Artemyriantholides A-K, guaiane-type sesquiterpenoid dimers from Artemisia myriantha var. pleiocephala and their antihepatoma activity.

Artemyriantholides A-K (1-11) as well as 14 known compounds (12-25) were isolated from Artemisia myriantha var. pleiocephala (Asteraceae). The structures and absolute configuration of compounds 2 and 8-9 were confirmed by the single crystal X-ray diffraction analyses, and the others were elucidated by MS, NMR spectral data and electronic circular dichroism calculations. All compounds were chemically characterized as guaiane-type sesquiterpenoid dimers (GSDs). Compound 1 was the first example of the GSD fused via C-3/C-11' and C-5/C-13' linkages, and compounds 2 and 5 were rare GSDs containing chlorine atoms. Eleven compounds showed obvious inhibitory activity in HepG2, Huh7 and SK-Hep-1 cell lines by antihepatoma assay to provide the IC50 values ranging from 7.9 to 67.1 µM. Importantly, compounds 5 and 8 exhibited the best inhibitory activity with IC50 values of 14.2 and 18.8 (HepG2), 9.0 and 11.5 (Huh7), and 8.8 and 11.3 µM (SK-Hep-1), respectively. The target of compound 5 was predicted to be MAP2K2 by a computational prediction model. The interaction between compound 5 and MAP2K2 was conducted to give docking score of -9.0 kcal/mol by molecular docking and provide KD value of 43.7 µM by Surface Plasmon Resonance assay.

Non-invasive imaging of pathological scars using a portable handheld two-photon microscope / 中华医学杂志(英文版)

BACKGROUND@#Pathological scars are a disorder that can lead to various cosmetic, psychological, and functional problems, and no effective assessment methods are currently available. Assessment and treatment of pathological scars are based on cutaneous manifestations. A two-photon microscope (TPM) with the potential for real-time non-invasive assessment may help determine the under-surface pathophysiological conditions in vivo . This study used a portable handheld TPM to image epidermal cells and dermal collagen structures in pathological scars and normal skin in vivo to evaluate the effectiveness of treatment in scar patients.@*METHODS@#Fifteen patients with pathological scars and three healthy controls were recruited. Imaging was performed using a portable handheld TPM. Five indexes were extracted from two dimensional (2D) and three dimensional (3D) perspectives, including collagen depth, dermo-epidermal junction (DEJ) contour ratio, thickness, orientation, and occupation (proportion of collagen fibers in the field of view) of collagen. Two depth-dependent indexes were computed through the 3D second harmonic generation image and three morphology-related indexes from the 2D images. We assessed index differences between scar and normal skin and changes before and after treatment.@*RESULTS@#Pathological scars and normal skin differed markedly regarding the epidermal morphological structure and the spectral characteristics of collagen fibers. Five indexes were employed to distinguish between normal skin and scar tissue. Statistically significant differences were found in average depth ( t = 9.917, P <0.001), thickness ( t = 4.037, P <0.001), occupation ( t = 2.169, P <0.050), orientation of collagen ( t = 3.669, P <0.001), and the DEJ contour ratio ( t = 5.105, P <0.001).@*CONCLUSIONS@#Use of portable handheld TPM can distinguish collagen from skin tissues; thus, it is more suitable for scar imaging than reflectance confocal microscopy. Thus, a TPM may be an auxiliary tool for scar treatment selection and assessing treatment efficacy.

Characteristics of Electrocardiogram Findings in Fulminant Myocarditis.

Fulminant myocarditis (FM) is an acute and severe form of myocarditis with rapid progression and poor clinical outcomes in the absence of acute or chronic coronary artery disease. Electrocardiogram (ECG) abnormalities can provide preliminary clues for diagnosis; however, there is a lack of systemic descriptions on ECG changes in FM populations. Thus, a retrospective analysis of 150 consecutive FM patients and 300 healthy controls was performed to determine the characteristic ECG findings in FM. All patients included had markedly abnormal ECG findings. Specifically, 83 (55.33%) patients had significantly lower voltage with remarkably decreased QRS amplitudes in all leads compared with healthy controls (p < 0.01), and 77 (51.33%) patients had a variety of arrhythmias with lethality ventricular tachycardia/ventricular fibrillation in 21 (14.00%) patients and third-degree atrioventricular block in 21 (14.00%) patients, whereas sinus tachycardia was only found in 43 (28.67%) patients with the median heart rate (HR; 88.00 bpm, IQR: 76.00-113.50) higher than that of controls (73.00 bpm, IQR: 68.00-80.00) (p = 0.000). Conduction and repolarization abnormalities were common in patients. A longer QTc interval (452.00 ms, IQR: 419.00-489.50) and QRS duration (94.00 ms, IQR: 84.00-119.00) were observed in patients compared to controls (QTc interval = 399.00 ms, IQR: 386.00-414.00; QRS duration = 90.00 ms, IQR: 86.00-98.00) (p < 0.05). Additionally, HR > 86.50 bpm, QTc > 431.50 ms, and RV5 + SV1 < 1.715 mV can be used to predict FM. Thus, marked and severe ECG abnormalities provide preliminary clues for the diagnosis of FM.

Design, synthesis, and biological evaluation of artemyrianolide H derivatives as potential antihepatoma agents.

Artemyrianolide H (AH) is a germacrene-type sesquiterpenolid isolated from Artemisia myriantha, and showed potent cytotoxicity against three human hepatocellular carcinoma cell lines HepG2, Huh7, and SK-Hep-1 with IC50 values of 10.9, 7.2, and 11.9 µM, respectively. To reveal structure-activity relationship, 51 artemyrianolide H derivatives including 19 dimeric analogs were designed, synthesized, and assayed for their cytotoxicity against three human hepatoma cell lines. Among them, 34 compounds were more active than artemyrianolide H and sorafenib on the three cell lines. Especially, compound 25 exhibited the most promising activity with IC50 values of 0.7 (HepG2), 0.6 (Huh7), and 1.3 µM (SK-Hep-1), which were 15.5, 12.0, and 9.2-fold higher than that of AH and 16.4, 16.3 and 17.5-fold higher than that of sorafenib. Cytotoxicity evaluation on normal human liver cell lines (THLE-2) demonstrated good safety profile of compound 25 with SI of 1.9 (HepG2), 2.2 (Huh 7) and 1.0 (SK-Hep1). Further studies revealed that compound 25 dose-dependently arrested cells at G2/M phase which was correlated with the up-regulation of both cyclin B1 and p-CDK1, and induced apoptosis through the activation of mitochondrial pathways in HepG2 cells. In addition, the migratory and invasive abilities in HepG2 cells after treatment with 1.5 µM of compound 25 were decreased by 89% and 86% with the increase of E-cadherin expression accompanied by the decrease of N-cadherin, vimentin expression. Bioinformatics analysis based on machine learning predicted that PDGFRA and MAP2K2 might be acting targets of compound 25, and SPR assays demonstrated compound 25 were bound with PDGFRA and MAP2K2 with KD value of 0.168 nM, and 8.49 µM, respectively. This investigation proposed that compound 25 might be considered as a promising lead compound for the development of antihepatoma candidate.

Minimally invasive right infra-axillary thoracotomy for transaortic modified Morrow procedure: a series of 60 cases / 中华外科杂志

Objective: To examine the short-term curative effect with minimally invasive right infra-axillary thoracotomy for transaortic modified Morrow procedure. Methods: The clinical data of 60 patients who underwent video-assisted thoracoscopic transaortic modified Morrow procedure from August 2021 to August 2022 at Department of Cardiovascular Surgery, Zhejiang Provincial People's Hospital were retrospectively analyzed. There were 31 males and 29 females, with the age (M (IQR)) of 54.0(22.3) years (range: 15 to 71 years). The echocardiography confirmed the diagnosis of moderate mitral regurgitation in 30 patients, and severe mitral regurgitation in 13 patients. Systolic anterior motion (SAM) was present preoperatively in 54 patients. All 60 patients underwent transaortic modified Morrow procedure through a right infra-axillary thoracotomy using femorofemoral cardiopulmonary bypass. Surgical procedures mainly included transverse aortic incision, exposure of left ventricular outflow tract (LVOT), septal myectomy, and correction of the abnormal mitral valve and subvalvular structures. Results: All 60 patients underwent the programmatic procedures successfully without conversion to full sternotomy. The cardiopulmonary bypass time was (142.0±32.1) minutes (range: 89 to 240 minutes), while the cross-clamp time was (95.0±23.5) minutes (range: 50 to 162 minutes). The patients had a postoperative peak LVOT gradient of 7.0 (5.0) mmHg (range: 0 to 38 mmHg) (1 mmHg=0.133 kPa). A total of 57 patients were extubated on the operating table. The drainage volume in the first 24 h was (175.9±57.0) ml (range: 60 to 327 ml). The length of intensive care unit stay was 21.0 (5.8)h (range: 8 to 120 h) and postoperative hospital stay was 8 (5) days (range: 5 to 19 days). The postoperative septal thickness was 11 (2) mm (range: 8 to 14 mm). All patients had no iatrogenic ventricular septal perforation or postoperative residual SAM. The patients were followed up for 4 (9) months (range: 1 to 15 months), and none of them needed cardiac surgery again due to valve dysfunction or increased peak LVOT gradient during follow-up. Conclusion: Using a video-assisted thoracoscopic transaortic modified Morrow procedure through a right infra-axillary minithoracotomy can provide good visualization of the LVOT and hypertrophic ventricular septum, ensure optimal exposure of the mitral valve in the presence of complex mitral subvalvular structures, so that allows satisfactory short-term surgical results.

Clinical and 18F-FDG PET/CT imaging features of hilar tumor pulmonary infarction / 中华核医学与分子影像杂志

Objective:To investigate the clinical manifestations and 18F-FDG PET/CT imaging features of hilar tumor pulmonary infarction. Methods:From July 2016 to June 2021, 49 patients (40 males, 9 females; age 32-81 years) with hilar tumor pulmonary infarction who underwent PET/CT and enhanced CT in the second Hospital of Shandong University and Shandong Cancer Hospital and Institute, Shandong First Medical University were retrospectively enrolled. All patients were diagnosed by imaging follow-up or pathology. Clinical features and 18F-FDG PET/CT imaging features were analyzed. Results:A total of 108 infarcts were found in 49 patients by 18F-FDG PET/CT. Small cell carcinoma was the most common hilar tumor (67.35%, 33/49). The most common clinical manifestations of hilar tumor pulmonary infarction were cough (69.39%, 34/49) and hemoptysis (34.69%, 17/49). Pulmonary infarction was mainly multiple (69.39%, 34/49), and multiple lung lobes might be involved. The CT morphology of infarcts was wedge-shaped (46.30%, 50/108) or patchy (53.70%, 58/108), and the density was mainly bubble consolidation (61.11%, 66/108). There were 91 (84.26%, 91/108) infarcts showing FDG hypermetabolism, with the SUV max of 1.48-6.62, and the hypermetabolism mode was rim sign (36.11%, 39/108) or heterogeneous hypermetabolism (48.15%, 52/108). Nineteen patients (38.78%, 19/49) were complicated with pulmonary vein involvement, and 26 patients (53.06%, 26/49) had ipsilateral pleural effusion. Conclusions:Hilar tumor pulmonary infarction is characterized by cough. It is helpful for the diagnosis of hilar tumor pulmonary infarction in patients with hilar tumor when wedge-shaped, bubble consolidation, rim sign and heterogeneous hypermetabolism lesions are found in 18F-FDG PET/CT images.

Trans-ethnic Mendelian randomization study of systemic lupus erythematosus and common female hormone-dependent malignancies / 中华医学杂志(英文版)

BACKGROUND@#Observational research has reported that systemic lupus erythematosus (SLE) is related to common female hormone-dependent cancers, but the underlying causal effect remains undefined. This study aimed to explore the causal association of these conditions by Mendelian randomization (MR) analysis.@*METHODS@#We selected instrumental variables for SLE from genome-wide association studies (GWASs) conducted in European and East Asian populations. The genetic variants for female malignant neoplasms were obtained from corresponding ancestry GWASs. We utilized inverse variance weighted (IVW) as the primary analysis, followed by sensitivity analysis. Furthermore, we conducted multivariable MR (MVMR) to estimate direct effects by adjusting for the body mass index and estradiol. Finally, we implemented reverse direction MR analysis and gave a negative example to test the reliability of MR results.@*RESULTS@#We found SLE was significantly negatively associated with overall endometrial cancer risk (odds ratio [OR] = 0.961, 95% confidence interval [CI] = 0.935-0.987, P  = 3.57E-03) and moderately inversely related to endometrioid endometrial cancer (ENEC) (OR = 0.965, 95% CI = 0.936-0.995, P  = 0.024) risk in the European population by IVW. We replicated these results using other MR models and detected a direct effect by MVMR (overall endometrial cancer, OR = 0.962, 95% CI = 0.941-0.983, P  = 5.11E-04; ENEC, OR = 0.964, 95% CI = 0.940-0.989, P  = 0.005). Moreover, we revealed that SLE was correlated with decreased breast cancer risk (OR = 0.951, 95% CI = 0.918-0.986, P  = 0.006) in the East Asian population by IVW, and the effect was still significant in MVMR (OR = 0.934, 95% CI = 0.859-0.976, P  = 0.002). The statistical powers of positive MR results were all >0.9.@*CONCLUSION@#This finding suggests a possible causal effect of SLE on the risk of overall endometrial cancer and breast cancer in European and East Asian populations, respectively, by MR analysis, which compensates for inherent limitations of observational research.

Associations between vitamin D levels and systemic lupus erythematosus risk:a Mendelian randomized study / 中华预防医学杂志

Objective: To explore the causal effects of the serum Vitamin D levels on the risk of systemic lupus erythematosus (SLE). Methods: A two-sample Mendelian randomization (MR) study was performed to infer the causality. Three Genome-wide association studies (GWAS) for circulating Vitamin D levels, including 25-hydroxyvitamin D [25(OH)D], 25-hydroxyvitamin D3 [25(OH)D3] and C3-epimer of 25-hydroxyvitamin D3 [C3-epi-25(OH)D3] published in 2020, and one GWAS for SLE published in 2015 were utilized to analyze the causal effects of the serum Vitamin D levels on the risk of SLE. MR analyses were conducted using the inverse-variance weighted method (IVW), weighted median, MR-Egger methods, MR-pleiotropy residual sum and outlier (MR-PRESSO) method. Results: 34, 29 and 6 SNPs were respectively selected as instrumental variables to analyze the causal association of total 25 (OH) D level, 25 (OH) D3 level and C3-epi-25 (OH) D3 level with the risk of SLE. The MR results showed that each standard deviation decrease in the level of 25(OH)D3 would result in 14.2% higher risk of SLE (OR, 0.858; 95%CI, 0.753-0.978; P=0.022). The levels of 25(OH)D and C3-epi-25(OH)D3 had null associations with risk of SLE (OR, 0.849; 95%CI, 0.653-1.104; P=0.222; OR, 0.904; 95%CI, 0.695-1.176; P=0.452). Conclusion: This study have identified a causal effect of 25(OH)D3 on increased risk of SLE. These findings highlighted the significance of active monitoring and prevention of SLE in population of low Vitamin D levels.

Clinical Features and Prognostic Factors of Patients with Primary Cutaneous Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To retrospectively analyze the clinical characteristics and prognostic factors of patients with primary cutaneous lymphoma.@*METHODS@#The clinical data of 22 patients with primary cutaneous lymphoma admitted to Xinjiang Hotan District People's Hospital, Heji Hospital affiliated to Changzhi Medical College and the Fifth Medical Center of PLA General Hospital from January 2013 to June 2021 were retrospectively analyzed.@*RESULTS@#The incidence of primary cutaneous T cell and NK/T cell lymphoma was about 91.9/100 000, and the incidence of primary cutaneous B cell lymphoma was about 14.5/100 000. The overall survival (OS) of patients aged ≥65 years was significantly shorter than that of patients younger than 65 years (P <0.05). Patients with elevated β2-microglobulin (β2-MG) had shorter OS and progression-free survival (PFS) (both P <0.05). Patients who achieved complete/partial response after initial treatment had longer OS than those with stable or progressive disease (P <0.05). There were significant differences in OS and PFS among patients with different pathological types of primary cutaneous lymphoma that originated from T and NK/T cells, the OS and PFS of patients with mycosis fungoides were longer than those of patients with other pathological types (both P <0.05). In addition, disease stage might also affect the PFS of the patients (P =0.056).@*CONCLUSION@#The age, disease stage, β2-MG level, pathological type and remission state after treatment of the patients were related to the clinical prognosis.

Diagnostic Study of Multi-spectral Intelligent Analyzer in Diagnosis of the Infiltration Degree of Lung Adenocarcinoma / 中国肺癌杂志

BACKGROUND@#Lung cancer is one of the most common malignant tumors in the world. The accuracy of intraoperative frozen section (FS) in the diagnosis of lung adenocarcinoma infiltration cannot fully meet the clinical needs. The aim of this study is to explore the possibility of improving the diagnostic efficiency of FS in lung adenocarcinoma by using the original multi-spectral intelligent analyzer.@*METHODS@#Patients with pulmonary nodules who underwent surgery in the Department of Thoracic Surgery, Beijing Friendship Hospital, Capital Medical University from January 2021 to December 2022 were included in the study. The multispectral information of pulmonary nodule tissues and surrounding normal tissues were collected. A neural network model was established and the accuracy of the neural network diagnostic model was verified clinically.@*RESULTS@#A total of 223 samples were collected in this study, 156 samples of primary lung adenocarcinoma were finally included, and a total of 1,560 sets of multispectral data were collected. The area under the curve (AUC) of spectral diagnosis in the test set (10% of the first 116 cases) of the neural network model was 0.955 (95%CI: 0.909-1.000, P<0.05), and the diagnostic accuracy was 95.69%. In the clinical validation group (the last 40 cases), the accuracy of spectral diagnosis and FS diagnosis were both 67.50% (27/40), and the AUC of the combination of the two was 0.949 (95%CI: 0.878-1.000, P<0.05), and the accuracy was 95.00% (38/40).@*CONCLUSIONS@#The accuracy of the original multi-spectral intelligent analyzer in the diagnosis of lung invasive adenocarcinoma and non-invasive adenocarcinoma is equivalent to that of FS. The application of the original multi-spectral intelligent analyzer in the diagnosis of FS can improve the diagnostic accuracy and reduce the complexity of intraoperative lung cancer surgery plan.
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[Effect of invisible appliance without bracket and self-locking bracket appliance on periodontal and subgingival flora in patients with periodontitis].

PURPOSE: To observe the effect of non-bracket invisible appliance and self-locking bracket appliance on periodontal health and subgingival flora in patients with periodontitis. METHODS: One hundred and ten patients with periodontitis who received orthodontic treatment were divided into invisible group and self-locking bracket group. The periodontal index including probing depth (PD), gingival index (GI), sulcular bleeding index (SBI) and plaque index (PLI) ，and the levels of inflammatory factors in the gingival crevicular fluid were examined. Visual analogue scale (VAS) was used to evaluate periodontal pain before and after correction, and the curative effect was evaluated. The status of common pathogenic bacteria in the subgingival plaque of patients after correction was detected by PCR. The data were analyzed with SPSS19.0 software package. RESULTS: Twelve months after treatment and at the end of treatment, PLI of the self-locking bracket group was significantly higher than the invisible group(P＜0.05), but PD, GI and SBI between the two groups had no significant difference. After correction, the inflammatory factors in the invisible group were significantly lower than those in the self-locking bracket group(P＜0.05). At 1d after treatment, pain index in the invisible group was significantly lower than the self-locking group(P＜0.05). The clinical total effective rate of the invisible group was significantly higher than the self-locking group (89.10% vs 76.36%). After treatment, the detection rate and the content of subgingival pathogenic bacteria in the self-locking bracket group were significantly higher than the invisible group(P＜0.05). CONCLUSIONS: During orthodontic treatment of periodontitis, wearing non-bracket invisible appliance can effectively inhibit inflammatory response and proliferation of subgingival pathogens, which is more conducive to the maintenance of periodontal health and oral hygiene.

Research on supporting mechanism of ancillary service of PV system to grid energy efficiency based on multi-time and space-time operation.

Under the background of high-energy penetration of new energy into the power grid, this paper takes the ancillary service capability of photovoltaic energy integrated into the grid as the starting point and builds a photovoltaic system reactive power service impact evaluation model on the grid energy efficiency. This is based on the multi-temporal and spatial scale operation mode, in order to study the supporting principles of photovoltaic system reactive power services on the energy efficiency of grid operation and the law of influence on system energy efficiency changes. In this way, the space for power system energy efficiency improvement and the reactive power service market value of renewable energy are explored to improve the renewable energy auxiliary services participation in the theoretical system of electric power spot market transactions. The research conclusions can provide a decision-making reference for system dynamic energy efficiency management and can assist relevant market entities to make optimal decisions in spot market transactions, and provide empirical data for improving the theory of renewable energy participation in auxiliary service market transactions.

First report of apple root rot caused by Phytopythium vexans in China.

Apple production is of great economic importance in the fruit industry of China, where Yunnan Province is considered as a major producing area. A survey was conducted to identify apple trees that were problematic from March to November 2020 in Yunnan Province. Symptoms included smaller yellowing leaves, fewer sprouts per branch, browning and necrosis of the roots and lower parts of the stem bark, and wilting. 20% to 45% of apple trees were found infected and randomly scattered in the surveyed orchards. A total of 110 soil samples were collected from the root area of symptomatic apple trees in Tuanjie Town of Kunming City, Zhaotong City, and Malong District of Qujing City in Yunnan Province. Two grams of each soil sample was suspended in 400 ml of sterile water for three days and each soil extract was baited with two apple leaves (Red Fuji's). Following the baiting, those leaves were cut into 10 pieces (5mm×5mm), surface-sterilized with 70% ethanol for 30 seconds, rinsed three times with sterile water, and then air-dried. Each leaf piece was placed in a Petri dish with the oatmeal agar medium containing PCNB 20 mg/ml, rifampicin 20 mg/ml, and then incubated at 25℃ in the dark for 3 days. A mycelial agar plug was picked from the edge of the colonies and transferred to a fresh Potato Dexrose Agar (PDA) plate. Seventy colonies with similar growing characteristics were isolated from the 110 soil samples. Three isolates were retained for further analysis and named XLD8-1, SD1, and YF2. After being cultivated on PDA plates and incubated at 25℃ in the dark for 4 days, their colonies were rose petal-type and white with dense aerial hyphae (Fig 1, A). In ten days of incubation, oogonium measuring 24.55 ± 1.9µm × 20.27 ± 2.3µm and sporangia measuring 21.65 ± 1.3µm × 19.35 ± 1µm were observed (Fig 1, C, D). The total DNA of the isolates was extracted and amplified using three pairs of primers, ITS1/ITS4 (White et al. 1990), LROR/LR7 (LSU) (Vilgalys R, et al. 1990), and FM58/FM66 (COXⅡ) (Martin F N. 2000). The sequences were uploaded to GenBank (Accession No. OL960234, OK037658, OK052604 for ITS, OL960388, OM838413, OM838314 for LSU, and OM962847, OM962848, OM962849 for COXⅡ). ITS sequences of the three isolates (XLD8-1, SD1, YF2) showed 99.87%,99.87%, 99.87% similar to Pp. vexans (Accession No. AB468784, AB468784, and AM701801). LSU sequences of the three isolates showed 99.92%, 99.72%, 100% similar to Pp. vexans (Accession No. EF426541, MT729990, and EF426541). COXⅡ sequences of the three isolates showed 100%, 99.81%, 99.81% similar to Pp. vexans (Accession No. GU133560). Based on the sequence similarity and morphology, the isolates were identified as Phytopythium vexans. Koch's postulates were conducted by wounding the bases of 3 apple seedlings (1-year-old Red Fuji's) with a cork borer. A plug of mycelium of the isolate XLD8-1 grown on PDA plates was placed on each wound (Fig 1, B). Controls were set up to use sterile agar plugs as an inoculum. Seedlings have incubated an incubator at 23-26°C under the alternating light and dark intervals, 12-hours of each. In 15 days, after were inoculated with XLD8-1 the roots and lower part of the stem bark of those seedlings became brownish and necrotic, and their epidermis was easily sloughed off (Fig 1, E-G). The pathogen isolated from the necrotic root tissues were identical to the isolate XLD8-1. Symptoms of apple growth decline caused by Pp. vexans were reported in Morocco (Jabiri Salma, et al. 2021). This experiment verified that Pp. vexans causes root rot of apple. In China, Fusarium sp. is usually considered the main pathogen causing apple root rot. However, the discovery of large numbers of apple trees that were infected by Pp. vexans in Yunnan Province and the confirmation of pathogenicity of Pp. vexans on apple seedlings have demonstrated for the first time that Pp. vexans could cause apple root rot as Fusarium spp does and become an incoming threat to the apple industry, which lays the foundation for study on the disease epidemiology and integrated management of apple root rot in China. References: Jabiri Salma, et al. 2021. Microorganisms, doi:10.3390/MICROORGANISMS9091916. Martin, F. N. 2000. Mycologia, 92(4), 711-727. Vilgalys R., et al. 1990. Journal of Bacteriology, 172:4238-4246 White, T. J., et al. 1990. PCR Protocols: a guide to methods and applications, 18: 315.

Physical agent detection ability of occupational health technical service institutions in Guangdong Province / 中国职业医学

@#Objective To analyze the physical agent detection ability of occupational health technical service institutions in Methods Guangdong Province. A total of 92 institutions in Guangdong Province that participated in the inter laboratory comparison of physical agents organized in 2020 were taken as the research subjects using purposive sampling method. The ， Results certified physical factor items number of measuring instruments and measurement standards were investigated. The ， ， certification and accreditation project on physical agents in 92 institutions with certification and accreditation rate >80.0% ， ， ， - were noise high temperature ultraviolet radiation hand transmitted vibration and illumination. The certification approval rates ， ， ， ， of power frequency magnetic field 1 Hz to 100 kHz electric field 1 Hz to 100 kHz magnetic field laser radiation physical ， - < （ ） labor intensity and whole body vibration were 60.0%. The certification and accreditation rate of noise 98.9% was the ， （ ） （P< ） ， highest and that of the physical labor intensity 3.3% was the lowest 0.01 . As for the number of measuring instruments （ ） the number of noise measuring instruments accounted for the highest proportion 52.6% in 92 institutions. The number of ， （P< ） measuring instruments from the most to the least was grade A grade B and unqualified institutions 0.01 . The number of - （P< ） measuring instruments in private institutions was greater than that in non private institutions 0.01 . In the measurement ， ， standards some institutions that have certified power frequency electric field power frequency magnetic field and microclimate ， - projects still used the abandoned standard. Some institutions that have certified microclimate illuminance and whole body Conclusion ， vibration used the wrong measurement standards. Among the physical agents the certification and accreditation ， rate of noise is the highest and the number of noise related measuring instruments is the largest. The qualified institutions and private institutions have greater number of certification and accreditation projects on physical agents and measuring instruments.

Inhibitory effect of mucopolysaccharide polysulfate cream on hypertrophic scar formation in a rabbit ear model and its mechanisms of action / 中华皮肤科杂志

Objective:To investigate the inhibitory effect and mechanisms of action of mucopolysaccharide polysulfate cream on hypertrophic scar formation.Methods:Circular full-thickness wounds with a diameter of 6 mm were made in both ears of 16 New Zealand white rabbits to establish a rabbit ear model of hypertrophic scar. There were 3 hypertrophic scars in each rabbit ear. About 14 days after the operation, scars on the left ear were topically treated with mucopolysaccharide polysulfate cream, and served as the experimental group; scars on the right ear were topically treated with the cream vehicle, and served as vehicle control group. The dosage of topical agents for one rabbit ear was approximately 0.4 g, which were given twice a day for 6 consecutive weeks. Scar tissues were collected on days 0, 14 and 42, that is, 14, 28 and 56 after operation respectively, and subjected to hematoxylin and eosin (HE) staining, Masson staining and immunohistochemical study, so as to evaluate histopathological scores, measure the scar thickness and collagen fiber density, and determine the expression of type Ⅰ and Ⅲ collagen and the ratio of type Ⅰ/Ⅲ collagen. The t test and one-way analysis of variance were used to compare the indices between groups. Results:Compared with pretreatment histopathological manifestations, HE staining showed extensive extracellular matrix deposition, inflammatory cell infiltration and local hyperemia in the control group after 42-day treatment, but no obvious changes in the experimental group. The pathological scores of scar tissues on the rabbit ears significantly increased over time in the control group (days 0, 14 and 42: 4.16 ± 1.61, 6.50 ± 1.46, 6.53 ± 1.34, respectively; F = 13.69, P = 0.001) , while there was no significant change in the experimental group (days 0, 14 and 42: 4.65 ± 1.52, 5.13 ± 1.83, 5.38 ± 1.60, respectively; F = 0.78, P > 0.05) . Masson staining showed extremely high content of dark blue-dyed collagen fibers in the control group on day 42, but there was a decrease in the content of collagen fibers in the experimental group; with the increase in treatment duration, the thickness of scar tissues significantly increased in the control group compared with that before treatment ( F = 5.64, P = 0.007) , while there was no significant change in the experimental group ( F = 1.48, P > 0.05) . Immunohistochemical study revealed no significant change in the expression of type Ⅲ collagen in either the experimental group or the control group at any of the above posttreatment time points compared with that on day 0 ( F = 0.22, 0.92, respectively, both P > 0.05) , but the expression of type Ⅰ collagen and the ratio of type Ⅰ/Ⅲ collagen significantly increased in the control group ( F = 7.47, P < 0.001; F = 4.70, P = 0.005, respectively) . On day 42, the expression of type Ⅰ collagen and the ratio of type Ⅰ/Ⅲ collagen significantly decreased in the experimental group compared with the control group ( t = 3.04, P = 0.007; t = 2.35, P = 0.030, respectively) . Conclusion:Topical mucopolysaccharide polysulfate cream is effective in preventing and inhibiting scar hypertrophy by reducing the scar thickness and inhibiting the collagen fiber hyperplasia and type I collagen expression.

The surgical outcome of adult patients with hypothalamic gliomas / 中国医师进修杂志

Objective:To analyze the clinic-pathological features and surgical outcomes of adult patients with hypothalamic gliomas.Methods:The adult cases pathologically confirmed as hypothalamic gliomas were analyzed from October, 2011 to January, 2022 in Beijing Tiantan Hospital.Results:There were 32 adult cases with hypothalamic gliomas, including 16 males and 16 females. Tumor was located in the hypothalamus in 6 cases, in the hypothalamus plus optic chiasma/nerve in 6 cases, in the hypothalamus plus thalamus in 9 cases, and in the hypothalamus plus the third ventricle in 11 cases. Pre-operative hydrocephalus was found in 20 cases. Five patents underwent stereotactic biopsy, 27 patients underwent craniotomy, and 11 patients underwent shunt surgery for hydrocephalus. Of 27 patients with craniotomy, trans-callosal approach was chosen for 9 patients, trans-cortical for 8 patients, via pterion approach for 4 patients, via lateral sub-frontal approach for 4 patients, via fissurae interhemisphaerica for 1 patient, and trans-sphenoidal approach for 1 patient. Twenty-two patients received gross-total or subtotal resection, 5 patients received partial resection. All the patients were pathologically confirmed, including 9 patients with high-grade and 23 patients with low-grade gliomas. Six patients died within 3 months after craniotomy, 8 patients suffered from endocrine dysfunction, 7 patients suffered from electrolyte disturbance, and 5 patients suffered from hydrocephalus. They were followed for 0.7-110.0 months, with 5-year progression-free survival rate of 63.8% and 5-year overall survival rate of 53.9% for all patients. The 5-year progression-free survival rate was 83.3% and the 5-year overall survival rate was 72.8% for low-grade gliomas.Conclusions:The peri-operative mortality is high for adult patients with hypothalamic gliomas, and protection of the hypothalamic function is important. Patients with low-grade hypothalamic gliomas have good prognoses.

Benefits and risks of prolonged dual antiplatelet therapy after percutaneous coronary intervention with drug-eluting stent in patients with stable coronary artery disease and diabetes / 中华心血管病杂志

Objective: To compare the efficacy and safety of prolonged dual antiplatelet therapy (DAPT>1 year) in patients with stable coronary artery disease (CAD) and diabetes who were event-free at 1 year after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) in a large and contemporary PCI registry. Methods: A total of 1 661 eligible patients were selected from the Fuwai PCI Registry, of which 1 193 received DAPT>1 year and 468 received DAPT ≤1 year. The primary endpoint was major adverse cardiac and cerebrovascular event (MACCE) and Bleeding Academic Research Consortium (BARC) type 2, 3 or 5 bleeding, MACCE was defined as a composite of all-cause death, myocardial infarction or stroke. Multivariate Cox regression analysis and inverse probability of treatment weighting (IPTW) Cox regression analysis were performed. Results: After a median follow-up of 2.5 years, patients who received DAPT>1 year were associated with lower risks of MACCE (1.4% vs. 3.2%; hazard ratio (HR) 0.412, 95% confidence interval (CI) 0.205-0.827) compared with DAPT ≤1 year, which was primarily caused by the lower all-cause mortality (0.1% vs. 2.6%; HR 0.031, 95%CI 0.004-0.236). Risks of cardiac death (0.1% vs. 1.5%; HR 0.051, 95%CI 0.006-0.416) and definite/probable ST (0.3% vs. 1.1%; HR 0.218, 95%CI 0.052-0.917) were also lower in patients received DAPT>1 year than those received DAPT ≤ 1 year. No difference was found between the two groups in terms of BARC type 2, 3, or 5 bleeding (5.3% vs. 4.1%; HR 1.088, 95%CI 0.650-1.821). Conclusions: In patients with stable CAD and diabetes who were event-free at 1 year after PCI with DES, prolonged DAPT (>1 year) provides a substantial reduction in ischemic cardiovascular events, including MACCE, all-cause mortality, cardiac mortality, and definite/probable ST, without increasing the clinically relevant bleeding risk compared with ≤ 1-year DAPT. Further well-designed, large-scale randomized trials are needed to verify the beneficial effect of prolonged DAPT in this population.

Mechanism of Cremastrae Pseudobulbus-Rhapontici Radix Against Breast Cancer： An Exploration Based on Network Pharmacology and Experimental Verification / 中国实验方剂学杂志

ObjectiveTo screen out the main targets and related signaling pathways of the herbal pair Cremastrae Pseudobulbus-Rhapontici Radix in treating breast cancer based on network pharmacology and verify their action mechanism in in vitro experiments. MethodThe main chemical components and related targets of Cremastrae Pseudobulbus-Rhapontici Radix were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP）， and the target genes related to breast cancer from GeneCards. Following the screening of the common targets of Cremastrae Pseudobulbus-Rhapontici Radix and breast cancer using Venn， the Cremastrae Pseudobulbus-Rhapontici Radix-breast cancer network and protein-protein interaction （PPI） network were constructed. The effective targets were then subjected to gene ontology （GO） and Kyoto encyclopedia of genes and genomes （KEGG） pathway enrichment analysis. The resulting outcomes were then verified by cell counting kit （CCK）-8 assay， flow cytometry， and Western blot. ResultThe screening yielded seven effective components and 61 targets of Cremastrae Pseudobulbus-Rhapontici Radix， among which 55 targets were involved in breast cancer. The GO analysis revealed 832 entries， which were mainly enriched in the biological processes. According to KEGG pathway enrichment analysis， 85 signaling pathways were obtained， including tumor suppressor p53， vascular endothelial growth factor （VEGF）， epidermal growth factor receptor （EGFR）， and phosphatidylinositol 3-kinase （PI3K）/protein kinase B（Akt）. It was verified in in vitro experiments that the alcohol extract of Cremastrae Pseudobulbus-Rhapontici Radix inhibited the proliferation of human breast cancer MDA-MB-231 cells and induced their apoptosis. Compared with the blank control group and the dimethyl sulfoxide （DMSO， 0.1% solvent） group， the medication groups exhibited obviously decreased absorbance in MDA-MB-231 cells （P<0.01） and increased apoptosis rate （P<0.01）. The results of Western blot demonstrated that compared with the blank control group and the DMSO group， each medication significantly reduced the phosphorylated （p）-PI3K/PI3K and p-Akt/Akt in cells （P<0.05）. ConclusionThe ethanol extract of Cremastrae Pseudobulbus-Rhapontici Radix effectively inhibits the proliferation of human breast cancer MDA-MB-231 cells and induces their apoptosis， which may be related to the inhibition of the activation of PI3K/Akt signaling pathway.

Advantages and application of restricted fluid therapy after resection of esophageal carcinoma / 中国胸心血管外科临床杂志

@#The incidence of complications after radical resection of esophageal carcinoma is high up to about 20%-50%. The incidence of pneumonia, pleural effusion, tracheal intubation, anastomotic fistula and cardiac events is relatively high. Among them, pulmonary complications are the most common complications after esophageal cancer operation and cause the most perioperative deaths. Among the factors that influence the occurrence of postoperative complications of esophageal cancer, the amount of fluid infusion during and after the operation is closely related to the occurrence of postoperative complications. Moreover, in the environment of enhanced recovery after surgery (ERAS), it is more important to optimize the postoperative fluid management of esophageal cancer. Restricted fluid therapy plays a more and more important role in patients undergoing esophagectomy. This review integrated the relevant research results and discussed the advantages of the restricted fluid therapy compared with other fluid therapy, how to control the restricted infusion volume and infusion speed and how to monitor and evaluate the infusion process and the selection of infusion types, so as to provide reference for clinical practice test.

Personal dose monitoring results of 307 interventional radiology workers in Liaoning Province, China / 中国辐射卫生

Objective To investigate the personal dose level of occupational external exposure among interventional radiology workers in Liaoning Province of China, and to provide a reference for better occupational radiation protection. Methods According to the national standard GBZ 128—2016 Specifications for individual monitoring of occupational external exposure, the thermoluminescence method was used to measure the monitoring dose inside the lead clothes (HW) and outside the lead clothes (HN) of interventional radiology workers, and the Mann-Whitney U test and the Kruskal-Wallis H test were used for statistical analysis. Results Dual dosimeter monitoring data were collected from 307 interventional radiology workers in Liaoning Province in 2019, with a mean annual effective dose of 0.81 mSv and a maximum annual effective dose of 7.03 mSv, and 72.96% of the workers monitored had an annual effective dose of less than 1 mSv. The interventional radiology workers in tertiary hospitals had a significantly higher mean annual effective dose than those in secondary hospitals (0.95 mSv vs 0.65 mSv, P < 0.05). There was a significant difference in mean annual effective dose between departments (P < 0.05), and the department of interventional radiology had a significantly higher mean annual effective dose than the other departments (0.92 mSv vs 0.64 mSv), while the department of cardiology had a similar mean annual effective dose to the cerebrovascular department (0.78 mSv vs 0.78 mSv). Conclusion The occupational exposure dose of 307 interventional radiology workers in Liaoning Province meets the requirements in national regulations and standards and is higher than the national level, which suggests that radiation protection supervision and personal training should be further strengthened for interventional radiology.