Improving image quality of triple-low-protocol renal artery CT angiography with deep-learning image reconstruction: a comparative study with standard-dose single-energy and dual-energy CT with adaptive statistical iterative reconstruction.

AIM: To investigate the improvement in image quality of triple-low-protocol (low radiation, low contrast medium dose, low injection speed) renal artery computed tomography (CT) angiography (RACTA) using deep-learning image reconstruction (DLIR), in comparison with standard-dose single- and dual-energy CT (DECT) using adaptive statistical iterative reconstruction-Veo (ASIR-V) algorithm. MATERIALS AND METHODS: Ninety patients for RACTA were divided into different groups: standard-dose single-energy CT (S group) using ASIR-V at 60% strength (60%ASIR-V), DECT (DE group) with 60%ASIR-V including virtual monochromatic images at 40 keV (DE40 group) and 70 keV (DE70 group), and the triple-low protocol single-energy CT (L group) with DLIR at high level (DLIR-H). The effective dose (ED), contrast medium dose, injection speed, standard deviation (SD), signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of abdominal aorta (AA), and left/right renal artery (LRA, RRA), and subjective scores were compared among the different groups. RESULTS: The L group significantly reduced ED by 37.6% and 31.2%, contrast medium dose by 33.9% and 30.5%, and injection speed by 30% and 30%, respectively, compared to the S and DE groups. The L group had the lowest SD values for all arteries compared to the other groups (p<0.001). The SNR of RRA and LRA in the L group, and the CNR of all arteries in the DE40 group had highest value compared to others (p<0.05). The L group had the best comprehensive score with good consistency (p<0.05). CONCLUSIONS: The triple-low protocol RACTA with DLIR-H significantly reduces the ED, contrast medium doses, and injection speed, while providing good comprehensive image quality.

Influence of psychological intervention on patients undergoing spinal anesthesia: a randomized trial.

OBJECTIVE: The aim of this study is to evaluate the effects of positive intervention on the anxiety and the physiological and psychological aspects among preoperative and post-surgical patients with spinal anesthesia. PATIENTS AND METHODS: A randomized trial was conducted with an intervention group (n=58) and a control group (n=59). In the intervention group, the patients were well-informed of the details during spinal anesthesia. Multiple methods were performed to control anxiety before surgery, and nurses were not allowed to discuss the condition during surgery. Anesthesiologists were invited to visit patients to avoid excessive anxiety. RESULTS: The intervention group showed lower scores of State-Trait Anxiety Inventory (STAI) (p<0.05) than the control group 24 hours post-operation. Physiological indices such as systolic blood pressure, low frequency (LF) power, high frequency (HF) power and ration of LF/HF showed better surgery recovery (p<0.05) than the control group. The length of post-anesthesia care unit stay was also significantly shortened in the intervention group (p=0.001) compared with the control group. Positive intervention may alleviate the anxiety in surgical patients receiving spinal anesthesia and improve the physiological and psychological outcomes clinically. CONCLUSIONS: Our results provide evidence indicating that proper intervention can be promoted clinically to improve the satisfaction and quality of life of patients undergoing spinal anesthesia.

[Variations in fecal microbiota of first episode schizophrenia associated with clinical assessment and serum metabolomics].

OBJECTIVE: To explore the role of the microbiota in drug naïve first-onset schizophrenia patients and to seek evidence from multidimensional longitudinal analyses of the intestinal microbiome and clinical phenotype with antipsychotic drugs (APDs) therapy. METHODS: In this study, 28 drug naïve first onset schizophrenia patients and age-, gender- and education-matched 29 healthy controls were included, and the patients were treated with APDs. We collected fecal and serum samples at baseline and after 6 weeks of treatment to identify the different microbiota strains and analyse their correlation with clinical symptoms and serum metabolites. The 16S rRNA genes of the gut microbiota were sequenced, and the diversity and relative abundance at the phylum and genus levels were analyzsed in detail. The PANSS score, BMI changed value, and serum metabolome were included in the data analyses. RESULTS: A multiomics study found a potential connection among the clinical phenotype, microbiota and metabolome. The species diversity analyses revealed that the alpha diversity index (chao1, ACE, and goods_coverage) in the schizophrenia APDs group was significantly lower than that in the control group, and the schizophrenia group had clear demarcation from the control group. The microbiota composition analysis results showed that the relative abundance of the genera of Bacteroides, Streptococcus, Romboutsia, and Eubacterium ruminantium group significantly changed after APDs treatment in the schizophrenia patients. These strains could reflect the APDs treatment effect. More genera had differences between the patient and control groups. The LEfSe analysis showed that Prevotella_9 and Bacteroides were enriched in schizophrenia, while Blautia, Dialister, and Roseburia were enriched in the control group. The correlation analysis between microbiota and clinical symptoms showed that Bifidobacterium in schizophrenia was positively correlated with the PANSS reduction rate of the general psychopathology scale. The BMI changed value was positively correlated with the alteration of Clostridium_sensu_stricto_1 during treatment and the baseline abundance of Bacteroides. Moreover, metabolomic data analysis revealed a significant correlation between specific genera and metabolites, such as L-methionine, L-proline, homovanillic acid, N-acetylserotonin, and vitamin B6. CONCLUSION: Our study found some microbiota features in schizophrenia patients and healthy controls, and several strains were correlated with APDs effects. Furthermore, the multiomics analysis implies the intermediate role of microbiota between antipsychotic effects and serum metabolites and provides new evidence to interpret the difference from multiple levels in the pathogenesis and pharmacological mechanism of schizophrenia.

[Application of locating supratrochlear artery and supraorbital artery in combined transfrontal and intranasal endoscopic approaches].

Objective: To investigate the localization methods of supratrochlear artery (STA) and supraorbital artery (SOA), and to explore the clinical benefit of locating nerve via accompanying vascular localization in combined transfrontal and intranasal endoscopic approaches. Methods: From June 2019 to May 2021, 14 patients, including 11 males and 3 females, aging from 18 to 69 years old, were underwent frontal sinus surgery through the combined transfrontal and intranasal endoscopic approaches in the Department of Otorhinolaryngology Head and Neck Surgery of the Third Affiliated Hospital of Sun Yat-sen University. Before the surgery, localization of STA and SOA was determined by color doppler flow imaging (CDFI), computerized topographic angiography (CTA) and contrast enhanced magnetic resonance angiography (CE-MRA) respectively, and the distances between STA and SOA from facial midline were measured on 28 eyebrows. The position of external incision was determined according to the preoperative localization of STA and SOA. The examination time, cost and postoperative complications of the three methods were recorded. The accuracy of localization at 14 sides was verified by the surgery. GraphPad Prism 8.3 software was used for statistical analysis. Results: STA and SOA could be located by CDFI, CTA and CE-MRA. There was no significant difference in the measurement of the distance between STA and SOA from the facial midline among 3 methods (all P>0.05). Determining the position of external incision according to the localization of STA and SOA could protect both the blood vessels and accompanying nerves. No postoperative complications such as numbness of the forehead skin occurred. The measurement time of CDFI, CTA and CE-MRA was 22.50 (15.75, 30.00), 30.00 (28.00, 34.25) and 48.00 (44.00, 52.75) min (M (Q1, Q3)), respectively (all P<0.05). CDFI incurred the lowest costs and took the shortest time. Conclusions: CDFI is an efficient and economic localization method. The localization of STA and SOA facilitates the precise selection of the position of external incision, protects the accompanying nerve and reduces postoperative complications.

[Anesthesia management of athletes' operation in Beijing Olympic Winter Games].

According to literature reports, the injury rate of the athletes in Olympic Winter Games recent years was as high as 10%-14%. Combined with the background of corona virus disease 2019 (COVID-19), the medical insurance work of the 24th Olympic Winter Games held in Beijing had put forward more complicated requirements and more severe challenges. In order to better optimize anesthesia management, this article summarized the perioperative treatment of athletes in Olympic Winter Games, the safety protection strategy of medical staff under general anesthesia, and the potential impact of peri-operative drugs on athletes. Anesthesiologists, as the core members of the rescue team, should be familiar with the particularity of operative anesthesia of athletes, sum up relevant experience to ensure the safety of perioperative patients. So all kinds of technical measures should be taken in the process of operation to minimize the indoor pollution caused by the patient's cough. For example, all the patients should wear N95 masks from the ward to the operating room, and after the operation, wear the N95 masks back to the ward. Although the International Olympic Committee had banned more than 200 drugs for participants and athletes who had to strictly follow International Olympic Committee requirements during anesthesia, the athletes were no longer participating in this Olympic Winter Games, so opioids (sufentanil and remifentanil) and glucocorticoid (dexamethasone) could be used according to the actual needs of surgery and anesthesia. Five athletes in Yanqing competition area underwent surgical anesthesia in Peking University Third Hospital Yanqing Hospital. All the five patients received general anesthesia, of whom four underwent orthopaedic surgery and one underwent laparoscopic cholecystectomy. General anesthesia with laryngeal mask airway was the first choice in the five patients. And the pain after orthopaedic surgery was severe and nerve block technique could effectively relieve the pain after surgery. Three patients received ultrasound-guided nerve block analgesia, the postoperative analgesia lasted 36 h. After the operation, non-steroidal anti-inflammatory drug (NSAID) was infused intravenously in the ward and all the patients recovered uneventfully. As the core member of the trauma rescue team, anesthesiologists should be familiar with the particularity of the athletes' surgical anesthesia, do a good job in medical security, and summarize relevant experience to ensure the life safety of the perioperative patients.

[Study on the diagnostic value of transient elastography, APRI and FIB-4 for liver fibrosis in children with non-alcoholic fatty liver disease].

Objective: To evaluate the diagnostic value of transient elastography, aspartate aminotransferase-to-platelet ratio index (APRI), and fibrosis index based on 4 factors (FIB-4) for liver fibrosis in children with non-alcoholic fatty liver disease (NAFLD). Methods: A retrospective study was conducted on 100 cases of nonalcoholic fatty liver disease in Hunan Children's Hospital between August 2015 to October 2020 to collect liver tissue pathological and clinical data. The receiver operating characteristic curve (ROC curve) was used to analyze the diagnostic value of liver stiffness measurement (LSM), APRI and FIB-4 in the diagnosis of different stages of liver fibrosis caused by NAFLD in children. Results: The area under the ROC curve (AUC) value of LSM, APRI and FIB-4 for diagnosing liver fibrosis (S≥1) were 0.701 [95% confidence interval (CI): 0.579 ~ 0.822, P = 0.011], 0.606 (95%CI: 0.436 ~ 0.775, P = 0.182), and 0.568 (95%CI: 0.397 ~ 0.740, P = 0.387), respectively. The best cut-off values were 6.65 kPa, 21.20, and 0.18, respectively. The AUCs value of LSM, APRI, and FIB-4 for diagnosing significant liver fibrosis (S≥ 2) were 0.660 (95% CI: 0.552 ~ 0.768, P = 0.006), 0.578 (95% CI: 0.464 ~ 0.691, P = 0.182) and 0.541 (95% CI: 0.427 ~ 0.655, P = 0.482), respectively. The best cut-off values were 7.35kpa, 24.78 and 0.22, respectively. The AUCs value of LSM, APRI and FIB-4 for the diagnosis of advanced liver fibrosis (S≥ 3) were 0.639 (95% CI: 0.446 ~ 0.832, P = 0.134), 0.613 (95% CI: 0.447 ~ 0.779, P = 0.223) and 0.587 (95% CI: 0.411 ~ 0.764, P = 0.346), respectively. The best cut-off values were 8.55kpa, 26.66 and 0.27, respectively. Conclusion: The transient elastography technique has a better diagnostic value than APRI and FIB-4 for liver fibrosis in children with NAFLD.

[Research progress of human coronaviruses and associated eye diseases].

Coronaviruses are RNA viruses. We should be alerted from the outbreak of the severe acute respiratory syndrome coronavirus (SARS-CoV) in 2003, the discovery of the human coronavirus NL63 (HCoV-NL63) in 2004 and the pneumonia outbreak caused by the novel coronavirus in 2019 (2019-nCoV). Coronaviruses can adhere to mucous membranes of the eye, nose, mouth, respiratory tract and digestive tract through various media, which leads to inflammatory reaction, pulmonary fibrosis, kidney failure and death in severe cases. As an exposed organ, the eye can also be infected. With the progress of molecular technology and the in-depth research of coronaviruses, there have been seven known coronaviruses that can infect humans, among which HCoV-NL63, SARS-CoV and 2019-nCoV can cause eye diseases. This article summarizes and analyzes the latest research results at home and abroad concerning the structural characteristics, transmission routes, ocular pathogenic characteristics and treatment of HCoV-NL63, SARS-CoV and 2019-nCoV, in order to provide reference for clinical diagnosis and treatment. (Chin J Ophthalmol, 2021, 57: 871-875).

Neuroprotective Effects of Isoquercetin: An In Vitro and In Vivo Study.

OBJECTIVE: Alzheimer's disease (AD) is considered a neurodegenerative disease that affects the cognitive function of elderly individuals. In this study, we aimed to analyze the neuroprotective potential of isoquercetin against the in vitro and in vivo models of AD and investigated the possible underlying mechanisms. MATERIALS AND METHODS: The experimental study was performed on PC12 cells treated with lipopolysaccharide (LPS). Reactive oxygen species (ROS), antioxidant parameters, and pro-inflammatory cytokines were measured. In an in vivo approach, Wistar rats were used and divided into different groups. We carried out the Morris water test to determine the cognitive function. Biochemical parameters, antioxidant parameters, and pro-inflammatory parameters were examined. RESULTS: The non-toxic effect on PC12 cells was shown by isoquercetin. Isoquercetin significantly reduced the production of nitrate and ROS, along with the altered levels of antioxidants. Isoquercetin significantly (P<0.001) down-regulated proinflammatory cytokines in PC12 cells treated with LPS. In the in vivo approach, isoquercetintreated groups considerably showed the up-regulation in the latency and transfer latency time, as compared with AD groups. Isoquercetin significantly reduced Aß-peptide, protein carbonyl, while enhanced the production of brainderived neurotrophic factor (BDNF) and acetylcholinesterase (AChE). Isoquercetin significantly (P<0.001) reduced pro-inflammatory cytokines and inflammatory mediators, as compared with AD groups. CONCLUSION: Based on the results, we may infer that, through antioxidant and anti-inflammatory systems, isoquercetin prevented neurochemical and neurobehavioral modifications against the model of colchicine-induced AD rats.

[Analysis of characteristics of Chenopodiaceae pollen induced seasonal allergic rhinitis in the Inner Mongolian grassland region of China].

Objective: To analyze the clinical characteristics of Chenopodiaceae pollen induced seasonal allergic rhinitis (SAR) as well as the distribution and sensitization characteristics of Chenopodiaceae pollen in Inner Mongolia grassland of northern China. Methods: From May 2015 to August 2015, using stratified, cluster and random sampling, a field interviewer-administered survey study and skin prick test (SPT) were conducted in six areas of Inner Mongolia grassland (Xilinhot, Erenhot, Duolun, Tongliao, Jarud, Kailu), and pollen monitoring was carried out in the above six areas from January 1 to December 31 of 2015. The clinical characteristics of Chenopodiaceae pollen induced SAR, distribution and sensitization characteristics of Chenopodiaceae pollen in these regions were observed. SAS software 9.4 was used for data processing. Results: A total of 6 043 subjects completed the study. The prevalence of Chenopodiaceae pollen induced SAR was 13.2% (795/6 043). The highest prevalence was found in the 18-39 age group. Subjects from urban areas showed higher prevalence of SAR than rural areas (61.2% vs 37.9%, P<0.001). There was significant regional difference in the prevalence rate of Chenopodiaceae pollen induced SAR among the above six areas (Xilinhot 21.5%, Erenhot 17.8%, Duolun 8.9%, Tongliao 6.9%, Jarud 15.3%, Kailu 9.7%, P<0.001). The main clinical symptoms of Chenopodiaceae pollen induced SAR were sneezing (96.5%) and nasal itching (92.2%). Eye itching was more obvious among the ocular symptoms (69.1%), while fatigue (32.1%) and drowsiness (31.5%) were more prominent among other related symptoms. Among comorbidities of Chenopodiaceae pollen induced SAR, allergic conjunctivitis accounted for 71.4% (568/795), food allergy accounted for 86.7% (689/795) and asthma accounted for 16.7% (133/795). The peak of Chenopodiaceae pollen spread was in August. The prevalence of Chenopodiaceae pollen induced SAR was positively correlated with the concentration of Chenopodiaceae pollen (R2=0.78, P=0.043). The SPT positive rate of Chenopodiaceae pollen was 21.2% (1 282/6 043), and Xilinhot had the highest rate in six regions (28.0%, 236/842). Conclusions: The prevalence of Chenopodiaceae pollen induced SAR in Inner Mongolia grassland stays at a high level. Sneezing is the most obvious symptom of SAR. The peak of Chenopodiaceae pollen spread is in August and the prevalence of Chenopodiaceae pollen induced SAR is positively correlated with the pollen concentration.

"Time Variable Earth Gravity Field Models From the First Spaceborne Laser Ranging Interferometer".

The Gravity Recovery and Climate Experiment Follow-On (GRACE-FO), launched May 22, 2018 and collecting science data since June 2018, is extending the 15-year data record of Earth mass change established by its predecessor GRACE mission (2002-2017). The GRACE-FO satellites carry onboard a novel technology demonstration instrument for intersatellite ranging, the Laser Ranging Interferometer (LRI), in addition to the microwave interferometer (MWI) carried on GRACE. The LRI has out-performed its in-orbit performance requirements both in terms of accuracy as well as the duration of tracking. Here, we compare and validate LRI-based gravity solutions for January 2019 to September 2020 against the MWI solutions. The comparison between the two sets of gravity solutions shows great similarities in general and nearly perfect consistency at a large hydrologic basin spatial scale (100,000 km2 and above), commonly viewed as the spatial resolution established by GRACE. The comparison in the spectral domain shows differences at the higher degrees of the spectrum, with lower error in the zonal and near zonal terms for the LRI solutions. We conclude that the LRI observations can be used to recover time-varying gravity signals to at least the level of accuracy established by the MWI-based solutions. This is a promising finding, especially when considering the benefits of using the LRI over the MWI, such as the great stability of the instrument and the low occurrence of instrument reboot events.

Dissolution enhancement of sorafenib tosylate by co-milling with tetradecanol post-extracted using supercritical carbon dioxide.

Sorafenib (SOR) is an important multikinase inhibitor for the treatment of cancers. It is commercially available (Nexavar from Bayer) in the form of sorafenib tosylate (SORt) due to its very low solubility. Studies have been made to further improve the dissolution behavior of the tosylate form (SORt), which could ultimately moderate the currently high daily dose. In the present study, SORt nanoparticles (SORt-NP) were prepared through a process that combined two industrially well-accepted techniques of co-milling and supercritical extraction. SORt was co-milled with hydrophilic polymers and tetradecanol, and the tetradecanol was post-extracted using supercritical carbon dioxide. The process enabled the formation of SORt-NP without using any toxic organic solvents, and the drug/excipient ratio (1:0.38) was substantially higher than determined in other studies (1:5.4-10). The enhanced dissolution behavior of SORt-NP was possible with an optimized number of milling cycles. Combining co-milling and supercritical extraction was able to form overall porous network structures with reduced crystallite size, which accelerated the dissolution of SORt-NP. The current method could be easily extended to other poorly soluble drugs as a general approach to improve their dissolution behaviors.

Exogenous IL-19 mediates downregulation of TGF-ß through Erk and p38 pathway to inhibit epidural fibrosis.

OBJECTIVE: To evaluate the effect of interleukin-19 (IL-19) treatment on epidural fibrosis and its mechanism of action with transforming growth factor ß (TGF-ß). MATERIALS AND METHODS: Initially, IL-19 (10, 20, 50 and 100 ng/L) was used to pretreat rat fibroblasts. TGF-ß (10 µg/L) was then applied to activate fibroblasts. The protein expression levels of TGF-ß receptor, extracellular-signal-regulated kinase (Erk) and p-38 were measured by Western blotting. In addition, we performed laminectomy at T10 vertebral plate in rats, followed by injection of IL-19 in caudal vein one week after injury. Furthermore, IL-19, TGF-ß and fibrosis indexes were measured by quantitative Real-time polymerase chain reaction (qRT-PCR) and Western blotting at 7 and 28 days after injury, respectively. RESULTS: Concentration-dependent IL-19 significantly down-regulated TGF-ß receptor expression and inhibited phosphorylated Erk (p-Erk) and phosphorylated p38 (p-p38). In vivo, IL-19 reduced the expressions of TGF-ß and connective tissue growth factor (CTGF) at 7 days. Furthermore, IL-19 significantly suppressed extracellular matrix productions formation, including α smooth muscle actin (α-SMA) and collagen-1 (COL-1), and fibronectin at 28 days. CONCLUSIONS: IL-19 inhibited TGF-ß expression via Erk and p38 pathway. Moreover, it decreased CTGF expression to suppress α-SMA, COL-1 and fibronectin in scar tissues, thereby preventing spinal cord from compression of scar tissues.

[Epidemiology of allergic rhinitis in children in grassland of Inner mongolia].

Objective: To investigate the self-reported prevalence, clinical characteristics, complications of allergic rhinitis (AR) and the sensitization of outdoor air pollen allergens in children in the Inner mongolia grassland region. Methods: A multistage, stratified and random clustered sampling with a face-to-face interview survey study in children from 0 to 17 years old was performed together with 10 common allergen skin prick tests (SPT) and measurements of the daily pollen count in 6 regions in the Inner mongolia grassland region from May to August of 2015. SAS 9.4 software was used for data analysis. Results: A total of 2 443 subjects completed the study. The self-reported prevalence of AR was 26.6%. The prevalence of boys was higher than that of girls (28.8% vs 24.3%, χ(2)=6.157, P<0.05). Subjects from urban areas showed higher prevalence than rural areas (34.7% vs 18.8%, χ(2)=79.107, P<0.05). There was significant regional difference in the prevalence of AR among the six areas investigated (χ(2)=221.416, P<0.05). The main clinical symptoms of AR were sneezing (88.2%) and nasal congestion (78.6%). Among combined diseases, asthma accounted for 16.5% (107/650), rhinoconjunctivitis accounted for 47.9% (311/650). The peak season of AR was April and July, with the top SPT positive allergens of Artemisia species and chenopodium in this area. Conclusions: The prevalence AR in children in the Inner mongolia grassland region is extremely high. Sneezing is the main clinical symptom. Rhinoconjunctivitis is the most common combined disease. High summer and autumn pollen exposure is the main cause of AR.

Influence of miR-34a on myocardial apoptosis in rats with acute myocardial infarction through the ERK1/2 pathway.

OBJECTIVE: To study the influence of micro-ribonucleic acid (miR)-34a on myocardial apoptosis in rats with acute myocardial infarction (AMI) through the extracellular signal-regulated kinase 1/2 (ERK1/2) pathway. MATERIALS AND METHODS: A total of 24 Sprague-Dawley (SD) rats were randomly divided into sham group (n=12) and model group (n=12). The heart was exposed in the sham group, while the AMI model was established in the model group. After sampling, the morphology of myocardial tissues was observed via hematoxylin-eosin (HE) staining, the expressions of B-cell lymphoma-2 (Bcl-2) and Bcl-2 associated X protein (Bax) were detected via immunohistochemistry, and the protein expression levels of ERK1/2 and phosphorylated ERK1/2 (p-ERK1/2) were detected via Western blotting. Moreover, the expression of miR-34a was detected via quantitative Polymerase Chain Reaction (qPCR), the apoptosis was detected via terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL), and the myocardial injury indexes were detected using a fully-automatic biochemical analyzer. RESULTS: The morphology of myocardial tissues was normal with a complete structure in the sham group, while there was damage to myocardial tissues in different degrees in the model group. The immunohistochemical results revealed that the Bax expression was increased and the Bcl-2 expression was decreased in the model group compared with those in the sham group (p<0.05). The results of Western blotting showed that the protein expression levels of both ERK1/2 and p-ERK1/2 were significantly increased in the model group compared with those in the sham group (p<0.05). The qPCR results manifested that the expression of miR-34a in the model group markedly declined compared with that in the sham group (p<0.05). Besides, the TUNEL detection showed that the apoptosis rate in the model group was remarkably increased compared with that in the sham group (p<0.05), and the content of cardiac troponin T and creatine kinase isoenzyme in the model group was significantly higher than that in the sham group ((p<0.05). CONCLUSIONS: MiR-34a affects the apoptosis in AMI by regulating the ERK1/2 signaling pathway.

Methylation and expression analysis of mismatch repair genes in extramammary Paget's disease.

BACKGROUND: Extramammary Paget's disease (EMPD) is a rare skin cancer with relative high frequencies of germline and somatic mismatch repair (MMR) genes mutations. However, the methylation and expression of these genes have not been validated in EMPD. OBJECTIVE: This study aims to confirm the methylation and expression of MMR genes in EMPD. METHODS: Immunohistochemical (IHC) staining detection and Methylation-specific PCR (MSP) were used to analyse MLH1, MSH2, MSH6 and PMS2 proteins' expression and promoters' methylation in 57 EMMD samples, and pyro-sequence was used to find highly methylated CpG sites in MSH2 promoter. RESULTS: Immunohistochemical detection displayed reduced expression of MSH2 in 38.6% EMPD cases but normal expression of MLH1, MSH6 and PMS2 in all tumour tissues. Hypermethylation also was found in the promoter of MSH2 but not in other MMR genes. Pyrosequencing of MSH2 promoter showed CpG6 (-87) and CpG3 (-98) were the most common two methylated CpG dinucleotides. There is a significant correlation between reduced MSH2 expression and MSH2 methylation. CONCLUSION: Reduced MSH2 expression and hypermethylation in this gene promoter were common genetic changes in EMPD, which expands our understanding of the role of MMR function in this skin cancer.

[Choroidal thickness in preschool children].

Objective: To estimate the choroidal thickness (CT) in healthy children aged 2-6 years old and its relation to axial length, age and gender. Methods: Cross-sectional study. CT was assessed using spectral domain optical coherence tomography (OCT) in 126 children aged 2 to 6 years. CT was measured at nine locations, including the subfovea and 1 mm and 3 mm nasal, temporal, superior and inferior to the fovea. Results: Mean subfoveal choroidal thickness (SFCT) was 331.56±62.03 µm. The choroid was thickest at the subfoveal and 1 mm temporal area, and thinner nasally compared to temporally, superiorly and inferiorly. No statistical significance of SFCT between male and female was noted. Stepwise multiple regression analysis revealed that axial length and age were associated significantly with SFCT (P=0.00), while there was no detectable effect of sex on SFCT (P=0.94). Conclusions: Choroidal thickness was negatively correlated to axial length and positively correlated to age in preschool children. The development of the choroid in early childhood offset the effect of the expansion of eyes. Gender played a minor role in the choroidal development in early childhood. (Chin J Ophthalmol, 2019, 55:111-114).

Correlation of hypertension and F2RL3 gene methylation with Prognosis of coronary heart disease.

The aim of this work was to investigate the correlation between methylation of F2RL3 gene and coronary heart disease (CHD) with or without hypertension, secondary cardiovascular events and mortality. Sixty patients with CHD who underwent a cardiovascular rehabilitation program were recruited. Group A included 30 patients with hypertension and CHD, and group B included 30 patients with non-hypertensive CHD, followed-up for more than 8 years. F2RL3 gene methylation was characterized by Sequenom matrix assisted laser desorption ionization time flight mass spectrometry. The correlation between methylation of the F2RL3 gene, hypertension and secondary cardiovascular events and all-cause mortality was analyzed by multivariate Cox, regression models that estimated confounders to control risk ratios. The results showed that during the follow-up, 3 patients in Group A developed non-fatal stroke, 2 patients died of cardiovascular disease, 1 patient died of other causes, and 4 patients in Group B developed non-fatal myocardial infarction. After adjusting for known prognostic factors, Cox model analysis showed that methylation of F2RL3 gene was closely related to hypertension and mortality. After F2RL3 included in the regression model, the correlation between hypertension and all prognostic outcomes increased. In conclusion, the methylation of F2RL3 can affect the prognosis of different types of acute coronary syndrome and is closely related to mortality.