Abstract Introduction: Propofol is a widely used anesthetic and its dose is closely related to aging. Telomere length (TL) is a unique heritable trait, and emerging as a biomarker of aging, health and disease. Telomerase RNA component (TERC) plays an important role in maintaining TL. We proposed a hypothesis that propofol dose in general anesthesia can be predicted by measuring TL before operation, which greatly reduced the risk of anesthesia, especially the elderly. Methods: The association between the propofol dose in anesthesia induction and: TL in the DNA of peripheral blood leukocytes; body weight; sex; difference of the Bispectral Index (BIS) before and after anesthesia induction in patients was evaluated by multivariable linear regression analyses. The mutation at the 5’end or 3’end of TERC was detected. We recruited 100 patients of elective surgery. Results: We found that propofol dose in anesthesia induction was clearly correlated significantly with TL (r = 0.78, p < 0.001), body weight (r = 0.84, p = 0.004), sex (r = 0.83, p= 0.84, p = 0.004), sex (r = 0.83, p = 0.004), and difference of BIS before and after anesthesia induction (r = 0.85, p = 0.029). By comparing the absolute values of standardized regression coefficients (0.58, 0.21, 0.19, and 0.12) of the four variables, it can be seen that TL contributes the most to the propofol dose in anesthesia induction. However, the mutation at the 5’ end or 3’ end of TERC was not found. Conclusions: These findings provide preliminary evidence that the propofol dose in anesthesia induction was clearly correlated with genetically determined TL. TL may be a promising predictor of the propofol dose, which is beneficial to improve the safety of anesthesia and reduce perioperative complications.

Abstract Objectives: To screen the COL1A1 and COL1A2 gene mutation sites in a family with type I osteogenesis imperfecta (OI)/hearing loss and analyze the characteristics and recovery of hearing loss in patients with osteogenesis imperfecta. Methods: The basic clinical data of Ol proband and her parents were collected, and the COL1A1 and COL1A2 genes were detected in peripheral blood by PCR amplification and generation Sanger sequencing. Literature of stapedial surgery in patients with osteogenesis imperfecta was collected. Results: The heterozygous mutation of the 26 exon c.1922_1923 ins C in the Ol progenitor COL1A1 gene led to the amino acid frameshift mutation of p.Pro 601FS, which was not detected in the phenotypic parents. The homozygous of exon 28 c.1782>G in COL1A2 was detected in the proband and her parents, resulting in changes in the protein p.Pro 549Ala. Conclusion: The clinical symptoms of the Ol proband is caused by heterozygous mutation of the 26 exon c.1922_1923 ins C in COL1A1 gene. Stapedial surgery can provide short-term and long-term hearing benefits for Ol patients with hearing loss. Level of evidence: Level 4.

Abstract Objective To generalise the features of PANP in case of potential clinical and pathological pitfall of diagnosis. Methods Thirteen patients diagnosed as PANP were retrospectively analyzed in the Pathology Department of Capital Medical University from August 2014 to December 2019. Immunohistochemical staining with CD34, CK, Vim, Calponin, Ki67, Bcl-2, and STAT-6 was performed with envision-two steps method. Results PANP is a benign tumor presenting with gross variegated tan to gray soft fleshy tissue with foci of obvious hemorrhage and necrosis. The imaging shows internal heterogeneous hyperintensity with a peripheral hypointense rim while postcontrast images display a strong nodular and patchy enhancement. Vimentin (Vim) stain was consistently positive, while negative for CD34, STAT-6 and Bcl-2 (focal positive in two cases). Calponin and CK stain was positive in nine cases, respectively. Conclusion PANP is a clinically rare tumor which may simulate malignancy lesion. Recognizing of characteristic features in these thirteen patients would be beneficial to avoid misdiagnosis and unnecessary aggressive treatment. Level of evidence: This work was Level 2 of evidence according to the Guide for Authors.

Abstract Introduction: Noise-induced hearing loss is one of the most common forms of sensorineural hearing loss. Nevertheless, the mechanisms of noise-induced hearing loss are still not fully understood. Objective: To investigate the dynamics of inflammatory responses in the mammalian cochlea following noise trauma at two different times, once during the light cycle and once during the dark. Methods: We challenged C57BL/6J mice with moderate, continuous noise trauma at either 9 a.m. or 9 p.m. Auditory function, histological changes in hair cells, and modifications in gene expression levels of inflammatory mediators were assessed at specific time points. Shifts in auditory brainstem response thresholds were measured at 1, 3, 7 and 14 days after noise exposure to measure potential noise-induced hearing loss. Cochlear basilar-membrane immunofluorescent staining was performed at 3 and 14 days after noise exposure. The mRNA levels of several inflammatory mediators were measured via quantitative real-time polymerase chain reaction before (pre) and after (0, 3, 12, 24 and 72 h) noise exposure. Results: We found that all noise-exposed mice developed a temporary threshold shift and that there were no significant differences between daytime and nighttime noise exposures in terms of inducing hearing-threshold shifts. Similarly, we did not detect significant histological changes in hair cells between these two groups. However, we discovered an interesting phenomenon in that the peak mRNA levels of IL-1β, IL-6, CCL2 and TNF-α were higher in day noise-exposed mice compared to those in night noise-exposed mice, and these mRNA levels subsided more slowly in day noise-exposed mice. Conclusion: Overall, these observations suggest that the circadian timing of noise exposure has a significant effect on noise-induced inflammatory responses in the mouse cochlea and that a greater inflammatory response might occur after daytime exposure.

RESUMO Porcos tibetanos são caracterizados por diferenças fenotípicas significativas em relação aos porcos de planície. Nosso estudo anterior demonstrou que os genes CRYAB e CTGF eram expressos diferentemente nos tecidos do coração entre os porcos tibetanos (raça das terras altas) e Yorkshire (raça das terras baixas), indicando que eles poderiam participar da adaptação à hipoxia. CRYAB (ɑB-crystallin) e CTGF (fator de crescimento do tecido conjuntivo) também foram relatados como estando associados ao desenvolvimento pulmonar. Entretanto, os padrões de expressão do CRYAB e CTGF nos tecidos pulmonares em diferentes altitudes e sua caracterização genética não são bem compreendidos. Neste estudo, o qRT-PCR e a mancha ocidental de tecido pulmonar revelou níveis de expressão de CRYAB mais elevados em porcos tibetanos e Yorkshire de altitude e média altitude do que em seus pares de planície. Com um aumento na altitude, o nível de expressão do CTGF aumentou nos porcos tibetanos, enquanto diminuiu nos porcos Yorkshire. Além disso, foram identificados dois novos polimorfismos de um único nucleotídeo na região flanqueadora de CRYAB (g.39644482C>T e g.39644132T>C) e CTGF (g.31671748A>G e g.31671773T>G). O polimorfismo pode contribuir parcialmente com as diferenças nos níveis de expressão entre grupos a uma mesma altitude. Estas descobertas proporcionam novos conhecimentos sobre as adaptações de hipoxia a alta altitude dos porcos tibetanos.

ABSTRACT Tibetan pigs are characterized by significant phenotypic differences relative to lowland pigs. Our previous study demonstrated that the genes CRYAB and CTGF were differentially expressed in heart tissues between Tibetan (highland breed) and Yorkshire (lowland breed) pigs, indicating that they might participate in hypoxia adaptation. CRYAB (ɑB-crystallin) and CTGF (connective tissue growth factor) have also been reported to be associated with lung development. However, the expression patterns of CRYAB and CTGF in lung tissues at different altitudes and their genetic characterization are not well understood. In this study, qRT-PCR and western blot of lung tissue revealed higher CRYAB expression levels in highland and middle-highland Tibetan and Yorkshire pigs than in their lowland counterparts. With an increase in altitude, the expression level of CTGF increased in Tibetan pigs, whereas it decreased in Yorkshire pigs. Furthermore, two novel single-nucleotide polymorphism were identified in the 5′ flanking region of CRYAB (g.39644482C>T and g.39644132T>C) and CTGF (g.31671748A>G and g.31671773T>G). The polymorphism may partially contribute to the differences in expression levels between groups at the same altitude. These findings provide novel insights into the high-altitude hypoxia adaptations of Tibetan pigs.

RESUMO O objetivo do presente estudo foi investigar a soroprevalência de infecção com Toxoplasma gondii (T. gondii) em cabras em cinco províncias do noroeste da China. Soroprevalência foi determinado usando o kit de teste de ensaio de imunoabsorção enzimática (ELISA). A soroprevalência geral foi 21.23% (197/928). Análise estatística revlou que diferenças significativas foram observadas em fêmeas (P= 0.048, OR= 0.567, 95% CI= 0.309 a 1.041) e nos grupos ≥ 2 (P= 0.002, OR= 0.330, 95% CI= 0.224 a 0.488). Nenhuma diferença estatisticamente significativa foi observada entre diferentes províncias. Nossos resultados indicam que a infecção com T. gondii, que pode ter implicações importantes sobre a saúde pública, teve diferenças significativas em sexo e idade, mas nenhuma significância foi observada em diferentes regiões. Além disto, nossos resultados também indicam que infecção por T. gondii em cabras é generalizada nas cinco províncias do noroeste.

This meta-analysis compared the efficacy and safety of the contact force (CF)-sensing catheter and second-generation cryoballoon (CB) ablation for treating atrial fibrillation (AF). Six controlled clinical trials comparing ablation for AF using a CF-sensing catheter or second-generation CB were identified from PubMed, EMBASE, Cochrane Library, Wanfang Data, and China National Knowledge Infrastructure. The procedure duration was significantly lower in the CB group compared with that in the CF group [mean difference (MD)=29.4; 95%CI=17.84–40.96; P=0.01], whereas there was no difference between the groups for fluoroscopy duration (MD=0.59; 95%CI=–4.48–5.66; P=0.82). Moreover, there was no difference in the incidence of non-lethal complications (embolic event, tamponade, femoral/subclavian hematoma, arteriovenous fistula, pulmonary vein stenosis, phrenic nerve palsy, and esophageal injury) between the CB and the CF groups (8.38 vs 5.35%; RR=0.66; 95%CI=0.37–1.17; P=0.15). Transient phrenic nerve palsy occurred in 17 of 326 patients (5.2%) of the CB group vs none in the CF group (RR=0.12; 95%CI=0.03–0.43; P=0.001). A comparable proportion of patients in CF and CB groups suffered from AF recurrence during the 12-month follow-up after a single ablation procedure [risk ratio (RR)=1.03; 95%CI=0.78–1.35; P=0.84]. AF ablation using CF-sensing catheters and second-generation CB showed comparable fluoroscopy duration and efficacy (during a 12-month follow-up), with shorter procedure duration and different complications in the CB group.

ABSTRACT Aims: Microwave ablation (MWA) is a technique which is used to destroy tumours and soft tissues by using microwave energy to create coagulation and localized tissue necrosis. It is used to treat the tumours which are considered to be inoperable and used to treat those patients who are ineligible for surgery due to some factors. The main objective of this study was to evaluate the use of MWA in the treatment of liver cancer. Methods: The data were collected from Department of Ultrasound, Harbin Medical University Cancer Hospital. From July 2010 to August 2011, a total of 123 patients with liver tumours was referred to Harbin Medical University Cancer Hospital. One hundred patients were selected for this study and treated with MWA. The study group contained 64 (64%) males and 36 (36%) females with an average age (± SD) of 52 (± 5.1) years. Results: One month after therapy, complete ablation was obtained in nodules. The complete ablation rate in tumors ≤ 3 cm and those > 3 cm was 98% and 94%, respectively. Microwave ablation success was higher with nodules ≤ 3 cm (57/58; 98.3%) in comparison to nodules > 3 cm. Conclusion: Sonographically guided percutaneous microwave ablation proved to be safe, fast and effective for treatment of hepatocellular carcinoma.

RESUMEN: Objetivos: La ablación con microondas (MWA) es una técnica que se utiliza para destruir tumores y tejidos blandos mediante el uso de la energía de microondas que producen coagulación y necrosis tisular localizada. Se utiliza para tratar los tumores considerados inoperables, así como para el tratamiento de pacientes no elegibles para cirugía debido a determinados factores. El objetivo principal de este estudio fue evaluar el uso de MWA en el tratamiento del cáncer de hígado. Métodos: Se recopilaron datos del Departamento de Ultrasonido del Hospital Oncológico de Harbin Medical University. De julio de 2010 a agosto de 2011, un total de 123 pacientes con tumores hepáticos fueron remitidos al Hospital Oncológico de Harbin Medical University. Cien pacientes fueron seleccionados para este estudio y tratados con MWA. El grupo de estudio estuvo formado por 64 varones (64%) y 36 (36%) mujeres con una edad promedio (± SD) de 52 (± 5.1) años. Resultados: Un mes después de la terapia, la ablación completa se obtuvo en los nódulos. La tasa de ablación completa en tumores ≤ 3 cm y tumores > 3 cm fue de 98% y 94%, respectivamente. El éxito de la ablación con microondas fue mayor con nódulos ≤ 3 cm (57/58; 98.3%) en comparación con nódulos > 3 cm. Conclusión: La ablación percutánea con microondas guiada mediante ecografía demostró ser segura, rápida y eficaz para el tratamiento del carcinoma hepatocelular.

In 1996, China adopted a virological classification of acute flaccid paralysis (AFP) cases for its surveillance system. Only AFP cases with wild poliovirus in stool specimens are confirmed as polio. Cases with adequate stool specimens that are negative for wild poliovirus are not counted. This paper describes a methodology to rule out poliomyelitis in AFP cases with inadequate stool specimens. National surveillance data were analysed using dot maps to detect clusters of AFP cases with high-risk factors for poliomyelitis. The surveillance system and vaccine coverage were assessed during field investigations. Four clusters of AFP cases were identified, but no poliomyelitis cases. Programmatic failures in the identified high-risk areas included low vaccination rates, poor stool specimen collection and inadequate AFP surveillance. Programme strategies were implemented to correct the identified failures. Use of this methodology provides strong evidence consistent with the absence of wild poliovirus in China.

Los esfuerzos desplegados en China para erradicar la poliomielitis han tenido mucho éxito, habiéndose notificado en septiembre de 1994 el último caso de poliovirus salvaje. Desde 1995, la vigilancia de la parálisis fláccida aguda (PFA) ha sido muy eficaz, y se han logrado tasas de detección de la PFA de más de 1,0 por 100 000 niños menores de 15 años. En 1996, el Ministerio de Salud de China adoptó para los casos de PFA el sistema de clasificación virológica recomendado por la OMS, en sustitución del sistema de clasificación clínica utilizado desde 1991. Con los nuevos criterios virológicos, la confirmación definitiva de un caso de poliomielitis a partir de los casos de PFA notificados depende de que se aísle poliovirus salvaje en el laboratorio. Sólo se confirman como casos de poliomielitis los casos de PFA con presencia de poliovirus en las muestras fecales; aquellos otros en los que no se detecta poliovirus salvaje en muestras fecales de características adecuadas se descartan y no se consideran casos de poliomielitis. Los casos de PFA cuyas muestras fecales son inadecuadas y negativas para el poliovirus salvaje, que tienen parálisis residual, que fallecen o con los que se pierde el contacto durante el seguimiento, se clasifican como «poliocompatibles». En el presente artículo se expone un método de análisis del 18% de los casos de PFA chinos clasificados como poliocompatibles en 1997, a fin de descartar la poliomielitis. Debe considerarse que los casos de PFA poliocompatibles se deben a fallos de la vigilancia; las investigaciones basadas en esta metodología pueden acompañarse de medidas para mejorar la vigilancia. Se analizaron los datos nacionales de vigilancia utilizando mapas de puntos para identificar los conglomerados de casos de PFA poliocompatibles con factores de alto riesgo de poliomielitis. Durante las investigaciones de campo se evaluaron el sistema de vigilancia y la cobertura de vacunación. De los 4771 casos de PFA notificados en China en 1997, 57 (1,2%) se clasificaron como casos de PFA poliocompatibles con factores de alto riesgo según los criterios utilizados en este estudio. Entre ellos se identificaron cuatro conglomerados en cinco distritos de tres provincias, pero no hubo casos de poliomielitis confirmada. Las búsquedas activas realizadas en los historiales de los dispensarios de médicos de aldea y en hospitales comarcales y cantonales revelaron siete casos de PFA que no habían sido notificados. En los distritos afectados, la tasa de PFA no poliomielítica por 100 000 menores de 15 años era superior a la tasa nacional (2,9 y 1,6, respectivamente). Los datos de la vigilancia de la PFA en esos distritos estaban incompletos o eran inexactos. Se obtuvieron muestras fecales adecuadas en el 68% de los casos de PFA. En las zonas investigadas, la cobertura sistemática mediana con tres o más dosis de vacuna oral contra la poliomielitis antes de cumplir un año de edad fue del 49% (intervalo de confianza del 95%: 35%-96%), con una cobertura inferior al 80% en seis de las nueve zonas. Los fallos del programa registrados en las zonas identificadas como de alto riesgo (tasas de vacunación bajas, obtención defectuosa de muestras fecales, vigilancia inadecuada de la PFA), fueron corregidos aplicando las estrategias programáticas adecuadas. La utilización de esta metodología aporta pruebas firmes que son coherentes con la ausencia de poliovirus salvaje en China.

En Chine, les efforts d’éradication de la poliomyélite ont été couronnés de succès, le dernier poliovirus sauvage ayant été isolé en septembre 1994. Depuis 1995, la surveillance de la paralysie flasque aiguë (PFA) a très bien fonctionné, avec des taux de détection de plus de 1,0 pour 100 000 enfants de moins de 15 ans. En 1996, le Ministère chinois de la Santé a adopté le système de classification virologique des cas de PFA recommandé par l’OMS, venu remplacer le système de classification clinique en usage depuis 1991. Avec ces nouveaux critères virologiques, la confirmation définitive d’un cas de poliomyélite à partir des cas de PFA notifiés repose sur l’isolement du poliovirus sauvage au laboratoire. Seuls les cas de PFA pour lesquels on retrouve dans les échantillons de selles la présence de poliovirus sauvage sont des cas de poliomyélite confirmés; pour ceux dont les échantillons de selles ont été recueillis dans de bonnes conditions et ne montrent pas la présence de poliovirus sauvage, le diagnostic de poliomyélite est écarté. Les cas de PFA pour lesquels les échantillons de selles n’ont pas été recueillis dans de bonnes conditions et ne montrent pas la présence de poliovirus sauvage, qui se caractérisent par une paralysie résiduelle, le décès des patients ou le fait que ces derniers ont été perdus de vue, sont classés comme étant compatibles avec la poliomyélite. Dans cet article, on trouvera une méthodologie permettant d’écarter un diagnostic de poliomyélite applicable à l’analyse des 18% de cas de PFA rangés dans la catégorie des cas compatibles avec la poliomyélite en 1997 en Chine. Les cas de PFA compatibles avec la poliomyélite doivent être considérés comme des échecs de la surveillance; les études menées avec cette méthodologie peuvent être accompagnées de mesures visant à améliorer la surveillance. Les données nationales de la surveillance ont été analysées au moyen de cartes de points servant à déceler les groupes de cas de PFA compatibles avec la poliomyélite comportant des facteurs de risque importants. Le système de surveillance et la couverture vaccinale ont été évalués au cours d’études sur le terrain. Sur les 4771 cas de PFA notifiés en Chine en 1997, 57 (1,2 %) ont été rangés dans la catégorie des cas de PFA compatibles avec la poliomyélite et comportant des facteurs de risque importants d’après les critères retenus dans cette étude. Parmi eux, on a recensé quatre groupes de cas situés dans cinq districts de trois provinces, mais aucun cas de poliomyélite n’a été confirmé. Des recherches actives dans les dossiers médicaux des médecins de village et des hôpitaux municipaux ou de district ont permis de découvrir sept cas de PFA supplémentaires qui n’avaient pas été notifiés. Le taux de PFA non poliomyélitique pour 100 000 enfants de moins de 15 ans dans les districts touchés était supérieur au taux national, à savoir 2,9 contre 1,6. Les données de la surveillance de la PFA dans ces districts étaient incomplètes ou inexactes. Des échantillons de selles prélevés dans de bonnes conditions ont été obtenus pour 68% des cas de PFA. La couverture médiane par au moins trois doses de VPO avant l’âge d’un an dans les régions étudiées était de 49% (intervalle de confiance à 95 %, 35-96) et inférieure à 80% dans six des neuf zones étudiées. Dans les régions à haut risque ainsi recensées, les défaillances des programmes tels les faibles taux de vaccination, le recueil des échantillons de selles dans de mauvaises conditions et la surveillance insuffisante de la PFA ont été corrigées en mettant en œuvre des stratégies appropriées. L’application de cette méthodologie laisse donc fortement à penser que le poliovirus sauvage est absent en Chine.