[Clinical outcome of combined over-the-top reconstruction with modified Lemaire procedure in one-stage revision anterior cruciate ligament reconstruction].

Objective: To investigate the clinical effect of over-the-top (OTT) reconstruction of the anterior cruciate ligament (ACL) combined with the modified Lemaire technique in one-stage ACL revision. Methods: It's a retrospective study. The clinical data of 37 patients who underwent one-stage revision of ACL using OTT combined with modified Lemaire technique from April 2020 to May 2023 in the Department of Sports Medicine of Xinhua Hospital Affiliated to Dalian University were retrospectively analyzed. There were 28 males and 9 females with a mean age of (32.7±5.7) years. The postoperative knee function and surgical revision effect were evaluated by subjective and objective evaluation indexes of the knee joint before and 3 months and 24 months after surgery. The subjective evaluation indexes included the International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner score; and the objective evaluation indexes included the anterior-posterior static displacement distance of the tibia, tibia-femur relative rotation angle, the Lachman test, the axial shift test, and the ratio of the loss of muscle strength of the lower limb. Results: At the final follow-up, all patients returned to pre-injury motor level, with significant improvements in IKDC scores (45.3±6.8 preoperatively, 67.5±4.7 and 93.2±2.3 at 3 months and 2 years after the operation, respectively), Lysholm scores (57.2±2.6 preoperatively, 72.6±2.9 and 89.7±3.7 at 3 months and 2 years after the operation, respectively), and Tegner scores (3.1±0.7 preoperatively, 4.9±0.6 and 5.8±1.3 at 3 months and 2 years after the operation, respectively) (all P<0.001). The anterior-posterior static displacement distance of the tibia reduced significantly [from (5.2±0.5) mm before the operation to (1.4±0.5) mm at 2 years postoperatively) (P<0.001)]; and the relative rotation angle of the tibia-femur restored to the normal physiological range, it was reduced from 6.2°±1.2° before the operation to 1.7°±0.3° 2 years after (P<0.001). The Lachman test and axial shift test at 2 years postoperatively were all negative. The muscle strength loss ratio of the affected lower limb was significantly better than that before the operation (P<0.001). Conclusion: The use of OTT reconstruction combined with modified Lemaire technique for revision of ACL in patients with ACL reconstruction failure can circumvent the tunnel problem for one-stage revision and better restore the stability and function of the knee joint, with ideal clinical results.

[Association between HULC gene locus rs7763881 polymorphism and recurrence and metastasis after radical resection in hepatocellular carcinoma].

Objective: To investigate the association between the expression of long non-coding RNA genes and the HULC rs7763881 polymorphism, recurrence, and metastasis after radical resection in patients with hepatocellular carcinoma (HCC). Methods: Paraffin tissue samples were selected from 426 cases diagnosed with HCC between January 2004 to January 2012. The expression of different genotypes of HULC gene locus rs7763881 in paraffin tissues was detected by PCR, and the association between different genotype expressions and clinical case characteristics of HCC [gender, age, TNM stage, alpha-fetoprotein, tumor maximum diameter (cm), vascular invasion, tumor capsule, tumor grade] was analyzed. Cox proportional risk regression model was used to analyze the correlation between different genotypes and clinicopathological features, prognosis, and recurrence. Survival analysis between different genotypes was performed using the Kaplan-Meier method for a parallel log-rank test. Results: There were 27 (6.3%) cases in the whole group who lost to follow-up. A total of 399 (93.7%) specimens were included in the study, and 105 (26.3%), 211 (52.9%) and 83 (20.8%) were included in the rs77638881 AA, AC, and CC genotypes, respectively. Kaplan-Meier curve showed that the postoperative overall survival and recurrence-free survival rate were significantly higher in patients with the AA than AC/CC genotype (P < 0.05). Univariate analysis showed that the AC/CC genotype was closely related to tumor vascular invasion and recurrence or metastasis of HCC (P < 0.05). Cox multivariate analysis results showed that patients with the AA genotype were taken as references, and the results showed that the risk of recurrence and metastasis in patients with the CA/CC genotype increased to varying degrees, with statistical significance (P < 0.05). Conclusion: The rs7763881 polymorphic loci located on the HULC gene are closely related to HCC recurrence and metastasis after radical resection. Thus, it may be an indicator for evaluating HCC recurrence and metastasis.

Socio-economic inequalities in health among older adults in China.

OBJECTIVES: This study aimed to explore socio-economic inequalities in the health status of older people in China using the most recent data available. STUDY DESIGN: This was a cross-sectional study. METHODS: Data for this study were obtained from the 2018 China Health and Retirement Longitudinal Study, which included 9831 subjects aged 60 years and older. We assessed differences in the prevalence of self-reported health, functional limitations, and chronic conditions by education level and household income level, and then estimated the Slope of Inequality Index (SII) and the Relative Inequality Index (RII) - indexes of the relative magnitude of socio-economic inequalities in health. RESULTS: We found inequalities in all dimensions of health (self-assessed health status, reported chronic conditions, and physical functional limitations) at the household income level. Physical functional limitations, particularly the ability to perform instrumental activities of daily living, produced greater inequality than other domains, with an adjusted SII of 0.495 (95% CI, 0.467-0.524) and an adjusted RII of 2.129 (95% CI, 1.604-2.653). ADL limitations (adjusted SII, 0.524, 95% CI, 0.473-0.575, adjusted RII, 1.527, 95% CI, 1.027-2.027) and self-measured health (adjusted SII, 0.523, 95% CI, 0.258-0.789, adjusted RII, 1.531, 95% CI, 0.551-2.512) were also clearly different. Inequalities were also found across all health domains in terms of educational attainment. Consistent with inequalities in household income, inequalities were greatest for limitations in the ability to perform instrumental activities of daily living (adjusted SII, 0.581, 95% CI, 0.424-0.739, adjusted RII, 3.699, 95% CI, 3.642-3.757). Relative inequalities in limitations in activities of daily living (adjusted SII, 0.676, 95% CI, 0.560-0.792, adjusted RII, 2.587, 95% CI, 2.392-2.784) and self-rated health (poor/very poor) (adjusted SII, 0.647, 95% CI, 0.617-0.677, adjusted RII, 2.406, 95% CI, 2.224-2.587) were also higher. CONCLUSION: Our study shows significant socio-economic differences in the areas of self-rated health, functional limitations, and reported chronic diseases, particularly in the area of IADL limitations. These inequalities need to be explicitly addressed and vulnerable subgroups should be targeted to reduce the socio-economic disparities.

[The multi-dimensional molecular characteristics of the indolent pulmonary ground-glass nodules].

With the dramatically increasing detection rate of ground-glass nodules (GGN), exact understanding and treatment strategy of them has become the hottest issue currently. More and more studies have begun to explore the underlying mechanisms of their indolent characteristics and favorable prognosis from the perspectives of molecular evolution and immune microenvironment. GGN has different dominating gene mutations at different evolutional stages. The pure GGN has a lower tumor mutation burden and genomic instability, while a gradually evolutionary feature of genomic mutation along with the pathological progression can be observed. GGN has less infiltration of immune cells, and they are under the pressure of immune surveillance with weakened immune escape. With the increase of solid components, an inhibitory immune microenvironment is gradually established and immune escape is gradually enhanced, leading to rapid tumor growth. Further exploration of the molecular characteristics of GGN will help to more precisely distinguish these highly heterogeneous lesions, which could be helpful to make personalized treatment plans.

[The diagnostic value of machine-learning-based model for predicting the malignancy of solid nodules in multiple pulmonary nodules].

Objective: To examine the efficiacy of a machine learning diagnostic model specifically for solid nodules in multiple pulmonary nodules constructed by combining patient clinical information and CT features. Methods: Totally 446 solid nodules resected from 287 patients with multiple pulmonary nodules in Department of Thoracic Surgery, Peking University People's Hospital from January 2010 to December 2018 were included. There were 117 males and 170 females, aging (61.4±9.9) yeras (range: 33 to 84 years). The nodules were randomly divided into training set (228 patients with 357 nodules) and test set (59 patients with 89 nodules) by a ratio of 4∶1. The extreme gradient boosting (XGBoost) algorithm was used to generate a predictive model (PKU-ML model) on the training set. The accuracy was verified on the test set and compared with previous published models. Finally, an independent single solid nodule set (155 patients, 95 males, aging (62.3±8.3) years (range: 37 to 77 years)) was used to evaluate the accuracy of the model for predictive value of single solid nodules. Area of receiver operating characteristic curve (AUC) was used to evaluate diagnostic values of models. Results: In the training set, the AUC of the PKU-ML model was 0.883 (95%CI: 0.849 to 0.917). In the test set, the performance of the PKU-ML model (AUC=0.838, 95%CI: 0.754 to 0.921) was better than the models designed for single pulmonary nodules (Brock model: AUC=0.709, 95%CI: 0.603 to 0.816, P=0.04; Mayo model: AUC=0.756, 95%CI: 0.656 to 0.856, P=0.01; VA model: AUC=0.674, 95%CI: 0.561 to 0.787, P<0.01), similar with PKUPH model (AUC=0.750, 95%CI: 0.649 to 0.851, P=0.07). In the independent single solid nodules set, the PKU-ML model also achieved good performance (AUC=0.786, 95%CI: 0.701 to 0.872). Conclusion: The machine learning based PKU-ML model can better predict the malignancy of solid nodules in multiple pulmonary nodules, and also achieved a good performance in predicting the malignancy of single solid pulmonary nodules compared to mathematical models.

[The association between serum total homocysteine and subacute combined degeneration of spinal cord].

Objective: The research was aimed to investigate the association between serum total homocysteine (tHcy) and subacute combined degeneration of the spinal cord (SCD). Methods: A retrospective survey of 106 newly diagnosed patients with SCD were enrolled in this research who were treated in the department of neurology of Xijing Hospital from January 2008 to February 2019, meanwhile, 121 patients with spinal cord lesion (not SCD) and 104 neurology mild outpatients were selected as controls. Serum tHcy level was determined by using the chemiluminescent immunoassay assay. A multivariate logistic regression model was used to analyze the risk factors for SCD. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve, sensitivity, specificity and Youden index were used to evaluate the diagnostic efficacy of tHcy. Spearman correlation analysis was used to observe the correlation between tHcy and SCD severity. The SCD patients were categorized into normal or mild tHcy group, moderate tHcy group, and severe tHcy group based on tHcy levels. Clinical symptoms, nerve conduction velocity, magnetic resonance imaging (MRI) findings from the patients were studied. Results: The serum tHcy levels in SCD patients were 64.3(26.5, 98.8) µmol/L, while in patients with spinal cord lesion (not SCD) group were 13.7(10.8, 19.2) µmol/L, neurology mild outpatients were 10.6(8.2, 13.0) µmol/L, which was higher in SCD group (H=112.020,P<0.001), (H=165.525,P<0.001).The multivariate logistic regression model showed tHcy is the impact factor of SCD (OR=1.107, 95%CI:1.077-1.139, P<0.001). At ROC analysis, tHcy showed diagnostic value with an optimal cut-off value of 24.9 µmol/L (AUC 0.913, 95%CI: 0.875-0.951, sensitivity 79.2%, specificity 91.6%). Spearman correlation analysis showed that tHcy was positively correlated with functional disability rating scale (r=0.254, P=0.009). Conclusions: Serum tHcy is the risk factor for SCD and related to its disability. Focus on the increased level of tHcy plays a positive role in the diagnosis of SCD.

[Correlation among age, sex, and liver diseases-related mortality risk in patients with hepatitis B virus-related liver cirrhosis].

Objective: To understand and compare the differences between age, sex and liver diseases-related mortality risk in patients with hepatitis B virus-related liver cirrhosis. Methods: Based on the front-page inpatient medical record database and the death registration system of Beijing patients with hepatitis B-related liver cirrhosis from 2008 to 2015 were included. The survival information of all patients were traced up to the occurrence of liver disease-related mortality event or until December 31, 2019. Kaplan-Meier method was used to calculate the cumulative incidence of liver disease-related mortality in patients with liver cirrhosis. Cox regression model was used to analyze the effect of age-gender interaction on liver disease-related mortality risk. Results: A total of 16 738 patients with hepatitis B-related liver cirrhosis were included, of which 13 969 cases (83.46%) were in compensated stage and 2 769 cases (16.54%) were in decompensated stage. Liver cirrhosis complications mortality risk in patients with compensated stage cirrhosis at 3, 5, and 8 years were 10.84%, 12.70%, and 14.37%, respectively; while in decompensated stage patients, the mortality risk was 16.70%, 19.02%, and 20.73%, respectively. The 3, 5, and 8-year liver cancer mortality rates of patients with compensated stage liver cirrhosis were 5.24%, 7.49%, and 10.25%, respectively; while those with decompensated stage liver cancer mortality rates were 9.01%, 11.16%, and 13.50%, respectively. Liver disease-related mortality risk was increased with age in patients with liver cirrhosis. Liver cirrhosis complications mortality risk in female patients with liver cirrhosis at age < 60 years was lower than that of male patients. Liver cirrhosis complications mortality risk in male and female patients aged 60-69 years were similar. Liver cirrhosis complications mortality risk in female patients aged ≥70 years was higher than that of male patients. However, female patients had a lower risk of liver cancer mortality than male patients in utmost age groups. Conclusion: Age is positively correlated with liver diseases-related mortality risk in patients with hepatitis B-related liver cirrhosis. Female sex is a protective factor for liver cancer mortality in patients with liver cirrhosis, and the protective effect on liver cirrhosis complications mortality risk gradually disappears with age.

Effect of anti-müllerian hormone on the development and selection of ovarian follicle in hens.

To elucidate the role of anti-müllerian hormone (AMH) in regulating the development of ovarian follicles in laying hens, the expressions of follicle-stimulating hormone receptor (FSHR), AMH receptor type 2 (AMHR2), steroidogenic-related genes steroidogenic acute regulatory protein (STAR), cytochrome P450 side-chain cleavage (CYP11A1), and 3ß-hydroxysteroid dehydrogenase (HSD3B1) genes were measured from different sized follicles and granulosa cells. The results showed that the expressions of FSHR and AMHR2 genes were higher in small follicles and decreased after follicular selection. Oppositely, the expressions of STAR, CYP11A1, and HSD3B1 were significantly increased after follicular selection. It indicated that AMHR2 might mediate AMH suppression in the stimulating effects of follicle-stimulating hormone (FSH) on steroidogenic-related genes expression. To make sure the effects of AMH in this process, a total of 40 hens were treated (negative control, sham operation, 150 ng AMH/d or 300 ng AMH/d) for 25 d. We analyzed ovarian morphology, progesterone concentration in blood plasma, and the expressions of steroidogenic genes in ovaries and follicles. The AMH300 group had significantly lower weight of ovary and hierarchical follicles. Egg weight and ovary weight in AMH150 group were higher than those of sham operation and AMH300 groups, so did hierarchical follicles weight. The steroidogenic genes expressions showed an increase in ovarian tissue and the largest follicle of AMH150 and AMH300 groups. However, progesterone level in the blood was reduced by AMH injection with different concentrations. To further verify the above results, granulosa cells from 6 to 8 mm follicles were cultured with AMH (0, 5, 10, 20, 40, or 80 ng/mL). The results revealed that excessive AMH (80 ng/mL) exerted an inhibitory effect on progesterone synthesis and the expressions of STAR, CYP11A1, and HSD3B1. However, these genes expressions showed a significant increase in 20 ng/mL AMH-treated group. In summary, AMH inhibited the development of prehierarchical follicles in laying hens. The effects of AMH treatment with different concentrations on follicle development showed the follicle was selected by changing FSH responsiveness of prehierarchical follicles.

[Comparative analysis of comprehensive health status among 31 provinces in China and 134 countries (regions) in 2015].

Objective: To evaluate comprehensive health status of 31 provinces in China and compare with other countries (regions). Methods: Social-demographic index, life expectancy and healthy life expectancy in 134 countries (regions) and 31 provinces in China were collected from the Global Burden of Disease Study 2015. K-means clustering method was used to classify comprehensive health status of various countries (regions) in the world. HemI 1.0.3 software was applied to draw distribution heat maps of social-demographic index, life expectancy and healthy life expectancy in different provinces of Mainland China. Discriminant analysis was used to evaluate comprehensive health status of different provinces in Mainland China. Results: Comprehensive health status of 134 countries (regions) was grouped into category 1-8 from good to poor, and Mainland China was in the category 4. The comprehensive health status of provinces in Mainland China is better in the east coast and poorer in the west inland, among which Shanghai and Beijing were grouped into the category 1, Zhejiang, Jiangsu, Guangdong and Tianjin into the category 2, Fujian, Liaoning and Shandong into the category 3, Yunnan, Guangxi, Xinjiang and Guizhou into the category 5, Qinghai and Tibet into the category 6, and the rest 16 provinces into the category 4. Conclusion: Comprehensive health status of Mainland China ranked middle to upper level in the world, and health status disparities were observed among different provinces in Mainland China.

Localization of cells using magnetized patterned thin films.

In this study, the nasopharyngeal carcinoma cell line was cultured in a superparamagnetic iron oxide nanoparticle aqueous solution with a concentration of 1 µg/mL by using magnetic labeling technology. The cells took up superparamagnetic nanoparticles through the endocytosis process, which caused the cells to become magnetic and manipulable by a magnetic field gradient. Each cell contained 5.266 × 106 superparamagnetic nanoparticles, as determined using the magnetophoresis method. A specific domain configuration and its related distribution of magnetic poles in a patterned thin film were obtained after applying a magnetic field in a specific direction. Here, patterned magnetic thin films were designed to form square grid and square ring structures. When the magnetic field of 3000 G was applied along the diagonal of the square (45° direction) and then released, magnetic cells were trapped at the intersection of the square grid and the 45° diagonal corner of the square ring structure. From micromagnetic simulation results, it was determined that head-to-head and tail-to-tail domain walls with a high magnetic pole density formed at the corners of the square ring structure in the 45° diagonal direction, and the attractive force between a head-to-head/tail-to-tail domain wall and a cell at a height of 1 µm above the corner was approximately 2.055 × 10-10 N. In the square grid case, the attractive force between the domain wall at the intersection and a cell at a height of 1 µm above the intersection was approximately 2.245 × 10-10 N. The results of this study demonstrated that cells can simultaneously be arranged at designated locations physically by using patterned magnetic thin films in a noninvasive manner without chemical modification of the substrate.

Analysis of Causes of Death and Related Factors of 102 Perinatal Infants in Chongqing.

OBJECTIVES: To analyze the causes of perinatal death and related factors from the perspective of forensic medicine, and to provide references for reducing perinatal mortality and guidance for forensic identification. METHODS: A retrospective analysis was performed on 102 cases of perinatal autopsy with clinical data from the Department of Forensic Medicine of Chongqing Medical University in 2004-2016. RESULTS: Of the 102 cases of perinatal deaths, 66 （64.71%） were neonatal deaths, 24 （23.53%） were stillborn foetuses, and 12 （11.76%） were stillbirths. Among the 66 neonatal death cases, 39 （59.09%） died within 1 d, 19 （28.79%） died within 1-3 d, and 8 （12.12%） died within >3-7 d of birth. The top 3 causes of neonatal death were pulmonary diseases, congenital malformation, umbilical cord and placental abnormalities. The causes of stillborn foetus and stillbirth were mainly umbilical cord and placental abnormalities, and intrauterine asphyxia. CONCLUSIONS: Pulmonary diseases, umbilical cord and placental abnormalities, and congenital malformations are the main causes of perinatal death. In order to reduce the perinatal mortality, pre-pregnancy examination and prenatal care should be strengthened, and the knowledge of pregnancy care should be popularized.

Effect of N-acetyl-l-methionine supplementation on lactation performance and plasma variables in mid-lactating dairy cows.

The objective of current study was to investigate the effect of N-acetyl-l-methionine (NALM) supplementation on lactation performance and plasma variables in mid-lactating dairy cows. Forty-eight multiparous cows were blocked into 12 groups based on parity, days in milk, and milk production and were randomly assigned to 1 of the 4 treatments: 0, 15, 30, or 60 g/d of NALM per cow to supplement the basal diet. The experiment was conducted over a 13-wk period, with the first week as adaptation. The yields of milk, fat-corrected milk, and milk lactose were increased quadratically, and energy-corrected milk yield tended to increase with increased NALM supplementation in a quadratic manner. The dry matter intake, milk protein yield, milk fat yield, contents of milk composition (protein, fat, lactose, total solids, and milk urea nitrogen), feed efficiency, and body weight change were not affected by NALM supplementation. In addition, plasma methionine concentration was increased quadratically, and proline, total nonessential AA, and total AA concentrations were significantly higher in the 30 g/d group compared with that of the control group. However, other AA and total essential AA concentrations were not affected with supplementation of NALM. Adding NALM increased concentrations of total protein and globulin in plasma, but decreased plasma urea nitrogen concentration in a quadratic manner. Meanwhile, plasma malonaldehyde concentration decreased linearly as doses of NALM addition increased. Our results suggested that the supplementation of NALM improved milk yield and protein synthesis in the liver, and lowered lipid peroxidation in mid-lactating dairy cows.

Short communication: Effects of dietary addition of N-carbamoylglutamate on milk composition in mid-lactating dairy cows.

The present study was conducted to investigate the effect of N-carbamoylglutamate (NCG) on milk production and composition in mid-lactating Holstein dairy cows. Sixty multiparous cows with a mean body weight of 669 kg (standard deviation = 71) and 176 days in milk (standard deviation = 55) were blocked based on parity and milk production and randomly assigned into 4 treatments, a basal diet supplemented with 0, 10, 20, or 40 g of NCG/d per cow. Milk yield and composition were recorded weekly, whereas dry matter intake and plasma variables were determined every 2 wk. The results showed that the addition of NCG had no effect on the dry matter intake and milk yield of the cows. Milk fat content and yield increased linearly with NCG addition. The contents of milk protein and total solid also increased linearly in the cows fed NCG, whereas the yield of protein was not affected by the treatments. Conversely, dietary addition of NCG increased the plasma nitric oxide content in a quadratic manner. Moreover, addition of NCG linearly increased the plasma Arg content. Overall, the results indicate that dietary NCG addition increased the milk protein and fat contents, which improved the milk quality of lactating dairy cows.

[Analysis on the consistency and timeliness of death data gathered from different sources in the residents of Beijing].

Objective: To further improve the quality of mortality data for Beijing residents, through describing and analyzing the current death data gathered from different sources in Beijing. Methods: Data on death of the Beijing residents from Beijing Public Security Bureau, Beijing Civil Affairs Bureau and Beijing Centers for Disease Control and Prevention (BJCDC) were collated and compared. Timeliness of related data from the three different sources were described and analyzed. The overall consistency and reported timeliness of data from the three sources appear good, but the consistency on the causes of death needs to be improved. Result: Numbers of deaths from the three different sources were 95 318, 130 906 and 160 779 respectively, with 387 003 in total. Data from the Beijing Public Security Bureau and BJCDC seemed better in terms of integrity and accuracy. Data from the Beijing Public Security Bureau had the highest filling rate of ID card number while data from the Beijing Civil Affairs Bureau had the best timeliness. The most informative source of data was from the BJCDC. Conclusion: The overall quality of the exchanged death data from Beijing Public Security Bureau, Beijing Civil Affairs Bureau and BJCDC appeared good but remained some areas for improvement.

[Probability of premature mortality caused by non-communicable diseases in Beijing, 2010-2015].

Objective: To understand the probability of premature mortality caused by non-communicable diseases (NCD) in Beijing from 2010 to 2015. Methods: The data of deaths from Beijing vital registration system were used to analyze age-standardized NCD mortality rates, proportion of NCD deaths in age group <70 years and premature NCD mortality. Results: NCD deaths accounted for 90% of the total deaths in Beijing. Age-standardized NCD death rate decreased from 332.43/100 000 in 2010 to 280.02/100 000 in 2015. Meanwhile, the probability of deaths from four NCDs between in age group 30-70 years (premature NCD mortality) decreased from 12.81% to 11.11% in Beijing. The premature mortality of four NCDs in men was 14.63%, and compared with 2015 baseline, it would decrease by 16.4% to reach 2025 goal (12.23%), and the probability of premature mortality four NCDs in women was 7.54%, and compared with 2015 baseline, it would decrease by 6.8% to reach the 2025 goal (7.03%). People living in suburb areas had a higher probability of premature NCD mortality (13.67%) than those living in urban areas (9.72%) in Beijing in 2015. Conclusions: The premature NCD mortality was much higher in men than in women in Beijing. More attention should be paid to the control of risk factors for NCD premature deaths, especially in men and in suburb residents, to reach the 25×25 goal.

[The concept of field cancerization and its clinical application].

Head and neck squamous cell carcinoma(HNSCC) is among the most common malignances worldwide. Patients with HNSCC often develop primary tumors at multiple sites and have tendency for local recurrences following curative resectional surgery. Field cancerization theory presumes that, after repeated carcinogenic exposures, the entire superficialepitheliium of the upper aerodigestive tract has an increased risk for developing (pre)malignant lesions because of multiple genetic abnormalities. This theorywell explains the strong potential with malignant transformation and loco-regional recurrence in HNSCC, and helps to better understand the pathogenesis, and thus provides a new idea for prevention and treatment of this disease. This paper will give an overview of field cancerization, including the concept and its clinical application.

[Influencing factors on healthy life expectancy in adults in Beijing].

OBJECTIVE: To understand the main influencing factors related to healthy life expectancy (HALE) among adults in Beijing. METHODS: The calculation on health-adjusted life expectancy was performed by Sullivan METHODS. Data from the self-reported health survey program on adults in Beijing 2012 was gathered. Hierarchical ordered probit model was used to estimate the severity-weighted prevalence of disability and then combined with the period life table to obtain the HALE. Factors associated with the severity-adjusted prevalence of the disabled were analyzed under the generalized additive models (GAM). RESULTS: The main influencing factors of HALE would include age (t=40.351, P<0.001), sex (t=9.689, P<0.001), levels of education (t=5.021, P< 0.001), exercise (t=5.487, P<0.001) and alcohol intake (t=-2.380, P=0.017) etc. The influence of per capita monthly income (χ(2) =3.949, P=0.044) showed as non-linear. CONCLUSIONS: Levels of income would directly influence the severity-weighted prevalence of the disability, which also affecting the HALE. Programs on improving healthy life style and health care in women should be promoted.

[Analysis on causes of death of residents in Beijing, 1965-1974].

OBJECTIVE: To fill up the absence of data on causes of death of urban residents in Beijing during 1965-1974 and provide evidence for the similar study in other areas. METHODS: All possible sources for death data during 1965-1974 were identified through expert consultations and record search. Stratified sampling was conducted to collect the death data of urban residents during this period in Beijing. The mortality rate, death cause constituent and rank of death causes were used in this descriptive analysis. RESULTS: A total of 11 668 records of deaths from 1965 to 1974 were collected from 10 local police stations in urban area of Beijing. The top 10 death causes in the urban residents were heart disease, tumor, cerebrovascular disease, accidental injury, respiratory system disease, digestive system disease, communicable disease and parasitic disease, nervous system disease, urogenital and reproductive system disease, endocrine and nutrition metabolic diseases. The deaths caused by these diseases accounted for 84.19% of the total deaths. Accidental injury accounted for 13.22% of the total deaths, which was significantly higher than that in either 1964 or 1975, two years before and after this period(P<0.01). Suicide accounted for 54.47% of the total accidental injury deaths. For men, accidental injury was the leading death cause, followed by cancer and heart disease; for women, heart disease, cancer and cerebrovascular disease were the top three death causes. CONCLUSION: The major death cause in urban residents changed from infectious diseases to chronic and non-communicable diseases during 1965-1974. A remarkable high proportion of deaths caused by accidental injury was due to the historical background during that period in Beijing, China.

The Effects of Dietary Phosphorus on the Growth Performance and Phosphorus Excretion of Dairy Heifers.

The objective of this study was to investigate the effects of reducing dietary phosphorus (P) on the frame size, udder traits, blood parameters and nutrient digestibility coefficient in 8- to 10-month-old Holstein heifers. Forty-five heifers were divided into 15 blocks according to the mo of age and were randomly assigned one of three dietary treatments: 0.26% (low P [LP]), 0.36% (medium P [MP]), or 0.42% (high P [HP]) (dry matter basis). Samples were collected at the wk 1, 4, 8. The results show that low dietary P had no effect on body measurement. The blood P concentration decreased with decreasing dietary P (p<0.05), while the blood calcium content of LP was higher than that of the MP and HP groups (p<0.05), though still in the normal range. The serum contents of alkalinephosphatase, potassium, and magnesium were similar among the treatments. No differences were found in all nutrients' apparent digestibility coefficients with varied dietary P. However, with P diet decreased from HP to LP, the total fecal P and urine P concentration declined significantly, as did fecal water soluble P (p<0.05). In conclusion, reducing the dietary P from 0.42% to 0.26% did not negatively affect the heifers' growth performance but did significantly lessen manure P excretion into the environment.