Objective: To investigate the risk factors for the occurrence of laryngopharyngeal reflux disease in the aged, and to analyze the characteristics of patients with pneumonia. Methods: Patients who underwent 24-hour laryngopharyngeal pH monitoring from June 2020 to July 2022 and the positive patients of those who underwent 24-hour esophageal pH monitoring from March 2017 to July 2022 at the Second Medical Center of the PLA General Hospital were enrolled retrospectively. Positive results of 24-hour laryngopharyngeal reflux monitoring were in the laryngopharyngeal reflux group, and the negative results were in the non-laryngopharyngeal reflux group. Patients with pneumonia and simple gastroesophageal reflux disease were in the esophageal reflux pneumonia group, and patients with pneumonia and simple laryngopharyngeal reflux disease were in the laryngopharyngeal reflux pneumonia group. Patients' basic data, co-morbidities, drug use and relevant examination and test results were collected. Multivariate logistic regression analysis was used to analyze the risk factors of laryngopharyngeal reflux disease in the aged and its relationship with pneumonia. Results: A total of 80 patients with 24-hour laryngopharyngeal pH monitoring were enrolled finally, including 34 cases, all male, aged (73±12) years, in the laryngopharyngeal reflux group, and 46 cases [44 males, 2 females, aged (78±11) years] in the non-laryngopharyngeal reflux group. Multivariate logistic regression analysis showed that the risk factors of laryngopharyngeal reflux disease in the aged included age ≤70 years (OR=13.07, 95%CI: 2.53-67.68), body mass index (BMI) (OR=1.37, each additional 1 kg/m2, 95%CI: 1.03-1.83), use of antipsychotic drugs (OR=8.00, 95%CI: 1.40-45.73) and calcium channel blockers (OR=5.27, 95%CI: 1.13-24.53) (all P<0.05). The protective factors of the laryngopharyngeal reflux disease in the aged included antacids (OR=0.19, 95%CI: 0.04-0.90, P=0.035). The incidence of pneumonia was higher in the laryngopharyngeal reflux group compared with the non-laryngopharyngeal reflux group [44.1% (15/34) vs 21.7% (10/46), P=0.033]. The esophageal reflux pneumonia group included 32 cases [31 males and 1 females, aged (84±12) years]. The laryngopharyngeal reflux pneumonia group included 15 cases [ 15 males, aged (79±11) years]. Compared to the patients in the laryngopharyngeal reflux pneumonia group, the patients in the esophageal reflux pneumonia group had a longer course of antibiotics [(27.7±27.0) vs (14.6±13.9) days, P=0.034], a higher frequency of seizure frequency [(4.3±3.0) vs (1.8±1.5) times/year, P<0.001] and a higher maximal body temperature [(38.2±0.9) vs (37.6±1.1) ℃, P=0.037]. Conclusions: The risk factors of laryngopharyngeal reflux disease in the aged included age ≤70 years, higher BMI, use of antipsychotic drugs and calcium channel blockers. The incidence of pneumonia in laryngopharyngeal reflux disease is higher, but the condition of pneumonia is milder.

Abstract Background The magnitude of the risk of death and cardiac arrest associated with emergency surgery and anesthesia is not well understood. Our aim was to assess whether the risk of perioperative and anesthesia-related death and cardiac arrest has decreased over the years, and whether the rates of decrease are consistent between developed and developing countries. Methods A systematic review was performed using electronic databases to identify studies in which patients underwent emergency surgery with rates of perioperative mortality, 30-day postoperative mortality, or perioperative cardiac arrest. Meta-regression and proportional meta-analysis with 95% confidence intervals (CIs) were performed to evaluate global data on the above three indicators over time and according to country Human Development Index (HDI), and to compare these results according to country HDI status (low vs. high HDI) and time period (pre-2000s vs. post-2000s). Results 35 studies met the inclusion criteria, representing more than 3.09 million anesthetic administrations to patients undergoing anesthesia for emergency surgery. Meta-regression showed a significant association between the risk of perioperative mortality and time (slope: -0.0421, 95%CI: from − 0.0685 to -0.0157; P = 0.0018). Perioperative mortality decreased over time from 227 per 10,000 (95% CI 134–380) before the 2000s to 46 (16–132) in the 2000–2020 s (p < 0–0001), but not with increasing HDI. 30-day postoperative mortality did not change significantly (346 [95% CI: 303–395] before the 2000s to 292 [95% CI: 201–423] in the 2000s-2020 period, P = 0.36) and did not decrease with increasing HDI status. Perioperative cardiac arrest rates decreased over time, from 113 per 10,000 (95% CI: 31–409) before the 2000s to 31 (14–70) in the 2000–2020 s, and also with increasing HDI (68 [95% CI: 29–160] in the low-HDI group to 21 [95% CI: 6–76] in the high-HDI group, P = 0.012). Conclusions Despite increasing baseline patient risk, perioperative mortality has decreased significantly over the past decades, but 30-day postoperative mortality has not. A global priority should be to increase long-term survival in both developed and developing countries and to reduce overall perioperative cardiac arrest through evidence-based best practice in developing countries.

Reducing carbon emissions from planting (PCE) is crucial for achieving the “dual carbon” objective within the agricultural sector. This paper aims to investigate the impact of agricultural productive services (APSs) on carbon emissions in the planting industry, providing novel insights into reducing carbon emissions in this field. Based on the panel data of 30 provinces and regions in China from 2005 to 2021, this study measured the PCE and the level of APSs. The internal relationship between the APSs and PCE is subsequently examined empirically using various statistical models, including the fixed effect model, instrumental variable model, mediating effect model, and threshold effect model. The findings suggest that the PCE experienced an initial increase, followed by a subsequent decrease between 2005 and 2021, with the peak observed in 2015. APSs has a significant inhibitory effect on PCE, which remains significant even after conducting various robustness tests. However, the carbon emission reduction effect of APSs varies across different crop-producing areas. The study also revealed that APSs can inhibit PCE by facilitating land transfer. Additionally, the inhibitory effect of APSs on PCE is influenced by the scale of land management and exhibits a U-shaped nonlinear relationship. To effectively reduce PCE and achieve sustainable agricultural development, policymakers should actively promote the integration of APSs with modern agriculture and form moderate-scale operations by facilitating land transfer to maximize APSs’ carbon emission reduction effect.

Background In terms of hospitalization risk for the elderly, the evidences for adverse effects and economic losses of air pollutants on different types of cardiovascular diseases (CVDs) are limited. This study aims to quantify the economic losses of five major CVDs affected by air pollutants in Southwestern China.Methods Hospitalization information of 358,271 participants in the top five CVDs among the elderly population was collected over a 4-year time span. The generalized additive model (GAM) was used to estimate the short-term exposure response relationship between air pollutants and elderly inpatients with CVDs. The cost of illness method (COI) was used to evaluate the corresponding direct and indirect costs, and we refer to this in the text as economic losses.Results Air pollutants significantly increase the risk of hospitalisation in elderly patients with coronary heart disease (CHD), myocardial ischaemia (MI), pulmonary heart disease (PHD), hypertension, and cardiac arrhythmia. CO, NO2, PM10 and SO2 were significant increase the risk of CHD, with the RRs were 0.09, 2.59, 0.31, and 6.54, respectively; CO, NO2, O3, PM10, PM2.5, and SO2 were notably increased the risk of MI， with the RRs were 0.16, 4.19, 0.76, 0.79, 0.92, and 7.49, respectively; CO, NO2, PM10, PM2.5, and SO2 were distinctly increased the risk of PHD, with the RRs were 0.14, 2.79, 0.75, 1.00, and 3.86, respectively; NO2 and SO2 significant increase the risk of hypertension, with the RRs were 1.41 and 5.94, respectively; CO, NO2, PM10, and SO2 were distinctly increased the risk of arrhythmia, with the RRs were 0.09, 2.23, 0.36, and 5.41, respectively. Furthermore, we quantify the economic losses of five major CVDs affected by air pollutants. The economic burden of air pollution on patients with CHD, hypertension, PHD, cardiac arrhythmia, and MI were 66.38, 36.58, 5.76, 5.66 5.21 million yuan, respectively.Conclusion Our study found that short-term exposure to pollutants can have a significant impact on hospital admissions for all types of CVDs in the elderly. In terms of hospitalisation rates, SO2 and NO2 had a significant effect on different types of CVDs. Moreover, we found that air pollutants cause a heavy economic burden on patients with hypertension and CHD. It follows that reducing the concentration of air pollutants is an effective way to bring potential health benefits as well as economic benefits to local residents. Government departments should actively formulate relevant policies to reduce the physical and mental damage caused by air pollution.

INTRODUCTION:This study aimed to investigate the possible role of galectin-3 in epilepsy and further explore its underlying mechanisms. METHODS:Sprague-Dawley rats were intraperitoneally injected with 30 mg/kg pilocarpine to induce an animal model of epilepsy. To inhibit galectin-3, the epilepsy model of rats was intraperitoneally injected with TD139. The severity of the seizure was graded according to the Racine score. The pathological changes in hippocampal CA1 regions were observed by hematoxylin and eosin and Nissl staining. Enzyme-linked immunosorbent assay, quantitative real-time polymerase chain reaction, and Western blot were used to detect the levels of cytokines and pyroptosis-related factors. The in vitro effects of galectin-3 were confirmed on BV2 cells and rat primary microglia by transfection with lentivirus vectors carrying Lgals3 shRNA or by treatment with TD139. RESULTS:A higher expression of galectin-3 was observed in the hippocampal CA1 regions of epilepsy rats than in sham rats. Inhibition of galectin-3 by administration of TD139 improved the severity of the seizure, hippocampal damage, and neuron loss. TD139 administration suppressed the expression of NLRP3, ASC, c-caspase-1, and GSDMD-N, and reduced the levels of cytokines. In kainic acid-treated microglia, Lgals3 shRNA or TD139 significantly inhibited Iba1 expression and limited NLRP3/pyroptosis-triggered inflammation. CONCLUSION:Galectin-3 activates the NLRP3/pyroptosis signaling pathway to promote microglial activation and neuroinflammation during epilepsy disease progression.

OBJECTIVE: We aimed to investigate the effects of methoxamine to prevent hypotension in the elderly with intraspinal anesthesia (IA) on myocardial injury and cardiac function. PATIENTS AND METHODS: A retrospective study was conducted by enrolling sixty elderly patients who underwent femoral head replacement (FHR) under IA in our hospital from August 2019 to August 2020. The patients were divided into two groups according to the random number table method. In the control group (CG) (30 patients), 5 mg of ephedrine was administered sedately when patients developed hypotension (20% below basal blood pressure). In the research group (RG) (30 cases), 2 μg/(kg·h) of methoxamine hydrochloride was given as a constant-rate pump before anesthesia, and 1 mg of methoxamine hydrochloride was administered intraoperatively if hypotension occurred. The hemodynamic [systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR)], myocardial injury indexes [cardiac troponin I (cTnI), creatine kinase isoenzyme MB (CK-MB), fatty acid binding protein (FABP), plasma amino-terminal brain natriuretic peptide precursor (NT-proBNP)], cardiac function indexes [systemic vascular resistance (SVR), stroke volume (SV), net percentage ejection time (ET)] were observed before anesthesia (T1), at the end of surgery (T2), and 6 h after surgery (T3) in both groups. The Bruggemann Comfort Score (BCS) and Visual Analog Scale (VAS) scores at T3, 12 h postoperatively (T4) and 24 h postoperatively (T5) in both groups were observed, and the incidence of adverse reactions to intralesional anesthesia in both groups was counted. RESULTS: SBP, DBP and HR at T2 were lower than those at T1 in both groups, and SBP, DBP and HR at T3 were higher than those at T2, and SBP, DBP and HR at T2 and T3 in the RG were higher than those in the CG (p<0.05). In both groups, cTnⅠ, CK-MB and FABP were higher at T2 and T3 than at T1, higher at T3 than at T2, and NT-proBNP was higher at T2 than at T1 and T3, and lower in the RG than in the CG (p<0.05). In both groups, SVR and SV at time point T2 were lower than at time point T1 and ET was higher than at time point T1, SVR and SV at time point T3 were higher than at time point T2 and ET was lower than at time point T2, SVR and SV in the RG were higher than in the CG and ET was lower than in the CG (p<0.05). VAS scores were higher in both groups at T4 and T5 than at T3, and lower in the RG than in the CG (p<0.05). CONCLUSIONS: Methoxamine can effectively reduce the risk of hypotension in geriatric endotracheal anesthesia, which can reduce myocardial injury and stabilize cardiac function in patients.

Background GPT-4 is a newly developed large language model that has been preliminarily applied in the medical field. However, GPT-4’s relevant theoretical knowledge of computer science has not been effectively transferred to the medical field. Objective To explore the application of prompt engineering in GPT-4 and to examine the reliability of GPT-4. Methods Different styles of prompts were designed and used to ask GPT-4 questions about agreement with the American Academy of Orthopaedic Surgeons (AAOS) osteoarthritis (OA) evidenced-based guidelines. Each question was asked 5 times. We compared the consistency with guidelines across different evidence levels for different prompts and assessed the reliability of different prompts by asking the same question 5 times. Results The ROT style had a significant performance for strong recommendations, with a total consistency of 77.5%, and showed steady performance at other levels of evidence compared to other prompts. The reliability of GPT-4 in different prompts was not stable (Fleiss kappa ranged from 0.334 to 0.525, and Kendall’s coefficient ranged from 0.701 to 0.814). Conclusions The application of prompt engineering could improve the performance of GPT-4 in medicine. The reliability of GPT-4 in answering medical questions is not clear, and further research is necessary.

In the background of the post-epidemic era, the consumption demand and market scale of cold chain logistics in China are expanding, but there is still an obvious gap with developed countries. To complete the balance between the supply and demand for aquatic products and the rational allocation of logistics resources and promote the rapid development trend of aquatic product cold chain logistics, it is particularly important to forecast and analyze the demand for aquatic product cold chain logistics. This article selects six main factors that affect the demand for aquatic products in cold chain logistics, uses the traditional grey model and the grey-BP neural network model to simulate and predict the demand for aquatic products in cold chain logistics in China from 2012 to 2021, and compares and analyzes the simulation results. Generally speaking, the demand for aquatic products from Chinese residents is on the rise. In the simulation prediction process, the prediction error of the grey-BP neural network is reduced compared to the traditional grey model, and the processing ability of the nonlinear system is ideal. The results show that the grey-BP neural network model is an effective method to predict the demand for cold chain logistics of aquatic products. Finally, suggestions are made on the future development of aquatic cold chain logistics in the post-epidemic era from the economic, social, and environmental aspects, which provide valuable decision-making reference for the development of marine aquaculture enterprises and cold chain logistics industry.

As one of the most polluted provinces in China, air pollution events occur frequently in Shandong. Based on the hourly (or daily) concentrations of six air pollutants (PM2.5, PM10, O3, NO2, SO2 and CO), the situations of air quality improvement in three kinds of cities (key cities, coastal cities and general cities) are assessed comprehensively during 2014–2020. Contrary to the daily maximum 8-h average ozone (MDA8 O3), the annual average concentrations of other pollutants show the downward trends during 2014–2020. Therein, the improvement rates of annual average concentrations of air pollutants in key cities are highest. By 2020, the day proportions of O3 as the primary pollutant are up to 38

OBJECTIVES:The aim of this study was to investigate the association of glucokinase (GCK) gene, glucokinase regulatory protein (GCKR) gene polymorphisms with the susceptibility to GDM in Chinese population. RESEARCH DESIGN AND METHODS:This case-control study included 835 GDM patients and 870 non-diabetic pregnant women who had their prenatal examinations at 24-28 gestational weeks at the Maternal and Child Health Hospital of Hubei Province from January 15, 2018 to March 31, 2019. The nurses were trained to collect clinical information and blood samples. The candidate single nucleotide polymorphism (SNPs, GCK rs1799884, rs4607517, rs10278336, rs2268574, rs730497 and GCKR rs780094, rs1260326) were genotyped on Sequenom Massarray platform. Statistical analysis including independent sample t test, chi-square test, logistic regression and one-way ANOVA were performed to evaluate the differences in allele and genotype distributions and their correlations with the odds of GDM. RESULTS:There were statistically significant differences in age, pre-gestational BMI, education level and family history of diabetes between case and control group (P < 0.05). After adjusting for these confounders, GCK rs1799884 was still significantly associated with GDM (P < 0.05), but there were no significant associations between rs4607517, rs10278336 and rs2268574, rs780094 and rs1260326 polymorphisms and GDM odds (P > 0.05). In addition, the pregnant women with rs4607517 TT genotype had the significantly higher fasting blood glucose level than CC genotype (P < 0.05). CONCLUSION:GCK rs1799884 mutation is associated with higher GDM odds in Chinese population. Further larger studies are needed to explore the association between GCK and GCKR polymorphisms and GDM susceptibility.

Evidence on the short-term effects of ambient air pollution on chronic obstructive pulmonary disease (COPD) mortality is still not conclusive. The aim of this study was to investigate the relationships between them in Wuhan China. Daily death numbers, concentrations of air pollutants (PM2.5, PM10, SO2, NO2, and O3), and meteorological characteristics in Wuhan from January 1, 2014, to December 31, 2019, were collected. Time-series analysis using generalized additive model was applied. The results showed that a total of 16,150 deaths (7.37 deaths per day) from COPD were observed. The daily average concentrations of PM2.5, PM10, SO2, NO2, and O3 were 59.03, 90.48, 12.91, 48.84, and 91.77 μg/m3, respectively. In single pollutant model, for every increase of 10 μg/m3 in PM10, SO2, and NO2 levels, COPD mortality increased by 0.583% (95% CI: 0.055–1.113%), 4.299% (95% CI: 0.978–7.729%), and 1.816% (95% CI: 0.515–3.313%) at lag03, respectively. No significant associations were found for PM2.5 and O3. Subgroup analysis demonstrated that females were more susceptible to PM2.5, PM10, SO2, and NO2. The concentrations of PM10, SO2, and NO2 were significantly associated with COPD mortality for older adults. The effects of PM2.5 and O3 on COPD mortality were higher in warm period. In two-pollutant models, the significantly positive associations between SO2 and NO2 and COPD mortality remained after adjusting for PM2.5 or O3. In conclusions, short-term exposure to PM10, SO2, and NO2 are significantly associated with a higher risk of COPD mortality. Female or elderly are more susceptible to air pollution. It is urgent to implement the environmental protection policy.

Objective:To study the thickness of cervical squamous epithelia and its correlation with cervical precancerous lesions.Methods:We selected 495 HE slides of 209 cervical biopsies from January 2020 to June 2020 in the Department of Pathology, the First and Seventh Medical Center of the PLA General Hospital, including 173 slides with low grade squamous intraepithelial lesion (LSIL) and 214 slides with high grade squamous intraepithelial lesion (HSIL). Artificial intelligence labeling software was used to assist in measuring the epithelial thickness of normal cervical squamous epithelium, LSIL and HSIL of each slide. The thickest, thinnest, and middle widths of epithelial thickness were measured, respectively. Average epithelial thickness was defined as the sum of the above three widths divided by 3. The correlation statistical analysis was performed by combining the data of age and pathological diagnosis.Results:The average thickness of normal cervical squamous mucosa was (245.83±91.40) μm, which was (222.42±81.22) μm and was (195.95±66.59) μm in LSIL and HISL epithelial respectively ( F=27.09, P<0.01). The average cell layers of normal cervical squamous epithelium was (15.5±4.2) layers, which of LSIL was (14.8±4.8) layers, and that of HSIL was (15.8±4.8) layers. The differences among normal, LSIL and HSIL were not statistically significant ( P>0.05). Further statistical analysis was stratified by age (≤30 years, 31-40 years, 41-50 years, 51-60 years, and >60 years), the results of Pearson correlation analysis showed that the thickness of normal cervical squamous epithelial gradually thinned with age (correlation coefficient r=-0.141 9, P<0.05), while LSIL and HSIL epithelial thickness had significant correlation with age ( P>0.05). In the subgroup of ≤50 years old, the epithelial thickness of normal squamous epithelium was the thickest, followed by LSIL, and HSIL epithelial thickness was the thinnest. The differences were statistically significant ( P<0.05). While in the subgroup of >50 years, the differences were not statistically significant ( P>0.05). Conclusions:The cervical squamous epithelium gradually becomes thinner with the degree of precancerous lesions increasing among patients of ≤50 years old. However, after age of 50 years, with the onset of menopause, the normal mucosal epithelium is becoming atrophy, so that mucosal thickness is no longer correlated with the extent of the lesion. In addition, it is suggested that the cervical vinegar white test performance during colposcopy is related to the protein changes in the mucosal epithelial cells, but not directly related to the thickness of the epithelial layer.

In order to explore the application effect of BioSilAc solid foliar fertilizer product produced by Indonesia Institute of biotechnology and Bio-industry on vegetables in red soil region, a field plot experiment was conducted to study the effects of different concentrations of BioSilAc foliar fertilizer (i.e., 200, 300, 400, 500, 600 g/hm 2times) on the agronomic traits, yield, nutrient uptake and nutritional quality of vegetables (pakchoi, Brassica chined L.) in red soil area. Results showed that spraying different concentrations of BioSilAc foliar fertilizer (L1~L5) could increase the plant height by 1.6%~11.3%, plant weight by 4.2%~33.3%, leaf number by 8.0%~23.2%, yield by 1.7%~15.3% compared with CK (spraying the same amount of water), increase the uptake of phosphorus by 0.9%~16.7%, potassium by 7.3%~31.1%, reduce the nitrate content by 3.5%~61.7%, and increase the reduced Vc content by 0.1%~28.5%,and the content of total soluble sugar by 1.4%~56.2%. Among them, L3~L5 treatment (spraying BioSilAc foliar fertilizer 400~600 g/hm 2times) had better effect on improving the yield and quality of pakchoi(Brassica chined L.) in red soil area.

Objective:To compare the clinical and histopathological characteristics of cervical adenoid basal cell carcinoma and adenoid cystic carcinoma for improving the diagnosis accuracy and differential diagnosis of these tumors.Methods:A retrospective study was conducted on 9 cases of cervical adenoid basal cell carcinoma and 3 cases of adenoid cystic carcinoma which were diagnosed and consulted at the First Medical Center of PLA General Hospital from March 2009 to April 2019. Detailed clinical data were reviewed. All pathological sections and immunohistochemical results were reviewed and the clinicopathological characteristics were analyzed. Follow-up information by telephone was collected and relevant literature was consulted.Results:Both tumors were more commonly found in postmenopausal women (the age of onset ranged 43-74 years). Adenoid basal cell carcinoma was often clinical asymptomatic. Most of them presented as abnormal smears of the cervix during physical examination, and there was no definite mass in colposcopy.Adenoid cystic carcinoma was mostly presented with abnormal vaginal bleeding. A mass was seen in colposcopy.Histologically, the two tumors were characterized by nest-like growth of the tumors, consisting of basal-like tumor cells, and often surrounded by palisade structures. The two lesions might coexist, or be mixed with squamous cell carcinoma or high-grade squamous intraepithelial lesions. The difference was that adenoid basal cell carcinoma was mostly located at the junction of cervical squamous epithelium and columnar epithelium and beneath the overlying epithelium, the tumor cells were arranged in nests, with squamous differentiation in the center of the nests, or in double-layer adenoid arrangement. The cell morphology was bland with occasional mitoses, and the stromal reaction was not obvious. And adenoid cystic carcinoma cells in the nest arranged like a sieve, the homogenous red-stained and blue-stained secretions were observed in the sieve holes, with obvious cell atypia, frequent mitoses, and obvious stromal reaction.In one case of adenoid cystic carcinoma, sarcomatoid area presented around the nests.Both of them were positive in clinical HPV test. Among the 9 cases of adenoid basal cell carcinoma, 3 were tested for HPV and 5 were tested for p16, and all showed positive expression. Among the 3 cases of adenoid cystic carcinoma, 2 were tested for HPV and 3 were tested for p16, both of which showed positive expression. Telephone follow-up was conducted by June 2019(follow-up time ranged 2-37 months). No recurrence or metastasis occurred in 7 of the 9 cases of adenoid basal cell carcinoma, while 1 case had a ground-glass nodule in lung and another had recurrence of vaginal stump 32 months after the surgery.One case of adenoid cystic carcinoma developed lung metastasis 8 months after surgery and died 2 years after surgery; another case was followed up for 6 months, which showed no recurrence or metastasis; the third case was lost to follow-up.Conclusions:Both adenoid cystic carcinoma and adenoid basal cell carcinoma of the cervix are the tumors originating from cervical reserve cells and are associated with high-risk HPV infection. Due to the differences in clinical treatment and prognosis, careful histological evaluation and immunohistochemical analysis should be carried out to make accurate pathological diagnosis.

Objective: To investigate the clinical, pathological and immunohistochemical features of seromucinous neoplasms, including seromucinous cystadenoma, borderline tumour and seromucinous carcinomas of the ovary. Methods: A retrospective review of the seromucinous neoplasms collected between June 2006 and December 2018 was conducted at the First Medical Center of PLA General Hospital. EnVision immunohistochemical staining was used to detect the expression of CK7, PAX8, ER, PR, WT1, p16, p53 and Baf250a which was encoded by the ARID1A gene. Results: A total of 75 ovarian seromucinous neoplasms were included. There were 30 cases of benign seromucinous cystadenoma, whose patients aged 12 to 83 years (mean, 36 years). The tumor histologically composed of endocervical-type mucinous epithelium and serous-type cells, each of which accounted for more than 10%. Among the 34 cases of seromucinous borderline tumour including 7 cases with concurrent endometriosis, the patients aged 21 to 72 years (mean, 39 years). Characteristic histologic features were broad papilla structure and an admixture of cell types, predominant endocervical-like mucinous cells (non-intestinal, no goblet cells), eosinophilic cells and others such as clear cells, hobnail cells, ciliated cells, and endometrioid cells. The larger papillae tended to have oedematous stroma containing neutrophils. In the 11 cases of seromucinous carcinomas including 2 cases with concurrent endometriosis, patients aged 26 to 61 years (mean, 40 years). Seromucinous carcinomas exhibited a predominant papillary architecture with smaller components of confluent glandular, microglandular and solid structure, expansive stromal invasion pattern, and sometimes locally destructive infiltration. An admixture of epithelial cell types was in seromucinous carcinomas, as well as borderline tumour. Immunohistochemically, the tumours were positive for CK7, PAX8, p16, estrogen receptor and progesterone receptor (positive in 10% to 80% of the cases). They were negative for WT1, while p53 staining showed a "wild-type" pattern. The Ki-67 positive rate was 20% to 60%. Loss of ARID1A-encoded protein Baf250a staining was observed in 6 (30%) of the 20 seromucinous borderline tumors, and 2 of the 11 seromucinous carcinomas. According to FIGO 2014 staging system, there were 4 cases of ⅠA, 3 cases of ⅡA and 4 cases of ⅢC. Follow-up information was available in 9 patients of seromucinous carcinomas, and 2 lost to follow-up. Eight were alive (follow-up for 6 to 108 months), including 2 patients with relapse, but 1 patient who initially presented with a stage ⅢC tumor died of disease 60 months after the cancer diagnosis. Thirty-four patients of borderline tumour were all alive at the end of follow-up, including 1 with relapse. Conclusions: Seromucinous neoplasms have characteristic histopathological and immunopathological features. Both borderline tumors and carcinomas have complex structures and cellular components. ARID1A as a tumor-suppressor gene plays a role in the oncogenesis of ovarian seromucinous neoplasms. The loss of staining with ARID1A-encoded Baf250a and wild-type p53 in seromucinous neoplasms together support that seromucinous neoplasms could be type Ⅰ tumor of dualistic model of epithelial ovarian cancer, with favourable prognosis.

(Eur J Anaesthesiol. 2019;36:745–754) Postpartum depression affects ∼20% of mothers in the first 3 months following childbirth, and can have significant long-term adverse effects. While many factors contribute to postpartum depression, intense labor pain is thought to be a risk factor. The use of epidural labor analgesia has been associated with a decreased risk of postpartum depression, but its impact on long-term depression is unclear. This study aimed to investigate whether neuraxial labor analgesia was associated with a reduced risk of maternal depression at 2 years postpartum.

Objective: To analyze data gathered from the laboratory records related to imported Dengue cases in Henan province in 2018. Methods: Suspected Dengue cases were found out through the Dengue fever surveillance network from the National infectious Disease reporting management information system. Serum samples of suspected Dengue cases were collected while case study and tested for Dengue NS1 antigen, IgM, IgG antibodies and Dengue RNA in Henan province in 2018. According to the standardized Dengue diagnosis criteria, confirmed cases were identified under the results of testing. Dengue RNA was checked by Real-time PCR genotyping and amplification of E gene in the samples being tested, before the PCR products were sequenced and analyses of homological and phylogenetic were performed. Results: In 2018, a total of 29 cases of Dengue fever was reported in Henan province, with all of which were imported cases, mainly from Southeast Asian countries and Africa. Majority of the cases were young and middle-aged farmers under 45 years old, and the number of males was significantly higher than that of females. The imported cases were dispersed in time and space. Among the 29 Dengue reported cases, 22 cases were with NS1 antigen and/or IgM positive through testing, while 6 cases were positive by detection of the Dengue virus RNA. These 6 samples with Dengue RNA were genotyped successfully, including 3 cases of Dengue virus type 1 and 3 cases of type 2. One of the Maldives import Dengue virus type 2 samples was sequenced. Result showed that the sequence belonged to the Asian Ⅰ genotype, which was most consistently similar to the Cambodia's Dengue virus type 2 JF730046, identified in 2008. Conclusions: The incidence of imported Dengue fever cases increased significantly in Henan province in 2018, compared to that in 2017, but fortunately did not cause any local epidemics.