Preoperative CT texture analysis of gastric cancer: correlations with postoperative TNM staging

AIM

To explore the role of computed tomography (CT) texture analysis in predicting pathologic stage of gastric cancers.

MATERIALS AND METHODS

Preoperative enhanced CT images of 153 patients (112 men, 41 women) with gastric cancers were reviewed retrospectively. Regions of interest (ROIs) were manually drawn along the margin of the lesion on the section where it appeared largest on the arterial and venous CT images, which yielded texture parameters, including mean, maximum frequency, mode, skewness, kurtosis, and entropy. Correlations between texture parameters and pathological stage were analysed with Spearman's correlation test. The diagnostic performance of CT texture parameters in differentiating different stages was evaluated using receiver operating characteristic (ROC) analysis.

RESULTS

Maximum frequency in the arterial phase and mean, maximum frequency, mode in the venous phase correlated positively with T stage, N stage, and overall stage (all p<0.05) of gastric cancer. Entropy in the venous phase also correlated positively with N stage (p=0.009) and overall stage (p=0.032). Skewness in the arterial phase had the highest area under the ROC curve (AUC) of 0.822 in identifying early from advanced gastric cancers. Multivariate analysis identified four parameters, including maximum frequency, skewness, entropy in the venous phase, and differentiation degree from biopsy, for predicting lymph node metastasis of gastric cancer. The multivariate model could distinguish gastric cancers with and without lymph node metastasis with an AUC of 0.892.

CONCLUSION

Multiple CT texture parameters, especially those in the venous phase, correlated well with pathological stage and hold great potential in predicting lymph node metastasis of gastric cancers.

Parent Artery Reconstruction for Large or Giant Cerebral Aneurysms Using the Tubridge Flow Diverter: A Multicenter, Randomized, Controlled Clinical Trial (PARAT)

BACKGROUND AND PURPOSE

Although flow diverters have been reported with favorable clinical and angiographic outcomes in various literatures, randomized trials determining their true effectiveness and safety are still in lack. The Parent Artery Reconstruction for Large or Giant Cerebral Aneurysms Using the Tubridge Flow Diverter (PARAT) trial was designed to evaluate the safety and efficacy of the Tubridge flow diverter in the treatment of large or giant aneurysms in comparison with Enterprise stent-assisted coiling.

MATERIALS AND METHODS

This prospective, multicenter, randomized trial was conducted at 12 hospitals throughout China. Enrolled adults with unruptured large/giant intracranial aneurysms were randomly assigned (1:1) to receive either Enterprise stent-assisted coiling or Tubridge flow diverter implantation. The primary end point was complete occlusion at 6-month follow-up, while secondary end points included technical success, mortality, target vessel-related stroke, aneurysm bleeding, in-stent stenosis, parent artery occlusion, and the frequency of all adverse events.

RESULTS

Among 185 enrolled subjects, 41 withdrew before procedure initiation. Overall, 82 subjects underwent Tubridge implantation, and 62 subjects were primarily treated with stent-assisted coiling. The results of 6-month follow-up imaging included complete occlusion rates of 75.34% versus 24.53% for the Tubridge and stent-assisted coiling groups, respectively, with a calculated common odds ratio of 9.4 (95% confidence interval, 4.14-21.38; P < .001). There was a higher, nonsignificant frequency of complications for Tubridge subjects. Multivariate analysis showed a decreased stroke rate at the primary investigational site, with a marginal P value (P = .051).

CONCLUSIONS

This trial showed an obviously higher rate of large and giant aneurysm obliteration with the Tubridge FD over Enterprise stent-assisted coiling. However, this higher obliteration rate came at the cost of a nonsignificantly higher rate of complications. Investigational site comparisons suggested that a learning curve for flow-diverter implantation should be recognized and factored into trial designs.

[Research Progress on Determination of Drowning Site]

The bodies found in water are one of the most common types in forensic practice. The discovery site of the body is often not the drowning site. However, the determination of drowning site is vital for the identification of victim. Inorganic particles and planktons, such as granular impurities, diatoms and bacteria, are valuable markers for the diagnosis of drowning. By comparing the granular impurities and planktons in tissues and suspicious drowning mediums, the drowning site can be concluded based on their similarity of types and distribution, which has practical applied value. In this paper, the research progress on determination of drowning site is summarized to provide reference for the peers.

P2Y12 deficiency in mouse impairs noradrenergic system in brain, and alters anxiety-like neurobehavior and memory

Purinergic receptor P2Y₁₂ (P2Y₁₂ ), a G protein-coupled purinergic receptor, is widely distributed in nervous system and involved in the progression of neurological diseases such as multiple sclerosis and neuropathic pain. The central noradrenergic system actively participates in a number of neurophysiological processes. Nevertheless, whether there is any direct relevance between P2Y₁₂ and noradrenergic signal transduction remains unknown. In the present study, we tested the hypothesis that lack of P2Y₁₂ impaired noradrenergic signal transduction in mouse brain. Our results showed that P2Y₁₂ knockout (KO) mice exhibited increased anxiety-like behavior in the open-field test (OFT) and elevated plus maze test and displayed deficits in memory in the radial-arm maze test (RAMT) and Morris water maze test (MWMT). They also exhibited reduced locomotion in the OFT and MWMT. Moreover, loss of P2Y₁₂ decreased the level of noradrenaline and the expression of noradrenergic α receptors, subtypes α2 (ARα2b) in mouse cerebellum and hippocampus. Meanwhile, it hampered the protein kinase A (PKA)/cAMP response element-binding protein (CREB)/brain-derived neurotrophic factor (BDNF) signaling pathway in these brain regions. Taken together, our results showed for the first time that P2Y₁₂ KO altered the anxiety, memory and locomotion of mice, which was closely associated with abnormal state of noradrenergic system in the brain. The findings implicate that P2Y₁₂ plays an indispensable role in noradrenergic signal transduction; its deficit is insufficient to limit anxiety responses or supports cognitive performance and activity.

Chronic activation of AMP-activated protein kinase increases monocarboxylate transporter 2 and 4 expression in skeletal muscle

Acute activation of AMP-activated protein kinase (AMPK) increases monocarboxylate transporter (MCT) expression in skeletal muscle. However, the impact of chronic activation of AMPK on MCT expression in skeletal muscle is unknown. To investigate, MCT1, MCT2, and MCT4 mRNA expression and protein abundance were measured in the longissimus lumborum (glycolytic), masseter (oxidative), and heart from wild-type (control) and AMPK γ3 pigs. The AMPK γ3 gain in function mutation results in AMPK being constitutively active in glycolytic skeletal muscle and increases energy producing pathways. The MCT1 and MCT2 mRNA expression in muscle was lower ( < 0.05) from both wild-type and AMPK γ3 animals compared to other tissues. However, in both genotypes, MCT1 and MCT2 mRNA expression was greater ( < 0.05) in the masseter than the longissimus lumborum. The MCT1 protein was not detected in skeletal muscle, but MCT2 was greater ( < 0.05) in muscles with an oxidative muscle phenotype. Monocarboxylate transporter 2 was also detected in muscle mitochondria and may explain the differences between muscles. The MCT4 mRNA expression was intermediate among all tissues tested and greater ( < 0.05) in the longissimus lumborum than the masseter. Furthermore, MCT4 protein expression in the longissimus lumborum from AMPK γ3 animals was greater ( < 0.05) than in the longissimus lumborum from wild-type animals. In totality, these data indicate that chronic AMPK activation simultaneously increases MCT2 and MCT4 expression in skeletal muscle.

Studies of low-energy K- nuclear interactions by AMADEUS

The goal of the AMADEUS experiment is to shed light on unsolved fundamental issues in the non-perturbative strangeness QCD sector through the study of lowenergy K- hadronic interactions with light nuclear targets. The main open questions are the controversial nature of the Δ(1405) state, which is investigated in hyperon-pion correlation studies, and the possible existence of exotic antikaon multi-nucleon clusters, whose search in K- induced reactions is intimately related to the studies of the K- multi-nucleon absorption processes in hyperon-nucleon/nucleus channels. The DAΦNE collider at the INFN-LNF provides unique monochromatic low-momentum kaons from the φ meson decay almost at-rest, suitable for the AMADEUS studies. The KLOE detector is exploited as an active target, in order to obtain excellent acceptance and resolution data for K- nuclear capture on H, 4He, 9Be and 12C, both at-rest and in-flight.

Search for the violation of Pauli Exclusion Principle at LNGS

In the VIP (VIolation of Pauli exclusion principle) and its follow-up VIP- 2 experiments at the Laboratori Nazionali del Gran Sasso, we test the validity of the Pauli Exclusion Principle, by searching for x-rays from copper atomic transitions from a 2p orbit electron to the ground state which is already occupied by two electrons. Such transitions are prohibited by the Pauli Exclusion Principle. The physics run of the VIP-2 experiment started in late 2016 and will collect data for three years. From the first data taking period of two months we have obtained a new limit better than the VIP result from three years of running. In this article we present the published first physics result from the VIP-2 experiment and discuss about the future perspectives.

The kaonic atoms research program at DAΦNE: from SIDDHARTA to SIDDHARTA-2

The interaction of antikaons with nucleons and nuclei in the low-energy regime represents an active research field in hadron physics with still many important open questions. The investigation of light kaonic atoms, in which one electron is replaced by a negatively charged kaon, is a unique tool to provide precise information on this interaction; the energy shift and the broadening of the low-lying states of such atoms, induced by the kaon-nucleus hadronic interaction, can be determined with high precision from the atomic X-ray spectroscopy, and this experimental method provides unique information to understand the low energy kaon-nucleus interaction at the production threshold. The lightest atomic systems, like the kaonic hydrogen and the kaonic deuterium deliver, in a model-independent way, the isospin-dependent kaon-nucleon scattering lengths. The most precise kaonic hydrogen measurement to-date, together with an exploratory measurement of kaonic deuterium, were carried out in 2009 by the SIDDHARTA collaboration at the DAΦNE electron-positron collider of LNF-INFN, combining the excellent quality kaon beam delivered by the collider with new experimental techniques, as fast and very precise X-ray detectors, like the Silicon Drift Detectors. The SIDDHARTA results triggered new theoretical work, which achieved major progress in the understanding of the low-energy strong interaction with strangeness reflected by the antikaon-nucleon scattering lengths calculated with the antikaon-proton amplitudes constrained by the SIDDHARTA data. The most important open question is the experimental determination of the hadronic energy shift and width of kaonic deuterium; presently, a major upgrade of the setup, SIDDHARTA-2, is being realized to reach this goal. In this paper, the results obtained in 2009 and the proposed SIDDHARTA-2 upgrades are presented.

[Correlation between Genetic Variants and Polymorphism of Caveolin and Sudden Unexplained Death]

OBJECTIVES

To explore the genetic variation sites of caveolin （CAV） and their correlation with sudden unexplained death （SUD）.

METHODS

The blood samples were collected from SUD group （71 cases）, coronary artery disease （CAD） group （62 cases） and control group （60 cases）, respectively. The genome DNA were extracted and sequencing was performed directly by amplifying gene coding region and exon-intron splicing region of CAV1 and CAV3 using PCR. The type of heritable variation of CVA was confirmed and statistical analysis was performed.

RESULTS

A total of 4 variation sites that maybe significative were identified in SUD group, and two were newfound which were CAV1： c.45C>T （T15T） and CAV1：c.512G>A （R171H）, and two were SNP loci which were CAV1：c.246C>T （rs35242077） and CAV3：c.99C>T （rs1008642） and had significant difference （P<0.05） in allele and genotype frequencies between SUD and control groups. Forementioned variation sites were not found in CAD group.

CONCLUSIONS

The variants of CAV1 and CAV3 may be correlated with a part of SUD group.

A G3P[13] porcine group A rotavirus emerging in China is a reassortant and a natural recombinant in the VP4 gene

Group A rotaviruses (RVAs) are a major cause of serious intestinal disease in piglets. In this study, a novel pig strain was identified in a stool sample from China. The strain was designated RVA/Pig/China/LNCY/2016/G3P[13] and had a G3-P[13]-I5-R1-C1-M1-A8-N1-T1-E1-H1 genome. The viral protein 7 (VP7) and non-structural protein 4 (NSP4) genes of RVA/Pig/China/LNCY/2016/G3P[13] were closely related to cogent genes of human RVAs, suggesting that a reassortment between pig and human strains had occurred. Recombination analysis showed that RVA/Pig/China/LNCY/2016/G3P[13] is a natural recombinant strain between the P[23] and P[7] RVA strains, and crossover points for recombination were found at nucleotides (nt) 456 and 804 of the VP4 gene. Elucidating the biological characteristics of porcine rotavirus (PoRV) will be helpful for further analyses of the epidemic characteristics of this virus. The results of this study provide valuable information for RVA recombination and evolution and will facilitate future investigations into the molecular pathogenesis of RVAs.

The Effect of Renal Impairment on the Pharmacokinetics and Pharmacodynamics of Ertugliflozin in Subjects With Type 2 Diabetes Mellitus

Ertugliflozin is a highly selective and potent inhibitor of the sodium-glucose cotransporter 2 in development for the treatment of type 2 diabetes mellitus. The glycemic efficacy of sodium-glucose cotransporter 2 inhibitors such as ertugliflozin depends on glucose filtration through the kidney. This phase 1, open-label study evaluated the effect of renal impairment on the pharmacokinetics, pharmacodynamics, and tolerability of ertugliflozin (15 mg) in type 2 diabetes mellitus and healthy subjects with normal renal function (estimated glomerular filtration rate not normalized for body surface area ≥90 mL/min) and type 2 diabetes mellitus subjects with mild (60-89 mL/min), moderate (30-59 mL/min), or severe (<30 mL/min) renal impairment (n = 36). Blood and urine samples were collected predose and over 96 hours postdose for pharmacokinetic evaluation and measurement of urinary glucose excretion over 24 hours. Log-linear regression analyses indicated predicted mean area under the concentration-time curve values for mild, moderate, and severe renal function groups that were ≤70% higher relative to subjects with normal renal function. Generally consistent results were obtained with categorical analysis based on analysis of variance. The increase in ertugliflozin exposure in subjects with renal impairment is not expected to be clinically meaningful. Regression analysis of change from baseline in urinary glucose excretion over 24 hours vs estimated glomerular filtration rate showed a decrease in urinary glucose excretion with declining renal function. A single 15-mg dose of ertugliflozin was well tolerated in all groups.

Bleeding from gestational trophoblastic neoplasia: embolotherapy efficacy and tumour response to chemotherapy

AIM

To evaluate retrospectively the impact of selective arterial embolisation (SAE) on the prognosis of patients with gestational trophoblastic neoplasia (GTN).

MATERIALS AND METHODS

A retrospective analysis of the records of all patients with GTN between January 2005 and January 2015 was performed. Forty-one patients (mean age, 28.9 ± 7.6 years) with massive vaginal haemorrhage from GTN (including 27 cases of choriocarcinoma and 14 cases of invasive mole) were treated with SAE. The complications, control of haemorrhage, and outcome of chemotherapy were reviewed retrospectively.

RESULTS

SAE successfully controlled the haemorrhage for 38 patients (92.7%). All patients with successful SAE received systemic chemotherapy without recurrent massive bleeding during the period of chemotherapy. The average number of chemotherapy cycles was 9.8 for every patient. Complete remission (CR) was achieved in 34 patients (89.5%), two patients had partial remission, and two patients died. Two patients with CR required repeated embolisation for recurrence of massive bleeding 30 and 47 months after the first embolisation procedure due to uterine arteriovenous malformation (AVM).

CONCLUSIONS

SAE can effectively control haemorrhage from GTN and these patients had good response to systemic chemotherapy following successful SAE. Uterine bleeding may recur due to uterine AVMs, even following complete embolisation and CR of GTN.

[Research Progress of the Correlation between Caveolin and Unexpected Sudden Cardiac Death]

Due to the negative autopsy and without cardiac structural abnormalities, unexpected sudden cardiac death （USCD） is always a tough issue for forensic pathological expertise. USCD may be associated with parts of fatal arrhythmic diseases. These arrhythmic diseases may be caused by disorders of cardiac ion channels or channel-related proteins. Caveolin can combine with multiple myocardial ion channel proteins through its scaffolding regions and plays an important role in maintaining the depolarization and repolarization of cardiac action potential. When the structure and function of caveolin are affected by gene mutations or abnormal protein expression, the functions of the regulated ion channels are correspondingly impaired, which leads to the occurrence of multiple channelopathies, arrhythmia or even sudden cardiac death. It is important to study the effects of caveolin on the functions of ion channels for exploring the mechanisms of malignant arrhythmia and sudden cardiac death.

ORF3a deletion in field strains of porcine-transmissible gastroenteritis virus in China: A hint of association with porcine respiratory coronavirus

Porcine‐transmissible gastroenteritis virus (TGEV) is a pathogenic coronavirus responsible for high diarrhoea‐associated morbidity and mortality in suckling piglets. We analysed the TGEV ORF3 gene using nested polymerase chain reaction and identified an ORF3a deletion in three field strains of TGEV collected from piglets in China in 2015. Eight TGEV ORF3 sequences were obtained in this study. Phylogenetic tree analysis of ORF3 showed that the eight TGEV ORF3 genes all belonged to the Miller cluster. CH‐LNCT and CH‐MZL were closely correlated with Miller M6, while CH‐SH was correlated with Miller M60. These results thus indicate that the existence of Miller, as well as the Purdue cluster, in Chinese field strains of TGEV. Furthermore, we found the first evidence for a large deletion in ORF3 resulting in the loss of ORF3a, previously reported in porcine respiratory coronavirus, in three field strains (CH‐LNCT, CH‐MZL, and CH‐SH) of TGEV. The results of the present study thus provide important information regarding the underlying evolution mechanisms of coronaviruses.

The pre-rRNA processing factor DEF is rate limiting for the pathogenesis of MYCN-driven neuroblastoma

The nucleolar factor, digestive organ expansion factor (DEF), has a key role in ribosome biogenesis, functioning in pre-ribosomal RNA (pre-rRNA) processing as a component of the small ribosomal subunit (SSU) processome. Here we show that the peripheral sympathetic nervous system (PSNS) is very underdeveloped in def-deficient zebrafish, and that def haploinsufficiency significantly decreases disease penetrance and tumor growth rate in a MYCN-driven transgenic zebrafish model of neuroblastoma that arises in the PSNS. Consistent with these findings, DEF is highly expressed in human neuroblastoma, and its depletion in human neuroblastoma cell lines induces apoptosis. Interestingly, overexpression of MYCN in zebrafish and in human neuroblastoma cells results in the appearance of intermediate pre-rRNAs species that reflect the processing of pre-rRNAs through Pathway 2, a pathway that processes pre-rRNAs in a different temporal order than the more often used Pathway 1. Our results indicate that DEF and possibly other components of the SSU processome provide a novel site of vulnerability in neuroblastoma cells that could be exploited for targeted therapy.

Abstract P6-02-08: Modulation of indoleamine 2, 3-dioxygenase (IDO1) expression in breast cancer cells by activated CD8+ T cells is controlled by DNA promoter methylation

Tumor infiltrating lymphocytes (TILs) play a critical role in regulating the immunomodulatory properties of triple negative breast cancer (TNBC). However, the specific adaptations that TNBC tumors undergo when challenged by lymphocyte infiltration remain unclear. In order to address this gap in knowledge, we conducted an immuno-phenotype comparison using mRNA sequencing between the TNBC cell line MDA-MB-231 and the luminal breast cancer cell line MCF7 after both were co-cultured with activated human T-cells. Although the cytokine-induced immune signature of the two cell lines were similar, MDA-MD-231 cells were able to transcribe the tryptophan catabolizing enzyme IDO1 at a significantly higher level than MCF7 cells. Stimulation with IFNg was able to differentially induce IDO protein expression and enzymatic activity in ER- cell lines compared to ER+ cell lines, though no differences were observed in upstream JAK/STAT1 signaling or IDO1 mRNA stability between the two cell lines. Further experiments showed that treatment with the demethylating agent 5-aza-deoxycytidine was able to reverse suppression of IDO1 expression in MCF7 cells, suggesting that DNA methylation serves as a potential determinant in IDO1 induction. Analysis of TCGA and other previously published breast cancer datasets revealed subtype-specific mRNA and promoter methylation differences in IDO1, with TNBC/basal-like subtypes exhibiting lower promoter methylation and higher mRNA expression than ER+/luminal subtypes. Bisulfite pyrosequencing validated the subtype-specific association of decreased promoter methylation with increased IDO1 expression in breast cancer cell lines and an independent cohort of primary breast tumors. In addition, decreased IDO1 promoter methylation and elevated IDO1 expression in basal-like breast tumors was found to be associated with increased levels of kynurenine, the metabolic product of IDO1, as well as higher numbers of CD8+ TILs. Furthermore, high kynurenine levels in breast tumors were associated with worse patient survival. Taken together, these findings suggest that subtype-specific IDO1 promoter methylation regulates the ability of breast tumors to escape from antitumor immune responses driven by CD8+ TILs and could be used as a predictive biomarker for IDO inhibitor-based immunotherapy.

Citation Format: Gu F, Noonepalle SK, Lee E-J, Choi J-H, Shull AY, Pei L, Sreekumar A, Ambs S, Shi H. Modulation of indoleamine 2, 3-dioxygenase (IDO1) expression in breast cancer cells by activated CD8+ T cells is controlled by DNA promoter methylation [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-02-08.

Abstract P4-01-02: Diagnostic value of breast specific gamma imaging for breast cancer

In this study, 422 female patients who presented with clinical indications and underwent ultrasound (US), mammography (MMG), and breast specific gamma imaging (BSGI) before surgery during the period from July 2013 to June 2015 were retrospectively reviewed. Twenty-two of the patients had no pathological report available and were excluded. These patients who presented with clinical indications underwent both ultrasound and mammographic examinations initially. If both US and MMG were positive, the patient was recommended for a BSGI examination for pre-surgical planning. A BSGI examination was also recommended for patients with negative or indeterminate mammographic findings.

The diagnostic results were compared with histological examination and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for each modality were determined. Combinations of either two or three of the diagnostic results were also reviewed and the corresponding diagnostic indicators calculated. For these combinations, a positive indication on one of the two (or three) diagnostic tests were interpreted as a positive result. The sensitivity of US, MMG, BSGI, the combination of US and MMG, US and BSGI, MMG and BSGI, and the combination of all three together in the diagnosis of breast carcinoma were determined for the 400 patients included in the study and are listed in Table 1, column 1. The specificity, PPV, and NPV for each of these modalities and combinations of modalities were also determined and are shown Table 1, column 2-4.

Table 1 SensitivitySpecificityPPVNPVUS61.389.289.759.8MMG67.594.394.765.2BSGI83.187.991.477.1US & MMG86.884.789.880.6US & BSGI91.382.889.186.1MMG & BSGI92.283.489.585.6US & MMG & BSGI97.579.087.895.4

The population was comprised of 243 patients with 245 malignant lesions and 157 patients with 189 benign lesions. The malignant lesions were primarily infiltrating ductal carcinoma (76%) and ductal carcinoma in situ (14%), with the remaining lesions (10%) being invasive lobular carcinoma, Paget's disease and mixed carcinomas. The benign lesions were primarily fibroadenoma (39%), adenosis (40%) and papilloma (10%), with the remaining lesions (11%) being duct ectasia, inflammation or phyllodes. There were 79 false negative cases by MMG, however, when ultrasound and BSGI were combined, 73 out of 79 were accurately identified. Additionally, there were nine, seventeen and eighteen Ductal Carcinoma in situ (DCIS) misdiagnosed by BSGI, MMG, and ultrasound respectively, but through joint imaging of BSGI+MMG+US; 33 out of 35 were accurately judged.

BSGI is a useful adjunct modality for the diagnosis of breast carcinoma. It is also extremely useful for diagnosis of non-calcified DCIS, and circumvents limitations of mammography in identifying malignant lesion in dense breast. Moreover, it is helpful for improving the diagnosis accuracy of breast carcinoma when BSGI is combined together with MMG and US.

Citation Format: Mallik DK, Zhang H, Shi H, Tan H, Shen L, Hu G, Hu H, Sejdinaj F, Pang Y, Zhu W, Yang W. Diagnostic value of breast specific gamma imaging for breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-01-02.

Effect of initial pH and pH-adjusted acid on nutrient recovery from hydrolysis urine by combining acidification with evaporation-crystallization

Nutrient recovery from human urine is a promising pretreatment of domestic wastewater and provides a sustainable recyclability of nitrogen (N), phosphorus (P), and potassium (K). In this study, we present a method to recover all nutrients from hydrolysis urine (HU) in the form of solid products by combining acidification with evaporation-crystallization. The effect of initial pH (pH_init.) on N retention was investigated, and the optimal pH_init. was further determined by analysis of N retention efficiency. Additionally, crystallization process and product composition based on different pH-adjusted acids were also compared. The results revealed that pH_init. of HU was the key factor for N retention, and the optimal pH_init. was 4. In addition, compared with HCl and H₂SO₄, acidification by H₃PO₄ could effectively reduce energy consumption and improve nutrient content in urine-derived solid products (UDSPs) but increase the acid consumption. The major compositions (mass percentage, %) in UDSPs-Cl, UDSPs-S, and UDSPs-P were salammoniac (80%), lecontite (41%) and ammonium nitrate sulfate (30%), and biphosphammite (84%), respectively. The results also demonstrated that the method of mixing of UDSPs-Cl/UDSPs-S and UDSPs-P and addition of fillers such as calcite, ground limestone, or ground dolomite into them is suitable for improving nutrient balance and fertilizer efficiency.

[Application of frailty index for comprehensive geriatric assessment in the elderly in China]

OBJECTIVE

To discuss the suitability of frailty index for comprehensive geriatric assessment(FI-CGA)in the elderly in China, and evaluate the application of FI-CGA in China.

METHODS

A comprehensive geriatric assessment was conducted among 118 old adults receiving health examination, and frailty index was calculated. Clinical frailty scale(CFS)was also used to evaluate the frail status of the old adults. The correlation between FI-CGA value and CFS level of the old adults was analyzed.

RESULTS

The mean value of FI-CGA was 0.19 ± 0.07, and the average level of CFS was 3.11 ± 1.46. Women had higher mean value of FI-CGA and higher CFS level than men(FI-CGA= 0.20 ± 0.02 for women, 0.19 ± 0.07 for men; CFS =3.40 ± 0.55 for women, 3.10 ± 1.48 for men), but the differences had no significance(t=0.270, 0.452, P=0.788, 0.652). The FI-CGA value and CFS level increased with age(F=10.437, 5.651, P=0.000, 0.001); and there was a positive correlation between FI-CGA value and CFS level(r=0.615, P=0.000).

CONCLUSION

FI-CGA is an effective model for the quantitative evaluation of the frail status of the elderly, and can be used in the clinical practice of geriatric medicine.

[A randomized, single-blind, parallel-controlled and multicentre study: compare the efficacy and safety of domestic and imported human recombinant FSH in WHO group Ⅱ anovulatory infertility]

OBJECTIVE

To evaluate the efficacy and safety of domestic human recombinant FSH(rhFSH)in women with anovulation of WHO group Ⅱ.

METHODS

A randomized, blind, parallel-controlled, non-inferiority and multicenter study was performed. A total of 534 admitted to 13 hospitals from May 2008 to August 2009. There were 531 women with ovulatory disorder was included in the statistical analysis, were randomly divided into test group(domestic rhFSH, n=352)and control group(imported rhFSH, n=179). Percentage of cycle with mature follicle, ovulation rate, clinical pregnancy rate, multiple pregnancy rate, ovarian hyperstimulation syndrome(OHSS)and adverse events were observed.

RESULTS

No statistical significant differences(P>0.05)were observed between the two groups in terms of the efficiency on mature follicle[91.8%(323/352)versus 88.8%(159/179)], ovulation rate[91.3%(295/323)verus 90.6%(144/159)], clinical pregnancy rate[19.2%(62/323)verus 18.2%(29/159)], the number of the follicles<14 mm, the level of serum LH and progesterone, the thickness of endometrium on the day of hCG administration. The number of follicle≥18 mm and 14 mm≤follicle<18 mm and the level of serum estradiol on the day of hCG in the test group were significantly higher than those in the control group(P<0.05). The number of days of rhFSH administration in the test group was significantly less than that in the control group[(9.8±2.2)versus(11.4± 0.6)days, P<0.05], the dosage of rhFSH was significantly lower than that in the control group[(879 ± 419)versus(1 043±663)U, P<0.05]. The multiple pregnancy rate in the test group was significantly higher than that in the control group[21%(13/62)versu 10%(3/29), P<0.05]. The incidence of OHSS and adverse events were similar between the two groups(P>0.05), and no other adverse events were observed in test group during treatment.

CONCLUSION

Ovarian stimulation with domestic rhFSH is effective, safe and economical in women with anovulation of WHO group Ⅱ.

Analysis of outcomes of fertility restoration surgery in women with infertility secondary to tubal pregnancy: a series of 77 cases

PURPOSE

To assess pregnancy outcomes after minimally-invasive fertility restoration surgery in women with infertility secondary to tubal pregnancy treated with salpingectomy.

MATERIALS AND METHODS

The study included 77 women diagnosed with infertility after salpingectomy for tubal pregnancy between December 2008 and October 2010 for intraoperative assessment and treatment of tubal and pelvic adhesions. The mean age of the patients was 31.12 ± 3.58 years and their duration of infertility was 3.91 ± 2.80 years. Chi-square test, Student's t-test, rank-sum test, and Kaplan-Meier test was used. A p-value < 0.05 was considered significant.

RESULTS

Tubal function was restored in 68.8% of women, 33.77% experienced intrauterine conception, 32.47% had a live birth, 5.19% had an ectopic pregnancy, and 1.30% had a spontaneous abortion within the three-year follow up period.

CONCLUSIONS

Minimally-invasive fertility restoration surgery after tubal pregnancy treated with salpingectomy restored tubal function in the contralateral fallopian tube in the majority of women.

Effects of Aerobic and Resistance Training Combined with Fortified Milk on Muscle Mass, Muscle Strength, and Physical Performance in Older Adults: A Randomized Controlled Trial

OBJECTIVES

Fortified milk and resistance training (RT) increase muscle mass, muscle strength, and physical performance in older adults, but it remains unclear whether RT combined with aerobic training (AT) would have stronger effects on these outcomes. The purpose of this study was to examine the effects of aerobic and resistance training (ART) combined with fortified milk consumption on muscle mass, muscle strength, and physical performance in older adults.

DESIGN

Open-labeled randomized controlled trial.

SETTING

University of Tsukuba.

PARTICIPANTS

Fifty-six older adults aged 65-79.

INTERVENTION

Participants were randomly allocated into resistance training (RT + fortified milk, n = 28) and aerobic and resistance training (ART + fortified milk, n = 28) groups. All participants attended supervised exercise programs twice a week at University of Tsukuba and ingested fortified milk every day for 12 weeks. Skeletal muscle index ([SMI]: appendicular lean mass/height2) was assessed using dual-energy X-ray absorptiometry as a muscle mass measure. One-repetition maximum strength was measured using four kinds of resistance training machines (chest press, leg extension, leg curl, and leg press) as muscle strength measures. Sit-to-stand and arm curl tests were also assessed as physical performance measures.

MEASUREMENTS

The primary measurements were muscle mass and strength. The secondary outcomes were physical performance, blood samples, habitual diet, habitual physical activity, and medication use.

RESULTS

Although the muscle strength and physical performance measures significantly improved in both groups, SMI significantly improved in only the RT group. There was no significant difference in the change in SMI and muscle strength measures between the two groups. However, the change in sit-to-stand and arm curl measures in the ART group were significantly higher than those in the RT group.

CONCLUSIONS

These results suggest that AT before RT combined with fortified milk consumption has similar effects on skeletal muscle mass and strength compared with RT alone, but it may be a more useful strategy to improve physical performance in older adults. Although the mechanism of our intervention is uncertain, our program would be an effective prevention for sarcopenia in older adults.

miR-10b-5p is a novel Th17 regulator present in Th17 cells from ankylosing spondylitis

OBJECTIVE

To determine the microRNA (miR) signature in ankylosing spondylitis (AS) T helper (Th)17 cells.

METHODS

Interleukin (IL)-17A-producing CD4+ T cells from patients with AS and healthy controls were FACS-sorted for miR sequencing and qPCR validation. miR-10b function was determined by miR mimic expression followed by cytokine measurement, transcriptome analysis, qPCR and luciferase assays.

RESULTS

AS Th17 cells exhibited a miR signature characterised by upregulation of miR-155-5p, miR-210-3p and miR-10b. miR-10b has not been described previously in Th17 cells and was selected for further characterisation. miR-10b is transiently induced in in vitro differentiated Th17 cells. Transcriptome, qPCR and luciferase assays suggest that MAP3K7 is targeted by miR-10b. Both miR-10b overexpression and MAP3K7 silencing inhibited production of IL-17A by both total CD4 and differentiating Th17 cells.

CONCLUSIONS

AS Th17 cells have a specific miR signature and upregulate miR-10b in vitro. Our data suggest that miR-10b is upregulated by proinflammatory cytokines and may act as a feedback loop to suppress IL-17A by targeting MAP3K7. miR-10b is a potential therapeutic candidate to suppress pathogenic Th17 cell function in patients with AS.

Study on correlation between liver ultrasonic appearance of patients with chronic hepatitis B and cirrhosis and hydrothorax

The article "Study on correlation between liver ultrasonic appearance of patients with chronic hepatitis B and cirrhosis and hydrothorax" by L.-L. Sun, Y.-H. Li, F. Chen, S. Wang, H. Shi, published in Eur Rev Med Pharmacol Sci 2015; 20 (17): 3412-3605-3608 has been withdrawn.

Zfp462 deficiency causes anxiety-like behaviors with excessive self-grooming in mice

Zfp462 is a newly identified vertebrate-specific zinc finger protein that contains nearly 2500 amino acids and 23 putative C2H2-type zinc finger domains. So far, the functions of Zfp462 remain unclear. In our study, we showed that Zfp462 is expressed predominantly in the developing brain, especially in the cerebral cortex and hippocampus regions from embryonic day 7.5 to early postnatal stage. By using a piggyBac transposon-generated Zfp462 knockout (KO) mouse model, we found that Zfp462 KO mice exhibited prenatal lethality with normal neural tube patterning, whereas heterozygous (Het) Zfp462 KO (Zfp462^+/- ) mice showed developmental delay with low body weight and brain weight. Behavioral studies showed that Zfp462^+/- mice presented anxiety-like behaviors with excessive self-grooming and hair loss, which were similar to the pathological grooming behaviors in Hoxb8 KO mice. Further analysis of grooming microstructure showed the impairment of grooming patterning in Zfp462^+/- mice. In addition, the mRNA levels of Pbx1 (pre-B-cell leukemia homeobox 1, an interacting protein of Zfp462) and Hoxb8 decreased in the brains of Zfp462^+/- mice, which may be the cause of anxiety-like behaviors. Finally, imipramine, a widely used and effective anti-anxiety medicine, rescued anxiety-like behaviors and excessive self-grooming in Zfp462^+/- mice. In conclusion, Zfp462 deficiency causes anxiety-like behaviors with excessive self-grooming in mice. This provides a novel genetic mouse model for anxiety disorders and a useful tool to determine potential therapeutic targets for anxiety disorders and screen anti-anxiety drugs.

The added value of SPECT/spiral CT in patients with equivocal bony metastasis from hepatocellular carcinoma

The aim of this study was to evaluate the incremental value provided by single-photon emission computed tomography (SPECT)/spiral computed tomography (CT) over SPECT alone for the evaluation of equivocal bone lesions in patients with hepatocellular carcinoma (HCC).

PATIENTS, METHODS

This was a retrospective study of 65 patients (61 men and 4 women; mean age, 53.1 ± 10.1 years; age range, 31-78 years) with HCC confirmed by pathology who underwent planar whole body scintigraphy and SPECT/CT. Each lesion was scored visually using a 5-point scale (0, negative; 1, benign; 2, likely benign; 3, likely bone metastasis; 4, bone metastasis). Lesions in which diagnostic confidence was scored as 3 or 4 were categorized into metastases.The final diagnosis of each lesion was based on pathological confirmation or follow-up by whole body scintigraphy and SPECT/spiral CT conducted two or more times. The diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of SPECT alone and SPECT/CT were computed.

RESULTS

The diagnostic accuracy, sensitivity, specificity, PPV, and NPV of SPECT alone were 78.4, 70.9%, 94.9%, 96.8% and 59.7%, respectively. Moreover, for agreement of SPECT alone and the final results, the kappa value was 0.567 (p < 0.001), which was considered to be moderate agreement. The diagnostic accuracy, sensitivity, specificity, PPV, and NPV of SPECT/CT were 99.2%, 100%, 97.4%, 98.9% and 100 %, respectively. Furthermore, for agreement of SPECT/CT and the final results, the kappa value was 0.981 (p < 0.001), which was considered to be nearly perfect agreement.

CONCLUSIONS

SPECT/spiral CT is more accurate and valuable than SPECT alone in the differential diagnosis of equivocal bone lesions in patients with HCC.