A randomised controlled trial of the non-inferiority of erector spinae plane block vs. thoracic paravertebral block for laparoscopic nephro-ureterectomy.

Erector spinae plane block and paravertebral block can provide analgesia for abdominal surgery. It is unclear whether erector spinae block is inferior to paravertebral block. We aimed to determine whether sufentanil dose and pain intensity (11-point scale) to 24 h after erector spinae block exceeded those after paravertebral block by no more than 5 µg and 1 point, respectively. We randomly allocated 166 adults to 0.4 ml.kg-1 ropivacaine 0.375% before scheduled laparoscopic nephroureterectomy, 83 each to erector spinae or paravertebral injection. We measured incision pain and intra-abdominal pain at rest and on movement 0.5 h, 2 h, 6 h, 18 h, 24 h and 48 h after surgery. Median (IQR [range]) cumulative sufentanil dose after erector spinae block was 15 (5-30 [0-105]) µg vs. 20 (10-50 [0-145]) µg after paravertebral block, median (95%CI) difference 5 µg (0-10), erector spinae non-inferiority p < 0.001. Median (IQR [range]) pain were 1.5 (1.0-2.0 [0.0-5.3]) after erector spinae block vs. 2.0 (1.0-2.5 [0.0-6.0]) after paravertebral block, median (95% CI) difference 0.3 (0.0-0.5), erector spinae non-inferiority p < 0.001. Adverse events did not differ between groups. Erector spinae block analgesia was not inferior to paravertebral block analgesia after laparoscopic nephroureterectomy.

[Long-term oncological outcomes of laparoscopic versus abdominal surgery in stage â a1 （LVSI+）-â b1 cervical cancer patients with different tumor size: a big database in China].

Objective: To compare the long-term oncological outcomes between laparoscopic and abdominal surgery in stage Ⅰa1 （lymph-vascular space invasion-positive, LVSI+）- Ⅰb1 cervical cancer patients with different tumor sizes. Methods: Based on the Big Database of Clinical Diagnosis and Treatment of Cervical Cancer in China (1538 project database), patients with stage Ⅰa1 （LVSI+）-Ⅰb1 cervical cancer who treated by laparoscopic or abdominal surgery were included. The 5-year overall survival (OS) and 5-year disease-free survival (DFS) between the two surgical approaches were compared under 1∶1 propensity score matching (PSM) in different tumor diameter stratification. Results: (1) A total of 4 891 patients with stage Ⅰa1 （LVSI+）-Ⅰb1 cervical cancer who underwent laparoscopy or laparotomy from January 1, 2009 to December 31, 2016 were included in the 1538 project database. Among them, 1 926 cases in the laparoscopic group and 2 965 cases in the abdominal group. There were no difference in 5-year OS and 5-year DFS between the two groups before matching. Cox multivariate analysis suggested that laparoscopic surgery was associated with lower 5-year DFS (HR=1.367, 95%CI: 1.105-1.690, P=0.004). After 1∶1 PSM matching, 1 864 patients were included in each group, and there was no difference in 5-year OS between the two groups （94.1% vs 95.4%, P=0.151）. While, the inferior 5-year DFS was observed in the laparoscopic group (89.0% vs 92.3%, P=0.004). And the laparoscopic surgery was associated with lower 5-year DFS (HR=1.420, 95%CI: 1.109-1.818, P=0.006). (2) In stratification analysis of different tumor sizes, and there were no difference in 5-year OS and 5-year DFS between the laparoscopic group and abdominal group in tumor size ≤1 cm, >1-2 cm and >2-3 cm stratification (all P>0.05). Cox multivariate analysis showed that laparoscopic surgery were not related to 5-year OS and 5-year DFS (P>0.05). In the stratification of tumor size >3-4 cm, there was no difference in 5-year OS between the two groups (P>0.05). The 5-year DFS in the laparoscopic group was worse than that in the abdominal group (75.7% vs 85.8%, P=0.025). Cox multivariate analysis suggested that laparoscopic surgery was associated with lower 5-year DFS (HR=1.705, 95%CI: 1.088-2.674, P=0.020). Conclusions: For patients with stage Ⅰa1 （LVSI+）-Ⅰb1 cervical cancer, laparoscopic surgery is associated with lower 5-year DFS, and the adverse effect of laparoscopic surgery on oncology prognosis is mainly reflected in patients with tumor size >3-4 cm. For patients with tumor sizes ≤1 cm, >1-2 cm and >2-3 cm, there are no difference in oncological prognosis between the two surgical approaches.

[Thalidomide in refractory Crohn's disease: long-term efficacy and safety].

Objective: To analyze the long-term efficacy and safety of thalidomide on refractory Crohn's disease (CD). Methods: A total of 79 patients with refractory CD in the First Affiliated Hospital of Sun Yat-sen University treated with thalidomide were enrolled in this retrospective study from September 2005 to July 2018. Clinical effects and adverse drug reactions were recorded and assessed. Results: In this cohort,69 patients were treated with thalidomide for ≥6 months. Sixty-eight patients among the 69 patients achieved complete clinical remission and were followed up for a median 33.5 months (range, 7-110 months). Seventeen cases relapsed during follow-up. The cumulative probabilities of remaining in remission at 12, 24, 60 months were 88.6% (95%CI 80.6%-96.6%), 80.7% (95%CI 70.3%-91.1%), 53.7% (95%CI 32.1%-75.3%) respectively. Disease activity was the only variable associated with relapse risk, with a hazard ratio (HR) of 3.559 for Crohn's disease activity index (CDAI) ≥220(95%CI 1.213-10.449, P<0.05). Adverse reactions were recorded in 42 (53.2%) patients including12 (15.2%) leading to discontinuation of thalidomide. No serious side effects were observed in all subjects. Conclusions: This study suggests a long-term benefit of maintenance treatment with thalidomide in refractory CD.Moderate to severe patients have an increased risk of relapse. The high incidence of drug adverse reactions may restrain the clinical application of thalidomide.

[Multi locus sequence typing and antibiotic susceptibility of extended-spectrum beta-lactamases producing Enterobacteriaceae in rural residents in villages with pig-breeding farms in Shandong province].

Objective: To analyze the antimicrobial resistance and multilocus sequence typing (MLST) results of extended-spectrum ß-lactamase (ESBLs)-producing Escherichia coli in rural residents in villages with pig breeding farms in a county of Shandong province. Methods: Antimicrobial susceptibility testing was performed with agar dilution method by using 360 ESBLs-producing E. coli strains from fresh stool samples of rural residents in villages with pig breeding farms in a county of Shandong. PCR was conducted to amplify the CTX-M, TEM, SHV genes and capillary electrophoresis was used to screen positive strains in July, 2016. MLST was performed for molecular typing analysis, and eBURST v3.0 software was used for cluster analysis. Results: Among 360 strains of ESBLs-producing E. coli, the resistance rates to cefotaxime, tetracycline, trimethoprim-sulfamethoxazole and florfenicol were 100.0% (360/360), 82.2% (296/360), 81.1% (292/360) and 80.3% (289/360), respectively. The positive rate of CTX-M gene was 99.2% (357/360), in which the positive rate of CTX-M-9 was 35.6% (128/360) and the positive rate of CTX-M-1 was 24.4% (88/360). The positive rate of TEM gene was 26.9% (97/360). A total of 132 STs were identified through MLST. The predominant ST was ST10, accounting for 12.5% (45/360). Cluster analysis showed that CC10 was the most important clone group, including 39 ST clones, involving 148 strains (41.1%). Conclusions: The drug resistances of ESBLs-producing E. coli to cefotaxime, tetracycline, trimethoprim-sulfamethoxazole and flurfenicol are serious in this rural area. There is a small-scale clustering of CC10 and transmission mode from animals to humans might exist.

Circulating miR-31-5p may be a potential diagnostic biomarker in nasopharyngeal carcinoma.

Aberrant expression of miR-31-5p has been detected in various cancers and plays a significant role in tumorigenesis. Low miR-31-5p expression was present in nasopharyngeal carcinoma (NPC) tissues and cell lines and acted as a tumor suppressive miRNA. Currently, circulating miRNAs are emerging as novel biomarkers for the early diagnosis of cancers using a non-invasive method. However, circulating miR-31-5p has rarely been reported in NPC. Therefore, the aim of this study was to explore peripheral blood miR-31-5p levels as a noninvasive biomarker and evaluate its clinical value for the early diagnosis of patients with NPC. A total of 110 participants were recruited, including 55 NPC patients and 55 healthy controls. Peripheral blood samples were collected from these participants, and total RNA was extracted to quantify the relative expression of miR-31-5p by RT-qPCR. We found a significantly lower expression of miR-31-5p in the NPC patients than in the healthy controls. Furthermore, low expression of miR-31-5p was highly correlated with tumor-node-metastasis (TNM) stage (I+II vs III+IV, p=0.001), T classification (T1 vs T2+T3+T4, p=0.036) and local lymph node metastasis (N1-N3 vs N0, p=0.002), but not distant metastasis (p=0.288). Moreover, miR-31-5p showed a moderate diagnostic performance (AUC=0.866, sensitivity = 0.782, specificity = 0.818). Thus, we concluded that circulating miR-31-5p can be a potentially novel and non-invasive biomarker for the early diagnosis of NPC and an attractive therapeutic target in NPC patients.

[Characteristics and drug resistance of non-O157 Shiga toxin-producing E. coli in animal feces, from Shandong Province].

Objective: To understand the infection status, characteristics and drug resistance of non-O157 Shiga toxin-producing E. coli (STEC) in animal feces in Shandong Province. Methods: From 2015 to 2016, convient sampling method was used to collect 1 022 fresh feces of animals in Weishan county and Laizhou city, and 24 non-O157 STEC were isolated. The serotypes of non-O157 STEC strains were confirmed through serum agglutination test. The susceptibility was explored through the antimicrobial sensitivity experiments. ESBLs activity was confirmed by double-disc diffusion. PCR method was used to detect the resistance genes. PFGE typing was operated to assess the relatedness and variability of the strains. The multi-locus sequence typing (MLST) was adopted to get the allelic profile and ST sequence of strains. Analysis was made on the evolutionary relationship between different ST groups was made through CLC Sequence Viewer and Counting Express. Results: A total of 24 non-O157 STEC were isolated from animal feces. 23 strains were from pig feces, and 1 strain was from cow feces, and the serotypes were more dispersed. All of the 24 strains carried stx2 genes. The highest resistance rate was sulfamethoxazole(22 strains), the mount of cotrimoxazole and nalidixic acid was 18 strains, chloramphenicol was 13 strains, tetracycline was 19, and there was a phenomenon of multiple drug resistance. The drug resistance spectrum was sulfamethoxazole tetracycline-compound novammin-naphthidine-chloramphenicol. All strains were sensitive to cefepime and imipenem. The ESBLs confirmatory test showed that 4 strains of non O157 STEC produced beta lactamase. PCR detected 7 resistance genes, and 4 tetracycline resistance genes (Tet A, Tet B, tetC and tetD) were detected. The beta lactamase resistance genes (blaSHV-1, bla CTX-M, bla TEM) were all negative. 24 strains were divided into 15 PFGE types, and their clustering results were more dispersed and no dominant PFGE type. There were 11 kinds of MLST types, most of them are ST540 and ST5133 types, each of which was 4 strains, and clustered into 1 MLST genomes. Conclusion: The serotypes of non-O157 STEC in animal feces O157 STEC were dispersed, and the resistant rate to common antibiotic was high. MLST typing results presents obvious polymorphism. Surveillance and manage ment of these strains should be strengthened.

[An analysis of status of personnel in occupational disease prevention and treatment institutions in Hunan Province, China, from 1996 to 2015].

Objective: To analyze the status of personnel in occupational disease prevention and treatment institutions in Hunan Province, China, from 1996 to 2015, to predict staff composition using grey model (GM) (1, 1) , and to provide a scientific basis and reference for optimizing human resource planning of occupational disease prevention and treatment in other provinces and regions and promoting the service capacity of the institutions. Methods: The data of the staff in occupational disease prevention and treatment institutions in Hunan Province, China, from 1996 to 2015 were obtained from the established basic information management system. The descriptive analysis method was used to analyze the dynamic changes in number and composition of the staff and the GM (1, 1) was used to predict the staff composition. Results: The numbers of the staff members in 1996 and 2015 in occupational disease prevention and treatment institutions in Hunan Province, China were 1591 and 1429, respectively. In the twenty years, the main education level of the staff transformed from "technical secondary school education and non-academic qualifications" to "bachelor degree or above and college degree"; the main major of the staff transformed from "other majors" to "public health and clinical medicine"; the proportion of the staff members without professional titles changed from >1/3 to 5%; and the proportions of the staff members with senior, intermediate, and junior professional titles were steadily rising. GM prediction showed that the proportions of highly educated staff members in 2018 and 2020 would be up to 41.00% and 45.61%, respectively; and the proportions of the staff members with a major in public health in 2018 and 2020 would be up to 44.15% and 46.60%, respectively. Conclusion: The staff in occupational disease prevention and treatment institutions in Hunan Province, China, in the twenty years have slight changes in staff size and great improvement in staff quality, which is beneficial to sustainable development of the occupational disease prevention and treatment undertakings. The education level and major will be further optimized in the next five years.

[Clinical outcomes of cervical disc herniation treated by posterior percutaneous endoscopic cervical discectomy].

Objective: To evaluate the clinical outcomes of posterior percutaneous endoscopic cervical discectomy (PPECD) for cervical disc herniation. Methods: A total of 23 patients who underwent PPECD for cervical disc herniation at Department of Spine Surgery, Guangdong Provincial Hospital of Chinese Medicine from August 2014 to April 2016 were reviewed. The mean age of the 17 males and 6 females was 49.5 years (range from 31 to 61 years). All patients had unilateral upper limb radiating symptoms, 13 patients with right upper limb radiating pain and 10 patients with left upper limb radiation pain, 17 patients with neck pain symptoms. Responsible segment: left C(4-5) 1 case, right C(4-5) 2 cases, left C(5-6) 4 cases, right C(5-6) 8 cases, left C(6-7) 5 cases, right C(6-7) 3 example.Operating time, length of hospitalization, complications, neck and arm Visual analog scale(VAS), and Neck Disability Index(NDI) were evaluated. The excellent and good rate of surgery was evaluated by using the Odom criteria. Harrison method was used to measure cervical curvature. The Cobb angle of the surgical segment was measured on the X-ray, and the range of motion (ROM) was calculated. The changes of the cervical curvature and the surgical segment ROM were compared pre- and post-operation. Results: The operation time was 94.1 min (range from 80 to 150 min). The average length of hospital stay was 4.8 days. The mean follow-up period was 23.5 months (range from 15 to 35 months). The preoperative arm VAS score was 6.95±0.88, 1-week postoperative arm VAS score was 2.09±0.67, the last follow-up arm VAS score was 1.04±0.98. The preoperative neck VAS score was 3.04±0.77, 1-week postoperative neck VAS score was 1.52±0.51 and the last follow-up neck VAS score was 0.61±0.78. The 1-week postoperative and last follow-up arm and neck VAS scores were significantly reduced compared with pre-operation (P<0.01). Compared with 1 week after surgery, the last follow-up of the arm and neck VAS score further reduced, the difference was statistically significant (P<0.01). The preoperative NDI was (58.52±4.98)%, the 1-week postoperative NDI was (33.74±4.72)%, the last follow-up NDI was (19.22±3.23)%. The 1-week postoperative and last follow-up NDI was significantly improved compared with pre-operation (P<0.01). Compared with 1 week after surgery, the last follow-up of the NDI further improved, the difference was statistically significant (P<0.01). The 1-week postoperative cervical curvature was (14.65±2.89)°, and it was improved compared with preoperative(14.23±3.06)°, the difference was statistically significant (P<0.05) . The last follow-up was cervical curvature(14.64±2.68)°, there was no significant difference compared with preoperative (P> 0.05). The preoperative surgical ROM was(5.37±1.83)°, 1-week postoperative was(5.53±1.52)°, and the last follow-up was (5.62±1.48)°, there was no significant difference pre-operative and post-operation (P> 0.05). The excellent and good rate was 91.3% (excellent in 16 cases, good in 5 cases, 2 cases). There was no nerve root injury, cerebrospinal fluid leakage, wound infection, and other complications. Conclusions: PPECD is a sufficient and safe supplement for cervical disc herniation, its recent clinical efficacy was good. And it has no significant effect on cervical stability.

[Serotype identification and antibiotic susceptibility of Shiga toxin-producing Escherichia coli in the Weishan area in Shandong Province, China].

Objective: To determine the serotypes and drug resistance profiles of Shiga toxin-producing Escherichia coli (STEC) in animal stools from the Weishan area in Shandong Province, China. To provide the basis for further study. Methods: Five hundred animal stool samples (from pigs, cattle, sheep, dogs and birds) were collected from the Weishan area and STEC strains were isolated from these samples. Strains were serotyped by a serum agglutination test, and their drug resistance profiles were determined through antimicrobial sensitivity experiments. In this study, PCR was used to detect tetracycline resistance genes (tetA, tetB, tetC, tetD) and beta-lactam resistance genes (blaSHV-1, blaCTX-M, blaTEM). Results: Sixteen strains of STEC were isolated from animal stool samples. Thirteen strains were isolated from pig stool samples, two from bovine stool samples and one from a sheep stool sample. Two of the strains were identified as E. coli O157:H7, and other 14 strains were non-O157 STEC of different serotypes. Antimicrobial sensitivity experiments showed that 15 of the strains were multidrug resistant. The rates of resistance were as follows: nalidixic acid (12/16 strains), sulfisoxazole (11/16), trimethoprim and sulphame-thoxazole (11/16), doxycycline (9/16), azithromycin (9/16), tetracycline (9/16), chloramphenicol (8/16) and streptomycin (8/16). Therefore, nalidixic acid showed the highest rate of resistance among the strains, followed by trimethoprim and sulphame-thoxazole, and sulfisoxazole. Resistance to cefepime or imipenem was not detected. In total, three types of drug resistance genes (tetA, tetB and tetC) were detected among the 16 strains. Conclusion: The results showed that STEC strains isolated from animals in the Weishan area were of a range of serotypes. The 16 strains of STEC isolated from animal stools in this area were resistant to a number of antibiotics, with many strains displaying multidrug resistance.

TLR3 preconditioning enhances the therapeutic efficacy of umbilical cord mesenchymal stem cells in TNBS-induced colitis via the TLR3-Jagged-1-Notch-1 pathway.

Toll-like receptor-3 (TLR3) priming may enhance mesenchymal stem cell (MSC) immunosuppressive activity, but this mechanism has not been investigated in the context of inflammatory bowel disease. Thus, we assessed the immunosuppressive properties of TLR3-primed MSCs using a trinitrobenzene sulfonate (TNBS)-induced mouse model of colitis. Intraperitoneally injected polyribocytidylic acid (poly (I:C)- (a ligand of TLR3) primed human umbilical cord-derived MSCs (hUC-MSCs) migrated to the inflamed colon and effectively improved clinical and pathological manifestations in colitic mice compared with mice treated with unstimulated hUC-MSCs (UCMs). Poly (I:C)-MSCs decreased a wide range of inflammatory cytokines and increased systemic interleukin-10 (IL-10) levels in colonic tissues. Poly (I:C)-MSCs also impaired T-helper type 1/17 (Th1/17) cell expansion and enhanced the suppressive effects of regulatory T cells (Treg) in vitro and in vivo. Poly (I:C)-MSCs suppressed the proliferation of activated mesenteric lymph node (MLN) cells via the overproduction of prostaglandin E2 (PGE2) and upregulation of Jagged-1. PGE2 produced by hUC-MSCs in response to poly (I:C) increased the production of IL-10 and promoted the differentiation of Treg, which could be reversed by inhibition of Notch-1. Collectively, preconditioning MSCs with poly (I:C) enhanced the therapeutic effects of hUC-MSCs in TNBS-induced colitis, and TLR3-activated Notch-1 signaling regulated the immune suppression of hUC-MSCs through the production of PGE2.

[An investigation of prevalence of occupational diseases and treatment implementation in migrant workers in Hunan, China].

Objective: To investigate the prevalence of occupational diseases and treatment implementation in migrant workers in Hunan, China, and to provide a scientific basis for related departments to develop preventive and treatment measures and social security system for migrant workers. Methods: A retrospective investigation was performed in 2015 to collect the information of occupational diseases in migrant workers, and age, type of work, type of occupational disease, and implementation of employment injury insurance for occupation diseases were analyzed. Results: The migrant workers with occupational diseases accounted for 50.43% (11 280/22 368) of all patients with occupational diseases in Hunan, among whom 99.4% (11 212/11 280) were male workers. The mean age of migrant workers with occupational diseases was 55 years. The types of occupational diseases involved 6 categories such as occupational pneumoconiosis and occupational skin diseases, totaling 42 legal occupational diseases; 98.31% of all migrant workers (11 089/11 280) had occupational pneumoconiosis. The main types of work were underground coal miners (62.42%) , heading drivers (29.79%) , and haulage workers (2.20%) in coal mines and non-coal mines. A total of 27.25% migrant workers with occupational diseases (2 072/7 605) enjoyed employment injury insurance, and 20.84% (1 585/7 605) did not receive any medical or life compensations. Conclusion: The occupational diseases in migrant workers in Hunan are mainly pneumoconiosis, and a large proportion of those with occupational diseases do not enjoy implementation of treatment. Coal mines and non-coal mines are the high-risk areas for occupational diseases in migrant workers and should be the focus of prevention and control.

[Artemisinin inhibits proliferation of gallbladder cancer cell lines through triggering cell cycle arrest and apoptosis].

OBJECTIVE: To evaluate the effects of artemisinin on proliferation, cell cycle and apoptosis of gallbladder cancer cells. METHODS: Gallbladder carcinoma cell lines(GBC-SD and NOZ)were cultured in vitro. The effects of artemisinin in different concentration on proliferation of the two cell lines in vitro were examined using MTT assay. The cell cycle distribution of GBC-SD and NOZ cells 24 h after treatments with artemisinin(20 µmol/L) were examined using flow cytometry. The apoptosis of GBC-SD and NOZ cells 24 h after treatments with artemisinin (20 µmol/L) were examined using Annexin V/PI staining.The expressions of p-ERK1/2, CDK4, cyclin D1, p16, cytochrome C and caspase-3 were examined by Western blot assay. t-test and one way ANOVA were used to evaluate the differences between two groups and more than two groups, respectively. RESULTS: The cell proliferation was significantly inhibited by artemisinin, the IC50 of artemisinin against GBC-SD and NOZ cells were 14.05 µmol/L and 12.42 µmol/L, respectively.Artemisinin induced cycle arrest, and G1 population of GBC-SD and NOZ cells increased to 74.60% and 78.86%. Cell apoptosis and apoptotic population of GBC-SD and NOZ cells were increased to 15.67% and 16.51% after dealt with artemisinin, respectively. In addition, expression of p16 was increased, and expressions of p-ERK1/2, CDK4 and cyclin D1 were down-regulated by artemisinin(all P<0.05). Cytochrome C was released from mitochondria to cytoplasm leading to the activation of caspase-3 and PARP after dealt with artemisinin(P<0.05). CONCLUSION: The inhibition effect of artemisinin on the proliferation gallbladder cancer cells is accompanied by down-regulation of ERK1/2 signaling pathway, G1 phase arrest and triggering caspase-3-mediate apoptosis.

[Nutritional risk screening in patients with Crohn's disease].

OBJECTIVE: To screen the nutritional risk in patients with Crohn's disease (CD), to explore the prevalence and characteristics of nutritional risk in CD patients, and to identify the possible risk factors. METHOD: A cross-sectional study was performed in 712 patients who was diagnosed as CD in the Center for Inflammatory Bowel Disease of First Affiliated Hospital of Sun Yat-sen University between January 2003 and January 2014. Montreal classification was used to classify CD, Crohn's Disease Activity Index (CDAI) was used to evaluate disease activity, and Nutritional Risk Screening 2002 (NRS2002) was used to assess the nutritional risk in each patient. Reappraisal with NRS 2002 was conducted in patients followed up for 1 year to identify the possible effect of treatment on nutritional risk of the CD patients. RESULTS: The prevalence of nutritional risk was 65.2% (464/712) in the enrolled CD patients. The prevalence of nutritional risk was significantly different among patients with different disease activity (χ(2)=117.169, P<0.001), also significantly different among patients of different age at diagnosis (χ(2)=11.256, P=0.004), with different lesion location (χ(2)=18.841, P=0.001) and different disease behavior (χ(2)=15.793, P<0.001), but not significantly different in patients of different sex (χ(2)=0.601, P=0.245). Multivariate Logistic regression showed that the independent predictive risk factors for nutritional risk included abdominal tenderness (OR=1.895, 95%CI: 1.080-3.324); mild (OR=1.846, 95%CI: 1.179-2.890), moderate (OR=4.410, 95%CI: 2.701-7.200) and severe (OR=14.069, 95%CI: 1.718-115.192) disease activity; B2 (stricturing) (OR=1.620, 95%CI: 1.034-2.538) and B3 (penetrating) (OR=1.920, 95%CI: 1.025-3.596) types of disease behavior; and high level with erythrocyte sedimentation rate (ESR) (OR=1.024, 95%CI: 1.015-1.034). On the other hand, >40 years at diagnosis (A3 type) (OR=0.332, 95%CI: 0.135-0.814) and high albumin level (OR=0.962, 95%CI: 0.934-0.990) were independent protective factors for nutritional risk. After 1-year follow-up, nutritional risk was eliminated in 32.0%(111/347)of the patients, and the rate was higher in patients received surgery than in those treated with medicine alone (42.9%(54/126)vs 25.8%(57/221), χ(2)=10.742, P=0.001). CONCLUSIONS: Two thirds of CD patients may have nutritional risk at diagnosis, which may differ with disease activity and Montreal classification. Abdominal tenderness, disease activity, B2 and B3 types of disease behavior, and high ESR may be independent risk factors for nutritional risk, whereas A3 type of age at diagnosis and high albumin level may be independent protective factors.

[Meta-analysis on epidemiology of iatrogenic-borne methicillin-resistant Staphylococcus aureus].

OBJECTIVE: To study the molecular-biologic characteristics and epidemiological status of iatrogenic related Community-acquired methicillin-resistant Staphylococcus (S.) aureus (CA-MRSA) in China through Meta-analysis. METHODS: Data through systematic searching for peer-reviewed articles published before December 3(rd), 2015 from 4 main electronic databases including China National Knowledge Infrastructure (CNKI), Wanfang Data, PubMed and Web of Science Core Collection was collected, for this Meta-analysis. PRISMA guidelines were followed and the proportion of MRSA, CA-MRSA, hospital-acquired MRSA (HA-MRSA) and panton-valentine leucocidin (PVL) gene in certain populations were quantitatively analyzed by Stata 13.0 software. RESULTS: Average proportion of CA-MRSA from S. aureus was 12% (95%CI: 8%-16%). CA-MRSA in MRSA was 18% (95%CI: 12%-24%). 42.1% (95%CI: 20.4%-63.7%) of the CA-MRSA carried a PVL gene, and the number was higher than general MRSA (t=-2.99,P=0.011). CONCLUSION: CA-MRSA was in lower proportion than HA-MRSA, both seen in general MRSA and in S. aureus, but under higher proportion of carrying the PVL gene. Transmission of CA-MRSA could be prevented within the general population through conducting effective surveillances and preventive programs.

Phase transformation of Cu-rich precipitates from 9R to 3R variant via ledges mechanism in ferritic steel containing copper.

Precipitates and solute enrich in aged ferritic steel containing copper were examined using high-resolution electron microscopy, high-angle annular dark-field scanning transmission electron microscopy and energy-dispersive X-ray spectroscopy. Two ledges with one-atom and two-atom layers height in the 9R/3R interface were observed. The enrichment of copper into two successive closed-packed planes with an interval of Fe-rich close-packed plane was detected. The passage of the Shockley partial, or the shearing, changes the stacking sequence of closed-packed planes. Finally, 9R Cu variant transformed into 3R Cu variant.

Expression patterns of melatonin receptors in chicken ovarian follicles affected by monochromatic light.

Artificial illumination is an important exogenous factor in the control of many physiological and behavioral processes as well as an important environmental factor in the management of laying hens. Melatonin receptors are members of the G protein-coupled receptor family. The hormone melatonin is secreted primarily by the pineal gland, with highest levels occurring during the dark period of a circadian cycle. The aim of this study was to examine the effect of monochromatic light on chicken egg reproduction and expression of melatonin receptors in chicken ovarian follicles. A total of 552 19-week-old hens were randomly divided into 4 groups with 138 birds in each group. Each group was randomly divided into 3 replicates with 46 birds in each replicate. Feed and water were provided for ad libitum. Light treatments were: control cool white (400-760 nm), blue (480 nm), green (560 nm), and red (660 nm). The short wavelength (blue light) group produced a greater total number of eggs at 300 days of age than did the long wavelength (red light) group, and the red light group showed higher melatonin receptor type 1A and melatonin receptor type 1C mRNA and protein expression. These results suggest that the wavelength of light is closely related to chicken egg number at 300 days of age; there is no effect of monochromatic light on melatonin receptor type 1B.

Dietary exposure to organochlorine pesticide residues of the Hong Kong adult population from a total diet study.

Dietary exposure of the Hong Kong adult population to organochlorine pesticide (OCP) residues was estimated using a total diet study (TDS) approach. OCPs listed under the Stockholm Convention as persistent organic pollutants (POPs) including, aldrin, dieldrin, chlordane, chlordecone, dichlorodiphenyltricholroethane (DDT), endosulfan, endrin, heptachlor, hexachlorobenzene (HCB), α-hexachlorocyclohexanes (HCH), ß-HCH, lindane, mirex, pentachlorobenzene and toxaphene, were studied. Out of 600 composite samples, 55% contained one or more OCP residues at detectable levels. The most commonly detected OCP was DDT (32% of all composite samples), followed by HCB (30%) and endosulfan (22%). The lower- and upper-bound mean exposure estimates of OCP residues ranged from 0% to 0.5% and were 0.1-8.4% of their respective health-based guidance values (HBGVs). The lower- and upper-bound 95th percentile exposure estimates ranged from 0% to 1.2% and were 0.1-13.6% of their respective HBGVs. This indicated that dietary exposures to the OCP residues analysed would be unlikely to pose unacceptable health risks to Hong Kong adults.

Cognitive motor interference for gait and balance in stroke: a systematic review and meta-analysis.

BACKGROUND AND PURPOSE: An increasing interest in the potential benefits of cognitive motor interference (CMI) for stroke has recently been observed, but the efficacy of CMI for gait and balance is controversial. A systematic review and meta-analysis of randomized controlled trials was performed to estimate the effect of CMI on gait and balance in patients with stroke. METHODS: Articles in Medline, EMBASE, the Cochrane Library, Web of Science, CINAHL, PEDro and the China Biology Medicine disc were searched from 1970 to July 2014. Only randomized controlled trials examining the effects of CMI for patients with stroke were included, and no language restrictions were applied. Main outcome measures included gait and balance function. RESULTS: A total of 15 studies composed of 395 participants met the inclusion criteria, and 13 studies of 363 participants were used as data sources for the meta-analysis. Pooling revealed that CMI was superior to the control group for gait speed [mean difference (MD) 0.19 m/s, 95% confidence interval (CI) (0.06, 0.31), P = 0.003], stride length [MD 12.53 cm, 95% CI (4.07, 20.99), P = 0.004], cadence [MD 10.44 steps/min, 95% CI (4.17, 16.71), P = 0.001], centre of pressure sway area [MD -1.05, 95% CI (-1.85, -0.26), P = 0.01] and Berg balance scale [MD 2.87, 95% CI (0.54, 5.21), P = 0.02] in the short term. CONCLUSION: Cognitive motor interference is effective for improving gait and balance function for stroke in the short term. However, only little evidence supports assumptions regarding CMI's long-term benefits.

Systematic review with meta-analysis: magnetic resonance enterography vs. computed tomography enterography for evaluating disease activity in small bowel Crohn's disease.

BACKGROUND: Magnetic resonance enterography (MRE) has been proposed as a non-ionising alternative method to computed tomography enterography (CTE). Some studies have directly compared CTE and MRE in patients with small bowel Crohn's disease (CD) with variable results. AIM: To compare the overall diagnostic accuracy in assessing the activity of small bowel and complications. METHODS: MEDLINE, EMBASE and Cochrane databases were searched for studies on the accuracy of MRE and CTE, as compared with a pre-defined reference standard. Pooled sensitivity, specificity, the weighted area under the curve (AUC), incremental yield (IY) and other diagnostic indices were evaluated. RESULTS: A total of 290 CD patients from six different studies were analysed. The pooled sensitivity and specificity for MRE in detecting active small bowel CD was 87.9% [95% confidence interval (CI), 81.8-92.5] and 81.2% (95% CI: 71.9-88.4) respectively. The AUC under the summary receiver-operating characteristic (sROC) of MRE was 0.905 (SEM 0.03, standard error of the mean). Likewise, the pooled sensitivity and specificity of CTE in detecting active small bowel CD was 85.8% (95% CI: 79.2-90.9) and 83.6% (95% CI: 75.3-90.1) with the AUC of 0.898. The AUC of MRE in detecting fistula, stenosis and abscess was 0.936, 0.931 and 0.996, respectively, compared to 0.963, 0.616 and 0.899 of CTE. No statistically significant IY for MRE vs. CTE was found (fixed model, P > 0.05). CONCLUSIONS: Magnetic resonance enterography has a diagnostic effectiveness comparable to computed tomography enterography, thus may serve as a radiation-free alternative for evaluation of patients with Crohn's disease.

First evidence for the contribution of the genetic variations of BRCA1-interacting protein 1 (BRIP1) to the genetic susceptibility of cervical cancer.

BRIP1 (BRCA1-interacting protein 1), a DNA-dependent ATPase and a DNA helicase, is critical for BRCA-associated DNA damage repair functions, and may be involved in the development of cervical cancer. Genetic markers in different regions of the BRIP1 gene have a plausible role in modulating the risk of cervical cancer. In this study, we evaluate the association between the BRIP1 variations and the risk of cervix cancer. We examined the potential association between cervical cancer and eighteen single nucleotide polymorphisms (SNPs, rs2048718, rs16945692, rs4968451, rs6504074, rs4988344, rs8077088, rs10515211, rs9897121, rs9906313, rs2159450, rs4986764, rs11871785, rs4986763, rs11079454, rs7213430, rs34289250, rs4988345 and rs12937080) of the BRIP1 gene using the MassARRAY system. The participants enrolled in this study included 298 patients with cervical cancer and 286 healthy women as the healthy controls from a Chinese Han population. The results showed that rs16945692 (intron 1), rs4968451 (intron 4), rs4986764 (exon 18) and rs7213430 (3'UTR) were significantly associated with cervical cancer (P<0.05). Furthermore, strong linkage disequilibrium (LD) was observed in three blocks (D'>0.9), and significantly more T-A-C-A haplotypes (block 1) (P=0.001) were found in the patients with cervical cancer. Significantly higher frequencies of C-A-T haplotypes (block 2) (P=0.018) and A-A haplotypes (block 3) (P=0.009) were detected in the healthy controls than in the patients with cervical cancer, suggesting that they may show protective effects against cervical cancer. These findings point to a role for the BRIP1 gene polymorphisms in cervical cancer in a Chinese Han population, and may be informative for future genetic or biological studies on cervical cancer.