ObjectiveTo reveal the correlation of Rehmannia glutinosa-soil feedback process with the formation of its continuous cropping obstacles through the identification of the root exudates of R. glutinosa and analysis of the specific rhizomicrobes recruited by the root exudate. MethodThe root exudates of R. glutinosa seedlings germinated under sterilized condition and those enriched in the rhizosphere of R. glutinosa cultivated in the field were collected and analyzed using the ultra-performance liquid chromatography quadrupole time-of-flight mass spectrometry（UPLC-Q-TOF-MS）. The highly abundant compounds identified in the root exudates were added into blank soil， and the soil microbial community was profiled using Illumina Miseq sequencing. The bacterial and fungal functions were predicted by PICRUSt and FUNGuild， respectively. ResultThe identification results showed that seven phenylethanoid glycosides were found in R. glutinosa root exudates， and acteoside possessed the highest abundance. In the soil enriched with acteoside， the bacterial genera such as Agromyces， Pseudomonas， Lysobacter， Sphingobium， Pseudoxanthomonas and Sphingomonas were enriched. For the fungi， the genera Neocosmospora， Plectosphaerella and Dactylonectria， and the species such as Neocosmospora rubicola， Plectosphaerella cucumerina， Dactylonectria alcacerensis and Fusarium solani showed higher abundance. The functional analysis indicated the above-mentioned bacterial genera may realize rapid proliferation by utilizing， biodegrading and transforming phenylethanoid glycosides， and some potential fungal pathogens were colonized. ConclusionThe R. glutinsoa-soil feedbacks were likely generated by the phenylethanoid glycosides in the root exudates together with the specific rhizomicrobes. The investigations of R. glutinsoa-soil feedbacks under continuous cropping system are critical to the further understanding of the underlying mechanisms related to its continuous cropping obstacles.

Objective:To evaluate the value of radiomics based on contrast-enhanced spectral mammography (CESM) of internal and peripheral regions combined with clinical factors in predicting benign and malignant breast lesions of breast imaging reporting and data system category 4 (BI-RADS 4).Methods:A retrospective analysis was performed on the clinical and imaging data of patients with breast lesions who were treated in Yantai Yuhuangding Hospital (Center 1) Affiliated to Qingdao University from July 2017 to July 2020 and in Fudan University Cancer Hospital (Center 2) from June 2019 to July 2020. Center 1 included 835 patients, all female, aged 17-80 (49±12) years, divided into training set (667 cases) and test set (168 cases) according to the "train-test-split" function in Python software at a ratio of 8∶2; and 49 patients were included from Center 2 as external validation set, all female, aged 34-70 (51±8) years. The radiomics features were extracted from the intralesional region (ITR), the perilesional regions of 5, 10 mm (PTR 5 mm, PTR10 mm) and the intra-and perilesional regions of 5, 10 mm (IPTR 5 mm, IPTR 10 mm) and were selected by variance filtering, SelectKBest algorithm, and least absolute shrinkage and selection operator. Then five radiomics signatures were constructed including ITR signature, PTR 5 mm signature, PTR 10 mm signature, IPTR 5 mm signature, IPTR 10 mm signature. In the training set, univariable and multivariable logistic regressions were used to construct nomograms by selecting radiomics signatures and clinical factors with significant difference between benign and malignant BI-RADS type 4 breast lesions. The efficacy of nomogram in predicting benign and malignant BI-RADS 4 breast lesions was evaluated by the receiver operating characteristic curve and area under the curve (AUC). Decision curve and calibration curve were used to evaluate the net benefit and calibration capability of the nomogram.Results:The nomogram included ITR signature, PTR 5 mm signature, PTR 10 mm signature, IPTR 5 mm signature, age, and BI-RADS category 4 subclassification for differentiating malignant and benign BI-RADS category 4 breast lesions and obtained AUCs of 0.94, 0.92, and 0.95 in the training set, test set, and external validation set, respectively. The calibration curve showed good agreement between the predicted probabilities and actual results and the decision curve indicated a good net benefit of the nomogram for predicting malignant BI-RADS 4 lesions in the training set, test set, and external validation set.Conclusion:The nomogram constructed from the radiomics features of the internal and surrounding regions of CESM breast lesions combined with clinical factors is attributed to differentiate benign from malignant BI-RADS category 4 breast lesions.

Objective:To study the effects of progesterone on the morphology, proliferation, and secretion of cytokines of human decidual stromal cells (DSCs) in late pregnancy, and to explore the mechanism of progesterone in preventing spontaneous preterm birth.Methods:Human decidual stromal cells in late pregnancy were cultured and treated with different concentrations of progesterone (in the experimental groups, 10 -6 mol/L, 10 -5 mol/L and 10 -4 mol/L progesterone was added to the culture medium respectively, and no progesterone was added to the culture medium of control group). The morphology of DSCs was observed under the microscope, the cell length/width ratio was measured, the proliferation was detected by methyl thiazolyl tetrazolium (MTT) method, and the expressions of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) mRNA were detected by RT-qPCR. Results:The length/width ratios of DSCs in progesterone 10 -4 mol/L (5.87±0.19) and 10 -5 mol/L (5.98±0.27) groups were lower than that in control group (6.42±0.19), the differences were statistically significant ( P<0.001, P=0.002). The length/width ratio in the 10 -4 mol/L group was lower than that in the 10 -6 mol/L group (6.28±0.32, P=0.005). The proliferation of DSCs in the 10 -5 mol/L (0.70±0.04) and 10 -4 mol/L (0.78±0.04) groups was higher than that in control group (0.59±0.05; P=0.027, P=0.002), and proliferation of DSCs in 10 -4 mol/L group was higher than that in 10 -6 mol/L group (0.61±0.01, P=0.004). The expression of TNF-α mRNA in each progesterone group was lower than that in control group (all P<0.001) and the expression of TNF-α mRNA in the 10 -5 mol/L and 10 -4 mol/L groups was lower than that in the 10 -6 mol/L group (all P<0.001) . The expressions of IL-6 mRNA decreased gradually in control group, 10 -6 mol/L, 10 -5 mol/L and 10 -4 mol/L groups, the differences were statistically significant (all P<0.001). Conclusion:Progesterone can make the decidual stromal cells wider, promote proliferation, and decrease the expressions of TNF-α and IL-6 mRNA, which may play an important role in the mechanism of progesterone preventing spontaneous preterm birth.

Objective:To study the effects of progesterone on the morphology, proliferation, and secretion of cytokines of human decidual stromal cells (DSCs) in late pregnancy, and to explore the mechanism of progesterone in preventing spontaneous preterm birth.Methods:Human decidual stromal cells in late pregnancy were cultured and treated with different concentrations of progesterone (in the experimental groups, 10 -6 mol/L, 10 -5 mol/L and 10 -4 mol/L progesterone was added to the culture medium respectively, and no progesterone was added to the culture medium of control group). The morphology of DSCs was observed under the microscope, the cell length/width ratio was measured, the proliferation was detected by methyl thiazolyl tetrazolium (MTT) method, and the expressions of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) mRNA were detected by RT-qPCR. Results:The length/width ratios of DSCs in progesterone 10 -4 mol/L (5.87±0.19) and 10 -5 mol/L (5.98±0.27) groups were lower than that in control group (6.42±0.19), the differences were statistically significant ( P<0.001, P=0.002). The length/width ratio in the 10 -4 mol/L group was lower than that in the 10 -6 mol/L group (6.28±0.32, P=0.005). The proliferation of DSCs in the 10 -5 mol/L (0.70±0.04) and 10 -4 mol/L (0.78±0.04) groups was higher than that in control group (0.59±0.05; P=0.027, P=0.002), and proliferation of DSCs in 10 -4 mol/L group was higher than that in 10 -6 mol/L group (0.61±0.01, P=0.004). The expression of TNF-α mRNA in each progesterone group was lower than that in control group (all P<0.001) and the expression of TNF-α mRNA in the 10 -5 mol/L and 10 -4 mol/L groups was lower than that in the 10 -6 mol/L group (all P<0.001) . The expressions of IL-6 mRNA decreased gradually in control group, 10 -6 mol/L, 10 -5 mol/L and 10 -4 mol/L groups, the differences were statistically significant (all P<0.001). Conclusion:Progesterone can make the decidual stromal cells wider, promote proliferation, and decrease the expressions of TNF-α and IL-6 mRNA, which may play an important role in the mechanism of progesterone preventing spontaneous preterm birth.

Objective:To evaluate the value of pretreatment 18F-fluorodeoxyglucose (FDG) PET/CT-based heterogeneity for early prediction of targeted therapy outcome in patients with human epidermal growth factor receptor 2 (HER2) positive metastatic breast cancer. Methods:From May 2012 to April 2018, 29 patients (all females, median age: 52 (32-69) years) who had HER2 positive metastatic breast cancer and underwent pretreatment 18F-FDG PET/CT in Fudan University Shanghai Cancer Center were retrospectively enrolled. All patients received trastuzumab as first-line treatment and were followed up for 6-87 (median time: 35) months. The relations between clinicopathologic parameters or PET/CT-based parameters and progression-free survival (PFS)/overall survival (OS) were analyzed with Cox univariate analysis. The parameters with P≤0.01 were further analyzed with Cox multivariate analysis. Optimal cut-off values were determined by time-dependent receiver operating characteristic (ROC) curve analysis. The survival analyses were estimated by Kaplan-Meier method and log-rank test. Results:The median OS of the 29 patients was 30 (6-83) months, and the median PFS was 10 (2-29) months. The PET/CT-based heterogeneity index(HI), including the maximum standardized uptake value (SUV max) ratio (SUV max-R; hazard ratio ( HR)=8.6, 95% CI: 2.7-27.8, P<0.001), the mean standardized uptake value (SUV mean)-2.5 (the cut-off value of standardized uptake value (SUV)=2.5) ratio (SUV mean-2.5-R; HR=2.6, 95% CI: 1.2-5.9, P=0.020), the metabolic tumor volume(MTV)-2.5 ratio(MTV-2.5-R; HR=2.4, 95% CI: 1.1-5.2, P=0.030), and the total lesion glycolysis(TLG)-2.5 ratio(TLG-2.5-R; HR=3.2, 95% CI: 1.4-7.4, P=0.008) of the lesion with the highest SUV max to that with the lowest SUV max, were significantly associated with PFS. None of the parameters was significantly associated with OS (all P>0.05). Multivariate analysis showed that the SUV max-R was the only independent predictor for PFS ( HR=6.8, 95% CI: 1.8-26.1, P<0.01). Area under the ROC curve for SUV max-R was 0.747. With a cut-off value of 1.8, SUV max-R could effectively distinguish the benefit from non-benefit population treated with trastuzumab (15.0 vs 7.0 months; χ2=18.68, P<0.01). Conclusion:Pretreatment 18F-FDG PET/CT-based HI has potential value for early prediction of first-line trastuzumab treatment outcome in patients with HER2 positive metastatic breast cancer.

Objective To establish a method of judge the pyrazinamide(PZA) susceptibility for Mycobacterium tuberculosis(MTB) with 24-hole micro-liquid culture silica gel color plate,and evaluate the clinical application value of this method.Methods According to the result of MGIT960,to detect PZA drug susceptibility for 30 MTB clinical isolates of whose PZA susceptibility were known with silica gel color plate.The effects of different pH value,different inoculation concentrations on the results were observed,and the optimum detection conditions were discussed.Finally,the 98 MTB clinical isolated of whose PZA susceptibility were unknown were simultaneously detected by gel color plate and MGIT960,the sensitivity,specificity and accuracy were judged by PZA drug sensitivity.Results The best pH was 5.8-5.9 and the best concentration was 2.5×10-1 mg/mL in gel color plate.The best results were read after 7-14 d.The sensitivity,specificity and accuracy were 95.50%,96.30%,and 98.21% respectively just at PZA critical concentration was 100 μg/mg.The sensitivity,specificity and accuracy were 90.90%,92.59%,and 91.84% respectively just at PZA critical concentration was 200 μg/mg.Conclusion The PZA susceptibility for MTB with 24-hole micro-liquid culture silica gel color plate is accurate,rapid,low-cost and simple.

Background and purpose:In preparation for using this tracer in humans, this study estimated thedosimetry of18F-FES with the method established by MIRD based on whole-body PET imaging of mice.Methods:Three female mice receivedⅣ tail injections of18F-FES and were scanned for 160 min in an Inveon dedicated PET/CT scanner. This study selected some important organs (brain, lung, liver, heart wall, small intestine, large intestine, kidney and urinary bladder), computed their residence times. Then, the residence times in mice organs were converted to human values using scale factors based on differences between organ and body weights. OLINDA/EXM 1.1 software was used to compute the absorbed human doses in multiple organs for both adult female and adult male body phantoms. Results:The highest absorbed doses in gallbladder wall, urinary bladder wall, small intestine, upper large intestine and liver are 0.072 5, 0.044 5, 0.043 0, 0.031 5 and 0.028 2 mGy/MBq, respectively. The organs which have the lowest ab-sorbed doses were brain (0.005 2 mGy/MBq), followed by skin (0.001 1 mGy/MBq), breast (0.001 1 mGy/MBq), heart wall (0.001 2 mGy/MBq) and thyroid (0.001 2 mGy/MBq). The mean absorbed doses for the other major organs ranged from 0.009 5 to 0.023 5 mGy/MBq. The total mean effective dose is 0.019 0 mSv/MBq and the mean effective doses equivalent is 0.025 0 mGy/MBq. A 370-MBq injection of18F-FES leads to an estimated effective dose of 7.03 mSv for the female. There was no statistical difference in the doses results obtained from direct measurement of18F-FES ab-sorption in normal people between previous publications by others and our work.Conclusion:The whole-body mouse imaging can be used as a preclinical tool for initial estimation of the absorbed doses of18F-FES in humans. Furthermore, the potential radiation risk associated with18F-FES imaging is well within the accepted limits.

Objective:To investigate the effect of MT01 on the differentiation of osteoblasts under infected condition through determining the expression level of collagen Ⅰ (Col Ⅰ )mRNA in MG63 cells treated with Porphyromonas gingivalis (Pg).Methods:The cultured MG63 cells were divided into blank control,MT01,Pg, and MT01+Pg groups.MT01 at a concentration of 1 mg·L-1 was added into the MG63 cells,and the cells were incubated for 3 h.The cells treated with PBS (1 mg·L-1 )were used as control group.Then Pg (MOI=100∶1) was added.Real-time PCR was used to detect the expression levels of ColⅠ mRNA in MG63 cells at 2,4,6,8, 12 and 24 h after incubation.Results:Compared with blank control group,the levles of ColⅠ mRNA in the MG63 cells in MT01 and MT01 + Pg groups had no significant changes at 2 and 4 h (P > 0.05);the Col Ⅰ mRNA expression levels in MT01 group at 8,12 and 24 h were increased (P < 0.05 or P < 0.01).Compared with Pg group,the expression levels of ColⅠ mRNA in MT01+ Pg at 2 and 4 h were decreased,but the expression levels of ColⅠ mRNA were increased at 6,8,12 and 24 h (P <0.05 or P <0.01).Conclusion:MT01 can up-regulate the expression level of Col Ⅰ mRNA in the infected MG63 cells; MT01 could promot the differentiation of osteoblasts under infected condition.

Objective:To transfect the non-viral vector polyethylenimine (PEI)mediated miR-2861 mimic into the MC3T3-E1 cell line,and to explore the transfection efficiency of PEI/miR-2861 complex and its effects on the proliferation and osteogenesis differentiation in pre-osteoblasts. Methods:The proper amount of PEI was blended with miR-2861 mimic and negative control (NC)separately in a ratio of N∶P=10∶1,and they were divided into experiment group and NC group. The NC/PEI complex acted as the NC group was used to eliminate the interference of osteogenesis from the addition of double-stranded RNA mimic.MTT assay was used to determine the optimal concentration of PEI/miR-2861 mimic complex.The fluorescence imaging technique and bulge-loop RT-PCR were used to detect the transfection efficiency and mRNA expression of miRNA-2861 in the cells with different concentrations (10,30, 50,and 100 nmol · L-1 ), separately.The osteogenesis ability of MC3T3 cells was identified with RT-PCR and Alizarin red staining with the selected concentration of PEI/miR-2861 by transient transfection.Results:Compared with blank control group,the proliferation rates of MC3T3 cells in 100 nmol·L-1 PEI/miR-2861 group was decreased significantly at 72 h (P < 0. 05 ). With the increasing of transfected concentration the transfection efficiency of miRNA/PEI complex was increased gradually.The results of Alizarin red staining and quantitative analysis showed that calcium deposits were more and bigger in experiment group after induced for 21 d,while both in blank control group and NC group they were less.Conclusion:The miRNA-2861 mimic can be effectively transfected into the MC3T3-E1 cell line and expresses with a high level,which is mediated by PEI as the gene vector.miR-2861 mimic has a certain ability of promoting osteogenesis differentiation of MC3T3-E1 cells.

Objective To learn the present hospital management conditions in Shanghai for upgrading quality of care.Methods The stratified sampling method was used for a questionnaire survey of the quality of care at 20 hospitals in Shanghai (10 tertiary hospitals and 10 secondary hospitals).The survey covered such six dimensions as organizational framework,management functions,management tools,professional training,regulations and norms,and supervision over operations.Results Medical quality management system is established at such hospitals and all of them have established medical quality management committees.Rooms of improvement remain in such details as departmental quality management,regulations standardization,IT support,and management tools popularity.Conclusion Management regulations and standards of medical quality management should be improved and implemented from both external and internal aspects,to improve medical quality and patient safety.