[Experimental study on evaluating renal redox metabolism in renal ischemia-reperfusion injury using GluCEST imaging with 3.0 T MRI].

Objective: To investigate the feasibility of 3.0 T glutamate chemical exchange saturation transfer (GluCEST) imaging in evaluating renal redox metabolism in renal ischemia-reperfusion injury (IRI). Methods: Rabbits in the IRI group (n=56) underwent surgery by clamping the left renal artery for 45 min and then releasing to establish IRI. Rabbits in the sham group (n=8) underwent the same operation without clamping the left renal artery. GluCEST MRI was performed before and at 1 h, 12 h, 1 day, 3 days, 7 days, and 14 days after the operations, with eight rabbits in the IRI group sacrificed immediately after each scanning and eight in the sham group sacrificed at 14 days after scanning. The left kidneys were removed for histopathological examination and reactive oxygen species (ROS) fluorescence staining. Differences in the magnetic resonance ratio asymmetry (MTRasym) of the renal cortex and outer medulla among different groups were compared. Correlations between the MTRasym and ROS were analyzed. Results: The MTRasym of the renal cortex in the sham and IRI subgroups were higher than that of the outer medulla (t=8.16, P<0.001; t=4.78, P=0.002; t=4.94, P=0.002; t=5.76, P=0.001, t=6.68, P<0.001; t=6.40, P<0.001; t=5.16, P=0.001; t=3.30, P=0.013). The MTRasym of the renal cortex and outer medulla in the IRI-1h, IRI-12h, IRI-1d, IRI-3d, IRI-7d, and IRI-14d groups were lower than in the sham and IRI-pre groups (all P<0.05). The MTRasym of the renal cortex and outer medulla in the IRI-1h group were lower than in the IRI-12h, IRI-1d, IRI-3d, IRI-7d, and IRI-14d groups (all P<0.05). The MTRasym of the renal cortex in the IRI-12h group was lower than in the IRI-7d and IRI-14d groups (1.84%±0.09% vs.2.42%±0.19%, 2.41%±0.31%, all P<0.05). The MTRasym of the renal cortex in the IRI-1d group was lower than in the IRI-7d group (1.99%±0.17% vs. 2.42%±0.19%, P=0.008). The MTRasym of the outer medulla in the IRI-12h group was lower than in the IRI-3d, IRI-7d, and IRI-14d groups (1.32%±0.27% vs. 1.79%±0.31%, 1.98%±0.18%, 1.66%±0.40%, respectively, all P<0.05]. The MTRasym of the outer medulla in the IRI-7d group was higher than in the IRI-1d and IRI-14d groups (1.98%±0.18% vs. 1.52%±0.31%, 1.66%±0.40%, all P<0.05). The MTRasym of the renal cortex and outer medulla had a strong negative correlation with the mean fluorescence intensity of ROS (ρ=-0.889, P<0.001; ρ=-0.784, P<0.001). Conclusion: 3.0 T GluCEST imaging can indirectly reflect the changes of renal redox metabolism in renal IRI.

[Research hot spots and trends of keratoconus in China: a bibliometric analysis].

Objective: To review the studies related to keratoconus in China, investigate research hotspots and development trends in this field, and provide reference for future research. Methods: This is a bibliometrics study. The relevant literature written in Chinese was retrieved from the WanFang DATA and the China National Knowledge Infrastructure, English articles were collected from the Web of Science Core Collection database. Searched for journal articles related to keratoconus VOSviewer software, CiteSpace, and Bibliometrix in the R language were employed to create the knowledge map. The analysis encompassed the distribution of published journals, research collaboration networks of countries/regions, institutions, and authors. Additionally, core authors, high-frequency keyword co-occurrence, keyword topic maps, and keyword emergence time ranking were examined. Results: The study ultimately included 1 100 Chinese articles and 668 English articles. Chinese literature and English literature began to increase in 1997 and 2009, respectively, indicating that the field is currently in a developmental stage. The publications involved 244 Chinese journals and 150 English journals, predominantly in the field of ophthalmology. The United States collaborated the most with China, contributing to 123 articles, followed by other countries such as the United Kingdom and Switzerland. Chinese literature and English literature involved 552 and 883 institutions, respectively. The institution with the highest number of Chinese literature publications was the Eye Institute of Shandong First Medical University (63 papers), while Wenzhou Medical University had the highest number of English literature publications (91 papers). Chinese literature involved 2 435 authors, and English literature involved 2 073 authors. The largest collaboration cluster in Chinese literature was formed by the teams of Xie Lixin and Shi Weiyun, while the Gao Hua team formed the largest cluster in English literature. However, collaboration between authors was primarily limited to within each team. A total of 622 and 1 611 keywords were extracted from Chinese and English literature, respectively. The node centrality of the four Chinese keywords, "keratoconus", "cornea", "corneal transplantation" and "myopia" as well as the three English keywords, "keratoconus", "collagen cross-linking" and "penetrating keratoplasty" was greater than 0.1. "Collagen", "riboflavin", "corneal transplantation" and "ultraviolet A" were identified as common core hotspots and important research topics in Chinese and English literature on keratoconus. Keyword emergence analysis indicated that the keywords with the highest intensity of emergence in Chinese and English literature were "myopia" (13.54) and "penetrating keratoplasty" (9.99), respectively. The longest emergence time was observed for "contact lenses" (1995-2006) and "penetrating keratoplasty" (2003-2014). Conclusions: At present, research on keratoconus in China is on the rise, with research hotspots including pathogenesis, various new surgical methods, and improvement in quality of life. The future research trend mainly focuses on early diagnosis and screening methods, artificial intelligence, biomechanical examination, subclinical keratoconus, and small incision lenticule extraction.

[Research advances on pharmacological interventions for hypertrophic scar].

Hypertrophic scar is an abnormal fibrous proliferative disease that occurs after deep cutaneous injury, which not only affects aesthetics and function but also has negative psychological effects on the patients. However, the mechanism of hypertrophic scar formation has not been fully elucidated, and its clinical treatment is complex with a high rate of recurrence and no radicle cure. Intervention based on molecular targets will likely be the future direction for the prevention and treatment of hypertrophic scar. In this article, we review the specific roles and mechanisms of drug-targeted interventions in hypertrophic scar formation, including general drugs, cytokines, immunomodulators, herbal extracts, exosomes, and nanomaterials, in the context of advances in both basic and clinical research at home and abroad.

[Three dimensional nephrometry system for partial nephrectomy: Our initial exploration].

OBJECTIVE: To construct a preoperative evaluation system for partial nephrectomy using CT three-dimensional visualization technology and to explore its practical value. METHODS: The clinical data of the patients who underwent partial nephrectomy for renal tumors in Department of Urology, Peking University First Hospital were collected retrospectively. At the same time, the homogenized standard data of patients who underwent partial nephrectomy for renal tumors were collected in 16 clinical centers in China. The CT three-dimensional visualization system was applied (IPS system, Yorktal) to evaluate tumor anatomy, blood supply, perirenal fat and other information. The parameters were summarized to build a three-dimensional nephrometry system, on the basis of which virtual surgery design and intraoperative navigation were completed. RESULTS: A three-dimensional visualization image was established based on the enhanced CT urography. The nephrometry system included the longest diameter and volume of the tumor, proportion volume of tumor invading the parenchyma, maximum depth of the tumor invading the parenchyma, contact surface area, flatness of the tumor surface, renal segment where the tumor was located, vascular variation, and perirenal fat. The average two-dimensional diameter of the tumor was (2.78±1.43) cm, the average three-dimensional maximum diameter was (3.09±1.35) cm, and the average postoperative pathological size was (3.01±1.38) cm. The maximum tumor diameter in the three-dimensional image was significantly related to the prolonged renal artery clamping time and intra-operative blood loss (r=0.502, P=0.020; r=0.403, P=0.046). The three-dimensional and pathological tumor volume were (25.7±48.4) cm3 and (33.0±36.4) cm3, respectively (P=0.229). The tumor volume was significantly related to the intraoperative blood loss (r=0.660, P < 0.001). The proportion volume of the tumor invading into renal parenchyma was significantly related to the prolongation of renal artery clamping and the occurrence of postoperative complications (r=0.410, P=0.041; r=0.587, P=0.005). The tumor contact surface area and the presence of vascular variation did not show correlation with the perioperative data and postoperative complications. While the preoperative evaluation was completed, the reconstructed three-dimensional image could be zoomed, rotated, combined display, color adjustment, transparency, and simulated cutting on the Touch Viewer system. The process generally consisted of showing or hiding the tissue, adjusting the transparency of the interested area, rotating and zooming the image to match the position of the surgical patient. Together, these functions met the requirements of preoperative virtual surgery plan and intraoperative auxiliary navigation. CONCLUSION: Three-dimensional images can provide a more intuitive anatomical structure. The CT three-dimensional visua-lization system clearly displays tumor anatomical parameters, blood supply and perirenal fat. The three-dimensional nephrometry system for renal tumors can help predict the difficulty of partial nephrectomy and perioperative complications. Importing the reconstructed three-dimensional visualization image into the specified program or robot operating system can complete virtual surgery and intraoperative navigation, helping the surgeon to better grasp the surgical process. The indexes included in the nephrometry system and the score weights of each index need to be confirmed and perfected by multi-center study with large samples.

[Correlation of capillary plexus with visual acuity in idiopathic macular epiretinal membrane eyes using optical coherence tomography angiography].

Objective: To observe changes in foveal avascular zone(FAZ) and capillary plexus in idiopathic macular epiretinal membrane (IMEM) in optical coherence tomography angiography (OCTA) and analyze their correlation with the visual acuity. Methods: Cross-sectional study. 42 patients (15 Males and 27 females, age 64.8) from the Eye Hospital of Wenzhou Medical University were included with 51 eyes diagnosed as IMEM (IMEM group), and 23 normal eyes (9 Males and 14 females, control group). All patients received the examination of fissure lamp combined with fundus pre-set lens, best corrected visual acuity (BCVA), OCT angiography (OCTA) and fundus photo. OCTA was performed on 3 mm× 3 mm sections centred on the fovea. The software automatically measured the superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel density(VD) and retinal thickness(RT) and FAZ area. The IMEM eyes were compared with the normal eyes and correlation between the parameters of OCTA and BCVA was analyzed in IMEM. Independent-sample t test and MannWhitney test were used for comparison between groups, and Spearman test was used for correlation analysis. Results: LogMAR BCVA in the IMEM group was 0.40(0.15, 0.70), in the control group was 0.10(0.05, 0.22). FAZ area of IMEM group was (0.09±0.05) mm(2), while that of control group was (0.34±0.13)mm(2).Compared with the control group, in IMEM group, the BCVA was worse (Z=-4.443, P<0.001), FAZ area was smaller (t=-9.198, P<0.001), RT was increased (P<0.001), The foveal DCP and SCP vessel density was increased (t=4.280, 9.079, P<0.01), The parafoveal DCP vessel density was decreased (P<0.05), The parafoveal SCP vessel density was decreased in superior, inferior and nasal side (t=-2.759, Z=-3.998, Z=-2.108; P<0.05). The BCVA was negatively correlated with FAZ area (r=-0.337, P=0.017), positively correlated with center macular thickness (r=0.324, P=0.020). The BCVA was no correlated with foveal VD and parafoveal DCP vessel density (P>0.05), but correlated with SCP vessel density(P<0.05). Conclusions: In the IMEM eyes the BCVA was worse, FAZ area was smaller, foveal vessel density was increased and the parafoveal vessel density was decreased compared with the normal eyes. The smaller the FAZ area, the smaller foveal SCP vessel density, the poorer BCVA. There was no correlation between BCVA and DCP vessel density. Changes in VD in IMEM eyes may lead to changes in vision. (Chin J Ophthalmol, 2019, 55:757-762).

[Analysis on current status and influential factors of occupational stress among couriers].

Objective: To investigate the current status and influencing factors of occupational stress among couriers. Methods: Couriers (n=925) were selected on this study used cluster sampling method from January to March 2018. They were from SF and Zhongtong Express Co., Ltd., on the Wechat platform, and surveyed by a job stress questionnaire based on a job demand-control model.Valid questionnaires(n=617) were obtained. Results: A total of 418 workers were occupational stress positive (67.7%). The results of Chi-square analysis showed that there were significant differences in occupational stress among workers categorized by job position, working years, mealtime, sleeping time, and weekly work time (P<0.05). The multivariate logistic analysis indicated that non-regular meals, short-term sleep and less than 0.5 working years were risk factors for occupational stress(P<0.05). Conclusion: Couriers generally have occupational stress. The main influencing factors are job position, working years mealtime, sleeping time, and weekly work time. It is necessary to guide healthy lifestyle, rationally organize labor and assign tasks, and improve working environment to relieve their occupational stress.

[Risk factors of retinopathy of prematurity in extremely low birth weight infants by strictly controlling oxygen inhalation after birth].

Objective: To observe the incidence and severity of retinopathy of prematurity (ROP) in extremely low birth weight (ELBW) infants by strictly controlling the risk factors of ROP, such as oxygen inhalation after birth, to explore the related factors of ROP in ELBW infants. Methods: This was a cross-sectional study. 166 ELBW infants underwent neonatal screening were enrolled in this study, whose birth weight was less than 1 000 g. There were 79 males and 87 females infants, whose average gestational age was (27.99±1.73)weeks, and average birth weight was (904.45±80.23)g. According to the final screening results, the ELBW infants were grouped as follows: (1)ROP group and non-ROP group; (2)severe ROP group and mild or no ROP group. Risk factors included gestational age, birth weight, test-tube infants, fetuses number, complications during pregnancy, delivery mode and Apgar scores in 1 to 10 minutes, weight and weight gain proportion at 1-6 weeks after birth, postnatal feeding mode, history of oxygen inhalation, anemia and blood transfusion, and other systemic diseases were recorded. And their correlation with severe ROP was analyzed by SPSS 20.0 statistical software. Results: Ninty-four (56.63%) ELBW infants developed ROP, 16 (9.64%) were severe ROP and 14(8.43%) received treatment. Average birth weight between ROP group (911.95±72.80)g and non-ROP group (894.67±88.58)g had no difference(t=1.379, P=0.170). Average gestational age between ROP group (27.49±1.53) weeks and non-ROP group (28.64±1.76) weeks had significant difference(t=-4.491,P<0.001).And pregnancy-induced hypertension during pregnancy (χ(2)=4.479, P=0.034), Apgar score in 5 minutes (t=-2.760, P=0.006) and 10 minutes (t=-2.099, P=0.043), pneumonia (χ(2)=6.233, P=0.013), neonatal pneumonia (χ(2)=18.026, P<0.001) had significant difference between ROP group and non-ROP group. There was no effect on weight (F=0.009,P=0.753) or weight gain proportion (F=2.394,P=0.124) at 1-6 weeks after birth in ELBW infants with or without ROP. Average birth weight between severe ROP group(875.63±74.85)g and mild or no ROP group(907.53±80.41)g had no difference(t=-1.518, P=0.131).Average gestational age between severe ROP group(26.88±1.31)weeks and mild or no ROP group (28.11±1.73)weeks had significant difference(t=-2.766,P=0.006).And only fundus hemorrhage (χ(2)=4.507,P=0.034) had significant difference between severe ROP group and mild or no ROP group. There was no effect on weight (F=2.683,P=0.103) or weight gain proportion (F=0.431,P=0.513) at 1-6 weeks after birth in ELBW infants with or without ROP. Logistic regression analysis revealed that only gestational age was correlated to the incidence (ß=-0.437,P<0.001) and severity (ß=-0.616,P=0.007) of ROP significantly. Conclusion: By strictly controlling the risk factors of ROP, such as oxygen inhalation after birth, the severe rate of ROP in ELBW infants is low. However, gestational age is still the inevitable independent high risk factor for the incidence of ROP in ELBW infants. (Chin J Ophthalmol, 2019, 55:280-288).

Analysis of Forensic Sciences Literature in SCIE from 2008 to 2017.

OBJECTIVES: To analyze the literature on forensic sciences indexed in Science Citation Index Expanded （SCIE） in recent 10 years, and to understand the research status, characteristics and trends in the field of forensic sciences. METHODS: Literature on forensic sciences from 2008 to 2017 in Web of Science （WoS） was retrieved. The documents number and geographical distribution, document types, source titles, organizations, research areas, authors, funding agencies, and the high cited articles were detected. The impact factors （IF） of journals were retrieved in Journal Citation Reports （JCR）. The data were analyzed with descriptive statistics. RESULTS: From 2008 to 2017, there were 21 001 documents on forensic sciences in SCIE. The main document type was articles, with English as the major language. With regards to research areas, pathology has the largest number of papers worldwide, and genetics and heredity has the largest number of publications in mainland China. Among the 18 journals where the documents was published, Forensic Science International ranks the first on publication count, and Forensic Science International Genetics has the highest IF （5.637） in the JCR 2017. In 2017, the number of papers from mainland China increased by 48.50% compared with 2016, which was higher than the global increase （32.63%） and the top-5 countries in terms of number of publications （the US, Germany, the UK, Australia, Italy）. The average document count per organization is 1.98 worldwide and 1.17 in mainland China, respectively. The publication number per author is 0.53 worldwide and 0.36 in mainland China, respectively. Around 28.17% of the publications were funded, with National Natural Science Foundation of China （NSFC） as the Top 1 funding agency （192 papers）. Among the documents with citations, the most cited publication has been cited for 366 times. CONCLUSIONS: The yearly numbers of publications on forensic sciences are increasing during recent 10 years. Focusing on the mainland China, there would be more high-quality papers with the steady funding of NSFC.

[Changes in mass spectrometry of proteins in patients with 1-bromopropane poisoning after treatment].

Objective: To investigate the changes in mass spectrometry of proteins in patients with 1-bromopropane (1-BP) poisoning after treatment and their biological functions. Methods: From May 2016 to December 2017, 3 male patients aged 31-47 years with 1-BP poisoning in Bao'an District of Shenzhen, China were enrolled in this study. The whole blood sample (2 ml) was collected before and after treatment. Label-free mass spectrometry-based proteomics was used for protein identification and quantification. The differentially expressed proteins after treatment were analyzed. Bioinformatics tools were used to analyze the functions of the identified proteins and the biological processes they were involved in. Results: Proteomic analysis showed that there were 47 proteins that were differentially expressed more than 2-fold (P<0.05) after treatment in the patients with 1-BP poisoning; of them, 27 were up-regulated and 20 were down-regulated in the serum of treated patients. The identified proteins were mainly involved in proteolysis, protein modification, immune response, complement activation, lipoprotein metabolism, signal transduction, and coagulation. Conclusion: The differentially expressed proteins after treatment can help with the diagnosis, treatment, and prognosis monitoring of 1-BP poisoning and provide potential therapeutic and prognostic markers for 1-BP poisoning treatment.

Associations between the C677T and A1298C polymorphisms of MTHFR and the toxicity of methotrexate in childhood malignancies: a meta-analysis.

As a common chemotherapy drug, methotrexate (MTX) has achieved remarkable clinical success. However, high inter-individual variability and unpredictable toxicity continue to challenge its use in clinical practices. Some studies suggest this variation is associated with a methylenetetrahydrofolate reductase (MTHFR) gene polymorphism, but results remain unclear. In this meta-analysis, we include 14 studies that focus on MTHFR C677T and A1298C polymorphisms in pediatric patients with malignancy. We found significant associations of the MTHFR C677T polymorphism with hepatotoxicity (grade ⩾2; CC vs CT/TT: risk ratio (RR): 0.82, 95% confidence interval (CI): 0.67-0.99; P=0.04), hematological toxicity (grade 3-4; CC vs CT/TT: RR: 0.65, 95% CI: 0.44-0.97; P=0.03) in a dominant genetic model and mucositis (grade ⩾3) in all models (CC vs CT/TT: RR: 0.18, 95% CI: 0.04-0.87; P=0.03; CC/CT vs TT: RR: 0.10, 95% CI: 0.03-0.32; P⩽0.0001; CC vs TT: RR: 0.10, 95% CI: 0.02-0.50; P=0.005). No significant association was found with the MTHFR A1298C polymorphism. For children with malignancy, genotyping of the MTHFR C677T polymorphism is expected to be a useful tool in reducing toxicity and improving outcome in personalized MTX therapy.

[Study on proteomic profiling changes of workers exposed to methylbenzene and healthy individuals].

Objective: This study focused on the proteomicchanges between workers exposed to methylbenzene (WMB) and healthy individuals (HI) . Methods: The serum of WMB and HI was collected and the unmarked label free mass spectrometry was utilized for protein identification and quantitative comparison. The differentlyexpressed proteins in WMB and the HI were screened, followed by the analysis of protein and biological functions by bioinformatics tools. Results: Thirty nine proteins were differently expressed between WMB and HI. Compared with HI, 24 proteins were up regulated and 15 proteins were down regulated over 2 fold change in WMB. Theseproteins were mainly involved in signal transduction, serine endopeptidase activity, inflammatory response, protein modification, stress reaction, coagulation reaction and so on. Conclusion: The differently expressed proteins provide a potential protein marker for the health assessment of WMB and early diagnosis of methylbenzene poisioning and expand our understanding of the molecular mechanism of methylbenzene intoxication.

[Prognostic factors of patients with T3N0M0 renal cell carcinoma: a single-center retrospective study of 182 patients].

OBJECTIVE: To evaluate the impacts of clinical, pathological, and laboratory factors on oncological outcomes of patients with T3N0M0 renal cell carcinoma. METHODS: The clinical data, laboratory exam results, and follow-up outcomes of 182 patients with T3N0M0 renal cell carcinoma who underwent nephrectomy from 2007 to 2012 in Peking University First Hospital were retrospectively collected. The 5-year cancer-specific survival and 5-year recurrence-free survival of all the patients were calculated using Kaplan-Meier method, and the statistical significance between the survival curves were compared using the Log-rank test. Variables with significant differences in the univariate analysis were subjected to the multivariate analysis by Cox regression model. All the comparisons were conducted using two-tailed test and P<0.05 was considered statistically significant. RESULTS: A total of 182 patients were included in this study. Of all the 182 patients, 126 were male (69.23%) and 56 were female (30.77%). The mean age was (56.75±12.45) years. The median follow-up time was 48 months (3-99 months). At the end of the follow-up, 50 patients (27.47%) died due to the disease after a median of 29.74 months and 59 patients (32.42%) had tumor recurrence after a median of 22.12 months. The 5-year cancer-specific survival of all patients was 68.30% (95% CI: 60.16%-75.84%); the 5-year recurrence-free survival was 60.70% (95% CI: 53.16%-68.84%). In the univariate analysis, diabetes mellitus, tumor invasion status, Fuhrman grade, serum album, serum cholestenone, anemia, and neutrophils percentage were associated with the cancer-specific survival and Fuhrman grade, serum album and anemia were associated with the recurrence-free survival. Variables with significant differences on univariate analysis were included in Cox multivariate regression analysis. Multivariate Logistic regression analysis showed that diabetes mellitus (HR=2.434, 95% CI: 1.243-4.769, P=0.010), hypoalbuminemia (HR=2.188, 95% CI: 1.074-1.074, P=0.031), and anemia (HR=3.320, 95% CI: 1.839-5.991, P<0.001) were independent risk factors significantly associated with cancer-specific survival; and higher Fuhrman grade (HR=2.552, 95% CI: 1.433-4.545, P=0.001), anemia (HR=2.535, 95% CI: 1.497-4.293, P=0.001) were independent factors significantly associated with recurrence-free survival. CONCLUSION: Diabetes mellitus, hypoalbuminemia, and anemia were independent risk factors significantly associated with cancer-specific survival of T3N0M0 renal cell carcinoma patients; higher Fuhrman grade and anemia were independent risk factors significantly associated with tumor recurrence of T3N0M0 renal cell carcinoma patients.