Altered brain iron deposition in patients with minimal hepatic encephalopathy: an MRI quantitative susceptibility mapping study

AIM

To explore the use of quantitative susceptibility mapping (QSM) in assessing changes in brain iron deposits and their association with cognitive function in patients with minimal hepatic encephalopathy (MHE).

MATERIALS AND METHODS

The study cohort comprised 27 cases with hepatitis B-associated cirrhosis with MHE (MHE group), 25 with hepatitis B-associated cirrhosis without MHE (NMHE group), and 25 healthy controls (HC group). Iron deposits in the bilateral frontal white matter, caudate nucleus (CN), putamen, globus pallidus, thalamus, red nucleus, substantia nigra (SN), hippocampus, and dentate nucleus were measured by QSM. The associations between iron deposition with the time taken to complete number connection tests A (NCT-A) and the score on digital-symbol test (DST) were analysed.

RESULTS

Susceptibility values differed significantly in the bilateral CN, left thalamus, right SN, and left hippocampus in the MHE group compared with the other groups and were positively associated with the times taken to complete the NCT-A in the bilateral CN, left thalamus, and right SN and negatively associated with DST scores in the bilateral CN, left TH, and left HP.

CONCLUSION

Reduced cognitive function in MHE patients was significantly associated with abnormally increased iron deposition in certain brain areas. The quantification of brain iron deposition by QSM may thus be an objective and accurate means of evaluating MHE.

Case report: Significance of the large rhomboid lip in microvascular decompression: insights from two clinical cases

The rhomboid lip (RL) is a layer of neural tissue that extends outside the fourth ventricle and is connected to the lateral recess of the fourth ventricle. Although this anatomical structure has been rigorously studied, it is often overlooked in microvascular decompression (MVD) surgery. In this report, we present two cases, one of hemifacial spasm (HFS) and one of glossopharyngeal neuralgia (GPN), in which a large RL was observed during surgery. We found that a large RL is easily confused with arachnoid cysts, and accurate identification and dissection are important to protect the lower cranial nerves.

[Immunogenicity, safety and immune persistence of the sequential booster with the recombinant protein-based COVID-19 vaccine (CHO cell) in healthy people aged 18-84 years]

Objective: To evaluate the immunogenicity, safety, and immune persistence of the sequential booster with the recombinant protein-based COVID-19 vaccine (CHO cell) in healthy people aged 18-84 years. Methods: An open-label, multi-center trial was conducted in October 2021. The eligible healthy individuals, aged 18-84 years who had completed primary immunization with the inactivated COVID-19 vaccine 3 to 9 months before, were recruited from Shangyu district of Shaoxing and Kaihua county of Quzhou, Zhejiang province. All participants were divided into three groups based on the differences in prime-boost intervals: Group A (3-4 months), Group B (5-6 months) and Group C (7-9 months), with 320 persons per group. All participants received the recombinant COVID-19 vaccine (CHO cell). Blood samples were collected before the vaccination and after receiving the booster at 14 days, 30 days, and 180 days for analysis of GMTs, antibody positivity rates, and seroconversion rates. All adverse events were collected within one month and serious adverse events were collected within six months. The incidences of adverse reactions were analyzed after the booster. Results: The age of 960 participants was (52.3±11.5) years old, and 47.4% were males (455). The GMTs of Groups B and C were 65.26 (54.51-78.12) and 60.97 (50.61-73.45) at 14 days after the booster, both higher than Group A's 44.79 (36.94-54.30) (P value<0.05). The GMTs of Groups B and C were 23.95 (20.18-28.42) and 27.98 (23.45-33.39) at 30 days after the booster, both higher than Group A's 15.71 (13.24-18.63) (P value <0.05). At 14 days after the booster, the antibody positivity rates in Groups A, B, and C were 91.69% (276/301), 94.38% (302/320), and 93.95% (295/314), respectively. The seroconversion rates in the three groups were 90.37% (272/301), 93.75% (300/320), and 93.31% (293/314), respectively. There was no significant difference among these rates in the three groups (all P values >0.05). At 30 days after the booster, antibody positivity rates in Groups A, B, and C were 79.60% (238/299), 87.74% (279/318), and 90.48% (285/315), respectively. The seroconversion rates in the three groups were 76.92% (230/299), 85.85% (273/318), and 88.25% (278/315), respectively. There was a significant difference among these rates in the three groups (all P values <0.001). During the sequential booster immunization, the incidence of adverse events in 960 participants was 15.31% (147/960), with rates of about 14.38% (46/320), 17.50% (56/320), and 14.06% (45/320) in Groups A, B, and C, respectively. The incidence of adverse reactions was 8.02% (77/960), with rates of about 7.50% (24/320), 6.88% (22/320), and 9.69% (31/320) in Groups A, B, and C, respectively. No serious adverse events related to the booster were reported. Conclusion: Healthy individuals aged 18-84 years, who had completed primary immunization with the inactivated COVID-19 vaccine 3 to 9 months before, have good immunogenicity and safety profiles following the sequential booster with the recombinant COVID-19 vaccine (CHO cell).

[Pulmonary nuclear protein of the testis midline carcinoma:a case report]

Nuclear protein of the testis (NUT) midline carcinoma (NMC) is a rare malignant epithelial tumor that typically occurs in the midline regions such as the head, neck, and mediastinum. This tumor is characterized by rapid development, aggressive growth, and strong invasiveness. Due to its short duration, most patients are diagnosed at advanced stages, often leading to rapid mortality. Although reports on pulmonary NUT carcinoma are uncommon, this article presents a case of pulmonary NUT carcinoma in which the patient repeatedly expectorated bronchial casts and tumor tissue. Additionally, a comprehensive review of relevant literature from recent years is provided to enhance understanding of this disease.

[Preliminary exploration of modified side overlap with fundoplication by Yamashita (mSOFY) anastomosis technique in laparoscopic proximal gastrectomy]

Objective: To discuss the feasibility and safety of modified side overlap with fundoplication by Yamashita (mSOFY) in laparoscopic proximal gastrectomy. Methods: Using the method of descriptive case series study, the clinical data of 9 patients with upper gastric cancer who successfully performed mSOFY anastomosis from March 2022 to October 2022 in the Affiliated Huaian No.1 People's Hospital of Nanjing Medical University were retrospectively analyzed.The reconstruction steps of mSOFY anastomosis are as follows: (1) Make a small incision on the right side of the esophageal stump and in front of the anterior wall of the gastric stump; (2) The 45mm linear cutting stapler is placed into the preset anastomosis of the esophagus and the remnant stomach, and the esophagus is rotated 90° counterclockwise along the axis, so that the right wall of the esophagus is anastomosed with the remnant stomach, and the stomach wall is sutured to the left side of the esophagus; (3) The common opening of esophagus and remnant stomach was sutured with inverted suture; (4)Suture the left and lower sides of the esophagus with the remnant stomach to make the esophagus flat against the stomach wall; (5) Open the sutured common opening: due to the pressure of the false dome, the posterior wall of the lower esophageal segment was compressed into a valve-like structure. We mainly observing the postoperative reflux and nutritional improvement of the patients, and recording the intraoperative situation and postoperative complications. Results: Nine patients with upper gastric cancer who completed laparoscopic proximal gastrectomy (mSOFY anastomosis) did not have conversion to laparotomy or intraoperative / postoperative complications. The operation time was (169.4±10.4) minutes, the anastomotic reconstruction time was (51.7±7.1) minutes, the intraoperative bleeding volume was (98.9±43.4) ml, and the number of lymph nodes dissected was (27.2±6.7). The patient recovered well after operation, without any complaints related to reflux esophagitis. Postoperative gastrointestinal radiography showed that the anastomosis was smooth, without stenosis and leakage. The serum albumin [(41.6±3.4) L vs. (39.9±2.6) L], prealbumin [(211.3±38.6) mg/L vs. (205.3±36.0) mg/L], and hemoglobin levels [(126.7±13.2) g/L vs. (121.0±9.7) g/L] of patients before and one month after surgery have no statistically significant differences (all P>0.05). Conclusion: mSOFY anastomosis can be used as one of the safe and feasible reconstruction methods in laparoscopic proximal gastrectomy.

A primary Rosai-Dorfman-Destombes disease of the scalp: case report and literature review

Background

Rosai-Dorfman-Destombes disease (RDD) was first described in 1965 as a benign histiocytic proliferative disorder of unknown cause. Cases of RDD limited to cutaneous tissue have been reported over the past few decades, but single cutaneous RDD of the scalp is rare.

Case presentation

We report a 31-year-old male with a lump on the parietal scalp without extranodal lesion lasting 1 month with gradual enlargement. The surgical incision ruptured with purulent after the first resection. Then the patient was treated with plastic surgery after disinfection and antibiotic treatment. Finally, he recovered well and discharged after 20 days.

Conclusions

RDD of the scalp is rare. Surgical incision can cure the lesion but it may become infected because of increased lymphocytic infiltration. Early diagnosis and differential diagnosis of RDD are necessary. For treatment, individualized therapy is critical to patient prognosis.

Trigeminal Nerve Isolation Application in Microvascular Decompression for Treating Trigeminal Neuralgia: A Retrospective Study

This study aimed to compare the outcomes of trigeminal nerve isolation (TNI) with conventional microvascular decompression (CMVD) in cases of trigeminal neuralgia (TN). We retrospectively reviewed 143 TN cases who underwent microvascular decompression from January 2017 to January 2020. The surgical management of TNI or CMVD in all patients was randomized. The cases were divided into two groups, one group underwent a TNI and the other one received CMVD. The general data, postoperative outcomes, and complications were reviewed retrospectively. Cases with a narrow cistern of cerebellopontine, short trigeminal nerve root, and arachnoid adhesion were defined as difficult cases. All of the cases were followed up for at least 1 year. Surgical outcomes were assessed and compared between the two groups. In results, we found no significant differences in the general data, duration of hospitalization and blood loss between the two procedures. However, of the 143 cases, 12 cases (17.1%) recurred after surgery in the CMVD group, and four cases (5.5%) recurred after TNI operation. The rates of pain relief were 69 (94.5%) in the CMVD group, and 58 (82.9%) for TNI (P=0.027). In the TNI group, there was only one difficult case among four no pain-relief cases, while in the CMVD group, 10 difficult cases were found among the 12 no pain-relief cases (P=0.008). In conclusion, the TNI technique is more effective than the CMVD procedure and could also be performed on patients with classical TN. Future double-blind and randomized controlled trials are necessary to confirm this result.

Investigation on oral nursing of elderly patients and prognosis of patients

OBJECTIVE

To understand the oral care status of elderly inpatients in various departments, analyze the existing problems, and provide a basis for further improving the oral care practices and promoting the oral health of elderly patients.

PATIENTS AND METHODS

This study intends to investigate the oral care status of patients in a tertiary hospital in Chongqing. This study was divided into two phases, the first phase was designed as a cross-sectional study. Our aim was to explore the implementation status of oral care in each department. The second phase of this study was to explore the correlation between patient oral care and patient outcomes.

RESULTS

We extracted a total of 9,164 cases of elderly discharged patients. Primary care patients were mainly distributed in various general wards, among which orthopedics was the most frequent, accounting for 30.19%. The oral care doctor order rate of the patients with premium care was 80.21%, and the rate of oral care orders of the primary care patients was only 2.10%. The study analysis found that among surgical and intensive care unit (ICU) patients, patients in high-frequency group and low-frequency group were significantly better than that of patients without oral care in terms of overall survival.

CONCLUSIONS

The oral care is still insufficient, and the frequency of use is relatively infrequent. This study also found that oral care can improve patient outcomes and reduce the incidence of ventilator-associated pneumonia (VAP).

[Recommendations for the diagnosis and treatment of connective tissue disease associated pulmonary arterial hypertension in China]

Pulmonary arterial hypertension (PAH) is a clinicopathological syndrome caused by the increase of pulmonary artery, and it is the most serious complication of connective tissue disease (CTD). In recent years, a lot of progress has been made in the diagnosis, treatment and evaluation of PAH. Chinese Rheumatology Association formulated this recommendation on the basis of current experience and guidelines, in order to promote early screening, early diagnosis and early intervention of CTD-PAH, as well as patient follow-up and management, to improve the prognosis of CTD-PAH patients.

[Risks and preventive strategy of periodontal treatments for patients with cardiovascular and cerebrovascular diseases]

The prevalence and mortality of the patients who suffer cardiovascular and cerebrovascular diseases are rising in China, and the number of periodontitis patients with cardiovascular and cerebrovascular diseases is growing. Certain principles should be followed during periodontal treatments for these patients due to their particular health conditions. Stomatologists should cooperate with cardiovascular physicians to evaluate the risks and benefits of periodontal treatments in advance, and to select reasonable treatment timings and plans. During treatments, the heart rates, blood pressures and other vital indicators are monitored in real time to avoid acute cardiovascular and cerebrovascular events. The application, discontinuation and adjustment of specific cardiovascular drugs are determined by cardiovascular physicians.

[Analysis of differences and influencing factors of liver injury associated with different strains of 2019-nCoV infection]

Objective: To analyze whether there are differences and related influencing factors in liver injury associated with different strains of 2019-nCoV/SARS-CoV-2 infection. Methods: Data of epidemiology, clinical symptoms, laboratory tests, and treatment outcomes of patients with COVID-19 infection confirmed with Alpha and Delta virus strain in Zhejiang Province were retrospectively collected. Statistical analysis was performed using independent samples t-test or Mann-Whitney U test, χ² test or Fisher's exact test, and logistic regression analysis. Results: A total of 788 and 381 cases with Alpha and Delta virus strain were included. Vaccination ratio was 0% in Alpha and 85.30% in Delta group (P<0.001), The proportion of patients with fever (80.71% vs. 40.94%, P<0.001) was significantly higher in Alpha than Delta strain group. The proportion of critical ill patients was significantly higher in Delta group (9.90% vs. 1.57%, respectively, P<0.001). The virus negative conversion time was significantly longer in Delta than Alpha group (22 d vs. 11 d, P<0.001), but the incidence of liver injury was significantly higher in Alpha than Delta group (20.05% vs. 13.91%, P=0.011). Univariate analysis showed that Alpha virus strain infection, male sex, body mass index, chronic liver disease, fever, diarrhea, shortness of breath, severe/critical illness, elevated creatine kinase (CK), elevated international normalized ratio (INR) and an elevated neutrophil/lymphocyte ratio was significantly associated with an increased risk of liver injury occurrence, and in patients with pharyngeal pain the risk of liver injury occurrence was significantly reduced. Multivariate analysis showed that shortness of breath [OR, 2.667 (CI: 1.389-5.122); P=0.003], increased CK [OR, 2.544 (CI: 1.414-4.576); P=0.002] and increased INR [OR, 1.721] (CI: 1.074-2.758); P=0.024] was significantly associated with an increased risk of liver injury occurrence, and in patients with pharyngeal pain the risk of liver injury occurrence was significantly reduced [OR, 0.424 (CI: 0.254-0.709); P=0.001]. Conclusion: Although the virulence of the Delta is stronger than Alpha strain, most patients infected with Delta strain vaccinated against COVID-19 in Zhejiang province had milder clinical symptoms and a lower incidence and degree of liver injury. Notably, the infection risk even remains after vaccination; however, symptoms and the incidence of severe and critical illness can be significantly reduced.

[Diffuse midline gliomas with H3K27 alteration in children: a clinicopathological analysis of forty-one cases]

Objective: To investigate the clinicopathological features of pediatric diffuse midline glioma with H3K27 alteration and to analyze their relationship with prognosis. Methods: Forty-one cases of childhood diffuse midline glioma with H3K27 alteration were collected at Children's Hospital of Fudan University (39 cases) and Xi'an Children's Hospital (2 cases), from July 2016 to July 2020. The clinical manifestations, imaging data, histopathology, immunohistochemical phenotype and molecular genetics features, tumor size, site and histological grading were evaluated. Results: Among the 41 cases, 21 were males and 20 females, the age of onset was 3-14 years, the average and median age was 7.6 years and 7.0 years, respectively. The tumor sites were brain stem (n=36) and other locations (n=5). The clinical manifestations were dizziness, gait disturbance, and limb weakness, etc. The MRI features were variable. The histology varied from low-grade to high-grade glioma with neuron differentiation. Immunohistochemistry showed that the tumor cells expressed H3K27M, GFAP, and Olig2. Genetic study showed that 76% (16/21) of tumors had H3F3A gene mutation, mostly accompanied by TP53 (62%, 13/21) missense mutation; five tumors (24%, 5/21) had HIST1H3B gene mutation, accompanied by missense mutations in ACVR1 and PI3K pathway-related gene PIK3CA (4/5) and PIK3R1 (1/5) mutations. The prognosis was dismal with only one alive and others died. The average and median overall survival time was 7 months and 4 months, respectively. Cox multivariate regression analysis showed that age, tumor location, radiologically maximum tumor diameter, histologic grading, and surgical methods were not significantly associated with overall survival rate (P>0.05). Conclusions: Pediatric diffuse midline gliomas with H3K27 alteration have unique clinicopathological and genetic characteristics. The prognosis is poor. The tumor location and histopathologic grading are not related to prognosis. New specific drugs and comprehensive treatment are needed to improve the prognosis.

Analysis of Kefir Grains from Different Regions of the Planet Using High-Throughput Sequencing

The taxonomic composition and spatial localization of yeast and bacteria in kefir grains (KG) obtained for study from different regions of the planet were investigated. The diversity of their microbiome has been demonstrated by high-throughput sequencing of bacterial 16S rRNA genes and the ITS1 region of the 18S-ITS1-5.8S-ITS2-28S complex of yeast rRNA. It has been established that the main representatives of the complex community of KG from different regions are lactic acid bacteria (LAB; lactobacilli, lactococci, and Leuconostoc spp. in different ratios) and different types of yeast of the genus Kazachstania (family Saccharomycetaceae). Acetic acid bacteria and a small percentage of yeast Kluyveromyces marxianus were detected in the KG from Tibet, and yeast Pichia kluyveri was detected in the KG from Ossetia.

Infestation and distribution of chigger mites on Brown rat (Rattus norvegicus) in Yunnan Province, Southwest China

Chigger mites is a group of arthropods and some of them are vectors of scrub typhus. As a common synanthropic rodent species, the Brown rat (Rattus norvegicus) often harbors lots of ectoparasites including chigger mites. According to some "data mining" strategies, the present study took the advantage of the abundant original data from a long-term field ecological investigation between 2001 and 2015 to make a detailed analysis of chigger mites on R. norvegicus in Yunnan Province, Southwest of China. From 18 of 33 investigated counties, only 1414 chigger mites were collected from 1113 Brown rats with relatively low infestations. The 1414 individual chigger mites were identified as comprising 61 species, 11 genera and 2 subfamilies of the family Trombiculidae with a high species diversity (S=61, H'=3.13). Of 61 mite species, there were four main species, Walchia ewingi, Ascoschoengastia indica, W. koi and A. rattinorvegici, which accounted for 44.41% of the total mites. All the chigger mites were of aggregated distribution among different individuals of R. norvegicus. The Brown rats in the outdoor habitats harbored much more individuals and species of chigger mites with a higher mean abundance (MA=1.46) and mean intensity (MI=12.53) than in the indoor habitats (P<0.05). The overall infestation of the rats was significantly higher in the mountainous landscapes than in the flatland landscapes (P<0.001). The species similarity (C_ss) of the mites on the male and female rats reached 64.44% with sex biased infestations. The male rats harbored more species and individuals of the mites than the female rats. The adult rats harbored more species and individuals of the mites than the juvenile rats. The species abundance distribution of the mites was successfully fitted by Preston's lognormal model with ŝ(R)=15e^{-[0.31(R-1)]2} (α=0.31, R²=0.95). On the basis of fitting the theoretical curve by Preston's model, the total mite species on R. norvegicus was estimated to be 86 species, and 25 rare mite species were missed in the sampling field investigation. The curve tendency of the species-plot relationship indicates that R. norvegicus have a great potential to harbor many species of chigger mites, and more species of the mites would be collected if more rats are sampled.

MiR-21 regulates pulmonary hypertension in rats via TGF-β1/Smad2 signaling pathway

OBJECTIVE

To investigate the effects of micro ribonucleic acid (miR)-21 on pulmonary hypertension (PH) in rats via regulating tumor growth factor-β1 (TGF-β1)/mothers against decapentaplegic homolog 2 (Smad2) signaling pathway and the possible underlying mechanism.

MATERIALS AND METHODS

MiR-21 inhibition vector (pLKO-anti-miR-21) was first constructed. The rat model of PH was established by hypoxia feeding induction. A total of three groups were established, including: blank control group, model group and miR-21 low-expression group were set up, with 12 rats in each group. The expression level of miR-21 in lung tissues of rats in each group was detected via quantitative polymerase chain reaction (qPCR). The right ventricle systolic pressure (RVSP) and right ventricular hypertrophy index (RVHI) of rats in each group were measured. The pathological changes in lung tissues of rats were detected using hematoxylin and eosin (H&E) staining. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining was used to detect the level of apoptosis in lung tissues of rats in each group. Furthermore, Western blotting was adopted to detect the expression levels of TGF-β1/Smad2 signal pathway-related proteins and apoptosis-related proteins in lung tissues of rats in each group.

RESULTS

Compared with blank control group, the expression level of miR-21 in lung tissues of rats in model group was significantly increased (p<0.01). Meanwhile, miR-21 expression in lung tissues of rats in miR-21 low-expression group was significantly decreased by transfection of miR-21 inhibition vector (p<0.01). The RVSP and RVHI of rats in model group were significantly higher than those of blank control group and miR-21 low-expression group (p<0.01). H&E staining results indicated that the degree of lung tissue injury in model group was remarkably higher than blank control group and miR-21 low-expression group (p<0.01). According to TUNEL staining results, the number of apoptotic cells in lung tissues of rats in model group was markedly smaller than that of miR-21 low-expression group (p<0.01). Moreover, the expression level of Caspase 3 in lung tissues of rats in model group was significantly lower than that of miR-21 low-expression group, while the expression level of B-cell lymphoma 2 (Bcl-2)/Bcl-2-associated X protein (BAX) was markedly higher. The expression levels of TGF-β1 and phosphorylated (p)-Smad2 in lung tissues of rats in model group were evidently higher than those of blank control group (p<0.01). In addition, lowly expressed miR-21 could effectively reduce the expressions of TGF-β1 and p-Smad2 (p<0.01).

CONCLUSIONS

MiR-21 regulates the symptoms of PH in rats by activating TGF-β1/Smad2 signaling pathway.

MiR-21 regulates pulmonary hypertension in rats via TGF-β1/Smad2 signaling pathway

The article "MiR-21 regulates pulmonary hypertension in rats via TGF-β1/Smad2 signaling pathway, by F. Ding, T. You, X.-D. Hou, K. Yi, X.-G. Liu, P. Zhang, X.-K. Wang, published in Eur Rev Med Pharmacol Sci 2019; 23 (9): 3984-3992-DOI: 10.26355/eurrev_201905_17828-PMID: 31115027" has been withdrawn from the authors. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/17828.

Clinical characteristics of non-critically ill patients with novel coronavirus infection (COVID-19) in a Fangcang Hospital

OBJECTIVES

To describe the clinical characteristics of patients in a Fangcang Hospital.

METHODS

Non-critically ill individuals with positive SARS-CoV-2 RT-PCR tests admitted between 7 February and 12 February 2020 to Dongxihu Fangcang Hospital, which was promptly constructed because of the rapid, exponential increase in COVID-19 patients in Wuhan, China, were included; clinical course through to 22 February was recorded.

RESULTS

A total of 1012 non-critically ill individuals with positive SARS-CoV-2 RT-PCR tests were included in the study. Thirty (of 1012, 3.0%) individuals were asymptomatic on admission. During hospitalization, 16 of 30 (53.3%) asymptomatic individuals developed different symptoms. Fourteen of 1012 patients (1.4%) remained asymptomatic from exposure to the end of follow up, with a median duration of 24 days (interquartile range 22-27). Fever (761 of 1012, 75.2%) and cough (531 of 1012, 52.4%) were the most common symptoms. Small patchy opacities (355 of 917, 38.7%) and ground-glass opacities (508 of 917, 55.4%) were common imaging manifestations in chest CT scans. One hundred patients (9.9%) were transferred to designated hospitals due to aggravation of illness. Diarrhoea emerged in 152 of 1012 patients (15.0%). Male, older age, diabetes, cardiovascular diseases, chills, dyspnoea, So2 value of ≤93%, white blood cell counts of >10 × 109/L and large consolidated opacities on CT images were all risk factors for aggravation of illness.

CONCLUSIONS

Non-critically ill individuals had different clinical characteristics from critically ill individuals. Asymptomatic infections only accounted for a small proportion of COVID-19. Although with a low incidence, diarrhoea was observed in patients with COVID-19, indicating the possibility of faecal-oral transmission.

Epidemiologic and clinical characteristics of 91 hospitalized patients with COVID-19 in Zhejiang, China: a retrospective, multi-centre case series

BACKGROUND

Recent studies have focused on initial clinical and epidemiological characteristics of the coronavirus disease 2019 (COVID-19), which is the mainly revealing situation in Wuhan, Hubei.

AIM

This study aims to reveal more data on the epidemiological and clinical characteristics of COVID-19 patients outside of Wuhan, Zhejiang, China.

DESIGN

This study was a retrospective case series.

METHODS

Eighty-eight cases of laboratory-confirmed and three cases of clinically confirmed COVID-19 were admitted to five hospitals in Zhejiang province, China. Data were collected from 20 January 2020 to 11 February 2020.

RESULTS AND DISCUSSION

Of all 91 patients, 88 (96.70%) were laboratory-confirmed COVID-19 with throat swab samples that tested positive for SARS-Cov-2, three (3.30%) cases were clinically diagnosed. The median age of the patients was 50 (36.5-57) years, and female accounted for 59.34%. In this sample, 40 (43.96%) patients had contracted the disease from local cases, 31 (34.07%) patients had been to Wuhan/Hubei, eight (8.79%) patients had contacted with people from Wuhan, and 11 (12.09%) patients were diagnosed after having flown together in the same flight with no passenger that could later be identified as the source of infection. In particular within the city of Ningbo, 60.52% cases can be traced back to an event held in a temple. The most common symptoms were fever (71.43%), cough (60.44%) and fatigue (43.96%). The median of incubation period was 6 (interquartile range 3-8) days and the median time from the first visit to a doctor to the confirmed diagnosis was 1 (1-2) days. According to the chest computed tomography scans, 67.03% cases had bilateral pneumonia.

CONCLUSIONS

Social activity cluster, family cluster and flying alongside with persons already infected with COVID-19 were how people got infected with COVID-19 in Zhejiang.

Role of miR-16-5p in the proliferation and metastasis of hepatocellular carcinoma

OBJECTIVE

The aim of this study was to investigate the role of miR-16-5p in hepatocellular carcinoma (HCC), and to explore the possible underlying mechanism.

PATIENTS AND METHODS

100 pairs of cancerous and para-cancerous tissues surgically removed in our hospital were collected. Real Time quantitative-Polymerase Chain Reaction (qRT-PCR) was used to detect the expression level of miR-16-5p in tissues. Bioinformatics and Dual-Luciferase reporter gene assay were used to screen and verify the potential target genes of miR-16-5p, respectively. Human HCC SMMC-7721 cells were used for functional experiments. Cell proliferation was detected by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) assay. Cell invasion and migration were evaluated by transwell and scratch wound-healing assay, respectively. The protein expression levels of epithelial-mesenchymal transition (EMT) associated markers were measured by Western blot (WB) assay.

RESULTS

QRT-PCR showed that miR-16-5p expression in HCC tissues was significantly lower than that of adjacent normal liver tissues. At the cellular level, miR-16-5p was lowly expressed in HCC cells (SMMC-7721). Bioinformatics websites (including Targetscan, PicTar, miRanda) predicted that insulin-like growth factor 1 receptor (IGF1R) was a potential target gene of miR-16-5p. Meanwhile, IGF1R was selected for further investigation due to its metastatic function. The results showed that no significant difference was found in the mRNA expression level of IGF1R in HCC tissues. However, the protein level of IGF1R was significantly up-regulated, which was negatively correlated with miR-16-5p. Combined with Dual-Luciferase reporter gene assay, it was confirmed that miR-16-5p could regulate the expression of IGF1R in a targeted manner. Furthermore, down-regulation of IGF1R significantly reduced the inhibitory effect of miR-16-5p on the proliferation and metastasis of SMMC-7721 cells.

CONCLUSIONS

We showed that miR-16-5p suppressed invasion and migration of HCC cells, mechanically by directly targeting and inhibiting IGF1R protein expression. The newly identified miR-16-5p/IGF1R axis might provide new insights into the pathogenesis of HCC and novel potential therapeutic targets for the treatment of HCC.

0688 Evaluation Of A Novel Nasal Airway Stent For Snoring And OSA Treatment By Prospective Japanese Patients

Introduction

This cross-sectional study evaluated a novel nasal airway stent (NAS) in the form of a single-use, disposable device (naśtent® classic, Seven Dreamers Laboratories, Inc., Tokyo, Japan), which represents a significant advancement in NAS technology for the treatment of OSA.

Methods

1353 individuals whom were interested in NAS treatment for their snoring and/or OSA were enrolled in this study conducted in different districts in Tokyo, Japan from 8/21/2015 to 3/7/2016. A total of 1335 participants with complete data were included in the final dataset. Collected data included demographic features, self-reported sleep and OSA characteristics, anatomic traits, Epworth Sleepiness Scale (ESS) scores, and NAS tolerance.

Results

The majority of the participants were middle-aged men (91.5% male, 45±10.8 years) with normal BMI (24.5±5.7). Self-reported sleep was 9-11 hours (0.1%), 7-9 hours (8.2%), 5-7 hours (66.7%), 3-5 hours (22%), 1-3 hours (1.2%), and unreported (1.9%). Their mean Epworth Sleepiness Scale score was 9±5.56, and their peak Mallampati and tonsillar grading scores were 2/4 and 3/5, respectively. Of the participants, 87.4% were aware of possible OSA either by snoring or by prior diagnosis of OSA, and their reasons for desiring use of NAS therapy presented in a similar ratio. Over 80% of the participants had never been treated for their diagnosis of OSA; for those with current or prior treatment for their OSA, 62.9% reported PAP as their primary therapy, followed by oral appliances (25.7%), surgery (0.5%), and other therapies (10.8%). On a scale of 1 to 5 where 5 indicated good tolerance to the NAS, the mean scores were 4±1.3 for easy of insertion and 4±1.2 for convenience of use.

Conclusion

This large, cross-sectional study indicated that the majority of individuals seeking a novel NAS treatment for their snoring and/or OSA in Tokyo, Japan were middle-aged men with 5-7 hours of self-reported sleep whom had some daytime sleepiness, displayed signs of mild anatomic upper airway narrowing, had not been treated for their OSA, and whom felt that the NAS was easy and convenient to use.

Support

Seven Dreamers Laboratories, Inc. and WSS ISRTP

MiR-181a affects myocardial ischemia-reperfusion injury in rats via regulating akt signaling pathway

OBJECTIVE

The aim of this study was to explore the influence of the micro ribonucleic acid (miR)-181a on myocardial ischemia-reperfusion injury (MIRI) in rats by regulating the protein kinase B (Akt) signaling pathway.

MATERIALS AND METHODS

A total of 30 male Sprague-Dawley rats were randomly divided into three groups, including: sham operation group (Sham group), ischemia-reperfusion group (I/R group), and miR group (MiR-181a group). The model of myocardial ischemia-reperfusion was successfully established in rats. The concentration of blood nitric oxide (NO) was detected by the relative kits. Myocardial apoptosis in rats of the three groups was detected using terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay. Furthermore, the expressions of myocardial cell apoptosis-related proteins and tumor necrosis factor-α (TNF-α), and the degree of Akt phosphorylation were determined by Western blotting.

RESULTS

Compared with Sham group and miR-181a group, I/R group exhibited significantly elevated left ventricular end-diastolic pressure (LVEDP) (p<0.05). However, the left ventricular end-systolic pressure (LVESP), stroke work (SW), differential pressure (DP), end-systolic pressure-volume relationship (ESPVR), and end-diastolic pressure-volume relationship (EDPVR) significantly decreased in the I/R group (p<0.05). In comparison with miR-181a group, the apoptosis index of myocardial cells was remarkably elevated in the I/R group, showing statistically significant differences (p<0.05). The protein bands were analyzed using the Quantity One detection software. The results demonstrated that, compared with the Sham group, I/R group showed significantly elevated expressions of cysteine-aspartic protease (Caspase)-3 and TNF-α in rat myocardial tissues (p<0.05). However, the protein levels of Akt and endothelial NO synthase (eNOS) phosphorylation and NO in rat myocardial cells were significantly down-regulated (p<0.05).

CONCLUSIONS

MiR-181a activates Akt to promote the phosphorylation of its downstream protein eNOS, inhibit the apoptosis of myocardial cells, and alleviate MIRI.

[Surveillance and sociological factors of schistosomiasis among mobile populations in Haining City]

OBJECTIVE

To investigate the correlation between the source of Schistosoma japonicum infections and sociological factors among mobile populations in Haining City, so as to provide insights into the management of schistosomiasis among mobile populations in Haining City.

METHODS

A total of 12 villages were randomly sampled from 8 townships and 4 subdistricts in Haining City. The mobile populations from schistosomiasis-endemic areas were detected for S. japonicum infections using serological tests. In addition, the awareness of schistosomiasis prevention and control knowledge was investigated using a questionnaire survey.

RESULTS

A total of 1 019 mobile populations were investigated in 12 villages from Haining City, and 23 sero-positives were found, with a positive rate of 2.26%; however, no egg-positives were detected. Logistic regression analysis showed that the mobile populations with original occupations of aquaculture and husbandry were more likely to be sero-positive. The mobile populations had an overall low awareness rate of schistosomiasis prevention and control knowledge, and a higher rate was seen in sero-positive than in sero-negatives.

CONCLUSIONS

The mobile populations with original occupations of aquaculture and husbandry were the key for the surveillance of source of S. japonicum infections. The health education should be intensified to improve the awareness of schistosomiasis prevention and control knowledge among mobile populations.

Optimization of Dietary Zinc Requirement for Broiler Breeder Hens of Chinese Yellow-Feathered Chicken

Simple Summary

China is the second-largest global producer of chicken meat, almost half of which is from the Chinese yellow-feathered breed; a systematic program has been initiated to improve its feeding standards. This study evaluated the optimal requirement of dietary zinc for maximal egg production, egg quality, tibial quality, and antioxidant indices of laying broiler breeders. The results revealed several beneficial effects of supplementary zinc on egg production, feed conversion ratio, yolk zinc content, tibial quality and the antioxidant indices in the serum, liver and ovary. The optimal zinc requirement was estimated based on a regression model.

Abstract

This study aimed to establish the optimal dietary zinc requirement of Chinese yellow-feathered Lingnan broiler breeders. A total of 576 breeder hens aged 58 weeks were randomly assigned to six treatments, each with 6 replicates of 16 birds (n = 96/treatment). The hens were fed either a basal diet (22.81 mg/kg Zn) or the same basal diet supplemented with additional 24, 48, 72, 96, and 120 mg Zn/kg up to 65 weeks of age. Compared to the results of birds fed the basal diet (22.81 mg Zn/kg), the dietary supplementation with additional Zn (mg/kg) showed higher egg laying rate (at 48–120 mg), EM (at 96 mg/kg), yolk Zn content (at 24–120 mg/kg), fertility (at 48–120 mg/kg), hatchability (at 48–96 mg/kg), tibial breaking strength (at 24–48 mg/kg), tibial ash content (at 48 mg/kg), serum CuZnSOD activity (at 72 mg/kg) and T-AOC (at 48 mg/kg), and ovarian CuZnSOD and GSH-Px activities (at 96–120 mg/kg), and lower FCR (at 96 mg/kg). The regression model showed that the optimal supplemental Zn for maximal egg laying rate, yolk Zn content, fertility, and hatchability of Chinese yellow-feathered broiler breeders aged 58 to 65 weeks were 71.09, 92.34, 94.44 and 98.65 mg/kg diet, respectively.

Effect of exogenous ammonium gluconate on growth, ion flux and antioxidant enzymes of maize (Zea Mays L.) seedlings under NaCl stress

Ammonium gluconate (AG) provides both an organic carbon source and a nitrogen source, which can positively improve soil fertility and delay soil degradation. We investigated the underlying mechanisms of both NH₄ ⁺ - and C₆ H₁₁ O₇ ^- -mediated resistance to high salt concentrations in maize (Zea mays L.), and how they relate to antioxidant cellular machinery, root system architecture, root activity and lignin content in roots. Seedlings treated with AG maintained lower Na⁺ content, higher chlorophyll content, higher CAT and POD activity, compared with those without AG and ammonium carbonate (AC). The total size of the root system, primary root length and number of lateral roots detected on the primary root treated with AG decreased compared with those not treated with AG at the same NaCl concentration. However, average root diameter and root activity when treated with AG were significantly higher than roots without AG at the same NaCl concentration. Furthermore, total size of the root system, primary root length and number of lateral roots detected on primary rootsof seedlings treated with AG were higher than those treated with AC at the same NaCl concentration. These results suggested that AG may be a good organic fertiliser under salt stress by decreasing Na⁺ content and increasing chlorophyll content, activity of antioxidant enzymes, root diameter and root activity in maize seedlings.

RNA interference-mediated silencing of aquaporin (AQP)-5 hinders angiogenesis of colorectal tumor by suppressing the production of vascular endothelial growth factor

Aquaporin (AQP)-5 is an essential member of AQP family involved in the tumorigenesis of various malignant tumors. However, its role in the angiogenesis of colorectal cancer is unclear and requires further investigation. In this study, a pRNA-H1.1 vector containing the short hairpin RNA (shRNA) targeting AQP5 mRNA was constructed to inhibit the endogenous expression of AQP5 in human umbilical vein endothelial cells (HUVECs). We found that the AQP5-silenced HUVECs acquired decreased proliferation, migration and tube formation ability. AQP5 shRNA also inhibited the enzyme activity of matrix metalloprotease (MMP)-9 in HUVECs without affecting the MMP-2. Further, two colorectal cancer cell lines (HT29 and HCT116) stably transfected with scrambled or AQP5 shRNA were established. The expression and secretion of vascular endothelial growth factor (VEGF)-A (a pro-angiogenic factor) in colorectal cancer cells were downregulated by AQP5 shRNA. HUVECs cultured in low-VEGF conditioned media (CM) obtained from cancer cells developed less vessel-like tubes and had decreased proliferation and migration. The growth and angiogenesis of xenograft tumors were suppressed when the endogenous AQP5 in HT29 cells was knocked down. Tumor samples were additionally collected from patients with colorectal cancer to analyze the expression of AQP5. The immunofluorescence data indicated that AQP5 was expressed in both inner cancer areas and CD31-positive vessels. Taken together, our study suggests AQP5 as a novel anti-angiogenesis target for colorectal cancer.

Therapeutic effects of probiotic Clostridium butyricum WZ001 on bacterial vaginosis in mice

AIMS

To observe the therapeutic effects of vaginal infusion of probiotic Clostridium butyricum WZ001 on bacterial vaginosis (BV) in mice.

METHODS AND RESULTS

Female ICR mice were used to establish the model of BV by infecting oestrogen-treated mice with Escherichia coli, and then treated with high- and low dose of C. butyricum. Clinical indexes of mice in the C. butyricum-treated groups were significantly improved and comparable to those in the antibiotic group. Pap staining showed that neutrophil count was significantly increased after modelling and largely decreased after C. butyricum treatment (P < 0·01). Dynamic observation of E. coli and Lactobacillus showed that the number of E. coli significantly decreased in the C. butyricum-treated groups or in the antibiotic group with prolonged treatment (P < 0·01). Besides, the number of E. coli in the low-dose C. butyricum group was higher than that in either its high-dose counterpart or the antibiotic group respectively (P < 0·01). The number of Lactobacillus decreased evidently in the antibiotic group (P < 0·01), while that in the C. butyricum groups remained consistent. Moreover, C. butyricum inhibited the proliferation of E. coli by the experiment in vitro. The phosphorylation of nuclear factor-kappa B (NF-κB) p65 in vaginal tissue and the serum levels of inflammatory cytokines, IL-1β, TNF-α and IL-6, increased after modelling and significantly decreased after treated with C. butyricum (P < 0·01), with no difference found when compared with the antibiotic group.

CONCLUSION

Clostridium butyricum inhibits the growth of pathogenic bacteria as well as the inflammatory response induced by E. coli and promotes the growth of Lactobacillus to maintain the vaginal micro-ecological balance.

SIGNIFICANCE AND IMPACT OF THE STUDY

Our results suggest that probiobitc C. butyricum WZ001 has a great potential in the clinical treatment of BV.

[Correlation between serum HBV DNA level and HBsAg titer in HBeAg-positive pregnant women and impact of genomic variability of hepatitis B virus pre S/S regions on their correlations]

Objective: To analyze the correlation between serum HBV DNA level and HBsAg titer in hepatitis B e antigen positive pregnant women without antiviral therapy, and investigate the impact of genomic variability of preS/S regions on their correlations. Methods: Prenatal serum samples from 882 pregnant women with chronic HBV infection who were positive for HBsAg, HBeAg and HBV DNA and were not on antiviral therapy were included in the analysis. The Abbott i2000 and m2000 systems were used to qualitatively or quantitatively detect HBsAg, HBeAg and HBV DNA levels, respectively. HBV genotyping was performed using a type-specific primer nested polymerase chain reaction (nPCR). In addition, serum samples of pregnant women with HBV DNA levels correlated with HBsAg titer and HBV DNA levels higher than HBsAg titers were used to perform preS/S region amplification by nPCR method. PCR products were directly sequenced and mutation sites were analyzed by MEGA6.0 stasticial software. Mann-Whitney U test was used for the measurement data, and 2-test test for count data. Correlations between variables were analyzed using Spearman's rank correlation. Results: Serum HBsAg titer of HBeAg-positive pregnant women was positively correlated with HBV DNA level (r = 0.754, P < 0.01). Compared with the control group, mutation sites A60V (100% vs. 15.38%, χ(2) = 7.61, P < 0.01), V90A (100% vs. 30.77%, χ(2) = 4.43, P < 0.05) and I161T of HBV preS/S region (80.00% vs. 0, χ(2) = 9.14, P < 0.01) showed a significant decrease in HBsAg titer. Conclusion: Serum HBV DNA levels were positively correlated with HBsAg titer in HBeAg-positive pregnant women. Therefore, serum HBsAg titer may be used as a surrogate marker of serum HBV DNA. Single or multiple amino acid mutations sites A60V, V90A, and I161T in preS/S region may be one of the reasons that lead to a significant drop in HBsAg titer and affect its correlation with HBV DNA levels.

[Liver transplantation for polycystic liver disease: 11 cases report and literature review]

Objective: To explore the indications and safety of orthopedic liver transplantation for polycystic liver disease (PLD). Methods: Data of 11 patients with PLD who underwent orthotopic liver transplantation between 2004 and 2013 was retrospectively analyzed. Demographic, clinical and follow-up data were collected for statistical analysis. The survival rate was calculated by Kaplan-Meier method. Results: Over a period of 10 years, the patients received modified piggyback orthopedic liver transplantation (n=9) or combined liver-kidney transplantation (n=2) for PLD. The recipients' median age was 56 years. Seven patients were classified as Gigot type Ⅱ PLD, and four were classified as Gigot type Ⅲ PLD. Eight patients had severe decreased mobility (Eastern Cooperative Oncology Group, ECOG≥3). Only three cases were Child-Pguh Class C patients and the model for end-stage liver disease (MELD) score was>20. The mean hospitalization duration was (45.4±15.3) days, and the mean length of stay in intensive care unit was (4.1±1.9) days. The perioperative mortality was 18.2% and morbidity of complications was 63.6%. The median follow-up period was 111 months. Two patients died of severe complications after combined liver-kidney transplantation. One patient died of ischemia cholangitis during follow-up. The actuarial 1-, 5-and 10-year survival rate during the follow-up period was 82.2%, 81.8%, and 65.5%, respectively. Conclusions: Liver transplantation is the only curative and safe procedure for PLD, and it provides a good long-term prognosis and high quality of life for PLD patients. Liver transplantation could be a primary option in treating progressive or advanced PLD.

Abstract P2-09-14: Immunogenomic pathway and survival analysis in breast cancers based on tumor location and molecular subtypes

Introduction: Most breast tumors respond poorly to immunotherapy. Triple-negative breast cancer (TNBC) breast tumors are thought to be more immunogenic than other breast cancer subtypes (luminal A/B or HER2+). Increased immune response in TNBC are characterized by high levels of tumor infiltrating T lymphocyte (TIL) composition that would predict excellent response to immune checkpoint blockade. For all breast cancers, tumors appear more commonly in the upper outer quadrant. However, it is not clear whether expression of immune response genes vary with tumor location among the subtypes. Here, we hypothesized that by analyzing differential gene expression associated with immune response pathways among molecular subtypes of breast cancer such as luminal A/B, HER2+ or TNBC, we can identify targetable pathways to improve therapy with breast cancer.

Methods: Using the Cancer Genome Atlas (TCGA) dataset, we have identified 918 breast cancer tumor samples and compared RNAseq gene expression based on molecular subtypes and anatomic locations of biopsies (i.e., right, left, lower inner quadrant, lower outer quadrant, upper inner quadrant or upper outer quadrant). Genes with significantly different expression (p&lt;0.01) were selected for survival analysis. R, Reactome Pathway Browser were used to retrieve and analyze data.

Results: In TNBC, tumors from lower outer quadrant, lower inner quadrant demonstrated significantly higher CD8B mRNA expression compared with luminalA/B and HER2 (p=2.93E-04, 2.73E-04) from same locations. CD8B mRNA was not significantly higher in TNBC tumors of other sites compared with luminalA/B and HER2. However, pathway/genes associated with CTL function remained significantly different between the different sites for TNBC compared with other subtypes. The metastasis suppressor gene, CD82, was significantly higher in TNBC samples from the right side (p=4.83E-05), lower outer quadrant (p=4.33E-05), lower inner quadrant (p=3.32E-03) and upper inner quadrant (p=4.51E-07), but this gene was not significantly expressed in the upper outer region, where tumors are prevalent.

From immune pathway analysis, genes involved in the antigen activates B cell receptor pathway (p&lt;0.05) were associated with overall survival (OS) in right and left sided Luminal A/B and HER2 tumors and right sided TNBC tumors. Finally, genes from pathway involved in immune-regulatory interactions between a lymphoid and a non-lymphoid cells were associated with OS in lower outer quadrant, upper outer quadrant tumors in luminal A/B and HER2 cases and right sided tumors in TNBC (p&lt;0.05).

Conclusion: While previous studies have reported that tumor infiltrating lymphocytes and lymphoid aggregates in tumors are associated with survival, following more complex analysis, we reveal novel genes and immune pathways that demonstrate improved survival prediction in the TCGA dataset for breast cancers. Furthermore, as expected, we confirm that different immune pathways are associated with survival in luminalA/B, HER2 and TNBC tumors. Our findings demonstrate the importance of a patient-centered approach to the treatment of patients with breast cancer.

Citation Format: Shen Y, Shyu C-R, Mitchem JB, Ding F, Shajahan-Haq AN. Immunogenomic pathway and survival analysis in breast cancers based on tumor location and molecular subtypes [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-09-14.

[Quantitative evaluation of intravoxel incoherent motion diffusion-weighted imaging and three-dimensional arterial spin labeling in Ki-67 labeling index and grading of brain gliomas]

Objective: To investigate the value of multiple parameters derived from intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and three-dimensional arterial spin labeling (3D-ASL) in Ki-67 labeling index (Ki-67 LI) and grading of human brain gliomas. Methods: From December 2015 to May 2018, 45 patients of gliomas confirmed by surgical pathology in Li Huili Hospital, Ningbo Medical Center were divided into low-grade group (20 cases of WHO grade Ⅱ) and high-grade group (12 cases of WHO grade Ⅲ, 13 cases of WHO grade Ⅳ), and the Ki-67 LI of glioma was obtained by immunohistochemistry. All patients, 24 males and 21 females, aged 25-83 years, mean(53±12)years, underwent conventional magnetic resonance imaging (MRI), IVIM-DWI and 3D-ASL before operation, then measured the true water diffusion coefficient (D), microcirculation perfusion coefficient (D(*)), perfusion fraction (f) and cerebral blood flow (CBF) in the tumor solid area and the contralateral normal white matter area. Those parameters and the Ki-67 LI were compared between the low-and high-grade groups with Mann-Whitney U test. Spearman's correlation was used to analyze the correlation between the quantitative parameters and Ki-67 LI. The ROC curve was used to assess the diagnostic efficacy of parameters in the grading assessment of brain gliomas. Results: The D(0.791×10(-3)mm(2)/s) and f (0.261) of the high-grade group were lower than those of the low-grade group, whereas D(*) (4.153×10(-3) mm(2)/s), CBF(102.027 ml·min(-1)·100 g(-1)) and Ki-67 LI (0.25) were higher (P<0.05). There was a moderate negative correlation between D, f and Ki-67 LI(r=-0.513,-0.457, all P<0.05). There was no significant correlation between D(*) and Ki-67 LI (P=0.571). The area under the curve (AUC) for identifying high-and low-grade gliomas by D, D(*), f and CBF values was 0.965, 0.745, 0.842, and 0.830 respectively (all P<0.05). Conclusion: D and f can be used for quantitative prediction of Ki-67 LI. IVIM-DWI and 3D-ASL are helpful in the grading assessment of gliomas, and the diagnostic efficiency of D is the highest.

Development of classification models for predicting chronic toxicity of chemicals to Daphnia magna and Pseudokirchneriella subcapitata

Both the acute toxicity and chronic toxicity data on aquatic organisms are indispensable parameters in the ecological risk assessment priority chemical screening process (e.g. persistent, bioaccumulative and toxic chemicals). However, most of the present modelling actions are focused on developing predictive models for the acute toxicity of chemicals to aquatic organisms. As regards chronic aquatic toxicity, considerable work is needed. The major objective of the present study was to construct in silico models for predicting chronic toxicity data for Daphnia magna and Pseudokirchneriella subcapitata. In the modelling, a set of chronic toxicity data was collected for D. magna (21 days no observed effect concentration (NOEC)) and P. subcapitata (72 h NOEC), respectively. Then, binary classification models were developed for D. magna and P. subcapitata by employing the k-nearest neighbour method (k-NN). The model assessment results indicated that the obtained optimum models had high accuracy, sensitivity and specificity. The model application domain was characterized by the Euclidean distance-based method. In the future, the data gap for other chemicals within the application domain on their chronic toxicity for D. magna and P. subcapitata could be filled using the models developed here.

[Influence of UCHL5 on proliferation and apoptosis of SW527 breast cancer cells]

Objective: To investigate the effect of UCHL5 on proliferation and apoptosis of breast cancer cells. Methods: SW527 cells were infected with lentiviral vector carrying short hairpin RNA to delete the expression of UCHL5. 3-(4, 5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay was used to examine cell proliferation, and subcutaneous transplantation experiments were performed to detect tumor growth. Cell apoptosis was detected using Annexin V/ Propidium iodide (PI) double staining. The correlation between UCHL5 expression and the expressions of proliferation and apoptosis associated genes was analyzed using TCGA breast invasive carcinoma data set. The relationship between UCHL5 expression and breast cancer patients'survival was analyzed using Kaplan-Meier Plotter online tool. Results: After knockdown of UCHL5, A values of SW527 cells on day 2 and day 4 were 0.822±0.017 and 1.045±0.023, respectively, which were significantly lower than 0.976±0.016 and 1.284±0.025 of control cells on day 2 and day 4 (P<0.001). In vivo xenografted mouse model, the volume in UCHL5-suppressed group was (166.90±75.05) mm(3,) significantly smaller than (329.80±35.84) mm(3) in control group (P=0.029). Flow cytometry analysis showed the apoptotic rate of SW527 cells was (8.60±1.13)% after knockdown of UCHL5, significantly higher than (2.95±0.07)% of control group (P=0.020). TCGA database analysis showed that the expression of UCHL5 was positively correlated with the expressions of genes related to cell proliferation, in paralled with the increased expression of UCHL5, the expression of the pro-apoptosis associated genes was decreased. Kaplan-Meier Plotter analysis demonstrated that the overall survival and relapse-free survival of breast cancer patients with high expression of UCHL5 were much shorter (all P<0.001). Conclusions: Down-regulation of UCHL5 inhibits the proliferation and tumor formation and promotes apoptosis of SW527 cells. High expression of UCHL5 may predict poor prognosis of breast cancer patients.

Erratum: Observation of D^{0} Meson Nuclear Modifications in Au+Au Collisions at sqrt[s_{NN}]=200 GeV [Phys. Rev. Lett. 113, 142301 (2014)]

This corrects the article DOI: 10.1103/PhysRevLett.113.142301.

Anomalous twin boundaries in two dimensional materials

Twin boundary defects form in virtually all crystalline materials as part of their response to applied deformation or thermal stress. For nearly six decades, graphite has been used as a textbook example of twinning with illustrations showing atomically sharp interfaces between parent and twin. Using state-of-the-art high-resolution annular dark-field scanning transmission electron microscopy, we have captured atomic resolution images of graphitic twin boundaries and find that these interfaces are far more complex than previously supposed. Density functional theory calculations confirm that the presence of van der Waals bonding eliminates the requirement for an atomically sharp interface, resulting in long-range bending across multiple unit cells. We show these remarkable structures are common to other van der Waals materials, leading to extraordinary microstructures, Raman-active stacking faults, and sub-surface exfoliation within bulk crystals.

All materials subjected to mechanical deformation form low energy interfaces known as twin boundaries. Here, the authors investigate a variety of structural features that form upon bending atomically thin 2D-crystals, and predict distinct classes of post deformation microstructure based on their atomic arrangement, bend angle and flake thickness.

Postcontrast T1 Mapping for Differential Diagnosis of Recurrence and Radionecrosis after Gamma Knife Radiosurgery for Brain Metastasis

BACKGROUND AND PURPOSE

The differential diagnosis of radionecrosis and tumor recurrence in brain metastases is challenging. We investigated the diagnostic efficiency of postcontrast T1 mapping in solving this problem.

MATERIALS AND METHODS

Between March 2016 and June 2017, fifty-six patients with brain metastases who underwent contrast-enhanced cerebral T1 mapping were recruited for this prospective study. The findings revealed new enhancement after gamma knife radiosurgery. The subjects were assigned to radionecrosis and recurrence groups based on follow-up (median, 11.5 months) and histopathologic results. T1 values of lesions 5 (T1_5min) and 60 (T1_60min) minutes after administration of contrast agent and their difference (T1_differ) were compared between the 2 groups with the 2-tailed Mann-Whitney U test. Receiver operating characteristic curves were used to determine the optimum cutoff values for differential diagnosis.

RESULTS

There were significant differences between the 2 groups in T1_5min, T1_60min, and T1_differ values (P = .012, P = .004, and P < .001, respectively). Relative to T1_5min and T1_60min, T1_differ exhibited greater sensitivity and specificity (P < .001, respectively) in identifying radionecrosis. The optimum T1_differ value for differential diagnosis was 71.1 ms (area under the curve = 0.97; 95% CI, 0.93-1.00), with sensitivity and specificity of 81.5% and 96.5%, respectively.

CONCLUSIONS

Postcontrast T1 mapping is optimal for the differential diagnosis of radionecrosis and tumor recurrence. Among T1 parameters, T1_differ is the most powerful parameter for differential diagnosis. Advantages in terms of quantitative analysis and high resolution portend the wide use of postcontrast T1 mapping in the future.

Selective growth of two-dimensional phosphorene on catalyst surface

Although the study of black phosphorene (BP) and its isomers has attracted enormous attention, the method of synthesizing high-quality samples in a large area is still pending. Here we explore the potential of using the chemical vapor deposition method to synthesize large-area two-dimensional (2D) phosphorene films on metal surfaces. Our ab initio calculations show that BP can be synthesized by using tin (Sn) as a catalyst, while one of its isomers, blue phosphorene (BLP), is very possible to be synthesized by using most other metals, such as Ag and Au. Besides, our study also suggests that the large binding energy between the 2D phosphorene and the active metal substrate may prohibit the exfoliation of the 2D phosphorene for real applications and, therefore, tin, silver and gold are predicted to be the most suitable catalysts for the synthesis of BP and BLP.

Measurement of the spin temperature of optically cooled nuclei and GaAs hyperfine constants in GaAs/AlGaAs quantum dots

Deep cooling of electron and nuclear spins is equivalent to achieving polarization degrees close to 100% and is a key requirement in solid-state quantum information technologies. While polarization of individual nuclear spins in diamond and SiC (ref. ) reaches 99% and beyond, it has been limited to 50-65% for the nuclei in quantum dots. Theoretical models have attributed this limit to formation of coherent 'dark' nuclear spin states but experimental verification is lacking, especially due to the poor accuracy of polarization degree measurements. Here we measure the nuclear polarization in GaAs/AlGaAs quantum dots with high accuracy using a new approach enabled by manipulation of the nuclear spin states with radiofrequency pulses. Polarizations up to 80% are observed-the highest reported so far for optical cooling in quantum dots. This value is still not limited by nuclear coherence effects. Instead we find that optically cooled nuclei are well described within a classical spin temperature framework. Our findings unlock a route for further progress towards quantum dot electron spin qubits where deep cooling of the mesoscopic nuclear spin ensemble is used to achieve long qubit coherence. Moreover, GaAs hyperfine material constants are measured here experimentally for the first time.

Concomitant mitral valve replacement and tricuspid valvuloplasty for severe mitral stenosis

OBJECTIVE

The purpose of this work is to analyze the clinical results of treating severe mitral stenosis (MS) with mild to moderate functional tricuspid regurgitation (FTR) with mitral valve replacement (MVR) alone or together with two different methods of tricuspid valvuloplasty (TVP).

PATIENTS AND METHODS

We split 132 patients into three groups: simple MVR with 47 cases (control group), MVR+ TVP (De Vega loop reduction) with 45 cases (observation group 1) and MVR+ TVP (Edwards MC3 tricuspid forming ring implantation) with 40 cases (observation group 2).

RESULTS

As expected, surgery for both observation groups was longer than for the control group, but we found no differences in aortic clamping time, cardiopulmonary bypass time, perioperative complications, and postoperative hospital stay. We found significantly fewer complications in both observation groups compared to the control group. After surgery, the diameter of the tricuspid valve ring and the maximum reflux bundle were significantly lower in the observation groups compared to the control group.

CONCLUSIONS

Overall, the long-term clinical effect of combined MVR and TVP to treat severe MS with mild to moderate FTR is better than using the simple MVR procedure. Our results also suggest that the Edwards MC3 tricuspid forming ring implantation is superior to the De Vega loop reduction.

Bone marrow fibrosis at diagnosis predicts survival for primary acute myeloid leukemia

PURPOSE

As a desmoplastic reaction, tissue fibrosis played crucial roles in solid tumor progression, chemo-resistance, and consequently heralded poor clinical outcome. Previous studies implied the effects of marrow fibrosis on prognosis for acute lymphoblastic leukemia were disputable. In this study, we aimed to investigate the potential role of bone marrow fibrosis on clinical survival in acute myeloid leukemia (AML) patients.

METHODS

Bone marrow fibrosis (evaluated as reticulin fiber density, RFD) in bone marrow sections was evaluated at diagnosis via computer technology. Receiver operating characteristic curve (ROC) was used to analyze the predictive value of RFD for relapse and survival status. Kaplan-Meier method was used to estimate survival rates per subgroup between patients with different RFD. Cox proportional hazard regression was used to model the overall survival.

RESULTS

High RFD at diagnosis in bone marrow sections from primary AML might predict early relapse and shorter survival (P = 0.003 and 0.001, respectively). The optimal cutoff value of RFD at diagnosis was determined to be 7.2%. Furthermore, the Kaplan-Meier analysis indicated that patients with high marrow RFD had shorter relapse-free survival (RFS) and overall survival (OS) than patients with low RFD (P = 0.007 and 0.000, respectively). Multivariate analysis suggested that similar with cytogenetics, marrow RFD at diagnosis was an independent prognostic factor for RFS [HR 0.564, 95% confidence interval (CI) 0.338-0.940, P = 0.028] and OS (HR 0.457, 95% CI 0.225-0.929, P = 0.031) in primary AML patients.

CONCLUSIONS

Our data suggest that marrow RFD before treatment should be seemed as prognostic factor in primary AML, it may provide valuable clues for developing new targeted therapy.