[Relationship between sleep status and occasional hypertension in preschool children in three provinces in the middle and lower reaches of the Yangtze River in China].

Objective: To understand the prevalence of occasional hypertension in preschool children in three provinces in the middle and lower reaches of the Yangtze River in China, and analyze the relationship between their sleep status and occasional hypertension. Methods: From October to November 2017, a total of 24 842 preschool children from 109 kindergartens in 11 cities in Hubei, Anhui and Jiangsu provinces were selected by intentional sampling method. A self-made questionnaire was used to collect basic information about the subjects, and the sleep status data was collected by the Children's Sleep Habits Questionnaire. Physical examinations were performed on the subjects, and height, weight and blood pressure were measured on-site. The difference in occasional hypertension detection rate among preschool children with different characteristics was compared, and the correlation between sleep status and occasional hypertension detection rate was analyzed by the multivariate logistic regression model. Results: The age of the subjects was (4.4±1.0) years, including 12 729 boys (51.2%). The prevalence of occasional hypertension was 31.8% (7 907/24 842). The prevalence of occasional hypertension among preschool children in three provinces of the middle and lower reaches of the Yangtze River was 31.8%. There were statistically significant differences in the detection rate of occasional hypertension among preschool children of different genders, age groups, family residence, family economic status and parents' education level (all P values<0.05). The detection rate of occasional hypertension in children with less than 10 hours of sleep was higher than those with sufficient sleep, and the difference was statistically significant (P<0.05). The results of multivariate logistic regression analysis showed that after adjusting for factors such as gender, age, family residence, family economic status, parental education level, parental smoking history, and physical constitution, the ORs (95%CI) for less than 10 hours of sleep, turning on the lights while sleeping, and poor sleep quality were 1.09 (1.03-1.15), 1.17 (1.07-1.28) and 1.04 (0.91-1.18), respectively, compared with the corresponding reference group. Conclusion: The detection rate of occasional hypertension is high in preschool children in the middle and lower reaches of the Yangtze River and there is a positive correlation between insufficient sleep and turning on the light when sleeping and occasional hypertension in preschool children.

[Interventional treatment of hemorrhage after percutaneous nephrolithotomy].

OBJECTIVE: To evaluate the effectiveness of super-selective renal artery embolization in treatment of post-percutaneous nephrolithotomy bleeding, and to analyse the causes of failure embolization. METHODS: In the study, 65 post-percutaneous nephrolithotomy patients with severe renal bleeding and hemodynamic instability were treated by super-selective renal artery embolization. First of all, we performed selective renal arteriography. After clarifying the location of the bleeding, superselective intubation of the injured vessel with a microcatheter was carried out. Then the injured vessel was embolized with Tornado micro-coil. When complete embolization was not achieved with micro-coil, a small amount of gelatin sponge particles were added. If there was no positive finding of the beginning selective renal arteriography, the following measures could be taken to prevent missing lesions: (1) Abdominal aorta angiography was performed to determine whether there were anatomical variations, such as accessory renal arteries or multiple renal arteries; (2) Ultra-selective intubation angiography next to the nephrostomy tube path was performed; (3) Renal arteriography was repeated; (4) Renal arteriography after removing the nephrostomy tube while retaining the puncture channel. We evaluated the different angiographic findings and analysed the causes of embolization failure. RESULTS: Bleeding was successfully controled in 60 patients (62 kidneys) whose renal arteriography was postive. Positive findings included: pseudoaneurysm formation, patchy contrast extravasation, pseudoaneurysm combined with arteriovenous fistula, contrast agent entering the collection system, extravascular perinephric leakage of contrast. After first embolization, bleeding was controled in 53 patients (55 kidneys). The success rate after the first and second embolization was 88.7% and 96.7% respectively. The second session was required because of failure to demonstrate bleeding arteries during the first session (4 patients, 57.1%) and recurrent hemorrhage of the embolized injured arteries (2 patients, 28.6%). In 5 patients with no positive findings, after conservative treatment, hematuria disappeared. All the patients were followed up for 3, 6, and 12 months after embolization, and no hematuria occurred again, and no sustained and serious renal insufficiency. CONCLUSION: Super-selective renal artery embolization is an effective treatment for post percutaneous nephrolithotomy bleeding. The main cause of failure is omitting of injured arteries during renal arteriography. Renal artery branch injury has various manifestations. Attention should paid to the anatomical variation of the renal artery, and patient and meticulous superselective intubation angiography is the key to avoiding missing the lesion and improving the success rate of embolization.

Development and potential application of a simultaneous multiplex assay of Golgi protein 73 and alpha-fetoprotein for hepatocellular carcinoma diagnosis.

OBJECTIVE: Detecting a single serum marker, such as Golgi protein 73 (GP73) or alpha-fetoprotein (AFP), may not meet the requirements for the early diagnosis of hepatocellular carcinoma (HCC) due to low sensitivity and specificity. Therefore, this study aimed to develop a simultaneous multiplex assay of GP73 and AFP. PATIENTS AND METHODS: Anti-human GP73- and AFP-coupled microsphere beads and biotin-labeled detectable antibodies were prepared to develop a multiplex assay of GP73 and AFP using the Luminex xMAP technology. The assay was evaluated for cross-reactivity, standard curve, sensitivity, range of detection, and precision. Additionally, the assay was used to determine the levels of serum GP73 and AFP in healthy controls and patients with chronic hepatitis, liver cirrhosis, and HCC. RESULTS: The multiplex assay was successfully developed to simultaneously detect GP73 and AFP without cross-reactivity. The sensitivity for GP73 detection was 0.215 ng/mL and that for AFP detection was 0.666 ng/mL. The ranges of GP73 and AFP detection were 0.98-861.08 ng/mL and 2.01-1848.73 ng/mL, respectively. The intra- and inter-assay coefficients of variation (CVs) were <10%, indicating good precision, with recovery rates of 75-125%. The levels of serum GP73 in healthy controls, chronic hepatitis patients, liver cirrhosis patients, and HCC patients were 61.64 ± 30.60 ng/mL, 208.4 ± 99.42 ng/mL, 183.7 ± 82.78 ng/mL, and 214.1 ± 160.5 ng/mL, respectively. The levels of serum AFP in healthy controls, chronic hepatitis patients, liver cirrhosis patients, and HCC patients were 24.87 ± 14.52 ng/mL, 134.4 ± 216.5 ng/mL, 66.45 ± 133.4 ng/mL, and 891.4 ± 1278 ng/mL, respectively. The receiver operating characteristic (ROC) results showed that the area under the curves (AUC) for the combination of GP73 and AFP was 0.972, which was larger than the AUC for each marker. The sensitivity and specificity of the combined detection of GP73 and AFP for the diagnosis of HCC were 90.91% and 98.86%, respectively. The multiplex assay demonstrated a good correlation with enzyme-linked immunosorbent assay (ELISA), with correlation coefficients of 0.818 and 0.982 for GP73 (p<0.001) and AFP (p<0.001), respectively. CONCLUSIONS: A multiplex assay for the simultaneous detection of GP73 and AFP with high sensitivity and accuracy was developed for the diagnosis of HCC. This assay may provide a reliable reference for the early diagnosis of HCC.

[Comparison of parameters for diffusion-weighted intravoxel incoherent motion imaging in lung cancer patients with different histopathological subtypes].

Objective: To explore the intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) model in lung cancer patients with different histopathological subtypes. Methods: A total of 105 patients were recruited, including 68 cases of adenocarcinoma, 22 cases of squamous carcinoma and 15 cases of small cell carcinoma. All patients underwent magnetic resonance examination consisting of axial IVIM-DWI sequence on a 3.0 T whole body scanner, then the standard ADC (sADC), diffusion coefficient (D), pseudo-diffusion coefficient(D(*)), perfusion fraction (f), distributed diffusion coefficient (DDC) and water diffusion heterogeneity index (α) were calculated for each lesion within the IVIM-DWI model. Results: Mean sADC values were (1.45±0.26) ×10(-3)mm(2)/s, (1.36±0.48) ×10(-3)mm(2)/s and (1.35±0.40) ×10(-3)mm(2)/s for adenocarcinoma, squamous carcinoma and small cell carcinoma, respectively. Mean f values were (59.75±16.37) %, (47.41±18.69) % and (48.96±19.88) % for adenocarcinoma, squamous carcinoma and small cell carcinoma, respectively. Mean α values were 0.72±0.13 for adenocarcinoma, 0.62±0.12 for squamous carcinoma, and 0.63±0.11 for small cell carcinoma, respectively. Statistical analyses indicated that the sADC, f and α values among different histopathological subtypes were significantly different (P<0.05), while there was no significant difference in D, D(*) and DDC values (P>0.05). Furthermore, the comparison showed that the sADC, f and α values of patients with adenocarcinoma were significantly higher than those with squamous carcinoma or small cell carcinoma (P<0.05), whereas there was no significant difference between squamous carcinoma group and small cell carcinoma group (P>0.05). Conclusions: The sADC, f and α values derived from the IVIM-DWI model can be used for comprehensive non-invasive evaluation of diffusion, perfusion and heterogeneity of microenvironment in lung cancer patients. And the IVIM-DWI model may be a promising tool for predicting histopathological subtypes of lung cancer.

[Analysis of life-threatening complications during perioperative period in patients undergoing radical cystectomy with orthotopic neobladder].

OBJECTIVE: To investigate the factors influencing life-threatening complications during perioperative period in patients undergoing traditional cystectomy with orthotopic neobladder. METHODS: To retrospectively analyze the clinical data of 206 cases who underwent radical cystectomy with orthotopic neobladder. Logistic regression analysis was used to analyze the significance of the factors such as age, amount of bleeding, pathological stage, effective supplement of albumin, cardiovascular disease, diabetes mellitus, operation duration, intestinal preparation, etc., on the occurrence of severe complications. RESULTS: Among the 206 patients who underwent radical cystectomy with orthotopic neobladder, 22 cases (10.7%) had life-threatening complications (intestinal fistula, hemorrhagic shock, severe infection) during the perioperative period, and 9 cases died (mortality rate 4.4%). Logistic regression analysis showed that the elderly age, long operation duration, lack of effective supplement of albumin, diabetes mellitus are independent factors influencing the occurrence of life-threatening complications during the perioperative period of radical cystectomy with orthotopic ileal neobladder (P<0.05 for all), and are risk factors positively correlated with the severe complications. CONCLUSION: The elderly age, long operation duration, lack of effective supplement of albumin, and diabetes mellitus are risk factors of the occurrence of life-threatening complications during the perioperative period in patients undergoing radical cystectomy with orthotopic ileal neobladder, therefore, attention should be paid to this issue.

Osteonecrosis of the femoral head: using CT, MRI and gross specimen to characterize the location, shape and size of the lesion.

OBJECTIVE: To investigate the accuracy of using CT and MRI to characterize lesions of osteonecrosis of the femoral head (ONFH). METHODS: Coronal CT and MRI scans were performed on 30 femoral head specimens collected from 23 patients who had undertaken hip arthroplasty owing to ONFH. The results were compared with findings from coronal sectional gross specimens. Two radiologists independently measured the volume of necrotic lesions from CT and MR images using computer software, and the results were averaged. The volume of specimens' necrotic lesion was measured using the water displacement method. RESULTS: There was a high degree of consistency between CT, MRI and the coronal sectional gross specimen on the location, shape and spatial structure of lesions. Differences of the lesion volume measured from CT and MR images were not statistically significant between two radiologists. The necrotic lesion volumes measured from CT and MR images and gross specimens were 22.07 ±5.35, 22.21 ± 5.15 and 21.12 ±4.96 cm(3), respectively, and the differences were not statistically significant (F = 0.396; p = 0.674). CONCLUSION: For patients with ONFH in Association Research Circulation Osseous stage III or above, CT and MRI can accurately display the characterization of lesion. ADVANCES IN KNOWLEDGE: The size and location of necrotic lesions are major factors associated with femoral head collapse. CT is superior to MRI in identifying subchondral fracture. CT can help diagnose and predict the prognosis of ONFH.

Effect of siRNA targeting EZH2 on cell viability and apoptosis of bladder cancer T24 cells.

We investigated the effect of siRNA targeting enhancer of EZH2 on cell proliferation, invasion, migration, and apoptosis of human bladder cancer T24 cells. An siRNA-expressing plasmid targeting the EZH2 gene was transfected into T24 cells. Quantitative polymerase chain reaction and Western blot analysis were used to detect EZH2 expression at the mRNA and protein levels, respectively. Proliferation, invasion, and migration of T24 cells were examined in vivo using MTT, wound healing, and transwell chamber migration assays, respectively. Annexin V-fluorescein isothiocyanate/propidium iodide flow cytometric analysis was performed to determine cell apoptosis levels. Expression of EZH2 in T24 cells was suppressed at the mRNA and protein levels. Following transfection for 48 h, growth was inhibited by 37.9%, which was markedly lower than that in the negative control group (P < 0.05). Following a wound-healing assay for 24 h, transfected cell migration distance was 1.37 ± 0.12, which was markedly less than the horizontal migration distance of negative control group cells (P < 0.01). In addition, the cell invasion ability of EZH2- siRNA group cells decreased by 67% compared with negative control group cells (P < 0.01). Following transfection for 48 h, early- and late-stage apoptosis rates for T24 cells were 22.8 and 3.60%, respectively, which were higher than in the negative control group (P < 0.01). EZH2 gene silencing effectively suppressed the proliferation, invasion, and migration abilities of human bladder cancer cells, promoting apoptosis.

Inhibitory effects of tea extract on aflatoxin production by Aspergillus flavus.

UNLABELLED: Aflatoxins, one of the most carcinogenic substances, have been implicated as a potential threat to the safety of tea beverages. In this study, we studied the inhibitory effects of the aqueous extracts from several Chinese traditional teas, such as green tea, black tea, flower tea, raw Puer tea (naturally fermented Puer tea) and Puer tea (inoculated Puer tea), on the growth and aflatoxin production of Aspergillus flavus. All the tested extracts inhibited the production of aflatoxin B1, whereas they did not inhibit mycelial growth of A. flavus. Considering the highest inhibitory effect of Puer tea extract on aflatoxin production, a semi-quantitative RT-PCR was designed to detect its impacts on the expression of genes responsible for the regulation of aflatoxin synthesis. The results showed that the transcriptions of both aflS and aflR were down-regulated to undetectable levels by the addition of Puer tea extract. This study indicated that most tea contained molecules inhibitory to aflatoxin production, which were very important factors for the risk assessment of tea exposed to aflatoxin. Some tea extracts could be developed as antiaflatoxin agents in food preservation. SIGNIFICANCE AND IMPACT OF THE STUDY: Recently, safety concerns of the popular Puer tea have arisen because of aflatoxin contamination. In this study, we analysed the inhibitory effect of 30 tea aqueous extracts on the growth and aflatoxin production of Aspergillus flavus. Our results indicated that most tea inhibited aflatoxin production by down-regulating the transcription of aflR and aflS. The findings could contribute to the safety assessment of tea exposed to aflatoxin and provide some useful data concerning a new approach for controlling aflatoxin contamination.

Rathke's cleft cyst: clinicopathological and MRI findings in 22 patients.

AIM: To evaluate clinical findings and magnetic resonance imaging (MRI) characteristics of Rathke's cleft cyst (RCC) in 22 patients. MATERIALS AND METHODS: Twenty-two patients were imaged using non-enhanced MRI and 17 underwent an additional contrast-enhanced MRI examination. Fifteen patients received an additional non-enhanced computed tomography (CT) examination, and amongst these, two underwent contrast-enhanced CT. Two radiologists read the images retrospectively. The imaging data were studied with regards to location, size, margin, signal intensity, enhancement characteristics, haemorrhage, and presence of calcifications. Clinical data, such as presenting signs and symptoms, physical findings, and medical histories, were collected. Histopathological studies were performed and analysed by two pathologists. RESULTS: Nine lesions were located in the intrasellar region, 12 in both the intra- and suprasellar regions and one in the suprasellar region. The maximum diameter of the RCCs varied from 0.7 to 4 cm, with an average size of 1.7+/-0.7 cm. MRI features of RCC were divided into three groups based on T1-weighted imaging (T1WI): hypo- (n=6), iso- (n=9), and hyperintensity group (n=7). Patients in the latter two groups were statistically younger than that in the former group. The lesion size in the iso- and hyperintensity groups was significantly less than that in the hypointensity group (F=6.421, p=0.007). Only two cases showed enhancement after contrast injection in the cohort. One lesion with haemorrhage was found as were two cases with intracystic nodules. CONCLUSION: Although MRI features of RCCs are variable, RCCs should be suspected when the following conditions occur: lesions located in the intrasellar region or involving both intra and suprasellar regions, less than 1.5 cm in diameter, iso- or hyperdense on T1WI and no signal enhancement after contrast injection. In addition, the first case of a RCC with a markedly enhanced intracystic nodule is reported.

MRI findings of intracranial cystic meningiomas.

AIM: To report the magnetic resonance imaging (MRI) features of intracranial cystic meningiomas and compare these features in intra- and peritumoural cyst groups. MATERIALS AND METHODS: Fourteen cases of peritumoural cystic meningiomas were compared with 18 cases of intratumoural cystic meningiomas. All patients were examined using non-enhanced and contrast-enhanced MRI. Tumour location, tumour size, signal intensity, enhancement characteristics, and cystic changes were assessed. The MRI features were compared between the intra- and peritumoural cyst groups. RESULTS: Most cystic meningiomas comprised two or more cysts. The solid parts of the tumours showed moderate or marked enhancement after the injection of contrast material. An enhanced cyst wall was found in six out of 14 cases in the peritumoural cyst group, but not in the intratumoural cyst group. Peritumoural cystic meningiomas were predominately located in the cerebral falx, whereas the intratumoural cystic meningiomas were predominantly found in frontal convexity (X(2)=7.434, p=0.024). The cysts were larger in the peritumoural cyst group than in the intratumoural cyst group (t=5.274, p=0.0258). Peritumoural oedema was more commonly found in the intratumoural cyst group (X(2)=6.863, p=0.008). Cystic meningiomas with solid parts located inside the cyst are reported for the first time. CONCLUSION: Cystic meningiomas, although uncommon, should be differentiated from other cystic intracranial lesions. Peri- and intratumoural cystic meningiomas have distinct MRI features. The present study provides the first report of two lesions with solid parts located inside the cyst, as well as one lesion with a calcified solid nodule and haemorrhage within the cyst.

Inhibition of fengycins on the production of fumonisin B1 from Fusarium verticillioides.

AIM: To understand the role of fengycins in regulating the fumonisin B1 (FB1)production of Fusarium verticillioides. METHODS AND RESULTS: The mass ratio of FB1 to mycelia was determined in order to identify the effect of fengycins on FB1 production. It was shown that the amount of FB1 produced by unit mass mycelia decreased to 28% of the control. Results from mycelia resuspension with fengycins also demonstrated that fengycins had a potent impact on FB1 production. Gene expression patterns using quantitative reverse-transcription PCR (RT-PCR) revealed that the transcriptional levels of both FUM1 and FUM8 (coding enzymes for the generation of FB1) were down-regulated with fengycin treatment. CONCLUSIONS: Fengycins could down-regulate the transcription of some key genes involved in the production of FB1, and impair FB1 synthesis by F. verticillioides. SIGNIFICANCE AND IMPACT OF THE STUDY: These results further improved our understanding of fengycins as the potential candidates to control FB1 contamination in crops and food.

Intracranial ganglioglioma: clinicopathological and MRI findings in 16 patients.

AIM: To record the clinical findings and magnetic resonance imaging (MRI) characteristics of intracranial gangliogliomas in 16 patients. MATERIALS AND METHODS: Sixteen patients were imaged using unenhanced and contrast-enhanced MRI. Eight patients underwent unenhanced CT and of these, three underwent contrast-enhanced CT. Two radiologists read the images retrospectively. The images were studied with regard to location, size, margin, signal intensity, enhancement characteristics, cystic changes, and presence of calcifications. Clinical data, such as presenting signs and symptoms, physical findings, and medical histories, were collected. Histopathological and immunohistochemical studies were performed and analysed by two pathologists. RESULTS: In 12 cases the tumours were located in one of the cerebral hemispheres; in the other cases they were located in the brainstem, cerebellum, suprasellar area or the thalamus. The tumour dimension varied from 1-7 cm, with a mean of 3.6 cm+/-1.8 cm. The MRI features of ganglioglioma in the present cohort can be divided into three patterns: cystic (n=2), cystic-solid (n=6), and solid (n=8). Solid lesions had a predilection for the temporal lobe; cystic and cystic-solid tumours had a wide anatomical distribution. Cystic lesions were significantly smaller than both cystic-solid and solid lesions (F=4.28, P<0.05). Cystic changes in the cystic-solid tumours showed one of the following patterns: those with walls showing contrast enhancement, those containing an enhancing nodule, or cysts without an obvious wall. The solid portion of cystic-solid gangliogliomas and the entire tumour in solid tumours showed homogeneous enhancement of variable degrees on T1-weighted (T1W) spin-echo (SE) images. Five tumours had mild or moderate oedema. In one patient two separate gangliogliomas were found, each lesion exhibiting different MRI features: solid and cystic-solid. One case of cortical ganglioglioma was found, causing bone erosion due to pressure. One tumour with chronic haemorrhage was found in the study. CONCLUSION: MRI features of gangliogliomas are non-specific. A ganglioglioma should be suspected when a tumour shows the following features: (1) a solid lesion located in the temporal lobes with mild or no oedema and homogeneous enhancement on SE T1W images; or (2) a small cystic lesion or cystic-solid mixed mass with a wall enhancement or a markedly enhanced nodule. We report a patient with two separate gangliogliomas and a case with bone erosion.

Depletion of CD4+ and CD8+ T lymphocyte subpopulations by CIA-1, a chicken infectious anemia virus.

The suppressive effect of chicken infectious anemia virus (CIAV) on T-lymphocyte subpopulation was evaluated in vivo by flow cytometry and dual immunostaining on frozen sections. Between 14 and 21 days postinoculation (PI), the percentage of CD4-, CD8-, and CT1-positive (CD4+, CD8+, and CT1+) cells was significantly lower in chickens infected at 1 day of age with CIA-1 strain of CIAV than in controls. The mean percentage of CD4+ cells in the thymus was only 43%, whereas in the controls it was 77%. The mean percentages of CD8+ cells in the thymus in infected and control chickens was 54% and 90%, respectively, and of CT1+ cells, 44% and 92%, respectively. At 28 days PI, the percentage of CD4+, CD8+, and CT1+ cells was similar in infected and control chickens. Also at 14 and 21 days PI, immunoperoxidase staining demonstrated fewer CD4+, CD8+, and CT1+ cells in the thymus of infected chickens than in controls. In frozen sections of thymus stained with CIA-1 antibodies and CD4, CD8, or CT1, few of the cells positive for CIAV antigen seen in the outer zone of the cortex carried CD4, CD8, or CT1 molecules. These results suggest that CIA-1 infection either destroys cells expressing CD4, CD8, or CT1 molecules on their surface or interferes with the expression of these molecules.

Abrogation of age-related resistance to chicken infectious anemia by embryonal bursectomy.

Embryonally bursectomized (Ebx) chickens developed signs and lesions typical of chicken infectious anemia (CIA) when infected with CIA-1 isolate of chicken infectious anemia virus (CIAV) at 21 or 38 days of age. In both cases, the chickens had low hematocrit values after the 14th day of inoculation, and the percentage of CD4+ and CD8+ cells in the thymus was markedly reduced at 21 days postinoculation. Even though intact chickens became infected, they never developed low hematocrit values. The data support the hypothesis that age-related resistance to CIA is antibody-mediated and is not due to disappearance of the CIAV target cell; the data also suggest that CD4+/CD8+ cells are the target for infection.