[Clinical application of split liver transplantation: a single center report of 203 cases].

Objective: To investigate the safety and therapeutic effect of split liver transplantation (SLT) in clinical application. Methods: This is a retrospective case-series study. The clinical data of 203 consecutive SLT, 79 living donor liver transplantation (LDLT) and 1 298 whole liver transplantation (WLT) performed at the Third Affiliated Hospital of Sun Yat-sen University from July 2014 to July 2023 were retrospectively analyzed. Two hundred and three SLT liver grafts were obtained from 109 donors. One hundred and twenty-seven grafts were generated by in vitro splitting and 76 grafts were generated by in vivo splitting. There were 90 adult recipients and 113 pediatric recipients. According to time, SLT patients were divided into two groups: the early SLT group (40 cases, from July 2014 to December 2017) and the mature SLT technology group (163 cases, from January 2018 to July 2023). The survival of each group was analyzed and the main factors affecting the survival rate of SLT were analyzed. The Kaplan-Meier method and Log-rank test were used for survival analysis. Results: The cumulative survival rates at 1-, 3-, and 5-year were 74.58%, 71.47%, and 71.47% in the early SLT group, and 88.03%, 87.23%, and 87.23% in the mature SLT group, respectively. Survival rates in the mature SLT group were significantly higher than those in the early SLT group (χ2=5.560,P=0.018). The cumulative survival rates at 1-, 3- and 5-year were 93.41%, 93.41%, 89.95% in the LDLT group and 87.38%, 81.98%, 77.04% in the WLT group, respectively. There was no significant difference among the mature SLT group, the LDLT group and the WLT group (χ2=4.016, P=0.134). Abdominal hemorrhage, infection, primary liver graft nonfunction,and portal vein thrombosis were the main causes of early postoperative death. Conclusion: SLT can achieve results comparable to those of WLT and LDLT in mature technology liver transplant centers, but it needs to go through a certain time learning curve.

[The analysis of features of first-onset neuromyelitis optica spectrum disease within 1 year after delivery].

To explore the clinical features and influencing factors of first-onset neuromyelitis optica spectrum disease (NMOSD) within 1 year after delivery. A single center, observational cohort study was used to retrospectively analyze 12 patients with first-onset NMOSD within 1 year after delivery hospitalized in the Department of Neurology of Beijing Tong Ren Hospital from June 2015 to June 2018(short as the postpartum onset group). 12 patients with first-onset NMOSD without 1 year after delivery hospitalized in our department during the same period were selected (short as the control group). The results showed the next recurrence interval in the postpartum onset group was longer than the control group [the postpartum onset group: (6.1±3.5) years, the control group: (1.6±1.5) years, t=3.622,P=0.005], the times of relapses were less than the control group [the postpartum onset group: (1.8±1.4) times, the control group:4.0 (3.0, 7.3) times, Z=-3.122,P=0.002], and expanded disability status scale (EDSS) of the last follow-up was lower than the control group [the postpartum onset group: 3.0(2.3, 3.9), the control group: 4.5(4.0, 6.0), Z=-3.358,P=0.001] with statistically significant differences. The recurrence rates of 1 year, 3 years and 5 years in the postpartum onset group (0%, 16.7%, 33.3%) were lower than control group (58.3%, 83.3%, 91.7%) with statistically significant differences (χ2=8.000,P=0.014;χ2=10.667,P=0.003; χ2=8.711,P=0.009). After the second delivery, the recurrence rate in postpartum onset group was 100% (n=3) and in control group was 50%(n=2), but the difference was not statistically significant (χ2=2.100,P=0.429). In the postpartum onset group, combination of autoimmune disease was consistent with positive in serum AQP-4 antibody moderately (Kappa=0.5, P=0.046). Positive in other autoimmune antibodies were consistent with positive in serum AQP-4 antibody moderately (Kappa=0.5, P=0.046). Combination of autoimmune disease were consistent with positive in serum other autoimmune antibodies well (Kappa=0.667, P=0.021). In conclusion, the first-onset NMOSD within 1 year after delivery have longer next recurrence interval, less times of relapses, lower relapse rate, better long-term prognosis of central nervous system, and they have trend to suffering from recurrent after the second delivery. For the females, combined with autoimmune disease or autoimmune antibody, who are ready for pregnancy, could detect serum AQP-4; if serum AQP-4 positive, they are recommended to prevent the occurrence of NMOSD after delivery.

Gene repression using synthetic small regulatory RNA in Methylorubrum extorquens.

AIM: Genetic tools are a prerequisite for engineering cell factories for synthetic biology and biotechnology. Methylorubrum extorquens is an important platform for a future one-carbon (C1) bioeconomy, but its application is currently limited by the availability of genetic tools. Small regulatory RNA (sRNA) is an important regulatory factor in bacteria and has been applied for gene repression in several strains. This study aimed to construct a synthetic sRNA system based on the MicC scaffold and the chaperone Hfq to control gene expression in M. extorquens. METHODS AND RESULTS: Initially, the exogenous lacZ gene was transposed into the M. extorquens chromosome as a reporter, and corresponding ß-galactosidase was measured to assess the knockdown efficiency of lacZ. A synthetic sRNA containing a 24-nt antisense RNA targeting lacZ and an Escherichia coli MicC scaffold were constructed, and different Hfqs from E. coli, M. extorquens AM1 and PA1 were further identified. The results showed that the expression of endogenous hfqs from the chromosome in M. extorquens strains was inadequate, and only when it was overexpressed via the plasmid did the colonies show a colour change and a corresponding decrease in ß-galactosidase expression. More specifically, M. extorquens strains with overexpressing their own Hfq showed the best gene repression efficiency. Furthermore, this E. coli MicC scaffold and AM1 Hfq system were combined to knock down crtI gene expression in AM1, leading to an 86% decrease in carotenoid production (0·09 mg g-1 ) compared to that (0·65 mg g-1 ) in the wild-type strain. CONCLUSION: A functional synthetic sRNA system combined with E. coli MicC and endogenous Hfq was constructed in M. extorquens strains, which was able to interfere with the target crtI gene and reduce carotenoid production. SIGNIFICANCE AND IMPACT OF THE STUDY: The synthetic sRNA system reported in this study provides a genetic tool for the manipulation of M. extorquens. The present findings might be helpful for achieving high-throughput gene knockdown expression.

[Health status and healthcare service utilization among children born to women with maternal syphilis in Shanghai].

Objective: To assess the health status and health service utilization of children born to syphilis infected mothers during pregnancy, in order to prevent mother-to-child transmission of syphilis to the newborns. Methods: Women with maternal syphilis were studied by trained researchers via phone calls, in Shanghai during 2014-2015. Data related to demographics, status of infection and health care, utilization by both mothers and their children were collected through specifically designed questionnaires. Non-parametric tests including chi-square were used to assess the health status and health service utilization of children born to mothers with different demographic and socioeconomic characteristics. Results: A total of 495 children born to mothers with maternal syphilis were recruited from 1 000 syphilis infected parturient women. A total of 61 out of the 495 children were diagnosed as having congenital syphilis (57 children were diagnosed at birth and another 4 were diagnosed during the follow-up period). Children born to women who received syphilis treatment during pregnancy were at lower risk on congenital syphilis (χ(2)=7.214, P=0.027). 37.8% of the children were reported to have had different illnesses in the past three months, mainly involving upper respiratory infections (32.3%) or diarrhea (3.6%). Children diagnosed with congenital syphilis showed a higher prevalence of different kinds of diseases, compared to those without congenital syphilis (47.5% vs. 36.6%). 81.6% of the children had received regular child health care services. Subjects with the following factors as: being immigrant, with lower education, unemployed, unmarried and multipara, were related to the less use of regular child healthcare services. Only 39.7% of the parents would inform the care-takers about the risk of congenital syphilis infection of their own children at the child health care centers. Mothers with residency of Shanghai, having higher education level and employed, were less willing to inform doctors about the risk of congenital syphilis infection of their children. Conclusions: Loss to follow-up among children born to syphilis infected pregnant women remained a serious problem. Few parents would be willing to inform the healthcare takers that their children are at risk of syphilis, when receiving child health care services at the centers. It was necessary to integrate the congenital syphilis follow-up programs into the routine child care services so as to timely diagnose and treat the patients with congenital syphilis.

[Investigation on demands for antenatal care services among 2 002 pregnant women during the epidemic of COVID-19 in Shanghai].

Objective: To identify problems and demands for antenatal care (ANC) among pregnant women in different trimesters of pregnancy in Shanghai for optimizing ANC service during the epidemic of COVID-19. Method: s Organized by maternal and child health care institute in the 16 districts of Shanghai, a cross sectional study was conducted among pregnant women who came to pregnancy registration in the community health centers or attended ANC in midwifery hospitals from February 7 to February 12, 2020. Consented participating women completed a semi-structured online questionnaire voluntarily. Data was analyzed using frequency,chi-square test and scoring. Result: s A total of 2 002 valid questionnaires were collected from 183 community health centers and 67 midwifery hospitals. About 94.6%(1 894/2 002) of the pregnant women worried about being infected during the COVID-19 epidemic, and 14.7% (294/2 002) demanded for psychological consultation. Time-lapse appointments for ANC were requested by 87.7% (1 756/2 002) of the participants for avoiding presenting themselves in people-density places. Compared with other pregnancy trimesters, pregnant women in the second trimester were more willing to reduce the frequency of ANC (35.2% versus 39.5% versus 48.1%, P<0.01). Compared with multiparas, primiparas were more willing to have online consultation and guidance (49.2% versus 63.8%, P<0.01). Regarding the needs for health knowledge on COVID-19, personal protection against 2019 novel coronavirus (2019-nCoV) was the most concerned for pregnant women, and 71.0% (1 421/2 002) of them preferred to obtain knowledge through health applications, official Weibo and WeChat. Conclusions: Pregnant women in Shanghai critically concern about the risk of 2019-nCoV infections, and highly demand knowledge and measures on prevention and protection from COVID-19. They ask for having time-lapse appointments for ANC and online access to health information and services. Maternal and child care institutes should understand the demands of pregnant women, optimize the means of ANC service, and provide tailored and accessible health education and service for the safety of mother and child.

[Analysis of results of ultrasound examination of thyroid nodules in nuclear power workers].

Objective: To investigate the detection of thyroid nodules and related risk factors in nuclear power workers, and to provide scientific evidence for thyroid protection of nuclear power workers. Methods: In December 2018, select 295 workers of a nuclear power production enterprise and 238 administrative staff of it, and select 250 staff members of a thermal power generation enterprise 70 kilometers away from the nuclear power station to conduct thyroid ultrasound examination and questionnaire survey for single factor. Analysis and further multivariate logistic regression analysis were used to study the risk factors of thyroid nodules in the population. Results: Women and smoking history were independent risk factors for the increased incidence of thyroid nodules in the study population; three shifts work pattern was an independent risk factor for the increased prevalence of thyroid nodules in nuclear power workers (P<0.05) , and other factors such as the history of nuclear exposure had no significant correlation with thyroid nodules (P>0.05) . Conclusion: Nuclear exposure has little effect on the prevalence of thyroid nodules in nuclear power workers.

The effects of varieties and levels of rapeseed expeller cake on egg production performance, egg quality, nutrient digestibility, and duodenum morphology in laying hens.

The objective of this study was to evaluate the effects of rapeseed expeller cake (REC) derived from Brassica napus rapeseed with different concentrations of glucosinolate (Gls) and erucic acid (EA) on the egg-production performance, egg quality, apparent nutrient digestibility, and intestinal morphology in laying hens. At 33 wk of age, a total of 1,080 laying hens were randomly divided into 9 treatment groups in a completely randomized design involving a control treatment without REC (a corn-soybean diet) and a 2 × 4 factorial arrangement with 2 concentrations of REC (at 7 and 14%) from 4varieties of rapeseed varying in Gls and EA concentrations [DY6 REC: 22.67 µmol/g (Gls, relative to rapeseed meal), 0.7% (EA, relative to total fatty acids); MB1 REC: 43.23 µmol/g, 3.5%; DY5 REC: 74.66 µmol/g, 16.20%; XH3 REC: 132.83 µmol/g, 44.60%]. The trial lasted for 8 wk. Compared with the control group, REC addition decreased the ADFI, egg production, egg weight, and egg mass of laying hens during wk1 to wk4, wk5 to wk8, and wk1 to wk8 (P < 0.05), and REC did not affect FCR, mortality during wk1 to wk4, wk5 to wk8, and wk1 to wk8 (P > 0.05). The XH3 REC group had a trend to lower egg weight when compared with the DY6 REC group during wk1 to wk8 (P = 0.07).REC decreased AME and DM digestibility at wk8 (P < 0.01), and REC addition in diet did not affect apparent nitrogen digestibility (P = 0.6). REC decreased villi height (P < 0.01) and increased crypt depth (P < 0.01). The XH3 REC group had a lower crude fat digestibility than the DY6 REC group, and the crude fat digestibility of the DY5 and MB1 REC groups was lower than the XH3 REC group (P < 0.01). The DY6 REC group had a higher villi height than the DY5, MB1, and XH3 REC groups (P < 0.01). The XH3 REC group had a higher crypt depth than the DY6, DY5, and MB1 REC groups (P < 0.01). The DY6 REC group had a higher value of the ratio of villi height to crypt depth than the DY5 and MB1 REC groups, and the DY5 and MB1 REC groups had a higher value of the ratio of villi height to crypt depth than the XH3 REC group (P < 0.01).REC decreased albumen height and Haugh unit during wk1 to wk8 (P < 0.01 and P = 0.004), and increased yolk color during wk1 to wk8 (P < 0.01).The XH3, MB1, and DY5 REC groups had a lower albumen height than the DY6 REC group during wk1 to wk8 (P < 0.01), and the XH3 and DY5 REC groups had a lower Haugh unit than the DY6 REC group during wk1 to wk8 (P < 0.01). The DY6 REC group had the highest value of yolk color than other three varieties of REC (DY5, MB1, XH3) at wk6 and wk8 (P < 0.01 and P < 0.01). It can be concluded that the exposure of laying hens to REC with higher Gls and EA (DY5, MB1, XH3) led to a lower egg weight, nutrient digestibility, intestinal absorptive area, and egg internal quality than those with lower Gls and EA (DY6).

Sex Recognition of Skulls in Chinese Uygur.

ABSTRACT: Objective Logistic regression method was used to establish a multiple regression sex discriminant function to discriminate the complete skull model and the incomplete skull model without frontal bone, occipital bone and mandible of Uygur adults in Turpan, Xinjiang. Methods A total of 117 （60 male and 57 female） three-dimensional skull models were collected by CT. Sixteen cranial measurement indexes were measured and calculated by computer software. The multivariate regression sex discriminant function was established with Logistic regression method and retrospectively tested. Results Among the 16 measurement indexes, except for nose width （x7） and maximum frontal breadth （x13）, the remaining 14 indexes had statistical significance of differences between male and female （P<0.05）. For the discriminant function of complete skull established by eyebrow arch convexity （x4）, mastoid width （x6）, maximum cranial length （x12）, cranial base length （x15）, cranial circumference （x16）, the male and female discrimination accuracy was 90.0% and 94.7%, respectively. For the sex discriminant function of incomplete skull without frontal bone established by mandibular angle width （x10）, mandibular height （x11） and cranial circumference （x16）, the discrimination accuracy of male and female was 85.0% and 84.2%, respectively. For the sex discriminant function of incomplete skull without occipital bone established by the index of eyebrow arch convexity （x4）, the discrimination accuracy of male and female was 80.0% and 73.7%, respectively. For the sex discriminant function of incomplete skull without mandible established by frontal chord （x5） and occipital protrusion angle （x9）, the discrimination accuracy of male and female was 85.0% and 78.9%, respectively. Conclusion The computer software and system developed in our study can achieve sex discrimination of complete skulls and incomplete skulls without frontal bone, occipital bone or mandible.

[The clinical analysis of optic neuropathy relative to Behcet's disease with clinical manifestation of anterior ischemic optic neuropathy].

Objective: To summarize the clinical manifestation, treatment and prognosis of anterior ischemic optic neuropathy(AION) which was the manifestation of optic neuropathy related with Behcet's disease (BD). Methods: Retrospective series of case studies. The clinical data of 6 cases (9 eyes) of AION associated with BD who were hospitalized at the neurology ward of Beijing Tongren Hospital from February to June in 2016 were collected, the clinical characteristics of these patients were summarized, visual acuity were compared by using Wingerchuk visual grade before and after treatment. Results: Among the 6 patients with AION associated with BD, there were 4 males and 2 female, aged 38-60 years. All patients were acute onset, 3 cases had the onset of one eye, 2 cases with the onset of both eyes and 1 case with successively onset of both eyes. Optic nerve was damaged in 6 cases (9 eyes), only 1 case felt pain of eyes, the best corrected visual acuity of 4 eyes were less than 0.1, optic disk edema and linear bleeding around optic disk were oberved in all patients, the lower half visual field defect was the most common damage type (5 eyes), P100 latency of visual evoked potential prolonged in all patients, optic nerve MRI showed abnormal signal of optic nerve involvement in 2 patients. All patients were treated with corticosteroids and followed for 3 months, there was significant improvement in 1 eye of which the vision improved above 3 grade, and improvement in 6 eyes of which vision improved for 1-2 grade, while there has been no change in 2 eyes. Conclusions: BD may be the etiology of AION. Visual impairment of this kind of patients is relatively serious, visual function is expected to improve with early treatment. (Chin J Ophthalmol, 2019, 55:203-207).

[Expert consensus on the diagnosis and treatment of cryptococcal meningitis].

Cryptococcal meningitis is a common and refractory central nervous system infection, with high rates of mortality and disability. The experts of the Society of Infectious Diseases of Chinese Medical Association have reached this consensus after a thorough discussion. Based on the current situation of cryptococcal meningitis in China, the management of cryptococcal meningitis includes 6 aspects: introduction, microorganism identification, clinical manifestations and diagnosis, principles of antifungal therapy, treatment of refractory and recurrent meningitis, treatment of intracranial hypertension. There is not a separate consensus on human immunodeficiency virus (HIV) infection in patients with cryptococcal meningitis. This article focuses on different antifungal regimens and reducing intracranial pressure by reference to Infectious Disease Society of America (IDSA) guidelines. The importance of early diagnosis, combined long-term antifungal therapy, control of intracranial hypertension are emphasized.

[Genetic diagnosis of Caroli syndrome with autosomal recessive polycystic kidney disease: a case report and literature review].

This case report is about one genetically specified diagnosed infant case of Caroli syndrome with autosomal recessive polycystic kidney disease (ARPKD) in China. The patient in this case report was an eight-month infant boy with an atypical onset and the main clinical manifestation was non-symptomatic enlargement of the liver and kidneys. The imaging study demonstrated a diffused cystic dilatation of intrahepatic bile ducts as well as polycystic changes in bilateral kidneys. The basic blood biochemical tests indicated a normal hepatorenal function. Four serum biomarkers of hepatic fibrosis were all elevated and the urine test for an early detection of the renal injury was positive. The genetic sequencing proved two heterozygous missense mutations of polycystic kidney and hepatic disease 1 (PKHD1) gene, c.9292G>A and c.2507T>C, inherited from each of his parents respectively. The former was a novel mutation that had been verified as disease causing through the predicting software while the latter had been reported from one recent case study on Chinese twins, which was possibly unique among Chinese population. The relations between the gene type and the clinical phenotype were not clarified yet. Up till a follow-up eleven months later after the discharge, the patient had a normal hepatorenal function without occurrence of any severe complication yet. The clinical symptoms of Caroli syndrome with ARPKD at infant stage were atypical and the enlargement of liver and kidney was usually the sole symptom. From the above systematic retrospective clinical analysis, as well as the relevant literature review, it's been concluded that the features of the hepatorenal images in patients with Caroli syndrome and ARPKD were distinctive. Genetic testing combined with the imaging study benefits a definite diagnosis as well as a differentiation from other hepatorenal fibrocystic diseases. Specific to the long-term management of this kind of patients, it's necessary to schedule a regular follow-up to monitor the hepatorenal function and the occurrence of various complications for an appropriate intervention, meantime to devote efforts to the genetic counseling work for the patients' family.

The Deposition and Elimination of Glucosinolate Metabolites Derived from Rapeseed Meal in Eggs of Laying Hens.

This study was to investigate the deposition and elimination of glucosinolate metabolites including 5-vinyl-1,3-oxazolidine-2-thione (5-VOT) and thiocyanate ion (SCN-) derived from rapeseed meal (RSM) in hen eggs. During 12 weeks accumulation phase, the serum triiodothyronine, thyronine, blood urea nitrogen, kidney index, and thyroid index linearly increased with the RSM at week 12 (P < 0.05). The thyroid histopathology revealed a sign of hyperplastic goiter in hens fed with 17.64-29.40% RSM. The 5-VOT content of eggs (Y, ng/g) was correlated with 5-VOT intake (X2, µg/d·bird) and 5-VOT feeding time (X1, week): Y = 54.94X1 + 0.51X2 - 430.34 (P < 0.01, R2 = 0.80). The SCN- content of eggs (Y, mg/kg) was correlated with RSM intake (X2, µg/d·bird) and RSM feeding time (X1, week): Y = 0.095X1 + 0.302X2 - 0.4211 (P < 0.01, R2 = 0.70). After a 4-week withdrawal of RSM, the 5-VOT and SCN- did not show in eggs. Taken together, 5.88% RSM with dietary supplements of 23.55 mg/kg 5-VOT and 10.76 mg/kg SCN- had no effects on hens with regard to serum parameters, organ index, and thyroid histopathology, and more than 4 weeks withdrawal should be considered for human and hen health.

[Cross-sectional survey of smoking and smoking cessation behaviors in adults in Jiangxi province, 2013].

Objective: To describe the prevalence of smoking and smoking cessation in adults of Jiangxi province in 2013. Methods: Multi-stage stratified cluster random sampling method was used to select 6 000 individuals aged ≥18 years from 10 chronic and non-communicable disease and risk factor surveillance points of Jiangxi province in 2013. A face-to-face questionnaire survey was carried out to collect information about the risk factors for chronic and non-communicable diseases and 5 997 records were used in final analysis of smoking and smoking cessation. Sample was weighted to represent the adult population of Jiangxi province. The prevalence of different groups were analyzed. Results: The prevalence of current smoking of the sample was 21.53% (1 291/5 997). After complex weighting, the prevalence of smoking was 26.07% in adults in Jiangxi (95%CI:23.48%-28.66%), and it was much higher in men (50.62%, 95%CI: 46.31%-54.94%) than in women(1.46%, 95%CI: 0.57%-2.35%), the difference was statistically significant (P<0.05). The differences in smoking prevalence were significant among different age groups (P=0.029), and the smoking prevalence increased with educational level, but decreased with the worse of self-reported health condition. Most current smokers smoked every day (87.16%, 95%CI: 83.29%-91.03%) and averagely 19.27 (95%CI: 17.69-20.85) cigarettes were smoked daily. The proportion of smokers with average daily consumption ≥20 cigarettes was 64.74% (95%CI: 55.79%-73.70%). The smokers'average age of starting daily smoking was 20.28 (95%CI: 19.74-20.82) years old, which was lower in men [20.11(95%CI: 19.61-20.61) years old] than in women [26.88(95%CI: 24.73-29.03) years old], the difference was statistically significant (P<0.05). Among the male smokers, 27.04%(95%CI:18.91%-35.16%) of male smokers was less than 18 years old when they started daily smoking, and the proportion was 17.46%(95%CI: 0%-37.71%) in female smokers. The smoking cessation rate was 14.80% (95%CI: 10.88%-18.72%) and increased with age, the increase of income level and the worse of self-reported health condition. The successful smoking cessation rate was 10.89%(95%CI: 8.36%-13.42%). Only 32.10%(95%CI: 21.95%-42.25%) of current smokers attempted to quit smoking. The prevalence of passive smoking was 54.71% (95%CI: 44.20%-65.21%). Conclusion: The prevalence of smoking was high in adults in Jiangxi and the proportion of heavy smokers was large. Less smokers quitted smoking and the proportion of current smokers attempting to quit smoking was small. Males and adolescent smokers are targeted populations for tobacco control and special strategy should be taken according to the characteristics of smoking population in Jiangxi.

[Analysis of maternal deaths in Shanghai from 1996 to 2015].

Objective: To analyze the trend of maternal mortality ratio (MMR) and cause of death in Shanghai from 1996 to 2015. Methods: To collect the material about the maternal death and the maternal death audit from 1996 to 2015, and to analyze the MMR, the cause of death and the result of the maternal death audit of Shanghai from 1996 to 2015 retrospectively. Results: (1) The change of MMR: the MMR in Shanghai decreased from 28.84 per 100 000 live births in 1996 to 6.66 per 100 000 live births in 2015. (2) The characteristic of maternal death: the proportion of Shanghai citizens was 27.4%(121/441) and the proportion of migrant women was 72.6%(320/441). The women with advanced maternal age was 8.2% (20/243) since 1996 to 2005, and increased to 16.7% (33/198) since 2006 to 2015. Maternal deaths during pregnancy increased from 27.6%(67/243) in the first 10 years (1996-2005) to 35.4%(70/198) in the recent 10 years (2006-2015) . The intrapartum maternal deaths was 6.2%(15/243) in the first 10 years and in the recent 10 years it was zero. The proportion of postpartum deaths in the first 10 years and in the recent 10 years were 66.3% (161/243) and 64.6%(128/198) respectively. (3) The cause of maternal death: During the recent 10 years, indirect obstetric causes [63.1%(125/198)] was more than direct obstetric causes [36.9% (73/198) ] for the first time. The death causes changed significantly. Postpartum hemorrhage remained the leading cause of maternal deaths, but the specific mortality rate (SMR) of postpartum hemorrhage decreased significantly from 7.42 per 100 000 live births in the first 10 years to 1.51 per 100 000 live births in the recent 10 years. The maternal deaths because of heart disease and cerebrovascular disease rose to the second and the forth reasons. (4) Maternal death audit: the avoidable maternal death ratio decreased from 3.66 per 100 000 live births in the first 10 years to 1.86 per 100 000 live births in the recent 10 years. Conclusions: During the past 20 years, the MMR of Shanghai decreased significantly and was close to the level of developed countries. In recent years, the causes of maternal death become more complicated. With the implementation of the second child policy, women with high risk factors increase, so government investment, policy support should be strengthened to optimize the management.

[Influence of long-time video operation on hemodynamics of the retrobulbar arteries in operators].

Objective: To investigate the influence of long-time video operation on hemodynamics of the retrobulbar arteries in operators. Methods: From March to October, 2015, a total of 120 soldiers for office work engaged in video surveillance were enrolled as study group, and 155 fire fighters were enrolled as control group. The incidence of eye discomfort was compared between the two groups. Color Doppler ultrasound was used to measure and compare the peak systolic velocity (PSV) , end-diastolic velocity (EDV) , and resistance index (RI) of the central retinal artery (CRA) and the short posterior ciliary artery (SPCA) , and the correlation of video operation time with the hemodynamic parameters of the retrobulbar arteries was analyzed. Results: The study group had a significantly higher incidence rate of eye discomfort than the control group (P<0.05) . Compared with the control group, the study group had significant reductions in the PSV and EDV of the CRA and the SPCA and a significant increase in the RI of the CRA (P<0.05) . Video operation time was negatively correlated with the PSV and EDV of the CRA and the SPCA (r=-0.61, -0.54, -0.65, and-0.68, all P<0.05) and positively correlated with the RI of the CRA and the SPCA (r=0.56 and 0.63, P<0.05) . Conclusion: Long-time video operation can increase the incidence of eye discomfort and lead to increased blood resistance of the CRA and the SPCA and reduced retinal perfusion.

Attenuation of Focal Adhesion Kinase Reduces Lipopolysaccharide-Induced Inflammation Injury through Inactivation of the Wnt and NF-κB Pathways in A549 Cells.

Overall analysis and understanding of mechanisms are of great importance for treatment of infantile pneumonia due to its high morbidity and mortality worldwide. In this study, we preliminarily explored the function and mechanism of focal adhesion kinase (FAK) in regulation of inflammatory response induced by lipopolysaccharides in A549 cells. Flow cytometry, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, quantitative reverse transcription polymerase chain reaction, and Western blot analysis were used to explore the correlation of FAK expression with cell apoptosis, viability, and the inflammatory cytokine activity in A549 cells. The results showed that knockdown of FAK enhanced cell viability, suppressed apoptosis, and decreased inflammatory cytokine activity. In addition, downregulation of FAK could activate the Wnt and nuclear factor κB signaling pathways. These findings suggest that FAK might be involved in progression of infantile pneumonia and could be a new therapeutic target for this disease.

[Effects of video work on the ocular vascular hemodynamic and visual of the operators].

Objective: To investigate the effects of long time video display terminal (VDT) operation on the ocular vascular hemodynamic and visual acuity. Methods: During March and October 2015, 120 cases of video monitoring warriors were selected as study group, another 155 cases of logistics personnel as the control group. The low vision of the two groups was calculated and compared, and the color Doppler flow imaging was used to measure the central retinal artery (CRA) , short posterior ciliary artery (SPCA) , anterior ciliary artery (ACA) , (peak systolic velocity, PSV) , end diastolic velocity (EDV) and (resistance index (RI) . The differences of hemodynamic parameters between these two groups were evaluated, and the relationship between the visual acuity and each hemodynamic parameter was analyzed. Results: The visual acuity of the study group was[0.8 (0.4-1.2) ], much lower than the control group, and the rate of low version in the study group was 40.00%, much higher than that of the control group. Compared with the control group, both of ACA and CRA of SPCA, PSV and EDV in the study group were decreased, while RI of CRA, ACA were increased (P<0.05) ; Compared with the control group, no statistical significance was found in the RI of SPCA in the study group (P>0.05) . The PSV and EDV were negatively correlated with visual acuity (r value of PSV and visual acuity were -0.352, -0.265 and -0.304; r value of EDV and visual acuity were -0.324, -0.348 and -0.365, while RI was positively correlated with visual acuity (r value were 0.363, 0.326 and 0.344) . Conclusion: Our data suggest that long time video operation may be associated with changes of ocular vascular hemodynamic parameters and raise the incidence of low vision.

Relationship between genetic polymorphisms of methylenetetrahydrofolate reductase and breast cancer chemotherapy response.

Activity of methylenetetrahydrofolate reductase (MTHFR), an enzyme involved in folate metabolism, is influenced by mutations in the corresponding gene, contributing to a decrease in 5,10-MTHF. Due to such polymorphisms, individuals differ in MTHFR enzyme activity and plasma folate levels. We investigated the relationship between two common MTHFR polymorphisms (C677T and A1298C) and breast cancer (BC) chemotherapy response. From February 2013 to January 2016, 148 advanced BC patients at the Center Hospital of Cangzhou were enrolled and treated with six different chemotherapy regimens. Subjects were genotyped using polymerase chain reaction-restriction fragment length polymorphism. Forty-one (27.7%), 70 (47.3%), and 37 (25.0%) patients carried the C/C, C/T, and T/T C677T genotypes, respectively; 101 (68.2%), 42 (28.4%), and 5 (3.4%) had the A/A, A/C, and C/C genotypes of A1298C, respectively. Total chemotherapy efficacy was 66.9% (99/148), with 7 (4.7%), 92 (62.2%), 36 (24.3%), and 13 (8.8%) cases showing complete response, partial response, no change, and progressive disease, respectively. Chemotherapy regimens did not differ in effectiveness (P > 0.05). Efficacy rates associated with C677T C/C, C/T, and T/T genotypes were 58.5, 58.6, and 91.9%, respectively, with T/T carriers exhibiting significantly better responses than the C/C (P < 0.05) and C/T groups (P < 0.05). Effectiveness among A1298C A/A, A/C, and C/C carriers was 70.6, 64.3, and 0.0%, respectively, but no difference was established between these genotypes in this regard (P > 0.05). The MTHFR C677T genotype may be associated with BC chemotherapy response, and could be of great value in guiding individualized treatment for this disease.

CYP19 gene polymorphisms and the susceptibility to breast cancer in Xinjiang Uigur women.

In this study, the relationship between CYP19 gene polymorphisms and breast cancer in Xinjiang Uigur women was investigated. A case-control study was designed to compare 112 Uigur breast cancer patients with 139 Uigur healthy controls. Individuals were genotyped for the CYP19 rs10046 polymorphism using polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP). Accordingly, the relationship between the rs10046 polymorphism and the susceptibility of Xinjiang Uigur women to breast cancer was analyzed. Given that the allele at the rs10046 site varies between C and T within the CYP19 gene, the frequency distribution of the C and T allele in breast cancer subjects were 48.2 and 51.8% respectively, and 47.5 and 52.5% in control cases. Moreover, the frequency distribution of the TC, CC, and TT genotype were 26.8, 42.9, and 30.4% in breast cancer cases, but 18.0, 59.0, and 23.0% in control cases (P < 0.05). Risk factors within the Uigur population for breast cancer included an age ≥ 50 years old, a BMI ≥ 25 kg/m(2), and a parity ≥ 2. Conversely, an abortion and the CYP19 rs10046 TC genotype were protective factors. Menopause was another independent risk factor for breast cancer in Uigur women after the correction for age, BMI, age at first parity, pregnancy, and breastfeeding. In conclusion, breast cancer in Xinjiang Uigur women is closely connected with the age, BMI, parity, abortion, and CYP19 rs10046 polymorphisms. The TC genotype and an abortion can reduce the risk of the breast cancer disease in Uigur women.