[Analysis of the efficacy of transnasal endoscopic annulus of zinn area decompression in the treatment of dysthyroid optic neuropathy].

Objective: To evaluate the early efficacy and safety of transnasal endoscopic decompression in the annulus of zinn (AZ) region for refractory dysthyroid optic neuropathy (DON) and to preliminarily analyze the correlated factors of postoperative visual function outcome. Methods: From July 2021 to January 2023, 35 patients (56 eyes) with DON who received AZ area decompression in Peking University Third Hospital were included retrospectively, including 9 males (13 eyes) and 26 females (43 eyes), aging (52.2±12.0) years. Among them, 35 eyes underwent two-wall (medial and inferior) orbital decompression using an endonasal endoscopic approach, while 21 eyes received three-wall (medial, lateral, and inferior) orbital decompression through a combined approach. Key parameters such as best corrected visual acuity (BCVA), visual field (MD value), eyeball prominence, intraocular pressure, and complications were recorded. Postoperative data were collected one month after surgery. The statistical analysis was performed using paired t-test and Spearman correlation analysis. Results: Significant outcomes were observed post surgery in BCVA, visual field, intraocular pressure and proptosis (t value was 8.37, 6.17, 4.50, and 9.20, respectively, all P<0.001). The reduction in proptosis was statistically significant between the 2-wall and 3-wall orbital decompression groups (t=-2.82, P=0.007). Changes in BCVA, visual field, and intraocular pressure before and after surgery was greater in the 3-wall orbital decompression group compared to 2-wall orbital decompression group, although the difference was not statistically significant (all P>0.05). Change in postoperative visual acuity and visual field was significantly positively correlated with preoperative visual acuity and preoperative visual field (all P<0.001). Similarly, change in intraocular pressure and proptosis was positively correlated with preoperative intraocular pressure and preoperative protrusion (all P<0.001). Preoperative diplopia was reported in seven patients (20.0%), and two new cases (5.7%) were noted post-operation, which resolved within 3 months after surgery. Conclusions: Endoscopic endonasal decompression of the AZ area is a safe and effective surgical treatment for DON, with notable improvements in BCVA. Furthermore, three-orbital wall decompression seems to yield better outcomes in terms of eye retraction.

[The correlation between reflux esophagitis and Helicobacter pylori infection based on natural population].

Objective: Reflux esophagitis (RE) may be negatively correlated with Helicobacter pylori (H. pylori) infection, but the conclusion and relevant mechanism is still controversial. This study proposed to explore the correlation between RE and H. pylori infection based on natural population. Methods: From July 2013 to December 2014, 3 940 residents aged 40-69 years were recruited in Linqu County of Shandong Province and Hua County of Henan Province by the whole sampling method. All the subjects underwent gastroscopy, and gastric mucosa biopsy specimens were collected for pathological diagnosis and Warthin-Starry (WS) staining to identify H. pylori infection. Venous blood samples of some subjects were collected for H. pylori immunoglobulin G (H. pylori-IgG) detection. Also, demographic and sociological data were collected. Chi-square test and logistic regression were used to analyze the correlation between RE and H. pylori infection. Results: A total of 359 cases of RE were detected. Excluding RE and other upper gastrointestinal organic diseases, 3 382 cases were considered as controls. Chi-square test showed that WS staining positive rate in RE group was significantly lower than that in control group (P=0.023), but there was no significant difference in the positive rate of H. pylori-IgG between the two groups (P=0.281). There were significant differences between RE group and control group in gender composition, age, body mass index (BMI), smoking, alcohol consumption, education level and mucosal active inflammation. Multivariate regression analysis showed that RE was negatively correlated with gastric mucosa active inflammation [OR=0.754 (95%CI 0.600-0.949), P=0.016], and positively correlated with male [OR=4.231 (95%CI 3.263-5.486), P<0.001], age ≥60 years, BMI≥24 kg/m2 [OR=1.540 (95%CI 1.220-1.945), P<0.001]. Compared to those aged 40-49 years and 50-59 years, the odds ratio (OR) of RE in these aged ≥60 years were 1.566 (95%CI 1.144-2.143, P=0.005) and 1.405 (95%CI 1.093-1.805, P=0.008). Conclusion: RE is more closely related to H. pylori present infection. Multivariate analysis showed that RE is negatively correlated with active inflammation of gastric mucosa caused by H. pylori infection, and positively correlated with male, overweight and aged ≥60 years.

[Time trends of H. pylori infection and related drug use in patients with peptic ulcer bleeding in a hospital in Beijing from 2010 to 2019].

Objective: To explore the time trends of H. pylori infection and related drug use in patients with peptic ulcer bleeding (PUB) in recent ten years. Methods: PUB patients in Peking University Third Hospital from 2010 to 2019 were included. Time trends of H. pylori infection, related drugs (non-steroidal anti-inflammatory drugs, aspirin, antiplatelet drugs, anticoagulant drugs, glucocorticoids) use and non-H. pylori-non-drug ulcer in PUB patients were analyzed. Results: A total of 1 140 PUB patients were included from 2010 to 2019 (including 925 males and 215 females). The age M(Q1,Q3)was 53.5 (33.0, 66.0) years, with 833 patients <65 years old. The positive rates of H. pylori were 79.3%, 75.7%, 73.1%, 71.6%, 77.0%, 70.4%, 69.7%, 63.1%, 51.4%, 50.9%, respectively, showing a decreasing trend (χ²=32.386, P<0.001), and the decreasing trends were significant in different ulcer location, age and gender subgroups(all P<0.05). The proportions of PUB patients using at least one of the above drugs were 23.1%, 28.6%, 34.0%, 39.5%, 33.8%, 35.9%, 28.7%, 39.8%, 40.9%, 41.8%, respectively, showing an increasing trend (χ²=6.857, P=0.009), and the proportions of patients with antiplatelet drugs and anticoagulant drugs history showed increasing trends. The proportions of non-H. pylori-non-drug patients were 12.3%, 22.1%, 14.6%, 13.2%, 7.7%, 13.0%, 16.9%, 18.7%, 22.6% and 20.9%, respectively, showing an increasing trend (χ²=4.808, P=0.028). Accordingly, the proportions of elderly (≥65 years old) patients (χ²=4.608, P=0.032) and large ulcer (≥2 cm) patients (χ²=8.173, P=0.004) showed increasing trends. Conclusion: In the last decade, the positive rate of H. pylori in PUB patients showed a decreasing trend, while the proportions of patients with antiplatelet drugs and anticoagulant drugs history and the proportion of non-H. pylori-non-drug patients showed increasing trends.

[Quality of life of 22 patients with type 1 Gaucher disease after enzyme replacement therapy].

Objective: To investigate the living status and quality of life (QOL) in type1 Gaucher disease (GD1) patients who underwent long-term enzyme replacement therapy (ERT) and identify possible relevant factors affecting QOL. Methods: Clinical data and SF-36 questionnaires were recorded in 22 adult GD1 patients under regular ERT at Peking Union Medical Colleague Hospital (PUMCH) from January 1995 to June 2017. Results: 13 males and 9 females were included in this study. The current median age, age at diagnosis and initial time of ERT were 41 (24-52) , 6 (1-38) and 26 (6-41) years respectively. Of these patients, 68.2% was living in less-developed regions, 86.4% were under college education, and 77.3% had personal annual income less than ¥30 000 RMB. Though after a median 16 (7-22) years of ERT, the QOL of GD1 patients was still significantly worse (P<0.05) compared with normal Chinese population based on SF-36 questionnaires. History of splenectomy was a negative factor of QOL, mainly in physical health (P<0.05) . Patients could get benefit from early start of ERT in both physical and mental health (P<0.05) . Mental health was not affected by history of splenectomy and related bone diseases. Conclusion: Most adult GD1 patients at PUMCH reside in less-developed regions and have low levels of education and annual income. History of splenectomy and time to start ERT are two important factors affecting QOL. Chinese adult GD1 patients are associated with reduced QOL, even after long-term ERT.

LncRNA SAMD12-AS1 down-regulates P53 to promote malignant progression of glioma.

OBJECTIVE: To study the expression level of long non-coding RNA (LncRNA) SAMD12-AS1 in glioma and its influence on the invasive ability of glioma cells; meanwhile, the regulation mechanism of LncRNA SAMD12-AS1 promoting the development of glioma was further explored. PATIENTS AND METHODS: The expression level of SAMD12-AS1 in 40 pairs of tumor tissue specimens and paracancerous ones collected from glioma patients were examined through Real Time quantitative-Polymerase Chain Reaction (qRT-PCR) method, and the interplay between SAMD12-AS1 expression and clinical indicators of glioma patients was also analyzed. Meanwhile, the expression of SAMD12-AS1 in glioma cell lines was further verified by qRT-PCR. In addition, SAMD12-AS1 knockdown model was constructed using glioma cell lines (T98-G and U87). Cell Counting Kit-8 (CCK-8), cell wound healing test, and transwell assays were conducted to examine the impact of SAMD12-AS on glioma cell functions. Additionally, whether it exerted its biological characteristics through P53 was finally explored. RESULTS: qPCR results in the study revealed that SAMD12-AS1 expression in tumor tissue specimens of glioma patients was remarkably higher than that in the adjacent ones, and the difference was statistically significant. Compared with patients with low expression of SAMD12-AS1, patients with high expression of SAMD1-AS1 had a higher incidence of lymph node or distant metastasis. In addition, compared to the NC group, knocking down SAMD12-AS1 markedly attenuated the proliferation rate, as well as the invasiveness and migration ability of glioma cells. Subsequently, in glioma tissues, it was verified that P53 expression was remarkably decreased and negatively correlated with SAMD12-AS1. Finally, cell recovery experiment also demonstrated that there may exist a mutual regulation between SAMD12-AS1 and P53, which then together affected the malignant progression of glioma. CONCLUSIONS: LncRNA SAMD12-AS1 may accelerate the invasion and migratory capacities of glioma cells by modulating P53, and its expression was confirmed to be significantly relevant to the incidence of lymph node or distant metastasis.

[Late-onset upper airway obstruction caused by alkali inhalation injury: a case report].

SummaryAlkalis can produce severe tissue injury through liquefaction. Since the liquefaction loosens tissue planes and allows deeper penetration of the agent, alkali burns tend to be more severe than acid burns. Alkaline substances ingestion and inhalation frequently causes damage to the upper respiratory and digestive tract. Initial presentation of airway alkali burn includes oropharyngeal pain, dysphagia, hoarseness and stridor. Patients with a clear history of caustic ingestion or inhalation could always receive proper management. In this paper, a middle aged female presented with acute upper airway obstruction was introduced. The cause of the airway compromise was finally determined to be alkali inhalation 3 weeks ago. By reviewing this special case, the clinical features and management of airway alkali burn was summarized.

[The role of body fat rate in the evaluation of obstructive sleep apnea].

Objective: To investigate the role of body fat ratio in the evaluation of obstructive sleep apnea(OSA). Methods: A retrospective analysis was made on 174 cases (between November, 2017 and April, 2018 showed that) of sleep monitoring in the Department of Otorhinolaryngology in Peking University Third Hospital. The data included the gender, age, body fat rate, body mass index (BMI), neck circumference, and apnea-hypopnea index (AHI). The above data were analyzed by non parametric correlation analysis, receiver operating characterristic (ROC) curve analysis and multiple factor Logistic regression analysis to study the relationship between the gender,age,body fat rate,BMI,neck circumference and other indexes of the patients with AHI. Results: Nonparametric correlation analysis showed that the correlation from strong to weak to AHI among women was BMI (r=0.621, P<0.001),body fat rate (r=0.602, P<0.001), age (r=0.570, P<0.001), neck circumference (r=0.402, P=0.014), respectively. BMI (r=0.599, P<0.001), neck circumference (r=0.493, P<0.001), body fat rate (r=0.318, P<0.001), and age (r=0.256, P=0.003) among men. ROC curve analysis showed that the strong to weak index (area under curve,AUC) of the AHI>15/h among women was the body fat rate (AUC=0.884, P=0.001), BMI(AUC=0.810, P=0.008), neck circumference (AUC=0.759, P=0.027), age (AUC=0.750, P=0.033), and the male was BMI (AUC=0.765,P<0.001), neck circumference (AUC=0.720, P<0.001), age (AUC=0.634, P=0.008), and body fat rate (AUC=0.632, P=0.010), respectively. Multifactor Logistic regression analysis showed that the body fat rate (OR=1.704,95%CI=1.012-2.870) in women was an independent risk factor for AHI greater than 15/h; the age of male (OR=1. 044, 95%CI=1.005-1.085) and BMI (OR=1.285, 95%CI=1.056-1.562) were independent risk factors for AHI greater than 15/h. Conclusion: Body fat rate can be used as a new indicator for predicting the severity of OSA,especially in adult female population. In adult female moderate to severe OSA patients (AHI>15/h), compared with BMI,neck circumference and age,the body fat rate has the greatest correlation with AHI. Compared with BMI,neck circumference and age,the body fat rate has a decisive role in predicting moderate to severe OSA (AHI>15/h).

[Effect of sirolimus on erythropoiesis of K562 cell line and patients with pure red cell aplasia in vitro].

Objective: To understand the effect of sirolimus on the erythropoiesis of K562 cell line and bone marrow cells from pure red cell aplasia (PRCA) patients and normal controls. Methods: Different concentrations (10, 100, 1 000 nmol/L) of sirolimus were added to the K562 cell line or bone marrow cells from PRCA patients or normal controls and cultured 14 days for BFU-E formation. Meanwhile, sirolimus was also added to the serum treated PRCA bone marrow cells to cultivate for the same priod of time. Results: Neither K562 cells, bone marrow cells from PRCA patients or normal controls showed any difference when sirolimus was added to the culture system for BFU-E. However, BFU-E formation decreased after serum was added in PRCA patients (76.40±22.48 vs 136.33±12.58, t=-4.329, P=0.001) and this suppression of BFU-E was partly corrected by 1 000 nmol/L sirolimus treatment (97.14±15.83 vs 76.40±22.48, P=0.038). Conclusions: Sirolimus may modulate the suppression of erythropoiesis by serum instead of directly stimulate the growth of red blood cells in PRCA patients.

[Automobile Traffic Accident Death Case Analysis of Characteristics of Driver Injury].

OBJECTIVES: To distinguish the injury characteristic changes on the drivers between the injuries of drivers and passengers in traffic accidents, and to provide scientific evidence for confirming the identity of driver in traffic accidents. METHODS: Data of 126 automobile traffic accident death cases in the reclamation areas of Heilongjiang province from 2006-2014 were retrospectively studied. The injury characteristics on the drivers of automobile traffic accident death cases were analyzed and the forensic identification problem in the injuries of drivers and passengers were discussed. RESULTS: Injuries were frequently observed on driver's neck, chest and abdomen. The characteristic injuries caused by auto parts were also found, which appeared at the places of passenger's head, face and limbs contacted with automobile. Such characteristic injuries were not found at other places. CONCLUSIONS: The location and type of injury are associated with the identity of the deceased.

[Analysis on the Injury Mechanism and Characteristics of Ox Horn].

OBJECTIVES: To study the morphological characteristics of the injury caused by ox horn on human body and its injury mechanism, and to discuss the rules and characteristics of injury by ox horn and provide forensic evidences for identification of such cases. METHODS: The comparative analysis of position and morphological characteristics were performed by summarizing the data of 100 victims gored by ox accepted by Heilongjiang agricultural areas public security bureau during 2004-2014. RESULTS: The specific injuries only could be found at the contact positions such as thorax and abdomen, lower back and limbs of the victims gored by ox horn. Most of the skin wounds had the characteristics of sharp injuries, the bar-type injury by club which called "rail way bruise" was an obvious characteristic appeared on the soft tissue. CONCLUSIONS: Ox horn can cause non-specific injuries on thorax and abdomen, lower back and limbs of human body, which are similar with the characteristics of sharp injury and injury by club. Careful analyzation and identification should be performed on such injury in daily work.

[Current in eosinophilic otitis media].

Eosinophilic otitis media(EOM) is a kind of intractable disease. It has drawn much attention since it being recognitized first time in 1995. The pathogenesis of EOM remains unknown, and clinical manifestation varies. Early diagnosis and treatment is of great importance for improving the prognosis and avoiding severe hearing loss. This article reviewed current analysis of EOM for better understanding of this disease, and help to establish a standard procedure for the diagnosis and treatment of EOM.

[The relationship between type ⠡ diabetes mellitus and hearing loss：a Meta-analysi].

Objective:Analysis of the relationship between type 2 diabetes and hearing loss through the available literature.Method:According to the main keyword retrieval databases at home and abroad,and in accordance with the inclusion and exclusion criteria for the literature,the listening incidence rate,OR value,the frequency of pure tone hearing threshold,tests the average standard deviation were chose as the evaluation index. Meta analysis was carried out using Rev Man5.3 software. Result:According to the inclusion and exclusion criteria,the articles were screened and included in the final to meet the requirements of the 17 studies. The prevalence of hearing loss in patients with type II diabetes mellitus was 21.0%-74.6%,which was 2.54 times higher than the control group. The difference was statistically significant between the two groups(OR=2.54,95% CI 1.85-3.49,P<0.000 01). In addition,the hearing threshold of all frequencies in type Ⅱ diabetes group was higher than that of control group(Z=5.03,P<0.000 01). Conclusion:Type 2 diabetes can affect hearing loss,especially at the high frequencies.

Synthetic Biology Approaches to New Bisindoles.

Bisindoles are a class of natural products derived from oxidative dimerization of tryptophan, and many of these molecules have potential use as anticancer agents. The recent isolation of new bisindoles and their corresponding gene clusters has greatly expanded the repertoire of biosynthetic genes available to synthetic biologists. This chapter describes methods to exploit the biosynthetic pathways leading to bisindoles, using cladoniamides as a representative example. Specifically, we describe how to identify and heterologously express gene clusters and how to manipulate pathways in order to generate new bisindoles. We also discuss methods for cultivating, extracting, purifying, and characterizing these new metabolites.

TM4SF5-CTD-2354A18.1-miR-4697-3P may play a key role in the pathogenesis of gastric cancer.

AIMS: Our aim is to identify important lncRNAs and mRNAs which may play a key role in contributing to pathogenesis of gastric cancer. METHODS: Different LncRNAs and mRNAs are identified by microarray in gastric cancer tissue and corresponding normal tissues. The function and relationship of different LncRNAs and mRNAs is performed by GO analysis and Pathway analysis and made code-non-code network (CNC) by Pearson correlation coefficients (PCC). Then mRNA-miRNA relationship is predicted through mRNA-miRNA relationship software (http://www.targetscan.org). Lastly, mRNA-miRNA-LncRNA network is established for further research. RESULTS: The expression profiles of 3732 lncRNAs showed different expression (fold change (FC)≥2.0, p<0.05) in gastric cancer tissue and normal tissue and expression profiles of 3994 mRNAs also showed different expression (FC≥2.0, p<0.05) in gastric cancer and corresponding normal tissue. CONCLUSION: The expression of TM4SF5, CTD-2354A18.1 and miR-4697-3P is in balance at physiological conditions, however, the balance is disrupted by some situations, which may contribute to gastric cancer. GO analysis and Pathway analysis also showed TM4SF5 played an important role in proliferation, differentiation and apoptosis. Therefore, TM4SF5-miR-4697-3P- CTD-2354A18.1 may play a key role in the pathogenesis of gastric cancer (Tab. 2, Fig. 4, Ref. 30).

Synthesis of carboxylated chitosan and its adsorption properties for cadmium (II), lead (II) and copper (II) from aqueous solutions.

Carboxylated chitosan (CKCTS) was prepared for the removal of Cd(II), Pb(II), and Cu(II) from aqueous solutions. The effects of experimental parameters such as pH value, initial concentration, contact time and temperature on the adsorption were studied. From the results we can see that the adsorption capacities of Cd(II), Pb(II), and Cu(II) increase with increasing pH of the solution. The kinetic rates were best fitted to the pseudo-second-order model. The adsorption equilibrium data were fitted well with the Langmuir isotherm, which revealed that the maximum adsorption capacities for monolayer saturation of Cd(II), Pb(II), and Cu(II) were 0.555, 0.733 and 0.827 mmol/g, respectively. The adsorption was an exothermic process.

Regulation of rat 5-hydroxytryptamine type 2 receptor gene activity: identification of cis elements that mediate basal and 5-hydroxytryptamine-dependent gene activation.

The 5-hydroxytryptamine type 2 receptor gene is transcriptionally induced by 5-HT-mediated activation of the 5-HT2 receptor in rat myometrial smooth muscle cells. We recently cloned the promoter of the rat 5-HT2 receptor gene and showed that a 1.4-kilobase promoter construct transfected into myometrial smooth muscle cells displays both constitutive and serotonin-dependent promoter activity. We have examined a series of deletional mutants of this promoter for their transcriptional activity. Deletions from base pair (bp) -1314 to bp -184 (with respect to the major transcriptional start (site) resulted in no changes in constitutive or 5-HT-dependent transcriptional activity. A substantial loss of serotonin-dependent transcriptional activation was observed with a promoter construct from which the bp -184 to -108 sequence was deleted. A sequence [termed the serotonin-1 (S1) element], 5'-AGGTTnnnnnnnAACCT-3' (where n represents any deoxynucleotide), containing a novel dyad repeat is contained within this region. In addition to the S1 element, two simian virus 40 promoter factor 1 (SP-1) sites contiguous to this site, as well as an initiator element, appear to be important. Deletion of both the S1 and SP-1 sites resulted in an almost total loss of activity. Myometrial smooth muscle cells contain nuclear proteins that interact specifically with the S1 and SP-1 elements. Thus, multiple elements appear to be involved in serotonin-dependent induction of promoter activity. Analysis of the promoter elements that direct constitutive (i.e., serotonin-independent) activity revealed the involvement of a different region. Deletions from bp -1314 to bp -75 resulted in only minor increases in basal promoter activity. Deletion to bp -50 resulted in a 2.5-fold increase in basal promoter activity, whereas deletion to bp -25 resulted in a 5-fold increase in promoter activity. These results suggest that the basal promoter unit includes bp -25 to 1 and that upstream sequences act to repress basal promoter activity.

Isolation and characterization of the rat 5-hydroxytryptamine type 2 receptor promoter: constitutive and inducible activity in myometrial smooth muscle cells.

Previous studies from this laboratory have demonstrated that the 5-hydroxytryptamine (5-HT2) receptor subtype is transcriptionally regulated by 5-HT (serotonin) itself in rat myometrial smooth muscle cells. To better understand this transcriptional regulation, we have isolated and characterized the 5'-flanking region of the 5-HT2 receptor gene. Screening of a rat genomic library was accomplished using 5'-directed fragments of 5-HT2 cDNA, and a 5.2-kilobase fragment was isolated. Sequencing demonstrated that the fragment overlapped the 5'-end of the 5-HT2 cDNA by 226 base pairs. Primer extension and RNase protection analyses indicated that three transcriptional start sites, which are common to both rat brain and myometrium, appear to exist and that the 5'-untranslated region of the 5-HT2 receptor cDNA is 1120 base pairs long. Neither classical TATA boxes nor CCAAT sequences were found upstream of any of the start sites identified. Upstream of the dominant start site, however, an initiator consensus sequence, two GC boxes (SP-1 binding sites), and several AP-2 binding sites were identified. Based on this information, a 1.4-kilobase fragment beginning 64 base pairs downstream from the dominant start site was constructed by polymerase chain reaction and ligated into a pCAT vector. Transient transfection of this construct into rat myometrial smooth muscle cells displayed both constitutive and serotonin-induced promoter activity. Serotonin-inducible activity was abolished by a selective 5-HT2 receptor antagonist; however, antagonists selective for other 5-HT receptor subtypes were without effect. Conversely, a selective 5-HT2 receptor agonist completely substituted for serotonin as an inducer. Preliminary deletion experiments indicate that regulation of basal and serotonin-inducible activity likely depends upon different cis elements in the 5-HT2 receptor gene promoter.