[Perioperative serious complications in patients undergoing transcatheter aortic valve replacement: a single-center experience]

Objective: To observe the incidence of perioperative severe complications in aortic stenosis (AS) patients undergoing transcatheter aortic valve implantation (TAVR), and to explore the influence of the accumulated experience of the operators on the incidence of complications. Methods: This is a single-center retrospective study. Patients with AS who underwent TAVR from May 2016 to November 2020 in General Hospital of Northern Theater Command were included. The occurrence of severe complications during perioperative period was recorded. Severe complications included all-cause death, surgical transfer to thoracotomy, coronary artery occlusion, peripheral vascular approach complications, severe cerebrovascular events, moderate or above perivalvular leakage, valve displacement (implanted valve middle valve), pacemaker implantation, etc. In order to observe the influence of the accumulated experience of the operators on the occurrence of postoperative complications, the complications in each stage of the patients were counted and the bar chart was drawn with interval of every 30 patients. Results: A total of 119 patients were included, including 64 males and 55 females, the mean age was (73.9±6.9) years. The valve implantation was unsuccessful in 3 out of 119 patients (2.5%). There were 39 cases of severe complications during perioperative period, including 1 death (0.8%), 2 cases of thoracotomy (1.7%), 2 cases of coronary artery occlusion (1.7%), 8 cases of peripheral vascular approach complications (6.7%), and 1 case of new severe cerebrovascular event (0.8%), 3 cases of moderate or higher perivalvular leakage (2.5%), 8 cases of valve displacement leads to midvalvular implantation (6.7%), 14 cases of permanent pacemaker implantation due to new atrioventricular block (11.8%). The bar chart showed that the incidence of permanent pacemaker implantation and in-valve implantation did not significantly decrease with the accumulation of experience, while the incidence of other complications showed a decreasing trend after 30 cases. Conclusions: Most serious complications occurred in the early stage of TAVR in our center. The incidence of all cause death, coronary artery occlusion and peripheral vascular approach complications in the perioperative period post TAVR could be reduced in the TAVR center in the learning stage through the accumulation of procedure-related experience, but the incidence of pacemaker placement and the implanted valve within the valve dose not significantly decrease over time.

[Progress of researches on roles of dendritic cells in immune tolerance caused by Echinococcus infections]

Dendritic cells (DCs), a type of antigen-presenting cells (APC), are recognized as an important regulator of immune response and immune tolerance, and play a critical role in the host innate immunity and adaptive immunity. Previous studies have shown that the long-term parasization of Echinococcus in the host is strongly associated with the host immune tolerance induced by DCs. This review summarizes the research progress of the role of DCs in host immune tolerance caused Echinococcus infection, aiming to provide the theoretical basis and insights into the management and immunotherapy of Echinococcus infections.

Quantification of peak blood flow velocity at the cardiac valve and great thoracic vessels by four-dimensional flow and two-dimensional phase-contrast MRI compared with echocardiography: a systematic review and meta-analysis

AIM

To objectively examine the agreement and correlation between four-dimensional (4D) flow magnetic resonance imaging (MRI) and traditional two-dimensional (2D) phase-contrast (PC) MRI with the reference standard of Doppler echocardiography for measuring peak blood velocity at the cardiac valve and great arteries, and to assess if 4D flow MRI offers an advantage over the traditional 2D method.

MATERIALS AND METHODS

The literature was searched systematically for studies that evaluate the degree of correlation and agreement between 4D flow MRI or 2D PC MRI and Doppler retrieved from PubMed, EMBASE, and the Cochrane Library. A meta-analysis was conducted to determine the peak velocity pooled bias with 95% limits of agreement (LoA) and correlation coefficient (r) for 4D flow MRI and 2D PC MRI compared with Doppler.

RESULTS

Ten studies that compared 4D flow MRI with Doppler and 12 studies that compared 2D PC MRI with Doppler were included. 4D flow MRI showed an underestimation with bias and 95% LoA of -0.09 (-0.41, 0.24) m/s (p=0.079) while 2D PC MRI showed a poorer agreement with a bias and 95% LoA of -0.25 (-0.53, 0.03), p=0.596. 4D flow MRI and 2D PC MRI showed a strong correlation with R=0.80 (95% CI 0.75, 0.84; p<0.001) and R=0.83 (95% CI 0.79, 0.87; p<0.001), respectively.

CONCLUSION

In this meta-analysis, 4D flow MRI provides improved assessment of peak velocity when compared with traditional 2D PC MRI. 4D flow MRI can be considered an important complement or substitute to Doppler echocardiography for peak velocity assessment.

One-Step Synthesis of SnI2·(DMSO)x Adducts for High-Performance Tin Perovskite Solar Cells

Contemporary thin-film photovoltaic (PV) materials contain elements that are scarce (CIGS) or regulated (CdTe and lead-based perovskites), a fact that may limit the widespread impact of these emerging PV technologies. Tin halide perovskites utilize materials less stringently regulated than the lead (Pb) employed in mainstream perovskite solar cells; however, even today's best tin-halide perovskite thin films suffer from limited carrier diffusion length and poor film morphology. We devised a synthetic route to enable in situ reaction between metallic Sn and I₂ in dimethyl sulfoxide (DMSO), a reaction that generates a highly coordinated SnI₂·(DMSO)_x adduct that is well-dispersed in the precursor solution. The adduct directs out-of-plane crystal orientation and achieves a more homogeneous structure in polycrystalline perovskite thin films. This approach improves the electron diffusion length of tin-halide perovskite to 290 ± 20 nm compared to 210 ± 20 nm in reference films. We fabricate tin-halide perovskite solar cells with a power conversion efficiency of 14.6% as certified in an independent lab. This represents a ∼20% increase compared to the previous best-performing certified tin-halide perovskite solar cells. The cells outperform prior earth-abundant and heavy-metal-free inorganic-active-layer-based thin-film solar cells such as those based on amorphous silicon, Cu₂ZnSn(S/Se)₄ , and Sb₂(S/Se)₃.

[Method of double data entry and quality control by REDCap system]

In medical research, the quality of data is the key to success. Thus, data quality control becomes an important part of ensuring the research's high quality. REDCap system is an emerging data acquisition system in medical research, which is gradually applied in research at home and abroad. It is a hot issue to realize double data entry and data quality control in using the REDCap system, which researchers are concerned about when this system is supposed to apply. This article will systematically introduce how to use the REDCap system for double data entry and quality control from the aspects of research project creation, data collection tool design, double data entry, data checking and exporting.

Twenty-year changes in mortality rates and underlying causes of death in patients with rheumatoid arthritis-associated interstitial lung disease

Objectives: Despite recent advances in the treatment of rheumatoid arthritis (RA), few population-based studies have assessed the mortality rates and the underlying causes of death (UCDs) among patients with RA and RA-associated interstitial lung disease (RA-ILD). This study evaluated the trends in mortality rates, demographic characteristics, and UCDs among patients with RA-ILD.Method: Using data from death certificates (1999-2018) from the US Centers for Disease Control and Prevention Multiple Cause of Death files, we explored the trends in mortality rates and UCD for patients with RA and RA-ILD. Moreover, we examined the crude and age-standardized mortality rates (ASMRs) for such patients.Results: Among patients with RA or RA-ILD, ASMR variation decreased over 20 years. The ASMR ratio of RA-ILD to RA decreased by 5.84%. The ASMR for RA and RA-ILD stratified by gender or age group also decreased. The change in the ASMR ratio of RA-ILD to RA trended downwards in women and upwards in men. Arthropathies and ILD were the most frequent UCDs for RA-ILD, while arthropathies and ischaemic heart disease were the most frequent UCDs for RA.Conclusions: Although RA and RA-ILD presented a downward trend in mortality, RA combined with ILD may reduce life expectancy. Specifically, the mortality rate for patients with RA-ILD remained relatively stable during the study period when ILD was the UCD, suggesting the need for active prevention, early diagnosis, and effective management of RA-ILD.

LncRNA MT1JP inhibits the malignant progression of hepatocellular carcinoma through regulating AKT

OBJECTIVE

The purpose of this study was to investigate the expression profile of long non-coding RNA (lncRNA) MT1JP in hepatocellular carcinoma (HCC), and to explore the relationship between its expression level and the clinical indicators, as well as the prognosis of HCC patients.

PATIENTS AND METHODS

In this study, the expression level of MT1JP in 45 pairs of tumor tissue specimens and paracancerous ones collected from HCC patients were examined through quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) method, and the interplay between MT1JP expression and clinical indicators, as well as the prognosis of HCC patients, was also analyzed. Meanwhile, the expression of MT1JP in HCC cell lines was further verified by qRT-PCR. In addition, MT1JP overexpression model was constructed using lentivirus in HCC cell lines (Hub7 and HepG2), and then, Cell Counting Kit-8 (CCK-8), cell colony formation assay, and flow cytometry were performed to examine the impact of MT1JP on the HCC cell functions. Additionally, whether MT1JP exerts its biological characteristics through protein kinase B (AKT) was finally explored.

RESULTS

In this experiment, qRT-PCR results showed that the expression level of lncRNA MT1JP in tumor tissues of HCC patients was remarkably lower than that in adjacent tissues, and the difference was statistically significant. Meanwhile, compared with patients with high expression of MT1JP, patients with low expression of MT1JP had a higher pathological staging and a lower overall survival rate. In addition, overexpression of MT1JP remarkably attenuated the proliferation ability of HCC cells but enhanced cell apoptosis rate at the same time. Finally, Western blot results revealed that the overexpression of MT1JP may markedly reduce the AKT expression, thereby suppressing the malignant progression of HCC.

CONCLUSIONS

LncRNA MT1JP expression is remarkably decreased in HCC tumor tissue samples, which is associated with pathological stage and poor prognosis of HCC patients. In addition, MT1JP may inhibit the malignant progression of HCC by downregulating AKT.

[Five-year clinical outcomes of the second generation biodegradable polymer sirolimus-eluting stent (EXCROSSAL) in treating patients with de novo coronary lesions]

Objective: To evaluate the five-year safety and efficacy of the second generation biodegradable polymer sirolimus-eluting stent (EXCROSSAL) in treating patients with de novo coronary artery diseases. Methods: Patients with coronary artery disease (CAD)who were implanted with EXTROSSAL stents in CREDIT Ⅱ and CREDIT Ⅲ study were included. CREDIT Ⅱ was a randomized trial, and CREDIT Ⅲ was a single-arm study. From November 2013 to December 2014, 833 CAD patients with de novo coronary lesions implanted with EXTROSSAL stents were selected from 33 centers in China. The primary outcome was 5-year target lesion failure (TLF), a composite of cardiac death, target vessel myocardial infarction and clinically indicated target lesion revascularization. Secondary endpoints was patient-oriented composite endpoint (PoCE), including all-cause death, all myocardial infarction, or any revascularization within 5 years post stenting and stent thrombosis according to Academic Research Consortium's (ARC) definition. Kaplan Meier method was used to calculate the incidence of TLF and PoCE within 5 years after operation. Univariate Cox regression analysis was used to analyze the impacts of diabetes, small vessel disease (vessel diameter ≤ 2.74 mm), lesion length ≥ 16.7 mm and multivessel disease on the incidence of TLF within 5 years after operation. Results: A total of 833 patients were included in this study including 579 males (69.5%), the age was (59.3±9.1) years. And 832 (99.9%) patients completed 5-year clinical follow-up. The incidence of TLF and PoCE in the 5-year follow-up were 10.6%(86/811) and 15.5%(126/811), respectively. Stent thrombosis occurred in 1.0%(8/811) of patients. Univariate Cox regression analysis showed that vessel diameter ≤ 2.74 mm (HR=3.20,95%CI 1.90-5.39,P<0.001), lesion length ≥ 16.7 mm (HR=1.88,95%CI 1.18-2.99,P=0.007) and multivessel disease (HR=2.44,95%CI 1.60-3.72,P<0.001) were related factors of TLF within 5 years after operation. Conclusion: EXCROSSAL stent is effective and safe in treating CAD patients with de novo coronary lesions, with low incidence of TLF and PoCE within 5 years after operation.

Effects of rapamycin on osteosarcoma cell proliferation and apoptosis by inducing autophagy

OBJECTIVE

To investigate the influences of rapamycin on proliferation and apoptosis of human osteosarcoma MG-63 cells and the mechanisms of action.

MATERIALS AND METHODS

The human osteosarcoma MG-63 cells were randomly divided into Control group, Rapamycin group, and Rapamycin + Beclin-1 plasmid transfection group. 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was adopted to detect the viability of MG-63 cells in each group, and the 5-Ethynyl-2'-deoxyuridine (EdU) staining and Hoechst staining were applied to determine the proliferation and apoptosis, respectively, of MG-63 cells in each group. The levels of B-cell lymphoma-2 (Bcl-2) and Bcl-2-associated X protein (Bax) were measured using enzyme-linked immunosorbent assay (ELISA) kits, and the protein expression levels of Beclin-1 and Vps34 in each group of MG-63 cells were tested using the Western blotting.

RESULTS

Compared with the Control group, Rapamycin group, and Rapamycin + Beclin-1 plasmid transfection group had markedly weakened the viability of MG-63 cells, inhibited cell proliferation, remarkably increased cell apoptosis rate, elevated Bax level, notably declined Bcl-2 level, and significantly raised the levels of Beclin-1 and Vps34 proteins in MG-63 cells. Besides, the effects in Beclin-1 plasmid transfection group were stronger.

CONCLUSIONS

Rapamycin may decrease the viability, inhibit the proliferation, and promote the apoptosis of MG-63 cells by activating autophagy.

MiR-155-5p accelerates cerebral ischemia-reperfusion injury via targeting DUSP14 by regulating NF-κB and MAPKs signaling pathways

OBJECTIVE

This study aimed to explore the role of miR-155-5p in middle cerebral artery occlusion/reperfusion (MCAO/R) model in rats and oxygen-glucose deprivation/reoxygenation (OGD/R)-induced SH-SY5Y cells. In addition, this study also aimed to explore the underlying mechanisms to expect that miR-155-5p may be investigated as a new and effective diagnostic and therapeutic target for ischemic stroke.

MATERIALS AND METHODS

The in vivo MCAO/R rat model and in vitro OGD/R cell model were established. The miR-155-5p mRNA expression was detected by quantitative Reverse Transcription-Polymerase Chain Reaction (qRT-PCR). Dual specificity ATPase (DUSP) 14 was predicted to be a potential target of miR-155-5p by TargetScan. The targeting relationship was confirmed by Luciferase assay. The cell viability was determined using the Cell Counting Kit-8 (CCK-8). The expression level of inflammatory cytokines, including tumor necrosis factor alpha (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) levels were detected by Enzyme-Linked Immunosorbent Assay (ELISA). Western blot was used to detect the protein expression of DUSP14, the apoptotic protein Cleaved cysteine-aspartic acid protease (caspase)-3, and Cleaved PARP, as well as nuclear factor kappa B (NF-κB) and MAPKs signaling pathways related proteins.

RESULTS

MiR-155-5p was upregulated in both MCAO/R rats and OGD/R-induced SH-SY5Y cells. MiR-155-5p knockdown inhibited OGD/R-induced cell injury and inflammation, as well as MCAO/R-induced brain injury. MiR-155-5p regulated the NF-κB and MAPKs signaling pathways by targeting DUSP14. DUSP14 knockdown partially reversed the protective effect of miR-155-5p knockdown on OGD/R-induced SH-SY5Y cell injury and inflammation.

CONCLUSIONS

MiR-155-5p accelerates cerebral I/R injury via targeting DUSP14 by regulating NF-κB and MAPKs signaling pathways. Inhibition of miR-155-5p significantly reduces apoptosis and brain injury. These results indicated that miR-155-5p plays a key role in cerebral I/R injury and has the potential to be explored as a new target for ischemic stroke.

Alterations in leaf photosynthetic electron transport in Welsh onion (Allium fistulosum L.) under different light intensity and soil water conditions

Welsh onions (Allium fistulosum L.) are often affected by stressful environments, such as high light and drought, during summer cultivation, which hinders their growth. We used CO₂ assimilation, OJIP transient and MR curves to analyse the photosynthetic characteristics of Welsh onion. The results showed that single high light stress caused a decrease in the net photosynthesis rate through stomatal limitation, while the single drought treatment and the combined stress induced nonstomatal limitation. F_O and F_J increased, F_m decreased, and a distinct K-phase was induced. High light and drought stress blocked MR transients, leading to a gradual decrease in V_PSI and V_PSII-PSI . In general, photosynthesis of Welsh onion was inhibited by high light and drought, which destroyed the receptor and donor side of PSII and reduced electron transport capacity of PSII and PSI.

Integrated Structure and Device Engineering for High Performance and Scalable Quantum Dot Infrared Photodetectors

Colloidal quantum dots (CQDs) are emerging as promising materials for the next generation infrared (IR) photodetectors, due to their easy solution processing, low cost manufacturing, size-tunable optoelectronic properties, and flexibility. Tremendous efforts including material engineering and device structure manipulation have been made to improve the performance of the photodetectors based on CQDs. In recent years, benefiting from the facial integration with materials such as 2D structure, perovskite and silicon, as well as device engineering, the performance of CQD IR photodetectors have been developing rapidly. On the other hand, to prompt the application of CQD IR photodetectors, scalable device structures that are compatible with commercial systems are developed. Herein, recent advances of CQD based IR photodetectors are summarized, especially material integration, device engineering, and scalable device structures.

PEAR1 rs12041331 polymorphisms and the risk of adverse cardiovascular outcomes in patients with acute coronary syndrome and/or percutaneous coronary intervention: a systematic review and meta-analysis

Background

Platelet endothelial aggregation receptor-1 (PEAR1), expressed in endothelium, platelets, and other tissues, is a platelet transmembrane tyrosine kinase receptor involved in platelet aggregation and platelet-platelet contact. The minor allele (A) in intron 1 of the PEAR1 gene (rs12041331, G&gt;A) is associated with an reduced PEAR1 protein expression and suppressed platelet aggregation response toward multiple agonists. But current evidences on the association between PEAR1 rs12041331 polymorphisms and cardiovascular outcomes in patients with acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI) are discordant.

Purpose

To characterize and quantify the association between PEAR1 rs12041331 polymorphisms and cardiovascular outcomes in patients with ACS and/or PCI.

Methods

We conducted a systematic review and meta-analysis by searching MEDLINE via PubMed, EMBASE, Cochrane Central Register of Controlled Trials, SinoMed, CNKI, and Wanfang Data before Dec 7, 2019 to identify studies evaluating the association between PEAR1 rs12041331 polymorphisms and cardiovascular outcomes in patients with ACS and/or PCI. The primary outcome was the major adverse cardiovascular outcomes (MACEs) defined by each study. We adopted the Mantel-Haenszel method to calculate the relative risks (RRs) with 95% confidence intervals (CIs) and the corresponding P values using the random effect model. To assess the effect of ethnicity, we performed the subgroup analyses per ethnic population using the fix effect model.

Results

Among 542 citations identified along with 1 from additional sources, we included 4 studies, which documented 218 MACEs in 8180 patients. The A allele frequency in each study was comparable with that reported in the 1000 Genome Project, but varied among ethnic populations, that is 45.8% in East Asians, 46.5% in American Africans, and 9.2% in Caucasians, adopted from the 1000 Genome Project. A-allele carriers are associated with a 54% increase in MACEs than non-A-carriers (RR, 1.54; 95% CI, 1.10–2.16; P=0.01) with a low but non-significant heterogeneity. Subgroup analyses showed that A-allele carriers tend to have more MACEs than non-A-allele carriers despite of ethnicity, that is 1.32-fold increase in East Asians (RR, 1.32; 95% CI, 0.99–1.77; P=0.06), 2.43-fold in Caucasians (RR, 2.43; 95% CI, 0.99–5.98; P=0.05), and 3.56-fold (RR, 3.56; 95% CI, 1.08–11.70; P=0.04) in American Africans.

Conclusions

Our study indicates that the PEAR1 rs12041331 is prognostic in patients with ACS and/or PCI and treated with DAPT, which might be not caused by the associations with pharmacological response to antiplatelet agents. Further investigations are thus required to address the unrevealing mechanisms of PEAR1, especially on the development of atherosclerosis and the occurrence of acute adverse ischemic events.

Figure 1

Funding Acknowledgement

Type of funding source: None

Genetic polymorphisms and cardiovascular outcomes in Chinese patients undergoing PCI and treated with clopidogrel and aspirin

Background

Genetic polymorphisms of key proteins involved in clopidogrel absorption, metabolism, and action may contribute to variability in platelet inhibition in patients undergoing percutaneous coronary intervention (PCI), but their impacts on cardiovascular outcomes remain unclear.

Purpose

To examine the associations between genetic polymorphisms and cardiovascular outcomes in Chinese patients undergoing PCI and treated with clopidogrel and aspirin.

Methods

This prospective cohort study consecutively enrolled 2,453 post-PCI patients treated with clopidogrel and aspirin. Adenosine diphosphate-induced platelet aggregation was measured by light transmission aggregometry. A total of 40 single nucleotide polymorphisms (SNPs) of 18 genes selected according to published studies were investigated using an improved multiplex ligation detection reaction technique. The primary outcome was major adverse cardiovascular event (MACE), the composite of cardiovascular death, non-fatal myocardial infarction (MI), and ischemic stroke within one year after PCI.

Results

We restricted the analyses to the first 1,452 patients who had finished one-year follow-up and complete data on genotyping and platelet aggregation. 44 (3.03%) patients suffered MACE. Among the 40 SNPs, only the A-allele carriers of CYP2C19*2 had a significant higher risk of MACE (adjusted HR 2.05; 95% CI, 1.01–4.19; p=0.048) and platelet aggregation than non-A-carriers after adjusting age, sex, MI presentation, and left ventricular ejection fraction. CYP2C19*3, CYP2B6 rs3745274, and PEAR1 rs12041331 variants were also significantly associated with platelet aggregation (all p&lt;0.05) but not with MACE at 1 year.

Conclusion

About 54.2% of Chinese patients with PCI were A-allele carriers of CYP2C19*2, who face a two-fold higher risk of MACE than non-A-allele carriers in Chinese patients after PCI. It would help identify low clopidogrel responders and optimize antiplatelet therapy before drug administration.

Figure 1

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Natural Science Funding of China

Electrocardiographic (ECG) predictors of major adverse cardiac events in women with ischemia and no obstructive coronary artery disease (INOCA)

Introduction

The Women's Ischemia Syndrome Evaluation (WISE) studies observed that majority of women undergoing coronary angiography for symptoms/signs of ischemia have no obstructive coronary artery disease (INOCA) but have an increased risk of major adverse cardiac events (MACE) exceeding 2.5% yearly by 5 years. Identifying modifiable and non-modifiable factors that help predict or contribute to adverse outcomes in this population is important.

Purpose

Identifying electrocardiographic predictors of MACE in women with INOCA.

Methods

In a cohort of women referred for coronary angiography between 1996–2001 for symptoms and/or signs of ischemia, 944 underwent a resting 12-lead ECG at baseline read at core lab. No obstructive CAD was found in 567/944 (60%), (mean age 55.6±11 years). Complete follow up information for MACE as (first occurrence of all-cause death, nonfatal myocardial infarction (MI), nonfatal stroke, or hospitalization for heart failure) or angina was available in 425 women.

Results

At follow up (median 5.9 years) MACE had occurred in 17.6% with angina hospitalization in 22.8% of these women. Women who experienced MACE were older (mean age 59±11 vs 55±10 years, P=0.02) and had longer corrected QT interval (mean QTc 437±29.7 vs 425±26.7 ms, P=0.001) vs. women without MACE. Diabetes, hypertension and history of smoking did not differ between MACE groups. Predictors of MACE by univariate analysis were: age at presentation (P=0.013), baseline heart rate (P=0.03), and QTc (P=0.0005). Baseline ST-T wave changes, QTc and waist circumference predicted angina hospitalization (P=0.003, 0.003 and 0.013 respectively). After adjusting for other risk factors in the multivariate analysis (see Figure) QTc, peripheral arterial disease (PAD) and current smoking were found to be independent predictors for MACE. ST-T wave changes and QTc independently predicted angina hospitalizations.

Conclusion

Among ECG findings in women with INOCA, QTc was a significant predictor of MACE and this was driven by hospitalization with angina. Ongoing ischemia likely contributes to these baseline ECG signals which could prove useful to better select subgroups for more intense anti-ischemic management.

Figure 1

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Heart, Lung, and Blood Institute (NHLBI)

Proximal Type - Epithelioid Sarcoma- A Rare And Aggressive Soft Tissue Neoplasm

Introduction/Objective

Epithelioid Sarcoma is a rare malignant soft tissue neoplasm that is well known for local recurrence, regional lymph node involvement, and metastasis. It accounts for less than one percent of all sarcomas. Two subtypes of epithelioid sarcoma are described: the conventional or classic subtype and the proximal subtype, with the classic type being more common than the proximal type. We present a case of proximal epithelioid sarcoma involving the inguinal region, in which the patient presented with the history of weight loss for one year and a slow- growing inguinal mass for the last few months. The biopsy was done in an outside hospital and showed carcinoma of unknown origin. Imaging also failed to reveal any clear source of this mass.

Methods

The mass was resected and sent to pathology, where H&E staining and immunohistochemistry was done for diagnosis.

Results

The H&E sections of the left inguinal mass showed proliferation of large epithelioid cells with a moderate amount of cytoplasm, vesicular nuclear chromatin and prominent nucleoli. Mitosis was also seen. Necrosis was not identified. Immunohistochemical staining was done and revealed that the tumor cells were immunoreactive for epithelial marker cytokeratin AE1/AE3 and showed loss of INI-1. Tumor cells were also negative for Myogenin, ERG, HMB-45, MART-1, Myo-D1, S100, and SMA. Considering the cytomorphology and immunophenotypic findings the diagnosis of epithelioid sarcoma, proximal type was made.

Conclusion

Epithelioid sarcoma is a malignant mesenchymal neoplasm with epithelioid cytomorphology and phenotype. Among the two types of epithelioid sarcoma, the proximal type is reported about 50% less than the classic type and is associated with aggressive behavior and worse prognosis. The classic cytomorphology and immunohistochemistry findings helped us in making the diagnosis in this case.

A Comparative Analysis of Immunohistochemical Profile of Primary and Metastatic Endometrial Endometrioid Carcinoma

Introduction/Objective

Beta catenin plays an important role in cancer tumorigenesis and have been found to be associated with metastasis in a variety of tumors. Analyzing TCGA data, we found that 30% of endometrial endometrioid carcinoma cases have beta-catenin mutations. We hypothesize that beta-catenin mutation may be associated with metastasis of endometrial endometrioid carcinoma. ER and PR expression was also compared to determine any changes after metastasis.

Methods

Retrospective institutional review of all endometrial endometrioid carcinoma (192 cases) between 2011 to 2018 was performed, including 149 cases of FIGO grade I, 38 cases of FIGO grade II and 5 cases of FIGO grade III. 19 cases with paired primary and metastatic specimen were identified. Immunohistochemistry staining (IHC) was carried out for ER, PR and beta-catenin.

Results

Median patient age was 56 years. The most common metastatic site was vagina, accounting for 68% of metastasis (14/19), followed by bladder (3/19), lung (2/19) and rectum (1/19). The primary and metastatic carcinoma of all 19 cases exhibit very similar morphology. All of those cases were positive and concordant for ER and PR in primary and metastatic endometrioid carcinoma. On the other hand, nuclear beta-catenin staining caused by mutation was positive in 5 metastatic carcinoma but not in primary carcinoma.

Conclusion

IHC expression of ER and PR remains unchanged between primary and metastatic carcinoma, demonstrating the reliability of ER and PR to confirm the origin of metastatic carcinoma. 26% of the metastatic carcinoma (5/19) exhibit nuclear beta-catenin staining but not in primary carcinoma, suggesting the possible role of beta-catenin in metastasis of endometrial endometrioid carcinoma.

Structural exercise-based intervention for health problems in individuals with autism spectrum disorders: a pilot study

OBJECTIVE

Exercise-based intervention promises to be more effective in a structured framework for individuals with autism spectrum disorders (ASD). The aim of this study was to observe changes in behavior of individuals with ASD by investigating their physical status after the structured exercise-based intervention.

PATIENTS AND METHODS

The exercise intervention integrated an 8-week exercise program that included aerobic, resistive, and neuromuscular exercises. Body composition and the Autism Treatment Evaluation Checklist (ATEC) were evaluated to assess changes after the exercise-based intervention.

RESULTS

After the exercise intervention, the fat mass of individuals with ASD were significantly reduced, and their behavior improved markedly.

CONCLUSIONS

This pilot study demonstrated that individuals with ASD require long-term, structured exercise-based intervention, and that such exercise-based intervention is effective for improving their health.

[Lung cancer combined with connective tissue disease-related interstitial lung disease: CT features]

Objective: To investigate the CT features and dynamic changes of new developed lung cancer in patients with connective tissue disease-related interstitial lung disease (CTD-ILD). Methods: A series of chest CT images of 58 CTD-ILD patients during follow-up were collected. The CT features of interstitial lung disease, the initial appearance time of lung cancer, the time of diagnosis of lung cancer, the morphological characteristics (location, shape, size) of lung cancer lesions and the dynamic changes of CT features were analyzed. Results: Among 58 patients, rheumatoid arthritis was the most common (31 cases). Chest CT images showed coexistence of two or more interstitial CT signs. During the follow-up, a total of 59 lung cancer lesions were found. The median time of lung cancer lesion occurred was 289 days. The median delay in diagnosis was 43 days. There were 44 cases of non-small cell lung cancer (including 23 cases of squamous cell carcinoma and 19 cases of adenocarcinoma), 12 cases of small cell lung cancer. Forty-three (72.9%) lesions were located in the lower lobes and 41 (69.5%) lesions were located in the area of pulmonary interstitial fibrosis. According to CT morphological characteristics of lung cancer, nodular type (37 cases), inflammatory consolidation (12 cases) and intra-honeycomb type (10 cases) were identified. Conclusions: The chest CT features of patients with CTD-ILD are complex. New developed lung cancer is easily missed or misdiagnosed in the early stage. Pay attention to the special CT characteristics of CTD-ILD with lung cancer is helpful for early diagnosis.

[The clinical features and prognosis of 32 cases of pulmonary actinomycosis]

Objectives: To describe the clinical features and prognosis of pulmonary actinomycosis in a tertiary Chinese hospital. Methods: We conducted a retrospective analysis of 32 patients diagnosed with pulmonary actinomycosis between January 2013 and December 2019. General characteristics, clinical manifestations, lab data, chest CT imaging, treatment and follow-up information were reviewed and analyzed. Results: This study consisted of 19 males and 13 females, with a mean age of (58±12) years, ranging from 16 to 76 years. There were 26 cases with co-morbidities. Among them, there were 16 cases with pulmonary co-morbidity. Sixteen cases had a smoking history. Eight cases, 5 men and 3 women, with a mean age of (48±8) years, ranging from 41 to 58 years, received thoracic surgery for diagnosis. The remaining 24 cases who did not receive thoracic surgery consisted of 14 males and 8 females, with a mean age of (54±14)years, ranging from 16 to 76 years. Cough (25cases), expectoration (21 cases) and fever (16 cases) were the common clinical manifestations. The erythrocyte sedimentation rate (ESR) ranged from 2 to 114 mm/1 h, with a mean value of (28±31) mm/1 h. The ESR was elevated (>20 mm/1 h) in 15 cases. The C-reactive protein (CRP) ranged from 1 to 116 mg/L, with a mean value of (28±45) mg/L. The CRP was elevated (>8 mg/L) in 16 cases. Localized air-space consolidation (18 cases), pulmonary mass or nodules (16 cases) were the common chest CT manifestations. When compared with non-surgical cases, fever was the sole characteristic that was less common in cases with thoracic surgery (1 case in surgical group vs 11 cases in non-surgical group, P<0.05). Actinomyces spp. was found in 7 cases (87.5%) who received thoracic surgery, in 16 (61.5%) specimens collected through bronchoscopy and in 10 (55.6%) sputum samples of good quality. All of our enrolled cases were administrated with oral antibiotics, and 14 cases were prescribed with intravenous antibiotics initially. Among them, 27 cases were administrated with more than one antibiotic. Penicillin, ampicillin and amoxillin were prescribed for 25 cases. Finally, 30 cases showed improvement or cure in our hospital. Conclusions: Pulmonary actinomycosis tended to develop in aged patients with co-morbidities. Cough, expectoration, fever and localized air-space consolidation were the common clinical and radiological manifestations, respectively. Actinomyces spp. could be found more easily in the surgically resected tissues than other specimens. The prognosis of our enrolled cases was good after treatment with combined antibiotics.

MFN2 contributes to metabolic disorders and inflammation in the aging of rat chondrocytes and osteoarthritis

OBJECTIVE

Metabolic disorders and inflammation of chondrocytes are major pathological changes in aging cells and osteoarthritis (OA). Recent studies demonstrated age-related mitochondrial dysfunction may be a key contributing factor in the development of OA. Mitofusin 2 (MFN2) is a key regulator of mitochondrial fusion, cell metabolism, autophagy and apoptosis. This study was performed to ascertain whether MFN2 was involved in the aging of chondrocytes and OA.

METHODS

Metabolic measurements were taken in rat chondrocytes between different ages (3-week, 5-month, 12-month). MFN2 activity was detected in both human and rat chondrocytes during aging and OA. Then, knockdown of MFN2 with small interfering RNA (siRNA) was performed to confirm whether MFN2 contributes to metabolic changes. Lentiviruses were used to establish MFN2-overexpression/knockdown OA models both in vivo and in vitro to confirm whether MFN2 contributes to OA progress. Further, regulatory mechanism of MFN2 was assessed and interaction between MFN2 and PARKIN was performed.

RESULTS

A metabolic shift to mitochondrial respiration was confirmed in rat chondrocytes during aging. MFN2 expression was elevated in both human and rat chondrocytes during aging and OA. Knockdown of MFN2 with siRNA reversed the age-related metabolic changes in rat chondrocytes. Overexpression of MFN2 exacerbated inflammation and OA progress, while knockdown of MFN2 ameliorated inflammation and OA progress. Further, MFN2 could be ubiquitinated by PARKIN, declined PARKIN expression during aging and OA might result in elevated MFN2 expression.

CONCLUSIONS

Elevated MFN2 contributes to metabolic changes and inflammation during aging of rat chondrocytes and osteoarthritis.

MiR-663a, regulated by lncRNA GAS5, contributes to osteosarcoma development through targeting MYL9

Osteosarcoma is characterized by high malignancy and high metastasis rate, resulting in high mortality and disability. MiR-663a has been reported in a variety of tumors to promote tumorigenesis. However, miR-663a has not been reported in the pathogenesis of osteosarcoma. Bioinformatics analysis and experiments including real-time quantitative polymerase chain reaction (RT-qPCR), luciferase reporter, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, Western blot, RNA immunoprecipitation, and flow cytometry assay were applied to explore the function and mechanism of miR-663a in MG63, U2OS, Saos-2, SF-86, and hFOB1.19 cells. In this study, we found that miR-663a is highly expressed in osteosarcoma. At the same time, we discovered that miR-663a facilitates cell proliferation and migration, whereas suppresses cell apoptosis in osteosarcoma. Through a series of biological experiments, it was found that miR-663a regulates the cellular process in osteosarcoma by modulating the expression of MYL9. In addition, we also found that long noncoding RNA (lncRNA) GAS5 serves as a molecular sponge for miR-663a and regulates the progression of osteosarcoma via the ceRNA mechanism. We uncover that miR-663a promotes osteosarcoma development through targeting MYL9, which was regulated by lncRNA GAS5.

No effect of ovarian stimulation and oocyte yield on euploidy and live birth rates: an analysis of 12 298 trophectoderm biopsies

STUDY QUESTION

Does ovarian stimulation affect embryo euploidy rates or live birth rates (LBRs) after transfer of euploid embryos?

SUMMARY ANSWER

Euploidy rates and LBRs after transfer of euploid embryos are not significantly influenced by gonadotropin dosage, duration of ovarian stimulation, estradiol level, follicle size at ovulation trigger or number of oocytes retrieved, regardless of a woman’s age.

WHAT IS KNOWN ALREADY

Aneuploidy rates increase steadily with age, reaching &gt;80% in women &gt;42 years old. The goal of ovarian stimulation is to overcome this high aneuploidy rate through the recruitment of several follicles, which increases the likelihood of obtaining a euploid embryo that results in a healthy conceptus. However, several studies have suggested that a high response to stimulation might be embryotoxic and/or increase aneuploidy rates by enhancing abnormal segregation of chromosomes during meiosis. Furthermore, a recent study demonstrated a remarkable difference in euploidy rates, ranging from 39.5 to 82.5%, among young oocyte donors in 42 fertility centres, potentially suggesting an iatrogenic etiology resulting from different stimulation methods.

STUDY DESIGN, SIZE, DURATION

This is a retrospective cohort study that included 2230 in vitro fertilisation (IVF) with preimplantation genetic testing for aneuploidy (PGT-A) cycles and 930 frozen-thawed single euploid embryo transfer (FET) cycles, performed in our centre between 2013 and 2017.

PARTICIPANTS/MATERIALS, SETTING, METHODS

A total of 12 298 embryos were analysed for ploidy status. Women were divided into five age groups (&lt;35, 35–37, 38–40, 41–42 and &gt;42 years old). Outcomes were compared between different durations of stimulation (&lt;10, 10–12 and ≥13 days), total gonadotropin dosages (&lt;4000, 4000–6000 and &gt;6000 IU), numbers of oocytes retrieved (&lt;10, 10–19 and ≥20 oocytes), peak estradiol levels (&lt;2000, 2000–3000 and &gt;3000 pg/mL), and sizes of the largest follicle on the day of trigger (&lt;20 and ≥20 mm).

MAIN RESULTS AND THE ROLE OF CHANCE

Within the same age group, both euploidy rates and LBRs were comparable between cycles regardless of their differences in total gonadotropin dosage, duration of stimulation, number of oocytes harvested, size of the largest follicles or peak estradiol levels. In the youngest group, (&lt;35 years, n = 3469 embryos), euploidy rates were comparable between cycles with various total gonadotropin dosages (55.6% for &lt;4000 IU, 52.9% for 4000–6000 IU and 62.3% for &gt;6000 IU; P = 0.3), durations of stimulation (54.4% for &lt;10 days, 55.2% for 10–12 days and 60.9% for &gt;12 days; P = 0.2), number of oocytes harvested (59.4% for &lt;10 oocytes, 55.2% for 10–19 oocytes and 53.4% for ≥20 oocytes; P = 0.2), peak estradiol levels (55.7% for E2 &lt; 2000 pg/mL, 55.4% for E2 2000–3000 pg/mL and 54.8% for E2 &gt; 3000 pg/mL; P = 0.9) and sizes of the largest follicle (55.6% for follicles &lt;20 mm and 55.1% for follicles ≥20 mm; P = 0.8). Similarly, in the oldest group (&gt;42 years, n = 1157 embryos), euploidy rates ranged from 8.7% for gonadotropins &lt;4000 IU to 5.1% for gonadotropins &gt;6000 IU (P = 0.3), from 10.8% for &lt;10 days of stimulation to 8.5% for &gt;12 days of stimulation (P = 0.3), from 7.3% for &lt;10 oocytes to 7.4% for ≥20 oocytes (P = 0.4), from 8.8% for E2 &lt; 2000 pg/mL to 7.5% for E2 &gt; 3000 pg/mL (P = 0.8) and from 8.2% for the largest follicle &lt;20 mm to 8.9% for ≥20 mm (P = 0.7). LBRs after single FET were also comparable between these groups.

LIMITATIONS, REASONS FOR CAUTION

Although this large study (2230 IVF/PGT-A cycles, 12 298 embryos and 930 single FET cycles) demonstrates the safety of ovarian stimulation in terms of aneuploidy and implantation potential of euploid embryos, a multi-centre study may help to prove the generalisability of our single-centre data.

WIDER IMPLICATIONS OF THE FINDINGS

These findings reassure providers and patients that gonadotropin dosage, duration of ovarian stimulation, estradiol level, follicle size at ovulation trigger and number of oocytes retrieved, within certain ranges, do not appear to significantly influence euploidy rates or LBRs, regardless of the woman’s age.

STUDY FUNDING/COMPETING INTEREST(S)

No external funding was received and there are no competing interests to declare.

TRIAL REGISTRATION NUMBER

N/A

Inverted Si:PbS Colloidal Quantum Dot Heterojunction-Based Infrared Photodetector

Silicon and PbS colloidal quantum dot heterojunction photodetectors combine the advantages of the Si device and PbS CQDs, presenting a promising strategy for infrared light detecting. However, the construction of a high-quality CQDs:Si heterojunction remains a challenge. In this work, we introduce an inverted structure photodetector based on n-type Si and p-type PbS CQDs. Compared with the existing normal structure photodetector with p-type Si and n-type PbS CQDs, it has a lower energy band offset that provides more efficient charge extraction for the device. With the help of Si wafer surface passivation and the Si doping density optimization, the device delivers a high detectivity of 1.47 × 10¹¹ Jones at 1540 nm without working bias, achieving the best performance in Si/PbS photodetectors in this region now. This work provides a new strategy to fabricate low-cost high-performance PbS CQDs photodetectors compatible with silicon arrays.

[Comparative study on the EPLAD of profoundly deaf children with hearing aid fittings or cochlear implantations at the same age]

Objective:The purpose of the current study was to provide good clinical values for rehabilitation exercises and counseling of hearing impaired children by comparing the early prelingual auditory development（EPLAD） of children with hearing aid fittings or cochlear implantations at the same age. Method:Longitudinal evaluation of EPLAD, profoundly deaf children, who received hearing aid fittings or cochlear implantations at 2 years of age, were recruited in this study, and would be tested with Infant-toddler meaningful auditory integration scale（IT-MAIS） at 3, 6 and 12 months after intervention. One hundred and four children were recruited in this study and divided into two groups based on the types of devices: Cochlear implant group（CI group） and Hearing aid group（HA group）. Each child could be permitted to miss follow-up one time. Result:The IT-MAIS scores of children in both groups improved with increasing wear time. The scores in CI group showed a statistically significant improvement between each interval after switch-on（P=0.000）. However, there was just a statistical difference between overall scores at 3 and 12 months after fitting in HA group（P=0.042）. In addition, the IT-MAIS scores of the two groups were statistically significant at 6 and 12 months after switch-on/fitting（P=0.026, P=0.005）. Simultaneously, the mean overall score of children in CI group at 12 months after switch-on approached the average level of unaided peers with mild hearing loss. However, the mean score at 12 months after fitting was close to the average level of unaided peers with moderate hearing loss. Conclusion:Both of CI and HA could improve EPLAD of profoundly deaf children. However, the EPLAD of CI children could improve faster in the first year after switch-on. And the results would also provide more comprehensive clinical values for rehabilitation and counseling of hearing impaired children by comparing to normal and unaided hearing impaired children.

Neuroendoscopic lavage for ventriculitis: Case report and literature review

BACKGROUND

Ventriculitis, one of the difficulties in neurosurgical treatment, is a significant cause of death and morbidity in patients with hydrocephalus. Neuroendoscopy is widely used in the treatment of non-communicable hydrocephalus. The advantages of neuroendoscopy may play a decisive role in the treatment of ventriculitis.

CASE REPORT AND METHODS

We report a 34-year-old male patient with refractory fever and rapid progressive disturbance of consciousness due to ventriculitis caused by intraventricle rupture in a left colliculus abscess. He received intravenous (IV) antibiotics and saline neuroendoscopic lavage (NEL) combined with septostomy and endoscopic third ventriculostomy leading to rapid recovery and remission of symptoms. We also reviewed the use of NEL for ventriculitis in PubMed from 1970 to January 20, 2019.

RESULTS

In our review, 93 cases (including the present report) were treated with NEL; 91 cases of infection subsided, and 7 patients died.

CONCLUSION

NEL may be an effective method for the treatment of ventriculitis.

Amorphous ZnO/PbS Quantum Dots Heterojunction for Efficient Responsivity Broadband Photodetectors

The integration of lead sulfide quantum dots (QDs) with a high-conductivity material that is compatible with a scalable fabrication is an important route for the applications of QD-based photodetectors. Herein, we first developed a broadband photodetector by combining amorphous ZnO and PbS QDs, forming a heterojunction structure. The photodetector showed detectivity up to 7.9 × 10¹² and 4.1 × 10¹¹ jones under 640 and 1310 nm illumination, respectively. The role of the oxygen background pressure in the electronic structure of ZnO films grown by pulsed laser deposition was systematically studied, and it was found to play an important role in the conductivity associated with the variation of the oxygen vacancy concentration. By increasing the oxygen vacancy concentration, the electron mobility of amorphous ZnO layers dramatically increased and the work function decreased, which were beneficial for the photocurrent enhancement of ZnO/PbS QD photodetectors. Our results provide a simple and highly scalable approach to develop broadband photodetectors with high performance.

[Safety and effectiveness of transoral robotic surgery for oropharyngeal cancer: a pilot study]

Objective: To evaluate the indication, safety and effectiveness of transoral robotic surgery (TORS) for oropharyngeal cancer based on our preliminary experience. Methods: Twelve patients, including six with tonsil cancer, five with tongue base cancer and one with posterior pharyngeal wall cancer, who underwent TORS with Da Vinci Si surgical system from March 2017 to October 2018 at Tongji Hospital of Huazhong University of Science Technology were respectively analyzed. And the surgical time, intraoperative blood loss, postoperative local bleeding, dyspnea, nerve function injury, oral intake time, whether or not to receive chemoradiotherapy were analyzed. Results: All tumors in the 12 patients were en bloc removed by TORS. Surgical time ranged from 25 to 80 min with an average of 34.2 min. The blood loss ranged from 10 ml to 50 ml with an average of 20.8 ml. The recovery time for oral intake ranged from 1 day to 30 days with an average of 8.4 days. No patient underwent tracheostomy after TORS. Also, no patient manifested with airway obstruction, bleeding or nerve injury symptoms after operation. All 12 patients reached pathologically negative surgical margins. The patients were followed up for 4 to 22 months, with a median of 12 months. All patients who combined with more advanced than T3 stage, or more advanced than N2 stage were recommended to oncologist, then, followed with radiotherapy or chemoradiotherapy if no relevant contradictions occurred. No local recurrence or distant metastasis case was found. Conclusion: With proper indications, the application of TORS in oropharyngeal cancer is a relatively safe, effective and minimal invasive therapy, which merits more clinical applications.

[Suggestions for prevention of 2019 novel coronavirus infection in otolaryngology head and neck surgery medical staff]

The epidemic of the 2019 Novel Coronavirus (2019-nCoV) infection has presented as a grim and complex situation recently. More than 11,000 cases of 2019-nCoV infection has been confirmed in China until February 1st 2020, which are causing great impact to economy and society, and seriously interfering with ordinary medical practice of otolaryngology and head and neck surgery. This advice guideline discusses the medical protection measures required in the outpatient clinic as well as in operation ward in otolaryngology head and neck department, which aims to protect medical staff from 2019-nCoV infection.

[The dosimetry comparison study between 3D print template and free-hand guided of precision (125)I seeds implantation on superficial metastatic carcinoma]

Objective: To compare the dose difference of (125)I seeds implantation on superficial metastatic carcinoma between 3D print template guided operation and traditional implantation. To investigate the accuracy of seeds implantation according preplan guided by 3D print template. Methods: A total of 21 cases of patient with 27 lesions underwent (125)I seeds implantation from January 2015 to May 2018 in Hebei General Hospital were analyzed retrospectively. In which, ten lesions underwent seeds implantation guided by 3D print template (template group) and 17 lesions underwent free-hand traditional implantation (traditional group). All patients had been fixed as the position of operation and then performed CT scan. After preplan was designed, the 3D templates were printed in template group. Postplan was performed after the operation.The dose volume histogram, D90 was calculated. The D90 pre and post operation were collected and compared in each group. The difference of D90 and the percentage difference of D90 between pre and post operation were calculated by the formula D90d=D90post-D90pre, D90d%=(D90post-D90pre)/D90pre×100%, and compared the difference between two groups. Results: The mean D90 pre and post operation in template group were (92±26) and (93±27) Gy respectively, t=-0.749, P=0.473. The mean D90 pre and post operation in traditional group were (104±29) and (104±26) Gy respectively, t=-0.139, P=0.891. The difference of D90 in two groups were (3.1±2.4) and (10.0±8.7) Gy, Z=-2.5, P=0.012. The percentage difference of D90 in two groups were 3.1%±1.9% and 9.5%±7.9%, Compared with the traditional group, the template group had smaller fluctuations, and the difference was statistically significant (Z=-2.7, P=0.006) (all P<0.05). Conclusions: The dose parameters of 3D template guided seeds implantation between postplan and preplan are nearly consistent.3D template has good repeatability, which provides a theoretical basis for the popularization of 3D printing technology.

Efficient and Stable Inverted Perovskite Solar Cells Incorporating Secondary Amines

Large-bandgap perovskites offer a route to improve the efficiency of energy capture in photovoltaics when employed in the front cell of perovskite-silicon tandems. Implementing perovskites as the front cell requires an inverted (p-i-n) architecture; this architecture is particularly effective at harnessing high-energy photons and is compatible with ionic-dopant-free transport layers. Here, a power conversion efficiency of 21.6% is reported, the highest among inverted perovskite solar cells (PSCs). Only by introducing a secondary amine into the perovskite structure to form MA_{1- x} DMA_x PbI₃ (MA is methylamine and DMA is dimethylamine) are defect density and carrier recombination suppressed to enable record performance. It is also found that the controlled inclusion of DMA increases the hydrophobicity and stability of films in ambient operating conditions: encapsulated devices maintain over 80% of their efficiency following 800 h of operation at the maximum power point, 30 times longer than reported in the best prior inverted PSCs. The unencapsulated devices show record operational stability in ambient air among PSCs.

[Long-term efficacy of a second generation biodegradable polymer sirolimus-eluting stent (EXCEL2) in treating patients with de novo coronary artery diseases]

Objective: To evaluate the long-term efficacy of a second generation biodegradable polymer sirolimus-eluting stent (EXCEL2) in treating patients with de novo coronary artery diseases. Methods: CREDIT Ⅱ trial was a prospective, multicenter, randomized, controlled study, conducted at 15 Chinese cardiac centres from November 2013 to December 2014. In this analysis, eligible patients for coronary stenting (n=419) were randomized to receive either the EXCEL2 stent (n=208) or the EXCEL stent (n=211). The primary endpoint was target lesion failure (TLF) at 3 years after PCI defined as a composite endpoints of cardiac death, target vessel myocardial infarction (TVMI), or clinically indicated target lesion revascularization (CI-TLR). Secondary endpoints included patient-oriented composite endpoint (PoCE) including all-cause death, all MI, or any revascularization at 3 years and independent components, and stent thrombosis according to Academic Research Consortium's (ARC) definition. Results: Among 419 enrolled patients, 413 (98.6%) patients completed 3-year clinical follow-up. Compared with the EXCEL group, 3-year TLF (5.4%(11/204) vs. 11.5% (24/209), P=0.025) and PoCE (9.8% (20/204) vs. 20.1% (42/209), P=0.003) were significantly lower in the EXCEL2 group. The cumulative event rate of CI-TLR (2.0% (4/204) vs. 5.7% (12/209), P=0.042) and any revascularization (4.9% (10/204) vs. 14.4% (30/209), P=0.001) were statistically lower in the EXCEL2 group than in the EXCEL group. There were no significant difference between two groups in terms of all-cause death and all MI. Rates of stent thrombosis were low without significant difference between the two groups (EXCEL2 vs. EXCEL, 1.0% (2/204) vs. 2.9% (6/209), P=0.285). Conclusion: 3-year clinical follow-up results demonstrate that EXCEL2 stents are effective and safe in treating CAD patients with de novo coronary lesions.

Tailoring Low-Temperature Performance of a Lithium-Ion Battery via Rational Designing Interphase on an Anode

Performances of lithium-ion batteries at subambient temperatures are extremely restricted by the resistive interphases originated from electrolyte decomposition, especially on the anode surface. This work reports a novel strategy that an anode interphase of low impedance is constructed by applying an electrolyte additive dimethyl sulfite (DMS). Electrochemical measurements indicate that the as-constructed interphase provides graphite/LiNi_0.5Co_0.2Mn_0.3O₂ pouch cells with excellent low-temperature performance, outperforming the interphase constructed by 1,3,2-dioxathiolane 2,2-dioxide (DTD), a common commercially used electrolyte additive. Spectral characterizations in combination with theoretical calculations demonstrate that the improved performance is attributed to the unique molecular structure of DMS, which presents appropriate reduction activity and constructs the more stable and ionically conductive anode interphase due to the weaker combination of its reduction product with lithium ions than DTD. This rational design of interphases via an additive structure has been proven to be a low cost but rather an effective approach to tailor the performances of lithium-ion batteries.

[The clinical experience of pirfenidone based on corticosteroids and immunosuppressant treatment for interstitial pneumonia with autoimmune features]

Objective: To explore the effect of pirfenidone in fibrotic interstitial pneumonia with autoimmune features (IPAF) after treatment with corticosteroids and immunosuppressants. Methods: We conducted a retrospective analysis of 2 adult patients with IPAF in the Peking Union Medical College Hospital. As their fibrotic interstitial lung disease failed to improve with further treatment with corticosteroids and immunosuppressants, they were treated with pirfenidone based on corticosteroids and immunosuppressants. Their clinical, chest radiological data and prognosis were collected and relevant literatures were reviewed. Results: One patient was a 43 year old female, the other was a 53 year old male. IPAF was diagnosed with their classic clinical, serological and radiological features. They were partially responded to corticosteroids and immunosuppressants at the initial period. Pirfenidone was suggested for them as their lung fibrosis was not improved further with immunosuppressive therapy. After 4-5 months treatment with pirfenidone, based on corticosteroids and immunosuppressant administration, their clinical and radiological manifestations improved significantly. Conclusions: Pirfenidone might be a good add-on choice for fibrotic IPAF when the disease did not respond well to corticosteroids and immunosuppressants.

[Preliminary observation on the changes of T(1) weighted signal of globus pallidus after multiple intravenous injection of linear gadolinium contrast agent]

Objective: To explore the changes in signal intensity (SI) ratios of globus pallidus (GP) on unenhanced T(1)-weighted(T(1)WI)magnetic resonance imaging (MRI) scans between the first and last MRI using the linear gadolinium-based contrast agent (GBCAs) intravenously. Methods: Clinical and imaging data of 114 patients who underwent at least 4 consecutive enhanced MRI examinations at the Affiliated Hospital of Xuzhou Medical University between January 2016 and April 2018 were analyzed. The SI ratio of GP, thalamus and cerebrospinal fluid (CSF) were measured on unenhanced T(1)WI. The GP to thalamus SI ratio was calculated by dividing the SI in the GP by that in the thalamus, and so was the GP to CSF SI ratio. The difference of SI ratio in the same patient was analyzed by nonparametric tests, linear regression analysis was used to analyze clinical factors. Results: The SI ratio of GP-to-thalamus and GP-to-CSF after multiple enhancement were higher than before, and the difference was statistically significant. The SI ratio of GP-to-thalamus and GP-to-CSF before and after repeated contrast-enhanced were 1.036(1.010, 1.075), 1.104(1.074, 1.168); 4.215(3.590, 5.614), 5.409(4.213, 6.502), all P<0.01. The SI ratio differences showed a significant positive correlation with the number of enhanced examination(pons:b=0.023, P<0.01,CSF:b=0.279,P=0.034), and a significant negative correlation with the interval (pons: b=-0.002,P< 0.01, CSF: b=-0.023, P=0.039). There was no correlation with other clinical factors (all P>0.05). Conclusions: There is an increase in SI in the GP after serial injections of linear GBCAs, and there is a positive correlation with the times of enhanced examination, and a negative correlation with time interval.

Effective Dimensionality Reduction for Visualizing Neural Dynamics by Laplacian Eigenmaps

With the development of neural recording technology, it has become possible to collect activities from hundreds or even thousands of neurons simultaneously. Visualization of neural population dynamics can help neuroscientists analyze large-scale neural activities efficiently. In this letter, Laplacian eigenmaps is applied to this task for the first time, and the experimental results show that the proposed method significantly outperforms the commonly used methods. This finding was confirmed by the systematic evaluation using nonhuman primate data, which contained the complex dynamics well suited for testing. According to our results, Laplacian eigenmaps is better than the other methods in various ways and can clearly visualize interesting biological phenomena related to neural dynamics.

Genome-wide association study identified genes in the response to Salmonella pullorum infection in chickens

Pullorum is a bacterial disease that threatens the modern poultry industry. Over the years, research on this topic has focused mainly on its epidemiology, whereas the hosts' genetic basis of infection is still vague. In order to identify chickens' genes associated with pullorum, we sequenced 300 New Pudong chicken by double digest genotyping-by-sequencing. We obtained 1 527 953 SNPs for a genome-wide association analysis, which identified 43 genome-wide significant markers. Most of the significant SNPs were in the interval of 57.7-59.0 Mb on chromosome 5. The gene set enrichment analysis suggests a potential manner for bacterial infection and remaining inside the host. This work provides basic data for the purification, prevention and treatment of pullorum disease.

Construction of a novel DNA vaccine candidate targeting F gene of genotype VII Newcastle disease virus and chicken IL-18 delivered by Salmonella

AIMS

Genotype VII Newcastle disease (ND) is one of the most epidemic and serious infectious diseases in the poultry industry. A novel vaccine targeting VII Newcastle disease virus (NDV) is still proving elusive.

METHODS AND RESULTS

In this study, we constructed regulated delayed lysis Salmonella strains expressing either a fusion protein (F) alone under an eukaryotic CMV promoter or together with chicken IL-18 (chIL-18) as a molecular adjuvant under prokaryotic P_trc promoter, named pYL1 and pYL23 respectively. Oral immunization with recombinant strains induced NDV-specific serum IgG antibodies in both pYL1- and pYL23-immunized chickens. The presence of chIL-18 significantly increased lymphocyte proliferation in immunized chickens, as well as the percentages of CD3⁺ CD4⁺ and CD3⁺ CD8⁺ T cells in serum, even if a statistically significant difference did not exist. After a virulent challenge, pYL23 immunization provided about 80% protection at day 10 postinfection, compared with 60% of protection offered by pYL1 immunization and 100% protection in the inactivated vaccine group, indicating the enhanced immune response provided by chIL-18, which was also confirmed by histochemical analysis.

CONCLUSIONS

Recombinant lysis Salmonella-vectored DNA vaccine could provide us a novel potential option for controlling NDV infection.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study took use of a regulated delayed lysis Salmonella vector for the design of an orally administrated vaccine against NDV.