Objective To analyze a large number of Cumulative Paternity Index (CPI) data in Single-parentage identification with stochastic simulation method. Methods Using the software in Identifiler, PP18D, AGCU EX20, PP21, AGCU 21+1 system, 1 million groups of STR genotyping of parent-child were analyzed. The average rate of very low CPI (RVLCPI), the median of PI in every loci (MPI), and the average PI of 39 STR loci (PIsolo) were counted out. And calculation formula of the number of STR loci that need more testing (N) was derived. Results RVLCPI in Identiifler, PP18D, AGCU EX20, PP21, AGCU 21+1 system were 24.9%, 6.5%, 1.4%, 0.7%, 0.000 1%. On the premise of inclusion relations between every kits, the number of autosome STR loci is inversely proportional to RVLCPI. PIsolo was 1.843 2. There was a signiifcant positive correlation between MPI and PEduo (r=0.956, P<0.001). The formula of the number of STR loci that need more testing was N=?log1.843 2(10 000/P)?. Conclusion The result and the formula in this paper are effcient in single-parentage identiifcation.

Objective:To investigate the short-term and long-term effects of occlusal rehabilitation on the co-contractration patterns of masticatory muscles of patients with extensive tooth wear.Methods: Twenty-nine patients with severe tooth wear were selected and conducted with occlusal rehabilitation.The surface electromyography(EMG) of masseter(MM),anterior temporalis(TA) and posterior temporalis(TP) at rest position,during clenching and chewing were separately recorded in the stage of pre-treatment,1 month after temporary restoration,1 month after permanent restoration and long-term observation(mean 3.5 years).The Asymmetry Indexes(AI) of bilateral muscles,Activity Indexes of MM/TA,MM/TP and TA/TP were compared in each stage.Results:(1) After occlusal rehabilitation,all the AIs of bilateral MM,TA and TP at rest position,during clenching and chewing showed obvious decrements.(2) In every stage of occlusal rehabilitation,all of the Activity Indexes of MM/TA at rest position,during clenching and chewing had no obvious changes.(3) The Activity Indexes of MM/TP and TA/TP during clenching and chewing significantly increased after occlusal rehabilitation.Conclusion: The treatment of occlusal rehabilitation can significantly improve the bilateral symmetry of masticatory muscles in patients with extensive tooth wear,and also change the coordinated EMG activity of different masticatory muscles.

Objective To investigate the potential factors which have impact on the working space for surgeons in gasless laparoscopic cholecystectomy and to probe into the specifications of gasless surgeries.Methods Clinical data of 49 cases of gasless laparoscopic cholecystectomy between March 2007 and July 2010 were summarized.The impacts of body mass index,bowel preparation and means of anesthesia on operation time and conversion to laparotomy were analyzed.Results For patients with body mass index ≤25and ＞ 25,operation times were (43.0 ± 5.4) min,and (52.8 ± 7.4 ) min,respectively,and rates of conversion to laparotomy were 0/34 and 4/15,respectively.Both indices in the first group were higher.For patients with and without bowel preparation,operation times were (44.5 ± 5.4) min and (46.1 ± 8.0)min,respectively,and rates of conversion to laparotomy were 2/26 and 2/23,respectively.For patients with epidural anesthesia and lumbar/epidural anesthesia,operation times were (46.5 ± 7.9) min and (44.1 ±6.8) min,respectively,and rates of conversion to laparotomy were 2/24 and 2/25,respectively.Conclusions The operation time of gasless laparoscopic cholecystectomy could be affected by many factors,such as body mass index.Gasless operations can be improved by evaluating the conditions of patients correctly and by selecting suitable operation methods,anesthesia means and bowel preparation.

Objective :To explore influence of intra—arterial thrombolysis combined hyperbaric oxygen on serum levels of soluble intercellular adhesion molecule—1 (sICAM—1) and calcitonin gene related peptide (CGRP) in patients with severe ischemic stroke .Methods : A total of 96 patients with severe ischemic stroke in our hospital were randomly and equally divided into thrombolysis group and combined treatment group (received intra—arterial thrombolysis +hyperbaric oxygen therapy ).United States National Institutes of Health Stroke score (NIHSS) was used to assess neurological function recovery , and modified Rankin rating score (mRS) was used to assess recovery of clinical symptoms.After two—week treatment ,clinical therapeutic effect etc .were compared between two groups .Results :Compared with thrombolysis group after treatment ,there was significant rise in total effective rate (77.08% vs. 93. 75%, P＝0.021) ;significant reductions in scores of NIHSS [ (8.10 ± 3.45) scores vs .(5.36 ± 2.11) scores] and mRS [ (2.58 ± 0. 80) scores vs .(1.81 ± 0.76) scores] ;significant reduction in serum sICAM—1 level [ (237.31 ± 18. 04) ng／ml vs.(220.25 ± 16.40) ng／ml] ,and significant rise in serum CGRP level [ (27.02 ± 6.06) pg／ml vs. (35.24 ± 6.13) pg／ml] in combined treatment group , P＝0.001 all.There was no significant difference in revascu—larization within two weeks between two groups , P＝0.551. Conclusion : Intra—arterial thrombolysis combined hy—perbaric oxygen possesses significant therapeutic effect on patients with severe ischemic stroke .It can relieve clinical symptoms ,recover cognitive function ,improve revascularization rate in these patients .

Chronic obstructive pulmonary disease (COPD) is an important healthcare problem worldwide. Often, glucocorticoid (GC) resistance develops during COPD treatment. As a classic hypoglycemic drug, metformin (MET) can be used as a treatment strategy for COPD due to its anti-inflammatory and antioxidant effects, but its specific mechanism of action is not known. We aimed to clarify the role of MET on COPD and cigarette smoke extract (CSE)-induced GC resistance. Through establishment of a COPD model in rats, we found that MET could improve lung function, reduce pathological injury, as well as reduce the level of inflammation and oxidative stress in COPD, and upregulate expression of nuclear factor E2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), multidrug resistance protein 1 (MRP1), and histone deacetylase 2 (HDAC2). By establishing a model of GC resistance in human bronchial epithelial cells stimulated by CSE, we found that MET reduced secretion of interleukin-8, and could upregulate expression of Nrf2, HO-1, MRP1, and HDAC2. MET could also increase the inhibition of MRP1 efflux by MK571 significantly, and increase expression of HDAC2 mRNA and protein. In conclusion, MET may upregulate MRP1 expression by activating the Nrf2/HO-1 signaling pathway, and then regulate expression of HDAC2 protein to reduce GC resistance.

Objective:To investigate the prognostic value of pretreatment 18F-FDG PET/CT metabolic parameters in patients with elderly classical Hodgkin′s lymphoma (cHL). Methods:From April 2011 to April 2020, the pretreatment clinical and 18F-FDG PET/CT metabolic parameters of 42 elderly cHL patients (29 males and 13 females, median age 69 years) pathologically confirmed in the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were obtained with 41%SUV max as the threshold. ROC curve analysis was applied to obtain the best prognostic cut-off value of SUV max, MTV and TLG. Kaplan-Meier method and log-rank test were used for univariate survival analysis, and Cox proportional hazard regression model was used for multivariate survival analysis. Results:SUV max, MTV and TLG of 42 elderly cHL patients were 16.49(12.24, 23.59), 79.29(26.29, 184.51) ml and 729.02(206.03, 2 073.98) g, respectively. ROC curve showed that the AUCs of SUV max, MTV and TLG were 0.425, 0.882 and 0.832, respectively, and the best prognostic cut-off values were 16.49, 82.38 ml and 556.26 g, respectively. Univariate analysis showed that age, B symptoms, lactate dehydrogenase (LDH) level, Hb content, Ann Arbor stage, German Hodgkin Study Group (GHSG) score, MTV and TLG were relative factors affecting progression-free survival (PFS) rate ( χ2 values: 4.50-12.60, all P<0.05), and age, B symptoms, LDH level, Ann Arbor stage, GHSG score, MTV and TLG were relative factors affecting overall survival (OS) rate ( χ2 values: 5.20-11.17, all P<0.05). Multivariate analysis showed that MTV (relative risk ( RR)=5.370, 95% CI: 1.697-16.277) and TLG ( RR=4.854, 95% CI: 1.228-23.352) were independent prognostic predictors of PFS rate (both P<0.05), and GHSG score ( RR=3.761, 95% CI: 1.092-12.955; RR=3.668, 95% CI: 1.068-12.571), MTV ( RR=6.173, 95% CI: 1.431-16.322) and TLG ( RR=5.162, 95% CI: 1.200-22.199) were independent prognostic predictors of OS rate (all P<0.05). Conclusion:MTV and TLG in pretreatment 18F-FDG PET/CT are independent prognostic factors for predicting PFS and OS in patients with elderly cHL patients, which have certainly reference value for prognosis.

Objective:To investigate the prognostic value of bone marrow (BM) 18F-fluorodeoxyglucose ( 18F-FDG) uptake pattern of pretreatment positron emission tomography/computed tomography (PET-CT) in extranodal NK/T cell lymphoma (ENKTL) patients. Methods:We retrospectively collected clinical data from a series of 63 ENKTL patients with stageⅡ~Ⅳ, who have received both 18F-FDG PET-CT and bone marrow biopsy (BMB) prior to treatment. According the BM 18F-FDG uptake pattern of PET-CT, the patients were divided into three groups: focal BM FDG uptake higher than liver (fPET+ ), diffuse BM uptake higher than liver (dPET+ ) and normal BM uptake (lower than liver) (nPET). The Kaplan-Meier method and Log-rank test were respectively used for survival analysis and univariate analysis, and COX proportional hazards model for multivariate analysis. Results:Among the 63 patients, 22 patients had nPET, 24 patients showed dPET+ , and 17 patients had fPET+ . BMB positive was found in 8 patients, and negative in 55 patients. Thirty-seven patients had disease progression or relapse, and 31 patients died. The 3-years progression free survival (3y-PFS) rates of fPET+ patients and nPET patients were 14.7% and 63.6% ( P=0.006). The 3-years overall survival (3y-OS) rates were 18.8% and 64.8% ( P=0.005). The 3y-PFS of dPET+ patients and nPET patients were 35.6% and 63.6% ( P=0.161), 3y-OS were 47.9% and 64.8% ( P=0.280). Univariate analysis showed that lactate dehydrogenase (LDH) level, Epstein-Barr virus DNA (EBV-DNA), Korean prognostic index (KPI) and BM 18F-FDG were related with PFS and OS (all P<0.05). Multivariate analysis showed EBV-DNA and BM 18F-FDG were independent predictors for PFS ( P<0.05). EBV-DNA was also an independently predictor for OS ( P<0.05). Conclusions:PET/CT-directed BM patterns are meaningful in predicting prognosis of newly diagnosed ENKTL patients. Focal BM 18F-FDG uptake pattern is an independent predictor for PFS.

Objective:To investigate the prognostic value of bone marrow (BM) 18F-fluorodeoxyglucose ( 18F-FDG) uptake pattern of pretreatment positron emission tomography/computed tomography (PET-CT) in extranodal NK/T cell lymphoma (ENKTL) patients. Methods:We retrospectively collected clinical data from a series of 63 ENKTL patients with stageⅡ~Ⅳ, who have received both 18F-FDG PET-CT and bone marrow biopsy (BMB) prior to treatment. According the BM 18F-FDG uptake pattern of PET-CT, the patients were divided into three groups: focal BM FDG uptake higher than liver (fPET+ ), diffuse BM uptake higher than liver (dPET+ ) and normal BM uptake (lower than liver) (nPET). The Kaplan-Meier method and Log-rank test were respectively used for survival analysis and univariate analysis, and COX proportional hazards model for multivariate analysis. Results:Among the 63 patients, 22 patients had nPET, 24 patients showed dPET+ , and 17 patients had fPET+ . BMB positive was found in 8 patients, and negative in 55 patients. Thirty-seven patients had disease progression or relapse, and 31 patients died. The 3-years progression free survival (3y-PFS) rates of fPET+ patients and nPET patients were 14.7% and 63.6% ( P=0.006). The 3-years overall survival (3y-OS) rates were 18.8% and 64.8% ( P=0.005). The 3y-PFS of dPET+ patients and nPET patients were 35.6% and 63.6% ( P=0.161), 3y-OS were 47.9% and 64.8% ( P=0.280). Univariate analysis showed that lactate dehydrogenase (LDH) level, Epstein-Barr virus DNA (EBV-DNA), Korean prognostic index (KPI) and BM 18F-FDG were related with PFS and OS (all P<0.05). Multivariate analysis showed EBV-DNA and BM 18F-FDG were independent predictors for PFS ( P<0.05). EBV-DNA was also an independently predictor for OS ( P<0.05). Conclusions:PET/CT-directed BM patterns are meaningful in predicting prognosis of newly diagnosed ENKTL patients. Focal BM 18F-FDG uptake pattern is an independent predictor for PFS.

Objective: To evaluate the safety, feasibility and operational effectiveness of master-slave system controlled Robot-assisted flexible endoscopy 'YunSRobot’ in upper gastrointestinal endoscopy examination in living pigs. Methods: Seven Guangxi BA-MA Mini-pigs underwent upper gastrointestinal endoscopy examination with master-slave system controlled Robot-assisted flexible endoscopy 'YunSRobot’ and Olympus GIF-Q260J gastroendoscope (Japan). The experiment divided into manual operation group and robot operation group. Nine gastroenterologists skilled with endoscopy operation handled the robot once in vitro to familiar with the mechanism and method of robot operation. And then performed manual operation and robot operation four times each. Endoscopy pictures and operation time were recorded. T test and one-way analysis of variance were performed for statistical analysis. Results: Both manual operation and robot operation could successfully finish standard esophagus and stomach endoscopic examination. There were no complications such as hemorrhage, perforation, mistaken insertion into of trachea, injures of pharynx and larynx and inhalation pneumonia. Esophagus, gastric cardia, gastric fundus, gastric body, gastric angle, gastric antrum and gastric pylorus could be clearly observed in both groups. The manual operating time of nine gastroenterologists was (3.67±1.95) minutes, which was shorter than that of robot operating time ((7.60±2.00) minutes), and the difference was statistically significant (t=8.445, P<0.01). The time of first in vitro operation performed by nine gastroenterologist was (13.10±6.32) minutes. The operation times of each case of nine gastrienterologist were (8.49±0.90) minutes, (7.50±1.19) minutes, (7.30±1.33) minutes and (7.12±1.61) minutes. The difference was statistically significant (F=7.901, P<0.01). Operation time gradually shortened and operation proficiency significantly improved. Conclusion Master-slave system controlled Robot-assisted flexible endoscopy 'YunSRobot’ which provides a clear observation of esophagus and stomach is safe in endoscopic examination of living animal.

Objective To analyze the epidemiological characteristics of patients with sea lice injury in coastal baths in Qinhuangdao City, and provide scientific evidence for the importance of prevention of sea lice injury and the early warning of sea lice outbreak. Methods The data of 2 659 patients with sea lice injury, including gender, age composition, severity of bruises and other epidemiological data reported by the coastal bathing stations in Qinhuangdao City from 2016 to 2018 (mainly from July to August) were retrospectively analyzed, and the correlation between the temperature at the surface of sea water and the number of patients with sea lice injury was also analyzed. Results Among the 7 bathing beaches along the coast of Qinhuangdao City, Dongshan Bathing Spot (1 101 cases) and Repulse Bay Bathing Beach (1 365 cases) had the largest numbers of bruises, while the Gold Coast Bath had the least (only 5 cases), and the differences in number of bruises in different baths were statistically significant in 2016, 2017, 2018 years (277, 1 890, 492 cases respectively, χ2= 490.611, P < 0.05). Among 2 659 patients, 1 124 were children (≤14 years old), 1 535 were adult, 1 570 male and 1 089 female patients. The severity type of patients' sea lice injury in each bath was mainly mild to moderate type; among the total injury cases, there were 2 589 cases with mild type injury accounting for 97.37%, 61 cases with moderate type (2.29%) and 9 cases with severe type (0.34%). A linear trend between sea surface temperature and the patients' number of bruises was seen, and there was a positive correlation between the sea surface temperature and the patients' number (r = 0.433, P < 0.05). Conclusion The sea lice injuries in Qinhuangdao City are mainly distributed in the Dongshan and Repulse Bay Baths, the main type of injury is light one, and in the mean time the injury is influenced by factors such as popularization of science, medical care, environmental factors, and collective sea lice drift, etc.