The histologic features, molecular features, detection and management of serrated polyps: a review.

The serrated pathway to colorectal cancers (CRCs) is a significant pathway encompassing five distinct types of lesions, namely hyperplastic polyps (HPs), sessile serrated lesions (SSLs), sessile serrated lesions with dysplasia (SSL-Ds), traditional serrated adenomas (TSAs), and serrated adenoma unclassified. In contrast to the conventional adenoma-carcinoma pathway, the serrated pathway primarily involves two mechanisms: BRAF/KRAS mutations and CpG island methylator phenotype (CIMP). HPs are the most prevalent non-malignant lesions, while SSLs play a crucial role as precursors to CRCs, On the other hand, traditional serrated adenomas (TSAs) are the least frequently encountered subtype, also serving as precursors to CRCs. It is crucial to differentiate these lesions based on their unique morphological characteristics observed in histology and colonoscopy, as the identification and management of these serrated lesions significantly impact colorectal cancer screening programs. The management of these lesions necessitates the crucial steps of removing premalignant lesions and implementing regular surveillance. This article provides a comprehensive summary of the epidemiology, histologic features, molecular features, and detection methods for various serrated polyps, along with recommendations for their management and surveillance.

Development of a nomogram to predict 30-day mortality of sepsis patients with gastrointestinal bleeding: An analysis of the MIMIC-IV database.

Background: We aimed to establish and validate a prognostic nomogram model for improving the prediction of 30-day mortality of gastrointestinal bleeding (GIB) in critically ill patients with severe sepsis. Methods: In this retrospective study, the current retrospective cohort study extracted data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, then partitioned the cohort randomly into training and validation subsets. The cohort was partitioned into training and validation subsets randomly. Our primary endpoint was 30-day all-cause mortality. To reduce data dimensionality and identify predictive variables, the least absolute shrinkage and selection operator (LASSO) regression was employed. A prediction model was constructed by multivariate logistic regression. Model performance was evaluated using the concordance index (C-index), receiver operating characteristic (ROC) curve, and decision curve analysis (DCA). Results: The analysis included 1435 total patients, comprising 1005 in the training cohort and 430 in the validation cohort. We found that age, smoking status, glucose, (BUN), lactate, Sequential Organ Failure Assessment (SOFA) score, mechanical ventilation≥48h (MV), parenteral nutrition (PN), and chronic obstructive pulmonary disease (COPD) independently influenced mortality in sepsis patients with concomitant GIB. The C-indices were 0.746 (0.700-0.792) and 0.716 (0.663-0.769) in the training and validation sets, respectively. Based on the area under the curve (AUC) and DCA, the nomogram exhibited good discrimination for 30-day all-cause mortality in sepsis with GIB. Conclusions: For sepsis patients complicated with GIB, we created a unique nomogram model to predict the 30-day all-cause mortality. This model could be a significant therapeutic tool for clinicians in terms of personalized treatment and prognosis prediction.

The coverage of SARS-CoV-2 vaccination and the willingness to receive the SARS-CoV-2 variant vaccine among employees in China.

BACKGROUND: COVID-19, which is caused by SARS-CoV-2, is a major global health threat. The dominant variant of SARS-CoV-2 has changed over time due to continuous evolution. We aimed to evaluate the coverage of SARS-CoV-2 vaccination among employees in China, explore their willingness to receive the SARS-CoV-2 variant vaccine and examine the potential factors influencing vaccination coverage and willingness. METHODS: A cross-sectional epidemiological survey was conducted online from January 1, 2022, to January 30, 2022. The information collected in the survey included sociodemographic characteristics, lifestyle habits, vaccination coverage, willingness to be vaccinated against SARS-CoV-2 variants and the reasons for vaccination and willingness. Multivariable logistic regression models were used to assess the associations of potential factors with the rate of vaccination and the willingness to be vaccinated. RESULTS: Among 62,395 eligible participants, the coverage of SARS-CoV-2 vaccination was 98.9% for at least one dose and 70.1% for a booster. The great majority of vaccinated individuals (94.4%) voluntarily received the vaccine. A total of 60,694 respondents (97.7%) were willing to be vaccinated against SARS-CoV-2 variants, mainly due to confidence in the effectiveness of vaccines (92.8%). A total of 1431 respondents were unwilling to be vaccinated, mainly because of concerns about the adverse effects of vaccines (77.6%). Longer education duration was associated with a higher rate of SARS-CoV-2 vaccination and willingness to be vaccinated. General or poor health status and having no history of influenza vaccination were associated with a lower rate of SARS-CoV-2 vaccination and willingness to be vaccinated. Additionally, we observed a significant positive association of abuse experience with the willingness to be vaccinated. CONCLUSION: Although the rate of SARS-CoV-2 vaccination and the willingness to be vaccinated were relatively high in the study population, there were still some respondents with vaccine hesitancy. Relevant strategies based on significant related factors should be developed and implemented to encourage vaccination.

Phillygenin Attenuated Colon Inflammation and Improved Intestinal Mucosal Barrier in DSS-induced Colitis Mice via TLR4/Src Mediated MAPK and NF-κB Signaling Pathways.

Ulcerative colitis (UC) is a chronic, relapsing, and nonspecific inflammatory bowel disease (IBD). Phillygenin (PHI), a natural bioactive ingredient, isolated from Forsythiae Fructus, exhibits anti-inflammatory, anti-oxidative, and hepatoprotective activities. However, few reports provide direct evidence on the efficacy of PHI in improving colitis mice. The present study elucidated that the symptoms of DSS-induced colitis mice were alleviated after PHI administration, including body weight loss, the disease activity index, colon length shortening, colonic pathological damage, splenomegaly, and hepatomegaly. PHI treatment improved the intestinal mucosal barrier by protecting goblet cells, promoting gene expressions of Clca1, Slc26a3, and Aqp8, increasing tight junction proteins (TJs), and reducing epithelial cell apoptosis. In addition, the levels of oxidative stress (MPO, SOD, and MDA) and inflammatory cytokines (TNF-α, IL-1ß, IL-6, and IL-10) were reversed by PHI in colitis mice. According to transcriptome and network pharmacology analysis, inflammatory pathway might be an important mechanism for PHI to improve colitis. Western blotting displayed that the PHI inhibited the activation of tyrosine kinase Src mediated by TLR4, and then reduced the phosphorylation of downstream proteins p38, JNK, and NF-κB in colitis mice. In summary, our results suggested that PHI might be an appropriate and effective drug candidate to protect colitis.

[Long-term Succession Patterns and Driving Factors of Water Quality in a Flood-pulse System Lake: A Case Study of Lake Luoma, Jiangsu Province].

Lake Luoma is an important storage lake for the Eastern route of the South-to-North Water Diversion Project (NSBD), which has many functions including flood control and irrigation, drinking water supply, and ecological maintenance. In order to understand the succession patterns and driving factors of water quality in Lake Luoma, we used monthly monitoring data from 2009 to 2020 in combination with historical data from 1996 to 2008. The long-term succession patterns, seasonal dynamics, and spatial patterns of total nitrogen (TN), total phosphorus (TP), permanganate index, and ammonia nitrogen (NH+4-N) were examined, and the influence of meteorological and hydrological factors on water quality was explored through correlation analyses and generalized additive models. The results showed that it remained in the status of grade Ⅳ-inferior Ⅴ over the past 25 years. The concentration of TN, which was the main pollutant, changed significantly (1.06-3.49 mg·L-1), experiencing three stages of gradual decline (1996-2002), significant interannual fluctuation (2002-2015), and significant increase (2015-2020). Permanganate index decreased significantly (2.97-6.38 mg·L-1), whereas TP and NH+4-N concentration fluctuated slightly, ranging from 0.024-0.076 mg·L-1 and 0.11-0.69 mg·L-1, respectively. The concentration of TN and TP increased abnormally in the summer of 2017-2020, reaching 3.30 mg·L-1 and 0.14 mg·L-1 in August, respectively, which was approximately 1.5 and 2.4 times the annual average. In terms of seasonal dynamics, the seasonal variation in water quality between summer/autumn and winter/spring reversed after 2015, with water quality in summer/autumn being worse than that in winter and spring, indicating the exacerbation of eutrophication. The water quality in the southern area was obviously better than that in the northern area. The input of pollutants from the Yihe River and Middle Canal increased with water quantity since 2015, which drove the water quality deterioration through nutrients. Our results suggested that the water quality of Lake Luoma should be improved by strengthening exogenous pollution reduction, endogenous control, polder dismantling, and ecological restoration.

Characteristics of childhood-onset systemic lupus erythematosus in pregnancy and its association with pregnancy outcomes: a retrospective comparative cohort study.

BACKGROUND: Disease situations are more aggressive in patients with childhood-onset systemic lupus erythematosus (cSLE) than in those with adult-onset SLE (aSLE). However, information on pregnant women with cSLE and its association with pregnancy outcomes is limited. This study aimed to compare pregnancies in patients with cSLE vs. aSLE, and further analyse the characteristics of cSLE in pregnant women and explore its association with adverse pregnancy outcomes. METHODS: Altogether, data of 167 pregnancies from 150 women, including 22 pregnancies with cSLE and 145 pregnancies with aSLE, were retrospectively analysed. Characteristics and disease activity were compared between the cSLE and aSLE groups during pregnancy. Associations between cSLE and the risk of active SLE (SLEPDAI > 4), active lupus nephritis (LN), and adverse pregnancy outcomes were analysed using logistic regression. RESULTS: The cSLE group had a higher incidence of active SLE (12/22 vs. 30/145, P = 0.001) and active LN (11/22 vs. 26/145, P = 0.001) than the aSLE group. In the multivariable analysis, cSLE was a risk factor for active SLE and active LN during pregnancy, with ORs of 4.742 (95%CI 1.678-13.405, P = 0.003) and 4.652 (95%CI 1.630-13.279, P = 0.004), respectively. No significant association between cSLE and the risk of composite adverse gestational outcomes was identified after sequentially adjusting pre-pregnancy characteristics and pregnancy factors (P > 0.05). CONCLUSION: Disease activity of women with cSLE in pregnancy was more aggressive than that of women with aSLE, which was similar to the characteristics of non-pregnant women with SLE. cSLE might have indirect effects on the risk of adverse pregnancy outcomes through LN and active disease. Therefore, closely monitoring patients with cSLE during pregnancy is crucial.

Glucosamine use, smoking and risk of incident chronic obstructive pulmonary disease: a large prospective cohort study.

Chronic inflammation exerts pleiotropic effects in the aetiology and progression of chronic obstructive pulmonary disease (COPD). Glucosamine is widely used in many countries and may have anti-inflammatory properties. We aimed to prospectively evaluate the association of regular glucosamine use with incident COPD risk and explore whether such association could be modified by smoking in the UK Biobank cohort, which recruited more than half a million participants aged 40-69 years from across the UK between 2006 and 2010. Cox proportional hazards models with adjustment for potential confounding factors were used to calculate hazard ratios (HR) as well as 95 % CI for the risk of incident COPD. During a median follow-up of 8·96 years (interquartile range 8·29-9·53 years), 9016 new-onset events of COPD were documented. We found that the regular use of glucosamine was associated with a significantly lower risk of incident COPD with multivariable adjusted HR of 0·80 (95 % CI, 0·75, 0·85; P < 0·001). When subgroup analyses were performed by smoking status, the adjusted HR for the association of regular glucosamine use with incident COPD were 0·84 (0·73, 0·96), 0·84 (0·77, 0·92) and 0·71 (0·62, 0·80) among never smokers, former smokers and current smokers, respectively. No significant interaction was observed between glucosamine use and smoking status (Pfor interaction = 0·078). Incident COPD could be reduced by 14 % to 84 % through a combination of regular glucosamine use and smoking cessation.

Glucan, Water-Dikinase 1 (GWD1), an ideal biotechnological target for potential improving yield and quality in rice.

The source-sink relationship determines the overall agronomic performance of rice. Cloning and characterizing key genes involved in the regulation of source and sink dynamics is imperative for improving rice yield. However, few source genes with potential application in rice have been identified. Glucan, Water-Dikinase 1 (GWD1) is an essential enzyme that plays a pivotal role in the first step of transitory starch degradation in source tissues. In the present study, we successfully generated gwd1 weak mutants by promoter editing using CRISPR/Cas9 system, and also leaf-dominant overexpression lines of GWD1 driven by Osl2 promoter. Analysis of the gwd1 plants indicated that promoter editing mediated down-regulation of GWD1 caused no observable effects on rice growth and development, but only mildly modified its grain transparency and seed germination. However, the transgenic pOsl2::GWD1 overexpression lines showed improvements in multiple key traits, including rice yield, grain shape, rice quality, seed germination and stress tolerance. Therefore, our study shows that GWD1 is not only involved in transitory starch degradation in source tissues, but also plays key roles in the seeds, which is a sink tissue. In conclusion, we find that GWD1 is an ideal biotechnological target with promising potential for the breeding of elite rice cultivars via genetic engineering.

Tunable high-order sideband generation in a coupled double-cavity optomechanical system.

Tunable high-order sideband generation has important applications in the realization of the optical frequency comb with a varying spectral region (corresponding to the sideband range) and frequency resolution (corresponding to the sideband interval). In this paper, we propose a theoretical scheme to tune both the range and the interval of the high-order sidebands in a coupled double-cavity optomechanical system, which consists of an optomechanical cavity and an auxiliary cavity. Our proposal can be realized by driving the optomechanical cavity with a control field and a probe field simultaneously, driving the auxiliary cavity with a pump field. Furthermore, we assume that the frequency detuning between the control field and the probe field (the pump field) equals ωb/n (ωb/m), where ωb is the mechanical frequency, m and n are integers. When n = m = 1, we find that the sideband range can be effectively enlarged by increasing the pump amplitude or the photon-hopping coupling rate, or by decreasing the auxiliary cavity damping rate. When n = 1 and m > 1, the output spectrum consists of a series of integer-order sidebands, fraction-order sidebands, and the sum and difference sidebands, and the sideband interval becomes ωb/m and can be diminished by simultaneously increasing m and the pump amplitude.

Genome-Wide Identification and Expression Analysis of OsbZIP09 Target Genes in Rice Reveal Its Mechanism of Controlling Seed Germination.

Seed dormancy and germination are key events in plant development and are critical for crop production, and defects in seed germination or the inappropriate release of seed dormancy cause substantial losses in crop yields. Rice is the staple food for more than half of the world's population, and preharvest sprouting (PHS) is one of the most severe problems in rice production, due to a low level of seed dormancy, especially under warm and damp conditions. Therefore, PHS leads to yield loss and a decrease in rice quality and vitality. We reveal that mutation of OsbZIP09 inhibited rice PHS. Analysis of the expression of OsbZIP09 and its encoded protein sequence and structure indicated that OsbZIP09 is a typical bZIP transcription factor that contains conserved bZIP domains, and its expression is induced by ABA. Moreover, RNA sequencing (RNA-seq) and DNA affinity purification sequencing (DAP-seq) analyses were performed and 52 key direct targets of OsbZIP09 were identified, including OsLOX2 and Late Embryogenesis Abundant (LEA) family genes, which are involved in controlling seed germination. Most of these key targets showed consistent changes in expression in response to abscisic acid (ABA) treatment and OsbZIP09 mutation. The data characterize a number of key target genes that are directly regulated by OsbZIP09 and contribute to revealing the molecular mechanism that underlies how OsbZIP09 controls rice seed germination.

Fraction-order sideband generation in an optomechanical system.

We propose a scheme for generating a new kind of sideband, i.e., the fraction-order sideband, in an optomechanical system. In the conventional scheme of high-order sideband generation [Opt. Lett.38, 353 (2013)OPLEDP0146-959210.1364/OL.38.000353], the sideband interval has a minimum frequency limitation, which is equal to the mechanical frequency ωb, and this limits the precision of the sideband comb. With our proposed fraction-order sidebands, the sideband interval can break that limitation and reach ωb/n (n is an integer). The scheme we propose can be realized by driving the optomechanical system with three laser fields, including a control field (ωc) and two probe fields (ωp, ωf), in which the detuning between ωc and ωp is equal to the mechanical frequency ωb, while the detuning between ωc and ωf is equal to ωb/n. In this case, we find that not only the integer-order (high-order) sidebands, but also the fraction-order sidebands, and the sum and difference sidebands between the integer- and fraction-order sidebands, will appear in the output spectrum. Moreover, the sideband interval becomes ωb/n, and it can be decreased by increasing n. Our work paves the way to achieve a tunable optical frequency comb based on the optomechanical system.

Onset of Coronary Heart Disease is Associated with HCMV Infection and Increased CD14 +CD16 + Monocytes in a Population of Weifang, China.

OBJECTIVE: To investigate the relationship between human cytomegalovirus (HCMV) infection and peripheral blood CD14 +CD16 + monocytes in the pathogenesis of coronary heart disease (CHD), and to elucidate the mechanism of pathogenesis in CHD by analyzing the correlation between infection, inflammation, and CHD, to provide a basis for the prevention, evaluation, and treatment of the disease. METHODS: In total, 192 patients with CHD were divided into three groups: latent CHD, angina pectoris, and myocardial infarction. HCMV-IgM and -IgG antibodies were assessed using ELISA; CD14 +CD16 + monocytes were counted using a five-type automated hematology analyzer; mononuclear cells were assessed using fluorescence-activated cell sorting; and an automatic biochemical analyzer was used to measure the levels of triglyceride, cholesterol, high- and low-density lipoprotein cholesterols, lipoprotein, hs-CRp and Hcy. RESULTS: The positive rates of HCMV-IgM and -IgG were significantly higher in the CHD groups than in the control group. HCMV infection affects lipid metabolism to promote immune and inflammatory responses. CONCLUSION: HCMV infection has a specific correlation with the occurrence and development of CHD. The expression of CD14 +CD16 + mononuclear cells in the CHD group was increased accordingly and correlated with acute HCMV infection. Thus, HCMV antibody as well as peripheral blood CD14 +CD16 + mononuclear cells can be used to monitor the occurrence and development of CHD.

[Succession Pattern of Phytoplankton and Its Drivers in Lake Luoma, Jiangsu Province].

As a water storage lake for the South-to-North Water Diversion Project, it is crucial to examine changes in aquatic ecosystem structures in Lake Luoma, Jiangsu province. Field sampling was carried out in Lake Luoma monthly from 2014 to 2018 to study the relationship between the phytoplankton community structure and environmental factors. During the studied period, total nitrogen, permanganate index, and electrical conductivity in water column gradually increased, whereas fluoride content declined. The pattern of total phosphorus and dissolved oxygen was not distinct. A total of 71 genera of phytoplankton were identified from 2014 to 2018, and the average monthly biomass variation ranged from 0.16 to 5.51 mg·L-1. Bacillariophyta and Chlorophyta were the dominant phyla in the four years, followed by Pyrrophyta and Cryptophyta. The dominant genera were Synedra sp., Chroomonas spp., Aulacoseira spp., Dinobryon sp., Scenedesmus spp. , Fragilaria spp., Mougeotia sp. , Ankistrodesmus sp. , and Euglena spp. The results showed that the phytoplankton community structure significantly changed in the four years, which was mainly ascribed to the redistribution of biomass. Specifically, in addition to the dominance of Bacillariophyta and Chlorophyta, the dominance of Pyrrophyta and Cyanophyta increased during the last two years. Non-metric multidimensional scaling analysis showed that variation of the phytoplankton community in Lake Luoma was mainly related to total nitrogen, fluoride, water temperature, total phosphorus, dissolved oxygen, pH, conductivity, and permanganate index, among which the total nitrogen, water temperature, and fluoride concentration dominated the phytoplankton community change after the generalized additive model test. Water temperature is the driving factor affecting seasonal changes of the phytoplankton community. Total nitrogen and fluoride concentrations are the driving factors affecting the interannual variation in the phytoplankton community. Our study indicated that in recent years, the implementation of the ban on sand mining and demolition of the enclosed aquaculture in Lake Luoma has affected the water environment, resulting in a significant succession of the phytoplankton community.

Proof-of-principle demonstration of measurement-device-independent quantum key distribution based on intrinsically stable polarization-modulated units.

The experimental demonstration of measurement-device-independent quantum key distribution (MDI-QKD) has been widely demonstrated. Thus far, several experimental groups have implemented polarization encoding MDI-QKD but with manual polarization controllers, or polarization modulators that make circular polarization states unstable. Here, we apply an intrinsically stable polarization-modulated unit (PMU) to MDI-QKD so that Alice and Bob can modulate four BB84 polarization states, all of which can be kept stable from even the harsh environment. Moreover, our PMU can provide two operational polarization encoding modes suitable to different application scenarios. A proof-of-principle demonstration of MDI-QKD based on our PMU is implemented with an interference visibility of 46.6%, an average quantum bit error rate of 1.49% for the Z basis and the secure key rate of 4.25 × 10-6 bits per pulse. The proposed study is helpful for building polarization encoding MDI-QKD systems with better stability.

Gibberellin recovers seed germination in rice with impaired brassinosteroid signalling.

Seed germination is essential for ensuring grain yield and quality. Germination rate, uniformity, and post-germination growth all contribute to cultivation. Although the phytohormones gibberellin (GA) and brassinosteroid (BR) are known to regulate germination, the underlying mechanism of their crosstalk in co-regulating rice seed germination remains unclear. In this study, the isobaric tags for relative and absolute quantitation (iTRAQ) proteomic approach was employed to identify target proteins responsive to GA during recovery of germination in BR-deficient and BR-insensitive rice. A total of 42 differentially abundant proteins were identified in both BR-deficient and BR-insensitive plants, and most were altered consistently in the two groups. Gene Ontology (GO) analysis revealed enrichment in proteins with binding and catalytic activity. A potential protein-protein interaction network was constructed using STRING analysis, and five Late Embryogenesis Abundant (LEA) family members were markedly down-regulated at both mRNA transcript and protein levels. These LEA genes were specifically expressed in rice seeds, especially during the latter stages of seed development. Mutation of LEA33 affected rice grain size and seed germination, possibly by reducing BR accumulation and enhancing GA biosynthesis. The findings improve our knowledge of the mechanisms by which GA and BR coordinate seed germination.

Abscisic Acid Represses Rice Lamina Joint Inclination by Antagonizing Brassinosteroid Biosynthesis and Signaling.

Leaf angle is a key parameter that determines plant architecture and crop yield. Hormonal crosstalk involving brassinosteroid (BR) plays an essential role in leaf angle regulation in cereals. In this study, we investigated whether abscisic acid (ABA), an important stress-responsive hormone, co-regulates lamina joint inclination together with BR, and, if so, what the underlying mechanism is. Therefore, lamina joint inclination assay and RNA sequencing (RNA-Seq) analysis were performed here. ABA antagonizes the promotive effect of BR on leaf angle. Hundreds of genes responsive to both hormones that are involved in leaf-angle determination were identified by RNA-Seq and the expression of a gene subset was confirmed using quantitative real-time PCR (qRT-PCR). Results from analysis of rice mutants or transgenic lines affected in BR biosynthesis and signaling indicated that ABA antagonizes the effect of BR on lamina joint inclination by targeting the BR biosynthesis gene D11 and BR signaling genes GSK2 and DLT, thus forming a multi-level regulatory module that controls leaf angle in rice. Taken together, our findings demonstrate that BR and ABA antagonistically regulate lamina joint inclination in rice, thus contributing to the elucidation of the complex hormonal interaction network that optimizes leaf angle in rice.

iTRAQ-Based Analysis of Proteins Co-Regulated by Brassinosteroids and Gibberellins in Rice Embryos during Seed Germination.

Seed germination, a pivotal process in higher plants, is precisely regulated by various external and internal stimuli, including brassinosteroid (BR) and gibberellin (GA) phytohormones. The molecular mechanisms of crosstalk between BRs and GAs in regulating plant growth are well established. However, whether BRs interact with GAs to coordinate seed germination remains unknown, as do their common downstream targets. In the present study, 45 differentially expressed proteins responding to both BR and GA deficiency were identified using isobaric tags for relative and absolute quantification (iTRAQ) proteomic analysis during seed germination. The results indicate that crosstalk between BRs and GAs participates in seed germination, at least in part, by modulating the same set of responsive proteins. Moreover, most targets exhibited concordant changes in response to BR and GA deficiency, and gene ontology (GO) indicated that most possess catalytic activity and are involved in various metabolic processes. Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) analysis was used to construct a regulatory network of downstream proteins mediating BR- and GA-regulated seed germination. The mutation of GRP, one representative target, notably suppressed seed germination. Our findings not only provide critical clues for validating BR⁻GA crosstalk during rice seed germination, but also help to optimise molecular regulatory networks.

Dental caries and first permanent molar pit and fissure morphology in 7- to 8-year-old children in Wuhan, China.

To obtain the caries experience and, plaque accumulation severity and pit and fissure morphology in first permanent molars in 7-8 children in Wuhan, as a reasonable prediction of caries risk and preventive attention in the future, a convenient sample of five primary schools in the vicinity of the Wuhan University School and Hospital of Stomatology was drawn. Two calibrated examiners orally examined all present grade 2 children in the classroom, using standard caries plaque and tooth morphology criteria. Dental caries was scored at enamel (D(2)) and dentine (D(3)) for tooth and surface level. Independent variables were age, gender and school. Data analysis used analysis of variance and t-test. The sample comprised 1 043 7- and 8-year-olds. The prevalence of dental caries in permanent dentition was 8.7% and in primary dentition, 68.7%. Mean Decayed, Missing, Filled Teeth/S (DMFT/S) scores were 0.11 and 0.14, respectively. Mean dmft/s scores were 2.8 and 5.0. The d-component constituted 75% of the d(3)mft index, while enamel carious lesions constituted 36% of the total number of carious lesions (d(2,3)-component). Prevalence of medium and deep pits and fissures was 84.6%. Prevalence of medium and severe plaque accumulation was 67.4%. Prevalence of dental caries in the deciduous and permanent dentitions of 7- to 8-year-old children was high. Deep pits and fissures in high caries risk children should be sealed.

[Antireflux anastomosis following resection of esophageal cancer].

OBJECTIVE: To investigate the antireflux effects of a modified Nissen fundoplication following esophagectomy for cancer. METHODS: From March 2006 to March 2007, 70 patients with esophageal cancer were divided into two groups randomly. Esophagogastrostomy with a stapler only was perform in 35 patients as controls (group C), and a modified Nissen fundoplication was added after esophagogastrostomy with stapler in the other 35 patients as observed group (group O). There were 48 male and 22 female, ranging in age from 47 to 77 years (mean 60.1 years). The operative morbidity and mortality were recorded. Fourty-nine patients were followed at 3 months after surgery, and the questionnaire of life quality (EORTC QLQ C-30) was conducted in 24 patients in group C and 25 patients in group O. Thirty patients were examined with esophageal manometry, 24 h pH monitoring and gastroscopy. There were 16 patients in group C and 14 patients in group O. RESULTS: There was no significant difference in postoperative morbidity between the two groups (P > 0.05). However, the scores of heart burn and regurgitation in the group O were less than in group C (P = 0.041 and 0.034 respectively), but there was no difference in scores of dysphagia between the two groups (P = 0.677). The pressure at the anastomotic site was higher than that in the stomach in group O (P = 0.032), but not in group C (P = 0.448). DeMeester score in group O was 53 ± 46, compared to 140 ± 103 in group C (P = 0.043). The score of esophagitis was 0.9 ± 0.8 in group O, which was lower than 1.6 ± 1.0 in group C (P = 0.041). CONCLUSIONS: Addition of modified Nissen fundoplication after esophagectomy and esophagogastrostomy for cancer significantly increases the pressure at the anastomotic site, thus reduces the extent of gastroesophageal reflux, which leads to the reduction of the extent of reflux esophagitis and the improvement of the quality of life.

[The effects of blood motilin and gastrin on electrical activity and emptying of the intrathoracic stomach after esophagectomy for cancer].

OBJECTIVE: To observe the effects of blood motilin and gastrin on the electrical activity and emptying of the intrathoracic stomach after esophagectomy for cancer. METHODS: Electrogastrography and determination of blood motilin and gastrin were carried out in 52 subjects, including 20 normal volunteers and 32 esophageal cancer patients before and 1, 3, 6, 12 months after operation. Gastric emptying of radiopaque granula was studied in 35 of the 52 subjects, including 5 normal volunteers, 7 preoperative patients and 23 postoperative patients. RESULTS: The preoperative gastric emptying of radiopaque granula was 28.0 +/- 8.0 pieces 120 second after eating the test meal, significantly less than that of the normal controls [(38.0 +/- 2.0) pieces, t = 3.515, P = 0.006], and decreased to (16.0 +/- 4.8) pieces one month after esophagectomy (t = 6.987, P = 0.000), and then recovered to 16.8 +/- 4.8 one year after surgery but still could not reach normal (t = 9.387, P = 0.0000). Compared with the normal controls, the amplitude of electrogastrogram (EGG) of the preoperative patients was (229 +/- 118) microv, not significantly different from that of the controls [(226 +/- 62) microv, t = 0.085, P = 0.933], and the frequency of EGG of the preoperative patients was (3.1 +/- 0.2) times per minute, not significantly different from that of the controls too [(3.2 +/- 0.1) times per minute, t = 0.872, P = 0.387]. But the frequency and amplitude of EGG of the patients one month after operation were (2.9 +/- 0.3) times per minute and (172 +/- 46) microv respectively, both significantly decreased in comparison with those of the normal controls (t = 2.336, P = 0.024; and t = 3.118, P = 0.003). The amplitude reached normal [(223 +/- 60) microv, t = 0.145, P = 0.885] 1 year after surgery, but the frequency still remained at a low level [(3.0 +/- 0.1) times per minute, t = 2.208, P = 0.033). The level of blood motilin of the preoperative patients was (488 +/- 197) ng/L, significantly higher than that of the controls [(248 +/- 98) ng/L, t = 5.030, P = 0.000], and the blood gastrin level of the preoperative patients was (26 +/- 15) ng/L, significantly higher than that of the controls [(20 +/- 12) ng/L, t = 2.741, P = 0.043]. One year after operation the blood motilin level maintained at a high level [(443 +/- 129) ng/L, t = 3.725, P = 0.001], and the gastrin level remained at a high level too [(48 +/- 23) ng/L, t = 3.703, P = 0.001]. CONCLUSION: Physiologically important, persistent elevation of blood gastrin and motilin in the patients who underwent esophagectomy for cancer facilitates the recovery of electrical activity and emptying of the intrathoracic stomach.