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Objective: To analysis the risk factors for major adverse cardiovascular event (MACE) in pregnant women with valvular heart disease (VHD) and to construct a risk prediction model. Methods: The clinical data of 245 pregnant women with VHD who were hospitalized in Beijing Anzhen Hospital from January 1, 2012, to June 1, 2023 were retrospectively analyzed, including general information, pre-pregnancy and pregnancy-associated cardiac conditions, and MACE. Univariate analysis and logistic regression models were employed to identify risk factors for MACE during pregnancy among pregnant women with VHD. Furthermore, a predictive model was constructed and internal validation was conducted using bootstrap techniques. Results: (1) Among 245 pregnant women with VHD, the incidence of MACE was 18.0% (44/245), and the most common MACE was heart failure (61.4%, 27/44). The mitral valve was the most frequently affected valve (64.9%, 159/245). Prior to pregnancy, the most common type of valve surgery undertaken was mechanical valve replacement, representing 31.4% (77/245) of surgeries. In contrast, among those pregnant women who did not undergo valve surgery before pregnancy, the most common lesion type was mitral regurgitation (17.6%, 43/245). (2) Comparing the maternal and infant outcomes of warfarin, low molecular weight heparin (LMWH) and LMWH sequential with warfarin, the fetal loss rate (36%, 15/42) and malformation rate (7%, 3/42) were the highest, but the MACE rate (12%, 5/42) was the lowest in warfarin group. The fetal loss rate (1/19), malformation rate (1/19) and artificial valve thrombosis rate (0) of LMWH sequential with warfarin were the lowest, and the fetal loss rate and artificial valve thrombosis rate of the three anticoagulation methods were statistically significant (all P <0.05). (3) There were no significant differences in gestational age, age of diagnosis of heart disease, weight at delivery, pre-pregnancy body mass index, proportion of multiparous women and chronic medical history between women with MACE and those without MACE (all P >0.05). (4) Binary logistic regression analysis identified the following as risk factors for MACE during the second trimester of pregnancy among pregnant women with VHD: pre-pregnancy cardiac symptoms, history of corrective surgery for congenital heart disease, pregnancy risk grade Ⅴ, anticoagulation with LMWH during pregnancy, and arrhythmia (all P <0.05). Based on the results of multivariate analysis, a receiver operating characteristic curve was constructed, with an area under the curve of 0.837, indicating good discriminative ability. The calibration plot demonstrated a close alignment between the standard curve and the calibration prediction curve, suggesting excellent calibration of the model. Conclusions: Pregnant women with VHD are at a high risk of experiencing MACE during gestation. Five risk factors, including pre-pregnancy cardiac symptoms, history of corrective surgery for congenital heart disease, pregnancy risk grade Ⅴ, anticoagulation with LMWH, and arrhythmia, could aid in identifying high-risk pregnant women.

Objective: To observe the changes of lung function and inflammatory factors in rat models of coal workers' pneumoconiosis at different time points. Methods: In June 2021, 96 healthy male SD rats with SPF grade were divided into 1, 3, and 6-month control group and dust staining group (coal dust group, coal silica dust group, quartz group) according to random number table method, with 8 rats in each group. After one week of adaptive feeding, a one-time non-exposed tracheal perfusion method (1 ml/ piece) was used. The dust dyeing group was given 50 g/L coal dust, coal silica mixed dust and quartz dust suspension, respectively, and the control group was given 0.9% normal saline solution. At 1, 3 and 6 months after perfusion, lung function was detected by animal lung function apparatus, then all lung tissues and alveolar lavage fluid were killed, and lung histopathological morphological changes were observed by HE staining, and the contents of interleukin (IL-1β), IL-18, IL-4 and IL-10 in alveolar lavage fluid were detected by ELISA. One-way analysis of variance was used to compare groups. Two factors (inter-group treatment factor (4 levels) and observation time factor (3 levels) ) were used in the analysis of the effects of inter-group treatment and treatment time on related indicators. Results: HE staining results showed that coal spot appeared in the lung tissue of coal dust group, coal spot and coal silicon nodule appeared in the lung tissue of coal dust group, and silicon nodule appeared in the lung tissue of quartz group. Compared with the control group, the forced vital capacity (FVC) and forced expiratory volume at 0.2 second (FEV(0.2)) of rats in the dust staining group had interaction between the treatment and treatment time ( P <0.05). With the increase of dust dyeing time, FVC and FEV(0.2) decreased significantly at 3-6 months of dust dyeing, and the maximum gas volume per minute (MVV) decreased significantly at 1-3 months of dust dyeing ( P <0.05). The lowest lung function index was in quartz group, followed by coal-silica group and coal-dust group. There were statistically significant differences in the main effect and interaction effect of the pro-inflammatory factor IL-18 among all groups in treatment and treatment time (IL-18: F =70.79, 45.97, 5.90, P <0.001), and interaction existed. The highest content of inflammatory factors in alveolar lavage fluid of all dust groups was quartz group, followed by coal silica group and coal dust group. There were significant differences in the main effect and interaction effect of anti-inflammatory factors between groups and treatment time (IL-4: F =41.55, 33.01, 5.23, P <0.001, <0.001, <0.001; IL-10: F =7.46, 20.80, 2.91, P =0.002, <0.001, 0.024), and there was interaction. The highest content of anti-inflammatory factor was in quartz group, followed by coal silica group and coal dust group. Conclusion: Lung function decreased and levels of inflammatory fators increased in rat models of coal workers' pneumoconiosis, with the quartz group being the most severely damaged. Lung function is mainly impaired in thrid-six months, and the content of inflammatory factors begins to change in first-thrid months. MVV are the earliest and most obvious in lung function. IL-18 is suitable for monitoring changes in the pro-inflammatory response of coal workers' pneumoconiosis, and IL-10 is suitable for monitoring changes in anti-inflammatory response.

Zhari Namco is situated in the alpine grassland belt of northwestern Xizang with a fragile ecological environment. As the third-largest lake in Xizang, there has been a long-term lack of research data concerning its basin water environment. In an effort to elucidate the surface water environment characteristics of the basin and the factors influencing them, an extensive investigation was conducted from August 2021 to June 2022, encompassing periods of high flow, low flow, and base flow. Further, the study also involved comprehensive assessments of the water chemistry characteristics and spatial-temporal variation in lake sampling sites of the basin that were not significant by using mathematical statistics, hydrochemical analysis, correlation analysis, and principal component analysis. The findings revealed the following： ① The water in the Zhari Namco Basin exhibited an alkaline nature, with dominant ionic compositions in the lake comprising Na + , SO 4 2- , and Cl - , whereas the rivers were primarily characterized by Ca 2+ , HCO 3 - , and SO 4 2- . ② The main pollutants exceeding established standards included sulfates, arsenic, chlorides, and total phosphorus. The study identified significant spatiotemporal variations in water quality. Temporally, the exceedance of sulfates, arsenic, and total phosphorus was most pronounced during high-flow periods, followed by that during low-flow and base flow periods, with chloride levels showing less temporal variation. Spatially, river water quality surpassed that of the lakes, with arsenic, total phosphorus, TDS, sulfate, chloride, K + , and Na + concentrations in lakes 1 to 2 orders of magnitude higher than those in rivers. Water qualities exceeding the established standard were primarily found in the lake, with less spatial variations within the lake itself. ③ Hydrochemical processes within the basin were found to be primarily influenced by natural phenomena, including evaporation-concentration and rock weathering. Various elements entered the lakes via surface runoff, where they continuously accumulated under the influence of evaporation-concentration processes, ultimately leading to exceedances. ④ Temporal variations in water quality were primarily attributed to increased elemental loss and intensified evaporation during high-flow periods. The spatial discrepancies in water quality were predominantly a consequence of the differing hydrodynamic conditions between flowing water bodies and enclosed water bodies.

High spatiotemporal resolution data on near-surface ozone concentration distribution is of great significance for monitoring and controlling atmospheric ozone pollution and improving the living environment. Using TROPOMI-L3 NO 2 , HCHO products, and ERA5-land high-resolution data as estimation variables, an XGBoost-LME model was constructed to estimate the near-surface ozone concentration in the Beijing-Tianjin-Hebei Region. The results showed that： ① Through correlation analysis, surface 2 m temperature （T2M）, 2 m dewpoint temperature （D2M）, surface solar radiation downwards （SSRD）, tropospheric formaldehyde （HCHO）, and tropospheric nitrogen dioxide （NO 2 ） were important factors affecting the near-surface ozone concentration in the Beijing-Tianjin-Hebei Region. Among them, T2M, SSRD, and D2M had strong correlations, with correlation coefficients of 0.82, 0.75, and 0.71, respectively. ② Compared with that of other models, the XGBoost-LME model had the best performance in terms of various indicators. The ten-fold cross-validation evaluation indicators R 2 , MAE, and RMSE were 0.951, 9.27 μg·m -3 , and 13.49 μg·m -3 , respectively. At the same time, the model performed well at different time scales. ③ In terms of time, there was a significant seasonal difference in near-surface ozone concentration in the Beijing-Tianjin-Hebei Region in 2019, with the concentration changing in the order of summer &gt; spring &gt; autumn &gt; winter. The monthly average ozone concentration in the region showed an inverted "V" trend, with a slight increase in September. The highest value occurred in July, whereas the lowest value occurred in December. In terms of spatial distribution, the near-surface ozone concentrations in the Beijing-Tianjin-Hebei Region during the months of February and March were generally at the same levels. In January, November, and December, there was a relatively insignificant trend of higher concentrations in the north and lower concentrations in the south. For the remaining months, the spatial distribution of near-surface ozone concentrations in this area predominantly exhibited a pattern of higher concentrations in the south and lower concentrations in the north. High-value areas were predominantly found in the plain regions of the southern part with lower altitudes, dense population, and higher industrial emissions； low-value areas, on the other hand, were primarily located in mountainous areas of the northern part with higher altitudes, sparse population, higher vegetation coverage, and lower industrial emissions.

Objective: To investigate the association between body composition and coronary artery calcification in patients with chronic kidney disease (CKD). Methods: This cross-sectional study enrolled patients with CKD hospitalized from May 2019 to April 2022 at Sun Yat-sen Memorial Hospital, Guangzhou, China. Skeletal muscle mass index and visceral fat area were measured by bioelectrical impedance analysis. Coronary artery calcification was assessed by computed tomography. Patients were divided into coronary artery calcification group and non-coronary artery calcification group according to the incidence of coronary artery calcification. Patients were categorized into tertile groups according to their skeletal muscle mass index and visceral fat area levels ranging from the lowest to the highest levels (T1 to T3). We defined skeletal muscle mass index≤30.4% as low muscle mass and visceral fat area≥80.6 cm 2 as high visceral fat based on the results of the restricted cubic spline graph. All individuals were divided into 4 phenotypes: normal body composition, low muscle mass, high visceral fat, and low muscle mass with high visceral fat. Spearman correlation analysis and logistic regression analysis were used to assess the association between skeletal muscle mass index, visceral fat area and coronary artery calcification. Results: A total of 107 patients with CKD were enrolled, with an age of (60.0±14.1) years, including 41 female patients (38.3%). Patients of coronary artery calcification group had lower skeletal muscle mass index ((32.0±4.8) vs. (34.3±4.8), P =0.016) and higher visceral fat area ((70.8±32.6) cm 2 vs. (47.9±23.8) cm 2 , P <0.001) than those of non-coronary artery calcification group. Patients in the T3 group of skeletal muscle mass index had a lower prevalence of coronary artery calcification (17 (48.6%) vs. 28 (77.8%)) and a lower coronary artery calcification score (0.5 (0, 124.0) vs. 12.0 (0.3, 131.0)) than those in the T1 group ( P <0.05). Similarly, patients in the T1 group of visceral fat area had a lower prevalence of coronary artery calcification (14 (40.0%) vs. 29 (80.6%)) and a lower coronary artery calcification score (0 (0, 3.0) vs. 37.0 (2.0, 131.0)) than those in the T3 group ( P <0.05). Likewise, patients with both low muscle mass and low muscle mass with high visceral fat had a higher prevalence of coronary artery calcification (11(78.6%) vs. 33 (47.8%); 15 (83.3%) vs. 33 (47.8%)) and a higher coronary artery calcification score (31.1 (0.8, 175.8) vs. 0 (0, 16.4); 27.6 (6.4, 211.4) vs. 0 (0, 16.4)) than those with normal body composition ( P <0.05). Spearman correlation analysis showed that skeletal muscle mass index was inversely correlated with coronary artery calcification score ( r =-0.212, P =0.028), and visceral fat area was positively correlated with coronary artery calcification score ( r =0.408, P <0.001). Multivariate logistic regression analysis showed that increased skeletal muscle mass index was inversely associated with coronary artery calcification prevalence (T2: OR =0.208, 95% CI: 0.056-0.770, P =0.019; T3: OR =0.195, 95% CI: 0.043-0.887, P =0.034), and reduced visceral fat area was inversely associated with coronary artery calcification prevalence (T1: OR =0.256, 95% CI: 0.071-0.923, P =0.037; T2: OR =0.263, 95% CI: 0.078-0.888, P =0.031). Consistently, both low muscle mass and low muscle mass with high visceral fat were associated with coronary artery calcification prevalence ( OR =6.616, 95% CI: 1.383-31.656, P =0.018; OR =5.548, 95% CI: 1.062-28.973, P =0.042). Conclusion: Reduced skeletal muscle mass index and increased visceral fat area are significantly associated with both the prevalence and severity of coronary artery calcification in patients with CKD.

Objective： To explore the effect of psychological nursing on the prognosis of male patients with urethral riding injury treated by ureteroscopic urethral catheter implantation (UCI)., Methods: This study included 63 male patients with urethral straddle injury treated in the General Hospital of Southern Theater Command from February 2020 to March 2023. We divided the patients into a control (n = 29) and an experimental group (n = 34) according to the odd- or even-numbered days of admission and treated them by ureteroscopic UCI. Meanwhile those of the former group received routine nursing care and the latter underwent psychological nursing intervention in addition. We obtained the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores of the patients, recorded their postoperative pain scores, catheter-removal time, hospitalization days, postoperative complications and overall recovery status, and compared the data collected between the two groups., Results: At 3 days after surgery, both the SAS and SDS scores were significantly lower in the experimental group than in the control (SAS: 45.2 ± 2.9 vs 50.4 ± 3.6, P< 0.05; SDS: 41.9 ± 2.5 vs 48.3 ± 4.0, P< 0.05), and so were the pain scores at 24 hours (6.2 ± 0.6 vs 6.8 ± 0.9, P< 0.05), 48 hours (4.9 ± 0.7 vs 6.1 ± 0.8, P< 0.05) and 72 hours after surgery (2.5 ± 0.6 vs 3.9 ± 0.9, P< 0.05). The hospitalization time was remarkably shorter in the experimental than in the control group (［14.1 ± 2.9］ vs ［16.1 ± 3.4］ d, P< 0.05), but there was no statistically significant difference in the time of postoperative catheterization between the two groups of patients (［19.3 ± 3.7］ vs ［19.6 ± 4.4］ d, P > 0.05). A 30-day postoperative follow-up found 2 cases of difficult urination in the control group but no complications in the experimental group., Conclusion: Ureteroscopic UCI is a safe, effective and minimally invasive treatment method for male urethral riding injury, and psychological nursing helps not only shorten the time of catheterization and hospitalization but also avoid postoperative complications.

To investigate the effects of different irrigation and nitrogen application modes on nitrogen gaseous loss in winter wheat farmland, we conducted a field experiment at Changqing Irrigation Experiment Station in Shandong Province, with two irrigation levels (80%-90% θ f (I 1 ) and 70%-80% θ f (I 2 )) and three nitrogen application levels (conventional nitrogen application of 240 kg·hm -2 (N 1 ), nitrogen reduction of 12.5% (N 2 ), and nitrogen reduction of 25% (N 3 )). The results showed that ammonia volatilization and nitrous oxide emission rate peak appeared within 2-4 days after fertilization or irrigation. The ammonia volatilization rate during the chasing fertilizer period was significantly higher than that during the basal fertilizer period. Compared with other treatments, the ave-rage ammonia volatilization rate of I 2 N 2 treatment during the chasing fertilizer period was reduced by 10.1%-51.6%, and the average nitrous oxide emission rate over the whole growth period was reduced by 15.4%-52.2%. The ammonia volatilization rate was significantly positively associated with surface soil pH value and ammonium nitrogen content, while the nitrous oxide emission rate was significantly positively associated with nitrate content in topsoil. The accumulation amount of soil ammonia volatilization and nitrous oxide emission ranged from 0.83-1.42 and 0.11-0.33 kg·hm -2 , respectively. Moderate reduction of irrigation water and nitrogen input could effectively reduce cumulative amounts of ammonia volatilization and nitrous oxide emission from winter wheat farmland. The cumulative amounts of ammonia volatilization and nitrous oxide emission under I 1 N 3 and I 2 N 2 treatments were signi-ficantly lower than those under other treatments. The highest winter wheat yield (5615.6 kg·hm -2 ) appeared in I 2 N 2 treatment. The irrigation water utilization efficiency of I 2 was significantly higher than that of I 1 , with the maximum increase rate of 45.2%. Compared with N 1 and N 3 treatments, the maximum increase rate of nitrogen fertilizer productivity and agricultural utilization efficiency in N 2 reached 15.2% and 31.8%, respectively. In conclusion, the treatment with 70%-80% θ f irrigation level and 210 kg·hm -2 nitrogen input could effectively improve the utilization efficiency of irrigation water and nitrogen fertilization and reduce gaseous loss from winter wheat farmland.

Perfluorinated compounds, especially Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), are widely detected in water environments in China. Considering the potential health risks of drinking water exposure routes, PFOA and PFOS have been added to the water quality reference index of the newly issued "Standards for Drinking Water Quality (GB5749-2022)", with limit values of 40 and 80 ng/L, respectively. This study analyzed and discussed the relevant technical contents for determining the limits of the hygiene standard, including the environmental existence level and exposure status of PFOA and PFOS, health effects, derivation of safety reference values, and determination of hygiene standard limits. It also proposed prospects for the future direction of formulating drinking water standards.

Objective: To establish the norms and clinical application standards of mass spectrometry method to measure vitamin D in capillary blood. Methods: Following the "Province-City-Hospital" sampling procedure, a cross-sectional sample of 1 655 healthy children under 7 years of age were recruited from 12 provinces, autonomous regions, or municipalities in China from November 2020 to December 2021. Both venous and capillary blood samples from the same individual were collected, for which serum 25(OH)D levels were measured by high-performance liquid chromatography-mass spectrometry (HPLC-MS/MS) method. Pearson correlation analysis and linear regression analysis were used to detect the correlation and determine a correction algorithm. The agreement was analyzed using Bland-Altman plot and Kappa statistic. The sensitivity and specificity were evaluated using receiver operating characteristic (ROC) curve method. Results: Venous and capillary 25(OH)D levels of 1 655 healthy children under 7 years of age were 74.25 (59.50, 92.00) and 68.75 (54.44, 86.25) nmol/L, respectively, showed a significant difference( Z =22.14, P <0.001) as well as a highly significant correlation between venous and capillary 25(OH)D levels( r =0.95, P <0.001). Linear regression analysis was then performed to determine the correction algorithm: lg(corrected capillary 25(OH)D)=0.13+0.95×lg(capillary 25(OH)D)( R 2 =0.90, P <0.001). The deviation between venous and corrected capillary 25(OH)D levels was (0.50±17.50) nmol/L, a difference value that did not reach statistical significance ( P >0.05). The cut-off values of capillary blood 25(OH)D values 30.00, 50.00, 75.00 nmol/L corresponding to venous blood 25(OH)D values were 26.59, 45.56, and 69.84 nmol/L, respectively. Good consistency was observed between venous and corrected capillary 25(OH)D levels in clinical diagnosis (Kappa value 0.68-0.81). Corrected capillary 25(OH)D showed a high clinically predictive value (area under curve 0.97-0.99,sensitivity 0.72-0.92,specificity 0.89-0.99). Conclusion: The standardized capillary HPLC-MS/MS method can be used to detect 25(OH)D levels in children clinically.

The application of straw biochar in farmland in Dongting Lake area can realize the resource utilization of straw and reduce environmental risk. In 2020, a rice pot experiment was conducted to investigate the effects of different biochar application levels on ammonia volatilization rate, cumulative ammonia volatilization, pH value, and NH 4 + -N concentration in surface water. Six levels of reed ( Miscanthus lutarioriparius ) biochar amount, i.e. , 0%, 1%, 2%, 4%, 6% and 8% of soil weight of the 0-20 cm column, were applied in two typical paddy soils in sou-thern China, i.e ., reddish clayey soil derived from quaternary red soil and granitic sandy soil derived from granite. Compound fertilizer was applied at a rate of 200 kg N·hm -2 . The results showed that biochar application resulted in significant differences in the rate and cumulative amount of ammonia volatilization between the two soils and among different biochar treatments. For the granitic sandy soil, peak ammonia volatilization under different biochar treatments appeared at the second day after fertilization, which was decreased by 23.6%-53.4%. For the reddish clayey soil, peak ammonia volatilization appeared between the 7th to 13th day after fertilization, which increased with biochar addition level. The rate of ammonia volatilization from the granitic sandy soil was generally higher than that from the reddish clayey soil. For the granitic sandy soil, addition of <4% biochar could inhibit the ammonia volatilization and cumulative volatilization amount, with the greatest reduction (46.9%) at the treatment with 2% biochar addition. The addition of biochar did not affect the pH value of surface water at the early stage of rice growth. For the reddish clayey soil, the pH value and NH 4 + -N concentration in the surface water increased with biochar addition level, resulting in the increases of ammonia volatilization rate and cumulative volatilization amount by 1.3-10.5 times. Biochar addition level was the key factor affecting ammonia volatilization from the two soils. Elovich equation could well fit the variation trend of cumulative ammonia volatilization with time for the two soils, with the correlation reaching extremely significant level for each treatment. Overall, the application of reed biochar could suppress ammonia volatilization from the granitic sandy soil which was nearly neutral in acidity, while would promote ammonia volatilization via increasing pH value and NH 4 + -N concentration of surface water for the acidic reddish clayey soil. Therefore, appropriate dosages of reed biochar should be selected for different types of soil in order to reduce nitrogen loss.

Objective: To explore current vitamin D status and influential factors of vitamin D deficiency and insufficiency among children under 7 years of age in 11 provinces, autonomous regions or municipalities of China. Methods: According to the "province-city-hospital" sampling technical route, a total of 1 531 healthy children under 7 years of age were sampled from 11 provinces, autonomous regions or municipalities in China by the cluster random sampling method from November 2020 to November 2021. The demographic information, family conditions, behavior and living habits and feeding behaviors were collected using unified questionnaire. Serum 25-hydroxyvitamin D(25(OH)D) levels were measured by liquid chromatography-tandem mass spectrometry. Serum 25(OH)D<30 nmol/L was considered deficient and 30-50 nmol/L was considered insufficient. With 25(OH)D≤50 nmol/L as the dependent variable, multivariate Logistic regression was applied to analyze the association between vitamin D deficiency and insufficiency and potential influential factors. Results: The prevalence of vitamin D deficiency and insufficiency among children under 7 years of age in 11 provinces, autonomous regions or municipalities of China was 14.0% (215/1 531), 3.8% (25/664) and 21.9% (190/867) in 0-<3 and 3-<7 of age years, respectively. Compared to children aged 0-<3 years, children aged 3-<7 years had a 2.6-fold increased risk of vitamin D deficiency and insufficiency ( OR =3.60, 95% CI 1.93-6.72, P <0.001). Frequent sunlight exposure ( OR =0.46, 95% CI 0.29-0.73, P =0.001), vitamin D supplementation (sometimes, OR =0.33, 95% CI 0.21-0.51, P <0.001; daily, OR =0.20, 95% CI 0.11-0.36, P <0.001) and infant formula intake(4-7 times per weeks, OR =0.43, 95% CI 0.28-0.68, P <0.001) were protective factors for vitamin D deficiency and insufficiency. Conclusion: Vitamin D deficiency and insufficiency are common among children under 7 years of age in 11 provinces, autonomous regions or municipalities of China, which is affected by age, sunlight exposure, vitamin D supplementation and infant formula intake.

Due to the high altitude of plateau cities and strong ultraviolet radiation, the sources and fates of volatile organic compounds show unique characteristics. In this study, the atmospheric volatile organic compound (VOCs) samples were collected at two urban sites and one background site using tank sampling in Lhasa in 2019, and then the composition, concentration, and sources were characterized. The results showed that the average φ (VOCs) in Lhasa was 49.83×10 -9 , of which the proportion of alkanes was the highest (61%), followed by OVOCs (12%), halogenated hydrocarbons (9%), olefin (9%), aromatic hydrocarbons (5%), and alkynes (4%). The respective contributions of VOCs sources at urban sites, such as Barkhor Street and Radiation Station in Lhasa, were as follows:combustion (64% and 48%) > traffic emission (17% and 31%) > industrial emission (14% and 14%) > solvents and coatings (3% and 3%) ≈plant+background (2% and 4%). The contribution of combustion was large mostly due to local incense burning (especially at Barkhor Street) and heating emissions. Traffic emissions contributed about one third to the VOCs at Radiation Station, which is related to its proximity to the transportation hub and the storage and logistics center upwind. Industrial emissions have a regional impact on ambient VOCs. Under the synergistic influence of meteorology and emissions, VOCs concentration, composition characteristics, and source contribution showed obvious seasonal variations and site differences in the Lhasa area.

Objective: To evaluate the nutritional status by the Controlling Nutritional Status (CONUT) score and its association with the long-term prognosis in patients with acute heart failure (AHF). Methods: This prospective monocentric study consecutively enrolled patients admitted to our hospital for AHF from April 2012 to May 2016. Patients were divided into 3 groups based on the CONUT score at admission: normal (0-1), mild malnutrition (2-4) and moderate-severe malnutrition (5-12) groups. Baseline information was obtained and recorded within 24 hours after admission. All patients were followed up every 3 months by outpatient visit or telephone call until March 2019. The primary endpoint was all-cause mortality. The Kaplan-Meier survival curves and log-rank test were used to compare all-cause mortality between groups. Variables showing statistical significance in the univariate analysis were incorporated into multivariate Cox regression model to analyze the independent risk factors for all-cause mortality after discharge. Results: A total of 396 patients were enrolled in this study, including 114 patients with normal nutritional status, 200 patients with mild malnutrition and 82 patients with moderate-severe malnutrition. One hundred and fifty-eight patients died during a median follow-up of 34 (18, 46) months. The mortality was 32.4% (37/114), 39% (78/200) and 52.4% (43/82) in normal, mild malnutrition and moderate-severe malnutrition groups, respectively. The mortality was significantly higher in the moderate-severe malnutrition group than in normal nutrition group ( P <0.05). However, there was no significant difference in mortality between normal and mild malnutrition group as well as between mild and moderate-severe malnutrition group (both P >0.05). Kaplan-Meier curves indicated that patients with high CONUT score group was at higher risk of all-cause mortality compared with those with low CONUT score ( P =0.002). Cox proportional hazard analyses showed that the risk of all-cause mortality of moderate-severe malnutrition group was significantly higher than that of normal nutrition group ( HR =1.648, 95% CI 1.021-2.660, P =0.041). Conclusions: The CONUT score of patients with AHF at admission is associated with the long-term prognosis. High CONUT score is an independent risk factor for all-cause mortality in AHF patients after discharge.

Allergic transfusion reaction (ATR) caused by plasma transfusion is one of the main adverse transfusion reactions, and severe allergic reactions may even endanger the patient's life. Currently, ATR is mainly prevented and controlled by drug prevention and symptomatic treatment, and there still lack of preventive measures such as in vitro experiments. It has been shown that mast cells and basophils are the main effector cells of allergic reactions, and histamine is one of the main mediators of IgE-mediated allergic reactions. Some experiments can be used to identify patients with allergies or plasma components containing allergens, such as detection of serum-specific IgE, IgA, anti-IgA antibody, tryptase and histamine, mast cell degranulation test, basophil activation test, and so on. The basophil activation test can also be used for functional matching of plasma in vitro. Research of in vitro experiment of ATR is good for directing the precise infusion of plasma, reducing waste of resources, and avoiding the risk of blood transfusion. As a pre-transfusion laboratory test for clinical use, in vitro experiment of functional matching provides a new way to prevent ATR.

Objective: To analyze the clinical data of pregnant women complicated with cardiovascular disease in our center in the past 10 years, and to explore the trend of incidence, clinical diagnosis, and treatment of the disease. Methods: Clinical data of pregnant women with cardiovascular disease who delivered in Beijing Anzhen Hospital, Capital Medical University from 2010 to 2019 were collected and analyzed retrospectively. According to the time of the establishment of multidisciplinary team (MDT) in the center, the pregnant women were divided into the first 5-year group (2010-2014) and the second 5-year group (2015-2019). The general data, the composition of pregnancy complicated with cardiovascular disease and the changes of maternal and infant outcomes of the two groups were analyzed. Results: (1) During 2010-2019, there were 2 267 cases of pregnancy complicated with cardiovascular disease (836 cases in the first 5-year group and 1 431 cases in the second 5-year group), with a total incidence of 10.2% (2 267/22 334). Among all kinds of cardiovascular diseases, arrhythmia (41.0%, 930/2 267) and congenital heart disease (38.2%, 865/2 267) were more common. (2) There were 212 cases (25.4%, 212/836) and 426 cases (29.8%, 426/1 431) classified as Ⅲ or Ⅳ by modified WHO cardiovascular risk classification in the first 5-year group and the second 5-year group, respectively, and the difference was statistically significant ( χ ² = 5.076, P= 0.024). Among all kinds of cardiovascular diseases, there were 111 cases (13.3%, 111/836) and 159 cases (11.1%, 159/1 431) with valvular disease in the first 5-year group and the second 5-year group, respectively. The change of the component ratio was -16.5% (the difference was significant when the absolute value of change>10%), showing a significant decreasing trend. Aortic disease was found in 16 cases (1.9%, 16/836) and 56 cases (3.9%, 56/1 431), respectively, with a significant upward trend of 105.3%. (3) The mortality rate of pregnant women with cardiovascular disease was 1.0% (22/2 267), and 1.2% (10/836) and 0.8% (12/1 431) in the first 5-year grouop and the second 5-year group, respectively. There was no significant difference between the two groups ( χ²= 0.702, P= 0.402). ICU occupancy rates in the first 5-year group and the second 5-year group were 25.6% (214/836) and 20.7% (296/1 431), respectively, and the difference between the two groups was statistically significant ( χ²= 7.306, P =0.007). There were no significant differences in cesarean section rate, mortality rate and incidence of adverse events between the two groups of pregnant women, and there were no significant differences in birth weight, preterm birth rate, mortality rate and asphyxia rate between the two groups of newborns (all P >0.05). Conclusions: Pregnancy complicated with cardiovascular disease is a common cause of adverse obstetric outcomes. There are various types of specific cardiovascular diseases, and the prognosis varies greatly. In recent years, the disease composition ratio has changed, and the severity and complexity of diseases have increased. Hierarchical management, MDT and individual management could improve the treatment level and reduce adverse outcomes.

Objective: To investigate the efficacy and safety of different stents assisted embolization in the treatment of subarachnoid hemorrhage(SAH) caused by V4 dissecting aneurysm of vertebral artery. Methods: The clinical data of 39 patients with spontaneous SAH V4 dissecting aneurysm treated at the Department of Neurosurgery, the Northern Theater General Hospital from January 2016 to June 2019 were analyzed retrospectively.There were 21 males and 18 females, aged (48±17) years(range:35 to 68 years).There were 24 cases of HUNT-HESS grade Ⅰ and 15 cases of grade Ⅱ.Among them, 20 cases were treated with single stent-assisted embolization, 9 cases with multi-stent-assisted embolization, 9 cases with semi-dense mesh-assisted embolization, and 1 case with dense-mesh stent-assisted embolization.The perioperative and postoperative complications, postoperative recurrence were collected. Results: Intraoperative complications included 2 cases of aneurysm rupture and 2 cases of acute thrombosis.All aneurysms were densely packed according to the angiography performed immediately after operation.Postoperative complications included 3 cases of long-term responsible vascular ischemia(modified Rankin score<2). The patients were followed up for 15.1 months(range: 12 to 29 months). At the last follow-up, aneurysms recurrence occured in 10 cases, the recurrence rate was 25.6%(10/39). There were 6 cases of recurrence and 2 cases of complications in 20 cases with single stent-assisted embolization, 3 cases of recurrence and 4 cases of complications in 9 cases with multi-stent-assisted embolization, 1 case of recurrence and 1 case of complications in 9 cases with semi-dense mesh stent. Conclusion: Endovascular treatment is feasible for patients with vertebral artery dissecting aneurysm, and the appropriate surgical method should be selected according to the vascular structure and the location of the aneurysm.

Objective: To explore the association between sleep duration, sleep quality and the prevalence of hypertension in the elderly aged 65 years and above. Methods: This study was conducted among the elderly in communities in Yiwu, China from April to July, 2019, and participants were recruited through physical examination in the hospital. Face-to-face interview was performed to obtain basic information. Sleep duration and sleep quality were evaluated by Pittsburgh Sleep Quality Index (PSQI). Associations between sleep duration, sleep quality and hypertension were evaluated by multivariate logistic regression analysis. Results: A total of 3 169 elderly persons, aged ≥65 years old, were included in the study. The overall prevalence of hypertension was 50.8%. The elderly with very poor sleep quality and short sleep duration accounted for 22.4% and 28.5%, respectively. After adjusting for demographic characteristics, socioeconomic status, lifestyle and health status, the OR of hypertension for the elderly with very poor sleep quality was 1.42 (95% CI : 1.12-1.80) compared with those with very good sleep quality. Compared with the elderly with sleep duration of 6-7 h a night, the OR of hypertension for those with sleep duration <6 h was 1.37 (95% CI : 1.15-1.65). As the sleep quality decreased, the risk for hypertension increased. An U-shaped association was found between sleep duration and risk of hypertension. Subgroup analyses showed that this association existed in both men and women, but only significant in the elderly aged <75 years. Conclusion: Poor sleep quality and short sleep duration were associated with risk for hypertension in the elderly.

Objective: To study the effect of MYD88 L265P mutation on the expression of PD-L1 in tumor cells and tumor microenvironment in diffuse large B-cell lymphoma (DLBCL), and to provide theoretical basis for immunotherapy for patients. Methods: Multiplex ligation-dependent probe amplification (MLPA) was used to detect the frequency of MYD88 L265P mutation in 72 cases of DLBCL diagnosed by pathologists in Cancer Hospital of Chinese Academy of Medical Sciences from August 2008 to May 2010. Expression of PD-L1 in tumor cells and tumor microenvironment in all samples was evaluated using PD-L1 (22C3) and PD-L1 (SP142) with Ventana automatic immunohistochemical (IHC) platform. The relationship between MYD88 L265P mutation and the expression of PD-L1 in DLBCL tumor cells and tumor microenvironment was assessed. Results: Of the 72 cases of DLBCL, MYD88 L265P mutation was detected in 15 (20.8%) cases. Nine cases with JAK2 amplification were excluded, and the remaining 63 cases of DLBCL were divided into MYD88 L265P mutant group ( n =14) and MYD88 L265P wild-type group ( n =49). IHC results showed that among the 14 cases of MYD88 L265P mutant groups, PD-L1 (22C3) was positive in 7 cases (7/14) of tumor cells and PD-L1 (SP142) was positive in 4 cases (4/14) of tumor microenvironment. Among the 49 cases of MYD88 L265P wild-type group, 9 cases (18.4%) were positive for PD-L1 (22C3) in tumor cells, and 38 cases (77.6%) were positive for PD-L1(SP142) in tumor microenvironment. In addition, among the 16 cases with PD-L1(22C3) expression in tumor cells, only 2 of the 7 cases with MYD88 L265P mutation were positive for PD-L1 (SP142) in tumor microenvironment. All 9 cases with wild-type MYD88 L265P were positive for PD-L1 (SP142) in tumor microenvironment. Statistical analysis showed that the expression level of PD-L1 (22C3) in tumor cells in the MYD88 L265P mutant group was significantly higher than that in the MYD88 L265P wild-type group ( P =0.017). The expression level of PD-L1 (SP142) in tumor microenvironment in the MYD88 L265P mutant group was significantly lower than that in the MYD88 L265P wild-type group ( P =0.001). Conclusions: MYD88 L265P mutation may play an important role in the regulation of PD-L1 expression in DLBCL tumor cells and tumor microenvironment. Further studies will provide a theoretical basis for immunotherapy of DLBCL patients with MYD88 L265P mutation.

Objective: To analyze the clinical features, genetic characteristics, treatment and follow-up results of patients with hydrocephalus caused by methylmalonic acidemia combined with homocysteinuria, and to discuss the optimal strategies for assessing and treating such patients. Methods: From January 1998 to December 2020, 76 patients with hydrocephalus due to methylmalonic acidemia combined with homocysteinuria in the Department of Pediatrics in 11 hospitals including Peking University First Hospital were diagnosed by biochemical, genetic analysis and brain imaging examination. The patients were divided into operation-group and non-operation-group according to whether they underwent ventriculoperitoneal shunt. The clinical features, laboratory examinations, genotype, and follow-up data were retrospectively analyzed. Data were compared between the two groups using rank sum test, and categorical data were compared using χ 2 test. Results: Among the 76 patients (51 male, 25 female), 5 were detected by newborn screening, while 71 were diagnosed after clinical onset, 68 cases (96%) had early-onset, 3 cases (4%) had late-onset. The most common clinical manifestations of 74 cases with complete data were psychomotor retardation in 74 cases (100%), visual impairment in 74 cases (100%), epilepsy in 44 cases (59%), anemia in 31 cases (42%), hypotonia or hypertonia in 21 cases (28%), feeding difficulties in 19 cases (26%) and disturbance of consciousness in 17 cases (23%). Genetic analysis was performed in 76 cases, all of whom had MMACHC gene variations, including 30 homozygous variations of MMACHC c.609G>A. The most common variations were c.609G>A (94, 62.7%), followed by c.658&#95;660del (18, 12.0%), c.567dupT (9, 6.0%) and c.217C>T (8, 5.3%). Therapy including cobalamin intramuscular injection, L-carnitine and betaine were initiated immediately after diagnosis. A ventriculoperitoneal shunt operation was performed in 41 cases (operation group), and 31 patients improved after metabolic intervention (non-operation group). There was no significant difference in the age of onset, the age of diagnosis, the blood total homocysteine, methionine, and urinary methylmalonic acid concentration between the two groups (all P >0.05). The symptoms of psychomotor development, epilepsy, and visual impairments improved gradually after a long-term follow-up in the operation group. Conclusions: Hydrocephalus is a severe complication of methylmalonic acidemia combined with homocysteinuria. The most common clinical manifestations are psychomotor retardation, visual impairment, and epilepsy. It usually occurs in early-onset patients. Early diagnosis and etiological treatment are very important. Hydrocephalus may improve after metabolic intervention in some patients. For patients with severe ventricular dilatation, prompt surgical intervention can improve the prognosis.

Purpose: To analyze the nutritional status of patients with malignant oral and maxillofacial neoplasms complicated with diabetes mellitus during perioperative period., Methods: Sixty-four patients with malignant oral and maxillofacial neoplasms complicated with diabetes mellitus were collected. Fasting venous blood of patients was extracted on the morning of the day before surgery and then at the 1st, 3rd and 7th day after surgery, respectively. The hemoglobin (Hb), total protein (TP), pre-albumin (PA), lymphocyte count (L), creatinine (Scr), uric acid (UA), urea nitrogen (BUN), glomerular filtration rate (EGFR&#95;EPI&#95;C), white blood cells (WBC) of the patients were detected. The intake of enteral nutrition on the 7th day after operation was investigated. The correlation between nutritional status and the length of stay was analyzed. SPSS 23.0 software package was used for statistical analysis., Results: Compared with the indicators before surgery, the values of TP, ALB, PA, Hb were decreased significantly after surgery in all groups(P<0.05). The level of TP on postoperative day 7 was significantly higher than that on postoperative day 1 and postoperative day 3(P<0.05). The PA level on the third day after surgery was significantly lower than that on the first day after surgery(P<0.05). The Hb level on the 7th and 3rd day after surgery was significantly lower than that on the 1st day after surgery (P<0.05). The level of L decreased significantly in each group after surgery compared with the level before surgery(P<0.05), and gradually increased in each group after surgery, with significant difference among each two groups (P<0.05). Compared with preoperative value, blood Scr was significantly decreased in all groups after surgery (P<0.05), the UA level after surgery was significantly lower than the preoperative level in all groups(P<0.05), and at the 3rd day after surgery was significantly lower than at the 1st day after surgery(P<0.05). After surgery, the eGFR&#95;EPI&#95;c level was significantly higher than the level before surgery in all groups (P<0.05), and at the 7th day after surgery was significantly higher than at the 1st day after surgery (P<0.05). The level of WBC in all patients after surgery was significantly higher than that before surgery(P<0.05), and the level at the 3rd and 7th day after surgery was significantly higher than that at the 1st day after surgery(P<0.05). At the 7th day after surgery, the energy and protein intakes of the patients were significantly lower than the recommendations. There was positive correlation between preoperative BMI and TP, ALB levels at the 1st postoperative day and the TP level at 3rd postoperative day(P<0.05). There was no direct correlation between preoperative BMI and the length of postoperative hospital stay (P>0.05). The length of postoperative hospital stay was negatively correlated with the age and negatively with TP and ALB levels at the 1st postoperative day(P<0.05)., Conclusions: Early postoperative nutritional status of patients with malignant oral and maxillofacial neoplasms complicated with diabetes mellitus decreased significantly. The energy and protein intakes of the patients are significantly lower than the recommendations. The length of postoperative hospital stay is negatively correlated with early postoperative nutritional status and age.

Objective: To observe the clinical effect of treatment with follicular unit extraction (FUE) and transplantation in treating cicatricial alopecia. Methods: The retrospective cohort study was conducted. From January 2012 to January 2018, 56 patients (36 males and 20 females, aged (25±9) years, 1% to 30% alopecia area of the whole scalp area) who met the inclusion criteria visited the outpatient department of the First Affiliated Hospital of Xi'an Medical University. They were treated with FUE transplantation. The procedure of treatment was performed through the preoperative planning, follicular extraction, follicular preparation, punching recipient site and hair transplantation. The survival rate of hair and density of survived hair were calculated, hair growth and complication were observed. The evaluation was conducted through questionnaire survey by 4 levels: very satisfied, satisfied, not satisfied, and not at all satisfied with effects. Results: After a follow-up of 9 to 24 months, the survival rate of hair in 56 patients was (70±9)%, and the density of survived hair was (35±8) roots/cm 2 . In the evaluation of the curative effect after the first stage surgery, 34 cases (60.7%) were very satisfied, 16 cases (28.6%) were satisfied, and 6 cases (10.7%)thought the treatment was effective but not satisfied. Six unsatisfactory patients and 16 satisfactory patients underwent the second-stage transplantation, with 19 (86.4%) of them being very satisfied and 3 cases (13.6%) satisfied after the second-stage operation. None of the patients underwent the third-stage surgery. The transplanted hairs grew naturally, and there were no serious complications in all cases. Conclusions: FUE transplantation can effectively treat and improve cicatricial alopecia with less trauma, fewer complication, no scar in the donor site and rapid post-operative recovery, so it is worthy of clinical promotion.

The statistical model (log-normal model), niche models (Zipf model, broken stick mo-del, niche preemption model), and neutral model were used to fit the species-abundance distribution patterns based on the measurements of environmental factors and inventory data of trees with DBH≥1 cm in a 1.5 hm 2 plot in the primary forest (PF) and a 1.5 hm 2 plot in the secondary forest (SF). The results showed that species-abundance distribution was affected by habitat heterogeneity in Q. aliena var . acutiserrata forest. Topography had a predominant impact on the species-abundance distribution in PF. Species distribution was affected by both neutral and niche processes, with neutral process having a less prominent effect in large convexity habitats. While the neutral model was rejected by the K-S and Chi-square test in low convexity habitats, the species-abundance distribution satisfied the assumption of niche theory. Niche process and neutral process were equally important in the community in areas with steep slopes, while niche differentiation was the dominant in flat areas. In SF, the main factors affecting species distribution were soil nutrients. The niche process was the mainly ecological process affected species-abundance distribution in habitats with high soil available phosphorus, while the niche and neutral processes existed simultaneously in habitats with low soil phosphorus availability. There was a significant scale effect on the species-abundance distribution pattern of Q. aliena var . acutiserrata forests in Taibai Mountain. The niche and neutral processes could protect the species-abundance distribution at the 20 m×20 m scale in PF, while the niche process could explain the species-abundance distribution at the 40 m×40 m and 70 m×70 m scales. The niche and neutral processes combined acted on the species abundance distribution at the 20 m×20 m, 40 m×40 m and 70 m×70 m scales in SF, with niche process being more important than neutral process. Moreover, besides the scale and habitat heterogeneity, the species-abundance distribution patterns of Q. aliena var. acutiserrata forests differed significantly between primary forest and secondary forest under anthropogenic disturbance.

Objective: To summarize the clinical characters and pregnancy outcome in pregnant women with history of atherosclerotic cardiovascular disease (ASCVD). Methods: A total of 14 pregnant women with pre-existing ASCVD admitted to Beijing Anzhen Hospital from October 2013 to May 2020 were enrolled as subjects, whose ASCVD disease status, clinical manifestations, treatment and pregnancy outcomes were collected and retrospectively analyzed. Results: The age of subjects at diagnosis of ASCVD was (31±7) years old. The main intervention before pregnancy was revascularization (10 cases), and the rest 4 cases were treated with medicine. The age of subjects at pregnancy was (36±5) years old. A total of 12 cases had risk factors of ASCVD. In early stages of pregnancy, there were 1 case with cardiac function level Ⅲ and 1 with cardiac function level Ⅳ. Abnormal ventricular wall motion and ventricular aneurysm formation were determined in 3 cases by echocardiography, one of which was complicated with moderate left ventricular ejection fraction impairment. Abnormal ST segment in 4 cases and sinus tachycardia in 1 case were found by electrocardiogram. Troponin (TNI) increased in 1 case. The serum low density lipoprotein cholesterol level (LDL-C) of these pregnant women at early stages of pregnancy was (2.3±1.0) mmol/L. A total of 9 pregnant women entered later stages of pregnancy, 1 of whom had chest tightness after slight activity. There were 4 cases with excessive weight gain and 2 cases with insufficient weight gain during pregnancy, and there were 1 case with cardiac function level Ⅲ and 1 case with mild impaired left heart function. The average level of LDL-C was (2.6±0.6) mmol/L in 5 pregnant women at their later stages of pregnancy. The main treat measures included anti-platelet therapy (aspirin, 75-100 mg/d) and healthy lifestyle interventions. Five pregnant women terminated their pregnancy at the early stage of pregnancy, and 9 full-term pregnant women underwent hysterotomy with intraoperative blood loss of 180-800 ml. Adverse cardiac events occurred in 2 cases and gestational diabetes was diagnosed in 3 cases during pregnancy, among which 2 cases were complicated with chronic hypertension and preeclampsia. The weight of 9 live newborns was (3 102±647) g, among which 2 were smaller than gestational age and 1 was of low birth weight. Conclusions: Women with established ASCVD before preynancy have risk of adverse cardiac events in pregnancy. Strengthening the management of high risk factors in pregnancy is conducive to achieving a good pregnancy outcome.

Objective: To study the significance of the level of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in serum and bronchoalveolar lavage fluid (BALF), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and Sequential Organ Failure Assessment (SOFA) score in evaluating the conditions and prognosis of children with severe pneumonia., Methods: A total of 76 children with severe pneumonia who were admitted from August 2017 to October 2019 were enrolled as the severe pneumonia group. According to the treatment outcome, they were divided into a non-response group with 34 children and a response group with 42 children. Ninety-four children with common pneumonia who were admitted during the same period of time were enrolled as the common pneumonia group. One hundred healthy children who underwent physical examination in the outpatient service during the same period of time were enrolled as the control group. The serum level of sTREM-1, APACHE II score, and SOFA score were measured for each group, and the level of sTREM-1 in BALF was measured for children with severe pneumonia. The correlation of the above indices with the severity and prognosis of severe pneumonia in children was analyzed., Results: The severe pneumonia group had significantly higher serum sTREM-1 level, APACHEII score, and SOFA score than the common pneumonia group and the control group (P<0.05). For the children with severe pneumonia, the non-response group had significant increases in the levels of sTREM-1 in serum and BALF and SOFA score on day 7 after admission, while the response group had significant reductions in these indices, and there were significant differences between the two groups (P<0.05). Positive correlation was found between any two of serum sTREM-1, BALF sTREM-1, and SOFA score (P<0.05). APACHE II score was not correlated with serum sTREM-1, BALF sTREM-1, and SOFA score (P>0.05)., Conclusions: The level of sTREM-1 in serum and BALF and SOFA score can be used to evaluate the severity and prognosis of severe pneumonia in children.

Objective: To investigate the effects of liraglutide combined with vitamin D on high-fat-induced non-alcoholic fatty liver disease (NAFLD) mice and its potential mechanism. Methods: C57BL/6 mice were divided into control group, NAFLD model group, liraglutide group, vitamin D group and liraglutide combined with vitamin D group. Each group consisted of 10 mice. The control group was fed with normal diet for 12 weeks; the model group was fed with high-fat diet for 12 weeks; the liraglutide group, vitamin D group and combined group were fed with high-fat diet for 12 weeks, From the 9th week, the three groups of mice were intraperitoneally injected with liraglutide (0.6 mg/kg), vitamin D(250 mg/(kg·d) ) by gavage, and combination. After 12 weeks of feeding, the blood and liver tissues of mice in each group were collected for biochemical and pathological examination, and the phosphorylation level of AMP-activated protein kinase (AMPK) in liver tissues of mice in each group was detected by immunoblotting. Results: Liraglutide or vitamin D alone or in combination could improve liver lipid accumulation (triglycerides: 6.0±0.7 vs 3.8±0.3, 3.9±0.3 and 2.1±0.2, all P＜0.05; cholesterol: 1.4±0.5 vs 0.9±0.2, 0.8±0.2 and 0.5±0.1, all P＜0.05) and steatosis (NAFLD activity score: 2.4±0.3 vs 1.0±0.2, 0.9±0.1 and 0.6±0.1, all P＜0.05) in NAFLD mice. In addition, compared with liraglutide or vitamin D group, liraglutide combined with vitamin D treatment was more effective, and might be related to the regulation of insulin resistance and AMPK phosphorylation. Conclusion: The results showed that vitamin D could enhance the therapeutic effect of liraglutide on NAFLD induced by high fat, and may be related to the regulation of insulin resistance and AMPK phosphorylation.

To investigate the inhibitory effects of two xanthone compounds, 1-hydroxy-2,3,4,8-4 methoxy xanthone(here in after referred to as Fr15) and 1-hydroxy-2,3,4,6-4 methoxy xanthone(here in after referred to as Fr17), on the proliferation of hepatocellular carcinoma cells HepG2, and to further investigate their mechanism in combination with transcriptomics. Cell counting was used to detect the effects of two kinds of xanthone compounds Fr15 and Fr17(0, 0.03, 0.15, 0.3 mmoL·L~(-1)) on the proliferation of HepG2 cells; the effects of the two compounds Fr15 and Fr17 on HepG2 cell cycle were detected by flow cytometry; the changes of autophagosomes count in cells were observed under fluorescence microscope; the expression of autophagy marker proteins autophagy marker proteins SQSTM 1(p62) and microtubule associated protein 1 light chain 3 Ⅰ/Ⅱ(LC3 Ⅰ/Ⅱ) in the cells was detected by Western blot; the differentially expressed genes between the control group and the experimental group were analyzed by RNA-seq transcriptome sequencing; qRT-PCR was used to verify the differentially expressed genes in sequencing. The results showed that compounds Fr15 and Fr17 inhibited the proliferation of HepG2 cells with the increase of drug concentration and time. Flow cytometry showed that compounds Fr15 and Fr17 had little effect on HepG2 cell cycle. Fluorescence microscopy results showed that the number of autophagosomes in cells increased with the increase of drug concentration. Western blot showed that the expression of p62 protein was decreased and the expression of LC3-Ⅱ protein was significantly increased after drug addition. The results of RNA sequencing showed that 26 102 and 52 351 differentially expressed genes were obtained in Fr15 and Fr17 respectively. Analysis of KEGG showed that drug treatment had a great effect on autophagy pathway. qRT-PCR verified that 6 up-regulated genes were related to autophagy, and their trend was consis-tent with sequencing results, where all 6 genes showed an up-regulated trend. Two xanthone compounds Fr15 and Fr17 may inhibit proliferation of HepG2 cells by inducing autophagy.

Objective: This study aims to compare the efficiency of three kinds of microtube extraction devices, namely, instrument removal system (IRS), micro-retrieve and repair (MR&R) system, and MR&R system using modified microtube in removing separated instruments with different exposure lengths., Methods: After a cross-section platform model was established, the IRS, MR&R, and MR&R modified microtube system with sidewall window reduced to 0.20 mm were used to retrieve various separated instrument models, and the differences in extraction effects were statistically analyzed by Chi-square test. The separated instrument models were divided into two groups: stainless steel and nickel-titanium instrument groups. In total, 23 instruments were tested for three times each., Results: When the exposed length of separated instrument was 0.50 mm, the removal efficiency of the modified MR&R system group was significantly higher than those of the IRS and MR&R system groups (P<0.001). When the broken end of the fracture instrument was up to 1.00 mm, the success rates of the MR&R system and modified MR&R groups were significantly higher than that of the IRS group (P<0.01). No difference was observed among these three devices when the exposure length of separated instruments was 1.50 mm or higher., Conclusions: The MR&R and modified MR&R systems have good removal effect when the exposed length of separated instrument is small.

Objective: To observe the effect of heat-sensitive moxibustion at "Zhongwan" (CV 12) on serum growth hormone (GH) and pepsinogen (PG) in chronic atrophic gastritis (CAG) rats, and to explore the potential mechanism of heat-sensitive moxibustion for CAG., Methods: A total of 66 male SD rats were randomized into a blank group (12 rats) and a model establishment group (54 rats). No intervention was given in the blank group. Rats in the model establishment group were intervented with compound pathogeny method for 12 weeks to establish CAG model, which were further divided into a model group (11 rats), a vitacoenzyme group (11 rats) and a moxibustion group (22 rats). In the moxibustion group, suspending moxibustion was applied at "Zhongwan" (CV 12) for 40 min. After the intervention of moxibustion, 0.9% sodium chloride solution was given by gavage (2 mL·kg -1 ·d -1 ). According to the changes of tail temperature, rats in the moxibustion group were divided into a heat-sensitive moxibustion group (11 rats) and a non-heat-sensitive moxibustion group (8 rats). The vitacoenzyme group was given vitacoenzyme as the same dose by gavage. The intervention was adopted once a day for 28 days. Changes of body weight were observed among the groups. Expressions of serum GH, PGⅠand PGⅡwere detected by ELISA, and the ratio of PGⅠand PGⅡ (PGR) was calculated. The morphological changes of gastric mucosa were observed by macroscopy and light microscope., Results: ①After modeling, the body weight of rats in the model establishment group was lower than the blank group ( P <0.01). Compared with the model group, the body weight of rats in the vitacoenzyme group, the heat-sensitive moxibustion group and the non-heat-sensitive moxibustion group was increased after intervention ( P <0.05), and there were no significant differences among the intervention groups ( P >0.05). ②Under macroscopy and light microscope, gastric tissue of rats after modeling showed dark red and pale gastric mucosa, lower plica and mucosal congestion. The glands of lamina propria were atrophied or disappeared with sparse and disordered arrangement, in which, lymphoid follicles and inflammatory cells could be observed. After intervention, morphology of gastric mucosa was improved in the vitacoenzyme group, the heat-sensitive moxibustion group and the non-heat-sensitive moxibustion group. ③Compared with the blank group, the serum levels of GH, PGⅠ, PGⅡ and PGR were decreased in the model group ( P <0.05, P <0.01). Compared with the model group, the serum levels of GH, PGⅠand PGⅡwere increased in the vitacoenzyme group, the heat-sensitive moxibustion group and the non-heat-sensitive moxibustion group ( P <0.05, P <0.01), the levels of PGR were increased without statistical difference ( P >0.05). Compared with the vitacoenzyme group and the non-heat-sensitive moxibustion group, the serum levels of GH and PGⅠwere increased in the heat-sensitive moxibustion group ( P <0.05)., Conclusion: Heat-sensitive moxibustion at "Zhongwan" (CV 12) can improve the morphology of gastric mucosa in chronic atrophic gastritis rats, its mechanism may be related to the up-regulation of serum GH and PGⅠ.

Objective: To compare the distribution characteristics of pressing sensitive acupoints on the body surface between bronchial asthma (BA) patients and healthy subjects, and to analyze the distribution rules of pressing sensitive acupoints in BA patients., Methods: Seventy BA patients and 70 healthy subjects were selected in this study. The pressing sensitive acupoints were checked with finger pulp and marked on human nerve segment graph. The numbers of pressing sensitive acupoints were counted and the positional relationship between distribution of pressing sensitive acupoints and the position of meridians and nerve segment was observed., Results: (1) The incidence rates of pressing sensitive acupoints in BA patients group and healthy subjects group were 91.4% (64/70) and 15.7% (11/70) respectively, and the BA patients group was higher than the healthy subjects group ( P <0.01). (2) The top 3 meridians with pressing sensitive acupoints occuring in BA patients were bladder meridian of foot- taiyang , lung meridian of hand- taiyin and large intestine meridian of hand- yangming , and the most frequent pressing sensitive acupoints were Feishu（BL 13）, Xinshu（BL 15）, Chize（LU 5） and Jueyinshu (BL 14). (3) The pressing sensitive acupoints in BA patients were distributed mainly on C 4 , C 6 and T 1 -T 6 nerve segment., Conclusion: Pressing sensitive acupoints have a close correlation with physical condition, and there is a close relation between pressing sensitive acupoints distribution and corresponding meridians and nerve segments in BA patients.

A pot experiment was carried out to simulate soil contaminated by sulfamethoxazole at different concentrations. The community structure of soil microorganisms was investigated using Illumina high-throughput sequencing, and 64 subtypes of antibiotic resistance genes (ARGs) resistant to six classes of antibiotic were also analyzed by PCR and droplet digital PCR. The results showed that soil contamination with sulfamethoxazole had no significant effect on fungal diversity after 120 days ( P >0.05) whereas bacterial diversity was significantly reduced ( P <0.05). The microbial community structure of the contaminated soil changed significantly, with the dominant bacterial and fungal genera being significantly different from the control soil. Sulfamethoxazole contamination resulted in an increase in ARG diversity, and the abundance of the sulfonamide resistance gene sul1 increased significantly ( P <0.05). However, the abundance of the sulfonamide resistance gene sul2 , the quinolone resistance genes floR and cmlA1 , and the tetracycline resistance genes tet ( 34 ), tetG2 , tetG1 , tetM , and tetA/P did not show significant changes in the contaminated soil ( P >0.05).

Ca 2+ is an important microbial growth factor that can affect the activity, flocculation, and sedimentation of activated sludge. In order to study the roles of Ca 2+ in the activated sludge system, the activity changes of ammonium oxidizing bacteria (AOB) and nitrite oxidizing bacteria (NOB) were analyzed using the specific oxygen uptake rates (SOUR AOB and SOUR NOB ). The changes in composition and structure of extracellular polymeric substances (EPS) were analyzed using Fourier transform infrared spectroscopy (FTIR) and three-dimensional excitation emission fluorescence spectroscopy (3D-EEM). The effects of Ca 2+ on the nitrification activity and microbial metabolites were investigated. The results showed that when the Ca 2+ concentration increased from 0.45 mmol·L -1 to 3 mmol·L -1 , SOUR AOB and SOUR NOB increased from 6.3 mg·(g·h) -1 to 10.4 mg·(g·h) -1 and from 2.3 mg·(g·h) -1 to 3.7 mg·(g·h) -1 , respectively. The EPS concentrations increased from 68 mg·g -1 to 93 mg·g -1 , and the flocculation ability (FA) of the sludge was improved. When the Ca 2+ concentration was higher than 3 mmol·L -1 , SOUR AOB and SOUR NOB both decreased. The FA was maintained at about 30%, and the particle size of the sludge continued to increase. Based on FTIR analysis, the main components of EPS were always amino, amide Ⅰ, and carboxyl with an increase in Ca 2+ concentration. Based on EEM analysis, the composition of loosely-bound (LB)-EPS did not change, and humic acid substances appeared in the tightly-bound (TB)-EPS at low nitrification rates. Low concentrations of Ca 2+ promoted nitrification activity and flocculation of the sludge. However, high concentrations of Ca 2+ led to a decline in the sludge nitrification activity.

Objective: To explore the value of contrast-enhanced CT combined with texture analysis in differentiating pancreatic cancer from mass-forming pancreatitis in pancreatic head. Methods: A retrospective study collected 21 patients with pancreatic head mass-forming pancreatitis confirmed by surgery or biopsy and 47 patients with pancreatic ductal adenocarcinoma confirmed by surgery. The patients visited the Affiliated Hospital of Nanjing University of Chinese Medicine and the First Affiliated Hospital of Wannan Medical College between January 2014 and December 2017. Gender, age and CT findings were collected. The parenchymal phase was selected for texture analysis. The minimum absolute shrinkage and selection operator (LASSO) method was applied for dimensionality reduction.Two independent sample t -tests or Mann-Whitney U test were used for continuous variables based on the Shapiro-Wilks normality test results. Categorical variables were tested by Chi-square or Fisher test. By multivariable regression analysis, CT findings, CT texture analysis, CT findings combined with texture analysis prediction models were established. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of individual indicators and each prediction model. The Delong test was used to compare the area under the curve (AUC) of each model. Results: The CT findings prediction model consisted of CT value of lesion on pancreatic parenchymal phase and pancreatic duct penetrating sign. The texture analysis prediction model consists of root mean square and low grey level run emphasis&#95;angle135. The AUC of them were not statistically different ( Z= 0.150, P> 0.05). The combined predictive model had the better diagnostic performance (AUC 0.944, sensitivity 83.0%, specificity 95.2%, +LR 17.43, -LR 0.18) than CT sign prediction model ( Z= 2.008, P< 0.05) and texture analysis prediction model( Z= 2.236, P< 0.05) were significantly different. Conclusions: The CT findings model and the texture analysis model have equivalent diagnostic performance in the differentiation of mass-forming pancreatitis and pancreatic cancer. The enhanced CT combined with texture analysis model has the best diagnostic efficiency and can further improve the diagnostic ability.

Objective: To investigate the curative effect of antiviral therapy and related factors influencing the curative affect in children with immune-tolerant phase chronic hepatitis B. Methods: From May 2014 to April 2015, 46 children with chronic hepatitis B, aged 1 to 16 years with immune-tolerant phase were enrolled as the treatment group. All cases in the treated group either received interferon alpha (3-5 MIU/m(2), once daily) in lamivudine combination (if HBV DNA decreased < 2 log(10)) or repeatedly received interferon-alpha alone (if HBV DNA decreased >2 log(10)) for 12 weeks. Interferon was discontinued at 72 weeks and followed-up period was continued with lamivudine for 24 weeks. At the same time, data of 23 cases of untreated children with immune-tolerant phase chronic hepatitis B were collected as the control group. The treatment group and the control group were divided into two age groups: 1-7 years old and 7-15 years old. Data measurements were compared using t-test, analysis of variance and single factor analysis methods, and the count data were analyzed by χ (2) test. Multiple logistic regression analysis was used to analyze the effects of different factors on response. Results: (1) There were 22 cases aged 1-7 years in the treatment group (47.8%) and 12 cases aged 1-7 years in the control group (52.2%). The cases of mother-to-child transmission (MTCT) in treatment and control group were 34 (73.9%) and 17 (73.9%), while children with normal baseline ALT in the treatment and control group were 18 (39.1%) and 10 (43.5%). (2) At the end of follow-up, 15 cases in the treatment group (32.6%) had HBeAg serological conversion. Among them, nine (19.6%) cases had HBsAg clearance or HB-Ag seroconversion with anti-HBs, and one (2.2%) case had HBsAg clearance, but both HBeAg and anti-HBe were positive. In the control group, one case had HBV DNA lower than the lower limit of detection level, and one case had HBeAg seroconversion without HBsAg clearance. (3) At the end of follow-up, the seroconversion rates of HBeAg in patients aged 1 to 7 years and patients aged 7 to 15 years were 45.5% and 20.8%, respectively ( P = 0.078) and the clearance rates of HBsAg were 36.4% and 8.3% ( P = 0.023). The serum conversion rates of normal and abnormal baseline alanine aminotransferase levels were 5.6% and 50.0% ( P = 0.005), and the clearance rates of HBsAg were 5.6% and 32.1% ( P = 0.077), respectively. There was no statistically significant difference in gender, mother-to-child transmission, HBV DNA genotyping and baseline HBsAg level in antiviral efficacy among children ( P > 0.05). (4) HBsAg and HBeAg clearance occurred in 100% of patients at the end of follow-up who had HBsAg < 3 000 IU/ml at 24 weeks of treatment. (5) Multivariate logistic regression analysis showed that serum HBeAg conversion rate had relation with non-MTCT transmission and abnormal baseline alanine aminotransferase. Furthermore, HBsAg clearance rate was associated with the age of children. Conclusion: Sequential combination of interferon and lamivudine with a prolonged course can improve the HBV DNA negative conversion rate, HBeAg seroconversion rate, HBsAg loss rate and mild ALT abnormalities at baseline in children under the age of 7 years with immune-tolerant phase chronic hepatitis B.

Objective: To analyze the clinicopathological features and differential diagnosis of interdigitating dendritic cell sarcoma (IDCS). Methods: The clinical pathological features of 7 IDCS were analyzed. Among them, the follow-up results of 6 cases were available. Results: Among the 7 IDCS patients, 4 cases were male and 3 were female. The age of the patients ranged from 26 to 69 years.Three cases were originated from lymph nodes and 4 cases were originated from skin, stomach, adrenal gland and mesentery, respectively. Microscopically, the tumor cells presented as fascicular and storiform proliferation and infiltrated by lymphocytes. The tumor cells were short-spindle or ovoid, with indistinct border of cytoplasm. The immunohistochemistry results showed that tumor cells were S-100, Vim, CD68 and CD163 positive, and AE1/AE3, EMA, CD117, CD34, Desmin, SMA, CD1α, CD21, CD23, CD35, HMB45, Melan-A, MelanPan and ALK negative.The BRAF mutation and clonal rearrangement of T and B cells were not detected. Among the follow-up period of 7 IDCS patients, 3 occurred disease progressions. Conclusions: IDCS is extremely rare with unique pathological features, and its lesion is not limited to the lymph node. The IDCS patients with extensive lesions may have worse prognose. The differential diagnosis of IDCS includes other histiocytic and dendritic cell neoplasms, malignant melanoma and soft tissue neoplasms.

Purpose: To explore the correlation between dietary nutrient intake and PG-SGA score in patients with oral cancers before radiotherapy., Methods: Sixty-five patients with oral cancers treated in Shanghai Ninth People's Hospital were selected. The 72-hour dietary survey method was used to understand the food intake of the patients. PG-SGA was used to make quantitative scoring of the nutritional status of the patients. SPSS 23.0 software package was used for data analysis., Results: The number of severe malnutrition cases in male patients was significantly higher than that in female patients (P＜0.05). Energy, fat and fat energy ratio, carbohydrate and carbohydrate energy ratio from diet in good nutrition/mild malnutrition group, moderate malnutrition, severe malnutrition patients were over reference intake of dietary nutrients for Chinese residents; protein intake and protein energy ratio were greater than reference intake of nutrients for Chinese people. There was no significant difference among the three groups. The selenium intake of the well-nourished/mildly malnourished, moderately malnourished and severely malnourished groups was 67.15, 81.04 and 81.59 μg; vitamin E was 27.81, 30.88, 26.40 mg α-TE; vitamin C was 150.19, 159.81, 183.71 mg; retinol was 904.65, 1401.51, and 1373.81 μg RAE, respectively. Niacin was 12.97, 18.76 and 14.27 mg NE, respectively, reaching or exceeding the reference intake. There was no significant difference among the three groups. In male patients, dietary energy and niacin intake were negatively correlated with PG-SGA score (P<0.05)., Conclusions: Patients with oral cancers have a high incidence of malnutrition before radiotherapy, and the average intake of dietary energy, protein, fat, carbohydrates and micronutrients such as selenium, vitamin E, vitamin C, retinol and niacin reached or exceeded the reference intake. Energy and niacin intake were negatively correlated with PG-SGA score in male patients.

Objective: To investigate the association of the grades of histologic prostatic inflammation (HPI) with prostate cancer in biopsy specimens for male patients with total serum PSA (tPSA) of 4－10 μg/L., Methods: We performed prostate biopsy for 200 patients with tPSA of 4－10 μg/L from January 2015 to December 2017. We determined the location, extent and intensity of HPI and analyzed the correlation of the grades of HPI with the risk of prostate cancer., Results: Of the 200 biopsy specimens, BPH was detected in 169 (84.5%) and PCa in 31 (15.5%). Statistically significant differences were found in the positive rates of PCa between grades 1, 2 and 3 HPI, which were 19.3%, 25.8% and 54.8% based on the location (P < 0.01), 77.4%, 19.4% and 3.2% based on the extent (P < 0.01), and 51.6%, 29.0% and 19.4% based on the intensity of the lesion (P < 0.01), but not in the positive rates of BPH (P > 0.05). Multivariate logistic regression analysis showed that the risk of PCa was correlated negatively with the location (95% CI: 0.052－0.407, OR = 0.113, P = 0.001, r = －2.078) and extent of HPI (95% CI: 0.068－0.819, OR = 0.231, P = 0.023, r = －1.526) but not correlated with its intensity (95% CI: 0.796－4.193, OR = 1.804, P = 0.215). The positive predictive value, negative predictive value, sensitivity and specificity of the combined application of the location and extent of HPI in differentiating PCa from BPH were 51.2%, 90.3%, 91.5% and 50.8%, respectively., Conclusions: The location and extent of HPI are negatively while its intensity is not correlated with the risk of PCa. The grading of HPI based on its location and extent could help reduce the repetition of prostate biopsy.

Objective: To explore the feasibility of using computer-aided design(CAD) combined with 3D printing technology to repair and reconstruct the comminuted fracture of the posterior wall of acetabulum with osteochondral defect, to evaluate the biomechanical properties of composite titanium nitride bioceramic coatings with porous titanium alloy scaffolds and steel plate integrated implants., Methods: Based on CT images of continuous tomography, the computer-aided design software was used to construct a digital model of porous titanium alloy plate implant with a specially open cellular three-dimensional structure, and the three-dimensional implant was prepared with Ti6Vl4V powder by using the 3D printing technology, following by titanium nitride coating on its articular surface. The degree of matching and attachment between the implant and acetabulum were observed; Ansys software was used for finite element modeling to analyze the stress distribution, stress conduction and deformation displacement of the acetabulum of the normal group, the traditional group and the implant group under the same load state, and to verify the biomechanical properties of the implant., Results: The porous titanium alloy implant fit well with the acetabular bone defects, the shape of the plate was well attached to the bone surface, and it was rated as excellent according to the Matta criteria. The Von Mises stress peak of the implant group 13.38 MPa was close to the normal group 13.11 MPa and smaller than that in the traditional group 15.66 MPa. The Von Mises stress distribution and conduction of implant group were basically consistent with the normal group, slightly better than the traditional group; the maximum relative displacement of the implant was 0.166 mm, according to the finite element analysis., Conclusions: The porous titanium alloy stent plate implant with titanium nitride coating prepared by 3D technology has excellent matching degree and biomechanical properties; the anatomical reconstruction makes the stress distribution and conduction recovery well, close to normal hip joints, which provides a new option for the clinical treatment of comminuted posterior acetabular wall fractures with severe bone defects., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© 2019 by the China Journal of Orthopaedics and Traumatology Press.)

Objective: To compare the distribution regularity of the pressure-sensitive acupoints in patients with chronic non-atrophic gastritis (CNAG) and healthy subjects, so as to provide suitable acupoint combinations for clinical treatment., Methods: A total of 120 volunteer subjects including 60 CNAG patients (29 men and 31 women, (40.7±10.3) years at the average age) and 60 healthy subjects (28 men and 32 women, and (40.8±10.2) years at the average age) were enrolled in the present study. The pressure-sensitive acupoints were checked by a fixed operator using his finger pulp along the body trunk and the four limbs and marked on a prepared human dermatome graph. The number of pressing sensitive acupoints were counted, and the relationship between the distribution of the detected sensitive acupoints and the position of meridians and nerve segments was analyzed., Results: The incidence of pressure-sensitive acupoint in CNAG patients and healthy subjects were 86.7% and 15.0%, respectively. In 60 CNAG patients, the most frequently met sensitive acupoints were Xuehai (SP10), Zhongwan (CV13), and Zhongting (CV17) in sequence, mainly covering the Conception Vessel, Spleen Meridian of Foot-Taiyin (SP), and the Stomach Meridian of Foot-Yangming (ST). The sensitive acupoints presented a nerve-segmental distribution within T7-T10 and L3-L5., Conclusion: The pressure-sensitive acupoints present a nerve-segmental distribution and have a higher corresponding rate with some meridians related to the stomach, especially under diseased conditions.

Objective: To observe the effects of moxibustion at different temperatures (38 ℃ and 45 ℃) on blood lipoids and serum level of oxidized low density lipoprotein (ox-LDL) and nitric oxide (NO) in rats with hyperlipidemia, and to explore the correlation between regulating blood fat and anti-oxidative stress and protection of vascular endothelium of moxibustion at 45 ℃., Methods: According to random number table, 60 SD rats were randomly divided into a normal group, a model group, a moxibustion at 38 ℃ group and a moxibustion at 45 ℃ group, 15 rats in each group. The rats in the normal group received no treatment; the rats in the remaining three groups were fed with high-fat diet for 8 weeks to prepare rat models of hyperlipidemia. After successful modeling, the rats in the model group received no treatment; the rats in the moxibustion at 38 ℃ group and moxibustion at 45 ℃ group were treated with moxibustion at "Shenque" (CV 8) and "Zusanli" (ST 36), and the temperature was controlled at (38±1) ℃ and (45±1) ℃, respectively. The moxibustion was given for 10 min at each acupoint, once every two days, and totally 4-week treatment was given. After treatment, the levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured by using biochemical colorimetric method; the levels of ox-LDL and NO were measured by using ELISA method., Results: ① Compared with the normal group, the levels of TC, TG and LDL-C were significantly increased in the model group (all P <0.01); compared with the model group and moxibustion at 38 ℃ group, the levels of TC, TG and LDL-C were significantly decreased in the moxibustion at 45 ℃ group ( P <0.01， P <0.05); compared with the model group, the levels of TC, TG and LDL-C were insignificantly decreased in the moxibustion at 38 ℃ group (all P >0.05). ② Compared with the normal group, the level of ox-LDL was increased but that of NO was decreased in the model group (both P <0.01); compared with the model group and moxibustion at 38 ℃ group, the level of ox-LDL was decreased but that of NO was increased in the moxibustion at 45 ℃ group ( P <0.01, P <0.05); compared with the model group, the level of ox-LDL was decreased but that of NO was increased in the moxibustion at 38 ℃ group (both P <0.05)., Conclusion: Moxibustion at 45 ℃ has regulating effects on blood lipid in rats with hyperlipidemia, which can regulate blood lipid through various ways, such as anti-oxidative stress and protection of vascular endothelium.

Purpose: To study DNA methylation patterns of non-syndromic cleft lip/palate(NSCL/P) using bioinformatic methods, including methylated positions and regions., Methods: Whole blood DNA methylation data of NSCL/P samples was download from Gene Expression Omnibus(GEO) database, including 67 NSCL/P cases and 59 controls without birth defects. Data analysis included ①data cleaning, such as probes filtering, quality control and normalization; ②differential methylation analysis, including methylated positions and regions; ③Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis on differential methylated genes. R 3.4.3 software was used for data cleaning, differential methylated positions and regions analysis. DAVID6.8 tool was used for GO and KEGG analysis., Results: 814 differential methylated positions were detected (adjusted P＜0.001，|Δβ|＞0.125）, of which 178 were hypermethylated in NSCL/P patients, and 636 were hypomethylated. In addition, 386 differential methylated regions were identified (P＜0.05), of which 204 were hypermethylation regions and 182 were hypomethylation regions. GO analysis showed that 38 differential methylated genes were involved in 7 kinds of biological processes, 163 differential methylated genes were involved in 3 kinds of molecular functions, and 114 differential methylated genes were involved in 3 kinds of cellular components (P＜0.01). KEGG analysis showed that 59 differential methylated genes were involved in 9 kinds of signal pathways., Conclusions: Abnormal DNA methylation patterns of NSCL/P might be an important epigenetic mechanism affecting the development of NSCL/P. This study might contribute to the identification of identification of biomarkers and targeted interventions of NSCL/P.

In March 2017, a severely burned male patient aged 36 years with hypovolemic shock was admitted to our hospital. The patient received large quantities of antibiotics and blood products and repeated skin graft after admission, and then he suffered wound errhysis and throat congestion. The patient was healthy before without family history of bleeding or thrombosis disease. Laboratory tests showed that prothrombin time and activated partial coagulation time were remarkably prolonged, blood coagulation factor Ⅴ activity was extremely low, and the result of qualitative test of coagulation factor inhibitor was positive. Acquired blood coagulation factor Ⅴ deficiency was diagnosed. After application of dexamethasone (5 mg, twice per day) and infusion of fresh frozen plasma, blood coagulation indicators of patients recovered in 4 days, the result of qualitative test of coagulation factor inhibitor was negative, and bleeding symptoms were improved.

Objective: To investigate the diagnostic efficiency of HCY and NO/ET-1 to cognitive dysfunction in patients with severe obstructive sleep apnea hypopnea syndrome, and to interfere with the cognitive function of severe OSAHS patients. Method: Eighty-six patients with OSAHS were divided into mild group (22 cases), moderate group (23 cases), severe group (41 cases) and healthy physical examination group (50 cases). The levels of serum HCY and NO/ET-1 were compared between the four groups. The Montreal cognitive assessment scale was used to evaluate the incidence of mild cognitive impairment in severe OSAHS group, and the correlation between the level of serum HCY, NO/ET-1 and cognitive function in severe OSAHS group was analyzed. Result: The level of serum HCY in patients with severe OSAHS with cognitive impairment was(32.28±3.92)μmol/L, higher than that of the cognitive moderate group(26.34±4.05)μmol/L, and mild group (18.62±3.29)μmol/L. The level of serum NO/ET-1 in patients with severe OSAHS with cognitive impairment was (0.69±0.19), higher than that of the cognitive moderate group(2.76±0.28), and mild group (3.98±0.37), the difference was statistically significant ( P <0.05). In severe group, there was a negative correlation between the level of serum HCY and the score of MoCA and its subscores ( P <0.05), and there was a positive correlation between the total scores of NO/ET-1 and MoCA and their subscores ( P <0.05), and negative correlation between HCY and NO/ET-1 ( P <0.05). The area under the ROC curve of predicting serum HCY and NO/ET-1 levels in severe OSAHS patients with cognitive impairment were 0.788(95% CI 0.654-0.921) and 0.770 (95% CI 0.642-0.899). Conclusion: Serum HCY and NO/ET-1 were the factors influencing the formation of cognitive impairment in severe OSAHS patients. The level of HCY was negatively correlated with the degree of cognitive impairment, and NO/ET-1 was positively correlated with the degree of cognitive impairment., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

In order to improve the biological removal efficiency of nitrogen and phosphorus and bioflocculation performance of salt-containing wastewater, the effect of NaCl salinity on the efficiency of denitrification and phosphorus removal in the anoxic zone of an A 2 /O process was investigated. Fourier transform infrared spectroscopy (FTIR) and X-ray photoelectron spectroscopy (XPS) were used to analyze the composition and structure of extracellular polymeric substances (EPS) in activated sludge of the anoxic zone, to discern the effect of salinity on bioflocculation. Results showed that when NaCl salinity was 0-5 g·L -1 , flocculation ability (FA) in A 2 /O anoxic zone was about 44% and the sludge particle size was 45.5 μm. EPS content increased from 52.3 mg·L -1 to 62 mg·L -1 and protein (PN)/polysaccharide (PS) remained at 2.1. When NaCl salinity increased from 10 g·L -1 to 40 g·L -1 , bioflocculation of sludge significantly decreased. FA decreased from 40% to 22% and sludge particle size decreased from 43.7 μm to 32.1 μm. EPS content increased from 76.5 mg·L -1 to 101.0 mg·L -1 and PN/PS decreased from 1.5 to 1.3. Based on FTIR analysis, with increase in salinity, the main components of EPS were always amino, amideⅠ, and carboxyl. Based on XPS analysis, increasing salinity led to charge transfer of some groups (such as C, O, and N groups) during the interaction between EPS and Na + , but its form did not change.

In order to improve the activity and working life of metal catalysts in the heterogeneous catalytic ozonation of organic wastewater, four kinds of Mn-Co/ceramic honeycomb (CH) catalysts with different mass ratios of Mn and Co were prepared by coating method using cobalt nitrate hexahydrate [Co(NO 3 ) 2 ·6H 2 O] and manganese nitrate [Mn(NO 3 ) 2 ] as precursors, respectively, and CH as the carrier. The structure of the catalysts was analyzed via X-ray diffraction (XRD), N 2 adsorption/desorption, field emission scanning electron microscopy (FESEM), and X-ray photoelectron spectroscopy (XPS). The mechanical properties of the catalysts were studied. The reaction kinetics model of O 3 alone and catalytic ozonation of the hydroquinone were established and catalytic ozonation performance of catalysts was investigated. The results showed that the crystal phase of Mn 0 Co 1 /CH belonged to CoAl 2 O 4 and that the crystal phase of the Mn-Co/CH catalyst (Mn 1 Co 1 , Mn 2 Co 1 , and Mn 3 Co 1 ) mainly belonged to Mn 3 O 4 and CoO. In particular, the Mn 1 Co 1 /CH catalyst had a large specific surface area of 190 m 2 ·g -1 , high pore volume of 0.25 cm 3 ·g -1 , and pore size of 4.8 nm. The highest catalytic activity was obtained when Mn∶Co was 1∶1 (Mn 1 Co 1 /CH catalyst). The catalytic activity of the Mn 1 Co 1 /CH catalyst was the highest, and removal efficiencies of hydroquinone and COD were 78% and 54%, respectively, using Mn 1 Co 1 /CH catalytic ozonation. The Mn-Co/CH catalyst had a high compressive strength (15.89-16.94 MPa). The degradation efficiency of hydroquinone decreased significantly after the addition of tert-butanol, which indicated that·OH played an important role in the Mn 1 Co 1 /CH catalytic ozonation. The catalytic ozonation process fitted the first-order kinetic model. The apparent rate constant k for O 3 alone was only 0.0306. Furthermore, the Mn 1 Co 1 /CH catalyst had the highest rate, with an apparent rate constant k of 0.0535 min -1 . The Mn-Co/CH catalyst was easy to industrialize owing to its lower consumption, excellent catalytic characteristics, and long working life.