[Feasibility of a three-sided encapsulation procedure based on fascia anatomy in laparoscopic lateral lymph node dissection for middle and low rectal cancer].

Objective: To explore the feasibility and value of performing a three-sided encapsulation procedure based on fascia anatomy in laparoscopic lateral lymph node dissection (LLND) for middle and low rectal cancer. Methods: This was a retrospective review. The study cohort comprised patients who met the diagnostic criteria for rectal cancer according to the Chinese Guidelines for the Diagnosis and Treatment of Colorectal Cancer, had a short lymph node diameter of >5 mm on the lateral side within the 15 days before surgery, were evaluated as feasible candidates for laparoscopic total mesorectal excision+LLND surgery, had been diagnosed with low or intermediate level rectal cancer, and whose tumor was less than 8 cm away from the anal verge according to pathological examination of the operative specimen. Patients with a history of other malignant tumors of the abdomen or with incomplete follow-up data were excluded. Forty-two patients with middle and low rectal cancer who had undergone lateral lymph node dissection in diagnosis and treatment center of Gastrointestinal Cancer of Guangdong Hospital of Chinese Medicine from Jan.2018 to Dec.2022 were enrolled. There were 24 men (57.1%) and 18 women (42.9%) aged 58.4±11.8 years and the median BMI was 22.5 (19.3-24.1) kg/m2. The main point of the three-sided encapsulation procedure is to expand the external side medial to the external iliac artery and vein, narrowing the range of exterior side dissection. The anterior-medial side is designed to expand the vesical fascia to define the range of anterior-medial side extension. The internal side is fully extended to the ureterohypogastric nerve fascia; the distal point of the caudal extension reaches the level of the Alcock canal and the bottom reaches the piriformis, enabling dissection of the obturator nerve and No.283 lymph nodes. No.263D lymph nodes are dissected by exposing the internal iliac artery and its branches, dissecting the group No.263P lymph nodes, and severing the inferior vesical artery. Finally, the lateral lymphatic tissue is completely resected. Relevant variables were recorded, including the number of lateral lymph nodes detected, the rate of lymph node metastasis, operation duration, intraoperative blood loss, postoperative complications, postoperative hospital stay, and 3-year overall survival rate. Results: Laparoscopic surgery was successfully completed in all patients with no conversions to open surgery and no intraoperative complications. Twenty-seven (64.3%) of the study patients underwent left-sided LLND, 10 (23.8%) right-sided LLND, and five (11.9%) bilateral LLND, with lymph nodes cleared on both sides. All patients' lymph nodes were examined pathologically. A median of 17.0 (11.7, 26.0) lymph nodes was detected, the median of lateral lymph nodes being 5.0 (2.0, 10.2). The median operation time was 254.5 (199.0, 325.2) minutes. The median intra-operative blood loss was 50.0 (30.0, 100.0) mL. All patients were diagnosed with adenocarcinoma by pathological examination of the operative specimen. Two patients developed postoperative intestinal obstruction, one lymphatic leakage, and one a perineal incision infection. There were no cases of anastomotic leakage. The median postoperative hospital stay was 6.0 (5.0, 7.0) days and the median follow-up time 23.5 (9.0, 36.7) months. During follow-up, three patients (7.1%) died of tumor recurrence and metastasis. Two (4.8%) experienced mild urinary dysfunction, and one (2.4%) had moderate postoperative erectile dysfunction. One patient (2.4%) was found to have prostate and lung metastases 3 month after surgery. The 3-year overall survival rate was 74.4%. Conclusions: Three sided encapsulation is a safe and feasible procedure for LLND, achieving accurate and complete clearance of lateral lymphatic tissue.

[Implementing and evaluating the online course system of orthodontic education].

A new teaching mode with the combination of online teaching and flipped class was designed and implemented in the Stomatological College of Nanjing Medical University based on the National Online Open Courses, the Virtual Interactive Network Teaching Platform and the E-learning Network Teaching Platform. The new online course system of orthodontic education was constructed with several components including the process and outcome assessments, the professional literature and knowledge summary reports and the virtual interactive online training. With the informative and convenient online teaching resources and modes, students' comprehensive abilities of independent learning were improved.

[Key gene leading to poor prognosis of triple-negative breast cancer based on bioinformatics analysis].

Objective: To find the possible targets for the study and treatment of triple-negative breast cancer (TNBC), and to analyze and predict the key genes affecting the prognosis of TNBC by bioinformatics. Methods: Raw data on transcriptome sequencing of clinical specimens from patients with TNBC were searched by searching GEO Datasets in the National Center for Biotechnology Information (NCBI) database. The differential gene was then submitted to the Enrichr website for pathway enrichment. Survival analysis was used to finally identify the most significant differences in the prognosis of patients with TNBC. Results: Only ADAM9 gene showed a significant correlation with the poor prognosis of patients with TNBC (P<0.05), and ADAM9 only showed specificity associated with prognosis in patients with TNBC, and was not with other breast cancer types. Conclusion: ADAM9 gene has been proved to be related to the poor prognosis in patients with TNBC. Therefore, ADAM9 gene can be regarded as a possible key gene leading to lymph node metastasis and poor prognosis in patients with TNBC.

Role of lncRNA-ENST00000412010 in regulating nasopharyngeal cancer cell survival.

BACKGROUND: Nasopharyngeal carcinoma (NPC) is a rare tumor with highly recurrent and lack of effective treatment. Long non- coding RNAs (lncRNAs) have been reported to play roles in various cancers including NPC. METHODS: In the current study, two cell lines of NPC (CNE-2Z and 5-8F cells) were transfected with short hairpin RNA (shRNA) targeting lncRNA-ENST00000412010 (shlncRNA) or control shRNA (shControl). Cell proliferation, survival, in vitro colony formation, and in vivo xenograft tumor formation were then investigated. RESULTS: The study found that cells transfected with shlncRNA grew significantly slower than the cells transfected with shControl as measured on day 5; increased in Annexin V expression; decreased in colony formation; and smaller in xenograft tumor size on day 45. Expression of DNA damage-inducible transcript 3, dual specificity protein phosphatase 5, insulin receptor substrate 1, interleukin-6, and tribbles homolog 3 genes was significantly up-regulated in the cells transfected with shlncRNA, while gene expression of matrix metalloproteinase-7 and cyclin-dependent kinase 4 inhibitor B was significantly down-regulated in the cells transfected with shlncRNA. Immunoblotting assay confirmed DUSP5 protein was significantly increased while proteins of MMP-7 and CDKN2B were significantly lower in the cells lacking lncRNA than that of the control cells. CONCLUSIONS: These findings suggested that lncRNA-ENST00000412010 plays a role in modulating NPC survival and tumorigenesis through regulating molecules associated with cell cycle and protein phosphatase.

Long noncoding RNA GAS5 enhanced by curcumin relieves poststroke depression by targeting miR-10b/BDNF in rats.

The treatment for post-stroke depression (PSD) is mainly based on a therapeutic strategy combining anti-stroke and anti-depressant drugs. In the present study, the therapeutic effect of curcumin on rats with PSD was detected by open field tests and tail suspension tests, as well as the examination of corticosterone and corticotropin-releasing hormone (CRH) levels in the serum and neurotransmitter 5-hydroxytryptamine (5-HT), 5-hydroxyindoleacetic acid (5-HIAA) and dopamine (DA) levels in the hippocampus. Curcumin notably alleviated depression compared to the controls. Furthermore, long noncoding RNA growth arrest-specific transcript 5 (GAS5) enhanced by curcumin contributed to activation of the BDNF/Trkß signaling pathway to promote the expression of synaptic-related proteins. GAS5 was demonstrated to function as a sponge of miR-10b. GAS5 upregulation by curcumin could reduce miR-10b to compromise the BDNF mRNA levels. Taken together, these results revealed a novel mechanism of curcumin on PSD through the GAS5/miR-10b/BDNF regulatory axis.

[Emerging of Japanese encephalitis virus and Getah virus from specimen of mosquitoes in Inner Mongolia Autonomous Region].

Objective: To investigate the types and distribution of blood-sucking insects and arboviruses in Inner Mongolia autonomous region, and provide basic data for the prevention of arbovirus transmitted disease. Methods: Blood-sucking insects were collected by lamp trapping method in nature. Mosquito samples were classified according to morphologic characteristics and then stored at liquid nitrogen. Viruses were isolated in cell culture and characterized, using molecular biological methods. Results: A total of 24 240 mosquitoes and 17 110 aphids were collected from 2 sites of 5 counties (Flags) in Inner Mongolia in 2014 and during 2017-2018. Among them, Japanese encephalitis virus gene was detected in Culex pipiens pallens, and 4 virus strains isolates which could be stably passaged. The isolates were identified as Getah virus and densonucleosis virus by molecular biology identification. Phylogenetic analysis on the E2 gene of the Getah virus (NMDK1813-1) showed that it belonged to the same evolutionary branch of the Gansu isolates (GS10-2) and having six common amino acid variation sites. Conclusions: The emergence of Japanese encephalitis virus and Getah virus from specimen of mosquitoes in Inner Mongolia indicated the new challenges on the prevention and control of arbovirus and related diseases. The results pf this study provided basic data for the prevention and control stretagies of arbovirus transmitted diseases in Inner Mongolia.

[Isolation and identification of Arbovirus in Hainan province, 2017-2018].

Objective: To understand the types and distribution of Arboviruses in Hainan province. Methods: Blood-sucking insects were collected in Hainan province from 2017 to 2018. After laboratory treatment, BHK-21 cells and C6/36 cells were inoculated with grinding supernatant of all blood-sucking insects to isolate all of involving virus. Arbovirus genes in blood-sucking insects were detected in parallel by RT-PCR method. Results: A total of 15 062 mosquitoes were classified into four genera (Culex, Armigeres, Aedes, Anopheles) and 11 360 midges were collected. Culex tritaeniorhynchus was in the majority and accounted for 92.88% (13 990/15 062) of all the mosquitoes collected. Four strains of virus isolates were notified by tissue culture method. Three strains of viruses belonged to Japanese encephalitis virus (JEV), with the other one as Getah virus (GETV). Five pools of JEV gene amplification were positive, from Culex tritaeniorhynchus. Results from the phylogenetic analysis showed that they belonged to genotype JEV-Ⅰ. The minimum infection rate of JEV was 0.57‰ (8/13 990). A total of 5 pools of Akabane virus (AKV) gene amplification were positive. The minimum infection rate of AKV was 0.44‰ (5/11 360). Based on the S gene and M gene sequences of the virus, data from the phylogenetic analysis showed that the five AKV strains carried by midges in Hainan province were in a separate evolutionary branch and with formed unique geographical distribution. Conclusions: JEV and GETV had been isolated again from the mosquito specimens in this survey, since the 1980s. AKV was detected from the midge specimens in Hainan province. These results showed the needs of strengthening the programs on detection and monitor of JEV, GETV and AKV that were related to animal and human diseases in order to reduce the risks of related diseases in this area.

[Strategy of nursing care on the face skin injuries caused by wearing medical-grade protective equipment].

For effective resistance to virus attack and infection, reducing virus transmission chance, it is extremely important for the medical staff and related workers to have their own safe protection. This paper summarizes the development causes, common locations, and prevention ways about the device related pressure injuries on the face resulted from wearing medical-grade protective equipment for a long working time. The paper proposes the nursing strategy for device related pressure injuries and other nursing strategy is proposed to take care efficiently the device related pressure injuries. Meantime, a corresponding nursing strategy is also suggested to deal with the correlative skin diseases during the application of medical-grade protective equipment. These paper aims to provide reference for the prevention of device related pressure injuries and the care of skin-related diseases for clinical working staff, especially to the respectable personnel in front line of fighting against Corona virus disease 2019.

[A preliminary study of resting-state fMRI in patients with diarrhea-type irritable bowel syndrome after pinaverium bromide combined treatment with flupentixol-melitracen].

Objective: To observe the difference of brain activity in patients with diarrhea-type irritable bowel syndrome (IBS-D) treated with pinaverium bromide (PB) combined with flupentixol-melitracen (FM), and to explore the mechanism of efficacy of combined with anxiolytic/antidepressant drugs in IBS-D patients at the central level, using resting-state functional magnetic resonance imaging (rs-fMRI). Methods: Forty-eight patients with IBS-D, including 28 males, 20 females, mean age 22-48 (33±7) years, were selected from the Affiliated Hospital of Hangzhou Normal University from October 2015 to October 2018.All patients with IBS-D underwent rs-fMRI scans before and after receiving either PB (basic treatment group, n=16), PB combined with FM (combination therapy group, n=16), or no medication (no treatment group, n=16). Rs-fMRI regional homogeneity (ReHo) parameter among the three groups of patients were compared using One-way ANOVA analysis and post analysis.Partial correlation and mediation analyses were performed on ReHo values and the improvement of symptoms scores (gastrointestinal symptom rating scale(GSRS) and hospital anxiety/depression scale (HAD)) in the two medicated groups. Results: No significant differences in ReHo values were observed among the three groups before treatment. Compared with patients on no-medication, patients receiving either PB or PB-FM showed decreased ReHo in the striatum, insular lobe, medial prefrontal cortex (MPFC) and subcallosal gyrus, and increased ReHo in the occipital cortex. In particular, the combined treatment group showed more extensive decreased ReHo in the left thalamus and left temporal pole, and increased in the left precuneus. Compared with the basic treatment group, the combined treatment group showed decreased ReHo in the right putamen, right insula, right MPFC and subcallosal gyrus, and increased ReHo in the left precuneus. In addition, the combined treatment group demonstrated a positive correlation between ReHo values in the left thalamus and the improvement of HAD score (r=0.653, P=0.011) , and a negative correlation between ReHo values in left precuneus and the improvement of GSRS and HAD score (r=-0.771, P=0.001; r=-0.716, P=0.004). ReHo values in the left precuneus were observed to mediate between gastrointestinal symptoms and anxiety-depressive symptoms in the combined treatment group. Conclusions: The efficacy of PB combined with FM is superior to PB alone in the treatment of IBS. In addition to more extensive changes in pain-related brain areas, IBS-D patients treated with anxiolytic/antidepressant also show changes in default network and brain areas related to emotional regulation, and are associated with improvement in gastrointestinal symptoms, anxiety and depression.

[Mosquitoes, midges and related arboviruses in southeast Sichuan province].

Objective: To investigate the distribution patterns of mosquitoes, midges and related arboviruses in Sichuan province. Methods: Blood-sucking insects were collected from houses and pens, using the ultraviolet lights. Mosquito samples were classified according to morphologic characteristics and then stored at liquid nitrogen. All samples were incubated with BHK-21 and C6/36 cells for virus isolation and then detected for their viral genes. Sequences of the virus were identified and analyzed by molecular biological software, such as BioEdit 7.0.5.3, MEGA 6.0. Results: In total, 17 019 mosquitoes from 3 genera and 4 species and 12 700 midges were collected from the southeast regions of Sichuan province in 2016 and 2017. Among them, 79.4% (13 519/17 019) belonged to Culex tritaeniorhynchus with 11.1% (1 897/17 019) as Armigeres subalbatus, 5.5% (930/17 019) were Anopheles sinensis and 4.0% (673/17 019) were Anopheles sinensis 3 virus strains that isolated from Culex tritaeniorhynchus were identified as typeⅠ Japanese encephalitis virus. Seven pools of mosquitoes isolated from Hejiang county were identified Japanese encephalitis virus gene positive through PCR amplification. With 4 pool midges were detected positive for Akabane virus through PCR gene amplification while midges samples didn't have virus isolates. Conclusions: Culex tritaeniorhynchus appeared the predominant species in the southeast regions of Sichuan. Japanese encephalitis virus transmitted by mosquitoes and Akabane virus by midges were prevalent in southeast Sichuan province.

Study on molecular mechanism of MiRNA-29a in promoting proliferation and invasion of non-small-cell lung cancer by inhibiting MTSS1.

OBJECTIVE: To investigate the biological role of micro-ribonucleic acid (miR)-29a in non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: 55 cases of NSCLC tissue specimens and paired normal lung tissue specimens collected in the Department II of Oncology, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine from July 2012 to April 2015 were randomly included. The fluorescent quantitative polymerase chain reaction, Western blotting, and immunohistochemistry were performed to detect the expression levels of miR-29a and metastasis suppressor 1 (MTSS1). Pearson correlation analysis was utilized to investigate the relationship between miR-29a expression and MTSS1 expression in NSCLC tissues, and the Kaplan-Meier survival curves were constructed to analyze the association of miR-29a expression with the survival time of NSCLC patients. A54 proliferation and invasion abilities were measured by means of plate clone formation assay, and transwell assay after the miR-29a was suppressed by miRNA inhibitor. Luciferase assay was used to detect the target gene of miR-29a. RESULTS: In NSCLC tissues, the miR-29a expression level was higher than that in normal lung tissues (p<0.05), while the expression level of MTSS1 protein was remarkably lower than that in normal lung tissues (p<0.05). The median survival time of the patients was 15.1 months in high miR-29a expression group and 18.3 months in low miR-29a expression group (p<0.05). The miR-29a expression was negatively correlated with the expression level of MTSS1 protein in NSCLC tissues (r=-0.762, p<0.05). Luciferase results suggest that miR-29a binds to the promoter region of MTSS1 and inhibits its transcription level. The expression of MTSS1 protein was up-regulated notably after miR-29a knockdown by an inhibitor. It was revealed in the results of transwell assay and plate clone formation assay that the proliferative and invasive capacity of A549 cells was significantly decreased after knockdown of miR-29a. CONCLUSIONS: The transcribed miR-29a down-regulates the protein level of MTSS1, suppressor of tumor proliferation and invasion, thereby promoting the proliferative and invasive capacity of NSCLC cells. Both miR-29a and MTSS1 are expected to become potential therapeutic targets for NSCLC.

[Study on diffusion kurtosis imaging in hyperacute phase of mild traumatic brain injury].

Objective: To explore the changes of cerebral white matter in the hyperacute period (<24 h) patients with mild traumatic brain injury (mTBI) by diffusion kurtosis imaging(DKI) technique. Methods: A total of 52 patients with mTBI were included in this study, collected in Emergency Department of Affiliated Hospital of Hangzhou Normal University from May 2016 to June 2017. Twenty-one healthy controls were recruited at the mean time(gender, age and years of education were matched with the patients). DKI data were acquired with 3.0 T scanners.The FSL software was used to preprocess the DKI data, and the white matter abnormalities were detected by tract-based spatial statistics (TBSS). Results: There were no statistical differences in gender, age and years of education between mTBI patients and healthy controls (P=0.427, P=0.235, P=0.165). The values of MK of the body of corpus callosum (BCC), the genu of corpus callosum (GCC), the splenium of corpus callosum (SCC), the bilateral anterior limb of interbal capsule (ALIP), the right posterior limb of internal capsule (PLIC_R), the bilateral anterior corona radiate (ACR), the bilateral posterior corona radiate (PCR), the bilateral superior corona radiate (SCR), the left inferior fronto-occipital fasciculus (IFOF_L)and the bilateral superior longitudinal fasciculus (SLF) were lower in mTBI patients((1.095±0.080), (1.130±0.066), (1.160±0.080), (1.135±0.077), (1.108±0.076), (1.203±0.069), (1.073±0.056), (1.052±0.055), (1.170±0.055), (1.149±0.050), (1.028±0.056), (1.051±0.059), (0.868±0.060), (1.194±0.048), (1.183±0.054) mm(2)/s) than those in healthy controls((1.153±0.054), (1.184±0.057), (1.215±0.068), (1.181±0.053), (1.163±0.062), (1.258±0.041), (1.115±0.037), (1.096±0.049), (1.210±0.040), (1.190±0.049), (1.063±0.042), (1.087±0.057), (0.913±0.063), (1.236±0.047), (1.214±0.038) mm(2)/s)(P<0.01). However, there were no statistical differences in fractional anisotropy (FA) between groups (P>0.01). Conclusion: DKI technology is more sensitive in detecting cerebral white matter abnormalities in patients with hyperacute mTBI which routine MRI findings was normal.

[Regional homogeneity in the patients of irritable bowel syndrome complicated with depression: a resting-state functional magnetic resonance imaging study].

Objective: To explore the changes of the brain regional homogeneity (ReHo) in the patients of irritable bowel syndrome (IBS) complicated with depression by using resting-state functional magnetic resonance imaging (rs-fMRI) and to investigate the relation between abnormal brain function and depression in those patients. Methods: A total of 35 patients with IBS were included in this study, collected in Gastroenterology Department of Affiliated Hospital of Hangzhou Normal University from June 2015 to June 2017.According to Hamilton's Depression Scale (HAMD)-17 score, the IBS patients was divided into two groups: IBS with depression group, 21 cases and non-depression group, 14 cases.Thirty-six healthy controls were recruited at the mean time (gender, age and years of education were matched with the patients). Rs-fMRI and 3D T1 data were acquired with 3.0 T scanners.For all subjects, ReHo, a method measuring the synchronism of regional spontaneous activities, was calculated and one-way ANOVA was performed to assess the group effects.For those regions with significant group effects, correlation between ReHo values and GSRS and HAMD scores was analyzed too. Results: Significant group effects were found in multiple regions: the right pons, the left inferior temporal gyrus (ITG)/fusiform, the left superior temporal gyrus (STG)/temporal pole, the right inferior frontal gyrus (IFG), the right middle occipital gyrus (MOG), the right caudate nucleus, the left posterior cingulate cortex/precuneus (pCC/pC), the left postcentral gyrus, the right inferior parietal lobule (IPF). Compared with control group, all the two patient groups had increased ReHo values in the left pCC/pC, the right IPF, the left postcentral gyrus and the left STG/temporal pole; all the two patient groups had decreased ReHo values in the right MOG and the right IFG.Compared with non-depression group, depression group had increased ReHo values in the right caudate nucleus, and decreased ReHo values in the right pons, the left pCC/pC, the right IPF, the left postcentral gyrus.Particularly, there was no significant difference in the ReHo value in the right caudate nucleus between the control group and the non-depressed IBS group.In the depression group, significantly positive correlations were observed between ReHo values and HAMD scores in the left pCC/pC (r=0.599, P=0.011), and significantly positive correlations were observed between ReHo values and GSRS in the left postcentral gyrus (r=0.547, P=0.023). Conclusions: IBS patients have abnormal ReHo regions in default network and pain regulation-associated brain area.IBS with depressed patients has its own characteristics in the brain regions which related with pain perception and self-regulation.IBS could has an abnormal self-regulation of visceral pain, which is associated with the occurrence of depression.Depression can aggravate the disorders of pain perception and other functions of IBS patients.

Positive Association Between Betatrophin and Diabetic Retinopathy Risk in Type 2 Diabetes Patients.

Betatrophin is a recently identified protein that has been shown to be associated with lipid metabolism and insulin resistance. This study aimed to measure serum betatrophin concentrations in patients with type 2 diabetes (T2DM) and evaluate the association of betatrophin with diabetic retinopthy (DR). Serum betatrophin concentrations were compared between (1) gender-, age- and body mass index-matched T2DM patients with (n=17) or without (n=33) DR; (2) gender-, age-, and body mass index-matched healthy subjects (n=31), newly-diagnosed T2DM patients before treatment (n=24), and T2DM patients under antidiabetic treatment (n=35). Serum betatrophin concentrations were determined by the enzyme-linked immunosorbent assay. Multivariate logistic regression was performed to assess the association between betatrophin concentration and DR. Serum betatrophin concentration was significantly associated with DR in T2DM patients under treatment (Odds Ratio 2.01; 95% Confidence Interval 1.12-3.60; p=0.019). Betatrophin concentrations were significantly increased in treated T2DM patients compared to the healthy subjects (4.17±0.60 vs. 0.54±0.07 ng/ml; p<0.001). Serum betatrophin concentrations are increased in T2DM patients under antidiabetic treatment and positively associated with diabetic retinopathy.

Emerging issues in public health: a perspective on China's healthcare system.

China's expenditure on healthcare has increased dramatically over the last 20 years, and three broad trends are seen in the associated health outcomes. First, limited improvements have been achieved to aggregate high-level health outcomes, e.g. infant mortality. Second, development of large and widening health inequalities associated with disparate wealth between provinces and a rural-urban divide. Finally, the burden of disease is shifting from predominantly communicable diseases to chronic diseases. Reasons for the limited gains from investment in healthcare are identified as: (1) increased out-of-pocket expenditure including a high proportion of catastrophic expenditure; (2) a geographical imbalance in healthcare spending, focusing on secondary and tertiary hospital care and greater expenditure on urban centres compared with rural centres; and (3) the commercialization of healthcare without adequate attention to cost control, which has led to escalation of prices and decreased efficiency. Recently, the Chinese Government has initiated widespread reform. Three key policy responses are to establish rural health insurance, partly funded by the Government (the New Rural Co-operative Medical Care System); to develop community health centres; and to aspire to universal basic healthcare coverage by 2020 (Healthy China 2020).

Feasibility study of vertical subcutaneous injection of insulin with an insulin pen injector in diabetic patients with normal body mass index.

This study explored the feasibility of vertical insulin injection with an insulin pen injector in 40 Chinese diabetic outpatients with a normal body mass index. The patients, who received insulin in the hospital clinic, were assessed for abdominal subcutaneous fat thickness and distribution at four abdominal points using ultrasonography. Abdominal subcutaneous fat thickness and distribution were found to be heterogeneous and to differ significantly at these four points. Abdominal subcutaneous fat thickness was < 5 mm in nine of the 40 patients. In patients with abdominal subcutaneous fat thickness of < 5 mm, vertical insulin injection risks injecting into the muscle layer and is, therefore, not desirable. Vertical injection into pinched skin with a rotary syringe is safe and effective in such patients.

Using molecular markers to identify two major loci controlling carotenoid contents in maize grain.

Maize is an important source of pro-vitamin A; beta-carotene, alpha-carotene and beta-cryptoxanthin, and the non-pro-vitamin A carotenoids including lutein and zeaxanthin. In the present study, a recombinant inbred (RI) population with 233 RI lines derived from a cross between By804 and B73 was employed to detect QTL for these nutritionally important components in maize grain. High Performance Liquid Chromatography was used to measure amounts of individual carotenoids over 2 years. A genetic linkage map was constructed with 201 molecular markers. In all, 31 putative QTL including 23 for individual and 8 for total carotenoids were detected on chromosome(s) 1, 3, 5, 6, 7, 8 and 10. The notable aspect of this study was that much of the phenotypic variation in contents of carotenoids could be explained by two loci (y1 and y9), and the QTL for carotenoids elucidated the interrelationships among these compounds at the molecular level. A gene targeted marker (Y1ssr) in the candidate gene phytoene synthase 1 (psy1) tightly linked to a major QTL explaining 6.6-27.2% phenotypic variation for levels of carotenoids was identified, which may prove useful to expedite breeding for higher level of carotenoids in maize grain. This functionally characterized gene (psy1) could also be exploited for further development of functional marker for carotenoids in maize. The QTL cluster located at y9 locus may also be used for pyramiding favorable alleles controlling contents of carotenoids from diverse maize germplasm.

Microdosimetric analysis for high LET radiation.

For short range high linear energy transfer (LET) radiation therapy the biological effects are strongly affected by the heterogeneity of the specific energy (z) distribution delivered to tumour cells. Three-dimensional (3-D) dosimetry information at the cellular level is required for this study. An ideal approach would be the reconstruction of the cell and the radiation source microdistribution from sequential autoradiographic sections, which is, however, not a practical solution. In this paper, a novel microdosimetry analysis method, which obtains the specific energy (z) distribution directly from the morphological information in individual autoradiographic sections, is applied to human glioblastoma multifore (GBM) and normal brain tissue specimens in boron neutron capture therapy. The results are consistent with Monte Carlo simulation and demonstrate a uniform radiation source distribution in both GBM and normal brain tissues. We also hypothesise a biophysical model based on specific energy for survival analysis. The specific energy distributions to cell nuclei were calculated with a uniform radiation source distribution. By combining this microdosimetric analysis with measured cell survival data at the low dose region, a cell survival curve at high doses is predicted, which is consistent with the commonly used simple exponential curve model for high LET radiation.

RBE of the MIT epithermal neutron beam for crypt cell regeneration in mice.

The RBE of the new MIT fission converter epithermal neutron capture therapy (NCT) beam has been determined using intestinal crypt regeneration in mice as the reference biological system. Female BALB/c mice were positioned separately at depths of 2.5 and 9.7 cm in a Lucite phantom where the measured total absorbed dose rates were 0.45 and 0.17 Gy/ min, respectively, and irradiated to the whole body with no boron present. The gamma-ray (low-LET) contributions to the total absorbed dose (low- + high-LET dose components) were 77% (2.5 cm) and 90% (9.7 cm), respectively. Control irradiations were performed with the same batch of animals using 6 MV photons at a dose rate of 0.83 Gy/min as the reference radiation. The data were consistent with there being a single RBE for each NCT beam relative to the reference 6 MV photon beam. Fitting the data according to the LQ model, the RBEs of the NCT beams were estimated as 1.50 +/- 0.04 and 1.03 +/- 0.03 at depths of 2.5 and 9.7 cm, respectively. An alternative parameterization of the LQ model considering the proportion of the high- and low-LET dose components yielded RBE values at a survival level corresponding to 20 crypts (16.7%) of 5.2 +/- 0.6 and 4.0 +/- 0.7 for the high-LET component (neutrons) at 2.5 and 9.7 cm, respectively. The two estimates are significantly different (P = 0.016). There was also some evidence to suggest that the shapes of the curves do differ somewhat for the different radiation sources. These discrepancies could be ascribed to differences in the mechanism of action, to dose-rate effects, or, more likely, to differential sampling of a more complex dose-response relationship.