Confinement loss prediction in diverse anti-resonant fibers through neural networks.

In this work, genetic algorithm (GA) is employed to optimize convolutional neural networks (CNNs) for predicting the confinement loss (CL) in anti-resonant fibers (ARFs), achieving a prediction accuracy of CL magnitude reached 90.6%, which, to the best of our knowledge, represents the highest accuracy to date and marks the first instance of using a single model to predict CL across diverse ARF structures. Different from the previous definition of ARF structures with parameter groups, we use anchor points to describe these structures, thus eliminating the differences in expression among them. This improvement allows the model to gain insight into the specific structural characteristics, thereby enhancing its generalization capabilities. Furthermore, we demonstrate a particle swarm optimization algorithm (PSO), driven by our model, for the design of ARFs, validating the model's robust predictive accuracy and versatility. Compared with the calculation of CL by finite element method (FEM), this model significantly reduces the cost time, and provides a speed-up method in fiber design driven by numerical calculation.

Reduced expression of semaphorin 3A in osteoclasts causes lymphatic expansion in a Gorham-Stout disease (GSD) mouse model / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Gorham-Stout disease (GSD) is a sporadic chronic disease characterized by progressive bone dissolution, absorption, and disappearance along with lymphatic vessel infiltration in bone-marrow cavities. Although the osteolytic mechanism of GSD has been widely studied, the cause of lymphatic hyperplasia in GSD is rarely investigated. In this study, by comparing the RNA expression profile of osteoclasts (OCs) with that of OC precursors (OCPs) by RNA sequencing, we identified a new factor, semaphorin 3A (Sema3A), which is an osteoprotective factor involved in the lymphatic expansion of GSD. Compared to OCPs, OCs enhanced the growth, migration, and tube formation of lymphatic endothelial cells (LECs), in which the expression of Sema3A is low compared to that in OCPs. In the presence of recombinant Sema3A, the growth, migration, and tube formation of LECs were inhibited, further confirming the inhibitory effect of Sema3A on LECs in vitro. Using an LEC-induced GSD mouse model, the effect of Sema3A was examined by injecting lentivirus-expressing Sema3A into the tibiae in vivo. We found that the overexpression of Sema3A in tibiae suppressed the expansion of LECs and alleviated bone loss, whereas the injection of lentivirus expressing Sema3A short hairpin RNA (shRNA) into the tibiae caused GSD-like phenotypes. Histological staining further demonstrated that OCs decreased and osteocalcin increased after Sema3A lentiviral treatment, compared with the control. Based on the above results, we propose that reduced Sema3A in OCs is one of the mechanisms contributing to the pathogeneses of GSD and that expressing Sema3A represents a new approach for the treatment of GSD.

Antiresonant fiber structures based on swarm intelligence design.

In this work, we obtained a new, to the best of our knowledge, structure of anti-resonant fiber (ARF) by an adaptive particle swarm optimization (PSO) algorithm. Different from the prior method of stacking elemental parts and optimizing parameters through experience or algorithm, we decompose some classic structures into points and optimize the positions of these points through swarm intelligence. The fiber structure is reconstructed by interpolation, and some new structures with low confinement loss (CL) and high higher order mode extinction ratio (HOMER) are obtained. These novel ARFs exhibit similar structural characteristics, and are named as "the bulb-shaped ARFs". Among these structures, the minimum achieved CL is 2.21 × 10-5dB/m at 1300 nm and the maximum achieved HOMER exceeds 14,000. This work provides a method with high degree of freedom in the design of non-uniform cross-section waveguides and helps to discover new fiber structures.

Comparison of short-term outcomes between fluorescence method versus modified inflation-deflation method on thoracoscopic anatomical segmentectomy: a study based on propensity score matching / 中华胸心血管外科杂志

Objective:To investigate the application value of fluorescence imaging in single-port thoracoscopic anatomic segmentectomy.Methods:The clinical data of 280 patients (145 patients with fluorescence method and 135 patients with modified inflation-deflation method) who underwent thoracoscopic anatomic segmentectomy were retrospectively studied in the Anhui Chest Hospital from June 2020 to June 2021. There were 113 patients in the simple segmentectomy group and 167 patients in the complex segmentectomy group. The baseline data of the fluorescence method and the modified inflation-deflation method in the complex segmentectomy group were corrected by propensity score matching, and the perioperative results were compared between the groups.Results:There were no significant differences in segmental resection time, intraoperative blood loss, postoperative drainage, postoperative pain, postoperative extubation time, length of hospital stay, incidence of complications and cost of hand-holding between the fluorescence method and the modified method of the simple segmentectomy group.In the complex segmentectomy group, the time of segmental resection with the fluorescence method was significantly shorter than that with the modified inflation-deflation method( P<0.05), and other indexes had no significant difference. Conclusion:Fluorescence method single-port thoracoscopic anatomic segmentectomy has the same perioperative safety and short-term efficacy as modified inflation-deflation method, which can significantly shorten the operative time and improve the operative efficiency in complex anatomic segmentectomy.

Primary central nervous system T-cell lymphoma: a case report / 中华神经科杂志

Primary central nervous system T-cell lymphomas (PCNSTL) are rare, the clinical symptoms and radiographic imaging of which are unspecific, and the pathological morphology is antypical, leading to misdiagnosis and delays in treatment. A 45-year-old male patient with diplopia accompanied by numbness and dysarthria was reported in this paper, which was considered as "lymphoma or lymphoproliferative lesions" on magnetic resonance imaging (MRI) while no typical tumor cells in brain biopsy. The clinical symptoms worsened one month later and the reexamined MRI showed that the scope of the lesion was enlarged and the enhancement was more obvious than before, which was still considered as lymphoma or lymphoproliferative lesion. The second biopsy was performed and still no typical tumor lymphocytes were seen. Finally, gene rearrangement was carried out and showed the β and γ chains both present positive mutations in T cell receptor (TCR) gene rearrangement. Combined with cell morphology, immunophenotype and TCR gene rearrangement results, the patient was finally diagnosed as PCNSTL. This article reviewed the clinical symptoms, imaging features, laboratory examinations, pathological characteristics, diagnosis and differential diagnosis of PCNSTL, so as to improve the understanding of this rare disease.

Formosanin C attenuates lipopolysaccharide-induced inflammation through nuclear factor-κB inhibition in macrophages

Extended inflammation and cytokine production pathogenically contribute to a number of inflammatory disorders. Formosanin C (FC) is the major diosgenin saponin  found in herb Paris formosana Hayata (Liliaceae), which has been shown to exert anti-cancer and immunomodulatory functions. In this study, we aimed to investigate anti-inflammatory activity of FC and the underlying molecular mechanism. RAW264.7 macrophages were stimulated with lipopolysaccharide (LPS) or pretreated with FC prior to being stimulated with LPS. Thereafter, the macrophages were subjected to analysis of the expression levels of pro-inflammatory mediators, including nitric oxide (NO), prostaglandin E2 (PGE), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and IL-6, as well as two relevant enzymes, inducible nitric oxide synthase (iNOS), and cyclooxygenase-2 (COX-2). The analysis revealed that FC administration blunted LPS-induced production of NO and PGE in a dose-dependent manner, while the expression of iNOS and COX-2 at both mRNA and protein levels was inhibited in LPS-stimulated macrophages pre-treated with FC. Moreover, LPS stimulation upregulated mRNA expression and medium release of TNF-α, IL-1β, and IL-6, whereas this effect was blocked upon FC pre-administration. Mechanistic studies showed that inhibitory effects of FC on LPS-induced inflammation were associated with a downregulation of IκB kinase, IκB, and p65/NF-κB pathway. Taken together, these data suggest that FC possesses an inflammation-suppressing activity, thus being a potential agent for the treatment of inflammation-associated disorders.

Design and application of cardiac surgery teaching based on Rain Classroom / 中华医学教育探索杂志

In this paper, Rain Classroom is integrated into the teaching design of cardiac surgery, and specific teaching applications are carried out in the clinical medicine general class and international students class. The Rain Classroom is applied in the pre-class preparation, classroom interaction, after-class expansion and teaching evaluation and analysis. The results show that the application of Rain Classroom can significantly improve students' enthusiasm and interaction in class, improve teaching quality and improve students' comprehensive quality, and provide new ideas for cardiac surgery teaching.

Protective effects of hypoxia inducible factor-1α on myocardial ischemia postconditioning in rats / 中国小儿急救医学

Objective:To investigate the protective role and mechanism of hypoxia inducible factor(HIF)-1α in myocardial ischemia postconditioning.Methods:Forty healthy adult SD rats were randomly divided into four groups with 10 rats in each group.The control group(group A)was sham operation group, and the rats underwent the same surgical procedures except that the suture passed under the left anterior descending branch(LAD)of the coronary artery was not tightened for 225 minutes.In the ischemia-reperfusion group(group B), the LAD was blocked for 45 minutes, and then reperfusion for 3 hours.In the ischemic postconditioning group(group C), 45 minutes after blocking the LAD, reperfusion was performed for 10 seconds-ischemia for 10 seconds at the beginning of reperfusion, a total of 3 cycles of intervention, and reperfusion for 3 hours.Ischemic postconditioning + HIF-1α inhibitor group(group D): 45 minutes after blocking the LAD, HIF-1α inhibitor AG490 (3 μg/g) was injected intraperitoneally, and reperfusion was performed for 10 seconds-ischemia 10 seconds at the moment of reperfusion.A total of 3 cycles of intervention, reperfusion for 3 hours.Blood samples were harvested from femoral vein at three time points(before ligation of the LAD, 45 minutes after ischemia, 3 hours after reperfusion)to analyze the serum levels of creatine kinase and cardiac troponin respectively.After 3 hours of reperfusion, myocardial tissue was used to measure the infarction size through 2, 3, 5-triphenyltetrazolium chloride staining method; and Western blot method was used to detect the expression of HIF-1α in each group.Results:(1) There were no significant differences in the serum levels of creatine kinase and cardiac troponin among four groups before ligation( P>0.05); 45 minutes after ischemia, there were significant differences between group B, group C, and group D compared with group A ( P<0.01). After 3 hours of reperfusion, there were significant differences between group B, group C, and group D compared with group A (all P<0.01), and group B, group D were significantly higher than that in group C ( P<0.05). (2)Compared with group A[(2.46±1.13)%], the area of myocardial infarction in group B was (45.81±5.96)%, in group C was (37.17±4.99)%, and group D was (45.00±3.29) %, and the differences were statistically significant ( P<0.01). (3)The HIF-1α protein in myocardial tissue in group A was slightly expressed; the expression of HIF-1α protein in group B was higher than that in group A( P<0.05); and group C was significantly higher than that in group B ( P<0.05); HIF-1α protein was almost not expressed in group D. Conclusion:After ischemic postconditioning, HIF-1α increased in myocardium; the increased expression of HIF-1α may be involved in the protective process of myocardial ischemic postconditioning in rats.

Formosanin C attenuates lipopolysaccharide-induced inflammation through nuclear factor-κB inhibition in macrophages

Extended inflammation and cytokine production pathogenically contribute to a number of inflammatory disorders. Formosanin C (FC) is the major diosgenin saponin  found in herb Paris formosana Hayata (Liliaceae), which has been shown to exert anti-cancer and immunomodulatory functions. In this study, we aimed to investigate anti-inflammatory activity of FC and the underlying molecular mechanism. RAW264.7 macrophages were stimulated with lipopolysaccharide (LPS) or pretreated with FC prior to being stimulated with LPS. Thereafter, the macrophages were subjected to analysis of the expression levels of pro-inflammatory mediators, including nitric oxide (NO), prostaglandin E2 (PGE), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and IL-6, as well as two relevant enzymes, inducible nitric oxide synthase (iNOS), and cyclooxygenase-2 (COX-2). The analysis revealed that FC administration blunted LPS-induced production of NO and PGE in a dose-dependent manner, while the expression of iNOS and COX-2 at both mRNA and protein levels was inhibited in LPS-stimulated macrophages pre-treated with FC. Moreover, LPS stimulation upregulated mRNA expression and medium release of TNF-α, IL-1β, and IL-6, whereas this effect was blocked upon FC pre-administration. Mechanistic studies showed that inhibitory effects of FC on LPS-induced inflammation were associated with a downregulation of IκB kinase, IκB, and p65/NF-κB pathway. Taken together, these data suggest that FC possesses an inflammation-suppressing activity, thus being a potential agent for the treatment of inflammation-associated disorders.

Clinical Characteristics and Survival of Primary Duodenal Lymphoma: Analysis Based on SEER Database / 胃肠病学

Background: Primary duodenal lymphoma (PDL) is a rare extranodal malignant lymphoma. Till now, there are insufficient data regarding its clinical characteristics and prognosis. Aims: To analyze the clinical characteristics and prognostic factors of PDL based on SEER database. Methods: Patients diagnosed as PDL between 1975 and 2015 were evaluated via data collected from the SEER database. The demographic, clinical, pathological features and survival time were reviewed. Survival analysis was conducted by using Kaplan-Meier method. Univariate and multivariate Cox regression analyses were applied to identify the survival predictors. Results: A total of 1 659 patients with PDL were enrolled in the study. The median age was 64 years, and the median survival time was 40 months. The overwhelming majority of PDLs were B-cell non-Hodgkin lymphomas (B-NHL), of which, follicular lymphoma (36.0%) and diffuse large B-cell lymphoma (DLBCL; 30.5%) accounting for approximately two thirds of the PDL patients. The 1-, 3-, 5-, and 10-year overall survival rates were 49.2%, 39.0%, 31.4%, and 13.8%, respectively. The prognosis of T-cell non-Hodgkin lymphoma (T-NHL) had a worse survival than B-NHL, and the prognosis of DLBCL was the worst in B-NHL. In multivariate Cox regression analysis, male gender, old age (>65 years), divorced/widowed or unmarried, T-NHL, and advanced clinical stage were identified as the independent risk factors for poor overall and tumor-specific survival in PDL patients, while diagnosed after 1997 (rituximab launch date) was an independent protective factor (all P<0.05). Conclusions: The prognosis of PDL patients is independently correlated with the gender, age, marital status, time of diagnosis, as well as the tumor pathological type and clinical stage. Early diagnosis of DLBCL and T-NHL may prolong the survival time. Immunotherapy such as rituximab may also improve the survival.

Anticoagulant Treatment After Transjugular Intrahepatic Portasystemic Shunt: A Systematic Review and Meta-analysis / 胃肠病学

Background: Transjugular intrahepatic portasystemic shunt (TIPS) is widely used for reducing portal hypertension. Post-TIPS anticoagulant treatment is controversial because of lack of obligatory evidence. Aims: To systematically review the effect of anticoagulant treatment on patients with liver cirrhosis after TIPS. Methods: Randomized controlled trials (RCTs) of liver cirrhosis patients after TIPS with anticoagulant treatment (anticoagulant treatment group) or without anticoagulant treatment/placebo (control group) were retrieved from PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, CBM and VIP databases in March 2020. Meta-analysis was conducted by RevMan 5.3. Results: Three RCTs involving 157 liver cirrhosis patients were enrolled. These studies mainly reported the effects of anticoagulant treatment on gastrointestinal rebleeding, stent patency, mortality and incidence of hepatic encephalopathy (HE). Meta-analysis revealed that no significant differences in total gastrointestinal bleeding rate (OR=1.04, 95% CI: 0.25-4.38, P=0.96), variceal bleeding rate (OR=1.04, 95% CI: 0.14-7.68, P=0.97), stent stenosis (OR=1.88, 95% CI: 0.73-4.79, P=0.19), occlusion (OR=0.07, 95% CI: 0.00-1.44, P=0.09), shunt dysfunction (OR=0.67, 95% CI: 0.10-4.29, P=0.67), mortality (OR=2.12, 95% CI: 0.06-72.77, P=0.68) and incidence of HE (OR=1.18, 95% CI: 0.45-3.06, P=0.74) were found between anticoagulant treatment group and control group. Conclusions: Post-TIPS anticoagulant treatment is safe and without increasing the rate of gastrointestinal rebleeding, mortality and incidence of HE. However, anticoagulant treatment does not further improve the stent patency. Therefore, anticoagulant treatment appears to be unnecessary in patients with liver cirrhosis after TIPS.

Gastroscopic manifestations of portal hypertensive gastropathy in liver cirrhosis and related factors / 临床肝胆病杂志

ObjectiveTo investigate the gastroscopic manifestations of gastric mucosa in portal hypertensive gastropathy (PHG) and the association of PHG with gastroesophageal varices, ulcers, and liver cirrhosis complications. MethodsA retrospective analysis was performed for the clinical data of 867 patients with liver cirrhosis who were treated in Daping Hospital of Army Medical University from August 2012 to June 2018, and the incidence rates of gastroesophageal varices, PHG, and ulcers were recorded. Meanwhile, the data of spontaneous bacterial peritonitis (SBP), hepatic encephalopathy (HE), and hepatocellular carcinoma (HCC) were collected. The chi-square test was used for comparison of categorical data between groups, and a Spearman correlation analysis was also performed. ResultsThe incidence rate of PHG in the patients with liver cirrhosis reached 66.2% (574/867), and gastric mucosa abnormalities in mild PHG were mainly red-spot lesions (68.6%) and snakeskin (56.8%), while diffuse erythema (76.5%) was the main gastric mucosa abnormality in severe PHG. There was a significant difference in the incidence rate of PHG between the patients with different severities of esophageal varices (χ2=304712, P＜0.05), and the severity of PHG increased with the aggravation of esophageal varices (r=0.515, P＜0.05). There was a significant difference in the incidence rate of PHG between the patients with different severities of gastric varices (χ2=81.004, P＜0.05), and the severity of PHG was positively correlated with that of gastric varices (r=0.292, P＜0.05). There was a significant difference in the incidence rate of PHG between the patients with varices at different locations (χ2=41.361, P＜0.05); the patients with gastric varices alone had the lowest incidence rate of PHG (34.8%) and only had mild PHG, and those with gastroesophageal varices had the highest incidence rate of PHG (85.6%). Among the patients without PHG, 71 (24.2%) were hospitalized due to hematemesis and/or tarry stool, and among the 574 patients with PHG, 316 (55.1%) were hospitalized, and there was a significant difference between the two groups (χ2=74562, P＜0.05). ConclusionPatients with different severities of PHG have different features of gastric mucosa abnormalities. The development and severity of PHG are closely associated with the severity of gastroesophageal varices and are important causes of gastrointestinal bleeding in liver cirrhosis. PHG should be treated and prevented to reduce the risk and complications of gastrointestinal bleeding.

Design and implementation of WeChat high-value consumables management platform based on SPD concept / 中华医院管理杂志

Enhancement of health management capability and resource utilization efficiency of hospitals has become an imperative need to deepen the healthcare reform. The high-value consumables are subject to point-to-point accurate tracking based on code scan, relying on the hospital′s WeChat official account for WeChat-based management. The WeChat platform enables the system to automatically push the preset procurement plan to the mobile terminal of the managers via the low-inventory alarm at the departments. On the other hand, vendors can use their own mobile terminals to receive in time the plans, query product inventory, and last month invoicing information. These measures facilitate the hospital management on high-value consumables.

MRI imaging of diffuse midline gliomas with H3K27M mutation / 中华放射学杂志

Objective To explore the MRI findings of diffuse midline gliomas with H3K27M mutation, and help us understand this new entity and improve the accuracy of diagnosis. Methods The clinical and imaging data of 17 diffuse midline gliomas with H3K27M mutation confirmed by pathology were retrospectively collected from July 2016 to April 2018 in Guangdong Sanjiu Brain Hospital. All patients were performed with pre?contrast and post?contrast MRI examination. All images were analyzed according to the location, shape, boundary, solid or cystic, signal feature, enhancement feature, and degree of edema. Results (1) Location:Six cases located in thalamus,4 cases located in brainstem,1 located in hypothalamus, 6 cases had multiple lesions in the midline and/or involving one or more brain. (2) Morphology and boundary:Seven cases had regular shape and clear boundary, 10 cases had irregular shapes and unclear boundaries. (3) Necrosis, cystic degeneration, hemorrhage: Twelve cases had necrosis or cystic degeneration in varying degree, 4 cases had hemorrhage. (4) Signal and enhancement features: The solid component showed slightly?low or low signal on T1WI, and slightly?high or high signal on T2WI; the cystic component showed obvious low signal on T1WI and obvious high signal on T2WI. T1WI enhancement:Eight cases showed uneven light?moderate enhancements, and all cases were adults; Six cases showed significant enhancements with large or small rings; Three cases showed uneven obvious enhancement. (5) Peritumoral edema: Fourteen cases had mild peritumoral edema,1 case had moderate peritumoral edema,2 cases had obvious peritumoral edema. Conclusion The MRI findings of diffuse midline gliomas with H3K27M mutation had certain characteristics,which can help to improve the level of diagnosis and differential diagnosis.

Modified transurethral bladder neck incision in treatment of female bladder neck obstruction / 中国医师进修杂志

Objective To evaluate the effect of modified transurethral bladder neck incision in treatment of female bladder neck obstruction. Methods Sixteen female patients with bladder neck obstruction from March 2008 to May 2016 in Beijing Haidian Hospital were selected, and the patients were treated with modified transurethral bladder neck incision at the 3, 6 and 9-O′clock positions. The international prostate symptom score (IPSS), quality of life (QOL) and maximum urinary flow rate (Qmax) were evaluated before surgery and 1 year after surgery respectively. Results All 16 patients underwent successful operation, and the mean operation duration was 20 min, with the blood loss＜10 ml. The difficulty of urination after removing the catheter was significantly improved. Postoperative pathological results were chronic inflammatory changes with fibrous tissue proliferation. There was no complication such as urinary incontinence, vesico-vaginal fistula and urethral stricture after operation. The IPSS, QOL and Qmax after surgery were significantly improved compared with those before surgery: (6.43 ± 3.31) scores vs. (25.21 ± 4.71) scores, (1.41 ± 1.15) scores vs. (4.43 ± 1.36) scores and (15.36 ± 4.82) ml/s vs. (7.49 ± 2.27) ml/s, and there were statistical differences (P＜0.01). Conclusions The modified transurethral bladder neck incision is a safe and effective therapy for female bladder neck obstruction.

Correlation Between Helicobacter pylori Infection and Portal Hypertensive Gastropathy: A Meta-analysis / 胃肠病学

Background: Portal hypertensive gastropathy (PHG) is a mucosa damaging disease caused by obstruction of blood drainage, and Helicobacter pylori (Hp) infection may further aggravate the gastric mucosal injury. Aims: To investigate the relationship between PHG and Hp infection. Methods: Literature of Hp infection in liver cirrhosis patients with or without PHG was retrieved from PubMed, Embase, Cochrane Library, ScienceDirect, CBM, CNKI and Wanfang databases. The literature was screened according to the inclusion and exclusion criteria. Meta-analysis was conducted by RevMan 5.3 software. Results: A total of 18 studies involving 2 159 patients with liver cirrhosis were included. Meta-analysis results showed that there was no statistical difference in Hp infection rate in liver cirrhosis patients with and without PHG (OR=1.37, 95% CI: 0.93-2.02, P=0.11). Subgroup analysis show that in ulcer and ulcer-free subgroups, domestic and foreign subgroups, invasive detection methods and non-invasive detection methods subgroups, no significant differences in Hp infection rate were found between liver cirrhosis patients with and without PHG (P>0.05). Conclusions: There is no significant correlation between Hp infection and PHG in patients with liver cirrhosis. The presence of peptic ulcer, different regions and different Hp detection methods have no influence on the result of meta-analysis.

MRIfeaturesofgemistocyticastrocytoma / 实用放射学杂志

Objective ToexploretheMRIfeaturesanddifferentialdiagnosisofgemistocyticastrocytoma(GemA).Methods The MRIfeaturesof10casesofGemAprovedbysurgeryandpathologywereinvestigatedretrospectively(thelocationoftumor,tumor shape,boundary,signalandenhancement)andtheliteraturewasreviewed.Results All10casesofGemA weresupratentorialand solitary.Ofthese10cases,7caseswerelocatedinthefrontallobe,5casesinthetemporallobe,6casesinmultiplelobesandinvaded theoppositebraintissuesthroughcorpuscallosum.8casesweresolidGcystic,8casespresentedwithunclearboundary,only2cases hadclearboundary.Therewasnoedemaormildedemain7casesandobviousedemain3cases.Thesolidpartoftumorswereisointense orslighthypointenseonT1WI,only1caseshowedhighintensityonT1WI,isointenseorslighthyperintenseonT2WI.CTsuggested calcificationin2cases.6casesweremildlyenhanced,4casesweremarkedlyenhanced.MRSshowed(n＝4)thatCHopeakwasmildly ormoderatelyincreased,NAApeakwassignificantlyreduced,theaverageratioofCho/NAA was2.91.DWIshowedhyperintenseor slighthyperintense(n＝3),theADCaveragevalueoftumorROIwasabout(1.150±0.081)×10－3 mm2/s.1caseofSWIsequence showedthickeningandcircuitousvascularshadow.Conclusion AsMRIofGemAischaracterizedbyhighandlowgradegliomas,the preoperativediagnosisisdifficult.Combiningenhancementwithfunctionalexamination,itisexpectedtoimprovetheaccuracyofpreoperative diagnosisofGemA.

Retrospective study on the characteristics of early organ injury in elderly patients with severe burns / 中华烧伤杂志

Objective@#To analyze the clinical characteristics of early organ injury in elderly patients with severe burns and the effects on the prognosis of patients.@*Methods@#From January 2010 to August 2018, 62 patients with severe burns (43 men and 19 women, aged from 60 to 89 years at the time of admission) who were hospitalized in the Institute of Burn Research of the First Affiliated Hospital of Army Medical University (the Third Military Medical University, hereinafter referred to as the author′s affiliation), meeting the inclusion criteria, were included in elderly (E) group, and 124 patients with severe burns (86 men and 38 women, aged from 18 to 59 years at the time of admission) at the same term were included in young and middle-aged (YM) group. Treatment of patients in the 2 groups followed the conventional procedures of the author′s affiliation. The following data of patients in the 2 groups were retrospectively analyzed. (1) Fluid replacement volume and urine volume within the first and second post injury hour (PIH) 24 were recorded. The levels of hemoglobin, haematocrit, and blood lactic acid at admission, PIH 24 and 48 were recorded. (2) The creatine kinase isozyme-MB (CK-MB), total bilirubin, blood creatinine, oxygenation index, and blood platelet count at admission, at shock stage, and on post injury day (PID) 3 to 7 were collected. (3) The days of seriously or critically ill and deaths were recorded. Data were processed with chi-square test, group t test, Mann-Whitney U test, analysis of variance for repeated measurement, and Bonferroni correction.@*Results@#(1) There were no statistically significant differences in fluid replacement volume within the first and second PIH 24, and urine volume within the second PIH 24 between patients in the 2 groups (t=0.351, 1.307, 1.110, P>0.05). The urine volume of patients in group E within the first PIH 24 was significantly less than that in group YM (t=5.628, P<0.05). There were no statistically significant differences in levels of hemoglobin (t=0.011, 1.075, 0.239), haematocrit (t=0, 0.033, 0.199), and blood lactic acid (t=0.017, 1.002, 0.739) at admission, PIH 24 and 48 between patients in the 2 groups (P>0.05). (2) There were no statistically significant differences in levels of CK-MB at admission and on PID 3 to 7 between patients in the 2 groups (t=0.069, 0.001, P>0.05). The level of CK-MB of patients in group E at shock stage was significantly higher than that in group YM (t=4.017, P<0.05). There were no statistically significant differences in levels of total bilirubin at admission and on PID 3 to 7 between patients in the 2 groups (t=0.227, 0.002, P>0.05). However, the level of total bilirubin of patients in group E at shock stage was significantly higher than that in group YM (t=6.485, P<0.05). The levels of blood creatinine of patients in group E at admission and shock stage were significantly higher than those in group YM (t=4.226, 12.299, P<0.05 or P<0.01), while there was no statistically significant difference between them on PID 3 to 7 (t=0.693, P>0.05). The oxygenation indexes of patients in group E at admission and shock stage and on PID 3 to 7 [(371±16), (263±16), and (228±18) mmHg (1 mmHg=0.133 kPa)] were lower than (420±13), (327±13), and (281±17) mmHg of patients in group YM, respectively (t=5.650, 9.782, 4.856, P<0.05 or P<0.01). There were no statistically significant differences in levels of blood platelet count at admission and shock stage between patients in the 2 groups (t=0.038, 0.588, P>0.05), while the level of blood platelet count of patients in group E on PID 3 to 7 was significantly lower than that in group YM (t=6.636, P<0.05). (3) The days of seriously or critically ill and death rate of patients in group E were respectively longer or higher than those in group YM (Z=-2.303, χ2=13.676, P<0.05 or P<0.01).@*Conclusions@#In the case of the same tissue perfusion at shock stage, injuries in heart, liver, kidney, lung, and coagulation system in elderly patients with severe burns are more obvious than those in young and middle-aged patients, with more severe illness and higher mortality.

A heading date QTL, qHD7.2, from wild rice (Oryza rufipogon) delays flowering and shortens panicle length under long-day conditions.

Heading date (HD) and panicle length (PL) are important traits that affect rice breeding and are controlled by pleiotropic genes. Some alleles associated with HD and PL from wild relatives might differ from those in cultivated rice. In this study, a main effect HD quantitative trait locus from wild rice, qHD7.2, was identified using a chromosomal segment substitution line (CSSL) population. First, qHD7.2 was determined to be located near RM172 on chromosome 7 based on association analysis of phenotype data from six environments and 181 polymorphic molecular markers. CSSL39, which has the latest flowering of all CSSLs and carries qHD7.2, was selected for further study, and qHD7.2 was narrowed to a 101.1-kb interval using a CSSL39/9311 F2 population. An OsPRR37-homologous gene was found within this region. The wild type allele delayed flowering and shortened PL under long-day conditions. The HD7.2, which was identified as a candidate gene for qHD7.2, transcript level was substantially higher than that in 9311. Our data showed that HD7.2 is likely a novel OsPRR37 allele. Sequence analysis revealed that OsPRR37 in cultivated rice had multiple origins, and natural variation in the coding domain sequence and promoter region contribute to flowering time diversity in cultivated rice.

Feasibility and preliminary technical experience of single incision plus one port laparoscopic total gastrectomy combined with π-shaped esophagojejunal anastomosis in surgical treatment of gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the feasibility, safety, and preliminary technical experience of single incision plus one port laparoscopic total gastrectomy combined with π-shaped esophagojejunal anastomosis (SILT-π) in the surgical treatment of gastric cancer.</p><p><b>METHODS</b>Clinical data of 5 gastric cancer patients undergoing SILT-π operation at the Department of General Surgery, The Second Affiliated Hospital of the Army Medical University from August to October 2017 were retrospectively analyzed. A 2.5-3.0 cm incision around the umbilicus was made for placing the gloveport as the passage for the lens, and the instruments of the surgeon and the assistant. Another operative port was placed in the left upper quadrant with a 12-mm Trocar for the passage of the energy device, the endoscopic cutting closure, as well as the postoperative drainage tube. A D2 lymph node (LNs) dissection was regularly conducted. After the abdominal esophagus was routinely mobilized, a side-to-side esophagus-jejunum anastomosis was made through a gastric pre-pulling esophagojejunal π-shaped anastomosis. The transection was then performed with a ligation on the cardia (or esophagus above the upper margin of the tumor) using a sterilized hemp rope in order to better expose the abdominal esophagus. Throughout the course of reconstruction, the ligature rope was held by the assistant to hold down the esophagus to allow easier esophagojejunal anastomosis. A hole was then made on the posterior wall of the esophagus, between 2 cm and 3 cm above the ligature rope, and another hole was made at the anti-mesenteric border of the jejunum 40 cm distal to the Treitz ligament. A side-to-side esophagojejunal π-shaped anastomosis was performed through two holes. An entry hole was formed after the anastomosis. After checking the anastomosis, this entry hole was closed through an intestinal mesenteric hole pre-made on its opposite side. The resected esophagus and stomach, together with the afferent loop jejunum, were simultaneously transected above the level of the entry hole by a stapler from the Trocar of the left upper abdominal quadrant. After the gloveport was closed, a side-to-side jejunojejunostomy anastomosis applied with another two staples was performed between the afferent loop stump and the roux limb 30 cm below the esophagojejunal anastomosis.</p><p><b>RESULTS</b>These five patients were all male, and aged (56.8±8.2) years with preoperative clinical stage cT2-4N0-2M0. All the 5 patients underwent SILT-π operation successfully. The average length of surgical incision was (2.9±0.2) cm. The average operation time was (396.0±36.1) minutes. The intraoperative blood loss was (140.0±66.7) ml. Postoperative pathology showed proximal and distal margins were (2.6±1.1) cm and (8.7±2.5) cm apart respectively, and the average number of retrieved lymph node was 25.8±7.2. Perioperative management was based on enhanced recovery following surgical (ERAS) principles. The average time to the first flatus was (2.6±0.5) days, and the average time to defecation was (3.6±0.5) days. The pain score on postoperative day 1 was 1-2, and the average postoperative hospital stay was (7.0±0.7) days. No perioperative complications occurred.</p><p><b>CONCLUSIONS</b>SILT-π procedure is safe and feasible for patients with gastric cancer, and has positive short-term outcomes, satisfactory cosmetic abdominal incision, light postoperative abdominal pain and rapid postoperative recovery. Preliminary observations show that SILT-π procedure has good potential for clinical application in future.</p>