[Value of spectral CT-based quantitative analysis in differential diagnosis of liver cancer and liver abscess]

Objective: To investigate the value of spectral CT-based quantitative analysis in the differential diagnosis of liver cancer and liver abscess. Methods: A total of 70 patients with space-occupying lesions in the liver(45 with liver cancer and 25 with liver abscess)underwent spectral CT scans to obtain spectral images in the arterial phase and portal venous phase. The solid constituents of lesions and the iodine and water concentrations in necrotic or cystic parts of lesions, normal hepatic tissue, and abdominal aorta in the arterial phase and portal venous phase were measured, and the normalized iodine concentration(NIC)and lesion-to-normal hepatic tissue ratio(LNR)of iodine concentration were calculated. The two samples t-test and the receiver operating characteristic(ROC)curve analysis were performed for the quantitative indices above. Results: The patients with liver cancer had higher NIC and LNR in solid constituents in the arterial phase than those with liver abscess(NIC: 0.15±0.06 mg/ml vs 0.14±0.02 mg/ml, P > 0.05; LNR: 2.78±0.65 vs 1.45±0.88, P < 0.001). The patients with liver abscess had significantly higher NIC and LNR in solid constituents in the portal venous phase than those with liver cancer(NIC: 0.65±0.08 mg/ml vs 0.52±0.08 mg/ml, P≤0.001; LNR: 1.22±0.23 vs 0.95±0.15, P≤0.001). There were no significant differences in NIC in the arterial phase or NIC and LNR in the portal venous phase in necrotic or cystic parts of lesions between the patients with liver cancer and liver abscess(P > 0.05). The optimal quantitative value for the differential diagnosis of liver cancer and liver abscess was LNR in arterial phase, and the cut-off value of 1.53 had a sensitivity of 100% and a specificity of 92%. Conclusion: Quantitative iodine concentration analysis in spectral CT imaging has a certain value in the differential diagnosis of liver cancer and liver abscess and can improve the accuracy of diagnosis.

[The application of captopril challenge test in the diagnosis of primary aldosteronism]

Objective: To evaluate the value of captopril challenge test (CCT) in the diagnosis of primary aldosteronism (PA). Methods: A total of 674 patients [(45.0±13.7) years, men 341, women 333] admitted to Peking Union Medical College Hospital from 2000 to 2015 were analyzed. Among them, 222 subjects were with essential hypertension (EH), 28 were with pheochromocytoma (PHEO), 246 were with idiopathic hyperaldosteronism (IHA) and 178 were with aldosterone producing adenoma (APA). All patients received CCT. 24 h urine sodium was measured in partial patients. Plasma renin activity (PRA), aldosterone (ALD) were detected. Results: Compared with EH [PRA: before 0.5(0.2, 0.9) μg·L(-1)·h(-1,) after 0.8(0.4, 1.5) μg·L(-1)·h(-1;) ALD: before (393±122) pmol/L, after (360±97) pmol/L] and PHEO [PRA: before 0.3(0.1, 0.9) μg·L(-1)·h(-1,) after 0.4(0.1, 1.6) μg·L(-1)·h(-1;) ALD: before (396±108) pmol/L, after (374±114) pmol/L], lower levels of PRA and higher levels of ALD before and after CCT were observed in PA patients [PRA: before 0.1 (0.1, 0.2) μg·L(-1)·h(-1,) after 0.1 (0.1, 0.2) μg·L(-1)·h(-1;) ALD: before (468±216) pmol/L; after (457±199) pmol/L]. After CCT, the suppression rate of ALD [2.8% (-8.8%, 15.4%) vs 6.6% (-4.3%, 17.6%)] and increasing rate of PRA [0(0, 50%) vs 50%(0, 200%)] in PA patients were lower than those in EH patients. The ALD/PRA ratio (ARR) were higher in PA than that in EH or PHEO patients. In the EH subjects, ALD levels of seated posture were higher than those of recumbent posture both before and after receiving captopril, but with no changes in ARR after CCT. No significant differences in ALD and ARR (before and after receiving captopril) were observed between seated and recumbent position in the PA group. The ARR after CCT tended to decrease in EH subjects with elevated urine-sodium compared with those with normal urine-sodium. No changes could be viewed in ALD and PRA levels between normal urine-sodium and elevated urine-sodium groups among APA, IHA and EH patients either before or after CCT. Among patients with APA, the ALD levels before CCT and the ARR after CCT were lower in the patients with AngiotensionⅡ(AngⅡ) reactive than those without. A ROC curve analysis suggested that the optimal cutoff value was 46.2 (ALD unit: ng/dl; PRA unit: μg·L(-1)·h(-1)) for ARR after challenge in diagnosing PA, with the sensitivity of 88.7% and specificity of 84.8%. Conclusions: ARR after 25 mg captopril had high sensitivity and specificity in diagnosis of PA with the cutoff of 46.2. Seated CCT could replace recumbent CCT as a more confirmatory test. The PRA increasing rate should be taken into consideration when diagnosis of PA.

Amino acid and phosphorus digestibility of fermented corn-soybean meal mixed feed with Bacillus subtilis and Enterococcus faecium fed to pigs

In the present study, a 2-stage solid-state fermentation process using followed by was performed with the purpose of improving the nutritional quality of corn and soybean meal (SBM) mixed feed (MF). The matrix of native MF and fermented MF (FMF) was analyzed using scanning electron microscopy to determine external structures after solid-state fermentation. Results of the present study indicated that the FMF had a greater concentration of CP and total P compared with the unfermented feed, whereas the contents of β-conglycinin, glycinin, phytate P, raffinose, stachyose, and NDF in FMF declined by 77.6, 86.7, 41.2, 47.2, 36.6, and 38.9%, respectively. The content of trichloroacetic acid-soluble protein, particularly those of small peptides and free AA, increased more than 3 times after fermentation. Scanning electron microscopy revealed that irregular shapes and a lot of porous structures were observed in the SBM of FMF, the cell wall of corn in FMF was destroyed, and the number of starch granules was decreased after 2-stage fermentation. Two animal experiments were conducted to evaluate the digestibility of CP and P in FMF when fed to pigs. In Exp. 1, 6 barrows (15.20 ± 1.27 kg initial BW) fitted with a T-cannula in the distal ileum were allotted to a replicated 3 × 3 Latin square with 3 diets and 3 periods per square. Two diets containing unfermented MF or FMF as the only source of protein and a N-free diet were formulated. Results indicated that the apparent ileal digestibility (AID) of total AA and Lys in FMF (74.98 and 75.34%) were greater ( < 0.05) than in untreated MF (69.66 and 68.56%). The standard ileal digestibility (SID) of Lys in FMF (82.17%) was also greater ( < 0.05) than in MF (75.91%). In Exp. 2, 16 barrows (17.57 ± 1.08 kg initial BW) were allotted to 2 diets formulated to contain MF or FMF as the sole source of P to determine the digestibility of P. The apparent total tract digestibility and standardized total tract digestibility of P in FMF were 58.14 and 64.72%, respectively. These values were greater ( < 0.01) than in untreated MF (37.11 and 44.89%, respectively). Our results indicate that a solid-state fermentation process using followed by offers an effective approach to improving the quality of corn and SBM MF.

Effects of Lactobacillus rhamnosus GG on the maturation and differentiation of dendritic cells in rotavirus-infected mice

Rotavirus-related diarrhoea is considered one of the most important diseases in field animal production. In addition to the classic vaccine strategy, a number of studies have utilised probiotics, such as Lactobacillus rhamnosus GG (LGG), to prevent rotavirus-induced diarrhoea. Although it has been partially revealed that Toll-like receptors (TLRs) are involved in the LGG-mediated protection against rotavirus infection, the details of the underlying immunologic mechanisms remain largely unknown. In this study, three-to-four-week-old female BALB/c mice were divided into three groups and orally administered phosphate buffered saline (PBS), PBS plus rotavirus or LGG plus rotavirus, respectively. The differentiation and maturation of dendritic cells (DCs) were then determined by FACS, the expression levels of TLR-3 and nuclear factor kappa beta (NF-κB) were evaluated using real time PCR, and the production of inflammatory cytokines in mesenteric lymph nodes (MLNs) were determined by ELISA. The results demonstrated that rotavirus infection significantly increased the percentage of CD11c⁺CD11b⁺CD8a^- DCs and decreased the percentage of CD11c⁺CD11b^-CD8a⁺ DCs in MLNs. By contrast, the presence of LGG significantly decreased the percentage of CD11c⁺CD11b⁺CD8a^- DCs and increased the percentage of CD11c⁺CD11b^-CD8a⁺ DCs, which indicates that the differentiation of DCs is involved in the protective effects of LGG. Rotavirus infection also resulted in the increased expression of surface markers such as CD40, CD80 and MHC-II in DCs, and the administration of LGG significantly increased the expression level further. The mRNA levels of TLR-3 and NF-κB in the intestine and MLNs were also significantly increased in the presence of rotavirus, which was further increased in the presence of LGG. The production of inflammatory cytokines was also determined, and the results showed that rotavirus caused the increased production of interleukin (IL)-12 and tumour necrosis factor alpha; this effect was further enhanced by LGG. Meanwhile, although rotavirus infection led to the increased production of IL-6 and IL-10, the presence of LGG significantly decreased the mRNA levels of these cytokines. By contrast, rotavirus infection resulted in the decreased production of interferon gamma (IFN-γ), and the administration of LGG significantly increased the levels of IFN-γ. Taken together, the protective effects of LGG were partially due to the modulation of the differentiation and maturation of DCs, the increased production of TLR-3 and NF-κB, and the modulation of inflammatory cytokines.

[The impact of cigarette cessation intervention on mental state of patients with coronary heart disease]

Objective: This study was designed to observe the impact of cigarette cessation on anxiety and depression in patients with coronary heart disease (CHD). Methods: A total of 690 cigarette smoking patients with CHD identified by coronary angiography (CAG) were included and analyzed in the study.The mental state were scored with Hamilton anxiety (HAMA) and depression (HAMD) scale both on admission and at 6-month follow-up.The patients were divided into two groups based on the cigarette cessation.The score of mental state between the two groups were compared.The patients were treated with percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), or medicine therapy (MT). Results: The clinic data and score of mental state were similar at the time of admission (HAMA: 10.66±5.53 vs 11.09±5.61, P=0.311; HAMD: 29.81±10.13 vs 28.94±10.22, P=0.266 4) between the two groups.After 6 months, the proportions of subjects in smoking cession group with anxiety (24.2% vs 32.3%, P<0.05), depression (18.0% vs 27.5%, P<0.05), and anxiety and depression (7.0% vs 16.2%, P<0.001) decreased significantly compared with those in smoking group irrespective of the treatment strategy.Both the HAMA and HAMD scores were lower in smoking cessation group (HAMA: 9.83±3.40; HAMD: 24.91±7.90) than in smoking group (HAMA: 10.98±4.87; HAMD: 27.70±11.16) (all P<0.001). Conclusions: Smoking cessation is good for the relief of anxiety and depression in CHD patient.

Alleviation of enterotoxigenic Escherichia coli challenge by recombinant Lactobacillus plantarum expressing a FaeG- and DC-targeting peptide fusion protein

FaeG is the major subunit of K88 fimbriae. These cell surface attachments are considered to be the major virulence factor of enterotoxigenic Escherichia coli (ETEC), which causes diarrhoea in piglets. The use of dendritic cell-targeting peptide (DCpep) has been demonstrated to be an effective approach to enhance the immunity of vaccines. Lactobacillus plantarum is an attractive candidate for oral vaccination owing to its beneficial effects and safety. In this study, L. plantarum was employed to deliver a FaeG-DCpep fusion antigen, and the immune response in mice was evaluated. The synthesis of FaeG-DCpep dramatically increased the adhesion of recombinant L. plantarum (RLP) to IPEC-J2 cell surfaces, resulting in direct competition between L. plantarum and ETEC during adhesion assays. Significantly higher levels of body weight gain, sera immunoglobulin G and intestinal immunoglobulin A were observed in BALB/c mice immunised with RLP. In addition, the number of CD19+ B cells and CD11c+DC cells and the expression levels of several cytokines in the spleen and lymph nodes increased significantly compared to non-immunised mice. The oral administration of RLP also alleviated the symptoms of ETEC challenge, as shown by haematoxylin-eosin staining, indicating that RLP may be an efficient vaccine candidate.

The Effects of Lentivirus-mediated shRNA Interference Targeting Mcl-1 on Growth of NK/T-cell Lymphoma

Myeloid leukemia-1 (Mcl-1) gene has been reported as an important factor in various types of cancer, but little research was processed on natural killer (NK)/T-cell lymphoma, a kind of a highly aggressive disease with a poor prognosis. Here we investigated the expression of Mcl-1 in seven lymphoma cell lines and its potential role as a molecular drug target for NK/T-cell lymphoma therapy by using lentivirus-mediated shRNA interference targeting Mcl-1 (lenti-shMcl-1). In our study, the expression of Mcl-1 in different lymphoma cell lines were evaluated firstly, after that lenti-shMcl-1 was constructed and transduced into NK/T-cell lymphoma cell line SNK-6 which had a high level expression of Mcl-1. Methylthiazolete-Trazolium (MTT) assay and flow cytometry (FCA) were employed to detect the status of proliferation and apoptosis after infection. Lastly we investigated the effects of chemotherapy agent vincristine (VCR) combination with lenti-shMcl-1 by MTT and FCA assay. The results showed that Mcl-1 gene expressed in all seven lymphoma cell lines at different levels. Recombinant lentiviruses could infect SNK-6 cells effectively. Mcl-1 expression level was remarkably down-regulated after infection with lenti-shMcl-1. The growth of SNK-6 cells was inhibited significantly through apoptosis pathway. Otherwise, lenti-shMcl-1 also revealed a significant chemosensitizing effect in combination with vincristine. In a word, we demonstrated that lenti-shMcl-1 had a significant anti-NK/T cell lymphoma effect and targeting Mcl-1 therapy could be a promising novel approach in treatment of lymphoma.

[Surveillance on the epidemiological and etiological characteristics of hand-foot-mouth disease during the outbreaks in three cities of Jiangsu province, 2012-2015]

Objective: To analyze the epidemiological and etiological characteristics through monitoring the outbreaks of hand-foot-mouth disease (HFMD), in three cities of Jiangsu province from 2012 to 2015 and to provide evidence for prevention and control of the disease. Methods: Data related to cases of HFMD during the outbreaks was collected through active surveillance programs in three cities of Jiangsu province, under the guidelines of clusters and outbreaks of HFMD (2012 edition HFMD). Features related to clusters and outbreaks of the disease were identified according to the real-time RT-PCR detection. Descriptive analysis was conducted to understand the type/subtype of HFMD virus and time, area, place and extent of the outbreaks. Logistic regression was used to explore the influencing factors. Results: From 2012 to 2015, a total of 1 425 HFMD epidemics, including 1 314 clusters and 111 outbreaks were reported. Two incidence peaks were observed each year, between March and June, as well as between September and December, accounting for 58.18% (829/1 425), 33.68% (480/1 425), respectively. Most HFMD clusters and outbreaks were reported in Wuxi city, accounting for 59.30% (845/1 425) of the total. Most HFMD clusters and outbreaks happened in kindergartens, accounting for 68.63% (978/1 425) of the total. A total of 931 HFMD clusters and outbreaks were confirmed under laboratory findings. The main pathogens were Entervirus type 71 (EV71) in 2013 and Coxsackie A16 (Cox A16) in 2015, respectively, while both EV71 and Cox A16 were predominant in 2012 and 2014. With multivariate backward conditional regression, surrounding environment was identified as important risk factor associated with the attack rate. Health condition of the environment was quite good, with low attack rates (middle vs. bad: OR=0.150, 95% CI: 0.034-0.667; good vs. bad: OR=0.072, 95%CI: 0.016-0.317). Time between the onset of index patient and the reporting of HFMD clusters or outbreaks was important in the control program of HFMD epidemics (4-7 d vs. 1-3 d: OR=3.452, 95%CI: 2.293-5.198; 8 d vs. 1-3 d: OR=12.108, 95%CI: 7.767-18.763). Conclusions: The clusters and outbreaks of HFMD happened in Jiangsu province showed an obvious feature of seasonality. The predominant types or subtypes of the virus varied in different years. Kindergartens were the hard-hit places of HFMD clusters and outbreaks. Timely report of the disease appeared the key point regarding the control of HFMD clusters and outbreaks.

Inactivation of Cronobacter sakazakii in reconstituted infant formula by combination of thymoquinone and mild heat

AIMS

The objective of this study was to determine the combined effect of thymoquinone (TQ) and mild heat on Cronobacter sakazakii in reconstituted infant formula.

METHODS AND RESULTS

Reconstituted infant formula samples inoculated with a mixture of four C. sakazakii strains (approx. 6·5 log CFU ml(-1) ) were prepared with various concentrations of TQ (0, 5, 10, 20 and 30 mmol l(-1) ) and were heated to 45, 50 and 55°C for 0, 10, 20, 30, 60 and 120 min, and the surviving populations of C. sakazakii at each sampling time were enumerated. To elucidate the mode of action of TQ, membrane integrity and changes in cell morphology were examined by LIVE/DEAD(®) BacLight(™) bacterial viability kit and field emission scanning electron microscope respectively. TQ at 30 mmol l(-1) reduced the pathogen to undetectable level in between 60 and 120 min at 45°C, 60 min at 50°C and 10 min at 55°C respectively.

CONCLUSIONS

Our results demonstrated that the combined treatments significantly reduced (P < 0·05) the population of C. sakazakii, compared to the control. Cronobacter sakazakii numbers were reduced much more rapidly with higher temperatures and increased concentrations of TQ. And combined treatment inactivated pathogen partly by causing cell membrane disruption.

SIGNIFICANCE AND IMPACT OF THE STUDY

These findings suggested that TQ, together with mild heat, may have potential application in infant formula to control C. sakazakii before consumption and therefore is a possible way to prevent infections associated with C. sakazakii in infant formula.

UBE2S, a novel substrate of Akt1, associates with Ku70 and regulates DNA repair and glioblastoma multiforme resistance to chemotherapy

Glioblastoma multiforme (GBM) is the most common primary malignant brain cancer in adults. However, the molecular events underlying carcinogenesis and their interplay remain elusive. Here, we report that the stability of Ubiquitin-conjugating enzyme E2S (UBE2S) is regulated by the PTEN/Akt pathway and that its degradation depends on the ubiquitin-proteasome system. Mechanistically, Akt1 physically interacted with and phosphorylated UBE2S at Thr 152, enhancing its stability by inhibiting proteasomal degradation. Additionally, accumulated UBE2S was found to be associated with the components of the non-homologous end-joining (NHEJ) complex and participated in the NHEJ-mediated DNA repair process. The association of Ku70 with UBE2S was enhanced, and the complex was recruited to double-stranded break (DSB) sites in response to etoposide treatment. Furthermore, knockdown of UBE2S expression inhibited NHEJ-mediated DSB repair and rendered glioblastoma cells more sensitive to chemotherapy. Overall, our findings provide a novel drug target that may serve as the rationale for the development of a new therapeutic approach.

A clock network for geodesy and fundamental science

Leveraging the unrivalled performance of optical clocks as key tools for geo-science, for astronomy and for fundamental physics beyond the standard model requires comparing the frequency of distant optical clocks faithfully. Here, we report on the comparison and agreement of two strontium optical clocks at an uncertainty of 5 × 10⁻¹⁷ via a newly established phase-coherent frequency link connecting Paris and Braunschweig using 1,415 km of telecom fibre. The remote comparison is limited only by the instability and uncertainty of the strontium lattice clocks themselves, with negligible contributions from the optical frequency transfer. A fractional precision of 3 × 10⁻¹⁷ is reached after only 1,000 s averaging time, which is already 10 times better and more than four orders of magnitude faster than any previous long-distance clock comparison. The capability of performing high resolution international clock comparisons paves the way for a redefinition of the unit of time and an all-optical dissemination of the SI-second.

Comparing the frequency of two distant optical clocks will enable sensitive tests of fundamental physics. Here, the authors compare two strontium optical-lattice clocks 690 kilometres apart to a degree of accuracy that is limited only by the uncertainty of the individual clocks themselves.