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Background and Aims: Accurate preoperative prediction of microvascular invasion (MVI) and recurrence-free survival (RFS) is vital for personalised hepatocellular carcinoma (HCC) management. We developed a multitask deep learning model to predict MVI and RFS using preoperative MRI scans., Methods: Utilising a retrospective dataset of 725 HCC patients from seven institutions, we developed and validated a multitask deep learning model focused on predicting MVI and RFS. The model employs a transformer architecture to extract critical features from preoperative MRI scans. It was trained on a set of 234 patients and internally validated on a set of 58 patients. External validation was performed using three independent sets (n = 212, 111, 110)., Results: The multitask deep learning model yielded high MVI prediction accuracy, with AUC values of 0.918 for the training set and 0.800 for the internal test set. In external test sets, AUC values were 0.837, 0.815 and 0.800. Radiologists' sensitivity and inter-rater agreement for MVI prediction improved significantly when integrated with the model. For RFS, the model achieved C-index values of 0.763 in the training set and ranged between 0.628 and 0.728 in external test sets. Notably, PA-TACE improved RFS only in patients predicted to have high MVI risk and low survival scores (p < .001)., Conclusions: Our deep learning model allows accurate MVI and survival prediction in HCC patients. Prospective studies are warranted to assess the clinical utility of this model in guiding personalised treatment in conjunction with clinical criteria., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Aim: To evaluate the overall diagnostic performance of magnetic resonance imaging (MRI), different image features, and different image analysis methods in predicting hepatocellular carcinoma (HCC) with cytokeratin 19 (CK19) expression., Materials and Methods: A systematic literature search was performed to identify studies using MRI to predict HCC with CK19 expression between 2012 and 2023. Data were extracted to calculate the pooled sensitivity and specificity. Overall diagnostic performance was assessed using areas under the summary receiver operating characteristic curve (AUC). Subgroup analyses were conducted for specific image features and according to image analysis methods (traditional image feature, radiomics, and combined methods). Z-test statistics was used to analyse the differences in diagnostic performance between combined and individual methods., Results: Eleven studies with 14 datasets (1,278 lesions from 1,264 patients) were included. The overall pooled sensitivity, specificity, and AUC with corresponding 95% confidence intervals were estimated to be 0.72 (0.55, 0.85), 0.88 (0.80, 0.93), and 0.89 (0.86, 0.91) for MRI in predicting HCC with CK19 expression. Combined methods had higher sensitivity than image feature methods (0.86 versus 0.54, p=0.001), with no difference in specificity (0.85 versus 0.87, p=0.641). There were no significant differences between radiomics and combined methods regarding sensitivity (p=0.796) and specificity (p=0.535), respectively., Conclusion: MRI shows moderate sensitivity and high specificity in identifying HCC with CK19 expression. The application of radiomics can improve the sensitivity of MRI in identifying HCC with CK19 expression., (Copyright © 2023. Published by Elsevier Ltd.)

In 2006, 2014 and 2020, the positive rates of HBsAg in 560, 384 and 402 children aged 1 to 14 years were 4.5%, 2.6% and 2.5%, respectively, with no statistically significant differences ( P >0.05). The positive rate of anti-HBs was highest in 2014 (57.8%) and lowest in 2006 (34.1%) ( P <0.05). The positive rate of anti-HBc was highest in 2006 (15.7%), and decreased in 2014 (7.8%) and 2020 (5.7%) ( P <0.001). The timely rate of the first dose of hepatitis B vaccine for children in Lhasa in 2006, 2014 and 2020 was 7.7% (43/560), 50.3% (193/384) and 94.8% (381/402), respectively. The overall vaccination rates were 15.4% (86/560), 35.2% (135/384) and 96.0% (386/402), respectively, showing a trend of gradual increases (χtrend values were 718.63 and 589.59, both P values<0.001).

Background: To investigate the resistance-gene mutation of Mycoplasma pneumoniae (MP) in the bronchoalveolar lavage fluid of children with Mycoplasma pneumoniae pneumonia (MPP) and the clinical characteristics of refractory Mycoplasma pneumoniae pneumonia (RMPP) correlation., Methods: Forty-eight children with MPP were selected and placed in RMPP and non-RMPP groups based on their clinical status - whether they had worsening clinical symptoms, persistent fever and a worsening lung image. They were also separated into drug-resistance gene mutation and non-mutated groups using nucleic acid detection. The participants' data were collected on high-sensitivity C-reactive protein and MP-DNA loads, fever time, hospitalisation time, macrolide antibiotic application time and fever regression time after application. The differences in imaging manifestations were determined by using multivariate logistic regression to analyse the clinical characteristics of RMPP. Additionally, the correlation between drug-resistance gene mutations and the clinical characteristics of RMPP was summarised., Results: Among the 48 MPP children, 31 (64.6%) had A2063G and/or A2064G gene mutation, 31 (64.6%) had RMPP and 23 (74.2%) had drug-resistance gene mutation. The children in the drug-resistance gene mutation group had higher high-sensitivity C-reactive protein and MP-DNA loads, longer fever time, hospitalisation time, macrolide antibiotic application time, fever regression time after application and extrapulmonary complications. There were more symptoms and more severe changes under bronchoscopy. The difference was statistically significant (P < 0.05). Logistic multivariate regression analysis showed that the mutation of drug-resistance genes had no significant correlation with RMPP., Conclusion: The mutation rate of drug-resistance genes in children with MPP is high, the inflammatory index and MP-DNA load are high, the course of the disease is long, and the changes under bronchoscopy are severe. The occurrence of RMPP is not only determined by drug-resistance genes but may also be the result of a combination of factors., (© 2022. The Author(s).)

Background: Pulmonary arterial hypertension maintains rapid cell proliferation and vascular remodeling through metabolic reprogramming. Recent studies suggested that circRNAs play important role in pulmonary vascular remodeling and pulmonary arterial smooth muscle cells proliferation. However, the relationship between circRNA, cell proliferation, and metabolic reprogramming in pulmonary arterial hypertension has not been investigated., Methods: RNA-seq and qRT-PCR reveal the differential expression profile of circRNA in pulmonary arteries of pulmonary arterial hypertension rat models. Transfection was used to examine the effects of circSMOC1 on pulmonary artery smooth muscle cells, and the roles of circSMOC1 in vivo were investigated by adenoassociated virus. Mass spectrometry, RNA pull-down, RNA immunoprecipitation, and dual-luciferase reporter assay were performed to investigate the signaling pathway of circSMOC1 regulating the metabolic reprogramming., Results: CircSMOC1 was significantly downregulated in pulmonary arteries of pulmonary arterial hypertension rats. CircSMOC1 knockdown promoted proliferation and migration and enhanced aerobic glycolysis of pulmonary artery smooth muscle cells. CircSMOC1 overexpression in vivo alleviates pulmonary vascular remodeling, right ventricular pressure, and right heart hypertrophy. In the nucleus, circSMOC1 directly binds to PTBP1 (polypyrimidine tract-binding protein), competitively inhibits the specific splicing of PKM (pyruvate kinase M) premRNA, resulting in the upregulation of PKM2 (pyruvate kinase M2), the key enzyme of aerobic glycolysis, to enhance glycolysis. In the cytoplasm, circSMOC1 acted as a miR-329-3p sponge, and its reduction in pulmonary arterial hypertension suppressed PDHB (pyruvate dehydrogenase E1 subunit beta) expression, leading to the impairment of mitochondrial oxidative phosphorylation., Conclusions: circSMOC1 is crucially involved in the metabolic reprogramming of pulmonary artery smooth muscle cells through PTBP1 and miR-329-3p to regulate pulmonary vascular remodeling in pulmonary arterial hypertension.

Background: Pulmonary hemorrhage (PH) in neonates is a life-threatening respiratory complication. We aimed to analyze the perinatal risk factors and morbidity with PH among very preterm infants in a large multicenter study., Methods: This was a multicenter case-control study based on a prospective cohort. Participants included 3,680 in-born infants with a gestational age at 24-32 weeks (birth weight <1,500 g) who were admitted between January 1, 2019, and October 31, 2021. All infants were divided into two groups, namely, the PH and no-PH groups, at a ratio of 1:2 according to the following factors: gestational age (GA), birth weight (BW), and the Score for Neonatal Acute Physiology with Perinatal extension II (SNAPPE II). Perinatal factors and outcomes were compared between the two groups by logistic regression analyses., Results: A total of 3,680 infants were included in the study, and the number of identified cases of PH was 262 (7.1%). The incidence was 16.9% (136/806) for neonates with extremely low BW (BW < 1,000 g) infants. The multivariate analysis showed that CPAP failure (OR 2.83, 95% CI 1.57, 5.08) was significantly associated with PH. PH was associated with a high likelihood of death (OR 3.81, 95% CI 2.67, 5.43) and bronchopulmonary dysplasia (BPD) (≥grade II) (OR 1.58, 95% CI 1.00, 2.48)., Conclusions: In this multicenter case-control study based on a prospective cohort, PH to be common among VLBW infants. PH is associated with significant morbidity and mortality, and perinatal management, especially CPAP failure. Respiratory management strategies to decrease the risk of PH should be optimized., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Wang, Zhao, Xu, Yu, Li, Zhang, Wen, Wu, Deng, Yang, Li, Ding, Wang, Zhang and Wang.)

Low expression of CTBP2 and CASP8AP2 correlated with poor outcome and predicted risk of relapse in pediatric B-cell acute lymphoblastic leukemia (B-ALL). This study aimed to investigate the molecular mechanism by which CASP8AP2 regulates LEF1 expression by interacting with CtBP2 and ZEB2 in Acute lymphoblastic lymphoma (ALL). There was an interaction between CASP8AP2, ZEB2, and CtBP2, and then the interaction between CtBP2 and ZEB2 was observed after downregulating the expression of CASP8AP2. The wild type (containing the ZEB2 binding site) or mutant (containing a mutant binding site) LEF1 gene promoter sequence was inserted into the pGL3-basic plasmid, and a dual-luciferase reporter gene detection system was used to observe how CASP8AP2, ZEB2, and CtBP2 regulate the transcription of the LEF1 gene. We conclude that CASP8AP2, CtBP2, and ZEB2 can all bind to the LEF1 gene promoter region and reduce the luciferase activity of the LEF1 promoter. Meanwhile, the interaction of ZEB2 and the LEF1 promoter was significantly weakened after downregulation of CASP8AP2. Knockdown of CASP8AP2 in the 697 cell lines resulted in the significant upregulation of the mRNA expression levels of the stemness-related genes CD44 , JAG1 , and SALL4 . In conclusion, CASP8AP2 is vital for the interaction between CtBP2 and ZEB2, inhibiting LEF1 and stemness-related genes expression ALL.Supplemental data for this article is available online at https://doi.org/10.1080/08880018.2022.2033369 .

Background: For initial respiratory management, continuous positive airway pressure (CPAP) is increasingly used for preterm infants, especially for gestational age less than 32 weeks. However, neonatologists are concerned about the potential risks of CPAP support failure., Objectives: To examine the association between different initial respiratory support modalities and the outcomes of preterm infants at <32 weeks of gestation across multiple neonatal intensive care units (NICU) in China., Methods: This study was carried out over a period of 12 months in 2018. Unadjusted relative risks (RR) for demographic and clinical characteristics were calculated for CPAP failure and CPAP success in the total cohort using log-linear model based on generalised estimating equations for clustered observations., Results: Among 1560 preterm infants delivered at <32 weeks, the incidence of CPAP failure was 10.3%. After adjustment for demographic and clinical factors, the relative risk of mortality (RR 7.54, 95% CI 5.56, 10.44), pneumothorax (RR 9.85, 95% CI 2.89, 61.53), pulmonary haemorrhage (RR 7.78, 95% CI 4.51, 14.64) and BPD (RR 3.65, 95% CI 3.65, 4.51) were considerably higher for infants in the CPAP failure group than those in the CPAP-S group. However, the risk of poor outcomes in CPAP failure infants was similar to that of those in the initial mechanical ventilation (MV) group., Conclusions: Continuous positive airway pressure failure was associated with an increased risk of mortality and major morbidities, including BPD, pulmonary haemorrhage and pneumothorax, and was comparable to the risk associated with initial MV., (© 2021 The Authors. Paediatric and Perinatal Epidemiology published by John Wiley & Sons Ltd.)

Background: Phimosis is one of the most common diseases in children. Early selection of appropriate treatment for phimosis in children is beneficial to the development of their reproductive organs and significantly improves the prognosis of phimosis in children. Although traditional circumcision is the most widely used, it has many disadvantages, including postoperative bleeding and incision infection, pain, obvious scars on the surgical incision, and unsatisfactory appearance. In addition, there is much controversy regarding treatment options and timing at home and abroad. Surgical procedures such as circumcision and cerclage for children with excessively long foreskin will greatly affect the normal life of children after the operation. Young children need general anesthesia, but this anesthesia carries a great risk., Aim: To design a new children phimosis dilatation retractor for children phimosis., Methods: The children phimosis was dilated with an elastic dilation frame, in order to expand the foreskin mouth and expose the penis head, and after that, the phimosis was cured., Results: A new type of phimosis dilatation retractor was designed, which can gently dilate the prepuce at multiple angles and in multiple directions at the same time. It has obtained the national patent for clinical application., Conclusion: The phimosis dilatation retractor based on the principle of elastically expanding the prepuce can achieve the purpose of expanding the phimosis. The clinical application shows that the effect of the children phimosis retractor is significant, which is worth promoting., Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose., (©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.)

To develop population - specific stature prediction equations from measurements of the lower limb bone in a contemporary Chinese. 303 individuals of Han group in Western China, including 201 females and 102 males were collected. The study sample was randomly divided into two subgroups. A calibration sample, which consisted of 171 females and 87 males, was used to develop the regression formula. A validation sample comprising the remaining 30 female and 15 male individuals was then used to test the predictive accuracy of the established formula. The regression equations were developed from intact bones and fragments of the femur, tibia and fibula, the maximum lengths of femur, tibia, and fibula were highly correlated with the stature. The maximum length of femur provide the most accurate result with the prediction accuracy of 3.84 cm for unknown sex, 4.00 cm in the male group, 3.45 cm in the female group, 3.61 cm in the group with age no more than 45, 3.45 cm in the group with age above 45. Moreover, the multiple regression equations were developed, and they portray a more accurate stature in instances in which the femur, tibia and fibula are available. This paper provides indications that the femur, tibia and fibula are important bones for stature estimation and they could be effectively used in forensic cases., (Copyright © 2019 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to the outbreak of pneumonia in Wuhan. The virus is highly infectious. Patients with cancer might be susceptible to the viral infection because of the immunosuppressive state cause by therapies on tumors., Case Presentation: We present the clinical features of four cancer patients who were infected with SARS-CoV-2 in late January of 2020 in our hospital. Cases 1 and 3 were diagnosed as mild and common type of coronavirus disease 2019 (COVID-2019) and survived from the viral infection. They acquired SARS-CoV-2 infection during their staying in hospital under radiotherapy and surgery of the tumors. Cases 2 and 4 suffered from severe type of COVID-19, and Case 2 was dead owning to the advanced age, uncontrolled chronic B cell lymphocytic leukemia and many other underlying diseases. The immunosuppressive state induced by liver transplantation and anti-rejection therapy might contribute to the severity of COVID-19 in Case 4, who suffered from hepatitis B related hepatocellular carcinoma. However, Case 4 was recovered from COVID-19 after a combination therapy against virus, bacteria and fungi, and also respiratory support. Nearly all patients showed a decrease in lymphocytes including total CD3 + T cells, B cells, and natural killer cells after infection of the virus., Conclusions: The severity of COVID-19 might be influenced by immune system state and underlying diseases in cancer patients. And the treatment of SARS-CoV-2 infection in cancer patients is challenged by the immunosuppressive state of these patients under chemotherapy or surgery.

Background: The objective of this prospective, multicentre, observational cohort study was to evaluate the association between admission hypothermia and neonatal outcomes in very low-birth weight (VLBW) infants in multiple neonatal intensive care units (NICUs) in China., Methods: Since January 1, 2018, a neonatal homogeneous cooperative research platform-Shandong Neonatal Network (SNN) has been established. The platform collects clinical data in a prospective manner on preterm infants with birth weights (BWs) < 1500 g and gestational ages (GAs) < 34 weeks born in 28 NICUs in Shandong Province. These infants were divided into normothermia, mild or moderate/severe hypothermia groups according to the World Health Organization (WHO) classifications of hypothermia. Associations between outcomes and hypothermia were tested in a bivariate analysis, followed by a logistic regression analysis., Results: A total of 1247 VLBW infants were included in this analysis, of which 1100 infants (88.2%) were included in the hypothermia group, 554 infants (44.4%) in the mild hypothermia group and 546 infants (43.8%) in the moderate/severe hypothermia group. Small for gestational age (SGA), caesarean section, a low Apgar score at 5 min and intubation in the delivery room (DR) were related to admission hypothermia (AH). Mortality was the lowest when their admission temperature was 36.5 ~ 37.5 °C, and after adjustment for maternal and infant characteristics, mortality was significantly associated with AH. Compared with infants with normothermia (36.5 ~ 37.5 °C), the adjusted ORs of all deaths increased to 4.148 (95% CI 1.505-11.437) and 1.806 (95% CI 0.651-5.009) for infants with moderate/severe hypothermia and mild hypothermia, respectively. AH was also associated with a high likelihood of respiratory distress syndrome (RDS), intraventricular haemorrhage (IVH), and late-onset neonatal sepsis (LOS)., Conclusions: AH is still very high in VLBW infants in NICUs in China. SGA, caesarean section, a low Apgar score at 5 min and intubation in the DR were associated with increased odds of hypothermia. Moderate/severe hypothermia was associated with mortality and poor outcomes, such as RDS, IVH, LOS.

Background: In December 2019, an ongoing outbreak of coronavirus disease 2019 (COVID-19) was first identified in Wuhan, China. The characteristics of COVID-19 patients treated in local hospitals in Wuhan are not fully representative of patients outside Wuhan. Therefore, it is highly essential to analyze the epidemiological and clinical characteristics of COVID-19 in areas outside Wuhan or Hubei Province. To date, a limited number of studies have concentrated on the epidemiological and clinical characteristics of COVID-19 patients with different genders, clinical classification, and with or without basic diseases., Aim: To study the epidemiological and clinical characteristics of COVID-19 patients in Hengyang (China) and provide a reliable reference for the prevention and control of COVID-19., Methods: From January 16 to March 2, 2020, a total of 48 confirmed cases of COVID-19 were reported in Hengyang, and those cases were included in this study. The diagnostic criteria, clinical classification, and discharge standard related to COVID-19 were in line with the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 7) released by National Health Commission and National Administration of Traditional Chinese Medicine. The presence of SARS-CoV-2 in pharyngeal swab specimens was detected by quantitative reverse transcription polymerase chain reaction. All the data were imported into the excel worksheet and statistically analyzed by using SPSS 25.0 software., Results: A total of 48 cases of COVID-19 were collected, of which 1 was mild, 38 were moderate, and 9 were severe. It was unveiled that there were 31 (64.6%) male patients and 17 (35.4%) female patients, with a female-to-male ratio of 1.82:1. The range of age of patients with COVID-19 was dominantly 30-49 years old [25 (52.1%) of 48], followed by those aged over 60 years old [11 (22.9%)]. Besides, 29.2% (14 of 48) of patients had basic diseases, and 57.2% (8 of 14) of patients with basic diseases were aged over 60 years old. The occupations of 48 COVID-19 patients were mainly farmers working in agricultural production [15 (31.5%) of 48], rural migrant workers from Hengyang to Wuhan [15 (31.5%)], and service workers operating in the service sector [8 (16.7%)]. The mean latent period was 6.86 ± 3.57 d, and the median was 7 [interquartile range (IQR): 4-9] d. The mean time from onset of symptoms to the first physician visit was 3.38 ± 2.98 (95%CI: 2.58-9.18) d, with a median of 2 (IQR: 1-5) d, and the mean time from hospital admission to confirmed diagnosis was 2.29 ± 2.11 (95%CI: 1.18-6.42) d, with a median of 2 (IQR: 1-3) d. The main symptoms were fever [43 (89.6%) of 48], cough and expectoration [41 (85.4%)], fatigue [22 (45.8%)], and chills [22 (45.8%)]. Other symptoms included poor appetite [13 (27.1%)], sore throat [9 (18.8%)], dyspnea [9 (18.8%)], diarrhea [7 (14.6%)], dizziness [5 (10.4%)], headache [5 (10.4%)], muscle pain [5 (10.4%)], nausea and vomiting [4 (8.3%)], hemoptysis [4 (8.3%)], and runny nose [1 (2.1%)]. The numbers of peripheral blood leukocytes, lymphocytes, and eosinophils were significantly reduced in the majority of the patients. The levels of C-reactive protein, fibrinogen, blood glucose, lactate dehydrogenase, D-dimer, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (γ-GT), myoglobin (MB), and creatine kinase (CK) were increased in 64.6%, 44.7%, 43.2%, 37.0%, 29.5%, 22.9%,20.8%, 21.6%, 13.6%, and 12.8% of patients, respectively. The incidence of ALT elevation in male patients was remarkably higher than that in females ( P < 0.01), while the incidences of AST, CK, and blood glucose elevations in severe patients were remarkably higher than those in moderate patients ( P < 0.05, respectively). Except for the mild patients, chest computed tomography showed characteristic pulmonary lesions. All the patients received antiviral drugs, 38 (79.2%) accepted traditional Chinese medicine, and 2 (4.2%) received treatment of human umbilical-cord mesenchymal stem cells. On March 2, 2020, 48 patients with COVID-19 were all cured and discharged., Conclusion: Based on our results, patients with COVID-19 often have multiple organ dysfunction or damage. The incidences of ALT elevation in males, and AST, CK, and blood glucose elevations in severe patients are remarkably higher., Competing Interests: Conflict-of-interest statement: All the authors declare that there is no conflict of interest., (©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)

Objectives: To establish a mathematical model of stature estimation for Sichuan Han females on the basis of the relationship between lower limbs and individual height, thus to provide evidence for forensic identification., Methods: Samples were collected from 171 Sichuan Han females. Large flat panel multi-function digital photography system was used to take the full-body X-ray films of the lower limbs. Indexes of long bones and stature of the subjects were measured, respectively. A linear regression analysis was carried out on the correlation between them, and a mathematical model of the stature calculation was established. Then the mathematical model was used to calculate the stature of another 29 Sichuan Han females to test its accuracy., Results: The maximum length of femur （ x 1 ） had the highest correlation with stature. A total of 13 linear regression equations were established （ P <0.05）, with the correlation coefficient （ R ） 0.821-0.897 and the standard error of the estimation （ SEE ） 2.994-3.812 cm. The backtesting showed that the equation y =41.604+1.205 x 1 +1.318 x 6 +2.444 x 12 +1.852 x 13 -2.388 x 14 had the smallest mean absolute deviation （2.485 years old） and the highest accuracy of ±2 SEE （92.9%）, and that the equation y =48.783+2.568 x 1 had the highest accuracy of ±1 SEE （60.7%）., Conclusions: The stature estimation is high by using the long bones of the lower limbs has high accuracy., 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 Forensic Medicine.)

Using sodium alginate hydrogel as skeleton, in combination with chitosan and magnetic Fe 3 O 4 , a new type of magnetic chitosan/sodium alginate gel bead (MCSB) was prepared. Adsorptive removal of Cu(II) from aqueous solutions was studied by using the MCSB as a promising candidate in environmental application. Different kinetics and isotherm models were employed to investigate the adsorption process. Based on Fourier transform infrared spectroscopy, field-emission scanning electron microscope, CHNS/O elements analysis, vibration magnetometer, and various means of characterization, a comprehensive analysis of the adsorption mechanism was conducted. The MCSB had a good magnetic performance with a saturation magnetization of 12.5 emu/g. Elemental analysis proved that the addition of chitosan introduced a considerable amount of nitrogen-rich groups, contributing significantly to copper adsorption onto gel beads. The contact time necessary for adsorption was optimized at 120 min to achieve equilibrium. Experimental data showed that the adsorption process agreed well with the Langmuir isotherm model and the pseudo-second-order kinetics model. The theoretical maximum adsorption capacity of MCSB for Cu(II) could reach as high as 124.53 mg/g. In conclusion, the MCSB in this study is a novel and promising composite adsorbent, which can be applied for practical applications in due course.

Induction of anaesthesia with target-controlled infusion of propofol may be achieved by stepwise increases in effect-site concentration until the patient loses consciousness (titration method), or by setting a high effect-site concentration target and observing the calculated effect-site concentration at loss of consciousness (standard method). When the estimated effect-site concentration at loss of consciousness is accurate, the difference between effect-site concentration at loss of consciousness and at recovery of consciousness should be small. This prospective, randomised, controlled trial was designed to compare this difference (effect-site concentration at loss of consciousness - effect-site concentration at recovery of consciousness) associated with the two techniques. Sixty-seven healthy patients undergoing elective hemithyroidectomy were recruited. Induction of anaesthesia was achieved using effect-site target-controlled infusion with the modified Marsh model and k e0 of 1.2 min -1 . The median (IQR [range]) difference between effect-site concentration at loss of consciousness and recovery of consciousness was significantly lower in patients in the titration group at 1.2 (0.8-1.5 [0.1-2.9]) μg.ml -1 compared with the standard group 2.1 (1.9-2.6 [0.2-3.6] μg.ml -1 ; p < 0.0001). There was a positive correlation between effect-site concentration at loss of, and recovery of, consciousness (R = 0.41, p = 0.016) in the titration group, which was not seen in the standard group (R = -0.15, p = 0.44). In conclusion, using the modified Marsh pharmacokinetic model, the titration method for target-controlled infusion propofol at induction of anaesthesia allows closer matching of propofol concentration to depth of anaesthesia than the standard method., (© 2018 Association of Anaesthetists.)

Background: Low expression of E2F3a and caspase 8 associated protein 2 ( CASP8AP2 ) are associated with poor prognosis of childhood acute lymphoblastic leukemia (ALL)., Methods: Dual-luciferase reporter assay and wild type as well as four mutated types of reporter plasmids were used to demonstrate the activation of E2F3a on CASP8AP2 transcription. The direct binding of E2F3a with the promoter of CASP8AP2 was shown by Chromatin Immunoprecipitation (ChIP). Cell proliferation activity and cell cycle were determined by MTS and flow cytometry in leukemic cells after treating with common chemotherapeutic drugs vincristine and daunorubicin., Results: In this study, we found that up-regulation of E2F3a in leukemic cells led to increased fraction of cells in S and G2/M phase, accelerated proliferation, and enhanced sensitivity to vincristine and daunorubicin. ChIP and luciferase assay indicated that E2F3a could directly bind to two fragments in the wild type of CASP8AP2 promotor (- 206 to - 69 and - 677 to - 507), and activate its transcription activity which was reduced in mutated promotors. The effect of E2F3a on chemotherapeutic sensitivity of leukemic cells could be reversed by down-regulating CASP8AP2 ., Conclusions: E2F3a could promote transcription and expression of CASP8AP2 . The effect of E2F3a on chemotherapeutic sensitivity of ALL cells was implemented by regulating CASP8AP2 expression to a great extent.

Objectives: To establish regression models of stature estimation for Sichuan Han female by the measurement of total vertebral column length in the frontal and lateral X-ray films of whole-spine., Methods: The frontal and lateral X-ray films of whole-spine were collected from 200 Sichuan Han females by large flat-panel multi-functional universal radiography and fluoroscopy system. The data and mean values of frontal and lateral total vertebral column length were measured and calculated in all the samples, respectively. The relationship of combined multi-markers and stature were analysed by linear regression analysis, and the mathematical models of stature estimation were established. The data of 30 new samples were selected and inputted for verifying the accuracy of the mathematical models., Results: The total vertebral column length showed a good correlation with stature, and the mean values of the frontal and lateral X-ray films of total vertebral column length had the highest correlation coefficients. Three established linear regression equation models were statistically significant （ P <0.05）, and the equation established with lateral total vertebral column length showed the highest accuracy., Conclusions: The stature estimation by the measurement of total vertebral column length has high accuracy., 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 Forensic Medicine.)

Objective: To analyze the comparation of national early warning score (NEWS), rapid emergency medicine score (REMS) and acute physiology and chronic health evaluation II (APACHE II) score in predicting prognosis of critically ill patients in emergency department (ED)., Methods: A retrospective study was conducted. Critically ill patients, aged > 16 years, hospitalized > 24 hours, and admitted to the ED of Nanhua Hospital Affiliated to South China University from January 2016 to June 2017 were enrolled. NEWS, REMS and APACHE II score were calculated based on the worst value of each index within 24 hours after emergency admission. The primary endpoint was 28-day mortality. The relationship between the three scoring systems and the prognosis of patients was analyzed. The predictive value of three scoring systems for the prognosis of critically ill patients in ED was analyzed by receiver operating characteristic curve (ROC)., Results: A total of 119 emergency severe patients were enrolled in the study, and the 28-day mortality was 21.0%. The scores of NEWS, REMS and APACHE II in the death group were significantly higher than those in the survival group (NEWS score: 9.40±3.19 vs. 5.72±2.35, REMS score: 12.64±4.46 vs. 7.97±3.28, APACHE II score: 26.64±6.92 vs. 16.19±5.48, all P < 0.01). With the increase of NEWS, REMS and APACHE II score, the 28-day mortality of patients gradually increased [28-day mortality of NEWS < 5, 5-6, ≥ 7 was 3.03% (1/34), 13.33% (4/34), 64.25% (20/51); 28-day mortality of REMS < 12, 12-16, ≥ 17 was 10.99% (10/91), 50.00% (11/22), 66.67% (4/6); 28-day mortality of APACHE II < 15, 15-24, ≥ 25 was 2.33% (1/43), 15.09% (8/59), 69.57% (16/23), respectively, all P < 0.01]. The ROC curve analysis showed that the areas under the ROC curve (AUC) of NEWS, REMS and APACHE II score for predicting the prognosis of emergency critically ill patients were 0.830 [95% confidence interval (95%CI) = 0.737-0.923], 0.782 (95%CI = 0.671-0.892) and 0.878 (95%CI = 0.800-0.956), respectively (all P = 0.000), and the accuracy of prediction was 57.4%, 48.6%, 65.4%, respectively., Conclusions: The scores of NEWS, REMS and APACHE II were useful in predicting prognosis of critically ill patients, with the highest accuracy of APACHE II forecast, followed by NEWS, and the lowest of REMS. After comprehensive consideration of cost-effectiveness, NEWS is more reliable in ED.

Objective: To analyze the clinical characteristics, pathological features and survival of patients with AIDS related non-Hodgkin's lymphoma (ARL) . Methods: The clinical data of 53 ARL cases diagnosed and received care at Zhongnan hospital of Wuhan University were retrospectively studied, and 106 controls were enrolled as control group according to 1∶2 for paired cases and control. SPSS 13.0 package was used for statistical analysis. Kaplan-Meier was applied to assess the survival probability. Results: The mean age of patients with ARL was 43 (11-67) years. Male versus female was approximately 4∶1. The median CD4(+) T cell count was (146±20) /ml. The Ann Arbor clinical classification showed that 52.8% of the cases were of stage Ⅲ and Ⅳ. Approximately 54.7% of the patients had elevated serum lactate dehydrogenase (LDH) . According to international prognosis index score, 64.2% of the patients were in high risk group. Diffuse large B-cell lymphoma (DLBCL) was the predominant histological subtype. Among 53 cases, 33 cases (62.3%) received combination of anti-HIV therapy and anti-NHL (CHOP) chemotherapy regimen, 8 cases (15.1%) only received anti-HIV therapy, and 12 cases (22.6%) asked for alleviative treatment. Median survival time was (6.0±1.3) months for ARL cases versus (48.0±10.0) months for controls ( P <0.05) . After eliminating cases who did not receive anti-lymphoma treatment, ARL cases showed a lower 1-year OS rates than control group (60.6% versus 83.0%) , but no difference about 2-, 3- and 5-year OS rates (53.5% versus 60.5%, 48.1% versus 45.9%, and 39.1% versus 27.5%, respectively) . Conclusions: ARL is more common in young adults; one-year mortality rate is high. Anti-HIV therapy combined with anti-NHL therapy could significantly improve the prognosis of ARL patients. CHOP regimen may be more suitable for ARL patients.

With secondary forest in the montane region of eastern Liaoning Province as research object, this paper analyzed the spatial distribution and scale effect of Gleason richness index, Simpson dominance index, Shannon diversity index and Pielou evenness index in a 4 hm 2 plot. The results showed that spatial distributions of the four diversity indices showed higher spatial heterogeneity. Variance of the four diversity indices varied with increasing scale. Coefficients of variation of the four diversity indices decreased with increasing scale. The four diversity indices of the tree layer were higher than those of the shrub layer, and the variation tendency varied with increasing scale. The results indicated that sampling scale should be taken into account when studying species diversity in the montane region of eastern Liaoning Province.

Objective: To evaluate the correlation between image quality and thoracic diameters, anteroposterior diameter (AP) and right-left diameter (RL) for the optimization of reducing radiation dose in coronary artery imaging with Dual-source CT., Methods: 118 patients underwent CT coronary artery imaging (CTCA) were divided into two groups (A and B) according to body mass index (BMI). There were 58 patients in group A with BMI values > or = 25 kg/m2 and < 30 kg/m2; and 60 patients in group B with BMI values < 25 kg/m2. Scan parameters: collimation 64 X 0.6 mm, reconstruction slice thickness 0.75 mm, reconstructin interval 0.7 mm, FOV 150-180 mm, the pitch adjusted according to heart rate automatically. CT imagings were obtained with tube voltage 100 kV, tube current 330 mAs (group A) and 100 kV, tube current 220 mAs (group B). The contrast-noise ratio (CNR), signal to noise ratio (SNR), as well as blind correlation test score values were calculated to establish the relationship among BMI, AP, RL and CNR, SNR., Results: RL of five levels in groups of A, B were correlated to CNRa (P < 0.05). In group A and B (except iii, iv level of Group A), AP were associated with CNRa (P < 0.05). In addition to ii, iv level of group A, v level of group B, BMI were associated with CNRa (P < 0.05). The correlation coefficient of CNRa and RL of group A except ii level was greater than that of CNRa and AP. The correlation coefficient of CNRa, SNRa and RL of group B was greater than that of CNRa, SNRa and AP. Except iii level, the correlation coefficient of CNRa, SNRa and AP of group A was greater than that of CNRa, SNRa and BMI. Except ii level, the correlation coefficient of CNRa and AP of group B was greater than that of CNRa and BMI., Conclusion: Thoracic diameter of RL can be used as a guider to select the appropriate scan protocol in the coronary imaging acqusition with dual-source CT.

This review summarizes the progress that has been made recently in the medicinal chemistry of cantharidin, a potent antitumor agent from traditional Chinese medicine. Thousands of analogs have been synthesized on the basis of cantharidin, a part of which shows excellent properties, in particular, norcantharidin and norcantharimide. Despite the enormous efforts made, the intriguing bioactivities, mechanism, indications, and their interplay are still ill-defined. This review provides our up-to-date understanding in connection with the therapeutic use, mechanism, structure-activity relationship (SAR) and interesting properties of cantharidin analogs. Considerable development in the design of cantharidin analogs, in combination with mechanistic studies, has laid a foundation for transforming novel antitumor drugs into the clinic.

Objective: To investigate the value of split-bolus 2-phase with virtual non-enhanced scan in CT urography., Methods: Eighty (80) patients with urinary obstruction were divided into two groups, group A was traditional CT urography scan, group B was split-bolus 2-phase with virtual non-enhanced scan. The scan sequence of group A included conventional scan first, then enhanced scan in arterial phase, parenchyma phase and excretion delayed phase after the injection of 100 mL contrast agent. The scan sequence of group B included conventional scan and enhanced scan following two bolus injection of contrast; the first injection of contrast was 40 mL, the second injection was 60 mL with 15-30 minutes delay, then enhanced scan was conducted in arterial and parenchymal phase, the parenchymal phase scan was performed with dual energy scanning sequence. The image quality of urinary collecting system, the detection of urinary obstructive lesion, and radiation dose were compared between the two groups., Results: Between the two imaging methods, the imaging quality of urinary system did not show significant difference, but radiation dose was statistically significant difference. The radiation dose of split-bolus 2-phase with virtual non-enhanced scan was only 55% of traditional CTU scan., Conclusion: Split-bolus2 phase with virtual non-enhanced scan could obtain the same image quality as tranditional CTU, while reducing the approximately half the radiation dose.

Objective: To evaluate the clinical value of low-dose chest pain protocol for cardiac and chest vascular imaging using dual-source computed tomography., Methods: 102 patients with requests for examinations of cardiac and thoracic blood vessels, were scanned in chest pain protocol for angiography. With heart electrical impulses dose control techniques, maximum tube current within the R-R interval was set up by different heart rate. Patients with a heart rate less than or equal to 75 beats/min were divided into two groups: regular-dose group (A) 28 patients; low-dose group (B) 25 patients. Patient with a heart rate of 76-120 beats/min were also divided into two groups: regular-dose group (C) 24 patients; low-dose group (D) 25 patients. The image quality of pulmonary artery, coronary artery and aortic were blind evaluated. The effective dose for each patient was calculated and group comparisons were made., Results: Every radiation dose gained satisfactory images. No differences in image quality were found between Group A and Group B, and between Group C and Group D (P > 0.05). The effective doses of Group A (7.09 +/- 0.95) mSv were significantly higher than those of Group B (5.01 +/- 0.34) mSv. The effective doses of Group C (4.79 +/- 0.91) mSv were significantly higher than those of Group D (2.48 +/- 0.43) mSv. CONCLUSION; For patients with acute chest pain and relatively stable heart rate, their cardiac and thoracic vessels can be shown clearly in images of low-dose chest pain protocol, which provides a rapid and clear diagnostic instrument.

Objective: To investigate the clinical value of dual-source computed tomography dual-energy Iodine overlay technique in the imaging diagnosis of acute necrotizing pancreatitis., Methods: The imaging data were retrospectively analyzed in 67 cases of acute necrotizing pancreatitis underwent contrast-enhanced dual-source dual-energy CT in portal venous phase. The CT imaging parameters, including the difference of CT value between pancreatic parenchyma and necrotic lesion, contrast-to-noise ratio of pancreatic parenchyma-to-necrosis, area of pancreatic necrosis and score of subjective diagnosis, were measured and assessed on CT images of 80 kV, 140 kV, weighted-average 120 kV as well as Iodine overlay., Results: The differences of CT value between pancreatic parenchyma and necrosis in the images of 80 kV, 140 kV, weighted-average 120 kV and Iodine overlay were (67.40 +/- 20.82) HU, (42.87 +/- 14.99) HU, (48.69 +/- 15.82) HU, (33.01 +/- 10.26) HU, respectively; contrast-to-noise ratios of pancreatic parenchyma-to-necrosis of each group were 8.36 +/- 3.58, 5.85 +/- 2.65, 7.68 +/- 3.51, 10.60 4.34; area of pancreatic necrosis of each group was (3.78 +/- 2.68) cm2, (3.28 +/- 2.59) cm2, (3.37 +/- 2.46) cm2, (2.42 +/- 1.98) cm2; the score of subjective diagnosis of each group was 3.88 +/- 0.33, 3.31 +/- 0.80, 3.58 +/- 0.66, 2.81 +/- 0.76, respectively. The four indexes in the images of Iodine overlay were significantly different from those of another three groups (P < 0.05). Contrast-to-noise ratio of pancreatic parenchyma-to-necrosis in the images of Iodine overlay was significantly higher than that of another three groups, while the difference of CT value, area of pancreatic necrosis and score of subjective diagnosis were lower. CONCLUSION; Dual-source CT dual-energy Iodine overlay is not helpful to improve subjective judgment in the diagnosis of pancreatic necrosis, but contributes to the display of hypoperfusion area around the necrosis.

Y2O3 acts as the matrix material when doped with different content of La2O3 for reducing sintering temperature and refining grains. The (Nd(0.01)La(x)Y(0.99-x))2O3 nanoparticles and transparent ceramics are fabricated by a combustion synthesis. The powder feature is characterized by TEM. The microstructure, mechanical properties and transmittance of the samples are examined by SEM, HV-1000 hardness tester and fluorescence analyzer respectively. The results show that the (Nd(0.01)La(x)Y(0.99-x))2O3 nanoparticles are homogeneous in size and nearly spherical with average diameter in the range of 40-60 nm. There are no other phases except the Y2O3 cubic phase in the (Nd(0.01)La(x)Y(0.99-x))2O3 nanoparticles. The grains of the samples significantly reduce with increasing La2O3 content. The hardness and fracture toughness increase rapidly first and then gradually tend to plateau with increasing La2O3 content. The transmittance of sample also increases gradually with increasing La2O3, the largest transmittance exceeds 77% when the La2O3 content is x = 0.12.

Objective: To investigate the clinical value of dual-source computed tomography dual-energy technology in the imaging diagnosis of acute necrotizing pancreatitis., Methods: Thirty-two cases with diagnosed acute necrotizing pancreatitis and underwent contrast-enhanced dual-source dual-energy CT in portal venous phase were retrospectively analyzed. Difference of CT value between pancreatic parenchyma and necrosis, contrast to noise ratio of pancreatic parenchyma-to-necrosis and score of subjective diagnosis were measured, calculated and assessed on CT images of 80 kV, 140 kV and weighted-average 120 kV., Results: The difference of CT value between pancreatic parenchyma and necrosis in the images of 80 kV, 140 kV and weighted-average 120 kV was (67.22 +/- 21.11) HU, (42.91 +/- 15.12) HU, (48.78 +/- 16.13) HU; contrast to noise ratio of pancreatic parenchyma-to-necrosis in the images of each group was 8.35 +/- 3.63, 5.89 +/- 2.67, 7.72 +/- 3.58; the score of subjective diagnosis in the images of each group was 3.87 +/- 0.34, 3.28 +/- 0.81, 3.56 +/- 0.67 respectively. Difference of CT value between pancreatic parenchyma and necrosis, contrast to noise ratio of pancreatic parenchyma-to-necrosis and score of subjective diagnosis were significantly different in three groups of images (P < 0.05). The three indexes at 80 kV were significantly higher than those of 140 kV and weighted-average 120 kV., Conclusion: At portal venous phase dual-sourcedual-energy enhancement CT, the demonstration of pancreas necrosis is better than those at 80 kV, 140 kV and weighted-average 120 kV in the diagnosis of acute necrotizing pancreatitis.

Objective: To investigate the incidence of hepatotoxicity in acquired immunodeficiency syndrome (AIDS) patients on combined anti-retroviral therapy (cART) containing nevirapine (NVP) and to assess the risk factors and its impact on cART., Methods: 330 AIDS patients from March 2003 to June 2008 at local county were enrolled and a retrospective study using Kaplan-meier survival and Multivariate logistic regression modeling was conducted., Results: 267 out of 330 patients received NVP based cART and 63 cases received EFV-based cART. The deference of prevalences of hepatotoxicity between the two groups is statistically significant (Chi2 = 6.691, P = 0.01). 133 out of 267 (49.8%) patients on NVP based cART had at least one episode of ALT elevation during a median 21 months (interquartile ranges, IQR 6, 37) follow-up time, amounts for 28.5 cases per 100 person-years. Baseline ALT elevation (OR = 14.368, P = 0.017)and HCV co-infection (OR = 3.009, P = 0.000) were risk factors for cART related hepatotoxicity, while greatly increased CD4+ T(CD4) cell count was protective against hepatotoxicity development (OR = 0.996, P = 0.000). Patients co-infected with HCV received NVP-based cART had the higher probability of hepatotoxicity than those without HCV co-infection (Log rank: Chi2 = 16.764, P = 0.000). 23 out of the 133 subjects (17.3%) with NVP related hepatotoxicity discontinued cART temporarily or shifted NVP to efavirenz., Conclusion: NVP related hepatotoxicity was common among ARV naive HIV infected subjects in our cohort. Baseline ALT elevation and HCV co-infection were associated statistically with the development of hepatotoxicity. Hepatotoxicity led to discontinuing cART temporarily or switching to other regimens in some subjects. It suggested that NVP should be used with caution in patients co-infected with HCV among whom anti-HCV therapy before cART initiation may contribute to minimizing the probability of NVP associated hepatotoxicity.

Y2O3 nanoparticles doped with different concentrations of Nd3+ were prepared by the coprecipitation method, and the Nd3+:Y2O3 transparent ceramics were fabricated by vacuum sintering at 1700 degrees C, under 1 x 10(-3) Pa for 6 h. The structural, morphological, and luminescence properties of the samples were characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM), scanning electron microscopy (SEM) and fluorescence analysis. The results show that the Nd3+:Y2O3 nanoparticles are homogeneous in size and nearly spherical, and the average diameter of the particles is in the range of 40-60 nm. There are no other phases except the Y2O3 cubic phase in the Nd3+:Y2O3 nanoparticles and transparent ceramics. Nd3+ dissolves completely in the Y2O3 cubic phase. The relative density of Nd3+:Y2O3 transparent ceramics is 99.7%, and the transmittance of the Nd3+:Y2O3 transparent ceramics exceeds 80% at the wavelength range.

Objective: To evaluate the accuracy of using 64-MDCT to assess right ventricular function., Methods: The ventricular function of 32 adult volunteers were assessed by ECG-gated 64-MDCT and MRI, which included right ventricular end-diastolic and end-systolic volume, stroke volume, and ejection fraction. Consistency between the two modalities was tested with Bland and Altman analysis and Pearson's correlation., Results: No significant differences were found in calculated RV volumes and EF between the two modalities (P = 0.29 to 0.66). Consistency was achieved in RV-EDV [(0.6 +/- 4.9) mL; r = 0.98)], RV-ESV [(-0.6 +/- 3.4) mL; r = 0.97], RV-SVC [(0.9 +/- 5.6) mL; r = 0.93, and RV-EFC (1.0 +/- 3.9) mL; r = 0.88]., Conclusion: ECG-gated 64-MDCT can accurately assess RV function.

Objective: To observe the effects of different concentrations of glucose and insulin in cell differentiation from bone marrow stem cells (BMSC) into osteoblasts (OB) and explore the acting mechanism of glucose and insulin in bone metabolism., Methods: The in vitro technique of cell culture was employed to separate, purify and cultivate BMSC from the tibia and femur of rats. Then the BMSCs were differentiated into osteoblasts under the inductions of different glucose concentrations (5.6, 25, 50 mmol/L) with or without the addition of insulin (0.6 microg/ml). Later the calcium nodule cell ratio of osteoblasts in alizarin red stain was observed microscopically to assay the mRNA expression of OB markers-ALP, BGP and Runx2 by real-time PCR., Results: With the increasing glucose concentrations, the number of red calcium nodules obviously decreased. PCR showed that the mRNA expression of ALP, BGP and transcription factor Runx2 decreased too. The difference was significant (P < 0.05). The differentiation of OB decreased with with the increasing glucose concentrations. The cell number of red calcium nodules obviously increased in the same glucose concentration groups. The mRNA expression of ALP, BGP and Runx2 also increased (P < 0.01). It hinted that insulin could enhance the differentiation of OB., Conclusion: Glucose can inhibit the differentiation from BMSC into OB. The inhibition is more sensitive along with the concentration increments. This may be one of the pathogenesises of diabetic osteoporosis. Insulin can enhance the differentiation from BMSC into OB. In addition, it can improve the inhibition of differentiation from BMSC into OB because of a high concentration of glucose.

Aim: To analyze the influence of human immunodeficiency virus (HIV) infection on the course of hepatitis C virus (HCV) infection., Methods: We performed a meta-analysis to quantify the effect of HIV co-infection on progressive liver disease in patients with HCV infection. Published studies in the English or Chinese-language medical literature involving cohorts of HIV-negative and -positive patients coinfected with HCV were obtained by searching the PUBMED, EMBASE and CBM. Data were extracted independently from relevant studies by 2 investigators and used in a fixed-effect meta analysis to determine the difference in the course of HCV infection in the 2 groups., Results: Twenty-nine trails involving 16750 patients were identified including the outcome of histological fibrosis or cirrhosis or de-compensated liver disease or hepatocellular carcinoma or death. These studies yielded a combined adjusted odds ratio (OR) of 3.40 [95% confidence interval (CI) = 2.45 and 4.73]. Of note, studies that examined histological fibrosis/cirrhosis, decompensated liver disease, hepatocellular carcinoma or death had a pooled OR of 1.47 (95% CI = 1.27 and 1.70), 5.45 (95% CI = 2.54 and 11.71), 0.76 (95% CI = 0.50 and 1.14), and 3.60 (95% CI = 3.12 and 4.15), respectively., Conclusion: Without highly active antiretroviral therapies (HAART), HIV accelerates HCV disease progression, including death, histological fibrosis/cirrhosis and decompensated liver disease. However, the rate of hepatocellular carcinoma is similar in persons who had HCV infection and were positive for HIV or negative for HIV.

Y2O3 acted as the matrix material, which was doped with different concentrations of Er3+, Er3+ : Y2O3 nanocrystalline powder was prepared by co-precipitation method, and Er3+ : Y2O3 transparent ceramics was fabricated by vacuum sintering at 1700 degrees C, 1 x 10(-3) Pa for 8 h. By using the X-ray diffraction (D/MAX-RB), transmission electron microscopy(Philips EM420), automatic logging spectrophotometer(DMR-22), fluorescence analyzer (F-4500) and 980 nm diode laser, the structural, morphological and luminescence properties of the sample were investigated. The results show that Er3+ dissolved completely in the Y2O3 cubic phase, the precursor was amorphous, weak diffraction peaks appeared after calcination at 400 degrees C, and if calcined at 700 degrees C, the precursor turned to pure cubic phase. With increasing the calcining temperature, the diffraction peaks became sharp quickly, and when the calcining temperature reached 1100 degrees C, the diffraction peaks became very sharp, indicating that the grains were very large. The particles of Er+ : Y2O3 is homogeneous and nearly spherical, the average diameter of the particles is in the range of 40-60 nm after being calcined at 1000 degrees C for 2 h. The relative density of Er3+ : Y2O3 transparent ceramics is 99.8%, the transmittance of the Er2+ : Y2O3 transparent ceramics is markedly lower than the single crystal at the short wavelength, but the transmittance is improved noticeably with increasing the wavelength, and the transmittance exceeds 60% at the wavelength of 1200 nm. Excited under the 980 nm diode laser, there are two main up-conversion emission bands, green emission centers at 562 nm and red emission centers at 660 nm, which correspond to (4)S(3/2) / (2)H(11/2) - (4)I(15/2) and (4)F(9/2) - (4)I(15/2) radiative transitions respectively. By changing the doping concentrations of Er3+, the color of up-conversion luminescence can be tuned from green to red gradually. The luminescence intensity is not reinforce with the increase in the concentration, so the doping concentration of Er3+ should not exceed 2%. If the doping concentration of Er3+ exceeds the range, the concentration has very small effect on the improvement of luminescence intensity.

Objective: The purpose of this study was to analyze the chest CT findings of immunocompetent patients with primary pulmonary cryptococcosis and to evaluate the utility of CT-guided percutaneous biopsy in the diagnosis., Methods: Chest CT scans of 12 immunocompetent patients with biopsy-proven primary pulmonary cryptococcosis were analyzed for the number of lesions, morphologic characteristics, distribution of parenchymal abnormalities, and the presence of lymphadenopathy and pleural effusion. Lung specimens were obtained by CT guided percutaneous biopsy (n = 9) and/or surgical resection (n = 7). A pulmonary pathologist reviewed the specimens., Results: The main manifestations were classified into two patterns. Localized multiple mixed lesions (nodules and/or masses and/or consolidation) were found in 67% (8/12) of the cases, and single nodules were found in 33% (4/12). Associated findings included air bronchograms (n = 9), cavity (n = 2), and CT halo sign (n = 4). Lung specimens were obtained by CT guided percutaneous biopsy in 9 cases, of which 7 (78%) were confirmed by pathology. Seven cases recovered after treatment with fluconazole, but cryptococcal meningitis occurred in 1 case 5 month after single excision., Conclusions: Chest CT findings of primary pulmonary cryptococcosis in immunocompetent patients have a predominant pattern of localized multiple mixed lesions. CT guided percutaneous biopsy is helpful in confirming the diagnosis. Fluconazole is effective in the treatment of pulmonary cryptococcosis in these patients.

Objective: To evaluate the efficacy and safety of cefdinir in the treatment of patients with mild to moderate bacterial community acquired pneumonia (CAP)., Methods: A prospective single-blind randomized controlled clinical study was performed comparing cefdinir with cefaclor in the treatment of sixty-four patients with CAP. The clinical and bacteriological efficacy and safety were compared between cefdinir and cefaclor in treating mild to moderate CAP. Thirty-three patients were treated with cefdinir 100 mg, orally, three times a day (cefdinir group), thirty-one patients were treated with cefaclor 500 mg, orally, three times a day (cefaclor group). In both groups 7-14 d was a treatment course., Results: The cure rate of cefdinir and cefaclor was 84.8% and 77.4% respectively and the overall efficacy rate was 93.9% and 87.1% respectively. The bacterial positive rates and bacterial eradication rates of the two groups were 81.8%, 80.7% and 96.3%, 88%, respectively. The adverse drug reaction rate were 3% in cefdinir group and 6.5% in cefaclor group. There was no statistical significant difference between the two groups for the above results (P >0.05). The time of given medicine of cefdinir and cefaclor was (10.8 +/- 1.6) d and (12.1 +/- 1.7) d (P <0.01) respectively., Conclusion: cefdinir is safe and effective, shorten the course of treatment in the treatment of mild to moderate bacterial community acquired pneumonia.

Objective: To describe the radiographic and CT findings of primary pulmonary non-Hodgkin lymphoma (PPL),and to evaluate percutanous transthoracic needle biopsy (PTNB) in the diagnosis of PPL., Methods: Chest radiographs and CT scans of three patients with histologically proven PPL were reviewed. The diagnosis of PPL was confirmed histologically with specimens obtained by means of PTNB., Results: Consolidation with air bronchograms on the chest X-ray films and CT scans was found in all cases. Multiple ill-defined nodules of various size in both lungs and a mass with air bronchogram in the right lower lobe on the CT scan were present in one case. Ground-glass opacity or reticular lesions were present in both lung fields. Hilar/mediastinal adenopathy and pericardial/pleural effusion were not features of these cases. PTNB was diagnostic in all three cases. No complications occurred during these procedures., Conclusions: PPL has some specific imaging features. Radiographic and CT findings are helpful in the diagnosis of primary pulmonary malignant lymphoma. A specific diagnosis can be obtained by means of PTNB.

This paper covers the determination of Pb, Zn Fe and Cd in the crude zinc produced from the imperial smelting furnace by XRF. Samples of crude zinc are taken on site and cast into ingots of definite shape. The analysed surface of the sample is polished and analysed directly without chemical treatment. The experience coefficient method is used to calibrate the matrix effect. Standard samples are prepared by artificial simulation. The linear relation coefficient between the concentration and the strength of X-ray is above 0.98. The standard deviation is less than 0.0056. The relative standard deviation is less than 2.41%. The results by XRF are the same as that by chemical analysis method.

Human plasma cholesteryl ester transfer protein (CETP) enhances transfer and exchange of cholesteryl ester (CE) and triglyceride (TG) between high-density lipoprotein and other lipoproteins. To define regions responsible for the neutral lipid transfer activities at the molecular level, a total of 27 linker insertion mutants at 18 different sites along the CETP molecule were prepared and transiently expressed in a mammalian cell line (COS). The inserted linkers were small (usually 6 bp) and did not interrupt the translational reading frame of the CETP cDNA. Although secretion of each mutant protein was less than that of wild-type CETP, the majority of the mutants had normal cholesteryl ester transfer activity (transfer activity per nanogram of CETP in media). However, insertional alterations in three regions severely impaired CE transfer activity: (1) in the region of amino acids 48-53; (2) at amino acid 165; and (3) in the region of amino acids 373-379. Although the impaired activities could also be a result of globally incorrect folding of these CETP mutants, hydrophobicity analysis and secondary structure predictions tended to exclude this possibility for most of the insertion sites at which insertions resulted in inactivation. The insertion at amino acid 379 occurs immediately after a triplet of lysine residues, suggesting that this region might be involved in an essential step in the mechanism of CE and TG transfer, such as the binding of CETP to phosphatidylcholine molecules in the lipoprotein surface. Effects on TG transfer activity were generally similar to those on CE transfer activity, suggesting a similar structural requirement for both neutral lipid transfer activities.