Clinicopathological features and prognostic factors of gastric intermediate-risk gastrointestinal stromal tumor after surgical resection: a retrospective study / 中华病理学杂志

Objective: To investigate the clinicopathological features, treatment and prognosis of gastric intermediate-risk gastrointestinal stromal tumor (GIST), so as to provide a reference for clinical management and further research. Methods: A retrospective observational study of patients with gastric intermediate-risk GIST, who underwent surgical resection between January 1996 and December 2019 at Zhongshan Hospital of Fudan University, was carried out. Results: Totally, 360 patients with a median age of 59 years were included. There were 190 males and 170 females with median tumor diameter of 5.9 cm. Routine genetic testing was performed in 247 cases (68.6%, 247/360), and 198 cases (80.2%) showed KIT mutation, 26 cases (10.5%) showed PDGFRA mutation, and 23 cases were wild-type GIST. According to "Zhongshan Method"(including 12 parameters), there were 121 malignant and 239 non-malignant cases. Complete follow-up data were available in 241 patients; 55 patients (22.8%) received imatinib therapy, 10 patients (4.1%) experienced tumor progression, and one patient (PDGFRA mutation, 0.4%) died. Disease-free survival (DFS) and overall survival rate at 5 years was 96.0% and 99.6%, respectively. Among the intermediate-risk GIST, there was no difference in DFS between the overall population, KIT mutation, PDGFRA mutation, wild-type, non-malignant and malignant subgroups (all P>0.05). However, the non-malignancy/malignancy analysis showed that there were significant differences in DFS among the overall population (P<0.01), imatinib treatment group (P=0.044) and no imatinib treatment group (P<0.01). Adjuvant imatinib resulted in potential survival benefit for KIT mutated malignant and intermediate-risk GIST in DFS (P=0.241). Conclusions: Gastric intermediate-risk GIST shows a heterogeneous biologic behavior spectrum from benign to highly malignant. It can be further classified into benign and malignant, mainly nonmalignant and low-grade malignant. The overall disease progression rate after surgical resection is low, and real-world data show that there is no significant benefit from imatinib treatment after surgery. However, adjuvant imatinib potentially improves DFS of intermediate-risk patients with tumors harboring KIT mutation in the malignant group. Therefore, a comprehensive analysis of gene mutations in benign/malignant GIST will facilitate improvements in therapeutic decision-making.

Gene expression and immunolocalization of chitin deacetylase BmCDA2 in silkworm / 生物工程学报

Deacetylation of chitin is closely related to insect development and metamorphosis. Chitin deacetylase (CDA) is a key enzyme in the process. However, to date, the CDAs of Bombyx mori (BmCDAs), which is a model Lepidopteran insect, were not well studied. In order to better understand the role of BmCDAs in the metamorphosis and development of silkworm, the BmCDA2 which is highly expressed in epidermis was selected to study by bioinformatics methods, protein expression purification and immunofluorescence localization. The results showed that the two mRNA splicing forms of BmCDA2, namely BmCDA2a and BmCDA2b, were highly expressed in the larval and pupal epidermis, respectively. Both genes had chitin deacetylase catalytic domain, chitin binding domain and low density lipoprotein receptor domain. Western blot showed that the BmCDA2 protein was mainly expressed in the epidermis. Moreover, fluorescence immunolocalization showed that BmCDA2 protein gradually increased and accumulated with the formation of larval new epidermis, suggesting that BmCDA2 may be involved in the formation or assembly of larval new epidermis. The results increased our understandings to the biological functions of BmCDAs, and may facilitate the CDA study of other insects.

Clinical significance of pathological diagnosis and genetic abnormalities detection in gastrointestinal stromal tumor using endoscopic biopsy / 中华病理学杂志

Objective: To investigate the clinical significance of pathological diagnosis and genetic abnormalities detection of gastrointestinal stromal tumor (GIST) using endoscopic biopsy. Methods: Patients with GIST diagnosed by endoscopic biopsy (from January 1st, 2016 to August 1st, 2018, at Zhongshan Hospital, Fudan University) were included in this study. This retrospective study evaluated the histopathologic and immunohistochemical (IHC) features, genetic abnormalities of the tumors and the treatment and clinical course of the patients. Results: Totally 4 095 cases of GIST were collected, among which 67 patients (67/4 095, 1.6%) underwent endoscopic biopsy. Forty-eight patients (71.6%) were male and 19 (28.4%) were female, with a mean age of 61 years (range 31-90 years). Fifty-nine lesions were located in stomach and eight in duodenum. Of all the 67 cases, 47 were spindle type, 14 were epithelioid type, and 6 mixed type. IHC staining showed the positive rates were 100.0% (64/64) for DOG1, 98.4% (62/63) for CD117, 87.5% (56/64) for CD34, 3.6% (2/56) for S-100 protein, 12.1% (7/58) for α-SMA, 12.3% (7/57) for desmin and 4.0% (2/50) for CKpan. Morphologically, 34 cases were malignant; three cases (all epithelioid type) were originally misdiagnosed as poorly differentiated carcinoma; missed-diagnosis were found in four cases (spindle type) due to the insufficient diagnostic tumor cells. The genetic abnormality detection rate in the biopsy tissue was 38.8% (26/67),among them two patients were lost to follow up after biopsy, 33 patients received surgical resection, 16 cases underwent operation after neoadjuvant therapy and 16 patients with advanced disease underwent continuous imatinib therapy, with the genetic testing rate of 6.1% (2/33), 10/16 and 14/16, respectively. Conclusions: Endoscopic biopsy is a useful but rare method for the preoperative diagnosis of GIST. For majority of biopsy, accurate pathological diagnosis and auxiliary examination can be completed to guide clinical treatment. A thorough history in combination with endoscopic finding is essential to avoid misdiagnosis (epithelioid type) and missed diagnosis (spindle type) in suspicious cases. Genetic testing should be recommended in patients who will undergo targeted therapy after endoscopic biopsy, and it can provide valuable information and guidance for clinical treatment.

Sex disparities in clinical characteristics of Chinese patients with systemic sclerosis / 中华内科杂志

Objective:To evaluate the differences in clinical characteristics between different genders of Chinese patients with systemic sclerosis(SSc).Methods:The data of SSc patients registered in Chinese Rheumatism Data Center between August 2008 and June 2020 were retrospectively analyzed.Results:A total of 1 844 patients with SSc were enrolled in the study. The ratio of males to females was 289 to 1 555. The onset age was (48.6±13.7) years in males and (45.5±13.1) years in females( P<0.001). Male patients represented shorter disease duration [2.0(0.0, 4.0)years vs.3.0(1.0, 7.0) years, P<0.001],higher proportion of diffuse cutaneous SSc (dcSSc) [63.0% (182/289)vs.44.2%(688/1 555), P<0.001]. Although more man patients experienced smoking [47.4%(137/289) vs. 1.7%(27/1 555), P<0.001] and exposure to harmful environments [7.6%(22/289) vs. 2.1%(33/1 555), P<0.001], there was no statistically significant difference in interstitial lung disease between male and female patients [69.3%(181/261) vs. 74.5%(1 085/1 457), P=0.084].Otherwise, Raynaud′s phenomenon [87.7% (1 364/1 555) vs.75.4%(218/289), P<0.001], arthritis [11.1%(173/1 555) vs.6.9%(20/289), P=0.032], gastroesophageal reflux disease [22.0%(342/ 1 555) vs.13.1%(38/289), P=0.001], and leucopoenia [10.7(161/1 511)% vs. 6.1%(17/279), P=0.019] were more common in female patients, but finger ulcer was less common [22.5%(350/1 555) vs. 30.4%(88/289), P=0.004]. Antinuclear antibody(ANA) positivity rate [85.6%(1 310/1 531) vs. 78.6%(221/281), P=0.003], anti-RNP antibody positivity rate [23.1%(342/1 479) vs.14.0%(38/271), P=0.001], anti-SSA antibody positivity rate [28.2%(419/1 487) vs.13.9%(38/274), P<0.001] were higher in female patients. Physician′s global assessment(PGA) scores [1.4 (1.0, 2.0) vs. 1.0 (0.3, 1.6), P<0.001] and modified Rodnan Skin Score(mRSS) [18.0 (9.5, 28.0) vs. 14.0 (5.0, 28.0), P=0.003] were higher in males. Conclusion:Even though male SSc patients account for a small proportion, more extensive skin involvement, finger ulcers and higher PGA are manifested in males. Physicians need pay attention to these clinical disparities between different genders in SSc.

Analysis of clinical manifestations at different age of onset in systemic sclerosis / 中华风湿病学杂志

Objective:To investigate the clinical and laboratory characteristics of systemic sclerosis (SSc) patients at different age of onset.Methods:Data of SSc patients with onset age ≥18 years old who were registered in the Peking Union Medical College Hospital and Chinese Rheumatism Data Center from August 2008 to June 2020 were included. Patients were divided into 3 groups by the age of onset according to the age segmentation of the World Health Organization. Counting variables were presented as frequency (percentage). Quantitative results were presented as mean±standard deviation, or median, inter quartile range. Differences between groups were analyzed by analysis of variance, the Mann-Whitney test or the chi-square test, depen-ding on the distribution of the variables.Results:Six hundred and eighty-two SSc patients were included. Accor-ding to the age of onset, they were divided into three groups: youth group (18-44 years old), middle-aged group (45-59 years old) and elderly group (over 60 years old). There were 361 patients in the youth group,245 patients in the middle age group and 76 patients in the elderly group. The mean age of onset was (43.8±12.1) years. The variables with significant different among the groups were as the following: left ventricular diastolic dysfunction [14.0%(14/100), 38.8%(39/98), 65.4%(17/26); χ2=30.756, P<0.001]; cardiac arrhythmias [1.9% (7/361), 3.7% (9/361), 7.9% (6/76), χ2=7.38, P=0.024), Raynaud's phenomenon [94.7% (342/361), 89.4%(219/245), 89.5%(68/76), χ2=6.73, P=0.035], loss of finger pad substance [36.9%(133/360), 25.4% (62/244), 18.4% (14/76), χ2=15.184, P=0.001]; digital ulcer [31.0% (112/361), 23.0% (56/244), 15.8% (12/76), χ2=9.86, P=0.007]; arthritis [16.3%(59/361), 13.5%(33/245), 5.3%(4/76), χ2=6.49, P=0.039], digital contracture [11.6%(42/361), 5.7%(14/245), 9.2%(7/76), χ2=6.10, P=0.047]; positive anti-RNP antibody [32.3% (116/359), 20.7% (50/241), 17.3% (13/75), χ2=14.06, P=0.001]; and positive anti-centromere antibody [8.9% (32/351), 18.4%(45/239), 23.7%(18/76), χ2=17.78, P<0.001] were significantly different between the young age group and elder group. Conclusion:The predominant age of disease onset of SSc is middle and young age. Elder onset SSc patients are more likely to have left ventricular diastolic dysfunction, and young onset patients are more likely to have microvascular lesions, which needs more attentions by clinicians.

A clinical analysis of 13 patients with scleroderma renal crisis and pulmonary arterial hypertension / 中华风湿病学杂志

Objective:To describe a series of systemic sclerosis (SSc) patients with the combination of scleroderma renal crisis (SRC) and pulmonary arterial hypertension (PAH).Methods:The medical records of 472 SSc patients in Peking Union Medical College Hospital between January 2012 and October 2020 were reviewed and a retrospective analysis of the characteristics of patients with SRC and PAH among SSc patients was conducted.Results:Thirteen patients suffered from SRC and PAH in the SSc patients, 1 case was limited cutaneous SSc, and 12 cases were diffuse cutaneous SSc. Five patients had renal crisis before pulmonary arterial hypertension, 4 patients had pulmonary arterial hypertension before the occurrence of renal crisis, and the remaining 4 patients were found at the same time. Among them, 11 patients had Raynaud's phenomenon, 7 had gastrointestinal bleeding, 6 had pulmonary edema and 3 had telangiectasias. Twelve cases were positive for anti-nuclear antibodies and 4 cases were positive for anti-Scl-70 antibodies. N-terminal pro-brain natriuretic peptide (NT-proBNP)>1 400 ng/L in 11 patients. Two patients had thrombotic microangiopathy (TMA). Among the 13 patients, 3 patients died during hospitalization, 2 patients were lost to follow-up, and 2 patients died within 5 years of follow-up. Six patients survived, and 1 of the 4 patients with regular dialysis were discharged from dialysis.Conclusion:In patients with scleroderma, SRC can occur earlier, later than, or at the same time with SSc-PAH. Patients may have a higher incidence of gastrointestinal bleeding and higher level of NT-proBNP. PDE5i or ERAs may be beneficial.

Clinicopathological features and prognosis of gastrointestinal stromal tumors with KIT/PDGFRA gene "homozygous mutation": a multicenter retrospective cohort study / 中华胃肠外科杂志

Objective: To investigate the clinicopathological features of gastrointestinal stromal tumor (GIST) with KIT/PDGFRA "homozygous mutation", the efficacy of targeted therapy and the prognosis. Methods: A retrospective cohort study and propensity score matching were used. "Homozygous mutation" was defined as the detection of KIT/PDGFRA gene status of GIST by Sanger sequencing, which showed that there was only mutant gene sequence in the sequencing map, lack of wild-type sequence or the peak height of mutant gene sequence was much higher than that of wild-type gene sequence (> 3 times). "Heterozygous mutation" was defined as the mutant gene sequences coexisted with wild type gene sequences, and the peak height was similar (3 times or less). The clinicopathological data and follow-up information of 92 GIST patients with KIT/PDGFRA "homozygous mutation" were collected from 4 hospitals in Shanghai from January 2008 to May 2021 (Renji Hospital, Shanghai Jiaotong University School of Medicine: 70 cases; Zhongshan Hospital, Fudan University: 14 cases; Changhai Hospital, Naval Military Medical University: 6 cases and Ruijin Hospital, Shanghai Jiaotong University School of Medicine: 2 cases). Patients with perioperative death, other malignancies, and incomplete clinicopathological information were excluded. The clinicopathological features of the patients and the efficacy of targeted drug therapy were observed and analyzed. The efficacy was evaluated using Choi criteria, which were divided into complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). In addition, a total of 230 patients with high-risk GIST with "heterozygous mutation" in exon 11 of KIT gene and 117 patients with recurrent or metastatic GIST with "heterozygous mutation" in exon 11 of KIT gene were included. The propensity score matching method was used to match GIST patients with "heterozygous" and "homozygous" mutations in exon 11 of KIT gene (1∶1) for survival analysis. The disease-free survival (DFS) between two groups of high-risk GIST patients who underwent complete surgical resection were compared. And progression-free survival (PFS) in patients with recurrent or metastatic GIST were compared. Results: Of the 92 GIST cases with KIT/PDGFRA "homozygous mutation", 58 were males and 34 were females, with a median onset age of 62 (31-91) years. Primary GIST 83 cases. Primary high-risk GIST (53 cases), metastatic GIST (21 cases) and recurrent GIST (9 cases) accounted for 90.2% (83/92). There were 90 cases of KIT gene"homozygous mutation" (exon 11 for 88 cases, exon 13 for 1 case, exon 17 for 1 case), and 2 cases of PDGFRA gene "homozygous mutation" (exon 12 for 1 case, exon 18 for 1 case). The median follow-up time was 49 (8-181) months. Among the 61 cases of primary localized GIST undergoing complete surgical resection, 2 cases were intermediate-risk GIST, 5 cases were low-risk GIST, and 1 case was very low-risk GIST, of whom 1 case of intermediate-risk GIST received 1-year adjuvant imatinib mesylate (IM) therapy after operation, and no tumor recurrence developed during the follow-up period. The remaining 53 cases were high-risk GIST, and follow-up data were obtained from 50 cases, of whom 22 developed tumor recurrence during follow-up. Of 9 patients directly receiving neoadjuvant targeted therapy (IM or avapritinib), 5 had complete imaging follow-up data, and the evaluation of efficacy achieved PR. Of all the 92 GIST cases with KIT/PDGFRA "homozygous mutation", 50 (54.4%) had tumor metastasis or tumor recurrence or progression during follow-up, and 12 (13.0%) died of the tumor. Survival analysis combined with propensity score showed that in 100 cases of high-risk GISTs with complete resection, GISTs with "homozygous mutation" in exon 11 of KIT gene had shorter disease-free survival (DFS) than GISTs with "heterozygous mutation" in exon 11 of KIT gene (median DFS: 72 months vs. 148 months, P=0.015). In 60 cases of recurrent or metastatic GISTs with KIT gene exon 11 mutation, IM was used as the first-line treatment, and the progression-free survival (PFS) of GISTs with "homozygous mutation" was shorter compared to GISTs with "heterozygous mutation" (median PFS: 38 months vs. 69 months, P=0.044). The differences were statistically significant. Conclusions: "Homozygous mutation" in KIT/PDGFRA gene is associated with the progression of GIST. The corresponding targeted therapeutic drugs are still effective for GIST with KIT/PDGFRA gene "homozygous mutation". Compared with GIST patients with "heterozygous mutation" in KIT exon 11, GIST patients with "homozygous mutation" in KIT exon 11 are more likely to relapse after surgery and to develop resistance to IM. Therefore, it is still necessary to seek more effective treatment methods for this subset of cases.

Association of Overlapped and Un-overlapped Comorbidities with COVID-19 Severity and Treatment Outcomes: A Retrospective Cohort Study from Nine Provinces in China / 生物医学与环境科学（英文）

Objective@#Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear.@*Methods@#A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients' medical records. Multivariable logistic regression models were used to estimate the odds ratio ( @*Results@#Overall, 158 (13.6%) patients were diagnosed with severe illness and 32 (2.7%) had unfavorable outcomes. Hypertension (2.87, 1.30-6.32), type 2 diabetes (T2DM) (3.57, 2.32-5.49), cardiovascular disease (CVD) (3.78, 1.81-7.89), fatty liver disease (7.53, 1.96-28.96), hyperlipidemia (2.15, 1.26-3.67), other lung diseases (6.00, 3.01-11.96), and electrolyte imbalance (10.40, 3.00-26.10) were independently linked to increased odds of being severely ill. T2DM (6.07, 2.89-12.75), CVD (8.47, 6.03-11.89), and electrolyte imbalance (19.44, 11.47-32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission (5.46, 3.25-9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes (6.58, 1.46-29.64) within two weeks.@*Conclusion@#Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.

Clinical Features of Relapsing Polychondritis Patients Presented with Arthropathy / 中国医学科学院学报

Objective To explore the clinical characteristics of relapsing polychondritis(RP)patients presented with arthropathy. Methods We retrospectively analyzed the clinical data of 201 RP patients who were hospitalized in our center between December 2005 and February 2019.After 16 patients with co-existing other autoimmune diseases and malignancies were ruled out,185 RP patients entered the final analysis,among whom 16 RP patients were presented with arthropathy and 169 without arthropathy.The demographic data,clinical manifestations,laboratory findings,and prognosis were compared between these two groups. Results Five of the 16 RP patients with arthropathy at presentation were misdiagnosed as rheumatoid arthritis.Compared with RP patients without arthropathy at presentation,RP patients with arthropathy at presentation had a longer disease course[(37.50±66.50)months

Expression of miR-622 and its significance in epithelial ovarian cancer / 中国实用妇科与产科杂志

OBJECTIVE: To investigate the expression of microRNA-622(miR-622)in epithelial ovarian cancer,andanalyze its influence on tumor cell migration and invasion.METHODS:Epithelial ovarian cancer(n=125),benignepithelial ovarian tumors(n=45),and normal ovarian tissues(n=25)were obtained from January 2003 to December 2016 at Dongguan People's Hospital of Southern Medical University.The expression of miR-622 was determined by real-timePCR.The miR-622 mimics were transiently transfected into human ovarian cancer cells,and their influence on cellmigration and invasion was analyzed by Transwell assay.RESULTS:Higher miR-622 expression was found in epithelialovarian cancer tissues than in benign epithelial ovarian tumors and normal ovarian tissues(P<0.05).Expression of miR-622 was correlated with FIGO stage and lymphatic metastasis(P<0.05).Up-regulation of miR-622 promoted theinvasion and migration of SKOV3 cells in vitro.CONCLUSION:The expression level of miR-622 is increased in tumourtissues,which indicates that miR-622 might be involved in the progression of epithelial ovarian cancer by promotingcancer cell migration and invasion.

Clinical value of antineutrophil cytoplasmic antibody in eosinophilic granulomatosis with polyangiitis / 中华风湿病学杂志

Objective To investigate the value of antineutrophil cytoplasmic antibody (ANCA) in clinical phenotype of eosinophilic granulomatosis with polyangiitis (EGPA).Methods The clinical data of 64 patients with EGPA from Peking Union Medical College Hospital between 2007 to 2016 were retrospectively analyzed,and the patients were followed up.Characteristics of patients with ANCA positive and ANCA negative were compared by independent-samples t test,Mann-Whitney U test and Chi-square test.Results Among 64 patients with EGPA,12(19％) were serum ANCA positive and 52(81％) were negative.The incidence of fever (77％ vs 35％,x2=9.403,P=0.002) and renal involvement,including proteinuria (67％ vs 25％,x2=7.678,P=0.006),hematuria (58％ vs 8％,x2=17.57,P＜0.01),renal inadequacy (33％ vs 4％,x2=9.978,P=0.002),and the BVAS score higher than 15 (92％ vs 60％,x2=4.440,P=0.035) in ANCA positive group were higher than ANCA negative group,while the presence of allergic rhinitis (17％ vs 56％,x2=5.969,P=0.015),mucocutaneous lesion (33％ vs 65％,x2=4.152,P=0.042) and cardiac involvement (8％ vs 44％,x2=3.361,P=0.021) in the ANCA-positive group was lower when compared with ANCA-negative patients.The positive ratio of rheumatoid factor (RF) (100％ vs 42％,x2=7.723,P=0.006),and the level of erythrocyte sedimentation rate (ESR) (50 vs 35.5 mm/1 h,P=0.034) in ANCA-positive group were higher than in ANCA negative group.There was no significant difference in pathological characteristics between the two groups.According to the treatment and prognosis,there were no significant differences between the two groups in the usage and dosage of steroids and immunosuppressant,the remission rate and recurrence rate of the disease,and the death rate due to the primary disease.Conclusion The clinical manifestations of EGPA are complicate.Whether ANCA is positive or not may be related to the clinical phenotypes.More attention should be paid to renal involvement in ANCA positive patients while cardiac involvement in ANCA negative patients.

Preparation of decontaminant for skin radioactive isotopes contamination of Co2+ and Mn2+ / 解放军医学杂志

Objective To develop a detergent for decontamination of Co2+ and Mn2+ on skin.Methods Single-factor experimental and orthogonal experimental designs were performed to study the formula composition of the decontaminant.The skin irritation experiment was performed and assessed according to the standard method.The detergent was prepared according the conventional process of showering gel.The pH,ethylenediaminetetraacetic acid (EDTA) level,total active substances of the detergent,and its stability were evaluated according to the chemical method recommended in the national standard GB/T 13173-2008.The decontamination efficiency on stable isotopes of Co2+ and Mn2+ contamination was measured on the back of hand skin of volunteers.Results The formula composition of the decontaminant was obtained through the orthogonal experiment.The pH value of the detergent was 6.99,total active substance was 20.49％ and the content of EDTA was 5.99％.After being kept at-5 ℃ and 40℃℃ for 24h,the decontaminant showed no strange smell,no precipitation,no discoloration and still kept transparent.The decontamination effects on Co2+ and Mn2+ contaminated on hand skin were 103.13％ ± 0.05％ and 100.62％ ± 0.09％,respectively,which was significantly higher than that of distilled water (81.77％ ± 0.23％ and 79.63％ ± 0.23％,P＜0.01,respectively).Conclusion The decontaminant has a high effect on decontamination of Co2+ and Mn2+ polluted on skin,and is hopeful to be developed as an effective detergent on radioactive isotopes contamination.

Rapid Detection of Trace Volatile Organic Compounds By Electric Driven Cryo-Trap Movable Mass Spectrometer / 分析化学

An electric driven cryo-trap enrichment apparatus for the movable mass spectrometer was designed to realize rapid and automatic detection of trace volatile organic compounds (VOCs) in the atmosphere. Compared with traditional cryo-trap with refrigerant,the lowest temperature of cryocooler was down to-196℃, and it was easy to carry due to its small size, light weight and refrigerant-free. Cryo-trap combined with time-of-flight mass spectrometer was used to analyze benzene,toluene and xylene,and the result showed that the signal strength of benzene,toluene and xylene,with the cryo-trap enrichment,was improved by 212-fold, 254-fold and 242-fold,and the recoveries reached 98%,87% and 87%,respectively. The analytical time for single sample was only 14 min. The electric driven cryo-trap combined with on-line mass spectrometer was used to detect 39 kinds of VOCs listed in TO-14 method of EPA and ambient air, and the sensitivity of the newly designed instrument was better than the threshold of national indoor VOCs. The combination of electric driven cryo-trap and time-of-flight mass spectrometer could be used for rapid enrichment and monitoring of trace VOCs in the atmosphere and indoor air, showing great potential in in-site measurement and real-time monitoring of volatile organic pollutants.

The Role of Fibrocyte in the Pathogenesis of Silicosis / 生物医学与环境科学（英文）

Exposure to free silica induces silicosis and myofibroblasts are regarded as primary effector cells. Fibrocytes can differentiate into myofibroblast. Therefore, the present study was designed to investigate whether fibrocytes participate in silicosis. The rat model of silicosis was established. Hematoxylin-eosin stainings and Masson stainings were used to evaluate the histopathology and collagen deposition. Flow cytometry and immunofluorescence were performed to detect the number of fibrocytes and their contribution to myofibroblasts. Results showed that fibrocytes participate in silicosis. Trend analysis of different sources of myofibroblasts during silicosis indicated that fibrocytes and lung type II epithelial cell-derived myofibroblasts play an important role in the early stage of silicosis, while resident lung fibroblast-derived myofibroblasts play a predominant role during the fibrosis formative period.

Effect of miR-191 on the proliferation of malignant meningioma cell through EGR1/TP53 signaling pathway / 中华内分泌外科杂志

Objective To study the influence of miR-191 expression on the proliferation of human malignant meningioma cell line IOMM-Lee in vitro and to explore its mechanism.Methods The expression of miR-191 in malignant meningioma tissue,the adjacent normal tissues and human Malignant meningioma cell lines IOMM-Lee and CH157-MN was tested by Realtime PCR.miR-191 inhibitor was transfected in IOMM-Lee cells and MTT assay was employed to detect the cell viability.Bioinformatics prediction software was used in miR-191 target gene predictive analysis and verified by luciferase reporter system.The effect of EGR1 siRNA on the proliferation of IOMM-Lee cells was observed.Prorein interaction database was used to analyze which proteins could interact with EGR1.The effect of inhibition of EGR1 expression on TP53 protein expression was detected.The influence of inhibition of miR-191 expression on EGR1and TP53 expression was observed.Result The expression of miR-191 in malignant meningioma tissue (0.933±0.144) was higher than that in the adjacent normal tissue (0.459±0.104,P＜0.05).The expressiong of miR-191 in humam malignant meningioma cell line IOMM-Lee (1.25±0.07) was higher than that in CH157-MN cell line (0.50±0.14,P＜0.05).The cell proliferation capability was significantly decreased in miR-191 inhibitor group [(0.53±0.02) vs (0.74±0.01),P＜0.05].EGR1 was identified and validated to be a target gene of miR-191.Inhibition of EGR1 gene can promote OMM-Lee cell proliferation (0.83±0.02,0.71 ±0.01,P＜0.05).EGR 1 could positively regulate TP53 protein expression [(13 758.17±57.22) vs (10 239.00±71.30),P＜0.001.miR-191 Inhibition could increase EGR1 [(14 663.00±80.08) vs (11 184.33±153.90),P＜0.001] and TP53 expression [(15 206.17±102.08) vs(11 400.17±97.00),P＜0.001].Conclusion Downregulation of miR-191 can inhibit the proliferation of IOMM-Lee cell,which may be related to the upregulation of EGR1/TP53 signaling pathway.

Chemical constituents from the male anthotaxy of Populus tomentosa Carr / 国际药学研究杂志

Objective To study the chemical constituents of the male anthotaxy of Populus tomentosa Carr.Methods The compounds were isolated and purified by ODS,silica gel,Sephadex LH-20 column chromatography and recrystallization.Their struc?tures were identified based on the physiochemical properties and spectroscopic data. The antioxidant capacities of some compounds were assayed by a rapid ABTS method.The antitumor activity was tested by the MTT assay.Results Fourteen compounds were isolat?ed from the ethyl acetate part of 70% ethanol extract of the male anthotaxy of P.tomentosa Carr.,and they were identified as pinocem?brin(1),dillenetin(2),chrysoeriol(3),naringenin(4),isosakuranetin(5),apigenin(6),kaempferol(7),apigenin-7-O-β-D(-6″-p-coumaroyl)-glucoside(8),tremuloidine(9),catechol(10),3,3′,4,4′-tetrahydroxybiphenyl(11),coumaric acid(12),ursolic acid (13),and betulonic acid(14),respectively. The results of the ABTS assay showed that 2,6 and 7 could scavenge ABTS+free radicals with the total antioxidant capacity of 0.61,0.14,0.46 respectively.The screening results of antitumor activity in vitro showed that the half inhibitory concentration(IC50)of compounds 1,4 and 5 for adenocarcinomic human alveolar basal epithelial cells A549 was 26.04 mg/L,43.45 mg/L and 24.01 mg/L,for human hepatocellular liver carcinoma cells HepG2 were 13.50 μg/ml,23.80 μg/ml and 9.13 μg/ml,and for human colon carcinoma cells HCT116 was 36.11 mg/L,48.95 mg/L and 32.25 mg/L.Conclusion Compounds 2,3,11,13 and 14 were isolated from the Populus genus for the first time,2-5,10,11 and 13-15 were isolated from the plant for the first time.Compounds 2,6 and 7 displayed the antioxidant activity to a certain extent.Compouds 1,4 and 5 showed varying de?grees of inhibitory effects on tumor cells in vitro.

Chinese expert investigation on diagnosis and disease activity evaluation in Takayasu's arteritis / 复旦学报（医学版）

Objective To investigate the current situation in Chinese rheumatologic physicians' clinical diagnosis and evaluation of Takayasu's arteritis (TA).Methods Nineteen rheumatology experts and three vascular surgery specialists in China were invited to make the nationwide investigation for the first time about the diagnosis and disease activity evaluation of TA in China,through the questionnaire survey on the internet.Weighted average was used to calculate the average scores of corresponding problems.Results Chinese experts mainly adopted 1990 American College of Rheumatology (ACR) classification criteria for clinical diagnosis of TA.In details,symptoms of age,limb claudication and amaurosis,signs including pulselessness or pulse weakening,vascular bruits,increasing bilateral pulse pressure and hypertension and acute phase reactants (APR) were critical to the clinical diagnosis of TA.Besides,noninvasive imaging examinations,such as computed tomography angiography (CTA),magnetic resonance angiography (MRA),vascular ultrasonography,and positron emission tomography (PET) were also of great importance.In the aspect of disease activity assessment,Chinese experts mainly used Kerr scoring tool.APR and noninvasive radiological examinations were considered with vital value.Some TA patients with carotid artery involvement were recommended using vascular ultrasonography,while others with pulmonary artery and thoracic/abdominal aorta trunk involvement were preferred CTA other than MRA.Conclusions APR and noninvasive imaging examinations were thought with great help to make clinical diagnosis and evaluation of TA for Chinese physicians.

Based on the Lanshi Micang-Anal Fistula Analysis of the Academic Thought of LI Dongyuan's Treatment of Hemorrhoids / 浙江中医药大学学报

Objective] To explore the treatment of Lanshi Micang disease with tumors related diagnosis and treatment method, in order to have a more comprehensive understanding of anal fistula, so as to broaden the mind, improve the clinical efficacy. [Method] FromLanshi Micang-Anal Fistulaof eight prescriptions for treatment of hemorrhoids and analysis, on the basis of combining the characteristics of compatibility with tumors inDongyuan effect testand the specific prescription, made analysis of anal fistula, diagnosis and treatment of anal fistula for the study of LI Dongyuan thought. [Results] LI Dongyuan from dampness, heat, wind, dryness four on the treatment of anal fistula, with angelica, Gentiana and blood dryness of medicine, to Shufeng pain, Xinrun and blood on regulation of syndrome treatment, paid attention to diet to restore the anal fistula. [Conclusion] LI DongyuanLanshi Micangis rich in content, the treatment of anal fistula has experience, as of today, the diagnosis and treatment on anorectal diseases of clinical thought still has important guiding significance.

Meta-analysis of open reduction internal fixation and non-operative treatment of multiple rib fractures / 中华创伤杂志

Objective To compare the efficacy between open reduction internal fixation and nonoperative treatment of multiple rib fractures.Methods Pubmed,Embase,Chinese National Knowledge Infrastructure database (CNKI),Chinese Biological Medical Literature database (CBM),Wanfang database and VIP database were searched for relevant studies comparing the effect of open reduction internal fixation and non-operative treatment of multiple rib fractures during 1990 and 2016.RevMan 5.3 software was used for the meta-analysis to compare differences of the two treatments concerning hospital stay,total ICU stay,duration of mechanical ventilation,proportion of pneumonia and atelectasis and pulmonary function.Results Eleven studies containing 799 patients met the inclusion criteria,including 431 patients in internal fixation group and 368 patients in non-operative group.Two groups had significant differences in hospital stay (95％ CI-11.00--3.34,P ＜-0.05),total ICU stay (95％ CI -4.48--1.29,P ＜ 0.05),duration of mechanical ventilation (95％ CI-7.52--1.54,P ＜ 0.05),proportion of pneumonia (95 ％ CI 0.19-0.42,P ＜ 0.05),proportion of atelectasis (95 ％ CI 0.24-0.57,P ＜ 0.05) and total lung capacity (95 ％ CI 1.57-1.97,P ＜ 0.05),forced vital capacity (FVC) (95 ％CI 0.98-1.27,P ＜ 0.05) and forced expiratory volume in one second (FEV1) (95％ CI 0.68-0.95,P ＜ 0.05).Conclusion Open reduction internal fixation of multiple rib fractures can significantly improve rehabilitation rate,reduce incidence of pulmonary complications dnring hospitalization,and facilitate recovery of lung function.

Crystalline Silica Promotes Rat Fibrocyte Differentiation in Vitro, and Fibrocytes Participate in Silicosis in Vivo / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>The aim of this study was to investigate the effects of SiO2 on fibrocytes and whether fibrocytes participate in silicosis in vivo.</p><p><b>METHODS</b>A macrophagocyte (AM)/fibrocyte coculture system was established, and AMs were treated with 100 μg/mL SiO2. Flow cytometry was used to detect the number of fibrocytes. Real-time PCR was performed to measure the expression of collagen I, collagen III, and α-SMA mRNA. The levels of collagen I, collagen III, and TGF-β1 protein were determined by ELISA. Immunohistochemical staining was performed to measure α-SMA protein expression. A rat silicosis model was induced by intratracheal instillation of SiO2. Lung histopathological evaluation was conducted using HE and Masson's trichrome staining after 1 and 9 weeks. The number of fibrocytes in peripheral blood or lung tissue of rat was detected by flow cytometry. Double-color immunofluorescence was applied to identify fibrocytes in the lung tissue.</p><p><b>RESULTS</b>Peripheral blood monocytes were found to differentiate into fibrocytes in vitro in a time-dependent manner, and exposure to crystalline silica might potentiate fibrocyte differentiation. In addition, fibrocytes were able to migrate from peripheral blood to the lung tissue, and the number of fibrocytes was increased after SiO2 exposure.</p><p><b>CONCLUSION</b>Silica exposure potentiates fibrocyte differentiation, and fibrocytes may participate in silicosis in vivo.</p>