The G932C mutation of chitin synthase 1 gene (CHS1) mediates buprofezin resistance as confirmed by CRISPR/Cas9-mediated knock-in approach in the brown planthopper, Nilaparvata lugens.

The brown planthopper (Nilaparvata lugens) is a major destructive rice pest in Asia. High levels of insecticide resistance have been frequently reported, and the G932C mutation in the chitin synthase 1 (CHS1) gene has been found to mediate buprofezin resistance. However, there has been no direct evidence to confirm the functional significance of the single G932C substitution mutation leading to buprofezin resistance in N. lugens. Here, we successfully constructed a knock-in homozygous strain (Nl-G932C) of N. lugens using CRISPR/Cas9 coupled with homology-directed repair (HDR). Compared with the background strain susceptible to buprofezin (Nl-SS), the knock-in strain (Nl-G932C) showed a 94.9-fold resistance to buprofezin. Furthermore, resistant strains (Nl-932C) isolated from the field exhibited a 2078.8-fold resistance to buprofezin, indicating that there are other mechanisms contributing to buprofezin resistance in the field. Inheritance analysis showed that the resistance trait is incomplete dominance. In addition, the Nl-G932C strain had a relative fitness of 0.33 with a substantially decreased survival rate, emergence rate, and fecundity. This study provided in vivo functional evidence for the causality of G932C substitution mutation of CHS1 with buprofezin resistance and valuable information for facilitating the development of resistance management strategies in N. lugens. This is the first example of using CRISPR/Cas9 gene-editing technology in a hemipteran insect to directly confirm the role of a candidate target site mutation in insecticide resistance.

Seasonal variations of macrozoobenthic community trophic structure in the waters adjacent to the seaweed beds of Dalian Island in the North Yellow Sea.

To investigate the effects of algal detritus export on the trophic structure of macrozoobenthic community in the adjacent benthic habitat during the bloom and decline of macroalgae, we collected macrozoobenthos from the adjacent sea area of Dalian Island in the North Yellow Sea in May (the algal bloom period) and August (the algal decay period) of 2020. We quantifyied the seasonal changes in the trophic structure of macrozoobenthic community by using carbon and nitrogen stable isotope techniques. Results showed that δ13C and δ15N values of macrozoo-benthos in May ranged from -23.14‰ to -14.24‰, 6.21‰ to 12.90‰, respectively, and -22.36‰ to -14.13‰, 5.33‰ to 12.00‰, respectively in August. Results of PERMANOVA analysis showed that δ13C values of macrozoobenthos differed significantly between the two months, while δ15N values were not significantly different. Based on the Euclidean distance, the macrozoobenthic communities in both months could be classified into five trophic functional groups. The trophic levels of macrozoobenthos ranged from 2.00 (Nitidotellina minuta) to 3.97 (Glycera onomichiensis) in May and from 2.00 (N. minuta) to 3.96 (G. onomichiensis) in August. The δ13C range, δ15N range, mean centroid distance, total area and corrected standard ellipse areas which represented community trophic structure indices in August were higher than those in May. Our results indicated that the trophic diversity level and trophic niche width of the macrozoobenthic community in the adjacent sea area of the seaweed bed were higher in the algal decline season.

Resistance Monitoring of Nilaparvata lugens to Pymetrozine Based on Reproductive Behavior.

On the basis of the inhibition effects of pymetrozine on the reproductive behavior of N. lugens, we established a bioassay method to accurately evaluate the toxicity of pymetrozine in N. lugens and clarified the level of pymetrozine resistance of N. lugens in the field. In this study, pymetrozine's effects on the fecundity of N. lugens were evaluated using the topical application method and rice-seedling-dipping method. Moreover, the resistance of N. lugens to pymetrozine in a pymetrozine-resistant strain (Pym-R) and two field populations (YZ21 and QS21) was determined using the rice-seedling-dipping method and fecundity assay methods. The results showed that treatment of N. lugens third-instar nymphs with LC15, LC50, and LC85 doses of pymetrozine resulted in a significantly reduced fecundity of N. lugens. In addition, N. lugens adults treated with pymetrozine, using the rice-seedling-dipping and topical application method, also exhibited a significantly inhibited fecundity. Using the rice-stem-dipping method, pymetrozine resistance levels were shown to be high in Pym-R (194.6-fold), YZ21 (205.9-fold), and QS21 (212.8-fold), with LC50 values of 522.520 mg/L (Pym-R), 552.962 mg/L (YZ21), and 571.315 (QS21) mg/L. However, when using the rice-seedling-dipping or topical application fecundity assay method, Pym-R (EC50: 14.370 mg/L, RR = 12.4-fold; ED50: 0.560 ng/adult, RR = 10.8-fold), YZ21 (EC50: 12.890 mg/L, RR = 11.2-fold; ED50: 0.280 ng/adult; RR = 5.4-fold), and QS21 (EC50: 13.700 mg/L, RR = 11.9-fold) exhibited moderate or low levels of resistance to pymetrozine. Our studies show that pymetrozine can significantly inhibit the fecundity of N. lugens. The fecundity assay results showed that N. lugens only developed low to moderate levels of resistance to pymetrozine, indicating that pymetrozine can still achieve effective control on the next generation of N. lugens populations.

CRISPR/Cas9-mediated knockout of NlCYP6CS1 gene reveals its role in detoxification of insecticides in Nilaparvata lugens (Hemiptera: Delphacidae).

BACKGROUND: The brown planthopper (Nilaparvata lugens) is one of the major rice insect pests in Asia. Recently, high levels of insecticide resistance have been frequently reported and cytochrome P450 monooxygenase (P450)-mediated metabolic detoxification is a common resistance mechanism in N. lugens. However, there has been no persuasive genetic method to prove the role of P450s in insecticide resistance in N. lugens. RESULTS: Here, CRISPR/Cas9 system was used to disrupt the P450 gene NlCYP6CS1 to elucidate its role in insecticide resistance in field populations of N. lugens. We successfully constructed a homozygous strain (Nl6CS1-KO) with a 5-bp deletion and 1-bp insertion mutation of NlCYP6CS1. Compared with a background resistant strain (Nl-R), the susceptibility of knockout strain Nl6CS1-KO to imidacloprid, nitenpyram, thiamethoxam, dinotefuran, and pymetrozine was increased by 2.3-, 3.4-, 7.0-, 4.2- and 3.9-fold, respectively, but not significantly changed to triflumezopyrim, chlorpyrifos and buprofezin. Life table analysis demonstrated that the Nl6CS1-KO strain resembled the Nl-R strain in terms of egg and nymph developmental duration and adult lifespan, but differed from the Nl-R strain in the survival rate of eggs and nymphs, reproduction, and body weight. CONCLUSIONS: Our study demonstrates the effect of functional deletion of NlCYP6CS1 on multiple insecticide resistance in N. lugens. For the first time, we applied CRISPR/Cas9 system to reveal the mechanism of insecticide resistance in N. lugens, which may shed light on similar studies in other hemipteran insects. © 2023 Society of Chemical Industry.

Monitoring, cross-resistance, inheritance, and fitness costs of brown planthoppers, Nilaparvata lugens, resistance to pymetrozine in China.

BACKGROUND: The brown planthopper, Nilaparvata lugens, is considered the most destructive pest of rice in many Asian countries including China. Use of pymetrozine in insect resistance management (IRM) has been one strategy to control this pest. In this study, we reported the status of pymetrozine resistance in Nilaparvata lugens (Stål) collected from China over the period 2017-2021 and selected a strain of N. lugens resistant to pymetrozine and evaluated the cross-resistance, inheritance and fitness costs of the resistance. RESULTS: Monitoring data (2017-2021) showed that field populations of N. lugens in China developed moderate- to high-level pymetrozine resistance during these 5 years. By continuous selection with pymetrozine in the lab, the pymetrozine selected N. lugens strain (Pym-R98 ) developed a 225.2-fold resistance compared to a susceptible strain. The Pym-R98 strain showed high cross-resistance to dinotefuran (66.6-fold) and low cross-resistance to nitenpyram (5.2-fold) and sulfoxaflor (5.8-fold). Inheritance pattern analysis of Pym-R93 revealed that resistance to pymetrozine was polygenic, autosomal and incompletely dominant. Fitness costs of pymetrozine resistance were present in Pym-R90 and WA2020 strains with a relative fitness of 0.72 and 0.60, respectively. The developmental duration of Pym-R90 and WA2020 was significantly longer and hatchability was significantly lower compared to pymetrozine-susceptible strain (Pym-S). CONCLUSIONS: N. lugens has developed high level of resistance to pymetrozine. Pymetrozine-resistance brown planthopper had cross-resistance with some of neonicotinoids such as dinotefuran, nitenpyram and sulfoxaflor. The autosomal, incompletely dominant and polygenic resistance to pymetrozine in N. lugens and the fitness costs associated with this resistance can be exploited in IRM strategies to preserve the lifetime of pymetrozine for control of N. lugens in China. © 2022 Society of Chemical Industry.

Effects of nicotinic acetylcholine receptor subunit deletion mutants on insecticide susceptibility and fitness in Drosophila melanogaster.

BACKGROUND: Nicotinic acetylcholine receptors (nAChRs) are major excitatory neurotransmitter receptors in insects and also the target site for many insecticides. Unfortunately, the effectiveness of these insecticides is diminishing as a consequence of the evolution of insecticide resistance. Further exploration of insecticide targets is important to sustainable pest management. RESULTS: In order to validate the role of nAChR subunits in insecticide susceptibility and test whether the subunit's absence imposes the fitness cost on insects, we determined the susceptibility of eight nAChR subunit deletion mutants of Drosophila melanogaster to nine insecticides. These findings highlighted the specific resistance of the Dα6 deletion mutant to spinosyns. Although triflumezopyrim, dinotefuran and imidacloprid are competitive modulators of nAChRs, differences in susceptibility of the insect with different deletion mutants suggested that the target sites of these three insecticides do not overlap completely. Mutants showed decreased susceptibility to insecticides, accompanied by a reduction in fitness. The number of eggs produced by Dα1attP , Dα2attP , Dß2attP and Dß3attP females was significantly lesser than that of the vas-Cas9 strain as the control. In addition, adults of Dα2attP , Dα3attP and Dα7attP strains showed lower climbing performance. Meanwhile, males of Dα3attP , Dα5attP , Dß2attP and Dß3attP , and females of Dß2attP showed significantly shorter longevity than those of the vas-Cas9 strain. CONCLUSION: This study provides new insights into the interactions of different insecticides with different nAChRs subunit in D. melanogaster as a research model, it could help better understand such interaction in agricultural pests whose genetic manipulations for toxicological research are often challenging. © 2022 Society of Chemical Industry.

Overexpression of ATP-binding cassette transporter Mdr49-like confers resistance to imidacloprid in the field populations of brown planthopper, Nilaparvata lugens.

BACKGROUND: The brown planthopper (BPH), Nilaparvata lugens (Stål), is the most severe pest attacking rice crops using sucking mouthparts. It causes significant damages to rice growth and food production worldwide. With the long-term and wide use of insecticides, field populations of BPH have developed resistance to many insecticides. RESULTS: Here, we showed that upregulation of an ATP-binding cassette transporter gene NlMdr49-like contributes to imidacloprid resistance in field populations of BPH. A comparative transcriptome analysis was performed to evaluate the gene expression in two field populations (JXSG18 and YNTC18). Compared with a susceptible strain (Sus), 202 upregulated genes and 170 downregulated genes were identified in both field populations. Functional enrichment analysis revealed that the differentially expressed genes (DEGs) are mainly linked to metabolic process and transmembrane transport. Among the candidate DEGs, NlMdr49-like was significantly upregulated in both field populations. Based on the genome and transcriptome of BPH, the full-length complementary DNA of NlMdr49-like was sequenced and its molecular characteristics were analyzed. Expression pattern analysis of various tissues showed that NlMdr49-like was predominantly expressed in midgut and Malpighian tubules which are important excretion organs. Knocking down NlMdr49-like reduced BPH resistance to imidacloprid, but did not affect its resistance to the other nine insecticides (chlorpyrifos, thiamethoxam, nitenpyram, dinotefuran, sulfoxaflor, triflumezopyrim, ethiprole, buprofezin and pymetrozine). Furthermore, a transgenic strain of Drosophila melanogaster overexpressing NlMdr49-like was less susceptible to imidacloprid. CONCLUSIONS: Our findings indicate that upregulation of NlMdr49-like is another mechanism contributing to imidacloprid resistance in N. lugens. This result is helpful to further understand the resistance mechanism of N. lugens to imidacloprid. © 2021 Society of Chemical Industry.

Factors influencing knee valgus alignment in Crowe type IV hip dysplasia after total hip arthroplasty.

BACKGROUND: Valgus deformity of the knee remains a complaint after total hip arthroplasty (THA) among some patients with Crowe type IV hip dysplasia. We aimed to identify the knee alignment in these patients before and after surgery, and to explore the factors contributing to postoperative knee valgus alignment. MATERIALS AND METHODS: We retrospectively reviewed a series of Crowe type IV patients who received THA between February 2010 and May 2019 in our hospital. The patients' medical data were collected from the hospital information system. On both preoperative and postoperative full limb length standing radiographs, the following parameters were measured: hip-knee-ankle angle (HKA), mechanical lateral distal femoral angle (mLDFA), medial proximal tibial angle, anatomical tibiofemoral angle, anatomical lateral distal femoral angle, femoral neck-shaft angle, pelvic obliquity, limb length, height and lateral distance of hip center, and femoral offset. Univariate and multivariate binary logistic regression were used to identify the factors influencing postoperative knee valgus alignment. RESULTS: A total of 64 Crowe type IV patients (87 hips) were included in the study. Overall, HKA improved from 176.54 ± 3.52° preoperatively to 179.45 ± 4.31° at the last follow-up. Those hips were subdivided into non-valgus group (≥ 177.0°, n = 65) and valgus group (< 177.0°, n = 22) according to postoperative HKA. Only postoperative mLDFA was a significant factor in the multivariate regression model. CONCLUSIONS: The postoperative mLDFA is a major factor related to knee valgus alignment after THA, which combines the preoperative anatomy and surgical reconstruction. Other factors previously published were found to have no significance. LEVEL OF EVIDENCE: III.

Jumbo cup in hip joint renovation may cause the center of rotation to increase.

BACKGROUND: Utilizing the large jumbo cup in revision total hip arthroplasty is an effective approach to cure many lacunar and segmental peripheral bone defects. However, with the use of the jumbo cup, the center of the hip joint may become elevated relative to the primary acetabulum, and the diameter of the large cup is greater. AIM: To study the height and the significance of the elevation of the hip joint center. METHODS: Eighty-eight patients matched the criteria for this condition and were included in the study. The center height of the hip joint was measured relative to the opposite normal hip joint. The diameter of the jumbo cup was measured and checked according to operation notes, and the diameter of the jumbo cup was measured with a prosthesis label. Then, the horizontal and vertical centers of rotation were measured on the surgical side and opposite side. The average center height of the hip joint on the renovated side and the opposite side and the position of the hip cup relative to the teardrop were compared using a paired t-test. RESULTS: Radiometric analysis showed that the average hip joint center was elevated by 7.6 mm. The rotational center height delta of the renovated hip was 7.6 ± 5.6 mm, and there was an obvious difference between the two groups (P = 0.00). The difference in horizontal distance was 0.5 ± 5.1 mm (-11.5 -14.0 mm), and there was no obvious difference between the two groups (P = 0.38). According to the foreign standard, the rotational center height delta of the renovated hip was 7.5 ± 6.2 mm, and there was a significant difference between the two groups (P = 0.00). There was no obvious difference between the domestic and foreign standards (P > 0.05) between the two groups. CONCLUSION: The application of the jumbo cup elevates the rotational center of the hip joint, but it is feasible and effective to use the jumbo cup.

Ground-state phase and superfluidity of tunable spin-orbit-coupled Bose-Einstein condensates.

We theoretically study the ground-state phases and superfluidity of tunable spin-orbit-coupled Bose-Einstein condensates (BECs) under the periodic driving of Raman coupling. An effective time-independent Floquet Hamiltonian is proposed by using a high-frequency approximation, and we find single-particle dispersion, spin-orbit-coupling, and asymmetrical nonlinear two-body interaction can be modulated effectively by the periodic driving. The critical Raman coupling characterizing the phase transition and relevant physical quantities in three different phases (the stripe phase, plane-wave phase, and zero momentum phase) are obtained analytically. Our results indicate that the boundary of ground-state phases can be controlled and the system will undergo three different phase transitions by adjusting the external driving. Interestingly, we find the contrast of the stripe density can be enhanced by the periodic driving in the stripe phase. We also study the superfluidity of tunable spin-orbit-coupled BECs and find the dynamical instability can be tuned by the periodic driving of Raman coupling. Furthermore, the sound velocity of the ground-state and superfluidity state can be controlled effectively by tuning the periodic driving strength. Our results indicate that the periodic driving of Raman coupling provides a powerful tool to manipulate the ground-state phase transition and dynamical instability of spin-orbit-coupled BECs.

Stability and quantum escape dynamics of spin-orbit-coupled Bose-Einstein condensates in the shallow trap.

The Bose-Einstein condensates in a finite depth potential well provide an ideal platform to study the quantum escape dynamics. In this paper, the ground state, tunneling, and diffusion dynamics of the spin-orbit coupling (SOC) of Bose-Einstein condensates with two pseudospin components in a shallow trap are studied analytically and numerically. The phase transition between the plane-wave phase and zero-momentum phase of the ground state is obtained. Furthermore, the stability of the ground state is discussed, and the stability diagram in the parameter space is provided. The bound state (in which condensates are stably trapped in the potential well), the quasibound state (in which condensates tunnel through the well), and the unstable state (in which diffusion occurs) are revealed. We find that the finite depth potential well has an important effect on the phase transition of the ground state, and, interestingly, SOC can stabilize the system against the diffusion and manipulate the tunneling and diffusion dynamics. In particular, spatial anisotropic tunneling and diffusion dynamics of the two pseudospin components induced by SOC in quasibound and unstable states are observed. We provide an effective model and method to study and control the quantum tunneling and diffusion dynamics.

Baseline determination, susceptibility monitoring and risk assessment to triflumezopyrim in Nilaparvata lugens (Stål).

Triflumezopyrim, a novel mesoionic chemical insecticide, is promoted as a powerful tool for control of susceptible and resistant hopper species in rice throughout Asia. For a newly commercialized insecticide it is important to establish susceptibility baseline, conduct susceptibility monitoring, and assess the risk of resistance via artificial selection to provide foundational information on designing resistance management strategy. The susceptibility baseline of triflumezopyrim was established for three rice planthopper species, Nilarpavata lugens (Stål), Sogatella furcifera (Horváth) and Laodelphax striatellus (Fallén). The LD50 of triflumezopyrim was 0.026, 0.032 and 0.094 ng/individual for the adults of the susceptible strains of S. furcifera, L. striatellus and N. lugens, respectively, determined by a topical application method. Using a rice stem (seedling) dipping method, the LC50 was determined as 0.042, 0.024 and 0.150 mg/L for the nymphs (3rd instar) of the three hopper species, respectively. In the meanwhile, the LC50 of Pyraxalt™ (triflumezopyrim 10% SC) was 0.064 mg/L for the N. lugens susceptible strain. Furthermore, the susceptibility of triflumezopyrim and other five neonicotinoid insecticides were monitored for N. lugens field populations collected from major rice production areas in China in 2015-2019. All monitored populations were susceptible to triflumezopyrim (0.5 to 3.9-fold resistance ratio), and showed no cross-resistance to the other five neonicotinoids. These results suggested that triflumezopyrim is a good option to control resistant N. lugens. In addition, a field-collected population of N. lugens was artificially selected with triflumezopyrim for 20 generations and resulted in 3.5-fold increase in LC50 from F0 and 6.0-fold increase from that of the susceptible strain. The realized heritability (h2) of resistance was estimated as 0.0451 by using threshold trait analysis. With this h2 value, the projected triflumezopyrim resistance development (a 10-fold increase in LC50) would be expected after 30.3 or 24.0 generations if 80% or 90% of the population was killed at each generation.

Pymetrozine inhibits reproductive behavior of brown planthopper Nilaparvata lugens and fruit fly Drosophila melanogaster.

Pymetrozine is a promising chemical used to control brown planthopper, which developed resistance to imidacloprid and buprofezin in the past decade. Field efficacy indicates that pymetrozine can reduce the number of offsprings of brown planthopper, but the specific physiological mechanism is unknown. In this study, we systematically described the mating process of brown planthopper including 8 steps (abdominal vibration, following, positioning, wing extension, attempted copulation, copulation, terminated copulation and leaving) and explored the optimal mating time after adult eclosion (3-5 days) and observation time (30 mins). Also, behavioral data showed that pymetrozine can affect the mating behavior and female fecundity of brown planthopper and fruit fly. As one of the target genes for pymetrozine, Nanchung (Nan), the nan36a mutant male courtship index, female receptivity and the number of offsprings were significantly decreased. Behavioral defects in nan36a mutant flies can be rescued by expressed NlNan. Our results indicated that Nan plays essential roles in the mating behavior and female fecundity. These findings provide useful information for demonstrating that pymetrozine effectively reduce the reproduction of brown planthopper and contribute to our understanding of reproductive strategies controlled by pymetrozine in insects.

[A preliminary study of three-dimensional printed porous titanium plate integrated implant for the repair of comminuted acetabular posterior wall fracture with bone defect].

OBJECTIVE: To explore the feasibility of using computer-aided design(CAD) combined with 3D printing technology to repair and reconstruct the comminuted fracture of the posterior wall of acetabulum with osteochondral defect, to evaluate the biomechanical properties of composite titanium nitride bioceramic coatings with porous titanium alloy scaffolds and steel plate integrated implants. METHODS: Based on CT images of continuous tomography, the computer-aided design software was used to construct a digital model of porous titanium alloy plate implant with a specially open cellular three-dimensional structure, and the three-dimensional implant was prepared with Ti6Vl4V powder by using the 3D printing technology, following by titanium nitride coating on its articular surface. The degree of matching and attachment between the implant and acetabulum were observed; Ansys software was used for finite element modeling to analyze the stress distribution, stress conduction and deformation displacement of the acetabulum of the normal group, the traditional group and the implant group under the same load state, and to verify the biomechanical properties of the implant. RESULTS: The porous titanium alloy implant fit well with the acetabular bone defects, the shape of the plate was well attached to the bone surface, and it was rated as excellent according to the Matta criteria. The Von Mises stress peak of the implant group 13.38 MPa was close to the normal group 13.11 MPa and smaller than that in the traditional group 15.66 MPa. The Von Mises stress distribution and conduction of implant group were basically consistent with the normal group, slightly better than the traditional group; the maximum relative displacement of the implant was 0.166 mm, according to the finite element analysis. CONCLUSIONS: The porous titanium alloy stent plate implant with titanium nitride coating prepared by 3D technology has excellent matching degree and biomechanical properties; the anatomical reconstruction makes the stress distribution and conduction recovery well, close to normal hip joints, which provides a new option for the clinical treatment of comminuted posterior acetabular wall fractures with severe bone defects.

[Nonlinear Regression Methods of Ethanol Raman Spectra Quantitative Analysis].

Ethanol concentration quantitative analysis of ethanol-water solution can be realized by measuring the ratio of Raman characteristic peak heights. The content of ethanol can be determined by linear relation between relative intensity ratio and ethanol concentration. However, this analytical method only applies to the ethanol solution at low concentration. Concerning this issue, relative intensity of characteristic peak of ethanol (asymmetric stretching vibration of CH2 2 924.0 cm-1) and peak background of water (3 350 cm-1) at different ethanol concentration is experimentally measured by using a self-developed laser Raman ethanol content detection system. According to the relationship between relative ratio of characteristic peak heights and ethanol concentration, the nonlinear regression analysis methods are proposed to apply in the measurement of ethanol concentration in a wide range. Adjacent region average method is utilized to remove mutational random noise in Raman spectra of ethanol solution. Combined with multi-point interpolation processing, the baseline of Raman spectra can be calibrated. The influences of mutational random noise and the strong fluorescence background can be effectively eliminated with baseline correction and normalization methods. Polynomial and exponential mathematical models are adopted for nonlinear regression analyses by the relation between ratio of characteristic peak heights and concentration of ethanol solution. The analysis results show that the correlation coefficient of linear fitting and nonlinear fitting is about 0.991 and higher than 0.997 respectively. The linear analytical method can be effectively applied when ethanol concentration range is 15%～60%. The nonlinear analytical method has higher measurement accuracy in a wider ethanol concentration range of 3%～97%. Nonlinear mathematical model will provide theoretical basis for analysis of ethanol concentration, which can be applied in laser Raman ethanol content detection system to calculate the relatively accurate ethanol concentration of ethanol-water solution. Rapid, real-time and accurate quantitative analysis of wide concentration range ethanol solution, which has mutational random noise and strong fluorescence background interference, can be achieved by these analytical methods.

Multicenter study on adult growth hormone level in postoperative pituitary tumor patients.

The objective of this study is to observe the adult growth hormone level in postoperative pituitary tumor patients of multi-centers, and explore the change of hypophyseal hormones in postoperative pituitary tumor patients. Sixty patients with pituitary tumor admitted during March, 2011-March, 2012 were selected. Postoperative hypophyseal hormone deficiency and the change of preoperative, intraoperative, and postoperative growth hormone levels were recorded. Growth hormone hypofunction was the most common hormonal hypofunction, which took up to 85.0 %. Adrenocortical hormone hypofunction was next to it and accounted for 58.33 %. GH + ACTH + TSH + Gn deficiency was the most common in postoperative hormone deficiency, which took up to 40.00 %, and GH + ACTH + TSH + Gn + AVP and GH deficiencies were next to it and accounted for 23.33 and 16.67 %, respectively. The hormone levels in patients after total pituitary tumor resection were significantly lower than those after partial pituitary tumor resection, and the difference was statistically significant; growth hormone and serum prolactin levels after surgery in two groups were decreased, and the difference was statistically significant. The incidence rate of growth hormone deficiency in postoperative pituitary tumor patients is high, which is usually complicated with deficiency of various hypophyseal hormones. In clinical, we should pay attention to the levels of the hypopnyseal hormones, and take timely measures to avoid postoperative complications.

Dynamic assessment of the changing geometry of the mitral apparatus in 3D could stratify abnormalities in functional mitral regurgitation and potentially guide therapy.

INTRODUCTION: In functional mitral regurgitation (FMR), effective regurgitant orifice area (EROA) displays a dynamic pattern. The impact of dynamic changes of annulus dysfunction and leaflets tenting on phasic EROA was explored with real-time three-dimensional transesophageal echocardiography (RT3D-TEE). METHODS: RT3D-TEE was performed in 52 FMR patients and 30 controls. Mitral annulus dimensions and leaflets tenting were measured throughout systole (TomTec, Germany). Phasic EROA was measured by proximal isovelocity surface area (PISA) method. RESULTS: Mitral annulus had the minimal area and an oval shape with saddle configuration during early systole in controls, which enlarged and became round and flattened towards mid and late systole (P<0.05). In contrast, annulus in FMR was significantly larger, rounder and flatter (P<0.001), which further dilated and became more flattened at late systole (P<0.05 vs control). Leaflet tenting height in FMR decreased in mid systole and remains unchanged towards late systole. The leaflet tenting volume peaked at early and late systole with a mid-systolic trough in both FMR and controls. But tenting volume of patients with FMR was significantly larger than that of controls (all P<0.001 vs control in whole systole). Further analysis demonstrated that early tenting volume (ß value=0.053, P<0.05) was a predictor of early EROA, whereas late tenting volume (ß value=0.031, P<0.05) and late annular displacement velocity were predictors of late EROA. CONCLUSIONS: The early and late peak EROAs of FMR was primarily contributed by tenting volume at early systole and late systole respectively. These findings would be of value to consider in interventions aimed at reducing the severity of FMR.

Quantitative analysis of mitral valve morphology in mitral valve prolapse with real-time 3-dimensional echocardiography: importance of annular saddle shape in the pathogenesis of mitral regurgitation.

BACKGROUND: Few data exist on the relation of the 3-dimensional morphology of mitral valve and degree of mitral regurgitation (MR) in mitral valve prolapse. METHODS AND RESULTS: Real-time 3-dimensional transesophageal echocardiography of the mitral valve was acquired in 112 subjects, including 36 patients with mitral valve prolapse and significant MR (≥3+; MR+ group), 32 patients with mitral valve prolapse but no or mild MR (≤2+; MR- group), 12 patients with significant MR resulting from nonprolapse pathologies (nonprolapse group), and 32 control subjects. The 3-dimensional geometry of mitral valve apparatus was measured with dedicated quantification software. Compared with the normal and MR- groups, the MR+ group had more dilated mitral annulus (P<0.0001), a reduced annular height to commissural width ratio (AHCWR) (P<0.0001) indicating flattening of annular saddle shape, redundant leaflet surfaces (P<0.0001), greater leaflet billow volume (P<0.0001) and billow height (P<0.0001), longer lengths from papillary muscles to coaptation (P<0.0001), and more frequent chordal rupture (P<0.0001). Prevalence of chordal rupture increased progressively with annulus flattening (7% versus 24% versus 42% for AHCWR >20%, 15%-20%, and <15%, respectively; P=0.004). Leaflet billow volume increased exponentially with decreasing AHCWR in patients without chordal rupture (r(2)=0.66, P<0.0001). MR severity correlated strongly with leaflet billow volume (r(2)=0.74, P<0.0001) and inversely with AHCWR (r(2)=0.44, P<0.0001). In contrast, annulus dilatation but not flattening occurred in nonprolapse MR patients. An AHCWR <15% (odds ratio=7.1; P=0.0004) was strongly associated with significant MR in mitral valve prolapse. CONCLUSION: Flattening of the annular saddle shape is associated with progressive leaflet billowing and increased frequencies of chordal rupture and may be important in the pathogenesis of MR in mitral valve prolapse.

Characterization of mid-term atrial geometrical and electrical remodeling following device closure of atrial septal defects in adults.

PURPOSE: Late-onset atrial arrhythmia after successful closure of atrial septal defect (ASD) is not uncommon. Right atrial (RA) enlargement and increased electrocardiographic P-wave dispersion (Pd) independently predict the development of atrial arrhythmia. Data on the degree of right atrial (RA) geometrical and electrical remodeling following device closure of ASD are limited. METHODS: Echocardiography and electrocardiography (ECG) were performed in 58 consecutive patients (47 ± 17 years) before and at 3 months after ASD closure. Persistent RA enlargement was defined as RA volume index (RAVI) ≥ 21 ml/m(2) at 3 months. Pd was calculated as the difference between maximal and minimal P-wave durations in 12-lead ECG. RESULTS: RA size reduced (RAVI: 50 ± 28 vs. 26 ± 16 ml/m(2), p<0.001) and Pd on ECG decreased (53 ± 17 vs. 49 ± 20 ms, p<0.05) significantly at 3 months when compared to baseline. However, persistent RA enlargement remained evident in 31 patients (53%). As a group, they were older with higher pulmonary arterial systolic pressure, larger Qp/Qs, longer maximal P-wave duration and Pd than those with normalized RA. Pd reduction only occurred in patients with normalized RA size. The 3-month Pd (hazard ratio: 1.033, p<0.001) predicted the presence of incomplete RA geometrical remodeling. ROC curve revealed that Pd ≥ 45 ms at 3 months was 77% sensitive and 86% specific in revealing residual RA enlargement. CONCLUSION: Both atrial geometrical and electrical reverse remodeling were evident at 3 months following ASD closure. However, only half of the included patients had normalization of RA size which could be revealed by a simple ECG surrogate of intra-atrial conduction disturbance.

[Mixed logit model and its application in insurance choices of the new rural cooperative medical system].

OBJECTIVE: To apply mixed logit model for analyzing the data of new rural cooperative medical with suitability and identify the factors affecting the residents choices of insurance mode. METHODS: Hypothesis test of IIA was performed using the mogtest module of Stata10.0 to test the eligibility of the condition. The mixed logit model was established to allow the parameters to vary in the population using SAS9.1 MDC module. RESULTS: The data in this study did not satisfy the IIA assumption (P<0.01), so that the multinomial logit model was not applicable. The adjusted Estrella of the mixed logit model was 0.6658. CONCLUSION: The mixed logit approach does not rely on the restrictive IIA assumption and allows for correlation patterns between choices and individual variation. This approach can help in the determination of the choices in new rural cooperative medical system.