Epidemiology of carbapenem-resistant Klebsiella pneumoniae bloodstream infections after renal transplantation from donation after cardiac death in a Chinese hospital: a case series analysis

Background

Although the high mortality rates have been extensively reported worldwide, few studies have investigated the epidemiology of CRKP-BSIs in the early stage after kidney transplantation (KTx) from donation after cardiac death (DCD). We sought to describe the epidemiological and clinical characteristics of cases of carbapenem resistant Klebsiella pneumoniae bloodstream infections (CRKP-BSIs) in kidney transplantation recipients (KTRs) from DCD in our hospital.

Methods

A retrospective analysis of clinical data of CRKP-BSIs in KTRs admitted to a Chinese hospital in Beijing, China, between January 1, 2012 and December 31, 2016 was performed. The annual percentage of patients with CRKP, the annual number of total KTRs and KTRs from DCD were determined. The genetic relatedness of the strains was determined by polymerase chain reaction and pulse field gel electrophoresis (PFGE).

Results

During the study period, there were total 947 KTRs in our hospital, including 275 KTRs from DCD. Five incidences of CRKP-BSIs in KTRs were identified, and two of them (Case 1,3) from the same foreign hospital. The incidence of CRKP-BSIs in the early stage (within 3 months) following kidney transplantation (KTx) from DCD was about 1.1% (3/275). In Case 1–3 and 5, the rupture of renal transplant artery was presented on the 40th, 16th, 43th and 74th day after KTx, and in Case 4, the thrombus of renal transplant artery was presented on the 13th day after KTx. Three cases (Case 1,2,5) occurring pneumothorax on the 45th, 51th and 32th day after KTx. Four cases (Case 1–4) received the excision of the transplanted kidney for the treatment. Polymerase chain reaction showed the bands for case 2 were distinctive from other cases. Pulse field gel electrophoresis showed mainly three clusters of the bands for all the isolates.

Conclusions

During the study period, we observed an increase in the occurrence of CRKP-BSIs among KTRs from DCD in our hospital. We demonstrated that rupture/thrombus of the renal transplant artery was associated with CRKP-BSI in the early stage after KTx from DCD. Albeit the low incidence of CRKP-BSI (1.1%) after KTx from DCD, the high mortality (4/5) had been observed from the prognosis of the patients. Thorough surveillance of DCD donors, early identification of CRKP-BSI, necessary preventative measurements and use of appropriate treatments should be the strategy for CRKP-BSI in the early stage after KTx from DCD.

Electronic supplementary material

The online version of this article (10.1186/s13756-018-0355-8) contains supplementary material, which is available to authorized users.

Ultrastable Quantum Dot Composite Films under Severe Environments

Semiconductor quantum dots (QDs) have attracted extensive attention because of their remarkable optical and electrical characteristics. However, the practical application of QDs and further the QD composite films have greatly been hindered mainly owing to their essential drawbacks of extreme unstability under oxygen and water environments. Herein, one simple method has been employed to enhance enormously the stability of Cd _xZn_{1- x}Se _yS_{1- y} QD composite films by a combination of Cd _xZn_{1- x}Se _yS_{1- y} QDs and poly(vinylidene) fluoride (PVDF), which is characteristic of closely arranged molecular chains and strong hydrogen bonds. There are many particular advantages in using QD/PVDF composite films such as easy processing, low cost, large-area fabrication, and especially extreme stability even in the boiling water for more than 240 min. By employing K₂SiF₆:Mn⁴⁺ as a red phosphor, a prototype white light-emitting diode (WLED) with color coordinates of (0.3307, 0.3387), T_c of 5568 K, and color gamut 112.1NTSC(1931)% at 20 mA has been fabricated, and there is little variation under different excitation currents, indicating that the QD/PVDF composite films fabricated by this simple blade-coating process make them ideal candidates for liquid-crystal display backlight utilization via assembling a WLED on a large scale owing to its ultrahigh stability under severe environments.

Association between serum resistin concentration and hypertension: A systematic review and meta-analysis

Objectives

Recent studies have suggested the involvement of adipokines in the pathogenesis of cardiovascular diseases, including hypertension. In this study, we evaluated the significance of serum resistin levels in hypertensive patients using a meta-analysis approach.

Materials and Methods

Relevant articles were retrieved by searching the following databases: PubMed, Embase, Ovid Medline, ISI Web of Knowledge. The retrieved studies were subjected to a thorough screening procedure to identify case-control studies that contained the required data. Data were extracted from each study and analyzed by Stata software and Review Manager software. In total, 14 case-control studies, containing 718 hypertensive patients and 645 normotensive controls, were included in this study. The major result of the meta-analysis revealed a statistically significant association between serum resistin concentration and hypertension (SMD = 0.85, 95% CI: [0.15, 1.54]), and the association was more obvious in Asian and Hispanic populations, diabetic population and studies with larger size cohorts. Publication bias was a low probability event for overall comparisons.

Conclusions

Based on our results, we conclude that serum resistin level in hypertensive patients is higher than normotensive controls, indicating resistin might be a risk factor for hypertension.

[Role of aquaporin-4 in the change of interstitial fluid drainage in Alzheimer's disease]

OBJECTIVE

To observe the characteristics of the interstitial fluid (ISF) drainage in the Alzheimer's disease (AD) rats through magnetic resonance imaging (MRI) tracer gadolinium-diethylene triamine pentacetic acid (Gd-DTPA)spread in the brain extracellular space (ECS) and to discuss the role of aquaporin-4 (Aqp4) in the AD.

METHODS

Wild type SD rats (300-350 g) and Aqp4 gene knock out (Aqp4^-/-) SD rats (300-350g) were divided into Sham group, AD group, Aqp4^-/--Sham group and Aqp4^-/--AD group. Sham group and Aqp4^-/--Sham group were injected with saline by intraperitoneal each day for 6 weeks, and the AD group and Aqp4^-/--AD group were injected with D-galactose by intraperitoneal each day for 6 weeks. MRI tracer Gd-DTPA (10 mmol/L, 2 μL) was injected into the hippocampus of the rats. MRI scan was performed at the end of 0.5 h, 1.5 h, 1 h, 2 h, and 3 h to observe the dynamic distribution of the Gd-DTPA in the hippocampus and the diffusion rate D^*, clearance rate k' and half-life t_1/2 measured.

RESULTS

The diffusion rate D* in Sham group was (2.66±0.36)×10^-6 mm2/s, the diffusion rate D^* in AD group was (2.72±0.62)×10-6 mm²/s, the diffusion rate D^* in Aqp4^-/--Sham group was (2.75±0.47)×10^-6 mm²/s, the diffusion rate D^* in Aqp4^-/--AD group was (2.802±0.55)×10^-6 mm²/s, and there was no statistically significant difference in the four groups (One-Way ANOVA, P>0.05).The clearance rate k' in Sham group was (4.57±0.14)×10^-4/s, the clearance rate k' in AD group was (3.68±0.22)×10^-4/s, the clearance rate k' in Aqp4^-/--Sham group was (3.17±0.16)×10^-4/s, the clearance rate k' in Aqp4^-/--AD group was (2.59±0.19)×10^-4/s, and there was significant difference in the four groups (One-Way ANOVA, P<0.05). The half-life t_1/2 in Sham group was (0.67±0.12) h, the half-life t_1/2 in AD group was (0.88±0.08) h, the half-life t_1/2 in Aqp4^-/--Sham group was (1.12±0.15) h, the half-life t_1/2 in Aqp4^-/--AD group was (1.58±0.11) h, and there was significance difference in the four groups(one-way ANOVA,P<0.05).

CONCLUSION

The ISF drainage is slow after AD and the loss of Aqp4 in the AD makes the ISF drainage obviously slow down, Aqp4 plays an important role in AD to remove the metabolism of waste out of the brain.

Rev-erbα dynamically modulates chromatin looping to control circadian gene transcription

Mammalian physiology exhibits 24-hour cyclicity due to circadian rhythms of gene expression controlled by transcription factors that constitute molecular clocks. Core clock transcription factors bind to the genome at enhancer sequences to regulate circadian gene expression, but not all binding sites are equally functional. We found that in mice, circadian gene expression in the liver is controlled by rhythmic chromatin interactions between enhancers and promoters. Rev-erbα, a core repressive transcription factor of the clock, opposes functional loop formation between Rev-erbα-regulated enhancers and circadian target gene promoters by recruitment of the NCoR-HDAC3 co-repressor complex, histone deacetylation, and eviction of the elongation factor BRD4 and the looping factor MED1. Thus, a repressive arm of the molecular clock operates by rhythmically modulating chromatin loops to control circadian gene transcription.

Npas4 Is a Critical Regulator of Learning-Induced Plasticity at Mossy Fiber-CA3 Synapses during Contextual Memory Formation

Synaptic connections between hippocampal mossy fibers (MFs) and CA3 pyramidal neurons are essential for contextual memory encoding, but the molecular mechanisms regulating MF-CA3 synapses during memory formation and the exact nature of this regulation are poorly understood. Here we report that the activity-dependent transcription factor Npas4 selectively regulates the structure and strength of MF-CA3 synapses by restricting the number of their functional synaptic contacts without affecting the other synaptic inputs onto CA3 pyramidal neurons. Using an activity-dependent reporter, we identified CA3 pyramidal cells that were activated by contextual learning and found that MF inputs on these cells were selectively strengthened. Deletion of Npas4 prevented both contextual memory formation and this learning-induced synaptic modification. We further show that Npas4 regulates MF-CA3 synapses by controlling the expression of the polo-like kinase Plk2. Thus, Npas4 is a critical regulator of experience-dependent, structural, and functional plasticity at MF-CA3 synapses during contextual memory formation.

Household light source for potent photo-dynamic antimicrobial effect and wound healing in an infective animal model

Photodynamic antimicrobial chemotherapy (PACT) is considered a promising alternative to conventional antibiotic approach. We have previously developed a novel PS containing five lysine amino acids, pentalysine-β-carbonylphthalocyanine Zinc (ZnPc(Lys)₅), which in the presence of light, is highly toxic against a range of bacterial strains, including hospital isolated, drug resistant Acinetobacter baumannii. Here, we study the effect of light fluence of the two light sources on the PACT potency of ZnPc(Lys)₅. We observed that an exposure of E.coli to a red LED light for only 2 seconds (light fluence of 0.15 J/cm²) in the presence of ZnPc(Lys)₅ significantly eradicated 80% of the E.coli. We further demonstrated that a light fluence of 4.5 J/cm² from a household light source induced a noticeable photodynamic effect in vitro and in vivo animal model. This study points to a new research direction of reducing light illumination time by increasing potency of PS.

Plasmonic nanoparticles embedded in single crystals synthesized by gold ion implantation for enhanced optical nonlinearity and efficient Q-switched lasing

We report on the synthesis of embedded gold (Au) nanoparticles (NPs) in Nd:YAG single crystals using ion implantation and subsequent thermal annealing. Both linear and nonlinear absorption of the Nd:YAG crystals have been enhanced significantly due to the embedded Au NPs, which is induced by the surface plasmon resonance (SPR) effect in the visible light wavelength band. Particularly, through a typical Z-scan system excited by a femtosecond laser at 515 nm within the SPR band, the nonlinear absorption coefficients of crystals with Au NPs have been observed to be nearly 5 orders of magnitude larger than that without Au NPs. This giant enhancement of nonlinear absorption properties is correlated with the saturable absorption (SA) effect, which is the basis of passive Q-switching or mode-locking for pulsed laser generation. In addition, the linear and nonlinear absorption enhancement could be tailored by varying the fluence of implanted Au⁺ ions, corresponding to the NP size and concentration modulation. Finally, the Nd:YAG wafer with embedded Au NPs has been applied as a saturable absorber in a Pr:LuLiF₄ crystal laser cavity, and efficient pulsed laser generation at 639 nm has been realized, which presents superior performance to the MoS₂ saturable absorber based system. This work opens an avenue to enhance and modulate the nonlinearities of dielectrics by embedding plasmonic Au NPs for efficient pulsed laser operation.

A maximum likelihood algorithm for reconstructing 3D structures of human chromosomes from chromosomal contact data

Background

The development of chromosomal conformation capture techniques, particularly, the Hi-C technique, has made the analysis and study of the spatial conformation of a genome an important topic in bioinformatics and computational biology. Aided by high-throughput next generation sequencing techniques, the Hi-C technique can generate genome-wide, large-scale intra- and inter-chromosomal interaction data capable of describing in details the spatial interactions within a genome. These data can be used to reconstruct 3D structures of chromosomes that can be used to study DNA replication, gene regulation, genome interaction, genome folding, and genome function.

Results

Here, we introduce a maximum likelihood algorithm called 3DMax to construct the 3D structure of a chromosome from Hi-C data. 3DMax employs a maximum likelihood approach to infer the 3D structures of a chromosome, while automatically re-estimating the conversion factor (α) for converting Interaction Frequency (IF) to distance. Our results show that the models generated by 3DMax from a simulated Hi-C dataset match the true models better than most of the existing methods. 3DMax is more robust to structural variability and noise. Compared on a real Hi-C dataset, 3DMax constructs chromosomal models that fit the data better than most methods, and it is faster than all other methods. The models reconstructed by 3DMax were consistent with fluorescent in situ hybridization (FISH) experiments and existing knowledge about the organization of human chromosomes, such as chromosome compartmentalization.

Conclusions

3DMax is an effective approach to reconstructing 3D chromosomal models. The results, and the models generated for the simulated and real Hi-C datasets are available here: http://sysbio.rnet.missouri.edu/bdm_download/3DMax/. The source code is available here: https://github.com/BDM-Lab/3DMax. A short video demonstrating how to use 3DMax can be found here: https://youtu.be/ehQUFWoHwfo.

Effect and safety of roflumilast for chronic obstructive pulmonary disease in Chinese patients

BACKGROUND

This trial aimed to evaluate the efficacy and safety of roflumilast for treating Chinese patients with chronic obstructive pulmonary disease (COPD).

METHODS

A total of 120 patients with COPD were recruited and were randomly divided into 2 groups (an intervention group and a placebo group) at a 1:1 ratio. Patients received either roflumilast or placebo 500 μg once daily for a total of 12 months. The primary outcome was lung function, measured by the change from baseline of forced expiratory volume in 1 second (FEV1), FVC = forced vital capacity (FVC), and FEF25-75%. The secondary outcome measurements included the quality of life, measured with the St. George's Respiratory Questionnaire (SGRQ). All outcomes were measured at the end of 12-month treatment and 3-month follow-up after the treatment. In addition, adverse events (AEs) were also recorded during the treatment period.

RESULTS

FEV1, FVC, FEF25-75%, and SGRQ were significantly better in the intervention group than those in the placebo group at the end of 12-month treatment and 3-month follow up after treatment. Moreover, AEs were much higher with roflumilast than placebo in this study.

CONCLUSIONS

The findings suggest that roflumilast has promising effect to improve lung function in Chinese population with COPD.

Combined Use of Mesenchymal Stromal Cell Sheet Transplantation and Local Injection of SDF-1 for Bone Repair in a Rat Nonunion Model

Bone nonunion treatments pose a challenge in orthopedics. This study investigated the joint effects of using mesenchymal stem cell (MSC) sheets with local injection of stromal cell-derived factor-1 (SDF-1) on bone formation. In vitro, we found that migration of MSCs was mediated by SDF-1 in a dose-dependent manner. Moreover, stimulation with SDF-1 had no direct effect on the proliferation or osteogenic differentiation of MSCs. Furthermore, the results indicated elevated expression levels of bone morphogenetic protein 2, alkaline phosphatase, osteocalcin, and vascular endothelial growth factor in MSC sheets compared with MSCs cultured in medium. New bone formation in fractures was evaluated by X-ray, micro-computed tomography (micro-CT), hematoxylin and eosin (H&E) staining, Safranin-O staining, and immunohistochemistry in vivo. In the rat bone fracture model, the MSC sheets transplanted into the injured site along with injection of SDF-1 showed significantly more new bone formation within the gap. Moreover, at 8 weeks, complete bone union was obtained in this group. In contrast, the control group showed nonunion of the bone. Our study suggests a new strategy involving the use of MSC sheets with a local injection of SDF-1 for hard tissue reconstruction, such as the healing of nonunions and bone defects.

Electric field tuned MoS2/metal interface for hydrogen evolution catalyst from first-principles investigations

Understanding the interfacial properties of catalyst/substrate is crucial for the design of high-performance catalyst for important chemical reactions. Recent years have witnessed a surge of research in utilizing MoS₂ as a promising electro-catalyst for hydrogen production, and field effect has been employed to enhance the activity (Wang et al 2017 Adv. Mater. 29, 1604464; Yan et al 2017 Nano Lett. 17, 4109-15). However, the underlying atomic mechanism remains unclear. In this paper, by using the prototype MoS₂/Au system as a probe, we investigate effects of external electric field on the interfacial electronic structures via density functional theory (DFT) based first-principles calculations. Our results reveal that although there is no covalent interaction between MoS₂ overlayer and Au substrate, an applied electric field efficiently adjusts the charge transfer between MoS₂ and Au, leading to tunable Schottky barrier type (n-type to p-type) and decrease of barrier height to facilitate charge injection. Furthermore, we predict that the adsorption energy of atomic hydrogen on MoS₂/Au to be readily controlled by electric field to a broad range within a modest magnitude of field, which may benefit the performance enhancement of hydrogen evolution reaction. Our DFT results provide valuable insight into the experimental observations and pave the way for future understanding and control of catalysts in practice, such as those with vacancies, defects, edge states or synthesized nanostructures.

Transcriptome-wide identification and competitive disruption of sacum-binding partners in human colorectal cancer

Human sacum is regulatory adaptor protein involved in cellular signaling network of colorectal cancer. Molecular evidences suggest that the protein is integrated into oncogenic signaling network by binding to SH3-containing proteins through its proline-rich motifs. In this study, we have performed a transcriptome-wide analysis and identification of sacum-binding partners in the genome profile of human colorectal cancer. The sacum-binding potency of SH3-containing proteins found in colorectal cancer was investigated by using bioinformatics modeling and intermolecular binding analysis. With the protocol we were able to predict those high-affinity domain binders of the proline-rich peptides of human sacum in a high-throughput manner, and to analyze sequence-specific interaction in the domain-peptide recognition at molecular level. Consequently, a number of putative domain binders with both high affinity and specificity were identified, from which the Src SH3 domain was selected as a case study and tested for its binding activity towards the sacum peptides. We also designed two peptide variants that may have potent capability to competitively disrupt sacum interaction with its partners.

Correlation between luminescence and structural evolution of colloidal silicon nanocrystals synthesized under different laser fluences

We present a detailed investigation of the structural evolution and photoluminescence (PL) properties of colloidal silicon (Si) nanocrystals (NCs) synthesized through femtosecond laser ablation at different laser fluences. It is shown that the mean size of colloidal Si NCs increases from ∼0.97-2.37 nm when increasing laser fluence from 1.0-2.5 mJ cm^-2. On the basis of structural characterization, temperature-dependent PL, time-resolved PL, and PL excitation spectra, we identify that the size-dependent spectral shift of violet emission is attributed to the quantum confinement effect. The localized excitons' radiative recombination via the oxygen-related surface states on the surface of the colloidal Si NCs is employed to explain the origin of the blue emission.

Regulation of pancreatic stellate cell activation by Notch3

Background

Activated pancreatic stellate cells (PaSCs) are the key cellular source of cancer-associated fibroblasts in the pancreatic stroma of patients with pancreatic ductal adenocarcinoma (PDAC), however, the activation mechanism of PaSCs is not yet known. The Notch signaling pathway, components of which are expressed in stromal cells, is involved in the fibrosis of several organs, including the lung and liver. In the current study, we investigated whether Notch signal transduction is involved in PaSC activation in PDAC.

Methods

The expression of Notch signaling pathway components in human PDAC was examined via immunohistochemical staining and assessed in mouse PaSCs using RT-qPCR and western blotting. Notch3 expression in both PDAC stromal cells and activated mouse PaSCs was evaluated using immunofluorescence, RT-qPCR and western blotting. The impact of siRNA-mediated Notch3 knockdown on PaSC activation was detected with RT-qPCR and western blotting, and the impact on PaSC proliferation and migration was detected using CCK-8 assays and scratch experiments. The effect of conditioned medium from PaSCs activated with Notch3 siRNA on pancreatic cancer (LTPA) cells was also detected with CCK-8 assays and scratch experiments. The data were analyzed for statistical significance using Student’s t-test.

Results

Notch3 was overexpressed in both human PDAC stromal cells and activated mouse PaSCs, and Notch3 knockdown with Notch3 siRNA decreased the proliferation and migration of mouse PaSCs. The levels of markers related to PaSC activation, such as α-smooth muscle actin (α-SMA), collagen I and fibronectin, decreased in response to Notch3 knockdown, indicating that Notch3 plays an important role in PaSC activation. Furthermore, we confirmed that inhibition of PaSC activation via Notch3 siRNA reduced the proliferation and migration of PaSC-induced mouse pancreatic cancer (LTPA) cells.

Conclusions

Notch3 inhibition in PaSCs can inhibit the activation, proliferation and migration of PaSCs and reduce the PaSC-induced pro-tumorigenic effect. Therefore, Notch3 silencing in PaSCs is a potential novel therapeutic option for patients with PDAC.

Electronic supplementary material

The online version of this article (10.1186/s12885-017-3957-2) contains supplementary material, which is available to authorized users.

[Correlation between the parameters of acoustic cardiography and BNP, LVEF and cardiac function grading in patients with chronic heart failure]

Objective: To explore the correlation between the parameters of the new generation of Acoustic Cardiography and brain natriuretic peptide (BNP), left ventricular ejection fraction (LVEF) and cardiac function grading in the diagnosis of heart failure. Methods: One hundred and sixty-eight inpatients, who were hospitalized in Department of Cardiology, Haikou People's Hospital from May 2016 to July 2017, were enrolled as heart failure group, including NYHA class Ⅰ(n=29), NYHA class Ⅱ(n=40), NYHA class Ⅲ(n=64), NYHA class Ⅳ (n=35). And eighty-seven patients with normal cardiac function were selected as healthy control group. The data of the two groups were analyzed after the Acoustic Cardiography test, BNP determination and LVEF examination. Results: The differences in QRS duration, electromechanical activation time (EMAT), EMAT%, systolic dysfunction index (SDI), third heart sound (S3) and other indicators among the groups with different levels of cardiac function were statistically significant (P<0.05). The difference in left ventricular systolic time (LVST) between the cardiac function grade Ⅰ and healthy group was not significant (P>0.05), while the differences among the rest groups were significant. There was a positive correlation between QRS duration, EMAT%, SDI, S3 and BNP (t=9.46, 11.38, 12.14, 9.67, respectively, P<0.05); LVST and BNP were negatively correlated (t=-14.27, P<0.05). There was a negative correlation between QRS duration, EMAT%, SDI, S3 and LVEF (t=11.24, -8.764, -2.393, -0.579, respectively, P<0.05). There was a positive correlation between LVST and LVEF (t=23.48, P<0.05). There was a positive correlation between QRS duration, EMAT%, SDI, S3 and cardiac function grading (β=0.003, 0.234, 0.419, 0.352, respectively, P<0.05). There was a negative correlation between LVST and cardiac function grade (β=-0.021, P<0.05). Conclusion: The parameters of the Acoustic Cardiography test (EMAT%, EMAT, SDI, S3 ) are closely related to BNP, LVEF and cardiac function grading, and can be used as assistant indexes for the diagnosis and evaluation of heart failure.

Synthesis, characterization, and thermal properties of cobalt(ii) compounds with guanidinate ligands

The synthesis, characterization, and thermal properties of cobalt(ii) compounds with guanidinate ligands and their potential as CVD precursors are reported.

[Clinical features and prognostic factors of squamous cell carcinoma of the base of tongue：an analysis of 124 cases]

Objective:To summarize the clinicopathological characteristics and prognostic factors of squamous cell carcinoma (SCC) of the base of tongue (BOT). Method:Review the clinical data of 124 cases of patients with BOT tumors. HPV-DNA was detected using SPF10-DNA enzyme immunoassay and LiPA genotyping method. Survival rates and prognostic factors was calculated with SPSS 19.0 software using the Kaplan-Meier method and multivariate Cox model survival analysis. Result:5-year disease-specific survival (DSS), 5-year overall survival and median survival time for patients with SCC BOT were 54.5%, 48.5% and 45.2 months, respectively. HPV infection rate was 18.3%(11/60), the HPV-16 subtype in 10 cases, accounting for 90.9%(10/11). Univariate analysis results showed that smoking history (P=0.028), drinking history (P=0.001), tumor stage (P=0.009) and p16 protein expression (P=0.015) significantly affected the prognosis. The prognosis of patients with HPV positive BOT cancers was better than the HPV negative patients (5-year DSS was 80.8% compared to 54.5%), but not statistical difference (P=0.138). Multivariate analysis revealed that independent prognostic factors of BOT tumors were drinking history (P=0.006) and tumor stage (P=0.035). Conclusion:The prognosis of BOT tumor was relatively poor. Smoking history, drinking history, tumor staging and the expression of p16 protein significantly affected the prognosis. Drinking history and tumor stage were independent prognostic factors for BOT cancers.

[Effect of high glucose-based peritoneal dialysis fluids on NLRP3-IL-1β in human peritoneal mesothelial cells]

OBJECTIVE

To explore the effect of high glucose-based peritoneal dialysis fluids on NLRP3-IL-1β in human peritoneal mesothelial cells.

METHODS

HMrSV5 cells (SV40 immortalized human peritoneal mesothelial cell line) were grown in type I collagen-coated dishes in DMEM/F12 containing 10% fetal calf serum (FCS). All experiments on HMrSV5 cells were performed between passages 5 and 10. The cells were divided into 7 groups: control, 1.5% dextrose, 2.5% dextrose, 4.25% dextrose, rotenone, thenoyltrifluoroacetone (TTFA), and antimycin A. Immunoblotting was used to evaluate the expression of IL-1β. Small interfering RNA (siRNA) targeting NLRP3 was used to downregulate the expression of NLRP3 and Western blot was used to evaluate the expression of IL-1β in human peritoneal mesothelial cells exposed to 4.25% dextrose. In the meanwhile, resveratrol (RSV) was used to induce autophagy, 3-methyladenine (3-MA) and siRNA against Beclin 1 or ATG5 were used to block auto-phagy, flow cytometric was used to analyze the respiring (mitotracker deep red), total (mitotracker green) and reactive oxygen species (ROS)-generating mitochondria (mitoSOX); Western blot was used to evaluate the expression of IL-1β.

RESULTS

The IL-1β relative expressions were 0, 0.175±0.082, 0.418±0.163, 2.357±0.288, 2.642±0.358, 3.271±0.462, and 0.123±0.091, indicating that the cells exposed to high glucose-based peritoneal dialysis fluids and cells treated with mitochondria respiratory chain key enzyme complex I, and complex III inhibitors increased the IL-1β expression. And we found that NLRP3 knock-down significantly blocked the upregulation of IL-1β. In addition, the fluorescence intensity of total mitochondria and ROS-generating mitochondria in the following groups: control, negative control, RSV, 3-MA, ATG5 siRNA, Beclin1 siRNA were 1.76±0.42, 1.83±0.55, 1.85±0.62, 7.36±0.92, 5.35±0.77, 5.06±0.62 and 821.68±95.12, 868.15±102.82, 723.39±92.56, 1 660.08±113.65, 1 433.01±107.24, 1 562.36±112.88 respectively. The increased concentrations of mitochondrial ROS and IL-1β upregulation were confirmed in the inhibition but not the induction of auto-phagy. We also found that downregulation of ATG5 and Beclin1 sensitized cells for the release of IL-1β induced by MSU (monosodium urate) or nigericin which was the NLRP3 inflammasome activator. RSV treatment attentuated this effect.

CONCLUSION

Long-term application of high glucose-based peritoneal dialysis fluids can trigger the consistent activation of NLRP3-IL-1β in peritoneal mesothelial cells. Timely initiation of autophagy may block the NLRP3-IL-1β activation and provide a basis for the further development of a potential therapeutic strategy for delay of chronic inflammation and peritoneal fibrosis associated with peritoneal dialysis.

[Free medial thigh perforator flaps with various pedicle origins for the reconstruction of defect after buccal mucosa squamous cell carcinoma resection]

Objective: To explore investigate the application of free medial thigh perforator flaps with different pedicle origins in the reconstruction of defect after radical resection of buccal mucosa squamous cell carcinoma. Methods: From January 2015 to December 2016, 32 cases with buccal mucosa squamous cell carcinoma underwent radical resection and buccal mucosa defect after surgery was reconstructed by free medial thigh perforator flap at the same stage. The patients included 32 males and 5 females, ranged in age from 36 to 71 years (45.2 years on average). According to UICC stage: T4N0M0 13 cases, T4N1M0 12 cases, T3N1M0 5 cases, T3N2M0 2 cases. The course ranged from 1 to 30 months (9.6 months on average). Results: The perforator flaps ranged from 8.0 cm×3.5 cm to 15.5 cm×6.0 cm in size, from 2.0 to 4.5 cm in thickness.The mean length of pedicles from gracilis muscle was (8.7±0.4) cm in 19 cases, the mean length of pedicles from adductor magnus muscle was (9.5±0.4) cm in 9 cases and the length of pedicles from femoral artery was (6.9±0.5) cm in 4 cases.All 44 perforator flaps survived uneventfully. The donor sites in the medial thigh were closed directly and healed well in all cases. Patients were followed up for 8 to 32 months with satisfied esthetic and functional results in reconstructed tongue, with no local recurrence. Only linear scars left in the donor sites, the functions of thighs were not affected. Conclusion: The free medial thigh perforator flap is an idea choice to reconstruct the defect after radical resection of buccal mucosa squamous cell carcinoma.

Procedure-Related Complication of Willis Covered Stent in the Treatment of Blood Blister-Like Aneurysm: Stent Detachment from Dilating Balloon

The use of Willis covered stent (WCS) for intracranial aneurysms has increased based on the promising results of previous studies about its safety and effectiveness. With the accumulation of cases, reports about peri-procedural complications are emerging. In our department, 25 patients were treated with WCS during December 2015 to March 2017. We here reported an unexpected technical complication occurred in the treatment with the WCS for a blood blister-like aneurysm (BBA). During the procedure, the distal end of the stents detached from the dilating balloon partially or as a whole. This was attributed to the tortuosity of the access route and the extracorporeal gas exhaust maneuver. Then we applied a half-dilating technique to retrieve the detached stent. The procedures were detailed in this report and the possible reasons and approaches to avoid it were explored.

Integrating SANS and fluid-invasion methods to characterize pore structure of typical American shale oil reservoirs

An integration of small-angle neutron scattering (SANS), low-pressure N2 physisorption (LPNP), and mercury injection capillary pressure (MICP) methods was employed to study the pore structure of four oil shale samples from leading Niobrara, Wolfcamp, Bakken, and Utica Formations in USA. Porosity values obtained from SANS are higher than those from two fluid-invasion methods, due to the ability of neutrons to probe pore spaces inaccessible to N2 and mercury. However, SANS and LPNP methods exhibit a similar pore-size distribution, and both methods (in measuring total pore volume) show different results of porosity and pore-size distribution obtained from the MICP method (quantifying pore throats). Multi-scale (five pore-diameter intervals) inaccessible porosity to N2 was determined using SANS and LPNP data. Overall, a large value of inaccessible porosity occurs at pore diameters <10 nm, which we attribute to low connectivity of organic matter-hosted and clay-associated pores in these shales. While each method probes a unique aspect of complex pore structure of shale, the discrepancy between pore structure results from different methods is explained with respect to their difference in measurable ranges of pore diameter, pore space, pore type, sample size and associated pore connectivity, as well as theoretical base and interpretation.

[Efficacy and safety of pegylated interferon α-2b injection (Y shape, 40 kD) in treatment of patients with genotype 1/6 chronic hepatitis C]

Objective: To investigate the efficacy and safety of the new investigational drug pegylated interferon α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 µg/week) combined with ribavirin in the treatment of patients with genotype 1/6 chronic hepatitis C (CHC), with standard-dose Peg-IFN-α-2a combined with ribavirin as a positive control. Methods: A multicenter, randomized, open-label, and positive-controlled phase III clinical trial was performed. Eligible patients with genotype 1/6 CHC were screened out and randomly divided into Peg-IFN-α-2b(Y shape, 40kD) group and Peg-IFN-α-2a group at a ratio of 2:1. The patients in both groups were given oral ribavirin for 48 weeks in addition and then followed up for 24 weeks after drug withdrawal. Abbott Real Time HCV Genotype II was used to determine HCV genotype, and Cobas TaqMan quantitative real-time PCR was used to measure HCV RNA level at 0, 4, 12, 24, 48, and 72 weeks. Adverse events were recorded in detail. The primary efficacy endpoint was sustained virological response (SVR), and a non-inferiority test was also performed. Results: A total of 561 patients with genotype 1/6 CHC were enrolled, among whom 529 received treatment; 90.9% of these patients had genotype 1 CHC. The data of the full analysis set showed that SVR rate was 69.80% (95% CI 65.00%-74.60%) in the trial group and 74.16% (95% CI 67.73%-80.59%) in the control group (P = 0.297 0). The data of the per protocol set (PPS) showed that SVR rate was 80.63% (95% CI 76.04%-85.23%) in the trial group and 81.33% (95% CI 75.10%-87.57%) in the control group (P = 0.849 8), and the 95% CI of rate difference conformed to the non-inferiority standard. The analysis of the PPS population showed that of all subjects, 47.9% achieved rapid virologic response, with a positive predictive value of 93.8%. The incidence rate of adverse events was 96.30% in the trial group and 94.94% in the control group, and the incidence rate of serious adverse events was 5.13% in the trail group and 5.06% in the control group. Conclusion: In the regimen of Peg-IFN-α combined with ribavirin for the treatment of genotype 1/6 CHC, the new investigational drug Peg-IFN-α-2b(Y shape, 40 kD) has comparable clinical effect and safety to the control drug Peg-IFN-α-2a.