Surgical treatment of nasopharyngeal cancer - a consensus recommendation from two Chinese associations.

BACKGROUND: Surgical treatment is playing an increasingly important role in the management of nasopharyngeal carcinoma (NPC). This consensus focuses on the indications for optimal surgery, and surgical methods in the whole process of treatment for NPC to provide a useful reference to assist these difficult clinical decisions. METHODOLOGY: A thorough review of available literature on NPC and surgery was conducted by the Association for the prevention and treatment of nasopharyngeal carcinoma in China, international exchange and promotion Association for medicine and healthcare, and the Committee on nasopharyngeal cancer of Guangdong provincial anticancer association. A set of questions and a preliminary draft guideline was circulated to a panel of 1096 experienced specialists on this disease for voting on controversial areas and comments. A refined second proposal, based on a summary of the initial voting and different opinions expressed, was recirculated to the experts in two authoritative medical science and technology academic groups in the prevention and treatment of NPC in China for review and reconsideration. RESULTS: The initial round of questions showed variations in clinical practice even among similar specialists, reflecting the lack of high-quality supporting data and resulting difficulties in formulating clinical decisions. Through exchange of comments and iterative revisions, recommendations with high-to-moderate agreement were formulated on general treatment strategies and details of surgery, including indications and surgical approaches. CONCLUSION: By standardizing the surgical indications and practice, we hope not only to improve the surgical outcomes, but also to highlight the key directions of future clinical research in the surgical management of NPC.

[Chinese expert guidance on overall application of lenvatinib in hepatocellular carcinoma].

Lenvatinib mesylate is an oral receptor tyrosine kinase inhibitor against targets of vascular endothelial growth factor receptors 1-3, fibroblast growth factor receptors 1-4, platelet-derived growth factor receptor α, stem cell growth factor receptor, and rearranged during transfection, et al. Lenvatinib has been approved by the National Medical Products Administration of China on September 4, 2018, for the first-line treatment of patients with unresectable hepatocellular carcinoma who have not received systematic treatment before. Up to February 2023, Lenvatinib has been listed in China for more than 4 years, accumulating a series of post-marketing clinical research evidences. Based on the clinical practice before and after the launch of lenvatinib and referring to the clinical experience of other anti-angiogenesis inhibitors, domestic multidisciplinary experts and scholars adopt the Delphi method to formulate the Chinese Expert Guidance on Overall Application of Lenvatinib in Hepatocellular Carcinoma after repeated discussions and revisions, in order to provide reference for reasonable and effective clinical application of lenvatinib for clinicians.

Anomalous depinning of magnetic domain walls within the ferromagnetic phase of the Weyl semimetal Co3Sn2S2.

We report bulk magnetization measurements and spatially resolved measurements of magnetic domains inCo3Sn2S2single crystals. The results indicate that a previously reported magnetic anomaly around 130 K is due to an anomalous domain wall depinning upon cooling. Our measurements also reveal a hysteresis between field-cooled-cooling and field-cooled-warming magnetization curves acquired under a constant magnetic field below 300 Oe. This observation rules out the possibility that the anomaly stems from a second-order phase transition. Our results further suggest that changes in the shape of hysteresis loops from 5 to 170 K are caused by an unusual temperature-dependent domain nucleation field that changes sign around 130 K. The Kerr rotation images of the magnetic domains confirm that the domain walls depin between 120 and 140 K.

An optimized scheme for detecting magneto-optic effects in ultrathin films with Sagnac interferometry.

Sagnac interferometry is advantageous in measuring time-reversal-symmetry breaking effects in ferromagnetic and antiferromagnetic materials as it suppresses time-reversal symmetric birefringent effects that are ubiquitous and often overwhelming in optical detection systems. When its sensitivity is limited only by the amplifier noise in the photo-detector, one needs to optimize the optical power that returns to the detector. We demonstrate an experimental scheme that maximizes the returning optical power in a Sagnac interferometry when detecting the magneto-optic effect in ultrathin films. In this scheme, the optical beam bearing the Faraday effect on a thin film is reflected at a second surface coated with a highly reflective gold film. The gold film increases the returned optical power by a factor of 4-5. For a normal-incidence Sagnac interferometer, this scheme yields an increase in the signal-to-noise ratio by the same factor. For an oblique-incidence Sagnac interferometer, this scheme should yield an increase in the signal-to-noise ratio by a factor of 20-25. For illustration, this scheme is used to measure magnetization curves and Kerr rotation images of 4.5-unit-cell thick SrRuO3(001) grown on SrTiO3(001).

The combined impact of xylo-oligosaccharides and gamma-irradiated astragalus polysaccharides on the immune response, antioxidant capacity, and intestinal microbiota composition of broilers.

The present study investigated the individual and combined effects of xylo-oligosaccharides (XOS) and gamma-irradiated astragalus polysaccharides (IAPS) on the immune response, antioxidant capacity and intestinal microbiota composition of broiler chickens. A total of 240 newly hatched Ross 308 chicks were randomly allocated into 5 dietary treatments including the basal diet (control), or the basal diet supplemented with 50 mg/kg chlortetracycline (CTC), 100 mg/kg XOS (XOS), 600 mg/kg IAPS (IAPS), and 100 mg/kg XOS + 600 mg/kg IAPS (XOS + IAPS) respectively. The results showed that birds in the control group had lower the thymus index and serum lysozyme activity than those in the other 4 groups (P < 0.05). Moreover, there was an interaction between XOS and IAPS treatments on increasing the serum lysozyme activity (P < 0.05). Birds in the CTC and XOS + IAPS groups had lower serum malondialdehyde concentration and higher serum total antioxidant capacity activity and mucosal interleukin 2 mRNA expression of jejunum than those in the control group (P < 0.05). In addition, birds in the control groups had lower duodenal and jejunal IgA-producing cells number than these in other 4 groups (P < 0.05). As compared with the CTC group, dietary individual XOS or IAPS administration increased duodenal IgA-producing cells number (P < 0.05). Meanwhile, there was an interaction between XOS and IAPS treatments on increasing duodenal and jejunal IgA-Producing cells numbers (P < 0.05). Dietary CTC administration increased the proportion of Bacteroides, and decreased the proportion of Negativibacillus (P < 0.05). However, dietary XOS + IAPS administration increased Firmicutes to Bacteroidetes ratio, the proportion of Ruminococcaceae, as well as decreased the proportion of Barnesiella and Negativibacillus (P < 0.05). In conclusion, the XOS and IAPS combination could improve intestinal mucosal immunity and barrier function of broilers by enhancing cytokine gene expression, IgA-producing cell production and modulates cecal microbiota, and the combination effect of XOS and IAPS is better than that of individual effect of CTC, XOS, or IAPS in the current study.

Oblique-incidence Sagnac interferometric scanning microscope for studying magneto-optic effects of materials at low temperatures.

We describe an oblique-incidence zero-area Sagnac interferometric microscope for studying spatial and temperature dependence of magneto-optic (MO) effects in samples under cryogenic conditions. The microscope is capable of independently measuring Kerr effects from three Cartesian components of a magnetization and thus can be used to map out the magnetization vector across the sample. For illustration, we present MO Kerr effect images of magnetic domains at 77 K of a LaCrGe3 crystal terminated with an a-c plane (the plane that contains the lattice a-axis and c-axis). We further present measurements of magnetization in these domains from 90 to 77 K during zero-field cooling and field cooling in an external magnetic field from 20 to 150 Oe. The inherently high sensitivity and the capability of detecting a magnetization without external modulation makes such a Sagnac interferometric microscope particularly useful for studying magnetic effects in novel materials at low temperatures.

Measuring linear electric quadrupole susceptibility of non-centrosymmetric crystals with reflectivity difference.

I report experimental methods for measuring real and imaginary parts of the linear electric quadrupole susceptibility tensor of nonlinear optical crystals that lack inversion centers. The third-ranked tensor is related to the corresponding second-order nonlinear susceptibility tensor. For opaque materials such as GaAs, the methods involve normal-incidence reflectivity difference detection schemes. For transparent materials, quadrupole susceptibility tensor elements may be measured with similarly construed transmission difference detection schemes.

The combined impact of xylo-oligosaccharides and gamma-irradiated Astragalus polysaccharides on growth performance and intestinal mucosal barrier function of broilers.

This study was conducted to investigate the individual and combined effects of xylo-oligosaccharides (XOS) and gamma-irradiated Astragalus polysaccharides (IAPS) on the growth performance and intestinal mucosal barrier function of broiler chickens. A total of 240 1-day-old Ross-308 chicks were allocated into 5 groups for 21 d: control group (basal diet), antibiotic growth promoter (AGP) group (basal diet supplemented with 50 mg/kg chlortetracycline), XOS group (basal diet supplemented with 100 mg/kg XOS), IAPS group (basal diet supplemented with 600 mg/kg IAPS), and XOS + IAPS group (basal diet supplemented with 100 mg/kg XOS and 600 mg/kg IAPS). The results showed that birds in the XOS + IAPS group showed higher ADG and lower feed-to-gain ratio than those in the control group (P < 0.05). The XOS, IAPS, and XOS + IASP treatments significantly increased villus height (VH) of all intestine segments, jejunal goblet cell numbers, and VH-to-crypt depth ratio (VH/CD) of broilers than those of the control group (P < 0.05). Birds in the XOS + IAPS group had higher jejunal VH/CD ratio and goblet cell numbers than those from the XOS or IAPS groups (P < 0.05). In addition, there was a synergy effect between XOS and IAPS on increasing duodenal goblet cell numbers and improving ileal morphology (higher VH and VH/CD ratio) (P < 0.05). The XOS, IAPS and XOS + IAPS treatments increased the mRNA expression of zonula occludens-1 and occludin of the jejunum as compared with the control group (P < 0.05). Simultaneously, birds in the XOS + IAPS group showed lower plasma D-lactic acid concentration and higher mRNA expression of claudin-1, claudin-3, and occludin in the jejunum than those in the control or IAPS groups (P < 0.05). Moreover, there was no significant difference in growth performance, intestinal morphology, and intestinal barrier function of broilers between the AGP and XOS + IAPS groups. In conclusion, the combination of XOS and IAPS had a better potential as chlortetracycline substitute for improving the growth performance, intestinal morphology, and intestinal barrier function of broilers.

Microbiota populations and short-chain fatty acids production in cecum of immunosuppressed broilers consuming diets containing γ-irradiated Astragalus polysaccharides.

This study was designed to evaluate the effects of γ-irradiated Astragalus polysaccharides (IAPS) on growth performance, cecal microbiota populations, and concentrations of cecal short-chain fatty acids of immunosuppressed broilers. A total of 144 one-day-old broiler chicks were randomly assigned into 3 groups: nontreated group (control), cyclophosphamide (CPM)-treated groups fed either a basal diet or the diets containing 900 mg/kg IAPS, respectively. On day 16, 18, and 20, broilers in the control group were intramuscularly injected with 0.5 mL sterilized saline (0.75%, wt/vol), and those in the CPM and IAPS groups were intramuscularly injected with 0.5 mL CPM (40 mg/kg of BW). The trial lasted 21 d. Compared with the control group, CPM treatment decreased the broiler average daily gain (ADG) and feed intake (P < 0.05) but did not affect the overall microbial diversity and compositions, as well as the concentrations of cecal acetate, propionate, and butyrate in cecum of broilers (P > 0.05). Dietary IAPS supplementation increased broiler ADG, Shannon index, and decreased Simpson index (P < 0.05). Specifically, broilers fed diets containing IAPS showed lower abundances of Faecalibacterium, Bacteroides, and Butyricicoccus and higher proportions of Ruminococcaceae UCG-014, Negativibacillus, Shuttleworthia, Sellimonas, and Mollicutes RF39_norank, respectively (P < 0.05). The IAPS treatment also increased butyrate concentration (P < 0.05) and tended to elevate acetate concentration (P = 0.052) in cecal digesta. The results indicated that IAPS are effective in increasing the cecal beneficial bacteria and short-chain fatty acids production, contributing to improvement in the growth performance of immunosuppressive broilers. These findings may expand our knowledge about the function of modified Astragalus polysaccharides in broiler chickens.

Innovative development ideas of web-based medical teaching during the COVID-19 epidemic.

OBJECTIVE: In response to the sudden COVID-19 epidemic outbreak, China's Ministry of Education proposed "continuing teaching and learning regardless of suspending classes" to provide "available courses and teachers" for students. Web-based teaching has become the main teaching method of medical colleges and universities during the COVID-19 epidemic period. Before the outbreak, the concept and technology of web-based teaching had been partially implemented. The epidemic situation has promoted the implementation of large-scale web-based teaching and the multidimensional development of education in China. Furthermore, there are higher requirements for information teaching. Teachers and students cannot adapt to the web-based teaching mode. The lack of interaction is a problem in the web-based teaching. To adapt to the rapid development of information technology, medical colleges and universities must consider the COVID-19 epidemic as an opportunity to quickly update educational concepts, train teachers' Internet thinking, innovate the web-based teaching mode, and make full use of the network platform to provide better teaching and services. Moreover, medical colleges and universities should eliminate the weaknesses of web-based teaching and improve the quality and connotation of teaching.

Glucose and lipid metabolism of broiler chickens fed diets with graded levels of corn resistant starch.

1. The aim of this study was to investigate the effects of graded levels of dietary corn resistant starch (RS) on glucose and lipid metabolism of broilers. 2. A total of 320 male broiler chicks (Arbor Acres, one-day-old) were randomly allocated to five dietary treatments, including a corn-soybean control diet, a corn-soybean based diet containing 20% corn starch, and three diets containing 4%, 8% and 12% RS by replacing corn starch with 6.67%, 13.33% and 20% Hi-Maize® 260 (identified as control, RS1, RS2, RS3 and RS4, respectively). Each treatment contained eight replicates with eight birds, and the experiment lasted 42 days. 3. Birds fed RS diets showed lower (P < 0.05) concentrations of serum low-density lipoprotein cholesterol and non-esterified fatty acid (NEFA) at d 21 and 42 of age, compared to the control. Lower (P < 0.05) hepatic apolipoprotein B concentration and citrate synthase (CS) activity, as well as a higher (P < 0.05) glycogen synthase (GS) concentration were observed in birds fed RS diets than those in the control group at d 21 of age. Consuming RS diets linearly increased (P < 0.01) serum glucose concentration, and linearly decreased (P < 0.01) NEFA concentrations in broilers at d 21 and 42 of age. Liver GS concentration and activities of hexokinase, pyruvate and CS were linearly increased (P < 0.01) in broilers at d 21 of age, but were linearly decreased (P < 0.05) in birds at d 42 of age in response to the increase of dietary RS levels. Feeding RS diets linearly decreased (P < 0.05) mRNA expressions of PC, PPARα and CPT-1 at d 21 of age and the mRNA expressions of SREBP-1 c, ChREBP, ACC and FAS at d 42 of age, and linearly increased (P < 0.05) the mRNA expressions of PEPCK, PC, LKB1, AMPKα1, PPARα, CPT-1 and L-FABP at d 42 of age. 4. Feeding broilers with diets containing higher concentration of RS promoted hepatic lipolysis and gluconeogenesis through activated AMPK signalling pathway and accelerated whole-body energy expenditures in the grower phase.

Hidden linear optical response reveals crystalline symmetry.

We show that a linear quadrupole response from a crystalline material to externally applied optical fields exists and has gone unnoticed, even though its nonlinear optical cousin has been studied and explored extensively for decades. Such a linear quadrupole response reveals the symmetry of the crystal, just as its nonlinear optical counterpart has done, and can be used to investigate phase transitions non-intrusively with high spatial and temporal resolution.

Growth performance, carcass traits and digestive function of broiler chickens fed diets with graded levels of corn resistant starch.

1. This study was conducted to assess the effects of graded levels of dietary corn resistant starch (RS) on growth performance, carcass traits, nutrient retention, digestive organ index, intestinal morphology, digestive enzyme activities, and mRNA expression of certain nutrient transporters in broiler chickens.2. A total of 320, 1-d-old Arbor Acres broiler chickens were randomly assigned to five dietary treatments, with eight replicates of eight birds in each. These treatments included one corn-soybean control diet, a corn-soybean based diet containing 20% corn starch, and three diets supplemented with 4%, 8% and 12% RS by replacing corn starch with 6.67%, 13.33% and 20% of Hi-Maize 260® (identified as control, RS1, RS2, RS3 and RS4, respectively). The feeding period lasted 42 days.3. Performance parameters including feed consumption, feed conversion, body weight gain and percentage of abdominal fat at d 42 of age, nutrient retention (including dry matter, fat, total starch and nitrogen free extract), and apparent metabolisable energy was measured from d 18 to 20 and d 39 to 41 and showed negative linear responses to increasing dietary RS level (P < 0.05). Birds fed the RS3 and RS4 diets showed higher relative weight of duodenum, jejunum and ileum, as well as lower villus height and villus height/crypt depth compared to the control (P < 0.05). The activity of pancreatic trypsin of birds at d 21 and 42 of age decreased linearly in response to the increase of dietary RS level (P < 0.01). There were linear changes in up-regulated mRNA expression of SGLT-1 and down-regulated mRNA expression of GLUT-2 with increasing proportion of RS at d 21 and 42 of age (P < 0.05), respectively.4. It was concluded that feeding broilers with diets containing higher concentrations of RS impaired the development of small intestine, which resulted in lower apparent total tract retention of nutrients and poorer body weight gain, feed efficiency and carcass traits of broiler chickens.

Anomalous Thermoelectric Effects of ZrTe_{5} in and beyond the Quantum Limit.

Thermoelectric effects are more sensitive and promising probes to topological properties of emergent materials, but much less addressed compared to other physical properties. We study the thermoelectric effects of ZrTe_{5} in a magnetic field. The presence of the nontrivial electrons leads to the anomalous Nernst effect and quasilinear field dependence of thermopower below the quantum limit. In the strong-field quantum limit, both the thermopower and Nernst signal exhibit exotic peaks. At higher magnetic fields, the Nernst signal has a sign reversal at a critical field where the thermopower approaches zero. We propose that these anomalous behaviors can be attributed to the gap closing of the zeroth Landau bands in topological materials with the band inversion. Our understanding to the anomalous thermoelectric properties in ZrTe_{5} opens a new avenue for exploring Dirac physics in topological materials.

Protective effects of γ-irradiated Astragalus polysaccharides on intestinal development and mucosal immune function of immunosuppressed broilers.

This study was aimed to assess the protective effects of γ-irradiated Astragalus polysaccharides (IAPS) on the development of small intestine and intestinal mucosal immunity of immunosuppressed broilers induced by cyclophosphamide (CPM). A total of 384 one-day-old broiler chicks with similar initial weight were randomly assigned into 6 groups: non-treated group (control), and CPM-treated groups fed either a basal diet or the diets containing 900 mg/kg APS, or 900, 600, 300 mg/kg IAPS, respectively. On days 16, 18, and 20, all broilers except for control group were intramuscularly injected with 0.5 mL CPM (40 mg/kg of BW). Broilers in the control group were intramuscularly injected with 0.5 mL sterilized saline (0.75%, wt/vol). This trial was lasted for 21 d. The results revealed that both APS and IAPS treatment elevated the duodenal IgA-producing cells number and the jejunal mRNA expression of interleukin-2 (IL-2), interleukin-10 (IL-10), and interferon γ of CPM-injected broilers (P < 0.05). The decreased jejunal villus height (VH), the ratio of VH to crypt depth (V/C), as well as the intestinal intraepithelial lymphocytes (IELs) and goblet cells number in CPM-injected broilers were elevated by dietary supplementation with 900 mg/kg APS or 900, 600 mg/kg IAPS (P < 0.05). The CPM-induced decrease in jejunum index, the duodenal VH and the jejunal IgA-producing cells number were only improved in the 900 mg/kg IAPS group (P < 0.05). Furthermore, the number of IELs and IgA-producing cells in duodenum, VH, V/C, the number of goblet cells, and mRNA expression of IL-2 and IL-10 in jejunum were higher in the 900 mg/kg IAPS group than those in the 900 mg/kg APS group (P < 0.05). In summary, IAPS possessed stronger immunomodulatory effect than APS at the same supplementation level. Therefore, gamma irradiation can be used as an alternative treatment to enhance the immunomodulatory activity of APS.

Attenuating effects of guanidinoacetic acid on preslaughter transport-induced muscle energy expenditure and rapid glycolysis of broilers.

This study evaluated the effects of dietary guanidinoacetic acid (GAA) supplementation on growth performance, plasma variables, muscle energy status, glycolytic potential, and meat quality of broilers experiencing transport stress during the summer. A total of 320 28-day-old male Arbor Acres broilers were randomly allotted to 3 dietary treatments, including a GAA-free basal control diet (160 birds) and basal diet supplementation with 600 (80 birds) or 1,200 mg/kg (80 birds) GAA for 14 D. On the morning of day 42, after an 8-h fast, the birds fed basal diets were divided into 2 equal groups, and all birds in the 4 groups of 80 birds were transported according to the following protocols: 1) a 0.5-h transport of birds on basal diets (as a lower-stress control group), 2) a 3-h transport of birds on basal diets, and a 3-h transport of birds on basal diets supplemented with either 3) 600 or 4) 1,200 mg/kg GAA. The results revealed that dietary supplementation with GAA at 600 and 1,200 mg/kg for 14 D prior to slaughter did not affect growth performance, carcass traits, and most textural characteristics and chemical composition of the pectoralis major (PM) muscle (P > 0.05). In the GAA-free group, a 3-h transport increased the broiler live weight loss, elevated the plasma corticosterone concentration, decreased the plasma glucose concentration, muscle concentrations of ATP, creatine and energy charge value, increased the muscle AMP concentration and AMP/ATP ratio, and accelerated glycolysis metabolism, which resulted in inferior meat quality (lower pH and higher drip loss, P < 0.05). However, dietary addition of GAA at 1,200 mg/kg increased the mRNA expression of S-adenosyl-l-methionine: N-guanidino-acetate methyltransferase in the liver and creatine transporter in both the liver and PM muscle. It also elevated muscle concentrations of creatine and phosphocreatine (P < 0.05), which helps improve meat quality by ameliorating the 3-h transport-induced muscle energy expenditure and delaying anaerobic glycolysis of broilers.

Effects of miR-153 on angiogenesis in MCAO rats through Shh signaling pathway.

OBJECTIVE: Cerebrovascular disease is a disease which has the highest mortality in China. Angiogenesis in the ischemic region after cerebral infarction is closely related to its prognosis. Recent studies found that microRNAs (miRNAs) are involved in the regulation of neovascularization. MicroRNA-153 (MiR-153) has protective effects on the ischemic injury, but its relationship with the Sonic Hedgehog (Shh) signaling pathway is still unclear. This work aimed to investigate the role of miR-153 in angiogenesis of middle cerebral artery occlusion (MCAO) rats through the Shh signaling pathway. MATERIALS AND METHODS: The rat cerebral ischemic injury (MCAO) model was established by thread embolism and treated by Agomir-153 and 5-EI. MiR-153 expression was detected using Real Time-Polymerase Chain Reaction (RT-PCR). The neurological function was assessed. The infarct area of the brain and the capillary density were determined using 2,3,5-triphenyl tetrazolium chloride (TTC) method. The Shh signaling pathway and angiogenesis-related factors were tested by Western blot assay. RESULTS: Agomir-153 or Agomir-153 combined with 5-EI significantly increased miR-153 expression, reduced the infarct area, and promoted the generation of cerebral capillaries in the MCAO model. 5-EI partially blocked the protective effects of Agomir-153 and angiogenesis. The up-regulation of miR-153 markedly inhibited patched (PTC) expression and activated the Shh signaling pathway. CONCLUSIONS: The up-regulation of miR-153 rats activated the Shh signaling pathway to promote angiogenesis and improve prognosis through lipid-coated Patch (PTC) in MCAO. MiR-153 was considered to be a new therapeutic target for promoting angiogenesis after MCAO.

[Multicenter investigation of extracorporeal membrane oxygenation application in pediatric intensive care unit in China].

Objective: To survey the conduction and evaluate the effectiveness of extracorporeal membrane oxygenation (ECMO) therapy in pediatric intensive care unit (PICU) in China mainland. Methods: In a questionnaire-based survey, we retrospectively reviewed the application of ECMO in children's hospital and general hospital in China mainland to summarize and analyze the categories of diseases and prognosis of children treated with ECMO therapy. Results: By December 31, 2017, a total of 23 hospitals using ECMO, including 22 tertiary referral hospitals and 1 secondary hospital, among which 16 were children's hospitals and 7 were general hospitals. Thirty-seven ECMO equipment was available. A total of 518 patients treated with ECMO, within whom 323 (62.4%) successfully weaned from ECMO and 262 (50.6%) survived to discharge. Among 375 pediatric patients, 233 (62.1%) were successfully weaned from ECMO and 186 (49.6%) survived to discharge. Among 143 newborn patients, 90 (62.9%) successfully weaned from ECMO, 76 (53.1%) survived to discharge. ECMO was applied in veno-arterial (VA) mode to 501 (96.7%) patients, veno-venous (VV) mode to 14 (2.7%) patients, and VV-VA conversion mode to 3 (0.6%) patients. Sixty-nine patients required extracorporeal cardiopulmonary resuscitation (ECPR), including 20 newborn patients (29.0%) and 38 pediatric patients (71.0%), who were all with cardiovascular disease. Neonatal respiratory distress syndrome (26/61), persistent pulmonary hypertension of the newborn (PPHN) (12/61), and meconium aspiration syndrome (MAS) (11/61) are the most common pulmonary diseases in newborn patients; among whom, infants with PPHN had highest survival rate (10/12), followed by MAS (9/11). Among newborn patients with cardiovascular diseases, those who admitted were after surgery for congenital cardiac disease were the most common (54/82), while those with septic shock had the highest survival rate (2/3). In pediatric pulmonary diseases, acute respiratory distress syndrome was the most common (42/93), while plastic bronchitis was with the highest survival rate (4/4), followed by viral pneumonia (13/16). Among pediatric cardiovascular diseases, congenital cardiac defect was the most common (124/282), while fulminant myocarditis had the highest survival rate (54/77). Conclusion: The application of ECMO as a rescue therapy for children with severe cardiopulmonary failure has dramatically developed in China mainland.

CT measurement and analysis of the target vertebral body in elderly patients with uncompressed osteoporotic thoracolumbar fractures.

OBJECTIVE: To evaluate the feasibility of determining the target vertebral body (TV) of uncompressed elderly osteoporotic thoracolumbar fractures through measuring Hounsfield unit (HU) value. PATIENTS AND METHODS: Elderly patients with osteoporotic thoracolumbar fractures aged above 65 years old hospitalized from 2015 to 2016 were retrospectively analyzed. The cases whose TV could not be determined by computed tomography (CT) imaging but confirmed by magnetic resonance imaging (MRI) were selected. The mean HU values of the trabecular bone regions of TV and adjacent vertebral body in the multi-detector CT (MDCT) sagittal three-dimensional reconstructed image were measured and compared. At the same time, 60 thoracolumbar adjacent vertebral bodies without fractures were selected from 20 people, and the mean HU value of the trabecular bone region of each vertebra in the MDCT sagittal three-dimensional reconstructed image was measured and compared. RESULTS: There were correlations among the mean HU values of 60 thoracolumbar adjacent vertebral bodies in the 20 people without fractures, and there were no differences in the correlations between middle vertebral body (MV) and upper vertebral body (UV) and between MV and lower vertebral body (LV) compared with the correlation between UV and LV. In the 31 fracture cases, the mean HU values had correlations among TV, UV and LV, there was no difference in the comparison of correlations between TV and UV and between TV and LV, but the correlations between TV and UV and between TV and LV had differences compared with the correlation between UV and LV. CONCLUSIONS: The mean HU value of TV of uncompressed elderly osteoporotic thoracolumbar fractures is increased abnormally compared with that of the adjacent vertebral body, and it is feasible to determine the TV of uncompressed osteoporotic thoracolumbar fractures according to the mean HU value.

[Association of fimA genotype to kgp genotype in Porphyromonas gingivalis from infected root canals of primary apical periodontitis].

Objective: To investigate the distribution of fimA and kgp genotypes as well as the common genotype combination of Porphyromonas gingivalis (Pg) in infected root canals of primary apical periodontitis for virulent isolates screening in future. Methods: Thirty-four samples harboring Pg were selected from infected root canals of primary apical periodontitis from patients of the Department of Endodontics, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from June 2013 to September 2015. FimA type-specific primers were used to amplify the samples, revealing the distribution of various fimA genotypes. The genotypes of kgp were obtained by using Mse Ⅰ restriction endonuclease. The prevalence of each genotype and common genotype combinations were then calculated. Pearson's chi-squared test was performed to analyze the correlation between genotype combinations and clinical symptoms and major signs of apical periodontitis. In addition, the bioflim architectures between Pg isolates with different fimA and kgp genotype combinations were observed compared using confocal laser scanning microscope. Results: Among the 34 Pg-positive samples, fimA Ⅱ was the most prevalent genotype [47% (16/34)] followed by fimA Ⅰ [26% (9/34)], while fimA Ⅴ was detected in only one sample. The prevalence of kgp Ⅰ [56% (19/34)] was slightly higher than that of kgp Ⅱ [44% (15/34)]. Both fimA Ⅱ+kgp Ⅰ and fimAⅡ+kgp Ⅱ were the most prevalent genotype combinations [24% (8/34) each]. No significant correlation was found between specific genotype combination and such major clinical manifestations as gingival swelling and sinus tract of dental origin (P>0.05). Three Pg isolates with different genotype combinations were acquired. Isolate A (fimAⅠ+kgpⅠ) formed densest biofilm, while the biofilm of isolate C (fimAⅤ+kgp Ⅰ) was much looser. The biofilm feature of isolate B (fimAⅢ+kgp Ⅱ) fell in between A and C. Conclusions: Pg with fimA Ⅱ was most frequently detected in infected root canals of primary apical periodontitis. The prevalence of Pg with kgp Ⅰ was slightly higher than that with kgp Ⅱ, and fimAⅡ+kgp Ⅰ as well as fimA Ⅱ+kgp Ⅱ were the commonest genotype combinations. According to the comparison of Pg biofilms formed by clinical isolates, it might be possible that different genotype combinations may lead to distinct biofilm architectures.