[The Origin and Academic Characteristics of Xujiang School].

Xujiang School of acupuncture and moxibustion has a long history with distinctive academic characteristics and regional influence. Xujiang School, originated from Xi Hong in Song Dynasty, is the oldest acupuncture and moxibustion school recorded in Chinese history. Later, it was passed down from family to family for more than ten generations. The tenth generation Xi Xinqing passed it on to Chen Honggang and gradually evolved into a school of acupuncture and moxibustion with regional characteristics and a certain national influence. In terms of academic characteristics, doctors in Xujiang School kept innovating based on the Classics.Its acupuncture and moxibustion academic ideas including reinforcement and reduction , point selection and searching for the primary cause of disease in treatment have had an important impact on contemporary acupuncture in clinic.

Anisotropic magnetoresistance and electronic features of the candidate topological compound praseodymium monobismuthide.

PrBi, a sister member of the rare-earth monopnictide family, is an excellent candidate for studying extreme magnetoresistance and nontrivial topological electronic states. In this study, we perform angular magnetoresistance measurements as well as bulk and surface band structure calculations on this compound. PrBi's magnetoresistance is revealed to be significantly angle-dependent and shows a fourfold symmetry as always observed in the nonmagnetic isostructural counterparts, including LaSb, LaBi, and LuBi. Its angular magnetoresistance can be reproduced well using the semiclassical two-band model. The deduced parameters suggest that PrBi hosts an elongated electron pocket with a mobility anisotropy of ∼3.13 and is slightly uncompensated in its carrier concentration. Our bulk and surface band structure calculations confirm the anisotropic electronic features. Moreover, we reveal that a nodal-line-shaped surface state appears at the X̄ point, and is associated with the quadratic dispersion along the -X̄ direction, and the linear type-I Dirac dispersion along the X̄-M̄ direction. Owing to the type-I Dirac dispersion feature, PrBi could serve as a promising material platform for studying many unexpected physical properties, such as the highly anisotropic transport and valley polarization of electrons.

Prognostic factors for 495 nonoperative esophageal squamous cancer patients receiving IMRT plus chemotherapy: A retrospective analysis.

PURPOSE: Chemoradiotherapy is regarded as a standard scheme for inoperable and unresectable esophageal cancers. Our aims were to explore the prognostic factors relevant to esophageal squamous cell carcinoma (ESCC) following intensity-modulated radiation therapy (IMRT) plus chemotherapy. MATERIAL AND METHODS: Totally 495 ESCC patients undergoing IMRT combined with chemotherapy in our hospital between 2011 and 2020 were retrospectively analyzed. Potential clinical prognosis-related factors were assessed by uni- and multivariate analyses. RESULTS: The median overall survival (OS) and progression-free survival (PFS) of the ESCC patients were 2.25 and 1.24years, respectively. Uni- and multivariate analyses demonstrated the relevant independent prognostic factors of OS and PFS were gender, T stage, N stage, clinical stage, and tumor location (P<0.05), but not chemotherapy or radiotherapy dose. We further compared the 5-year OS rates among different T stages, N stages, clinical stages, genders, and tumor locations. The survival rate at the higher clinical stage was significantly lower (P<0.001). The 5-year OS in the upper thorax of the tumor was 46.0% and exceeded other tumor locations (P<0.05). The 5-year OS was 56.1% among females and 33.3% among males (P=0.001). CONCLUSIONS: For ESCC patients receiving IMRT combined with chemotherapy, their long-term curative effects are influenced by T stages, N stages, clinical stages, genders, and tumor locations. ESCC patients who are females, or have upper thoracic tumor, or are at early clinical stage own better prognosis.

Experimental Demonstration of Efficient Harmonic Generation via Surface Plasma Compression with Lasers.

The efficiency of high-order harmonic generation from a relativistic laser interacting with solid targets depends greatly on surface plasma distribution. The usual method of enhancing efficiency involves tuning the plasma scale length carefully by improving the laser contrast. Here, we experimentally demonstrate that efficient harmonics can be achieved directly by compressing large-scale surface plasma via the radiation pressure of a circularly polarized normally incident prepulse. The harmonic generation efficiency obtained by this method is comparable to that obtained with optimized plasma scale length by high-contrast lasers. Our scheme does not rely on high-contrast lasers and is robust and easy to implement. Thus, it may pave a way for the development of intense extreme ultraviolet sources and future applications with high repetition rates.

[Long-term efficacy and safety of simultaneous integrated boost radiotherapy in non-operative esophageal squamous cell carcinoma: a multicenter retrospective data analysis (3JECROG R-05)].

Objective: To analyze the survival benefits and treatment related toxic effects of simultaneous integrated boost intensity-modulated radiotherapy (SIB-RT) for non-operative esophageal squamous cell carcinoma patients. Methods: The data of 2 132 ESCC patients who were not suitable for surgery or rejected operation, and underwent radical radiotherapy from 2002 to 2016 in 10 hospitals of Jing-Jin-Ji Esophageal and Esophagogastric Cancer Radiotherapy Oncology Group (3JECROG) were analyzed. Among them, 518 (24.3%) cases underwent SIB (SIB group) and 1 614 (75.7%) cases did not receive SIB (No-SIB group). The two groups were matched with 1∶2 according to propensity score matching (PSM) method (caliper value=0.02). After PSM, 515 patients in SIB group and 977 patients in No-SIB group were enrolled. Prognosis and treatment related adverse effects of these two groups were compared and the independent prognostic factor were analyzed. Results: The median follow-up time was 61.7 months. Prior to PSM, the 1-, 3-, and 5-years overall survival (OS) rates of SIB group were 72.2%, 42.8%, 35.5%, while of No-SIB group were 74.3%, 41.4%, 31.9%, respectively (P=0.549). After PSM, the 1-, 3-, and 5-years OS rates of the two groups were 72.5%, 43.4%, 36.4% and 75.3%, 41.7%, 31.6%, respectively (P=0.690). The univariate survival analysis of samples after PSM showed that the lesion location, length, T stage, N stage, TNM stage, simultaneous chemoradiotherapy, gross tumor volume (GTV) and underwent SIB-RT or not were significantly associated with the prognosis of advanced esophageal carcinoma patients who underwent radical radiotherapy (P<0.05). Cox model multivariate regression analysis showed lesion location, TNM stage, GTV and simultaneous chemoradiotherapy were independent prognostic factors of advanced esophageal carcinoma patients who underwent radical radiotherapy (P<0.05). Stratified analysis showed that, in the patients whose GTV volume≤50 cm(3), the median survival time of SIB and No-SIB group was 34.7 and 30.3 months (P=0.155), respectively. In the patients whose GTV volume>50 cm(3), the median survival time of SIB and No-SIB group was 16.1 and 20.1 months (P=0.218). The incidence of radiation esophagitis and radiation pneumonitis above Grade 3 in SIB group were 4.3% and 2.5%, significantly lower than 13.1% and 11% of No-SIB group (P<0.001). Conclusions: The survival benefit of SIB-RT in patients with locally advanced esophageal carcinoma is not inferior to non-SIB-RT, but without more adverse reactions, and shortens the treatment time. SIB-RT can be used as one option of the radical radiotherapy for locally advanced esophageal cancer.

[The distribution and variance of neonatal pulse oxygen saturation at different altitudes].

Objective: To analyze the distribution and variance of neonatal pulse oxygen saturation (SpO2) at different altitudes in China, and provide a new evidence for the screening of NCHD at high altitudes. Methods: Based on the database of National Screening Project of NCHD, the distribution of SpO2 values was described in 26 766 newborns at altitudes of 0-100 m, 600-700 m, 900-1 100 m, 1 400-1 600 m, 1 900-2 100 m, and 2 200-2 500 m. One-way analysis of variance was used to analyze the differences among SpO2 values in newborns at different altitudes. Results: The average SpO2 values of right hand in newborns at altitudes of 0-100 m, 600-700 m, 900-1 100 m, 1 400-1 600 m, 1 900-2 100 m and 2 200-2 500 m were 97.7%±1.4%, 97.1%±1.1%, 96.1%±1.3%, 96.0%±1.7%, 95.9%±1.7% and 95.5%±2.4%, respectively. And corresponding average SpO2 values of either foot were 97.7%±1.4%, 96.9%±1.1%, 96.3%±1.4%, 96.0%±1.7%, 95.6%±1.8% and 95.2%±2.7%, respectively. There were statistically significant differences in the average SpO2 values of newborns at different altitudes (right hand: F=1 248.35, P<0.001; either foot: F=1 280.45, P<0.001). The SpO2 of newborns tended to be lower with the increase of altitudes (P-trend<0.001). Conclusion: SpO2 values in newborns were negatively associated with the altitudes, which indicated that the cut-off value of screening for NCHD at sea level might not be applicable to newborns at higher altitudes. Thus, it is worthwhile to conducted studies on the normal values of SpO2 and the cut-off value of screening for NCHD in newborns at high altitudes.

[Efficacy analysis of the radiotherapy and chemotherapy in patients with stage â £ esophageal squamous carcinoma: a multicenter retrospective study of Jing-Jin-Ji Esophageal and Esophagogastric Cancer Radiotherapy Oncology Group (3JECROG R-01F)].

Objective: To evaluate the survival and prognostic factors of radiotherapy in patient with Ⅳ stage esophageal squamous carcinoma treated with radiation or chemoradiation. Methods: The medical records of 608 patients with stage Ⅳ esophageal squamous cell carcinoma who met the inclusion criteria in 10 medical centers in China from 2002 to 2016 were retrospectively analyzed. The overall survival and prognostic factors of all patients at 1, 3 and 5 years were analyzed. Results: The 1-, 3-, 5- year overall survival (OS) rates was 66.7%, 29.5% and 24.3% in stage ⅣA patients, and 58.8%, 29.0% and 23.5% in stage ⅣB patients. There was no statistical difference between the two groups (P=0.255). Univariate analysis demonstrated that the length of lesion, treatment plan, planned tumor target volume (PGTV) dose, subsequent chemotherapy, and degrees of anemia, radiation esophagitis, radiation pneumonia were related to the prognoses of patients with Ⅳ stage esophageal carcinomas after radiotherapy and chemotherapy (P<0.05). Multivariate analysis demonstrated that PGTV dose (OR=0.693, P=0.004), radiation esophagitis (OR=0.867, P=0.038), and radiation pneumonia (OR=1.181, P=0.004) were independent prognostic factors for OS. Conclusions: For patients with stage Ⅳ esophageal squamous cell carcinoma, chemoradiotherapy followed by sequential chemotherapy is recommended, which can extend the total survival and improve the prognosis of the patients. PGTV dose more than 60 Gy has better efficacy.

[Prognostic analysis of definitive radiotherapy for early esophageal carcinoma(T1-2N0M0): a multi-center retrospective study of Jing-Jin-ji Esophageal and Esophagogastric Cancer Radiotherapy Oncology Group].

Objective: To evaluate the prognostic factors of T1-2N0M0 esophageal squamous cell carcinoma (ESCC) treated with definitive radiotherapy. Methods: The clinical data of 196 patients with T1-2N0M0 ESCC who were treated with definitive radiotherapy in 10 hospitals were retrospectively analyzed. All sites were members of Jing-Jin-Ji Esophageal and Esophagogastric Cancer Radiotherapy Oncology Group (3JECROG). Radiochemotherapy were applied to 78 patients, while the other 118 patients received radiotherapy only. 96 patients were treated with three-dimensional conformal radiotherapy (3DCRT) and 100 treated with intensity-modulated radiotherapy (IMRT). The median dose of plan target volume(PTV) and gross target volume(GTV) were both 60 Gy. The median follow-up time was 59.2 months. Log rank test and Cox regression analysis were used for univariat and multivariate analysis, respectively. Results: The percentage of normal lung receiving at least 20 Gy (V(20)) was (18.65±7.20)%, with average dose of (10.81±42.05) Gy. The percentage of normal heart receiving at least 30 Gy (V(30)) was (14.21±12.28)%. The maximum dose of exposure in spinal cord was (39.65±8.13) Gy. The incidence of radiation pneumonia and radiation esophagitis were 14.80%(29/196) and 65.82%(129/196), respectively. The adverse events were mostly grade 1-2, without grade 4 toxicity. Median overall survival (OS) and progression-free survival (PFS) were 70.1 months and 62.3 months, respectively. The 1-, 3- and 5-year OS rates of all patients were 75.1%、57.4% and 53.2%, respectively. The 1-, 3- and 5-year PFS rates were 75.1%、57.4% and 53.2%, respectively. Multivariate analysis demonstrated that patients'age (HR=1.023, P=0.038) and tumor diameter (HR=1.243, P=0.028)were the independent prognostic factors for OS, while tumor volume were the independent prognostic factor for PFS. Conclusions: Definitive radiotherapy is a promising therapeutic method in patients with T1-2N0M0 ESCC. Patients' age, tumor diameter and tumor volume may impact patients' prognosis.

Proton pump inhibitor use and risk of spontaneous bacterial peritonitis in cirrhotic patients: a systematic review and meta-analysis.

We used a meta-analysis approach to investigate the association between proton pump inhibitor (PPI) use and risk of spontaneous bacterial peritonitis (SBP) in cirrhotic patients. We searched Ovid Medline, Embase, and the Cochrane Library to identify eligible studies. We included studies that compared cirrhotic patients who did or did not use PPIs. The primary outcome was SBP, and the secondary outcome was overall bacterial infection. Results were pooled using random-effect models. This process led to identification of 12 journal articles and 5 conference abstracts. The pooled data showed that PPI use in patients with cirrhosis and ascites was significantly associated with an increased risk of SBP [odds ratio (OR) = 2.17; 95% confidence interval (CI) = 1.46-3.23; P < 0.05; I2 = 85.6%] and overall risk of bacterial infection (OR = 1.98; 95%CI = 1.36-2.87; P < 0.05; I2 = 0). Subgroup analysis revealed that journal articles and studies reporting adjusted effect estimates demonstrated that PPI users had a significantly increased risk of SBP (OR = 2.13; 95%CI = 1.61-2.82; P < 0.05; I2 = 29.4%; and OR = 1.98; 95%CI = 1.42-2.77; P < 0.05; I2 = 67%, respectively). In conclusion, PPI use increased the risk of SBP and overall bacterial infection in patients with cirrhosis and ascites. PPIs should be administered after careful assessment of the indications in cirrhotic patients. Future well-designed prospective studies are warranted to clarify the dose relationships and to compare infection risks associated with different classes of PPIs.

Spectrally peaked electron beams produced via surface guiding and acceleration in femtosecond laser-solid interactions.

Highly collimated MeV electron beam guiding has been observed along the target surface following the interaction of bulk target irradiation by femtosecond laser pulses at relativistic intensities. The beam quality is shown to depend critically on the laser contrast: With a ns prepulse, the generated electron beam is well concentrated and intense, while a high laser contrast produces divergent electron beams. In the case of large preplasma scale lengths, tunable guiding and acceleration of the target surface electrons is achieved by changing the laser incident angle. By expanding the preplasma scale length to several hundred micrometers, we obtained MeV spectrum-peaked electron beams with a 100 pC per laser pulse and divergence angles of only 3°. This technique suggests a stable method of injection of elections into a variety of accelerator designs.

Early detection of radiation-induced glomerular injury by albumin permeability assay.

Renal irradiation leads predictably to glomerular vascular injury, cell lysis, matrix accumulation, sclerosis and loss of renal function. The immediate effects of renal irradiation that may be associated with glomerular pathology and proteinuria are not clear in the human disease or its rat model. We hypothesized that radiation-induced injury causes immediate and subtle alterations in glomerular physiology independent of the neurohumoral and hemodynamic regulatory mechanisms. We employed a sensitive in vitro functional assay of glomerular albumin permeability (P(alb)) to demonstrate radiation-induced damage to the glomerular filtration barrier immediately after total-body irradiation of rats. In blinded experiments, control rats were sham-treated, and experimental rats received 9.5 Gy X rays. Rats were killed humanely at 1 h to 9 weeks after irradiation and glomeruli were isolated. In parallel experiments, glomeruli were isolated from normal rats and irradiated in vitro. The change in glomerular capillary permeability due to an experimental oncotic gradient was determined using videomicroscopy and P(alb) was calculated. Results show that in vivo or in vitro irradiation of glomeruli caused an increased P(alb) at 1 h. Increased P(alb) was observed up to 3 weeks after irradiation. Glomeruli from mice irradiated with 9.5 or 19.0 Gy X rays did not show increased P(alb) at 1 h postirradiation. We conclude that glomerular protein permeability of irradiated rats increases in a dose-dependent manner immediately after irradiation and that it appears to be independent of hemodynamic or systemic influences.

Components of normal serum block the focal segmental glomerulosclerosis factor activity in vitro.

BACKGROUND: Sera from some patients with focal segmental glomerulosclerosis (FSGS) increase glomerular albumin permeability (P(alb)) in vitro. The hypothesis that a component of normal serum can protect the glomerular permeability barrier was tested using sera from FSGS patients, normal individuals, and several mammalian and avian species. METHODS: In most experiments, isolated rat glomeruli were incubated in medium containing FSGS serum known to increase P(alb) in vitro, normal serum, or both active FSGS and normal serum. In other experiments, fractions of normal serum and serum from other vertebrate species were incubated with active FSGS serum. P(alb) was calculated from glomerular capillary expansion in response to an oncotic gradient. To enrich the blocking activity, normal pooled human plasma was subjected to various biochemical manipulations. RESULTS: Normal human serum prevented the increase in P(alb) (active FSGS sera, 0.77 +/- 0.12; active FSGS sera:normal serum, 1:1 mix, 0.06 +/- 0.30, P < 0.001). Protection diminished as the concentration of normal serum was decreased. Specific fractions of human serum, including human albumin and immunoglobulin fractions, were not protective. Blocking activity was present in 80% ammonium sulfate precipitate and certain fractions from size-exclusion chromatography of normal pooled human plasma. Normal serum from each of the vertebrate species tested also prevented the increase in P(alb). Preincubation with normal serum was protective during subsequent incubation with FSGS serum, but normal serum was not protective after preincubation with FSGS serum. CONCLUSIONS: We conclude that a factor or factors in normal serum block the permeability effect of active FSGS sera. This phenomenon may account for variability in proteinuria among patients with FSGS and may explain inconsistent proteinuria following injection of FSGS sera into experimental animals. Characterization of the protective substance(s) and the mechanism by which the increase in permeability is blocked may provide insight into the pathogenesis of FSGS.

TNF-alpha increases albumin permeability of isolated rat glomeruli through the generation of superoxide.

Tumor necrosis factor-alpha (TNF-alpha) is a cytokine that plays a central role in inflammation. Glomerular levels of TNF-alpha are elevated in human and experimental glomerulonephritis. Glomerular cells produce and respond to TNF-alpha. One of the mechanisms by which these cells respond to TNF-alpha is through generation of reactive oxygen species. In this study, the effect of TNF-alpha on albumin permeability (P(albumin)) of isolated rat glomeruli and the possible mechanism of this effect were examined. Isolated rat glomeruli were incubated with TNF-alpha (0.4 ng/ml), TNF-alpha with anti-TNF-alpha antibodies, and TNF-alpha with the reactive oxygen species scavengers superoxide dismutase, catalase, DMSO, or dimethylthiourea for 12 min at 37 degrees C, and P(albumin) was calculated. TNF-alpha increased P(albumin) of isolated glomeruli compared with control (0.70 +/- 0.02, n = 25 versus 0.00 +/- 0.05, n = 26), and this effect was abrogated by anti-TNF-alpha antibodies (-0.18 +/- 0.05, n = 23). Superoxide dismutase abolished the increase in P(albumin) (-0.04 +/- 0.11, n = 23), whereas catalase (0.73 +/- 0.08, n = 30), DMSO (0.64 +/- 0.03, n = 10), or dimethylthiourea (0.51 +/- 0.08, n = 10) did not alter the effect of TNF-alpha. These results indicate that TNF-alpha increased P(albumin+)++ of isolated glomeruli and that the mediator of the increased P(albumin) is superoxide. It is concluded that TNF-alpha derived from glomerular or extraglomerular sources can increase glomerular P(albumin) through generation of superoxide and may lead to proteinuria.

[Glucose and lipid metabolism in patients with polycystic ovary syndrome].

Glucose and lipid metabolism were studied in 30 patients with polycystic ovary syndrome (PCOS), divided into obese (n = 17) and non-obese (n = 13) groups according to BMI > 27 or < 24. Another 30 healthy controls were also divided into obese (n = 14) and nonobese (n = 16) normal groups on the same index. Cubital venous blood was drawn from each participant for oral glucose tolerance test (OGTT), insulin and lipid profile determination, for PCOS groups at the end of 3 months amenorrhea and control groups within the first 10 days of the menstrual cycle. The results showed: (1) the PCOS groups had much higher insulin level before and after OGTT than the normal groups. There was a significant positive correlation between fasting insulin level and testosterone concentration; (2) in lipid profile, the triglyceride levels in both obese groups were significantly higher than that in the non-obese groups, in whom a strong positive correlation between triglyceride and BMI was found. It is concluded that the obese and non-obese PCOS were correlated with insulin alteration, and the changed serum lipid in obese PCOS patients might be the effect of obesity but not PCOS.

Relationships between pelvic pain and prostaglandin levels in plasma and peritoneal fluid collected from women after sterilization.

Prostaglandin levels in plasma and peritoneal fluid were determined in 10 sterilized women with pelvic pain without pathological findings. Another 15 healthy women were regarded as controls. The 6-keto-PGF1 alpha levels in peritoneal fluid collected from patients with pelvic pain were significantly higher than that from the controls (p less than 0.05). The results indicated that prostaglandins might play an important role in pelvic pain following sterilization.

PIP: Prostaglandin (PG) levels in plasma and peritoneal fluid were determined in 10 sterilized women with pelvic pain without pathological findings. Another 15 women who were healthy were regarded as controls. The 6-keto-PGF(1alpha) levels in peritoneal fluid collected from patients with pelvic pain were significantly higher than that from controls (p 0.05. The results indicated that PGs might play an important role in pelvic pain following sterilization.

[Treatment of secondary amenorrhea and oligohypomenorrhea with combined traditional Chinese and Western medicine].

This article reported the treatment of 149 cases (1087 cycles) with secondary amenorrhea and oligohypomenorrhea, including 42 cases who were treated by cycle treatment with traditional Chinese medicine (TCM) and clomiphene in comparison with clomiphene in 67 cases and/or TCM in 40 cases at the same time. The results showed that ovulatory rate of secondary amenorrhea, calculated according to menstrual cycles, was significantly higher in the group of TCM and clomiphene than that of clomiphene or TCM (P less than 0.01). The efficacy of clomiphene was better than that of TCM (P less than 0.01). The ovulatory rate of oligohypomenorrhea was significantly increased by using TCM and clomiphene in contrast to only western medicine (P less than 0.05). The phenomena mentioned above indicate that the TCM-WM treatment has obvious advantages.