Congenital leukemia: A case report and review of literature.

BACKGROUND: Acute leukemia in newborns is also known as neonatal or congenital leukemia (CL) and is a rare disease with an incidence rate of 1-5 per 1000000 live births. After birth, infants with CL exhibit infiltrative cutaneous nodules, hepatosplenomegaly, thrombocytopenia, and immature leukocytes in the peripheral blood. These symptoms are frequently accompanied by congenital abnormalities including trisomy 21, trisomy 9, trisomy 13, or Turner syndrome. Despite significant advances in disease management, the survival rate is approximately 25% at 2 years. CASE SUMMARY: Here, we document a case of trisomy 21-related acute myeloid leukemia (AML) in a female neonate. The baby was sent to the neonatal intensive care unit because of anorexia, poor responsiveness, and respiratory distress. She was diagnosed with AML based on bone marrow aspiration and immunophenotyping. Genetic sequencing identified a mutation in the GATA1 gene. After receiving the diagnosis, the parents decided against medical care for their child, and the baby died at home on day 9 after birth. CONCLUSIONS: The newborn infant was diagnosed with trisomy 21-related AML. Genetic sequencing identified a mutation in the GATA1 gene. The parents abandoned medical treatment for their infant after receiving the diagnosis, and the infant died at home on the 9th day after birth.

[Impacts of upslope inflow and soil pipe collapse on slope water erosion in the typical Chinese Mollisol region]. / å ¸åž‹é»‘åœŸåŒºå¡é¢ä¸Šæ–¹æ±‡æµå’ŒåœŸå£¤ç®¡é“å´©å¡Œå¯¹å¡é¢æ°´èš€çš„å½±å“.

Understanding the effects of upslope runoff and soil pipe collapse on slope water erosion can provide scien-tific basis for preventing Mollisol degradation caused by soil erosion. We conducted an experiment to investigate the effects of upslope inflow rate and soil pipe collapse on slope water erosion and to quantify the contribution of soil pipe erosion to slope soil erosion. The experiment included three inflow rates (30, 40, and 50 L·min-1) and three near-surface soil hydrological conditions (without soil pipe: NP; with soil pipe but no pipe flow: PF0; with pipe flow: PF1). The results showed that: 1) Slope soil erosion increased with increasing inflow rates; when the inflow rate increased from 30 L·min-1 to 40 and 50 L·min-1, slope soil erosion increased by 100.0%-111.5% and 214.8%-289.2%, respectively. 2) The soil pipe occurrence and pipe flow formation aggravated the slope water erosion process. At inflow rates of 30, 40, and 50 L·min-1, slope soil loss under the PF0 and PF1 treatments were 1.4-1.6 times and 1.7-2.1 times of that under the NP treatment. The contribution of soil pipe erosion to slope soil loss was 26.7%-37.6% under the PF0 treatment and 40.5%-51.9% under the PF1 treatment. 3) Soil pipe collapse intensified the rill erosion process. Compared with the NP treatment at 30, 40, and 50 L·min-1 inflow rate, rill erosion amounts under the PF0 and PF1 treatments increased by 38.1%-66.0% and by 93.7%-128.4%, respectively. Our results suggested that increasing upslope inflow rate resulted in higher surface runoff velocity, which promoted runoff detachment and transport capacity, and then aggrandized the amount of slope soil erosion. Moreover, soil pipe collapse exacerbated rill erosion process. When the soil pipe collapsed, all surface runoff was converted to soil pipe flow, which accelerated flow velocity and slope soil erosion process, and then increased the amount of slope soil erosion.

Compound erosion effect of snowmelt, wind, and rainfall on sloping farmlands of Chinese typical Mollisol region.

Research on the processes and mechanisms of compound soil erosion by multiple forces can provide scientific guidance for precisely controlling cropland soil erosion. Based on the seasonal alternation of freezing-thawing, snowmelt, wind, and rainfall erosion forces on sloping farmlands under natural conditions from November to next October of each year, we used a set of indoor simulation experiments of multi-force superimpositions to analyze the compound soil erosion processes of snowmelt (1 and 2 L·min-1), wind (12 m·s-1), and rainfall (100 mm·h-1). We further discussed the erosion effects of multi-force superimpositions. The results showed that, under single snowmelt erosion, an increase in snowmelt flow had a greater effect on sloping snowmelt erosion intensity than that of sloping runoff rate. When sloping snowmelt flow increased from 1 L·min-1 to 2 L·min-1, sloping runoff rate and erosion intensity increased by 2.7 and 4.0 times, respectively. Under snowmelt-wind superimposition erosion, previous sloping snowmelt erosion inhibited late wind erosion occurrence. As sloping snowmelt flow increased from 1 L·min-1 to 2 L·min-1, the inhibiting action subsequently increased and wind erosion intensity caused by previous snowmelt reduced by more than 50%. Both wind erosion and snowmelt-wind superimposed erosion intensified late rainfall erosion. The early wind erosion increased rainfall erosion by 24.5%. The snowmelt-wind superimposed effect increased the later slope rainfall erosion by 132.8% and 465.4% under 1 and 2 L·min-1 snowmelt runoff rates, respectively. The compound soil erosion amount driven by multiple force superimposition was not the sum of the corresponding erosion amount caused by single erosion force, with promoting or inhibiting effects of erosion force superimposition. The erosion effect of snowmelt-wind superposition was negative, but that of wind-rainfall superposition and snowmelt-wind-rainfall superpositions were positive.

[Characteristics of Phytoplankton Communities and Key Impact Factors in Three Types of Lakes in Wuhan].

To reveal the characteristics and key impact factors of phytoplankton communities in different types of lakes, sampling surveys for phytoplankton and water quality parameters were conducted at 174 sampling sites in a total of 24 lakes covering urban, countryside, and ecological conservation areas of Wuhan in spring, summer, autumn, and winter 2018. The results showed that a total of 365 species of phytoplankton from nine phyla and 159 genera were identified in the three types of lakes. The main species were green algae, cyanobacteria, and diatoms, accounting for 55.34%, 15.89%, and 15.07% of the total number of species, respectively. The phytoplankton cell density varied from 3.60×106-421.99×106 cell·L-1, chlorophyll-a content varied from 15.60-240.50 µg·L-1, biomass varied from 27.71-379.79 mg·L-1, and the Shannon-Wiener diversity index varied from 0.29-2.86. In the three lake types, cell density, Chla, and biomass were lower in EL and UL, whereas the opposite was true for the Shannon-Wiener diversity index. NMDS and ANOSIM analysis showed differences in phytoplankton community structure (Stress=0.13, R=0.048, P=0.2298). In addition, the phytoplankton community structure of the three lake types had significant seasonal characteristics, with chlorophyll-a content and biomass being significantly higher in summer than in winter (P<0.05). Spearman correlation analysis showed that phytoplankton biomass decreased with increasing N:P in UL and CL, whereas the opposite was true for EL. Redundancy analysis (RDA) showed that WT, pH, NO3-, EC, and N:P were the key factors that significantly affected the variability in phytoplankton community structure in the three types of lakes in Wuhan (P<0.05).

Electronic structure characteristics of two-dimensional ferroelectric heterostructuresα-In2Se3/ZnSe.

At present, chips urgently need breakthrough development in the power consumption and integration. The chip integrates billions or even tens of billions of electronic components, such as field effect transistor, diode and so on. Therefore, the research and development of new low-power electronic components with smaller size is an effective method to reduce chip power consumption and improve chip integration. In this paper, the ferroelectric field effect transistor (Fe-FET) based on two-dimensional heterostructuresα-In2Se3/ZnSe is proposed. Based on the first principle, the program will analyze the stability and band structure ofα-In2Se3/ZnSe under different stacking modes. In the heterojunction, the microphysical mechanism of ferroelectric polarization affecting the electronic structure is revealed from the aspects of charge transfer at the interface and the asymmetric surfaces with different work function. Combined with the non-equilibrium Green's function transport theory, the transport properties of Fe-FET based on theirα-In2Se3/ZnSe will be studied. The application will provide sufficient theoretical support for research and development of the device based onα-In2Se3/ZnSe structure.

Analysis of coronary angiographic findings in 117 children with Kawasaki disease and coronary artery lesion / 中华实用儿科临床杂志

Objective:To analyze the coronary angiographic (CAG) characteristics of coronary artery lesion (CAL) in children with Kawasaki disease (KD), and to clarify the necessity of CAG in the diagnosis and treatment of KD combined with CAL in children.Methods:It was a retrospective study to analyze the clinical data, electrocardiogram, echocardiography, time and findings of CAG in children with KD and CAL who underwent CAG in Shanghai Children′s Medical Center of Shanghai Jiao Tong University School of Medicine from January 2013 to August 2022.The distribution, type, severity, and prognosis of CAL were analyzed.Results:A total of 117 children with KD and CAL were included in the analysis.The onset age of KD was from 2 months to 12.8 years old, and the age of performing CAG was from 8 months to 18.1 years old.A total of 234 coronary artery lesions were detected in 117 cases.Among them, CAL in the right coronary artery (RCA), left anterior descending branch (LAD), left main coronary artery and left circumflex artery were detected in 96 branches(41.1%), 78 branches(33.3%), 44 branches(18.8%), and 16 branches(6.8%), respectively.Unilateral coronary artery involvement was detected in 43 cases (36.8%), of which LAD was the dominant; while bilateral involvement was detected in 74 cases (63.2%), among which, LAD and RCA were the most involved arteries.Stratified by the degree of coronary involvement, large coronary aneurysms and severe coronary stenosis were most frequently occurred in the RCA and LAD.In contrast, 10 cases (13.6%), 20 cases (24.3%), 55 cases (45.8%) and 37 cases (67.3%) of intraluminal lesions were found in small, medium and large coronary aneurysms, and stenosis or occlusion, respectively.The incidence of intraluminal lesions tended to be higher in the site of severe lesions.CAG showed stenosis or occlusion in a total of 55 cases, and collateral circulation at varying degrees was found in cases of severe stenosis or occlusion.Conclusions:CAL in children with KD are complex and varied.Although clinical symptoms, routine electrocardiogram and cardiac ultrasound may indicate severe CAL.Their applications are limited by the diagnosis of the type (especially stenosis), degree, and extent of CAL, as well as the detection of extracoronary lesions.CAG is of great significance to identify vascular lesions and guide clinical management of KD combined with CAL in children.

Diagnostic Efficacy of 18F-FDG PET/CT in Detecting Bone Marrow Infiltration in Patients with Newly Diagnosed Diffuse Large B-Cell Lymphoma / 生物医学与环境科学（英文）

OBJECTIVE@#Diffuse large B-cell lymphoma (DLBCL) is often associated with bone marrow infiltration, and 2-deoxy-2-(18F) fluorodeoxyglucose positron emission tomography/computed tomography ( 18F-FDG PET/CT) has potential diagnostic significance for bone marrow infiltration in DLBCL.@*METHODS@#A total of 102 patients diagnosed with DLBCL between September 2019 and August 2022 were included. Bone marrow biopsy and 18F-FDG PET/CT examinations were performed at the time of initial diagnosis. Kappa tests were used to evaluate the agreement of 18F-FDG PET/CT with the gold standard, and the imaging features of DLBCL bone marrow infiltration on PET/CT were described.@*RESULTS@#The total detection rate of bone marrow infiltration was not significantly different between PET/CT and primary bone marrow biopsy ( P = 0.302) or between the two bone marrow biopsies ( P = 0.826). The sensitivity, specificity, and Youden index of PET/CT for the diagnosis of DLBCL bone marrow infiltration were 0.923 (95% CI, 0.759-0.979), 0.934 (95% CI, 0.855-0.972), and 0.857, respectively.@*CONCLUSION@#18F-FDG PET/CT has a comparable efficiency in the diagnosis of DLBCL bone marrow infiltration. PET/CT-guided bone marrow biopsy can reduce the misdiagnosis of DLBCL bone marrow infiltration.

Clinical Features and Prognosis of Patients with Castleman's Disease / 中国实验血液学杂志

OBJECTIVE@#To analyze the clinical features and prognosis of patients with Castleman's disease (CD) and improve the diagnosis and treatment of CD.@*METHODS@#Clinical data of patients diagnosed with CD by pathological biopsy in Gansu Provincial Hospital from January 2009 to November 2020 were retrospectively analyzed. According to clinical classification, the patients were divided into two groups: UCD (unicentric CD) group (n=20) and MCD (multicentric CD) group (n=9). The clinical manifestations, laboratory examination, treatment regimens, pathological examination and follow-up data were statistically analyzed.@*RESULTS@#There were no significant differences in average age and gender ratio between UCD group and MCD group. In UCD patients, 80.0% were hyaline vascular type, and 20.0% were plasma cell type. In MCD patients, 33.3% were hyaline vascular type, 55.6% were plasma cell type, and 11.1% were mixed type. There was significant difference in pathological classification between the two groups (P=0.039). The UCD patients usually presented asymptomatic single lymph node enlargement with mild clinical symptoms, while the MCD patients were characterized by multiple superficial and deep lymph node enlargement throughout the body. The incidences of asthenia, splenomegaly, serous effusion in MCD group were higher than those in UCD group (P<0.05). Meanwhile, the incidences of anemia, hypoproteinemia, increased ESR, elevated serum globulin and elevated β2-microglobulin were significantly higher than those in UCD group too (P<0.05). There was no significant difference in the incidences of abnormal WBC, PLT and elevated LDH between the two groups (P>0.05). Among 20 patients with UCD, 13 cases reached complete remission (CR), 1 case achieved partial remission (PR). Among 9 patients with MCD, 3 cases received CR and 4 cases received PR.@*CONCLUSION@#Patients with CD requires pathological examination for diagnosis. Patients with UCD show mild clinical symptoms, good surgical treatment effect and good prognosis. Patients with MCD have diversified clinical manifestations and relatively poor prognosis, and these patients require comprehensive treatment.

Clinical characteristics of anomalous aortic origin of a coronary artery in children / 中华儿科杂志

Objective: To analyze the clinical characteristics, diagnosis and treatment of anomalous aortic origin of a coronary artery (AAOCA) in children. Methods: There were 17 children diagnosed with AAOCA from January 2013 to January 2022 in Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine.Their clinical manifestations, laboratory and imaging data, treatment and prognosis were retrospectively analyzed. Results: These 17 children included 14 males and 3 females, with the age of (8.7±3.5) years. There were 4 anomalous left coronary artery (ALCA) and 13 anomalous right coronary artery (ARCA). Seven children presented with chest pain or chest pain after exercise, three patients presented with cardiac syncope, one complained chest tightness and weakness, and the other six patients had no specific symptoms. Cardiac syncope and chest tightness occurred in patients with ALCA. Fourteen children had the dangerous anatomical basis of myocardial ischemia caused by coronary artery compression or stenosis on imaging. Seven children had coronary artery repair, of whom two were ALCA and five were ARCA. One patient had received heart transplantation because of heart failure. The incidence of adverse cardiovascular events and poor prognosis in ALCA group was higher than that in ARCA group (4/4 vs. 0/13, P<0.05). They were followed up in the outpatient department regularly for 6 (6, 12) months; except for the one who lost visit, the rest of the patients had a good prognosis. Conclusions: Cardiogenic syncope or cardiac insufficiency usually occurs in ALCA, and adverse cardiovascular events and poor prognosis are more common in ALCA than in ARCA. Early surgical treatment should be considered for children with ALCA and ARCA accompanied by myocardial ischemia.

Effects of the kynurenine pathway on the osteogenic differentiation of periodontal ligament stem cells / 中华口腔医学杂志

Objective: To explore the effect of kynurenine pathway on the osteogenic differentiation of periodontal ligament stem cells (PDLSC). Methods: Unstimulated saliva samples were collected from 19 patients with periodontitis (periodontitis group) and 19 periodontally healthy individuals (health group) in Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University from June to October of 2022. Contents of kynurenine and the metabolites in saliva samples were analyzed by ultra-performance liquid chromatography-tandem mass spectrometry. The expressions of indoleamine 2, 3-dioxygenase (IDO) and aryl hydrocarbon receptor (AhR) were further detected by immunohistochemistry in gingival tissues. The PDLSC used in this study were isolated from extracted teeth for orthodontic treatment in Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University from July to November of 2022. Experiments were then conducted using the cells by incubating with (kynurenine group) or without kynurenine (control group) in vitro. Seven days later, alkaline phosphatase (ALP) staining and assays of ALP activity were performed. Real-time fluorescence quantitative PCR (RT-qPCR) was utilized to detect the expressions of osteogenic related genes ALP, osteocalcin (OCN), runt-related transcription factor 2 (RUNX2), collagen type-Ⅰ (COL-Ⅰ) as well as the kynurenine pathway-associated genes AhR, cytochrome P450 family (CYP) 1A1, CYP1B1. Western blotting was used to detect the expression levels of RUNX2, osteopontin (OPN) and AhR proteins on day 10 and alizarin red staining was performed to observe the formation of mineral nodules on day 21 in control group and kynurenine group. Results: Salivary concentrations of kynurenine [8.26 (0, 19.60) nmol/L] and kynurenic acid [11.4 (3.34, 13.52) nmol/L] were significantly higher in the periodontitis group than in the health group [0.75(0, 4.25) nmol/L, 1.92(1.34, 3.88) nmol/L] (Z=-2.84, P=0.004; Z=-3.61, P<0.001). The expression levels of IDO (18.33±2.22) and AhR (44.14±13.63) in gingival tissues of periodontitis patients were significantly higher than that of the health group (12.21±2.87, 15.39±5.14) (t=3.38, P=0.015; t=3.42, P=0.027). In vitro, the ALP activity of PDLSC in the kynurenine group (291.90±2.35) decreased significantly compared with the control group (329.30±19.29) (t=3.34, P=0.029). The mRNA expression levels of ALP, OCN and RUNX2 in the kynurenine group (0.43±0.12, 0.78±0.09, 0.66±0.10) were decreased compared with the control group (1.02±0.22, 1.00±0.11, 1.00±0.01) (t=4.71, P=0.003; t=3.23, P=0.018; t=6.73, P<0.001), while the levels of AhR and CYP1A1 were increased in the kynurenine group (1.43±0.07, 1.65±0.10) compared with those in the control group (1.01±0.12, 1.01±0.14) (t=5.23, P=0.006; t=6.59, P<0.001). No significant difference was observed in COL-Ⅰ and CYP1B1 mRNA levels between groups. The protein levels of OPN, RUNX2 (0.82±0.05, 0.87±0.03) were reduced and that of AhR (1.24±0.14) was increased in the kynurenine group compared with those in the control group (1.00±0.00, 1.00±0.00, 1.00±0.00) (t=6.79, P=0.003; t=7.95, P=0.001; t=3.04, P=0.039). Conclusions: Over-activated kynurenine pathway in periodontitis patients can promote upregulation of AhR and suppress the osteogenic differentiation of PDLSC.

Guidelines for diagnosis and treatment of glucocorticoid-induced osteoporosis / 中华内科杂志

Glucocorticoid-induced osteoporosis (GIOP) is a skeletal disease characterized by decreased bone strength and increased fracture risk associated with long-term glucocorticoid use. GIOP is the most common secondary osteoporosis that critically affects the quality of life of patients. Currently, the incidence of GIOP in China remains high, with insufficient awareness and lack of prevention and treatment norms. Therefore, the Chinese Rheumatology Association has established this standard based on domestic and international experience, with the aim of raising awareness of prevention and treatment among clinicians, guiding the standardized diagnosis and treatment of this disease, and improving the overall prognosis of patients with GIOP.

Development and application syndromic surveillance and early warning system in border area in Yunnan Province / 中华流行病学杂志

Objective: To establish a dynamic syndromic surveillance system in the border areas of Yunnan Province based on information technology, evaluate its effectiveness and timeliness in the response to common communicable disease epidemics and improve the communicable disease prevention and control in border areas. Methods: Three border counties were selected for full coverage as study areas, and dynamic surveillance for 14 symptoms and 6 syndromes were conducted in medical institutions, the daily collection of information about students' school absence in primary schools and febrile illness in inbound people at border ports were conducted in these counties from January 2016 to February 2018 to establish an early warning system based on mobile phone and computer platform for a field experimental study. Results: With syndromes of rash, influenza-like illness and the numbers of primary school absence, the most common communicable disease events, such as hand foot and mouth disease, influenza and chickenpox, can be identified 1-5 days in advance by using EARS-3C and Kulldorff time-space scanning models with high sensitivity and specificity. The system is easy to use with strong security and feasibility. All the information and the warning alerts are released in the form of interactive charts and visual maps, which can facilitate the timely response. Conclusions: This system is highly effective and easy to operate in the detection of possible outbreaks of common communicable diseases in border areas in real time, so the timely and effective intervention can be conducted to reduce the risk of local and cross-border communicable disease outbreaks. It has practical application value.

Research progress of effective components of Astragalus on prevention and treatment of organ fibrosis / 药学学报

Astragalus, which was first documented in Shennong Bencao Jing, is the dried root of Astragalus membranaceus (Fisch.) Bge. or Astragalus membranaceus (Fisch.) Bge. var. mongholicus (Bge.) Hsiao. The active ingredients astragalus membranaceus saponins (AMS), astragalus polysaccharides (APS) and astragalus flavonoids (AFS) have pharmacological effects such as anti-tumor properties, lowering blood sugar, regulating lipid metabolism, cardiovascular protection, anti-oxidation, bone protection, anti-fibrosis, etc. Fibrosis affects almost all organs, particularly vital organs such as the lungs, liver, heart and kidneys. The primary pathological changes of fibrosis involve abnormal increase of myofibroblasts and excessive deposition of extracellular matrix (ECM) components, which lead to the formation of scar tissue, ultimately resulting in fibrosis and even functional loss or failure of organs, which seriously threatens human health and life. Recent, studies have shown that Astragalus membranaceus has a good therapetuic effect on organ fibrosis. This article reviews the current advances of Astragalus in the prevention and treatment of fibrosis of lungs, liver, heart, kidneys and other important organs.

[Effects of elevated CO2 concentration, warming, and winter wheat planting on soil enzyme activities.] / CO2æµ“åº¦å‡é«˜ã€å¢žæ¸©å’Œå†¬å°éº¦ç§æ¤å¯¹åœŸå£¤é ¶æ´»æ€§çš„å½±å“.

Understanding the responses of soil enzyme activities to elevated CO2 concentration and warming can provide a scientific basis for nutrient management of croplands under global climate change. We conducted a pot expe-riment with climate chamber to examine the effects of elevated CO2 concentration and warming and winter wheat growth on soil enzyme activities. There were four climate scenarios: control (CK, 400 µmol·mol-1 CO2 concentration+normal ambient temperature), and CO2 concentration elevation (ECO2, 800 µmol·mol-1 CO2 concentration+normal ambient temperature), elevated temperature (ET, 400 µmol·mol-1 + temperature increased 4 ℃), and elevated CO2 concentration and temperature (ECO2+T, 800 µmol·mol-1 CO2 concentration + temperature increased 4 ℃). We measured the activities of soil ß-glucosidase (ßG), ß-N-acetyl glucosidase (NAG), alkaline phosphate (ALP) and polyphenol oxidase (PPO) at four growth stages (JS, jointing stage; AS, anthesis stage; FS, filling stage and MS, maturity stage), with and without winter wheat planting. Without winter wheat planting, there was no significant difference in four kinds of soil enzyme activities between ECO2 and CK, while ET and ECO2+T treatments had significant negative effect on soil enzyme activities. With winter wheat planting, compared with CK, ECO2 and ECO2+T treatments did not affect the activities of those four soil enzyme; but the ET treatment had great impact on soil ALP and PPO activities. The activities of four kinds of soil enzyme were significantly diffe-rent between the ET and ECO2+T treatments. Compared with ET treatment, ECO2+T treatment increased soil ßG activity at the JS, decreased NAG activity at the JS, increased ALP activity at both AS and FS, decreased PPO activity in the JS and increased in the AS. The interaction of elevated CO2 concentration and warming had significant effect on soil NAG and ALP activities with and without winter wheat planting. The interaction of warming and expe-rimental stage had significant effect on four kinds of soil enzyme activities without winter wheat planting, but the interaction of warming and crop growth stage had significant effect on ALP and PPO activities with winter wheat planting. The interaction of elevated CO2 concentration, warming and experimental period had significant effect on soil ßG, ALP and PPO activities without winter wheat growth, while with winter wheat growth, it had significant impact on NAG, ALP and PPO activities. The winter wheat growth had significantly inhibitory effect on ßG, NAG and ALP activities in the two early growth periods (JS+AS), significant promoting effect in the later growth periods (FS+MS), and significantly inhibitory effect on PPO activity during whole growth period. Overall, elevated CO2 concentration did not affect soil enzyme activities, while the elevation of CO2 concentration and temperature on soil enzyme activities differed among the soil enzymes at different growth stages. In addition, the responses of four soil enzyme activities to the interaction of elevated CO2 concentration and warming varied with and without winter wheat planting.

What is the best prophylaxis against venous thromboembolism in Asians following total knee arthroplasty? A systematic review and network meta-analysis.

PURPOSE: Asians have a low venous thromboembolism (VTE) incidence following total knee arthroplasty (TKA). This systematic review and network meta-analysis was conducted to evaluate the best prophylaxis against VTE in Asians following total knee arthroplasty in current literature. MATERIALS AND METHODS: A systematic search of PubMed, Embase and CINAHL was conducted in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Prophylaxis types were separated into low-molecular-weight heparin (LMWH), novel oral anti-coagulants (NOAC), mechanical-only prophylaxis (MOP) and no prophylaxis (NP). The primary outcome was VTE incidence, grouped according to diagnosis modality (ultrasound, venography, clinical). The secondary outcome was bleeding incidence, grouped into minor and major bleeding. RESULTS: Fourteen eligible articles, totalling 4259 patients, were pooled with the following significant results: NOACs had lower venography-diagnosed VTE incidence than LMWH (12.77%, p = 0.02) and NP (20.64, p < 0.001). MOP had lower venography-diagnosed VTE incidence than LMWH (23.72%, p < 0.001), NOACs (10.95%, p < 0.001) and NP (31.59%, p < 0.001) but, interestingly, a statistically higher ultrasound-diagnosed VTE incidence than LMWH (6.56%, p = 0.024) and NP (4.88%, p = 0.026). No significant differences were observed between prophylaxis types for symptomatic VTE, pulmonary embolism (PE) or death. LMWH and NOACs had a higher minor bleeding incidence than NP (11.71%, p < 0.001 and 6.33%, p < 0.02, respectively). No significant differences were observed between prophylaxis types for major bleeding incidence. CONCLUSION: NOACs are a superior form of chemoprophylaxis, compared with LMWH, in reducing venography-diagnosed VTE incidence with no added bleeding incidence. However, routine chemoprophylaxis may not be required as LMWH and NOACs do not appear to reduce symptomatic VTE incidence compared with MOP and NP with an increased minor bleeding incidence. Mechanical prophylaxis in the form of graduated compression stockings or intermittent pneumatic compression should be routinely considered with significantly lower rates of venography-diagnosed VTE compared with NP. On the basis of current evidence, we recommend an individualised approach to select the most appropriate prophylaxis type.

[Effects of soil erosion and deposition on the spatial distribution of soil microbial quantity in Mollisol area of Northeast China.] / å ¸åž‹é»‘åœŸåŒºä¾µèš€-沉积对土壤微生物数量空间分布的影响.

Revealing the responses of soil microbial community to soil erosion can provide guidance for agricultural ecosystem management. We investigated the impacts of soil erosion intensity on soil microbial quantity at the Binzhou River Basin, a typical thin layer Mollisol area in Bin County of Heilongjiang Province, using 137Cs tracer. The results showed that there were seasonal variations in soil microbial quantity. The abundance of soil microbes in summer was considerably higher than that in autumn. Bacteria was more sensitive to seasonal variation than fungi and actinomycetes, which was increased by 1.4-2.6 times and 1.4-2.2 times in summer compared with autumn in different parts of slope and watershed, respectively. The spatial variation of soil erosion intensity had an important effect on the spatial distribution of soil microbial community. The highest proportion of bacteria was found at lower deposition area of slope (84.4%) and at the lightly eroded area of the downstream (85.4%). The numbers of soil microbes, soil bacteria and actinomycetes were negative linearly correlated with soil erosion modulus, with correlation coefficients of -0.595, -0.554 and -0.291, respectively. Soil erosion and deposition induced spatial differences in soil physical and chemical properties, with consequences on spatial distribution of soil microbial community.

Clinical analysis of elderly patients with anti-MDA5 antibody-positive dermatomyositis / 中华老年医学杂志

Objective:To retrospectively analyze the clinical characteristics of elderly patients with anti-MDA5 antibody-positive dermatomyositis.Methods:Data of 62 patients with anti-MDA5 antibody-positive dermatomyositis admitted to Second Xiangya Hospital from May 2016 to December 2019 were collected and patients were divided into an elderly group(≥60 years old, 17 cases)and a non-elderly group(<60 years old, 45 cases). The clinical manifestations, laboratory test resuls, treatment and prognosis of the patients in both groups were statistically analyzed.Results:A total of 62 patients with anti-MDA5 antibody-positive dermatomyositis were included in this study, including 17 elderly patients(27.4%)with an average age of(65.5±5.3)years and 45 non-elderly patients(72.6%)with an average age of(46.5±8.4)years.Compared with non-elderly patients, older patients had a shorter disease duration[(1.6±1.0)months vs.(3.7±3.3)months, t=3.883, P<0.001], a higher proportion of patients with exertional dyspnea(15/17 or 88.2% vs.26/45 or 57.8%, χ2=5.11, P=0.024)and with combined positive anti-Ro-52 antibodies(15/17 or 88.2% vs.26/45 or 57.8%, χ2=5.11, P=0.024), and a higher mortality rate[(12/17 or 70.6%) vs.(8/45 or 17.8%, χ2=15.748, P<0.001)]. In contrast, fewer elderly patients than non-elderly patients had the Heliotrope's sign(9/17 or 41.2% vs.38/45 or 57.8%), χ2=5.07, P=0.024). Conclusions:Elderly patients with anti-MDA5 antibody-positive dermatomyositis have a unique clinical phenotype with an acute onset, atypical rashes, severe pulmonary lesions, making treatment difficult, and have a poor prognosis.

Analysis of clinical characteristics of elderly patients with rheumatoid arthritis and lung cancer / 中华老年医学杂志

Objective:To investigate the clinical features of elderly rheumatoid arthritis(RA)patients with lung cancer, and to improve clinicians' understanding of this condition.Methods:Retrospective analysis was conducted over general information, clinical manifestations, laboratory results, pathological types, clinical stages, treatment and prognosis in elderly inpatients(≥60 years old)diagnosed with RA and lung cancer admitted to the Second Xiangya Hospital, Central South University from January 2012 to December 2019.Differences between male and female patients were compared.Results:There were 12 elderly patients with RA combined with lung cancer, including 7 males and 5 females, with an average age of(65.8±5.7)years(60-78). The median years from the diagnosis of RA to lung cancer was 11(7.5, 17.3). Eleven patients had clinical symptoms before the diagnosis of lung cancer, with cough and sputum as the most common initial manifestations(9/11). The proportion of smokers in male patients was 71.4%(5/6). Most patients(11/12)had elevated erythrocyte sedimentation rates(ESR)and C-reactive protein(CRP). Eight patients underwent rheumatoid factor(RF-IgM, IgA, IgG)and anti-cyclic citrullinated peptide(ACPA)examinations, and the positive rate was 100% for RF and 87.5% for ACPA.Among 10 patients undergone tumor marker examination, 6 had elevated CEA, 4 had elevated CYFRA21-1, 2 had SCC, 2 had NSE, and 2 had elevated CA125.Among the 12 patients, 7 had adenocarcinoma, 2 had squamous cell carcinoma, 2 had small cell lung cancer, and 1 had carcinoma in situ.Except for 1 case of carcinoma in situ, the remaining 11 patients were all at stage Ⅲ or Ⅳ at the time of diagnosis.Three patients gave up anti-cancer treatment, while the remaining 9 patients received different therapies.In the end, 10 patients died and 2 patients survived so far.The average follow-up time was 17.5(5, 25)months.Further analysis showed that there was no significant difference in clinical manifestations, laboratory test results, pathological types, treatment and prognosis between male and female patients, except that the ESR level was higher in the female group than in the male group(Z=-2.589, P=0.010). However, the average age of male patients was older than that of female patients(68±6.2, 62.6±3.1), and the age of male patients at the diagnosis of RA was also older (56.4±3.8, 52.0±9.5). The proportion of smokers in male patients was significantly higher than in female patients(71.4%, 20.0%), while women had higher proportions than men with elevated CEA(75%, 50%)and NSE(50%, 0.0%). The proportion of women with adenocarcinoma was slightly higher than that of men(80.0%, 42.9%), while the proportions of men with squamous cell carcinoma(28.6%, 0.0%)and small cell carcinoma(28.6%, 0.0%)were slightly higher than those of women.Male patients had a higher mortality rate(100.0%, 60.0%)and a shorter median follow-up time[16.0(2.0, 18.0), 26.0(11.5, 50.0)monthes]. Conclusions:Elderly RA patients with lung cancer are more common in men, and the average age is older than that of female patients.The occurrence of lung cancer is more likely in RA patients with longer disease duration.Most patients are positive with RF and ACPA.Adenocarcinoma is the most common pathological type of lung cancer, and most patients are at clinical stages Ⅲ and Ⅳ.Mortality is high and prognosis is poor.Thus, for elderly RA patients, it is necessary to receive regular monitoring in changes in pulmonary imaging for early detection of lung cancer and improved prognosis.

Comparison of the uric acid-lowering effect of 3,4-dihydroxy-5-nitrobenzaldehyde on mouse and quail hyperuricemia models / 西安交通大学学报(医学版)

【Objective】 To observe the uric acid-lowering effect of 3,4-dihydroxy-5-nitrobenzaldehyde (DHNB) on hyperuricemia models in mice and quails so as to improve the pharmacodynamic validation on hyperuricemia models. 【Methods】 The mouse hyperuricemia animal model was prepared by intraperitoneal injection of potassium oxonate 300 mg/kg; 30 g/(kg·d) yeast powder mixed feed (yeast powder∶feed, 1∶4) was used to prepare the quail hyperuricemia animal model. DHNB, 100 mg/kg, was intraperitoneally injected into the mice 1 hour prior to modeling; DHNB, 100 mg/kg, was intragastrically administered for two days consecutively into the quail hyperuricemia models. Control groups in mice and quails were set up respectively. Biochemical kits were used to detect serum uric acid, aspartate aminotransaminase (AST), alanine aminotransaminase (ALT), creatinine (Cr), and blood urea nitrogen (BUN) in mouse and quail serum. Heart, lung, liver and kidney tissues of mice and quails were stained with HE. 【Results】 The serum uric acid in the mouse and quail hyperuricemia model groups was higher than that in the control group [(277.37±94.89) μmol/L vs. (176.49±44.83) μmol/L, P0.05]. However, it significantly decreased serum uric acid in the quail model of hyperuricemia (313.58±191.87) μmol/L vs. (160.44±49.90)μmol/L, P<0.05]. Administration of DHNB 100 mg/kg one or two times had no effect on the liver and kidney functions of mice and quails, and had no toxicity to the heart, lung, liver or kidney tissues of mice and quails. 【Conclusion】 DHNB has a uric acid-lowering effect on the hyperuricemia quail model, and a single dose that caused the uric acid-lowering effect has no obvious toxicity to mouse or quail viscera. The quail hyperuricemia model is more suitable for the validation of the uric acid-lowering efficacy of DHNB than the mouse hyperuricemia model.

Medium and long-term follow-up of the Pul-Stent in treating postoperative branch pulmonary artery stenosis in children with congenital heart disease / 中华儿科杂志

Objective: To evaluate the effectiveness and safety of Pul-Stent as the treatment of postoperative branch pulmonary artery stenosis in children with congenital heart disease. Methods: This was a retrospective study. Thirty-three patients who underwent Pul-Stent implantation in Shanghai Children's Medical Center due to postoperative residual pulmonary artery stenosis from August 2014 to June 2015 were included. The immediate curative effect, follow-up and complications of Pul-Stent implantation were assessed. Comparisons between groups were performed with unpaired Student t test. Results: Pul-Stent implantation of 33 patients (19 males and 14 females) were performed successfully. Thirty-one patients underwent percutaneous stenting, and 2 patients underwent hybrid stenting. A total of 35 Pul-Stents were implanted (19 of model small, 15 of model medium and one of model large), 23 stents were planted in the proximal left pulmonary artery and 12 stents were in the proximal right pulmonary artery. The initial diameter of dilation balloon ranged from 6 to 16 mm, and the long sheath of percutaneous implantation ranged from 8 to 10 F in 29 patients (29/31, 94%). After stenting, the diameter of the narrowest segment of pulmonary artery increased from (4.0±1.7) mm to (9.1±2.1) mm in all patients (t=-21.60, P<0.001). The pressure gradient at the stenosis in 26 patients after biventricular correction decreased from (30.5±12.3) mmHg (1 mmHg=0.133 kPa) to (9.9±9.6) mmHg (t=12.92, P<0.001), and the right ventricular to aortic pressure ratio decreased from 0.57±0.14 to 0.44±0.12 (t=7.44, P<0.001). The pressure of the superior vena cava after stenting in 5 patients after cavopulmonary anastomosis decreased from (17.0±1.9) mmHg to (14.0±0.7) mmHg (t=2.86, P=0.046). Two patients died during reoperation for repairing other cardiac malformations. The remaining 31 patients were clinically stable during the follow-up period of (5.3±1.6) years, and one stent fracture was found on chest X-ray. Cardiac catheterization reexaminations in 16 patients showed that restenosis was found in one stent, while stent position and patency were satisfactory in the remaining stents. Nine children underwent post-dilation without stent fracture, displacement or aneurysm formation. Cardiac tomography showed no stent stenosis, fracture observed, or significant change in diameter of the stent in 8 patients. The inner diameter and pulmonary blood perfusion could not be accurately evaluated due to artifacts by cardiac magnetic resonance imaging in 4 patients. Conclusions: Pul-Stent has good compliance and adequate radial strength, and can dilate further over time to accommodate for somatic growth. It performs safely and effectively in treating post-operative branch pulmonary artery stenosis in children.