CT texture analysis for the presurgical prediction of superior mesenteric-portal vein invasion in pancreatic ductal adenocarcinoma: comparison with CT imaging features

AIM

To investigate the value of computed tomography (CT) texture analysis (TA) and imaging features for evaluating suspected surgical superior mesenteric-portal vein (SMPV) invasion in patients with pancreatic ductal adenocarcinoma (PDAC).

MATERIALS AND METHODS

Fifty-four patients with PDAC in the pancreatic head or uncinate process with suspected SMPV involvement were analysed retrospectively. SMPV invasion status was identified by surgical exploration. For each patient, 396 texture features were extracted on pretreatment CT. Non-parametric tests and minimum redundancy maximum relevance were used for feature selection. A CTTA model was constructed using multivariate logistic regression, and the area under the receiver operating characteristic (AUROC) of the model was calculated. Two reviewers evaluated qualitative imaging features independently for SMPV invasion and interobserver agreement was investigated. The diagnostic performance of the imaging features and the CTTA model for SMPV invasion was compared using the McNemar test.

RESULTS

Of the 54 patients with PDAC, SMPV invasion was detected in 23 (42.6%). The CTTA model yielded an AUROC of 0.88 (95% confidence interval, 0.76-0.97) and achieved significantly higher specificity (0.90) than the two reviewers (0.61 and 0.65; p=0.027 and 0.043). Interobserver agreement was moderate between the two reviewers (κ = 0.517). Of the 13 cases with disagreement between the two reviewers, 11 cases were predicted accurately by the CTTA model.

CONCLUSION

CTTA can predict suspected SMPV invasion in PDAC and may be a beneficial addition for qualitative imaging evaluation.

Relationship between NogoA/NgR1/RhoA signaling pathway and the apoptosis of cerebral neurons after cerebral infarction in rats

OBJECTIVE

The aim of this study was to investigate the effect and the mechanism of the NogoA/NgR1/RhoA signaling pathway on the apoptosis of neurons in cerebral infarction (CI) rats. Our findings might provide references for clinical prevention and treatment of CI.

MATERIALS AND METHODS

A total of 60 adult male Wistar rats were randomly divided into 3 groups, including: Sham operation group (Sham group), CI group, and CI + NogoA gene knockout group (CI + NogoA KO group) using a random number table. The model of CI was successfully constructed using suture method in rats of CI group and CI + NogoA KO group. Only blood vessels were exposed in Sham group. At 2 days after CI operation, the rats were killed, and brain tissues were collected. Reverse Transcription-Polymerase Chain Reaction (RT-PCR) and Western blotting were used to detect the messenger ribonucleic acid (mRNA) and protein expression levels of NogoA/NgR1/RhoA in brain lesion tissues of rats in the three groups, respectively. Subsequently, the pathological damage of brain tissues was detected via hematoxylin and eosin (H&E) staining. TTC staining was carried out to evaluate the infarction area in each group. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining was conducted to measure the apoptosis level of neurons in brain tissues of rats in each group. Additionally, the level of Nissl's body in brain tissues of each group was examined by Nissl staining. Furthermore, the expression level of the platelet-derived growth factor (PDGF) in brain tissues of rats in the three groups was measured via immunohistochemistry.

RESULTS

The mRNA and protein expression levels of the NogoA/NgR1/RhoA signaling pathway in brain tissues of rats in CI group increased significantly (p<0.05). NogoA KO could significantly reduce the infarction area of brain tissues in rats (p<0.05). H&E staining and Nissl's body staining revealed that neurons in the brain tissues of rats showed evident edema and disordered arrangement after CI. Meanwhile, the number of Nissl's body was remarkably reduced. However, after KO of NogoA, brain tissue damage was significantly alleviated in rats, and the number of Nissl's body increased remarkably at the same time (p<0.05). According to TUNEL staining results, inhibiting NogoA could notably reverse CI-induced apoptosis of neurons in brain tissues of rats (p<0.05). Immunohistochemical staining results demonstrated that the expression of PDGF in brain tissues of rats in CI group decreased markedly, whereas was significantly elevated in rats of CI + NogoA KO group (p<0.05).

CONCLUSIONS

The expression of the NogoA/NgR1/RhoA signaling pathway was significantly elevated in brain tissues of CI rats. Furthermore, suppressing the NogoA/NgR1/RhoA signaling pathway could reduce CI-induced apoptosis of neurons in rats.

Sugar in Beverage and the Risk of Incident Dementia, Alzheimer's Disease and Stroke: A Prospective Cohort Study

BACKGROUND

This study aimed to investigate the association between sugar in beverage and dementia, Alzheimer Disease (AD) dementia and stroke.

METHODS

This prospective cohort study were based on the US community-based Framingham Heart Study (FHS). Sugar in beverage was assessed between 1991 and 1995 (5th exam). Surveillance for incident events including dementia and stroke commenced at examination 9 through 2014 and continued for 15-20 years.

RESULTS

At baseline, a total of 1865 (63%) subjects consumed no sugar in beverage, whereas 525 (18%) subjects consumed it in 1-7 servings/week and 593 (29%) in over 7 servings/week. Over an average follow-up of 19 years in 1384 participants, there were 275 dementia events of which 73 were AD dementia. And 103 of 1831 participants occurred stroke during the follow-up nearly 16 years. After multivariate adjustments, individuals with the highest intakes of sugar in beverage had a higher risk of all dementia, AD dementia and stroke relative to individuals with no intakes, with HRs of 2.80(95%CI 2.24-3.50) for all dementia, 2.55(95%CI 1.55-4.18) for AD dementia, and 2.11(95%CI 1.48-3.00) for stroke. And the same results were shown in the subgroup for individuals with median intakes of sugar in beverage.

CONCLUSION

Higher consumption of sugar in beverage was associated with an increased risk of all dementia, AD dementia and stroke.

[Risk assessment of global COVID-19 imported cases into China]

Objective: To assess the risk of COVID-19 foreign imports cases to China. Methods: We collected epidemic data (cumulative daily confirmed cases in each country, cumulative confirmed imported cases), demographic data (population density, population) and information on potential source groups of tourists (the daily estimated number of overseas Chinese, overseas Chinese students, overseas workers, foreign students coming to China and flight passengers) and the global health security index (GHS) to assess and predict risk of imported cases for recent (February 1(st) to April 25(th)) and future (after April 26(th)). Results: Strong positive correlation was found among variables including the number of imported cases, cumulative confirmed cases, attack rate, number of overseas Chinese, number of overseas Chinese students, number of foreign students coming to China, number of flight passengers and GHS. In the recent risk analysis, imported cases of Russian were the highest, followed by United Kingdom, United States, France and Spain. In the future risk prediction, 44 countries including United States and Singapore are evaluated as potential high-risk countries in the future through the attack rate index of each country and the estimated average number of daily passengers. Conclusion: The risk assessment of COVID-19 imported cases can be used to identify high-risk areas in recent and future, and might be helpful to strengthen the prevention and control of the epidemic and ultimately overcome the epidemic.

[Inference of start time of resurgent COVID-19 epidemic in Beijing with SEIR dynamics model and evaluation of control measure effect]

Objective: To infer the start time of the resurgent COVID-19 epidemic in Xinfadi wholesale market in Beijing in June 2020 and evaluate the effect of comprehensive prevention and control measures in this epidemic. Methods: SEIR dynamics model was used to fit daily onset infections to search the start date of this resurgent COVID-19 epidemic in Beijing. The number of cumulative infections from June 12 to July 1 in Beijing were fitted considering different levels of control strength. Results: The current reemerged COVID-19 epidemic in Beijing probably started between May 22 and May 28 (cumulative probability: 95%), with the highest probability on May 25 (23%). The R(0) of the current reemerged COVID-19 epidemic was 4.22 (95%CI: 2.88-7.02). Dynamic model fitting suggested that by June 11, the cumulative number of COVID-19 cases would reached 99 (95%CI: 77-121), which was in line with the actual situation, and without control, by July 1, the cumulative number of COVID-19 cases would reach 65 090 (95%CI: 39 068-105 037). Since June 12, comprehensive prevention and control measures have been implemented in Beijing, as of July 1, compared with uncontrolled situation, the number of infections had been reduced by 99%, similar to the fitting result of a 95% reduction of the transmission rate. The sensitivity analysis showed consistent results. Conclusions: For the emergent outbreak of COVID-19, the dynamics model can be used to infer the start time of the transmission and help tracing the source of epidemic. The comprehensive prevention and control measures taken in Beijing have quickly blocked over 95% of the transmission routes and reduced 99% of the infections, containing the sudden epidemic timely and effectively, which have value in guiding the prevention and control of the epidemic in the future.

[Using Markov Chain Monte Carlo methods to estimate the age-specific case fatality rate of COVID-19]

Objectives: The COVID-19 epidemic has swept all over the world. Estimates of its case fatality rate were influenced by the existing confirmed cases and the time distribution of onset to death, and the conclusions were still unclear. This study was aimed to estimate the age-specific case fatality rate of COVID-19. Methods: Data on COVID-19 epidemic were collected from the National Health Commission and China CDC. The Gamma distribution was used to fit the time from onset to death. The Markov Chain Monte Carlo simulation was used to estimate age-specific case fatality rate. Results: The median time from onset to death of COVID-19 was M=13.77 (P(25)-P(75): 9.03-21.02) d. The overall case fatality rate of COVID-19 was 4.1% (95%CI: 3.7%-4.4%) and the age-specific case fatality rate were 0.1%, 0.4%, 0.4%, 0.4%,0.8%, 2.3%, 6.4%, 14.0 and 25.8% for 0-, 10-, 20-, 30-, 40-, 50-, 60-, 70- and ≥80 years group, respectively. Conclusions: The Markov Chain Monte Carlo simulation method adjusting censored is suitable for case fatality rate estimation during the epidemic of a new infectious disease. Early identification of the COVID-19 case fatality rate is helpful to the prevention and control of the epidemic.

Sirt6 regulates autophagy in AGE-treated endothelial cells via KLF4

Aims

To explore Sirt6 regulating autophagy in endothelial cells and the specific mechanism of this function with involvement of KLF4.

Materials and methods

Human umbilical vein endothelial cells were cultured with advanced glycation end products (AGE) treatment. Adv-Sirt6, LV-Sirt6 and LV-KLF4 were used to knockup Sirt6 and knockdown Sirt6 and KLF4 respectively. qPCR and Western Blotting were used to detect the mRNA and protein expression of Sirt6 and KLF4. Laser scanning confocal microscope was used to observe the LC3-II marked autophagosomes. Wildlife BALB/c mice were treated with STZ to produce diabetic mice model. AAV-Sirt6 was injected by tail vein injection to achieve Sirt6 knockdown. HE staining and scanning electron microscope were used to observe the aortic intima condition and autophagosomes number respectively.

Results

In AGE treated HUVECs, knockdown of Sirt6 led to impaired autophagy level along with less expression of autophagic markers LC3-II, Beclin-1, Lamp2 and autophagic marker p62. Knockdown and knockup of Sirt6 directly affected KLF4 expression level but KLF4 didn't have any effect on Sirt6 expression. Knockout of KLF4 offset the augmented autophagy caused by overexpression of Sirt6. In high-fat fed diabetic mice, downregulation of Sirt6 led to better cardiac function along with less autophagosomes and impaired aortic intima integrity.

Conclusions

Sirt6 improves autophagy both in vivo and in vitro and Sirt6 regulates autophagy via KLF4 in HUVECs.

Funding Acknowledgement

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

Comparing nanoparticle polymeric micellar paclitaxel and solvent-based paclitaxel as first-line treatment of advanced non-small-cell lung cancer: an open-label, randomized, multicenter, phase III trial

BACKGROUND

Polymeric micellar paclitaxel (pm-Pac) is a novel Cremophor EL-free, nanoparticle micellar formulation of paclitaxel. We aimed to compare the efficacy and safety between pm-Pac plus cisplatin and solvent-based paclitaxel (sb-Pac) plus cisplatin in advanced non-small-cell lung cancer (NSCLC).

PATIENTS AND METHODS

A total of 448 stage IIIB to IV NSCLC patients were randomly assigned (2:1) to receive six 3-week cycles of either pm-Pac (230 mg/m²) plus cisplatin (70 mg/m²; n = 300), followed by dose escalation of pm-Pac to 300 mg/m² from the second 3-week cycle if prespecified toxic effects were not observed after the first cycle, or sb-Pac (175 mg/m²) plus cisplatin (70 mg/m²; n = 148). The primary end point was objective response rate (ORR) assessed by independent review committees (IRCs). The secondary end points included IRC-assessed progression-free survival (PFS), overall survival (OS), and safety.

RESULTS

Patients in the pm-Pac-plus-cisplatin group showed significant improvements in IRC-assessed ORR compared with those in the sb-Pac-plus-cisplatin group (50% versus 26%; rate ratio 1.91; P < 0.0001). Additionally, subgroup analysis showed that a higher ORR was consistently observed in both squamous and nonsquamous histological types. IRC-assessed median PFS was significantly higher in the pm-Pac-plus-cisplatin group than in the sb-Pac-plus-cisplatin group (6.4-month versus 5.3-month; hazard ratio 0.63; P = 0.0001). Median OS was not significantly different between the two groups. The incidence of treatment-related serious adverse events (9% versus 18%; P = 0.0090) was significantly lower in the pm-Pac-plus-cisplatin group than in the sb-Pac-plus-cisplatin group.

CONCLUSION

Pm-Pac plus cisplatin yielded superior ORR and PFS along with a favorable safety profile and should become an option for patients with advanced NSCLC.

CLINICAL TRIAL IDENTIFIER

ClinicalTrials.gov NCT02667743; https://clinicaltrials.gov/ct2/show/NCT02667743.

Apply Molecular Method To Diagnosis A Very Rare Bone Primary Myoepithelial Tumor: A Case Report

Introduction/Objective

A 38-year-old female without a history of trauma and malignancy presented with left knee pain and swelling for two weeks. MRI and PET scan find a left knee mass arising from the bone along the medial metaphysis of the distal femur. She underwent femur resection, and the specimen was sent for pathology evaluation.

Methods

Grossly, the cut surface of the sample revealed a 4.5 x 2 cm area of hemorrhagic softening of the bone with adjacent soft tissue nodules. Microscopically, the tumor showed biphasic or multiphase morphologic features, prominently presented with areas showing well-differentiated epithelial features and other areas with spindling and sheets of tumor cells. Areas suspicious for a vascular invasion were seen at the periphery of the soft tissue extension of the tumor. Immunohistochemistry stains showed the tumor cells are positive for vimentin, AE1/3, EMA, CK7, CK19, GATA3, and BRST2; and are negative for S100, HMB45, GFAP, Calponin, CDX2, PAX8, WT1, P63, CD34, and ER. The molecular test showed positive for the ESWR1 gene but negative for SYT gene translocation.

Results

A diagnosis of primary myoepithelial carcinoma of bone extension into surrounding soft tissue was made.

Conclusion

The most challenging differential diagnosis for this case is metastatic breast cancer. Many of the positive epithelial stains distinctly highlight the epithelial featured geographic areas sparing the background spindled stroma. The positive staining of GATA3 and BRST2, two commonly used breast linage markers, is unusual and not known in myoepithelial carcinoma. In light of the EWSR1 positive and SYT FISH negative results, combined with the morphologic features, locations as well as negative PET scan against its breast origins. Although many myoepithelial markers, such as S100, Calponin, P63, and GFAP were negative, make this case very unique. The molecular diagnosis is the mainstay for this final diagnosis.

Pulmonary Cement Emboli After Kyphoplasty: A Case Of Bilateral Pulmonary Emboli And Exacerbation Of Interstitial Lung Disease

Introduction/Objective

Osteoporosis often complicates the management of vertebral conditions, including spinal stenosis and vertebral fractures in the geriatric population. In addition to pharmacologic pain management; surgical interventions are employed if the pain is not adequately managed. The surgical interventions include vertebroplasty and kyphoplasty. These procedures involve the introduction of a cement polymer, Polymethylmethacrylate (PMMA), into the vertebral body. Cement leakage is a reported complication more commonly seen in vertebroplasty (30-75%) compared to kyphoplasty (8-33%). This occurs due to distant leakage of cement into the venous plexus or retrograde migration into the aorta which leads to pulmonary cement emboli (PCE). PCE are usually asymptomatic; few patients are symptomatic; seen in 0.9% for vertebroplasty and 0.4% for kyphoplasty. PMMA has a prothrombotic effect, contributing to the thrombosis of the pulmonary vessels. Symptoms typically arise weeks to months after the procedure. In addition, it has been reported that rarely PCE can present with ARDS especially in patients with interstitial lung abnormalities.

Methods

We present a case of an 80-year-old female with a history of hypertension, diabetes mellitus and osteoporosis who underwent a kyphoplasty procedure with use of PMMA for spinal stenosis. Her post-operative course was complicated by multiple surgical revisions. She was noted to have pulmonary cement emboli five months post kyphoplasty and developed significant shortness of breath eight months post procedure. She ultimately developed cardio-pulmonary failure and was found to have bilateral pulmonary emboli and cement emboli at autopsy. Microscopic examination of the cement emboli documented round to oval vacuole-like cavities within and around blood vessels consistent with PMMA.

Conclusion

The histo-pathologic findings of cement emboli are not well documented in human beings compared to animal models. We attempt to highlight the gross and microscopic findings of PMMA cement emboli which is essential in the clinical-histo-pathologic correlation and characterization of pulmonary emboli at autopsy.

Identification Of Liver Fluke Eggs In Bile Duct Brush Cytology In An 82 Year Old Man With A Hepatic Mass: Report Of A Case

Introduction/Objective

Clonorchis sinensis infects the liver, gallbladder, and bile ducts in humans. It is acquired via consumption of raw/undercooked fish, crabs, or crayfish in endemic areas. Though majority are asymptomatic, long lasting infections may cause severe disease. Without treatment, human infections may persist for the parasite lifespan (25–30 years). Diagnosis in cytology is challenging with a potentially acellular sample with miniscule eggs that can be overlooked as an artifact. Here we reported a rare case of liver fluke eggs diagnosed in bile duct brush cytology.

Methods

An 82 year old man who emigrated from China 20 years prior presented to the hospital with worsening jaundice for 2 weeks. Abdominal CT revealed a 4.8 x 2.9 cm central right hepatic lobe mass extending to the hilum, obstructing the bile ducts, resulting in severe intrahepatic ductal dilatation and stricture and focal occlusion of the right anterior portal vein. His CBC revealed eosinophilia. Bile duct brushing was submitted for cytology.

Results

ThinPrep and cell block showed oval-shaped parasite eggs measuring 10-24 µm. There was no other cellular matter. Eggs had a convex operculum resting on “shoulders” at the smaller end of the egg. At the opposite (abopercular) end, a small knob or hook-like protrusion was often visible. Wet mounts revealed visible miracidium inside the eggs. These findings were compatible with liver fluke eggs.

Conclusion

Cytologic microbiologic features of fluke eggs confirmed the findings. The most important features are the shape and size of the eggs; The seated operculum with its prominent “shoulders”, a small knob at the abopercular end, which can distinguish them from acellular artifact or a human cell. The cytologic and microbiologic features combined with the travel history and clinical presentation can aid in achieving the diagnosis.

Nanoscale bubble delivered YCD-TK/Cx26 gene therapeutic system suppresses tumor growth by inducing necrosis of tumor tissues in mouse Xenograft bladder cancer models

OBJECTIVE

Bladder cancer is considered as the fifth most common cancer in the whole world. This study aimed to investigate the anti-tumor effects of Nanoscale bubbles delivered yeast cytosine deaminase thymidine kinase/connexin 26 (YCD-TK/Cx26) on tumor cell proliferation and tumor growth.

MATERIALS AND METHODS

Nanoscale bubble was prepared using thin-film hydration-sonication method. Nanoscale bubble-LV5-YCD-TK+PCD-Cx26 was generated and transfected into BIU-87 cells. MTT assay was employed to detect cell viability. Apoptosis was determined using a flow cytometry assay. YCD-TK and Cx26 expressions were detected using Western blot and Real Time-PCR (RT-PCR). BIU-87 cells were transplanted into mice to establish Xenograft models. The tumor volume was recorded. HE staining was used to examine necrosis areas in tumor tissues.

RESULTS

Nanoscale bubble (Nanoscale bubble-LV5-YCD-TK+PCD-Cx26) successfully mediated YCD-TK and Cx26 gene expression in BIU-87 cells. Nanoscale bubble delivered YCD-TK/Cx26 expression significantly inhibited cell viability and induced apoptosis compared to Nanoscale bubble-LV5-YCD-TK and Nanoscale bubble group (p<0.05). Nanoscale bubble delivered YCD-TK/Cx26 expression triggered significantly higher levels of bystander effect compared to single YCD-TK or single Cx26 gene (p<0.05). Nanoscale bubble delivered YCD-TK/Cx26 expression significantly reduced tumor volume in mouse Xenograft bladder cancer model compared to LV5-YCD-TK and 5-FC+GCV group (p<0.05). Nanoscale bubble delivered YCD-TK/Cx26 expression significantly reduced the necrosis of tumor tissues in mouse Xenograft bladder cancer model compared to LV5-YCD-TK group and 5-FC+GCV group (p<0.05).

CONCLUSIONS

Nanoscale bubble delivered YCD-TK/Cx26 gene therapeutic system efficiently reduced BIU-87 cell proliferation in vitro, and suppressed tumor growth by inducing necrosis of tumor tissues in mouse Xenograft bladder cancer models.

Influence of mesenchymal stem cells on respiratory distress syndrome in newborn swines via the JAK-STAT signaling pathway

OBJECTIVE

Acute respiratory distress syndrome (ARDS) threatens humans' health worldwide, causing huge labor and economic cost investment. This study aims to explore whether mesenchymal stem cells (MSCs) affect RDS in newborn swines via the Janus kinase-signal transducers and activators of transcription (JAK-STAT) signaling pathway by the establishment of the model of the disease.

MATERIALS AND METHODS

The phosphorylation of the JAK-STAT signal transduction proteins was first detected via Western blotting to verify the regulatory effect of MSCs on RDS in newborn swines through the JAK-STAT signaling pathway. Then, the Reverse Transcription-Polymerase Chain Reaction (RT-PCR) was utilized to analyze the influences of the injection of MSCs into the blood of newborn model RDS swines on inflammatory factors in vivo. To further demonstrate the signal transduction function put forwarded, the RT-PCR and enzyme-linked immunosorbent assay (ELISA) were adopted to analyze the influences of the JAK-STAT signaling pathway inhibitor on the expression of the signature proteins of RDS in newborn swines and the changes in the inflammatory factors.

RESULTS

MSCs induced the phosphorylation of JAK and STAT, and they activated the JAK-STAT signal transduction of RDS in newborn swines. Compared with those in normal saline group, the interleukin (IL)-2, IL-6, IL-8, and tumor necrosis factor-α (TNF-α) expression levels in MSC group were increased, namely, MSCs substantially promoted their expression levels (p<0.05), but those of IL-10 and IL-13 were significantly decreased (p<0.05).

CONCLUSIONS

The inhibitor of the JAK-STAT signaling pathway can suppress the therapeutic effect of MSCs on RDS in newborn swines.

Silence of MiR-9 protects depression mice through Notch signaling pathway

OBJECTIVE

To investigate the potential influence of micro ribonucleic acid (miR)-9 on depressive behaviors of depression mice.

MATERIALS AND METHODS

Depression model in mice was established via chronic unpredictable mild stress. A total of 36 C57BL/6 mice were randomly divided into control group (control mice, n=12), model group (depression mice administrated with control lentivirus, n=12) and miR-9 low-expression group (depression mice administrated with LV-miR-9-shRNA lentivirus, n=12). After 6 weeks, the depressive behaviors of mice were evaluated by behavioral experiments. Mice were then sacrificed for harvesting the hippocampus. Relative level of miR-9 in mouse hippocampus was determined via quantitative polymerase chain reaction (qPCR). Moreover, the number of newborn neurons in the hippocampus in each group was detected via immunofluorescence assay. Expression levels of doublecortin (DCX), post-synaptic density protein 95 (PSD95) and Notch signaling pathway in the hippocampus in each group were detected via Western blotting.

RESULTS

In the open field test, there were no significant differences in the crossing score and rearing score among control group, model group and miR-9 low-expression group (p>0.05). The immobility time of mice in tail suspension test and forced swimming test increased significantly in model group compared with that in control group (p<0.01), while it was significantly shorter in miR-9 low-expression group than that in model group (p<0.01). The expression of miR-9 in mouse hippocampus in model group was significantly higher than that in control group and miR-9 low-expression group (p<0.01). In miR-9 low-expression group, the number of newborn neurons in the hippocampus was significantly larger than that in control group and model group (p<0.01). Protein levels of both DCX and PSD95 were significantly higher in control group than those in model group (p<0.01). Besides, protein levels of Notch intracellular domain (NICD), Hes1 and Jag1 in the hippocampus in model group were remarkably declined compared with those in control group (p<0.01), which were higher in miR-9 low-expression group.

CONCLUSIONS

MiR-9 is upregulated in the hippocampus of depression mice. Silence of miR-9 in the hippocampus can effectively activate the Notch signaling pathway, promote the neuronal regeneration in the hippocampus and improve the depressive symptoms of mice.

Biomass-Derived, Water-Induced Self-Recoverable Composite Aerogels with Robust Superwettability for Water Treatment

Polluted water is a worldwide problem; therefore, effective separation of oil/water and removal of dyes, organic micropollutants, and heavy metals in wastewater are the need of the hour. Herein, hydrophilic β-cyclodextrin-grafted carboxymethyl cellulose, biodegradable polyvinyl alcohol, and chitosan were used as main raw materials to construct a multifunctional aerogel framework by simple sol-gel and directional freeze-drying methods. Featuring intrinsic superamphiphilic wettability in air, robust superoleophobic wettability underwater, and excellent shape-recovery characteristics, the biomass-derived aerogel presents durable oil/water separation even after 10 cycles. The aerogels possess prominent adsorption capacity for methyl blue, 1-naphthylamine, and Cu²⁺, which was as high as 121.55 mg/g, 33.96 mg/g, and 122.6 mg/g, respectively. In addition, various pollutant mixtures could be effectively adsorbed by the aerogel at the same time with the adsorption capacity of 121.75 mg/g for methyl blue, 0.97 mg/g for bisphenol A, and 20.11 mg/g for Cu²⁺.

[CAR T-cell bridging to allo-HSCT for relapsed/refractory B-cell acute lymphoblastic leukemia: the follow-up outcomes]

Objective: This study aims to investigate the efficacy and safety of chimeric antigen receptor (CAR) T-cell bridging allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of recurrent and refractory acute B-lymphocytic leukemia (R/R B-ALL) . Methods: A total of 50 R/R B-ALL patients who underwent CAR T-scell therapy to bridge allo-HSCT in the First Affiliated Hospital of Soochow University from January 2017 to May 2019 were retrospectively analyzed. The overall survival (OS) rate, event-free survival (EFS) rate, cumulative recurrence rate (CIR) , and transplant-related mortality (TRM) of patients with different bone marrow minimal residual disease (MRD) levels were analyzed before and after CAR T-cell infusion and before allo-HSCT. Results: The response rate of CAR T-cell therapy and the incidence rate of severe cytokine release syndrome were 92% and 28% , respectively. During 55 infusions, no treatment-related deaths occurred in any of the patients. The median time of CAR T-cell infusion to allo-HSCT was 54 (26-232) days, the median follow-up time after CAR T-cell infusion was 637 (117-1097) days, and the 1-year OS and EFS rates were (80.0±5.7) % and (60.0±6.9) % . The 1-year CIR and TRM after allo-HSCT were (28.0±0.4) % and (8.0±0.2) % . After CAR T-cell infusion and before allo-HSCT, patients with bone marrow MRD<0.01% had a significantly longer EFS [ (70.0±7.2) % vs (20.0±12.6) % , P<0.001; (66.7±7.5) % vs (36.4±14.5) % , P=0.008]and lower CIR [ (25.0±0.5) % vs (70.0±2.6) % , P<0.001; (23.08±0.47) % vs (45.45±2.60) % , P=0.038]. Conclusion: CAR T-cell therapy bridging allo-HSCT is safe and effective for recurrent and refractory B-ALL.

Effectiveness of health promoting school program: The relationship of HPS award level and outcome

Background

According to Taiwan health promoting school (HPS) accreditations program, the school was recognized with a gold award, silver award, bronze award, participation award, and non-awards. Previous studies have foci on the effectiveness of the HPS from the perspective of students' health behaviors. The main purpose of this study is to compare the students' health and social outcomes in different HPS award levels to assess the effectiveness of the HPS program.

Methods

This cross-sectional survey was conducted to 121 schools registering HPS accreditation program in 2018. Overall, a total of 8812 elementary, junior and senior high school students completed the questionnaire. The accredited schools were classified into four categories according to the award level: excellent (5 schools with gold), good (32 schools with silver), fair (23 schools with bronze and 18 schools with participation), and poor (44 schools with non-award). The outcome variables included perceived health status, well-being, and quality of life. The descriptive statistics and ANOVA were analysed using SPSS 20.0 software.

Results

There were awards level differences of students' health (F = 10.66, p&lt;.001) and social outcomes (e.g. well-being: F = 3.76, p&lt;.01; quality of life: F = 11.58, p&lt;.001). From the perspective of health outcomes, the results found that schools with excellent level (Mean=3.59), good level (Mean=3.52), and fair level (Mean=3.47) were better in students' perceived health status than schools with poor level (Mean=3.38). Similarly, the results showed that schools with excellent level were better in students' well-being (Mean=7.63) and quality of life (Mean=34.56) than schools with poor level (Mean=7.25; 33.56).

Conclusions

Students from schools with excellent levels exhibited better health and social outcomes. The finding suggests that future studies evaluate and track the effectiveness to conduct the longitudinal study, and the HPS program should be effectively implemented and sustained.

Key messages

To explore the effectiveness of the health promoting school program in health and social outcomes. Note: This work was funded by the Health Promotion Administration, Ministry of Health and Welfare. Health promoting schools award level is related to students’ perceived health status, well-being, and quality of life.

[Principles of dynamics model and its application in forecasting the epidemics and evaluation the efforts of prevention and control interventions]

During the epidemics of COVID-19 in domestic China and recently continuing rapid spread worldwide, a bunch of studies fitted the epidemics by transmission dynamics model to nowcast and forecast the trend of epidemics of COVID-19. However, due to little known of the new virus in early stage and much uncertainty in the comprehensive strategies of prevention and control for epidemics, majority of models, not surprisingly, predict in less accuracy, although the dynamics model has its great value in better understanding of transmission. This comment discusses the principle assumptions and limitations of the dynamics model in forecasting the epidemic trend, as well as its great potential role in evaluating the efforts of prevention and control strategies.

Melatonin activates autophagy via the NF-κB signaling pathway to prevent extracellular matrix degeneration in intervertebral disc

OBJECTIVE

This study investigated whether melatonin alleviates intervertebral disc degeneration (IVDD) by promoting autophagy through inhibiting the NF-κB signaling pathway.

METHODS

Magnetic resonance imaging (MRI), hematoxylin and eosin (H&E) staining and Safranin-O staining were used to measure disc degeneration in rat needle puncture IVDD models, and melatonin was injected intraperitoneally in the treated group to test its function. The expression of autophagy and extracellular matrix (ECM) degeneration related-markers were measured in the discs using immunohistochemistry. Transmission electron microscopy was used to evaluate the activation of autophagy in human nucleus pulposus (NP) tissues with different degenerated statuses. The expression of autophagy and disc degeneration related-markers were detected in NP cells by Western blot, RT-qPCR, and immunofluorescence analyses. NF-κB signaling pathway involvement was studied by lentivirus-mediated knockdown, Western blotting, and immunohistochemistry and immunofluorescence staining.

RESULTS

Melatonin prevented IVDD development in vivo and in vitro. Compared to non-degenerated disc tissues, degenerated human NP tissues showed a decrease in the autophagy-specific marker LC3B and the numbers of autophagosomes and autolysosomes, whereas the p62 level was increased; similar results were observed in rat IVDD models, indicating a negative correlation between autophagy and IVDD. Furthermore, both in vivo and in vitro studies found that melatonin application induced autophagy and reduced ECM disc degradation. Melatonin was also shown to regulate autophagy by inhibiting the NF-κB signaling pathway in vivo and vitro.

CONCLUSION

This study indicates that melatonin prevents IVDD by promoting autophagy, indicating its possible therapeutic potential for controlling the progression of IVDD.

ADMA mediates gastric cancer cell migration and invasion via Wnt/β-catenin signaling pathway

Objective

To explore the role of ADMA in gastric cancer.

Methods

The specimens of 115 gastric cancer patients were analyzed by ELISA and survival analysis. Functional assays were used to assess the effects of ADMA on gastric cancer cells. Experiments were conducted to detect the signaling pathway induced by ADMA in GC.

Results

Gastric cancer patients with high ADMA levels had poor prognosis and low survival rate. Furthermore, high level of ADMA did not affect the proliferation while promoted the migration and invasion of gastric cancer cell. Moreover, ADMA enhanced the epithelial–mesenchymal transition (EMT). Importantly, ADMA positively regulated β-catenin expression in GC and promoted GC migration and invasion via Wnt/β-catenin pathway.

Conclusions

ADMA regulates gastric cancer cell migration and invasion via Wnt/β-catenin signaling pathway and which may be applied to clinical practice as a diagnostic and prognostic biomarker.

Electronic supplementary material

The online version of this article (10.1007/s12094-020-02422-7) contains supplementary material, which is available to authorized users.

Characterization of carbapenem-resistant Klebsiella pneumoniae in a tertiary hospital in Fuzhou, China

Aims

The emergence of carbapenem‐resistant Klebsiella pneumoniae (CRKP) strains has led to increased mortality and morbidity rates. Tigecycline, a new class of broad‐spectrum glycyl‐tetracycline antibiotics, has been used to target multi‐ and pan‐drug‐resistant bacterial infections. This study aimed to assess the molecular characteristics of CRKP in a tertiary hospital, and its susceptibility to tigecycline, to create a reference for hospital infection control and clinical drug use.

Methods and Results

We retrieved patient clinical information and CRKP characterization from medical records and detected the MIC of tigecycline using the micro‐broth dilution method. Multi‐locus sequence typing was performed, and antibiotic resistance genes associated with CRKP were detected by qPCR. A total of 166 CRKP strains were detected in the sputum, urine and blood among intensive care unit patients (average age, 69·6 years). The most infrequently observed resistance genes were amikacin resistance genes, followed by tobramycin resistance genes. KPC‐2, CTX‐M9 and CTX‐M1 were the most frequently detected resistance genes.

Conclusions

No strain was resistant to tigecycline (MIC ≥ 8 µg ml⁻¹). Twenty‐four sequence types were identified, with ST11 being the most common type.

Significance and Impact of the Study

Clinicians and infection control experts should be aware of CRKP prevalence to facilitate clinical treatment and improve nosocomial infection control.

[Fitting and forecasting the trend of COVID-19 by SEIR(+CAQ) dynamic model]

Objectives: Fitting and forecasting the trend of COVID-19 epidemics. Methods: Based on SEIR dynamic model, considering the COVID-19 transmission mechanism, infection spectrum and prevention and control procedures, we developed SEIR(+CAQ) dynamic model to fit the frequencies of laboratory confirmed cases obtained from the government official websites. The data from January 20, 2020 to February 7, 2020 were used to fit the model, while the left data between February 8-12 were used to evaluate the quality of forecasting. Results: According to the cumulative number of confirmed cases between January 29 to February 7, the fitting bias of SEIR(+CAQ) model for overall China (except for cases of Hubei province), Hubei province (except for cases of Wuhan city) and Wuhan city was less than 5%. For the data of subsequent 5 days between February 8 to 12, which were not included in the model fitting, the prediction biases were less than 10%. Regardless of the cases diagnosed by clinical examines, the numbers of daily emerging cases of China (Hubei province not included), Hubei Province (Wuhan city not included) and Wuhan city reached the peak in the early February. Under the current strength of prevention and control, the total number of laboratory-confirmed cases in overall China will reach 80 417 till February 29, 2020, respectively. Conclusions: The proposed SEIR(+CAQ) dynamic model fits and forecasts the trend of novel coronavirus pneumonia well and provides evidence for decision making.

Abstracts of published randomised controlled trials in Endodontics: Reporting quality and spin

AIMS

To assess the reporting quality of recently published randomised controlled trial (RCT) abstracts in Endodontics, to investigate factors associated with reporting quality, and to evaluate the existence and characteristics of spin. Spin refers to reporting strategies that distort study results and misguide readers.

METHODOLOGY

The PubMed database was searched to identify abstracts of RCTs in the field of Endodontics published during 2017 to 2018. Two authors assessed the reporting quality of each included abstract using the original 16-item CONSORT for Abstracts checklist, with the overall quality score (OQS, range: 0 to 16) being the primary outcome measure. For each individual item, a score of '1' was given if it was described adequately, and '0' if the description was inadequate. Linear regression analyses were conducted to identify factors associated with reporting quality. For the evaluation of spin, two authors selected parallel-group RCTs with a nonsignificant primary outcome from the included abstracts, and evaluated independently the existence and characteristics of spin among these abstracts.

RESULTS

A total of 162 abstracts were included for assessment of reporting, for which the mean OQS was 3.97 (SD, 1.30; 95 % CI, 3.77 to 4.17). According to multivariable analysis, origin from Europe (P=0.001) and reporting of the exact P value (P=0.020) were significantly associated with better reporting. Forty abstracts with statistically nonsignificant results for their primary outcome were included for spin evaluation, among which 34 (85.0%) had at least one type of spin. Thirty-two abstracts (94.1%) had spin in their conclusions section, and six abstracts (17.6%) had spin in the results section.

CONCLUSIONS

The reporting quality of RCT abstracts in Endodontics needs to be improved. The occurrence rate of spin in the sample of abstracts of RCTs in the field of Endodontics was high. Relevant stakeholders are recommended to be familiar with the CONSORT for Abstracts guideline and develop active strategies to ensure its implementation.

[Application of external diaphragm pacemaker combination with high-flow nasal cannula in offline patients with postoperative severe cerebral hemorrhage]

Objective: To investigate the offline clinical effect of external diaphragm pacemaker (EDP) combination with High-flow nasal cannula oxygen therapy in postoperative severe cerebral hemorrhage patients. Methods: A total of 123 severe postoperative severe cerebral hemorrhage patients with tracheotomy and mechanical ventilation (MV) were selected, who were admitted in NICU of PLA Rocket Force Characteristic Medical Center from October 2016 to December 2019. These patients were randomly divided into the High-flow nasal cannula (HFNC) group (n=63) and HFNC+EDP group (n=60). In the HFNC group, the HFNC was given to the patients who were off ventilator. The HFNC+EDP group was added on the basis of treatment in the HFNC group, once a day and 30 minutes each time. Results: Compared to the HFNC group, the oxygenation index (OI) of the HFNC+EDP group was higher in the next 1, 12, 24 and 48 hour [(209±15) mmHg vs (218±18) mmHg, (215±14) mmHg vs (222±17) mmHg, (223±13) mmHg vs (235±15) mmHg, (236±7) mmHg vs (257±12) mmHg,P<0.05]. The offline time was shorter [(13±3) d vs (12±3) d,P<0.05]. The excursion of diaphragm was higher [(1.94±0.08) cm vs (2.91±0.11) cm,P<0.05]. The length of stay in NICU was shorter [(33±14) d vs (28±9) d,P<0.05]. The Glasgow Coma Scale (GCS) was higher when being discharged from the NICU (5.9±2.1 vs 7.8±0.4, P<0.05) and the hospital (9.9±2.1 vs 11.0±2.0, P<0.05). Conclusions: EDP combination with HFNC can increase the excursion of diaphragm, shorten the offline time and length of stay in the NICU, thereby enhancing the early recovery and improving the prognosis.

Matrix-material dependence on the elongation of embedded gold nanoparticles induced by 4 MeV C60 and 200 MeV Xe ion irradiation

We report the elongation of embedded Au nanoparticles (NPs) in three different matrices, i.e. amorphous carbon (a-C), crystalline indium tin oxide (In_xSn_1-xO_z; ITO) and crystalline calcium fluoride (CaF₂), under irradiations of 4 MeV C₆₀ ⁺ cluster ions and 200 MeV Xe¹⁴⁺ ions. Under 4 MeV C₆₀ cluster irradiation, strong sputtering is induced in CaF₂ layer so that the whole the layer was completely lost at a fluence of 5 × 10¹³ ions cm^-2. Au NPs were partly observed in the SiO₂, probably due to the recoil implantation. Amorphous carbon (a-C) layer exhibits low sputtering loss even under 4 MeV C₆₀ irradiation. However, the elongation in a-C layer was low. While the ITO layer showed a certain decrease in thickness under 4 MeV C₆₀ irradiation, large elongation of Au NPs was observed under both 4 MeV C₆₀ and 200 MeV Xe irradiation. The ITO layer preserved the crystallinity even after large elongation was induced. This is the first report of the elongation of metal NPs in a crystalline matrix.

First Measurements of Electrons and Waves inside an Electrostatic Solitary Wave

Electrostatic solitary wave (ESW)-a Debye-scale structure in space plasmas-was believed to accelerate electrons. However, such a belief is still unverified in spacecraft observations, because the ESW usually moves fast in spacecraft frame and its interior has never been directly explored. Here, we report the first measurements of an ESW's interior, by the Magnetospheric Multiscale mission located in a magnetotail reconnection jet. We find that this ESW has a parallel scale of 5λ_{De} (Debye length), a superslow speed (99  km/s) in spacecraft frame, a longtime duration (250 ms), and a potential drop eφ_{0}/kT_{e}∼5%. Inside the ESW, surprisingly, there is no electron acceleration, no clear change of electron distribution functions, but there exist strong electrostatic electron cyclotron waves. Our observations challenge the conventional belief that ESWs are efficient at particle acceleration.

The Application of Non-linear Flow Resistance in Cerebral Artery: Compared with Windkessel Model based on Genetic Algorithm

Continuous blood pressure is measured from various extracranial body sites, with difference in amplitude and phase with intracranial blood pressure. Consequent influences on the accuracy of Windkessel model need further investigation. Between blood pressure and intracranial flow rate, a model with non-linear flow resistance (R-DT) was proposed and compared with the 3-element Windkessel (RCR) model. From the measured blood flow velocity in middle cerebral artery, the blood pressure was estimated by R-DT and RCR models respectively. The parameters in the models were optimized by genetic algorithm. The accuracies of R-DT and RCR models were compared based on their estimation errors to the measured blood pressure. The capacitance element in RCR model indicated limited ability to take the time shift into account. Compared with RCR model, R-DT model had less error (averaged relative error: 5.19% and 2.49% for RCR and RDT models). The non-linear flow resistance was applicable in simulating cerebral arteries.

[The application of intravoxel incoherent motion diffusion imaging and 3D arterial spin labeling perfusion imaging in the evaluation of acute cerebral infarction]

Objective: To investigate the clinical value of magnetic resonance (MR) intravoxel incoherent motion (IVIM) diffusion imaging and 3D pseudo continuous arterial spin labeling (3D-pcASL) perfusion imaging in the evaluation of acute cerebral infarction. Methods: MR images of 49 patients with unilateral acute cerebral infarction diagnosed and treated in Affiliated Yancheng Hospital of Southeast University Medical College from October 2015 to February 2019 were retrospectively analyzed. High signal infarction area (S(D)) on diffusion image slice with the biggest lesion level and abnormal perfusion area (S(CBF)) on the corresponding level were measured. The presence of ischemic penumbra (IP) was represented by S(CBF)> S(D), and patients were divided into group IP and group non-IP. Regions of interest were set on the infarction core, brain tissue near the edge of the lesion (BNL) and their corresponding contralateral regions. The values of apparent diffusion coefficient (ADC), true diffusion coefficient (D), perfusion related diffusion coefficient (D(*)), perfusion fraction (f) and cerebral blood flow (CBF) of each region of interest were recorded and relative values of infarction lesion to its contralateral region (rADC, rD, rD(*), rf, rCBF) were calculated. Differences of each parameter value between infarction core, BNL and their corresponding contralateral regions and of each relative parameter value between infarction core and BNL, and between the two groups were compared.The differential diagnostic efficacy of relative parameter value with differences between groups was analyzed by receiver operating characteristics (ROC) curve. The correlations of each relative parameter value of 3D-pcASL and IVIM sequences were analyzed. Results: The ADC, D, f and CBF values of infarction core were significantly lower than those of contralateral regions in both groups (all P<0.01). Among all parameters of BNL in both groups, only the CBF value of group IP was significantly lower than that of contralateral region ((27.58±3.53) vs (41.20±5.66) ml·100 g(-1)·min(-1), P<0.01). The rADC, rD, rf and rCBF of infarction core were significantly lower than those of BNL in both groups (all P<0.01). The rCBF of BNL in group IP was significantly lower than that in group non-IP (0.68±0.12 vs 0.97±0.15, P<0.01), and the area under the curve was 0.949, the optimal threshold was 0.823, and the youden index was 0.855 for identifying the two groups. Other relative parameters values of infarction core and BNL had no statistical difference between the two groups. There were positive correlations between rCBF and rADC, rD, rf (r=0.428,0.335,0.565) of infarction core, rADC and rD, rf (r=0.853,0.602) of infarction core, also rADC and rD (r=0.336) of BNL (all P<0.05). Conclusions: IVIM can effectively evaluate the difusion and perfusion information of acute cerebral infarction lesions. However, its perfusion related parameters are not as good as 3D-pcASL in IP evaluation, which should be flexibly selected according to the actual needs of patients' condition evaluation.

Porous lantern-like MFI zeolites composed of 2D nanosheets for highly efficient visible light-driven photocatalysis

Porous lantern-like MFI zeolites composed of 2D nanosheets were fabricated for highly efficient visible light-driven photocatalysis.

Oxygen exchange in Bi2MoO6 nanosheets with different thicknesses during oxidative dehydrogenation of 1-butene

A series of Bi₂MoO₆ nanosheet catalysts with different thicknesses were synthesized for oxidative dehydrogenation (ODH) of 1-butene and the oxygen exchange process during ODH was clarified.

Facile approach to design a stable, damage resistant, slippery, and omniphobic surface

Creating a robust omniphobic surface that repels various liquids would have broad technological implications for areas ranging from biomedical devices and fuel transport to architecture. The present omniphobic surfaces still have the problems of complex fabrication methods, high cost, and being environmentally harmful. To address these challenges, here we report a novel process to design a non-fluorinated, long-term slippery omniphobic surface of candle soot nanoparticles with a silicone binder that cures at room temperature. The porosity, nanoscale roughness, strong affinity of the substrate with the silicone lubricant, and retention of lubricant after curing of the binder play an important role in its stability and low ice adhesion strength at sub-zero temperature. The developed surface exhibits damage resistant slippery properties, repellency to several liquids with different surface tensions including blood, delay in freezing point along with ultra-low ice adhesion strength (2 kPa) and maintains it even below 7 kPa under harsh environmental conditions; 90 frosting/defrosting cycles at −90 °C; 2 months under an ice layer; 2 months at 60 °C; 9 days flow in acidic/basic water and exposure to super-cold water. In addition, this novel technique is cheap, easy to fabricate, environmentally benign and suitable for large-scale applications.

A facile approach to design a stable, damage resistant slippery, and omniphobic surface.

[Comparison of high-risk human papillomavirus infection rate and genotype distribution between Han and Mongolian women]

Objective: To understand the infection rate and genotype distribution of high risk-human papillomavirus (HR-HPV) and the detection rate of different grades of cervical lesions in Han and Mongolian women in China and provide evidence for the development of screening and vaccination strategies for the prevention and control of cervical cancer in different ethnic groups. Methods: In June 2017, a multicenter, population-based study for cervical cancer screening in low-resource settings in China was conducted in three rural areas: Xiangyuan and Yangcheng counties in Shanxi province, and Etuoke county in Inner Mongolia Autonomous Region. A total of 9 517 women aged 30-65 years were included in the study, and two cervical and vaginal secretion samples were collected from them for HPV and PCR-based HPV DNA tests. The positive samples in any of two tests were used for PCR-based HPV genotyping test by using Sansure-pioneered One-Step Fast Release technology. Women with positive results in any the HPV tests were referred for colposcopy and punch biopsy was given if cervical intraepithelial neoplasia lesion (low-grade lesion or worse) was suspected in colposcopy evaluation. Endocervical curettage was performed if women had an unsatisfactory colposcopy exam (the squamocolumnar junction was not completely visible). Pathological detection result was used as the golden standard of diagnosis. Results: HR-HPV infection rates in Han and Mongolian women were 21.83% (1 842/8 438) and 24.93% (269/1 079), respectively. There were statistical differences in HPV infection rates between the two ethnic groups (χ(2)=5.328, P=0.021). The detection rate of cervical intraepithelial neoplasia grade 1 in Mongolian women (2.83%) was higher than that in Han women (0.87%), and the difference was statistically significant (χ(2)=33.509, P<0.001). There were no significant differences in cervical intraepithelial neoplasia grade 2 or worse detection rate between the two ethnic groups [Mongolian woman: 1.04% (11/1 059), Han Woman: 0.95% (80/8 378), χ(2)=0.069, P=0.793]. Among Han and Mongolian women with cervical intraepithelial neoplasia grade 2 or worse, the three most common HR-HPV types were HPV16, HPV52 and HPV58. There was no significant difference for multiple infection rate between Han and Mongolian women (41.37% vs. 44.35%, χ(2)=0.764, P=0.382). Conclusions: The results show that HPV infection rate in Mongolian women was higher than that in Han women. Close attention should be paid to HPV16, 52 and 58 in the prevention and control of cervical cancer in Han and Mongolian women.

Dual Cross-Linked Fluorinated Binder Network for High-Performance Silicon and Silicon Oxide Based Anodes in Lithium-Ion Batteries

In next generation lithium-ion batteries (LIBs), silicon is a promising electrode material due to its surprisingly high specific capacity, but it suffers from serious volume changes during the lithiation/delithiation process which gradually lead to the destruction of the electrode structure. A novel fluorinated copolymer with three different polar groups was synthesized to overcome this problem: carboxylic acid, amide, and fluorinated groups on a single polymer backbone. Moreover, a dual cross-linked network binder was prepared by thermal polymerization of the fluorinated copolymer and sodium alginate. Unlike the common chemical cross-linked network with a gradual and nonreversible fracturing, the dual cross-linked network which combines chemical and physical cross-linking could effectively hold the silicon particles during the volume change process. As a result, excellent electrochemical performance (1557 mAh g^-1 at a 4 A g^-1 current density after 200 cycles) was achieved with this novel reversible cross-linked binder. Further research studies with regard to the influences of fluorine and acrylamide content were conducted to systematically evaluate the designed binder. Moreover, with the help of new binder, the silicon/graphite and silicon oxide/graphite electrode exhibit superb cycle performance with capacity fade rate of 0.1% and 0.025% per cycle over 200 and 700 cycles, respectively. This novel and unsophisticated design gives a result for fabrication of high-performance Si based electrodes and advancement of the realization of practical application.

Discussion on Standardization of Forensic Assessment of Olfactory Dysfunction

Abstract

With the development of society, the improvement of living standards and the advancement of research methods, olfactory function has been paid more and more attention. Therefore, higher requirements for the forensic identification of olfactory function have also been put forward. Standardization construction of forensic medical examination and identification of olfactory dysfunction is urgently needed. Based on a comprehensive review of olfactory function and forensic assessment of olfactory dysfunction, this paper elaborates on problems related to the principles and timing of forensic assessment of olfactory dysfunction, the requirements of identification of traumatic olfactory dysfunction, the subjective and objective methods of examination of olfactory function. Strict control of the above issues is an important mean of standardization of forensic assessment of olfactory dysfunction.

[How to adjust confounders in studies on observational comparative effectiveness: (3) approaches on sensitivity analysis for confounder adjustment]

Confounders are difficult to avoid in studies on observational comparative effectiveness. It is often unclear whether the confounders have been completely eliminated after controlling the measured or unmeasured potential confounding effects or if sensitivity analysis is needed when using the specific statistical methods, under given circumstances. This manuscript summarizes and evaluates the confounding sensitivity analysis methods. Based on different studies, sensitivity analyses need to use different approaches. The traditional sensitivity analysis can be applied for the measured confounders. Currently, the relatively systematic sensitivity analyses for unmeasured confounders would include confounding function, bounding factor and propensity score calibration. Additionally, more investigations are associated with Monte Carlo and Bayesian sensitivity analysis. Reliability of the research conclusion thus may largely be improved when the sensitivity analysis results are consistent with the main analysis.

Prognostic value of the pretreatment albumin:globulin ratio combined with adult comorbidity evaluation 27 and TMN staging in patients with squamous cell carcinoma of the maxillary sinus

The albumin:globulin (A:G) ratio, adult comorbidity evaluation 27 (ACE-27), and TMN staging have been shown to be strong predictive indicators of the survival of patients with many types of tumours. We have investigated the prognostic value of pretreatment based on the A:G ratio combined with TMN staging and ACE-27 in patients with squamous cell carcinoma (SCC) of the maxillary sinus. We studied 196 patients, and the prognostic value was explored by univariate and multivariate Cox's hazards analysis. Multivariate analyses suggested that pretreatment A:G ratio was independently associated with overall survival (hazard ratio (HR) 1.542, 95% CI 1.219 to 1.991, p=0.002); disease-specific survival, (HR 1.499, 95% CI 1.197 to 1.842, p=0.001); and disease-free survival (HR 1.452, 95% CI 1.207 to 1.834, p<0.001). Additional prognostic factors shown in the survival analyses included ACE-27, pathological T stage, and pathological N stage. Pretreatment A:G ratio combined with ACE-27 and TMN staging were powerful prognostic indicators of outcome in patients with SCC of the maxillary sinus, which has potentially important ramifications for stratification of the disease in the future.

[Risk factors of human cystic echinococcosis in Shiqu County Sichuan Province: a case-control study]

OBJECTIVE

To identify the main risk factors of human cystic echinococcosis in Shiqu County, Sichuan Province, so as to provide the reference for the formulation of echinococcosis control strategies in Shiqu County.

METHODS

During the period from November 2015 through June 2017, the patients with cystic echinococcosis (case group) and healthy controls (control group) were randomly sampled from Shiqu County as the study subjects. A questionnaire survey was conducted to capture the study subjects'age, gender, ethnicity, occupation, religion, lifestyle, education level, number of household dogs, bovine and sheep, and density of dog feces in the courtyard. The major risk factors of human cystic echinococcosis were identified using a logistic regression model.

RESULTS

Univariate logistic regression analysis showed 7 risk factors with statistical significance between the case and control groups, and age, lifestyle, number of household bovine, number of household sheep, number of house-hold dogs, and the density of dog feces in the courtyard were included in the multivariate logistic regression model (OR = 1.026, 4.792, 1.067, 1.022, 1.709 and 1.095, respectively).

CONCLUSIONS

High age, pastoral nomadic lifestyle, high number of house-hold bovine, high number of household sheep, high number of household dogs and high density of dog feces in the courtyard are strongly associated with the riks of human cystic echinococcosis in Shiqu County.

MicroRNA-155 regulates cervical cancer via inducing Th17/Treg imbalance

OBJECTIVE

To explore the effect of microRNA-155 on cervical cancer and its underlying mechanism.

PATIENTS AND METHODS

Peripheral blood and cervical cancer tissues were collected. We used quantitative Real-time polymerase chain reaction (qRT-PCR) to detect expressions of microRNA-155, SOCS1, Th17-related genes (RORγt, IL-17A, IL-21, and IL-22), and Treg-related genes (foxp3, TGF-β, IL-10, and IL-35) in peripheral blood and cervical cancer tissues. Western blot was used to detect protein expressions of RORγt and foxp3. The proportions of Th17 and Treg cells in CD4+ T cells were measured by flow cytometry. Moreover, IL-17 expression was detected by enzyme-linked immunosorbent assay (ELISA).

RESULTS

MicroRNA-155 was overexpressed in peripheral blood and cervical cancer tissues of patients with cervical cancer compared with those of normal controls. Th17-related transcription factors and cytokines in cervical cancer tissues were remarkably elevated than those of normal controls, including RORγt, IL-17, and IL-6. Treg-related transcription factors and cytokines obtained the similar results. Besides, the proportion of Th17 cells in CD4+ T cells was higher in cervical tissues than that of normal controls. In vitro experiments suggested that overexpressed microRNA-155 can inhibit the expression of target gene SOCS1, promote the differentiation of Th17 and increase levels of IL-17, RORγt, and STAT3.

CONCLUSIONS

MicroRNA-155 is involved in the occurrence and progression of cervical cancer via inhibiting SOSC1 expression and inducing Th17/Treg imbalance.

Peritoneal dialysis effectively removes toxic substances and improves liver functions of liver failure patients

OBJECTIVE

Liver failure (LF) is a clinically complex disorder that characterizes with hepatic dysfunction. This study aimed at observing the therapeutic effects of peritoneal dialysis on liver function in LF patients.

PATIENTS AND METHODS

This study involves 62 patients diagnosed as LF hospitalized from February 2005 to December 2016. The 62 LF patients were randomly divided into 3 groups, including artificial liver applying plasma exchange group (PE, n = 28), peritoneal dialysis group (PD, n = 22), and conservative treatment group (CT, n=12). Laboratory indexes, including serum total bilirubin (TBiL), alanine aminotransferase (ALT), albumin (ALB), blood ammonia (AMMO), international normalized ratio (INR), and creatinine (Cr) were evaluated. Inflammatory cytokines, including tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), and procalcitonin (PCT) were examined using enzyme-linked immunosorbent assay (ELISA) kit.

RESULTS

Peritoneal dialysis significantly improves clinical outcomes, including decreased mortality, increased survival rate and total effective rate, compared to conservative treatment (p < 0.05). Peritoneal dialysis reduced hospitalization expenses compared to PE method and conservative treatment (p < 0.05). Peritoneal dialysis significantly removed toxic substances (including TBiL, AMMO, Cr) compared to conservative treatment (p < 0.05). The post-treatment level of Cr in peritoneal dialysis group was significantly lower compared to post-treatment level of Cr in PE group (p < 0.05). Peritoneal dialysis significantly improved liver function compared to conservative treatment (p < 0.05). Peritoneal dialysis prevented bleeding tendency compared to conservative treatment (p < 0.05). Peritoneal dialysis alleviated inflammatory response compared to conservative treatment (p < 0.05).

CONCLUSIONS

Peritoneal dialysis effectively removed toxic substances and improved liver functions of liver failure patients and with a lower therapeutic cost.