showing nonbalanced expression. We found expression asymmetries along wheat chromosomes, with homoeologs showing the largest inter-tissue, inter-cultivar, and coding sequence variation, most often located in high-recombination distal ends of chromosomes. These transcriptionally dynamic genes potentially represent the first steps toward neo- or subfunctionalization of wheat homoeologs. Coexpression networks reveal extensive coordination of homoeologs throughout development and, alongside a detailed expression atlas, provide a framework to target candidate genes underpinning agronomic traits in wheat.

Expression of APOB, ADFP and FATP1 and their correlation with fat deposition in Yunnan's top six famous chicken breeds.

1. Adipose differentiation related protein (ADFP), fatty acid transport protein 1 (FATP1) and apolipoprotein B (APOB) are suspected to play an important role in determining intramuscular fat and in overall meat quality. 2. Yunnan's top six famous chicken breeds (the Daweishan Mini, Yanjin Black-bone, Chahua, Wuding, Wuliangshan Black-bone and Piao chicken) are known for the high quality of their meat, but little is known about their expression of these three genes. 3. The present study aimed to examine the ADFP, FATP1 and APOB genes in different tissues of these six breeds at different development stages. The subcutaneous fat from the back midline and front, abdominal fat, liver and muscle tissue was sampled at 28, 49, 70, 91 and 112 days. The expression of ADFP, FATP1 and APOB was measured by real-time PCR. 4. The results showed that the expression of the three genes differed depending on age, tissue types and breeds. However, the expression of the three genes correlated with fat traits. In conclusion, the expression of the ADFP, FATP1 and APOB genes is associated with the fat traits of Yunnan's top six chicken breeds. These results could help with molecular marker screening and marker-assisted breeding to improve the quality of poultry for meat production.