Influence of different depths of anesthesia under the guidance of anesthesia depth detector on awakening quality of elderly patients with colon cancer after laparoscopic surgery / 中国医学装备

Objective:To explore the influence of different depths of anesthesia under guidance of anesthesia depth detector on the awakening quality of elderly patients with colon cancer after laparoscopic surgery.Methods:A total of 96 elderly patients with colon cancer who underwent surgical resection and admitted to Beijing Changping District Hospital from February 2017 to June 2020 were selected.They were randomly divided into mild anesthesia group,moderate anesthesia group and deep anesthesia group according to the random sampling,with 32 in each group.The bispectral index(BIS)of deep anesthesia group was within 30-39 interval,and the BIS of moderate anesthesia group was within 40-49 interval,and the BIS of mild anesthesia group was within 50-60 interval.The Prince-Henry pain scale scores of patients with different depths of anesthesia under anesthesia depth detector were observed.The stress response-related indicators included adrenocorticotropic hormone(ACTH),cortisol(Cor)and interleukin-6(IL-6)of patients at three different time points:pre operation(S1),intra operation(S2)and post operation(S3)were monitored.Additionally,the differences of the incidences of complications and the cognitive function also were analyzed.Results:The postoperative Prince-Henry pain scores of the three groups of patients with colon cancer showed there were no statistically significant differences among anesthesia groups with different depths(P>0.05).The stress response indicators included ACTH,Cor and IL-6 appeared significant time-dependent changes among anesthesia groups with different depths.The stress response indicators of all groups significantly increased at S2 point,and the ACTH,Cor and IL-6 levels of mild anesthesia group were respectively(13.73±1.63)nmol/L,(269.24±31.46)nmol/L and(83.67±3.44)μg/L,and these of moderate anesthesia group were respectively(18.26±2.52)nmol/L,(242.56±36.75)nmol/L and(109.35±6.44)μg/L,and these of deep anesthesia group were respectively(19.42±2.42)nmol/L,(432.35±31.34)nmol/L and(132.42±2.31)μg/L.There were significant differences in these indicators in same group between S2 point and S1 point(tmild group=7.99,12.48,16.48,tmoderate group=2.19,6.82,3.03,tdeep group=14.21,5.11,20.14,P＜0.05),respectively.The differences of the incidence rates of complication between the mild anesthesia group and the moderate anesthesia group,and between the mild anesthesia and the deep anesthesia group were statistically significant(x2=6.342,5.238,P<0.05),respectively.The MMSE scores 24 hours after surgery indicated that the difference of that between mild anesthesia group and deep anesthesia group,and between moderate anesthesia group and deep anesthesia group were significant(t=4.74,3.77,P<0.05),respectively.Conclusion:The depth of anesthesia has a significant influence on postoperative recovery quality,stress response and cognitive function.Using anesthesia depth detector to adjust the different depth of anesthesia can help to improve the awakening quality of elderly patients with colon cancer post-surgery and reduce the incidence of adverse reactions.

The identification and expression pattern of the sex determination genes and their sex-specific variants in the egg parasitoid Trichogramma dendrolimi Matsumura (Hymenoptera: Trichogrammatidae).

Introduction: Trichogramma wasps are egg parasitoids of agricultural lepidopteran pests. The sex of Trichogramma is determined by its ploidy as well as certain sex ratio distorters, such as the endosymbiotic bacteria Wolbachia spp. and the paternal sex ratio (PSR) chromosome. The sex determination systems of hymenopterans, such as Trichogramma spp., involve cascades of the genes transformer (tra), transformer-2 (tra2), and doublesex (dsx) and are associated with sex-specific tra and dsx splicing. First, these genes and their sex-specific variants must be identified to elucidate the interactions between the sex ratio disorders and the sex determination mechanism of Trichogramma. Methods: Here, we characterized the sex determination genes tra, tra2, and dsx in Trichogramma dendrolimi. Sex-specific tra and dsx variants were detected in cDNA samples obtained from both male and female Trichogramma wasps. They were observed in the early embryos (1-10 h), late embryos (12-20 h), larvae (32 h and 48 h), pre-pupae (96 h), and pupae (144 h, 168 h, 192 h, and 216 h) of both male and female T. dendrolimi offspring. Results: We detected female-specific tra variants throughout the entire early female offspring stage. The male-specific variant began to express at 9-10 h as the egg was not fertilized. However, we did not find any maternally derived, female-specific tra variant in the early male embryo. This observation suggests that the female-specific tra variant expressed in the female embryo at 1-9 h may not have originated from the maternal female wasp. Discussion: The present study might be the first to identify the sex determination genes and sex-specific gene splicing in Trichogramma wasps. The findings of this study lay the foundation for investigating the sex determination mechanisms of Trichogramma and other wasps. They also facilitate sex identification in immature T. dendrolimi and the application of this important egg parasitoid in biological insect pest control programs.

Posterior concentration of Wolbachia during the early embryogenesis of the host dynamically shapes the tissue tropism of Wolbachia in host Trichogramma wasps.

Introduction: The bacterial endosymbiont, Wolbachia spp. induce thelytokous parthenogenesis in certain parasitoid wasps, such as the egg parasitoid wasps Trichogramma spp. To complete the cycle of vertical transmission, Wolbachia displays efficient transovarial transmission by targeting the reproductive tissues and often exhibits strong tissue-specific tropism in their host. Method: The present study aimed to describe the basic Wolbachia distribution patterns that occur during the development of Wolbachia-infected, thelytokous Trichogramma dendrolimi, and T. pretiosum. We used fluorescence in situ hybridization (FISH) to investigate Wolbachia signal dynamics during early embryogenesis (from 30 to 120 min). Wolbachia titers and distributions from the embryo to adult stages of Trichogramma after early embryogenesis were detected by absolute quantitative polymerase chain reaction (AQ-PCR) and FISH. The symmetry ratios (SR) of the Wolbachia signals were calculated using the SR odds ratios in the anterior and posterior parts of the host. The SR was determined to describe Wolbachia tropism during early embryogenesis and various developmental stages of Trichogramma. Results: Wolbachia was concentrated in the posterior part of the embryo during early embryogenesis and the various developmental stages of both T. dendrolimi and T. pretiosum. Wolbachia density increased with the number of nuclei and the initial mitotic division frequency during early embryogenesis. The total Wolbachia titer increased with postembryogenesis development in both T. dendrolimi and T. pretiosum. However, the Wolbachia densities relative to body size were significantly lower at the adult and pupal stages than they were at the embryonic stage. Discussion: The present work revealed that posterior Wolbachia concentration during early host embryogenesis determined Wolbachia localization in adult wasps. By this mechanism, Wolbachia exhibits efficient vertical transmission across generations by depositing only female Wolbachia-infected offspring. The results of this study describe the dynamics of Wolbachia during the development of their Trichogramma host. The findings of this investigation helped clarify Wolbachia tropism in Trichogramma wasps.

Clinical study of using basement membrane biological products in pelvic floor reconstruction during pelvic exenteration / 中华胃肠外科杂志

Objective: To investigate the value of reconstruction of pelvic floor with biological products to prevent and treat empty pelvic syndrome after pelvic exenteration (PE) for locally advanced or recurrent rectal cancer. Methods: This was a descriptive study of data of 56 patients with locally advanced or locally recurrent rectal cancer without or with limited extra-pelvic metastases who had undergone PE and pelvic floor reconstruction using basement membrane biologic products to separate the abdominal and pelvic cavities in the Department of Anorectal Surgery of the Second Affiliated Hospital of Naval Military Medical University from November 2021 to May 2022. The extent of surgery was divided into two categories: mainly inside the pelvis (41 patients) and including pelvic wall resection (15 patients). In all procedures, basement membrane biologic products were used to reconstruct the pelvic floor and separate the abdominal and pelvic cavities. The procedures included a transperitoneal approach, in which biologic products were used to cover the retroperitoneal defect and the pelvic entrance from the Treitz ligament to the sacral promontory and sutured to the lateral peritoneum, the peritoneal margin of the retained organs in the anterior pelvis, or the pubic arch and pubic symphysis; and a sacrococcygeal approach in which biologic products were used to reconstruct the defect in the pelvic muscle-sacral plane. Variables assessed included patients' baseline information (including sex, age, history of preoperative radiotherapy, recurrence or primary, and extra-pelvic metastases), surgery-related variables (including extent of organ resection, operative time, intraoperative bleeding, and tissue restoration), post-operative recovery (time to recovery of bowel function and time to recovery from empty pelvic syndrome), complications, and findings on follow-up. Postoperative complications were graded using the Clavien-Dindo classification. Results: The median age of the 41 patients whose surgery was mainly inside the pelvis was 57 (31-82) years. The patients comprised 25 men and 16 women. Of these 41 patients, 23 had locally advanced disease and 18 had locally recurrent disease; 32 had a history of chemotherapy/immunotherapy/targeted therapy and 24 of radiation therapy. Among these patients, the median operative time, median intraoperative bleeding, median time to recovery of bowel function, and median time to resolution of empty pelvic syndrome were 440 (240-1020) minutes, 650 (200-4000) ml, 3 (1-9) days, and 14 (5-105) days, respectively. As for postoperative complications, 37 patients had Clavien-Dindo < grade III and four had ≥ grade III complications. One patient died of multiple organ failure 7 days after surgery, two underwent second surgeries because of massive bleeding from their pelvic floor wounds, and one was successfully resuscitated from respiratory failure. In contrast, the median age of the 15 patients whose procedure included combined pelvic and pelvic wall resection was 61 (43-76) years, they comprised eight men and seven women, four had locally advanced disease and 11 had locally recurrent disease. All had a history of chemotherapy/ immunotherapy and 13 had a history of radiation therapy. The median operative time, median intraoperative bleeding, median time to recovery of bowel function, and median time to relief of empty pelvic syndrome were 600 (360-960) minutes, 1600 (400-4000) ml, 3 (2-7) days, and 68 (7-120) days, respectively, in this subgroup of patients. Twelve of these patients had Clavien-Dindo < grade III and three had ≥ grade III postoperative complications. Follow-up was until 31 October 2022 or death; the median follow-up time was 9 (5-12) months. One patient in this group died 3 months after surgery because of rapid tumor progression. The remaining 54 patients have survived to date and no local recurrences have been detected at the surgical site. Conclusion: The use of basement membrane biologic products for pelvic floor reconstruction and separation of the abdominal and pelvic cavities during PE for locally advanced or recurrent rectal cancer is safe, effective, and feasible. It improves the perioperative safety of PE and warrants more implementation.

Clinical application value of surgical classification and pelvic floor reconstruction in pelvic exenteration for locally recurrent or advanced rectal cancer / 肿瘤

Objective:To investigate the value of surgical classification and pelvic floor reconstruction in pelvic exenteration for locally recurrent or locally advanced rectal cancer. Methods:A retrospective descriptive study method was used.Perioperative data were collected from 67 consecutive patients with locally advanced or locally recurrent rectal cancer who underwent pelvic exenteration at the Department of Anorectal Surgery,the Second Affiliated Hospital of Navy Military Medical University between November 2021 and November 2022 through the Chinese Combined Pelvic Exenteration Case Database for rectal cancer.The surgical range was divided into two categories:mainly localized in the pelvic cavity(48 cases)and combined with resection of the main tissue of the pelvic wall(1 9 cases).Outcome indexes included:(1)preoperative general data of patients;(2)intraoperative conditions;(3)postoperative recovery and complications(postoperative complications were evaluated by international Clavien-Dindo classification);(4)follow-up(outpatient and telephone follow-up were used to understand the postoperative survival,tumor recurrence and metastasis of patients,and the follow-up time was up to February 28,2023 or the case died).Measurement data are expressed by median(range),and enumeration data are expressed by example(％). Results:In the pelvic resection group,the median age of 48 patients was 57.5 years(range:31-82 years);29 were males and 19 were females;26 of them had locally advanced rectal cancer and 22 had locally recurrent rectal cancer;39 had a history of chemotherapy,immunotherapy or targeted therapy,and 26 had a history of radiotherapy;the median operation time was 425 min(range:240-1 020 min);the median intraoperative blood loss was 500 mL(range:200-4 000 mL);the median time to recovery of intestinal function was 3 d(range:1-9 d);the median recovery time of empty pelvis syndrome was 25.3 d(range:5-105 d);43 patients had postoperative complications＜grade Ⅲ,and of the 5 patients with ≥ grade Ⅲcomplications,2 died of multiple organ failure 7 d after operation,2 patients had surgical hemostasis for massive hemorrhage of pelvic floor wounds after operation,and 1 patient recovered from postoperative respiratory failure after rescue.In the combined pelvic wall resection group,the median age of 1 9 patients was 54.5 years(range:43-76 years);9 were males and 10 were females;4 patients had locally advanced rectal cancer and 15 patients had locally recurrent rectal cancer,all of whom had a history of chemotherapy,immunotherapy or targeted therapy,and 1 5 patients had a history of radiotherapy;the median operation time was 580 min(range:360-960 min);the median intraoperative blood loss was 1 600 mL(range:400-4 000 mL);the median intestinal function recovery time was 3 d(range:2-7 d);the median empty pelvis syndrome recovery time was 62.3 d(range:7-120 d);15 patients had postoperative complications＜grade Ⅲ,and of the 4 patients with grade ≥ Ⅲ,3 patients had surgical hemostatis for postoperative pelvic floor wound bleeding and 1 patient recovered after the second operation for intestinal obstruction.As of February 28,2023 or death,67 patients were followed up for a median of 7.5 months(range:3-1 5 months),and 3 patients died 3-8 months after operation due to rapid tumor progression,severe urinary tract infection,and sudden heart disease during the follow-up period.The remaining 62 cases survived. Conclusion:The surgical classification has guiding significance for preoperative surgical planning in patients with locally advanced or locally recurrent rectal cancer who undergo combined pelvic exenteration,and the method of pelvic floor reconstruction based on biological mesh is safe and feasible in combined pelvic exenteration for locally advanced or locally recurrent rectal cancer.

Correlation between serum vitamin D level and glucose and lipid metabolism among primary and middle school students in Inner Mongolia / 中国学校卫生

Objective@#To explore the correlation between serum vitamin D level and glucose and lipid metabolism among primary and middle school students in Inner Mongolia, so as to providing a scientific basis for guiding rational vitamin D supplementation among primary and middle school students in Inner Mongolia Region.@*Methods@#A total of 2 206 students of primary and middle school students from 8 counties (districts) in Inner Mongolia were enrolled for a questionnaire survey, physical examination, and laboratory test by a multi stage stratified random sampling approach.The levels of fasting blood glucose, blood lipid and other related indexes with different vitamin D levels were analyzed, and their correlation was further discussed.@*Results@#The deficiency and insufficiency rates of vitamin D among primary and middle school students were 33.2% and 42.8%, respectively, and the suitable rate was 24.0%. The body mass index (BMI) and waist height ratio (WHtR) of the vitamin D deficiency group [(22.87±7.41) kg/m 2 , 0.46±0.08)]were higher than the insufficiency [(20.59±8.00)kg/m 2, 0.44±0.09)] and suitable group [(18.01±7.38)kg/m 2, 0.43 ±0.08)] ( P <0.05). Compared with the vitamin D suitable group [(3.87±0.85) mmol/L], the total cholesterol (TC) level in the deficiency group [(3.73±0.67)mmol/L] decreased, with a statistically significant difference ( P <0.05). The levels of high density lipoproteins (HDL) in the vitamin D insufficiency[(1.40±0.33)mmol/L] and deficiency groups [(1.34±0.31)mmol/L] were lower than the suitable group [(1.48±0.34)mmol/L], with a statistically significant difference ( P <0.05). The detection rate of hyperuricemia (HUA) in the vitamin D deficiency group (22.95%) was higher than the suitable group (17.20%), with a statistically significant difference ( P <0.016 7). Pearson correlation analysis showed that vitamin D was negatively correlated with BMI and WHtR ( r =-0.23, -0.11), and positively correlated with TC and HDL level ( r =0.06, 0.16) ( P <0.05).@*Conclusions@#The deficiency and insufficiency rates of serum vitamin D among primary and middle school students in Inner Mongolia are high which are associated with several indicators of blood lipids. Therefore, it is recommended to supplement vitamin D preparations in moderation in daily life.

The efficacy of salbutamol combined with budesonide suspension nebulization in the treatment of AECOPD with respiratory failure and its impact on inflammatory related factors, C3a, and C3aR levels / 中国医师杂志

Objective:To evaluate the efficacy of salbutamol combined with budesonide suspension nebulization in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and respiratory failure, as well as its impact on inflammation related factors, complement 3a (C3a), C3a receptor (C3aR) levels, and helper T cell 17 (Th17), Th17/regulatory T cell (Treg) levels.Methods:A total of 120 AECOPD patients with respiratory failure admitted to the Jincheng People′s Hospital from March 2017 to March 2022 were selected as the study subjects. They were randomly divided into a control group of 60 cases and an observation group of 60 cases using a simple randomization method. The control group was treated with non-invasive positive pressure ventilation, while the observation group was treated with salbutamol combined with budesonide suspension nebulization on the basis of positive pressure ventilation. Two groups were compared in terms of efficacy, incidence of complications, length of hospital stay, COPD assessment test (CAT) scores, and inflammation related factors [white blood cell count (WBC), tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8), interleukin-23 (IL-23) ], differences in complement (C3a, C3aR), peripheral blood Th17/Treg balance factors, vital signs, and blood gas indicators.Resultsl:The total effective rate of the observation group was 93.33%(56/60), significantly higher than the 80.00%(48/60) of the control group, with a statistically significant difference ( P<0.05). After treatment, the levels of inflammation related factors, complement and Th17, Th17/Treg ratio in both groups were significantly lower than before treatment (all P<0.05), and Treg levels were significantly higher than before treatment (all P<0.05). In addition, the levels of inflammation related factors, complement and Th17, Th17/Treg ratio in the observation group were lower than those in the control group (all P<0.05), and Treg levels were higher than those in the control group (all P<0.05). After treatment, the heart rate (HR), respiratory rate (RR), and arterial partial pressure of carbon dioxide (PaCO 2) levels in both groups were significantly lower than those before treatment (all P<0.05), while blood oxygen saturation (SaO 2), partial pressure of oxygen (PaO 2), and pH levels were significantly higher than those before treatment (all P<0.05). The observation group had better lung function, vital signs, and blood gas indicators than the control group (all P<0.05). The hospitalization time in the observation group was significantly shorter than that in the control group ( P<0.05). After treatment, the CAT scores of both groups were significantly lower than those before treatment (all P<0.05), and the CAT scores of the observation group were lower than those of the control group ( P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the observation group [1.67%(1/60)] and the control group [5.00%(3/60)] ( P>0.05). Conclusions:The combination of salbutamol and budesonide suspension nebulization in the treatment of AECOPD with respiratory failure can correct the Th17/Treg imbalance, alleviate inflammatory reactions, improve blood gas indicators, and promote rehabilitation.

The application value and research progress of urine free DNA in tumor molecular diagnosis / 中华检验医学杂志

Urine cell-free DNA (ucfDNA) contains DNA fragments released from the lysis of cells in the urinary system, and circulating cell-free DNA (ccfDNA) can also enter the urine after glomerular filtration, and the mutation information carried by tumor DNA contained in ucfDNA and ccfDNA is consistent. Therefore, as a biomarker for molecular diagnosis of urological and non-urinary tumors, ucfDNA, has become a research hotspot in the field of liquid biopsy in recent years. UcfDNA has potential application value in individualized treatment, early diagnosis, dynamic monitoring of therapeutic efficacy, and prognosis assessment, etc. However, in order to realize the clinical application of urine ucfDNA, the extraction and accurate detection of ucfDNA still need to be solved.

Relationship between macular microstructure and visual acuity after scleral buckling for macular-off primary rhegmatogenous retinal detachment by 3D-OCT / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the correlation between macular mierostructure changes and visual outcomes after scleral buckling for macular-off primary rhegmatogenous retinal detachment(RRD)by three-dimensional optical coherence tomography(3D-OCT).<p>METHODS: Retrospective case review, the clinical data of scleral buckling in 30 eyes of 30 cases of RRD involving macular area were analyzed retrospectively. The changes of ellipsoid zone(EZ), external 1imiting membrane(ELM), subretinal fluid(SRF)and central retinal thickness(CRT)were observed and the relationship between them and best corrected visual acuity(BCVA)was analyzed by 3D-OCT at 2d, 2wk, 1, 3 and 6mo after operation.<p>RESULTS: Postoperative SRFH and CRT showed a descended trend. Postoperative BCVA showed an ascendant trend. Multiple comparisons: there were significant difference in each groups except SRFH(2wk <i>vs</i> 1mo, <i>P</i>>0.05), CRT(2d <i>vs</i> 2wk, <i>P</i>>0.05), BCVA(2d <i>vs</i> preoperation, 2wk <i>vs</i> preoperation, <i>P</i>>0.05). There are four forms of EZ and ELM::9 eyes, intact ELM and EZ(EZ+ELM+); B: 7 eyes, intact ELM with disrupted EZ:(EZ-ELM+); AC: 6 eyes, intact EZ with disrupted ELM:(EZ+ELM-); D: 8 eyes, disrupted ELM and EZ:(EZ-ELM-), the BCVA of the above four types are 0.15±0.04, 0.50±0.06, 0.54±0.05 and 0.59±0.09, there were significant difference in each groups except(C <i>vs</i> B, <i>P></i>0.05)and(C <i>vs</i> D, <i>P</i>>0.05). The incidence of SRF was 87% 2d after operation, 46.6% patients had persistent SRF at 6mo after operation. Postoperative CRT was positively correlated with postoperative SRFH.<p>CONCLUSION: After scleral buckling, the macular microstructure showed dynamic changes. The effect of SRF may be manifested as BCVA delayed recovery. With the slow absorption of SRF, CRT decreased and BCVA increased. The intact ELM or EZ shows better vision, but the disrupted ELM means worse vision.

Clinical study of different administration methods of mouse nerve growth factor in the treatment of occupational noise-induced deafness / 中国医师进修杂志

Objective:To compare the therapeutic effect of drum room injection and intramuscular injection of rat nerve growth factor on occupational noise-induced deafness (ONID).Methods:Sixty-six patients with ONID treatment from January 2018 to December 2019 in the People′s Hospital of Liaoning Province were divided into control group and study group by random number table, with 33 patients in each group. On the basis of conventional treatment, all patients in the study group were injected with 20 μg rat nerve growth factor in the drum room, and each ear was injected once every other day. The control group was given intramuscular injection of rat nerve growth factor 20 μg per day, and the patients in two groups were treatment for 28 d. The hearing threshold of left and right whisper frequency of the two groups were compared. The improvement of tinnitus, dizziness, headache, insomnia, other symptoms and the scores of Hamilton Depression Scale (HAMD) was compared between the two groups.Results:Before treatment, the hearing thresholds of left whisper frequency and right whisper frequency in two groups had no significant differences ( P>0.05). After treatment, the hearing thresholds of left whisper frequency and right whisper frequency in the study group were significantly lower than those in the control group: (23.8 ± 4.2) dB/HL vs. (34.5 ± 3.9) dB/HL, (23.2 ± 4.4) dB/HL vs. (35.9 ± 5.1) dB/HL, and there were statistical differences ( P<0.05). After treatment, tinnitus and dizziness symptom improvement rate in the study group were higher than those in the control group: 93.3% (28/30) vs. 72.4% (21/29), 15/17 vs. 8/16, and there were statistically significant differences ( χ2 = 4.584 and 5.705, P<0.05). There was no statistically significant difference in the improvement rate of headache and insomnia symptoms between 2 groups ( P>0.05). The total effective rate in the treatment group was significantly higher than that in the control group: 90.9% (30/33) vs. 69.7% (23/33), and there was statistical difference ( χ2 = 4.694, P<0.05). After treatment, the scores of HAMD of 2 groups were significantly decreased, and the scores of HAMD in the study group was lower than that in control group: (8.46 ± 3.13) scores vs. (10.55 ± 3.83) scores, and there was statistical difference ( P<0.05). The incidence of total adverse reactions between 2 groups had no significant difference ( P>0.05). Conclusions:The injection of mouse nerve growth factor into drum room to treat ONID can effectively improve the hearing level of patients, alleviate tinnitus and dizziness symptoms and improve adverse mood without obvious adverse reactions.

Systematic review and Meta-analysis of efficacy and safety of Compound Glycyrrhizin Injection in improving chronic hepatitis B liver damage / 中国中药杂志

To evaluate the efficacy and safety of Compound Glycyrrhizin Injection(CGI) in improving liver damage in chronic hepatitis B(CHB). PubMed, Web of Science, SinoMed, CNKI, Wanfang and VIP databases were retrieved from their inception to February 10, 2020. The randomized controlled trial(RCT) of CGI in the treatment of CHB was included. Data were independently extracted by two authors, and the methodological quality was evaluated using the Cochrane bias risk assessment tool by other two authors. Statistical analysis was performed using RevMan 5.3 software. A total of 18 two-armed RCTs were included, involving 1 915 participants. The methodological quality of all studies included was generally low. In the comparison between CGI and diammonium glycyrrhizinate, the results showed that CGI was superior to the control group in improving the overall clinical effectiveness, but there was no statistical difference between the two groups in increasing ALT normalization rate, reducing ALT and AST level. In the comparison between CGI and diammonium glycyrrhizinate+other general hepatoprotective drugs, the results showed that CGI was superior to the control group in reducing AST level, while there was no statistical difference between the two groups in reducing ALT level and increasing overall clinical effectiveness. In the comparison between CGI+other commonly used drugs(including energy mixture, glutathione, vitamins, potassium magnesium aspartate) and diammonium glycyrrhizinate+other commonly used drugs, the results showed that CGI combined with other commonly used drugs was better than the control group in reducing ALT and AST level and improving the clinical total effective rate, and there was no statistical difference between the two groups in increasing the rate of ALT normalization. In the comparison between CGI+other commonly used drugs and other commonly used drugs, the results showed that CGI combined with other commonly used drugs was superior to the control group in reducing ALT and AST level and improving the overall clinical effectiveness. In the comparison between CGI+vitamins and diammonium glycyrrhizinate+potassium magnesium aspartate+vitamins, the results showed no statistical difference between the two groups in reducing AST level. A small number of studies included reported that CGI caused mild adverse reactions when used alone or in combination with other drugs. Based on the results, CGI has a certain effect in improving CHB liver damage, but the evidence is not enough to prove that CGI would cause serious adverse events. In the future, more well-designed and strictly-enforced RCT with an adequate sample size are needed to further evaluate the effect CGI in alleviating CHB liver damage.

An acceptable method to evaluate the analytical performance of real-time fluorescent RT-PCR targeting SARS-CoV-2

It was necessary to carry out methodologies evaluations of real-time fluorescent reverse-transcription PCR (RT-PCR) targeting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Considering biosafety issues and lack of positive specimens in some special locations in China, the routine specimens from healthy individuals were used to perform methodologies evaluations, in which the indexes were the differences of quantification cycle values ({Delta} Cq) between human derived internal reference control (IRC) genes of a specimen and quality control (QC). Serial experiments were carried out to evaluate various factors that might affect aforementioned methodologies, such as types of virus transport mediums, methods of specimen pretreatment and template preparation, specimen vortex strength, specimen storage temperature and duration. The results showed that using {Delta}Cq values as indexes, among various factors that might affect analytical performance, it was better to store specimens in the normal saline transport mediums, inactivate pathogens using water or metal bath, release more virus particles from swabs by vortex mixing, extract nucleic acids with centrifuge methods, and perform amplification assays timely. Aforementioned opinions and optimum conditions were further confirmed by SRAS-CoV-2 pseudovirus and clinical positive specimens. Altogether, the results of this study indicated that the routine specimens from healthy individuals could be used to evaluate the analytical performance of real-time fluorescent RT-PCR targeting SRAS-CoV-2, of which the indexes were the {Delta}Cq values between IRC genes of a specimen and QC. This acceptable method was extremely valuable in both theoretical and practical significance under current pandemic of coronavirus disease 2019 (COVID-19).

Patient with frontal-variant syndrome in early-onset Alzheimer's disease.

The clinical manifestation of frontal-variant Alzheimer's disease (fvAD) is not typical, and it is difficult yet necessary to differentiate fvAD from frontal-variant frontal temporal dementia (fvFTD). We describe a patient with early-onset Alzheimer's disease (AD) who presented with an fvFTD-like syndrome and apolipoprotein E ɛ3/ ɛ4 genotype. A brain amyloid imaging procedure, 11C-Pittsburgh compound B positron emission tomography (PET), supported the final diagnosis of AD. Our present case highlights the clinical variability that characterises early-onset AD. A multimodal approach is crucial when assessing rare forms of dementia.

Optimal clutch size for quality control of bisexual and Wolbachia-infected thelytokous lines of Trichogramma dendrolimi Matsumura (Hymenoptera: Trichogrammatidae) mass reared on eggs of a substitutive host, Antheraea pernyi Guérin-Méneville (Lepidoptera: Saturniidae).

BACKGROUND: Trichogramma dendrolimi has been widely used in augmentative biocontrol of lepidopteran pests in China. In mass production of T. dendrolimi using Antheraea pernyi eggs as substitutive hosts, which are large in size, as clutch size is a parameter of importance to produce high quality parasitoids. Here, we aimed to determine the optimal clutch size for the bisexual Wolbachia-uninfected line (TdB) and Wolbachia-infected thelytokous line (TdT) of T. dendrolimi reared on A. pernyi eggs. RESULTS: A medium clutch size of 42.75 to 62.27 for TdB and 52.93 to 57.14 for TdT was optimal to maximize fitness-correlated traits of parasitoid individual. The optimal clutch sizes with maximized parameters included adult emergence rate, adult body size, adult longevity, fecundity, and sum of fecundity of all females per brood were 58.31 (86.00%), 42.75 (231.11 µm), 50.92 (2.69 days), 62.27 (150.89 eggs), and 83.25 (7926.33 eggs) for TdB and 57.14 (94.54%), 52.93 (236.97 µm), 53.64 (2.62 days), 56.80 (161.01 eggs), and 70.10 (8579.71 eggs) for TdT. The TdT had a shorter adult longevity, longer development time, and higher adult emergence rate than did its non-infected bisexual counterpart. CONCLUSION: A medium brood size in a A. pernyi egg host was optimal to produce offspring parasitoids with higher fitness parameters for both bisexual Wolbachia-uninfected and thelytokous Wolbachia-infected lines of T. dendrolimi. The determination of optimal clutch size for T. dendrolimi will provide the reference for the quality control of T. dendrolimi production and improvement of the field performance of the wasps. © 2020 Society of Chemical Industry.

Effects of temperature and superparasitism on quality and characteristics of thelytokous Wolbachia-infected Trichogramma dendrolimi Matsumura (Hymenoptera: Trichogrammatidae) during mass rearing.

Thelytokous Wolbachia-infected Trichogramma spp. are widely used egg parasitoids against lepidopteran pests in biological control programs. Wolbachia may manipulate host wasps for superparasitism and is sensitive to temperature. To explore effects of temperature and superparasitism, we compared fitness parameters and Wolbachia-mediated phenotype of thelytokous Wolbachia-infected Trichogramma dendrolimi between those emerging from superparasitised or single-parasitised hosts at 17, 21, 25, or 29 °C. Infected mothers of T. dendrolimi showed reduced superparasitism and parasitism increased with temperature. Wolbachia titre decreased with temperature when females emerged from singly-parasitised hosts, but there was no correlation in superparasitised hosts. Females showed higher Wolbachia titres at 21, 25, or 29 °C when developing from superparasitised hosts. The daily male ratio of offspring increased with temperature, and the day-age threshold for 5%, 50%, or 95% daily male ratio decreased with temperature in both parasitism forms. Females that emerged from superparasitised hosts had a shorter life span and reduced fecundity. These results indicate that Wolbachia may affect host behaviour by increasing superparasitism to enhance its spread, but this has negative effects on thelytokous Wolbachia-infected T. dendrolimi.

Co-occurrence of thelytokous and bisexual Trichogramma dendrolimi Matsumura (Hymenoptera: Trichogrammatidae) in a natural population.

Trichogramma dendrolimi is one of the most successful biocontrol agents in China. However, an inundative condition is necessary to obtain acceptable parasitism effect. A good solution to this is the application of its thelytokous counterparts which unfortunately are scarce in field. We here report the first case of a natural T. dendrolimi population in China comprising both bisexual wasps and an extremely low proportion of thelytokous wasps. These two forms of T. dendrolimi are phylogenetically related based on the reconstructions of ITS-2 and COI genes. Also, the phylogenetic results suggested a potentially Wolbachia-drived ITS-2 variation. The expression of thelytoky was hardly affected by temperature, which might help control Asian corn borer and Dendrolimus punctatus. Wolbachia are responsible for current thelytoky according to phylogenetic analyses, antibiotic treatment and introgression experiment. We also present the third case of paternal sex ratio chromosome that restrains the expansion of Wolbachia. Moreover, the low frequency of thelytoky may be common in natural populations. Consequently if for biological control it is determined that a thelytokous strain is to be preferred, then large number of field collected females should be set up as isofemale lines, to detect the rare thelytoky.

Gradual, temperature-induced change of secondary sexual characteristics in Trichogramma pretiosum infected with parthenogenesis-inducing Wolbachia.

Intersex is an intermediate stage of sexual differentiation in insects. Determining intersex morphology and the cause of its production will aid in the understanding of the mechanism of sexual differentiation in insects. In this paper, Wolbachia-infected Trichogramma pretiosum (T. preW+ ) that shows thelytokous parthenogenesis were used as subjects. In order to determine the causes of the T. preW+ intersex and the influence of parental generation temperature on gradual changes in secondary masculinization in intersex offspring, we examined the occurrence of intersex offspring (F1 and F2 generation) after the parental generations were treated with high temperature (27, 29, 31, and 33 °C) and described the external morphology of the intersexes. The results showed that the T. preW+ parental generation temperature is positively correlated with the probability of intersex offspring. The probability of F1 intersex is significantly higher than that of F2 intersex in different high temperature. The degree of secondary masculinization in T. preW+ intersexes increases as parental generation temperature increases. In addition, our study first identified 11 intersex types in T. preW+ and found that the primary and secondary sexual characteristics showed a regular distribution. We also found that the D type and H type of intersex have the highest frequency of appearance. The external genitalia of most intersexes were female, and only three intersex types have male external genitalia. Conclusions were ultimately obtained: Wolbachia is a direct factor that causes the occurrence of intersexes, while high temperature is an indirect factor that determines the external morphology of intersexes. The effects of high temperature on T. preW+ intersexes is passed through the parental generation to offspring, and this maternal effect weakens as the number of generations increases. In T. preW+ intersex individuals, most exhibit female primary sexual characteristics, and secondary sexual characteristics exhibit signs of masculinization.

Driver gene status and first line treatment of advanced lung adenocarcinoma:A single centric real-world study / 实用医学杂志

Objective To analyze driver genes status and its clinical characteristics of advanced lung adenocarcinoma, then evaluate the status of first-line treatment in a single centric real-world. Methods EGFR, ALK, ROS-1 gene in 204 advanced lung adenocarcinoma tissue were tested by ARMS-PCR method. And the relationship between driver genes status and clinical characteristics was analyzed as the first line treatment in real clinical practice. Results The positive rate of driver genes status in 204 advanced lung adenocarcinoma was 53.9％ (110/204) , including EGFR mutation 46.1％ (94/204) , ALK positive 6.4％ (13/204) and ROS1 positive 1.5％ (3/204). The driving genes status was significantly correlated with gender, smoking history, tumor staging and serosal invasion (P < 0.05). There were significantly differences among the proportion of first-line standard treatment in different subgroup (P = 0.000) , the first-line standard treatment rate of EGFR mutation, ALK/ROS1 positive and drive gene negative were 77.7％, 37.5％, and 46.8％ respectively. And the ratio of using 1 st generation EGFR-TKIs in all patients is 70.6％ (60/85). Conclusion More than half of advanced lung adenocarcinoma have driver genes changes, and EGFR-TKI first-line treatment has higher acceptability in real-word.

Prenatal diagnosis of partial trisomy 3q in a fetus / 中华医学遗传学杂志

OBJECTIVE@#To carry out prenatal diagnosis for a fetus with ultrasonographic abnormality.@*METHODS@#Chromosomal karyotyping and array comparative genomic hybridization (array-CGH) analysis were applied for the diagnosis. Peripheral blood samples were also taken from the parents for chromosome karyotyping analysis.@*RESULTS@#The fetal karyotype showed additional material of unknown-origin attached to Yq. Array CGH analysis confirmed that the material was derived from 3q22.1q29. The father was found to carry a balanced translocation 46, X, t(Y;3)(q12;q23) (which was diagnosed as 46,XY,Y≥18 elsewhere), whilst the mother was found to be normal.@*CONCLUSION@#3q partial trisomy may present as malformation of multiple systems. Combination of chromosome karyotyping and array-CGH can provide reliable diagnosis for fetuses with abnormalities by ultrasonography.

Status of health examination on public health employees in Beijing / 中华流行病学杂志

Objective@#The aim of this study was to understand the status of health examination on public health employees in Beijing, in order to further standardize the health management of the employees.@*Methods@#Questionnaire surveys and personal interviews were produced to obtain the basic information, physical examination, occupational training, knowledge of health laws and regulations, and satisfaction of employees. Pairwise comparison was conducted by chi-square test. Multivariate linear regression was used for multivariate analysis.@*Results@#The percentage of the public health employees who took the blood tests, X-ray examinations, fecal examinations, and skin examinations were 97.0%, 77.6%, 86.4%, and 51.0%, respectively. After excluding the skin examination, the completion rate of other examination items was 72.1%, and the difference of this rate between public hospitals and private hospitals were statistically significant (χ2=36.22, P<0.001; χ2=9.09, P=0.003; χ2=31.06, P<0.001). The percentage of correct answers to all the five questions was 3.2%, and age, working age and education level were positively correlated with knowledge scores of employees.@*Conclusions@#The problems in Beijing’s health examination of employees included poor examination quality, lack of supervision, inability to trace the source and low awareness rate of health knowledge, which suggested that counter measures should be taken immediately.