Evaluating serum CXCL12, sCD22, Lp-PLA2 levels and ratios as biomarkers for diagnosis of Alzheimer's disease

BACKGROUND

Grasping the underlying mechanisms of Alzheimer's disease (AD) is still a work in progress, and existing diagnostic techniques encounter various obstacles. Therefore, the discovery of dependable biomarkers is essential for early detection, tracking the disease's advancement, and steering treatment strategies.

AIM

To explore the diagnostic potential of serum CXCL12, sCD22, Lp-PLA2, and their ratios in AD, aiming to enhance early detection and inform targeted treatment strategies.

METHODS

The study was conducted in Dongying people's Hospital from January 2021 to December 2022. Participants included 60 AD patients (AD group) and 60 healthy people (control group). Using a prospective case-control design, the levels of CXCL12, sCD22 and Lp-PLA2 and their ratios were detected by enzyme-linked immunosorbent assay kit in the diagnosis of AD. The differences between the two groups were analyzed by statistical methods, and the corresponding ratio was constructed to improve the specificity and sensitivity of diagnosis.

RESULTS

Serum CXCL12 levels were higher in the AD group (47.2 ± 8.5 ng/mL) than the control group (32.8 ± 5.7 ng/mL, P < 0.001), while sCD22 levels were lower (14.3 ± 2.1 ng/mL vs 18.9 ± 3.4 ng/mL, P < 0.01). Lp-PLA2 levels were also higher in the AD group (112.5 ± 20.6 ng/mL vs 89.7 ± 15.2 ng/mL, P < 0.05). Significant differences were noted in CXCL12/sCD22 (3.3 vs 1.7, P < 0.001) and Lp-PLA2/sCD22 ratios (8.0 vs 5.2, P < 0.05) between the groups. Receiver operating characteristic analysis confirmed high sensitivity and specificity of these markers and their ratios in distinguishing AD, with area under the curves ranging from 0.568 to 0.787.

CONCLUSION

Serum CXCL12 and Lp-PLA2 levels were significantly increased, while sCD22 were significantly decreased, as well as increases in the ratios of CXCL12/sCD22 and Lp-PLA2/sCD22, are closely related to the onset of AD. These biomarkers and their ratios can be used as potential diagnostic indicators for AD, providing an important clinical reference for early intervention and treatment.

High normal alanine aminotransferase is an indicator for better response to antiviral therapy in chronic hepatitis B

Background

Evidence shows people living with CHB even with a normal ALT (40U/L as threshold) suffer histological disease and there is still little research to evaluate the potential benefit of antiviral benefits in them.

Methods

We retrospectively examined 1352 patients who underwent liver biopsy from 2017 to 2021 and then obtained their 1-year follow-up data to analyze.

Results

ALT levels were categorized into high and low, with thresholds set at >29 for males and >15 for females through Youden's Index. The high normal ALT group showed significant histological disease at baseline (56.43% vs 43.82%, p< 0.001), and better HBV DNA clearance from treatment using PSM (p=0.005). Similar results were obtained using 2016 AASLD high normals (male >30, female >19). Further multivariate logistic analysis showed that high normal ALT (both criterias) was an independent predictor of treatment (OR 1.993, 95% CI 1.115-3.560, p=0.020; OR 2.000, 95% CI 1.055-3.793, p=0.034) Both of the models had higher AUC compared with current scoring system, and there was no obvious difference between the two models (AUC:0.8840 vs 0.8835).

Conclusion

Male >30 or female >19 and Male >29 or female>15 are suggested to be better thresholds for normal ALT. Having a high normal ALT in CHB provides a potential benefit in antiviral therapy.

Gastric neuroendocrine tumors in a BRCA2 germline mutation carrier: A case report

BACKGROUND

The molecular changes present in gastric neuroendocrine tumors (NETs) include a loss of heterozygosity or mutation of MEN1, CDKN1B gene mutation, P27 heterozygous mutation, and ATP4A gene missense mutation. We identified and are the first to report a case of type 1 histamine-producing enterochromaffin-like cell NETs (ECL-cell NETs) with a BRCA2 gene germline mutation.

CASE SUMMARY

The patient had a history of iron-deficient anemia for 5 years, and gastroscopic examination indicated multiple gastric tumors. Then, the patient underwent distal gastrectomy. Microscopically, multifocal tumor cells were found in the mucosa and submucosa; tumor cells were organoid and arranged in nests and cords, and the stroma was rich in sinusoids. The surrounding gastric mucosa showed atrophy with mild intestinal metaplasia or pseudopyloric gland metaplasia. Neuroendocrine cells could be seen with diffuse linear, nodular, and adenomatous hyperplasia. Immunohistochemically, the tumor cells diffusely expressed cytokeratin, chromogranin, synaptophysin, and CD56. Whole-genome high-throughput molecular sequencing revealed a pathogenic germline mutation in the BRCA2 gene, a heterozygous germline frameshift mutation in exon 11, c.6443_6444del (p.S2148Yfs*2). The final diagnosis was gastric type 1 ECL-cell NETs with a BRCA2 gene germline mutation, accompanied by autoimmune gastritis.

CONCLUSION

This is the first report of a case of type 1 gastric ECL-cell NETs with a pathogenic germline mutation of the BRCA2 gene. The findings of this report will expand the germline mutation spectrum of gastric NETs and increase the understanding of the molecular changes present in these tumors for their improved diagnosis in the future.

[Research on the establishment of standard limits for perfluorooctanoic acid and perfluorooctane sulfonate in the "Standards for Drinking Water Quality（GB5749-2022）"in China]

Perfluorinated compounds, especially Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), are widely detected in water environments in China. Considering the potential health risks of drinking water exposure routes, PFOA and PFOS have been added to the water quality reference index of the newly issued "Standards for Drinking Water Quality (GB5749-2022)", with limit values of 40 and 80 ng/L, respectively. This study analyzed and discussed the relevant technical contents for determining the limits of the hygiene standard, including the environmental existence level and exposure status of PFOA and PFOS, health effects, derivation of safety reference values, and determination of hygiene standard limits. It also proposed prospects for the future direction of formulating drinking water standards.

Nano-Calcium Carbonate Affect the Respiratory and Function Through Inducing Oxidative Stress: A Cross-sectional Study Among Occupational Exposure of Workers and a Further Research for Underlying Mechanisms

OBJECTIVE

The aim of the study is to investigate whether nano-calcium carbonate (nano-CaCO 3 ) occupational exposure could induce adverse health effects in workers.

METHODS

A cross-sectional study was conducted in a nano-CaCO 3 manufacturing plant in China. Then, we have studied the dynamic distribution of nano-CaCO 3 in nude mice and examined the oxidative damage biomarkers of subchronic administrated nano-CaCO 3 on Sprague-Dawley rats.

RESULTS

The forced vital capacity (%) and the ratio of FEV1 to FVC is the rate of one second of workers were significantly decreased than unexposed individuals. Dynamic imaging in mice of fluorescence labeled nano-CaCO 3 showed relatively high uptake and slow washout in lung. Similar to population data, the decline in serum glutathione level and elevation in serum MDA were observed in nano-CaCO 3 -infected Sprague-Dawley rats.

CONCLUSIONS

We found that nano-CaCO 3 exposure may result in the poor pulmonary function in workers and lead to the changes of oxidative stress indexes.

Molecular and clinical features of papillary thyroid cancer in adult patients with a non-classical phenotype

Purpose

Genotyping is fundamental in papillary thyroid cancer (PTC) and helps to enhance diagnosis and prognosis and determine appropriate treatments. The phenotype-genotype association in PTC was previously studied, with BRAF V600E characterizing classic PTC and tall-cell PTC and RAS mutations characterizing follicular-variant PTC. In clinic, some non-classical histological subtypes of PTC were also identified, however, their genotype remains unclear. In this study, we collected samples of these non-classical PTC after the exclusion of classic phenotypes and examined their phenotypes, genotype and the relationship between phenotype and genotype.

Methods

We screened out non-classical PTC by excluding classical PTC from 1,059 different thyroid samples, and a total of 24 cases was obtained and described from the morphological features, which is rare in differentiated PTC. DNA/RNA sequencing was performed using 18 available samples to describe the genetic features.

Results

PTC with the non-classical phenotype were characterized cuboidal to low columnar tumor cells with subtle nuclear features of PTC and without discernible nuclear elongation, concurrently with dense microfollicles, delicate papillae or solid nodules with delicate fibrovascular cores. They were associated with lymphatic vessel invasion (P<0.001) but not with a worse prognosis (P=0.791). Gene fusions were identified in 14 of 18 (77.8%) cases, including eight fusions of NTRK and six fusions of RET. The high percentage of fusions in this papillary thyroid cancer subgroup suggested a correlation of gene fusions with the phenotype that does not belong to the BRAF V600E-mutant or RAS-mutant group.

Conclusions

Our study retrospectively screened a large cohort of different thyroid tissue samples, and presented the histopathological and genetic features of a non-classical phenotype of PTC from 24 patients. It may contribute to diagnose in PTC, and patients of these non-classical phenotype may benefit from targeted therapy, compared to a natural patient cohort without selection.

[Standardization of clinical application of mass spectrometry method for measurement of vitamin D in capillary blood of children: a multicenter study]

Objective: To establish the norms and clinical application standards of mass spectrometry method to measure vitamin D in capillary blood. Methods: Following the "Province-City-Hospital" sampling procedure, a cross-sectional sample of 1 655 healthy children under 7 years of age were recruited from 12 provinces, autonomous regions, or municipalities in China from November 2020 to December 2021. Both venous and capillary blood samples from the same individual were collected, for which serum 25(OH)D levels were measured by high-performance liquid chromatography-mass spectrometry (HPLC-MS/MS) method. Pearson correlation analysis and linear regression analysis were used to detect the correlation and determine a correction algorithm. The agreement was analyzed using Bland-Altman plot and Kappa statistic. The sensitivity and specificity were evaluated using receiver operating characteristic (ROC) curve method. Results: Venous and capillary 25(OH)D levels of 1 655 healthy children under 7 years of age were 74.25 (59.50, 92.00) and 68.75 (54.44, 86.25) nmol/L, respectively, showed a significant difference(Z=22.14, P<0.001) as well as a highly significant correlation between venous and capillary 25(OH)D levels(r=0.95, P<0.001). Linear regression analysis was then performed to determine the correction algorithm: lg(corrected capillary 25(OH)D)=0.13+0.95×lg(capillary 25(OH)D)(R²=0.90,P<0.001). The deviation between venous and corrected capillary 25(OH)D levels was (0.50±17.50) nmol/L, a difference value that did not reach statistical significance (P>0.05). The cut-off values of capillary blood 25(OH)D values 30.00, 50.00, 75.00 nmol/L corresponding to venous blood 25(OH)D values were 26.59, 45.56, and 69.84 nmol/L, respectively. Good consistency was observed between venous and corrected capillary 25(OH)D levels in clinical diagnosis (Kappa value 0.68-0.81). Corrected capillary 25(OH)D showed a high clinically predictive value (area under curve 0.97-0.99,sensitivity 0.72-0.92,specificity 0.89-0.99). Conclusion: The standardized capillary HPLC-MS/MS method can be used to detect 25(OH)D levels in children clinically.

Dan Bai Xiao Formula combined with glucocorticoids and cyclophosphamide for pediatric lupus nephritis: A pilot prospective study

BACKGROUND

Patients with lupus nephritis (LN) typically undergo long-term treatment with glucocorticoids (GCs) and immunosuppressants. There is a growing demand for optimal therapy with better remission results and fewer side effects. Sustained traditional Chinese medicine (TCM) might be quite valuable for multitarget therapy, reducing the total dosage of GCs and minimizing the side effects of immunosuppressants.

AIM

To evaluate whether Dan Bai Xiao Formula (DBXF) can reduce the exposure to GCs and cyclophosphamide (CYC) and to assess the efficacy and safety of DBXF for the resolution of proteinuria and hematuria in children with LN.

METHODS

A 24-wk pilot study was conducted at Beijing Children’s Hospital. Children with active LN were divided into either a TCM group or a control group. Children in the TCM group received DBXF combined with GCs and CYC, and the ones in the control group received GCs and CYC every 4 wk for 24 wk. The primary endpoints of this trial were urinary protein excretion of < 150 mg/d and normal serum albumin concentration and renal function.

RESULTS

The trial included 78 children, of whom 38 received GCs and CYC treatment (control group) and the remaining 40 received DBXF combined with GCs and CYC treatment (TCM group). At week 24, the TCM group showed a better rate of complete remission (42.5%); however, there was no significant difference compared with the control group (31.5%, P > 0.05). The urine red blood cell count and urine protein level were significantly lower in the TCM group than in the control group at weeks 4, 12, and 24 (P < 0.05). Furthermore, patients in the TCM group had a lower proportion of methylprednisolone pulses than those in the control group (1.30 ± 1.41 vs 3.05 ± 2.02, P < 0.0001). The ending GC dose was significantly lower in the TCM group than in the control group (P < 0.001). Moreover, more hepatic function damage, gastrointestinal adverse effects, and hypertension were observed in the control group than in the TCM group (P < 0.05).

CONCLUSION

The findings suggest that DBXF treatment is effective and safe as a supplementary therapy for LN and is superior to routine GC and CYC therapy. DBXF containing combination treatment possibly results in a faster resolution of proteinuria and hematuria, smoother GC reduction, fewer methylprednisolone pulses, and fewer adverse events.

Puerarin-V prevents the progression of hypoxia- and monocrotaline-induced pulmonary hypertension in rodent models

Pulmonary hypertension (PH) is a cardiopulmonary disease characterized by a progressive increase in pulmonary vascular resistance. One of the initial pathogenic factors of PH is pulmonary arterial remodeling under various stimuli. Current marketed drugs against PH mainly relieve symptoms without significant improvement in overall prognosis. Discovering and developing new therapeutic drugs that interfere with vascular remodeling is in urgent need. Puerarin is an isoflavone compound extracted from the root of Kudzu vine, which is widely used in the treatment of cardiovascular diseases. In the present study, we evaluated the efficacy of puerarin in the treatment of experimental PH. PH was induced in rats by a single injection of MCT (50 mg/kg, sc), and in mice by exposure to hypoxia (10% O2) for 14 days. After MCT injection the rats were administered puerarin (10, 30, 100 mg · kg-1 · d-1, i.g.) for 28 days, whereas hypoxia-treated mice were pre-administered puerarin (60 mg · kg-1 · d-1, i.g.) for 7 days. We showed that puerarin administration exerted significant protective effects in both experimental PH rodent models, evidenced by significantly reduced right ventricular systolic pressure (RVSP) and lung injury, improved pulmonary artery blood flow as well as pulmonary vasodilation and contraction function, inhibited inflammatory responses in lung tissues, improved resistance to apoptosis and abnormal proliferation in lung tissues, attenuated right ventricular injury and remodeling, and maintained normal function of the right ventricle. We revealed that MCT and hypoxia treatment significantly downregulated BMPR2/Smad signaling in the lung tissues and PPARγ/PI3K/Akt signaling in the lung tissues and right ventricles, which were restored by puerarin administration. In addition, we showed that a novel crystal type V (Puer-V) exerted better therapeutic effects than the crude form of puerarin (Puer). Furthermore, Puer-V was more efficient than bosentan (a positive control drug) in alleviating the abnormal structural changes and dysfunction of lung tissues and right ventricles. In conclusion, this study provides experimental evidence for developing Puer-V as a novel therapeutic drug to treat PH.

Physicochemical characterization of a fern polysaccharide from Alsophila spinulosa leaf and its anti-aging activity in Caenorhabditis elegans

Alsophila spinulosa , as a rare tree fern with potential medicinal value, has attracted extensive attention. Herein, the physicochemical properties, antioxidant and anti-aging activities of polysaccharide from A. spinulosa leaf (ALP) were investigated. ALP was composed of galactose, arabinose, glucose, rhamnose, galacturonic acid, mannose, and fucose. (1→), (1→6), and (1→2) bond types were the primary glycosidic bond in ALP. Surprisingly, ALP displayed the wonderful activity of antioxidant and anti-aging, including excellent scavenging ability against DPPH and ABTS radicals in vitro ; prolonging the life span, improving activity of antioxidative enzymes (SOD and CAT), and decreasing the level of ROS, MDA in Caenorhabditis elegans . Meanwhile, ALP promoted DAF-16 to move into the nuclear. Overall, our results illustrated that ALP could be further developed as a functional food ingredient.

Blood glucose mediated the effects of cognitive function impairment related to aluminum exposure in Chinese aluminum smelting workers

OBJECT

To explore the effects of occupational aluminum exposure on workers' cognitive function and blood glucose concentration, and to analyze whether blood glucose concentration can mediate the cognitive changes caused by aluminum.

METHOD

Our study recruited 375 workers from an aluminum factory in northern China. We collected the fasting elbow venous blood of the workers, measured their fasting blood glucose concentration (FBG), and used ICP-MS to determine plasma aluminum concentration (P-Al) as an indicator of internal exposure. The Montreal Cognitive Assessment (MoCA), was used to assess the cognitive function of workers. Generalized linear model was used to analyze the association of P-Al with cognitive function and blood glucose concentration, and the restricted cubic spline model was used to fit the dose-response relationship. We also conducted a mediation effect analysis.

RESULT

We observed the dose-response relationship, that is, as the P-Al increased, sum of MoCA, visuospatial/executive, naming, language, and abstraction scores decreased, and the blood glucose concentration increased. For every e-fold increase in P-Al, sum of MoCA, visuospatial/executive, naming, language, and abstraction scores decreased by 0.328 points, 0.120 points, 0.059 points, 0.060 points, and 0.083 points, respectively, and FBG rose by 0.109 mmol/L. FBG has a significant mediating effect between P-Al and sum of MoCA (P for mediator=0.042), and it could explain 10.7% of the effect of cognitive level related to P-Al.

CONCLUSION

Occupational aluminum exposure negatively affected the cognitive function of workers and positively affected FBG. FBG may partially explain the impact of occupational aluminum exposure on workers' cognitive function.

Effect of Alteplase Thrombolysis on Coagulation Function and Nerve Function of Patients with Ischemic Stroke

Objective

To investigate the effects of alteplase thrombolysis on coagulation function and nerve function of patients with ischemic stroke.

Methods

76 cases with ischemic stroke receiving thrombolytic therapy in Cangzhou Central Hospital from November 2018 to November 2019 were recruited. They were assigned via the random number table method at a ratio of 1 : 1 to receive alteplase thrombolysis either within 3h after the onset (observation group) or within 3-4.5 h after the onset (control group), followed by aspirin administration after no bleeding in cranial computed tomography (CT). Outcome measures included plasma fibrinogen (FIB), activated partial prothrombin time (APTT), platelet (PLT) levels, the National Institute of Health stroke scale (NIHSS) score, and adverse events.

Results

Alteplase thrombolysis within 3 h was associated with better prothrombin time (PT), APTT, FIB, and PLT levels versus thrombolysis within 3-4.5 h (P < 0.05). Thrombolysis within 3 h showed significantly lower NIHSS scores versus within 3-4.5 h (P < 0.05). The two groups showed a similar incidence of adverse events (X 2 = 2.963, P=0.615).

Conclusion

Alteplase thrombolysis showed benefits in mitigating the coagulation function and nerve function damage of patients with ischemic stroke, especially within 3 hours after the onset, with a high safety profile.

[Analysis of vitamin D status among children under 7 years of age in some regions of China]

Objective: To explore current vitamin D status and influential factors of vitamin D deficiency and insufficiency among children under 7 years of age in 11 provinces, autonomous regions or municipalities of China. Methods: According to the "province-city-hospital" sampling technical route, a total of 1 531 healthy children under 7 years of age were sampled from 11 provinces, autonomous regions or municipalities in China by the cluster random sampling method from November 2020 to November 2021. The demographic information, family conditions, behavior and living habits and feeding behaviors were collected using unified questionnaire. Serum 25-hydroxyvitamin D(25(OH)D) levels were measured by liquid chromatography-tandem mass spectrometry. Serum 25(OH)D<30 nmol/L was considered deficient and 30-50 nmol/L was considered insufficient. With 25(OH)D≤50 nmol/L as the dependent variable, multivariate Logistic regression was applied to analyze the association between vitamin D deficiency and insufficiency and potential influential factors. Results: The prevalence of vitamin D deficiency and insufficiency among children under 7 years of age in 11 provinces, autonomous regions or municipalities of China was 14.0% (215/1 531), 3.8% (25/664) and 21.9% (190/867) in 0-<3 and 3-<7 of age years, respectively. Compared to children aged 0-<3 years, children aged 3-<7 years had a 2.6-fold increased risk of vitamin D deficiency and insufficiency (OR=3.60, 95%CI 1.93-6.72, P<0.001). Frequent sunlight exposure (OR=0.46, 95%CI 0.29-0.73, P=0.001), vitamin D supplementation (sometimes, OR=0.33, 95%CI 0.21-0.51, P<0.001; daily, OR=0.20, 95%CI 0.11-0.36, P<0.001) and infant formula intake(4-7 times per weeks, OR=0.43, 95%CI 0.28-0.68, P<0.001) were protective factors for vitamin D deficiency and insufficiency. Conclusion: Vitamin D deficiency and insufficiency are common among children under 7 years of age in 11 provinces, autonomous regions or municipalities of China, which is affected by age, sunlight exposure, vitamin D supplementation and infant formula intake.

[Characteristics and Source Apportionment of Ambient VOCs in Lhasa]

Due to the high altitude of plateau cities and strong ultraviolet radiation, the sources and fates of volatile organic compounds show unique characteristics. In this study, the atmospheric volatile organic compound (VOCs) samples were collected at two urban sites and one background site using tank sampling in Lhasa in 2019, and then the composition, concentration, and sources were characterized. The results showed that the average φ(VOCs) in Lhasa was 49.83×10^-9, of which the proportion of alkanes was the highest (61%), followed by OVOCs (12%), halogenated hydrocarbons (9%), olefin (9%), aromatic hydrocarbons (5%), and alkynes (4%). The respective contributions of VOCs sources at urban sites, such as Barkhor Street and Radiation Station in Lhasa, were as follows:combustion (64% and 48%) > traffic emission (17% and 31%) > industrial emission (14% and 14%) > solvents and coatings (3% and 3%) ≈plant+background (2% and 4%). The contribution of combustion was large mostly due to local incense burning (especially at Barkhor Street) and heating emissions. Traffic emissions contributed about one third to the VOCs at Radiation Station, which is related to its proximity to the transportation hub and the storage and logistics center upwind. Industrial emissions have a regional impact on ambient VOCs. Under the synergistic influence of meteorology and emissions, VOCs concentration, composition characteristics, and source contribution showed obvious seasonal variations and site differences in the Lhasa area.

[Association between the Controlling Nutritional Status score and long-term outcome in patients with acute heart failure]

Objective: To evaluate the nutritional status by the Controlling Nutritional Status (CONUT) score and its association with the long-term prognosis in patients with acute heart failure (AHF). Methods: This prospective monocentric study consecutively enrolled patients admitted to our hospital for AHF from April 2012 to May 2016. Patients were divided into 3 groups based on the CONUT score at admission: normal (0-1), mild malnutrition (2-4) and moderate-severe malnutrition (5-12) groups. Baseline information was obtained and recorded within 24 hours after admission. All patients were followed up every 3 months by outpatient visit or telephone call until March 2019. The primary endpoint was all-cause mortality. The Kaplan-Meier survival curves and log-rank test were used to compare all-cause mortality between groups. Variables showing statistical significance in the univariate analysis were incorporated into multivariate Cox regression model to analyze the independent risk factors for all-cause mortality after discharge. Results: A total of 396 patients were enrolled in this study, including 114 patients with normal nutritional status, 200 patients with mild malnutrition and 82 patients with moderate-severe malnutrition. One hundred and fifty-eight patients died during a median follow-up of 34 (18, 46) months. The mortality was 32.4% (37/114), 39% (78/200) and 52.4% (43/82) in normal, mild malnutrition and moderate-severe malnutrition groups, respectively. The mortality was significantly higher in the moderate-severe malnutrition group than in normal nutrition group (P<0.05). However, there was no significant difference in mortality between normal and mild malnutrition group as well as between mild and moderate-severe malnutrition group (both P>0.05). Kaplan-Meier curves indicated that patients with high CONUT score group was at higher risk of all-cause mortality compared with those with low CONUT score (P=0.002). Cox proportional hazard analyses showed that the risk of all-cause mortality of moderate-severe malnutrition group was significantly higher than that of normal nutrition group (HR =1.648, 95%CI 1.021-2.660, P=0.041). Conclusions: The CONUT score of patients with AHF at admission is associated with the long-term prognosis. High CONUT score is an independent risk factor for all-cause mortality in AHF patients after discharge.

The roles of exosomal immune checkpoint proteins in tumors

Targeting immune checkpoints has achieved great therapeutic effects in the treatment of early-stage tumors. However, most patients develop adaptive resistance to this therapy. The latest evidence demonstrates that tumor-derived exosomes may play a key role in systemic immune suppression and tumor progression. In this article, we highlight the role of exosomal immune checkpoint proteins in tumor immunity, with an emphasis on programmed death ligand 1 (PD-L1) and cytotoxic T lymphocyte-associated antigen 4 (CTLA-4), as well as emerging evidence on roles of T cell immunoglobulin-3 (TIM-3), arginase 1 (ARG1), and estrogen receptor binding fragment-associated antigen 9 (EBAG9) expressed by exosomes.

Acute heat stress alters the expression of genes and proteins associated with the unfolded protein response pathway in the liver of broilers

1. The aim of this study was to explore the effects of acute heat stress on serum hormone levels and the expression of genes and proteins related to the unfolded protein response (UPR) pathway and apoptotic process in the liver of broilers.2. A total of 144 Arbor Acres broilers (35-d-old) were randomly allocated to 4 different environmental-controlled chambers for acute heat exposure. The temperature of the 4 environmental chambers was adjusted to 26°C (control), 29°C, 32°C, and 35°C within 1 h, respectively. The blood and liver samples were collected after 6 h of constant heat exposure at set temperatures.3. The results showed that 6 h of acute heat stress increased serum hormone levels and up-regulated the expression of heat shock protein. The endoplasmic reticulum (ER) stress markers, GRP78 and GRP94, in the liver of broilers were significantly upregulated at the mRNA and protein levels. The PERK, IRE1, and XBP1 genes, which are involved in the unfolded protein response signalling, were significantly up-regulated at the mRNA levels. However, other pro-apoptotic genes showed no significant changes in the liver of broiler chickens in all groups except for upregulation of the anti-apoptotic gene BCL-xl.4. The results suggested that broilers have tolerance to acute heat stress to a certain extent. The UPR activation can alleviate ER stress and further prevent apoptosis in the liver of broilers under short-term exposure to high ambient temperatures.

[Clinical analysis of pregnancy with cardiovascular diseases for a decade of Beijing Anzhen Hospital]

Objective: To analyze the clinical data of pregnant women complicated with cardiovascular disease in our center in the past 10 years, and to explore the trend of incidence, clinical diagnosis, and treatment of the disease. Methods: Clinical data of pregnant women with cardiovascular disease who delivered in Beijing Anzhen Hospital, Capital Medical University from 2010 to 2019 were collected and analyzed retrospectively. According to the time of the establishment of multidisciplinary team (MDT) in the center, the pregnant women were divided into the first 5-year group (2010-2014) and the second 5-year group (2015-2019). The general data, the composition of pregnancy complicated with cardiovascular disease and the changes of maternal and infant outcomes of the two groups were analyzed. Results: (1) During 2010-2019, there were 2 267 cases of pregnancy complicated with cardiovascular disease (836 cases in the first 5-year group and 1 431 cases in the second 5-year group), with a total incidence of 10.2% (2 267/22 334). Among all kinds of cardiovascular diseases, arrhythmia (41.0%, 930/2 267) and congenital heart disease (38.2%, 865/2 267) were more common. (2) There were 212 cases (25.4%, 212/836) and 426 cases (29.8%, 426/1 431) classified as Ⅲ or Ⅳ by modified WHO cardiovascular risk classification in the first 5-year group and the second 5-year group, respectively, and the difference was statistically significant (χ²=5.076,P=0.024). Among all kinds of cardiovascular diseases, there were 111 cases (13.3%, 111/836) and 159 cases (11.1%, 159/1 431) with valvular disease in the first 5-year group and the second 5-year group, respectively. The change of the component ratio was -16.5% (the difference was significant when the absolute value of change>10%), showing a significant decreasing trend. Aortic disease was found in 16 cases (1.9%, 16/836) and 56 cases (3.9%, 56/1 431), respectively, with a significant upward trend of 105.3%. (3) The mortality rate of pregnant women with cardiovascular disease was 1.0% (22/2 267), and 1.2% (10/836) and 0.8% (12/1 431) in the first 5-year grouop and the second 5-year group, respectively. There was no significant difference between the two groups (χ²=0.702,P=0.402). ICU occupancy rates in the first 5-year group and the second 5-year group were 25.6% (214/836) and 20.7% (296/1 431), respectively, and the difference between the two groups was statistically significant (χ²=7.306,P=0.007). There were no significant differences in cesarean section rate, mortality rate and incidence of adverse events between the two groups of pregnant women, and there were no significant differences in birth weight, preterm birth rate, mortality rate and asphyxia rate between the two groups of newborns (all P>0.05). Conclusions: Pregnancy complicated with cardiovascular disease is a common cause of adverse obstetric outcomes. There are various types of specific cardiovascular diseases, and the prognosis varies greatly. In recent years, the disease composition ratio has changed, and the severity and complexity of diseases have increased. Hierarchical management, MDT and individual management could improve the treatment level and reduce adverse outcomes.

[Analysis of the effect of stent-assisted embolization for low-grade subarachnoid hemorrhage caused by V4 segment dissecting aneurysm of vertebral artery]

Objective: To investigate the efficacy and safety of different stents assisted embolization in the treatment of subarachnoid hemorrhage(SAH) caused by V4 dissecting aneurysm of vertebral artery. Methods: The clinical data of 39 patients with spontaneous SAH V4 dissecting aneurysm treated at the Department of Neurosurgery, the Northern Theater General Hospital from January 2016 to June 2019 were analyzed retrospectively.There were 21 males and 18 females, aged (48±17) years(range:35 to 68 years).There were 24 cases of HUNT-HESS grade Ⅰ and 15 cases of grade Ⅱ.Among them, 20 cases were treated with single stent-assisted embolization, 9 cases with multi-stent-assisted embolization, 9 cases with semi-dense mesh-assisted embolization, and 1 case with dense-mesh stent-assisted embolization.The perioperative and postoperative complications, postoperative recurrence were collected. Results: Intraoperative complications included 2 cases of aneurysm rupture and 2 cases of acute thrombosis.All aneurysms were densely packed according to the angiography performed immediately after operation.Postoperative complications included 3 cases of long-term responsible vascular ischemia(modified Rankin score<2). The patients were followed up for 15.1 months(range: 12 to 29 months). At the last follow-up, aneurysms recurrence occured in 10 cases, the recurrence rate was 25.6%(10/39). There were 6 cases of recurrence and 2 cases of complications in 20 cases with single stent-assisted embolization, 3 cases of recurrence and 4 cases of complications in 9 cases with multi-stent-assisted embolization, 1 case of recurrence and 1 case of complications in 9 cases with semi-dense mesh stent. Conclusion: Endovascular treatment is feasible for patients with vertebral artery dissecting aneurysm, and the appropriate surgical method should be selected according to the vascular structure and the location of the aneurysm.

[Association between sleep and prevalence of hypertension in elderly population]

Objective: To explore the association between sleep duration, sleep quality and the prevalence of hypertension in the elderly aged 65 years and above. Methods: This study was conducted among the elderly in communities in Yiwu, China from April to July, 2019, and participants were recruited through physical examination in the hospital. Face-to-face interview was performed to obtain basic information. Sleep duration and sleep quality were evaluated by Pittsburgh Sleep Quality Index (PSQI). Associations between sleep duration, sleep quality and hypertension were evaluated by multivariate logistic regression analysis. Results: A total of 3 169 elderly persons, aged ≥65 years old, were included in the study. The overall prevalence of hypertension was 50.8%. The elderly with very poor sleep quality and short sleep duration accounted for 22.4% and 28.5%, respectively. After adjusting for demographic characteristics, socioeconomic status, lifestyle and health status, the OR of hypertension for the elderly with very poor sleep quality was 1.42 (95%CI: 1.12-1.80) compared with those with very good sleep quality. Compared with the elderly with sleep duration of 6-7 h a night, the OR of hypertension for those with sleep duration <6 h was 1.37 (95%CI: 1.15-1.65). As the sleep quality decreased, the risk for hypertension increased. An U-shaped association was found between sleep duration and risk of hypertension. Subgroup analyses showed that this association existed in both men and women, but only significant in the elderly aged <75 years. Conclusion: Poor sleep quality and short sleep duration were associated with risk for hypertension in the elderly.

[Characteristics of PD-L1 expression in tumor cells and tumor microenvironment of DLBCL with MYD88 L265P mutation]

Objective: To study the effect of MYD88 L265P mutation on the expression of PD-L1 in tumor cells and tumor microenvironment in diffuse large B-cell lymphoma (DLBCL), and to provide theoretical basis for immunotherapy for patients. Methods: Multiplex ligation-dependent probe amplification (MLPA) was used to detect the frequency of MYD88 L265P mutation in 72 cases of DLBCL diagnosed by pathologists in Cancer Hospital of Chinese Academy of Medical Sciences from August 2008 to May 2010. Expression of PD-L1 in tumor cells and tumor microenvironment in all samples was evaluated using PD-L1 (22C3) and PD-L1 (SP142) with Ventana automatic immunohistochemical (IHC) platform. The relationship between MYD88 L265P mutation and the expression of PD-L1 in DLBCL tumor cells and tumor microenvironment was assessed. Results: Of the 72 cases of DLBCL, MYD88 L265P mutation was detected in 15 (20.8%) cases. Nine cases with JAK2 amplification were excluded, and the remaining 63 cases of DLBCL were divided into MYD88 L265P mutant group (n=14) and MYD88 L265P wild-type group (n=49). IHC results showed that among the 14 cases of MYD88 L265P mutant groups, PD-L1 (22C3) was positive in 7 cases (7/14) of tumor cells and PD-L1 (SP142) was positive in 4 cases (4/14) of tumor microenvironment. Among the 49 cases of MYD88 L265P wild-type group, 9 cases (18.4%) were positive for PD-L1 (22C3) in tumor cells, and 38 cases (77.6%) were positive for PD-L1(SP142) in tumor microenvironment. In addition, among the 16 cases with PD-L1(22C3) expression in tumor cells, only 2 of the 7 cases with MYD88 L265P mutation were positive for PD-L1 (SP142) in tumor microenvironment. All 9 cases with wild-type MYD88 L265P were positive for PD-L1 (SP142) in tumor microenvironment. Statistical analysis showed that the expression level of PD-L1 (22C3) in tumor cells in the MYD88 L265P mutant group was significantly higher than that in the MYD88 L265P wild-type group (P=0.017). The expression level of PD-L1 (SP142) in tumor microenvironment in the MYD88 L265P mutant group was significantly lower than that in the MYD88 L265P wild-type group (P=0.001). Conclusions: MYD88 L265P mutation may play an important role in the regulation of PD-L1 expression in DLBCL tumor cells and tumor microenvironment. Further studies will provide a theoretical basis for immunotherapy of DLBCL patients with MYD88 L265P mutation.

[Clinical application and curative effect observation of follicular unit extraction and transplantation in the treatment of cicatricial alopecia]

Objective: To observe the clinical effect of treatment with follicular unit extraction (FUE) and transplantation in treating cicatricial alopecia. Methods: The retrospective cohort study was conducted. From January 2012 to January 2018, 56 patients (36 males and 20 females, aged (25±9) years, 1% to 30% alopecia area of the whole scalp area) who met the inclusion criteria visited the outpatient department of the First Affiliated Hospital of Xi'an Medical University. They were treated with FUE transplantation. The procedure of treatment was performed through the preoperative planning, follicular extraction, follicular preparation, punching recipient site and hair transplantation. The survival rate of hair and density of survived hair were calculated, hair growth and complication were observed. The evaluation was conducted through questionnaire survey by 4 levels: very satisfied, satisfied, not satisfied, and not at all satisfied with effects. Results: After a follow-up of 9 to 24 months, the survival rate of hair in 56 patients was (70±9)%, and the density of survived hair was (35±8) roots/cm². In the evaluation of the curative effect after the first stage surgery, 34 cases (60.7%) were very satisfied, 16 cases (28.6%) were satisfied, and 6 cases (10.7%)thought the treatment was effective but not satisfied. Six unsatisfactory patients and 16 satisfactory patients underwent the second-stage transplantation, with 19 (86.4%) of them being very satisfied and 3 cases (13.6%) satisfied after the second-stage operation. None of the patients underwent the third-stage surgery. The transplanted hairs grew naturally, and there were no serious complications in all cases. Conclusions: FUE transplantation can effectively treat and improve cicatricial alopecia with less trauma, fewer complication, no scar in the donor site and rapid post-operative recovery, so it is worthy of clinical promotion.

[Clinical and genetic studies on 76 patients with hydrocephalus caused by methylmalonic acidemia combined with homocysteinuria]

Objective: To analyze the clinical features, genetic characteristics, treatment and follow-up results of patients with hydrocephalus caused by methylmalonic acidemia combined with homocysteinuria, and to discuss the optimal strategies for assessing and treating such patients. Methods: From January 1998 to December 2020, 76 patients with hydrocephalus due to methylmalonic acidemia combined with homocysteinuria in the Department of Pediatrics in 11 hospitals including Peking University First Hospital were diagnosed by biochemical, genetic analysis and brain imaging examination. The patients were divided into operation-group and non-operation-group according to whether they underwent ventriculoperitoneal shunt. The clinical features, laboratory examinations, genotype, and follow-up data were retrospectively analyzed. Data were compared between the two groups using rank sum test, and categorical data were compared using χ² test. Results: Among the 76 patients (51 male, 25 female), 5 were detected by newborn screening, while 71 were diagnosed after clinical onset, 68 cases (96%) had early-onset, 3 cases (4%) had late-onset. The most common clinical manifestations of 74 cases with complete data were psychomotor retardation in 74 cases (100%), visual impairment in 74 cases (100%), epilepsy in 44 cases (59%), anemia in 31 cases (42%), hypotonia or hypertonia in 21 cases (28%), feeding difficulties in 19 cases (26%) and disturbance of consciousness in 17 cases (23%). Genetic analysis was performed in 76 cases, all of whom had MMACHC gene variations, including 30 homozygous variations of MMACHC c.609G>A. The most common variations were c.609G>A (94, 62.7%), followed by c.658_660del (18, 12.0%), c.567dupT (9, 6.0%) and c.217C>T (8, 5.3%). Therapy including cobalamin intramuscular injection, L-carnitine and betaine were initiated immediately after diagnosis. A ventriculoperitoneal shunt operation was performed in 41 cases (operation group), and 31 patients improved after metabolic intervention (non-operation group). There was no significant difference in the age of onset, the age of diagnosis, the blood total homocysteine, methionine, and urinary methylmalonic acid concentration between the two groups (all P>0.05). The symptoms of psychomotor development, epilepsy, and visual impairments improved gradually after a long-term follow-up in the operation group. Conclusions: Hydrocephalus is a severe complication of methylmalonic acidemia combined with homocysteinuria. The most common clinical manifestations are psychomotor retardation, visual impairment, and epilepsy. It usually occurs in early-onset patients. Early diagnosis and etiological treatment are very important. Hydrocephalus may improve after metabolic intervention in some patients. For patients with severe ventricular dilatation, prompt surgical intervention can improve the prognosis.

[Clinical characteristics and pregnancy outcome of 14 pregnant women with history of atherosclerotic cardiovascular disease]

Objective: To summarize the clinical characters and pregnancy outcome in pregnant women with history of atherosclerotic cardiovascular disease (ASCVD). Methods: A total of 14 pregnant women with pre-existing ASCVD admitted to Beijing Anzhen Hospital from October 2013 to May 2020 were enrolled as subjects, whose ASCVD disease status, clinical manifestations, treatment and pregnancy outcomes were collected and retrospectively analyzed. Results: The age of subjects at diagnosis of ASCVD was (31±7) years old. The main intervention before pregnancy was revascularization (10 cases), and the rest 4 cases were treated with medicine. The age of subjects at pregnancy was (36±5) years old. A total of 12 cases had risk factors of ASCVD. In early stages of pregnancy, there were 1 case with cardiac function level Ⅲ and 1 with cardiac function level Ⅳ. Abnormal ventricular wall motion and ventricular aneurysm formation were determined in 3 cases by echocardiography, one of which was complicated with moderate left ventricular ejection fraction impairment. Abnormal ST segment in 4 cases and sinus tachycardia in 1 case were found by electrocardiogram. Troponin (TNI) increased in 1 case. The serum low density lipoprotein cholesterol level (LDL-C) of these pregnant women at early stages of pregnancy was (2.3±1.0) mmol/L. A total of 9 pregnant women entered later stages of pregnancy, 1 of whom had chest tightness after slight activity. There were 4 cases with excessive weight gain and 2 cases with insufficient weight gain during pregnancy, and there were 1 case with cardiac function level Ⅲ and 1 case with mild impaired left heart function. The average level of LDL-C was (2.6±0.6) mmol/L in 5 pregnant women at their later stages of pregnancy. The main treat measures included anti-platelet therapy (aspirin, 75-100 mg/d) and healthy lifestyle interventions. Five pregnant women terminated their pregnancy at the early stage of pregnancy, and 9 full-term pregnant women underwent hysterotomy with intraoperative blood loss of 180-800 ml. Adverse cardiac events occurred in 2 cases and gestational diabetes was diagnosed in 3 cases during pregnancy, among which 2 cases were complicated with chronic hypertension and preeclampsia. The weight of 9 live newborns was (3 102±647) g, among which 2 were smaller than gestational age and 1 was of low birth weight. Conclusions: Women with established ASCVD before preynancy have risk of adverse cardiac events in pregnancy. Strengthening the management of high risk factors in pregnancy is conducive to achieving a good pregnancy outcome.

Lycium barbarum Polysaccharide Inhibited Hypoxia-Inducible Factor 1 in COPD Patients

Background

Chronic obstructive pulmonary disease (COPD) is a chronic airway inflammatory disease characterized by irreversible airflow obstruction. Pathogenic mechanisms underlying COPD remain largely unknown.

Objective

The current study was designed to explore serum concentration of hypoxia-inducible factor 1α (HIF-1α) in stable COPD patients and the potential effect of Lycium barbarum polysaccharides (LBP) on HIF-1α protein expression.

Methods

Serum HIF-1α was quantified by ELISA in 102 stable COPD patients before and after 2-week orally taken LBP (100 mL/time, twice daily, 5–15 mg/mL). Correlation of serum LBP and lung function (FEV1%) or blood gas (PO₂ and PCO₂) was also analyzed. As a control, 105 healthy subjects were also enrolled into this study.

Results

Serum concentration of HIF-1α was significantly higher in the stable COPD patients (37.34 ± 7.20 pg/mL) than that in the healthy subjects (29.55 ± 9.66 pg/mL, P<0.001). Oral administration of LBP (5 mg/mL, 100 mL, twice daily for 2 weeks) not only relieved COPD symptoms but also significantly reduced serum HIF-1α concentration (36.94 ± 9.23 vs 30.49 ± 6.42 pg/mL, P<0.05). In addition, level of serum HIF-1α concentration was significantly correlated with PCO₂ (r = 0.283, P<0.001), but negatively and significantly correlated with PO₂ (r = −0.490, P=0.005) or FEV1%(r = −0.420, P=0.018).

Conclusion

These findings suggested that activation of HIF-1 signaling pathway may be involved in the pathophysiology of COPD and that stabilization of serum HIF-1α concentration by LBP might benefit the stable COPD patients.

Sub-chronic administration of benzo[a]pyrene disrupts hippocampal long-term potentiation via inhibiting CaMK II/PKC/PKA-ERK-CREB signaling in rats

Benzo[a]pyrene (B[a]P) is recognized as a neurotoxic pollutant to mammals, which could impair learning and memory function. Although there is some evidence to suggest that N-methyl-d-aspartate receptor (NMDAR), a glutamate receptor and ion channel protein in nerve cells, is involved into the B[a]P induced neurotoxicity, the exact molecular mechanisms remain to be elucidated, particularly the effects of B[a]P on the NMDAR downstream signaling transduction pathways. In the present study, we examined the neurotoxicity of sub-chronic administrated B[a]P on male Sprague-Dawley rats. Our data suggested that B[a]P exposure caused significant deficits in learning and memory function and the impairment of hippocampal LTP in rats. Further mechanistic studies indicate that B[a]P-induced learning and memory deficits are associated with the inhibition of NMDAR NR1 subunit transcription and protein phosphorylation. More importantly, the inactivation of CaMK II/PKC/PKA-ERK-CREB signaling pathways in hippocampus was detected at both the 2.5 and 6.25 mg/kg B[a]P-treated groups, indicating that multiple targets in NMDAR and downstream signaling pathways are involved in the B[a]P-induced neurotoxicity.

Cooperative Shear in Bulk Metallic Glass Composites Containing Metastable β-Ti Dendrites

We report a novel plastic deformation mechanism of bulk metallic glass composites (BMGCs) containing metastable β-Ti dendrites. Plastic deformation of the BMGCs beyond the ultimate tensile strength is mediated by cooperative shear events, which comprise a shear band in the glassy matrix and a continuous ω-Ti band with a thickness of ∼10  nm in the β-Ti dendrite. The cooperative shear leads to serrated shear avalanches. The formation of narrow ω-Ti bands is caused by high local strain rates during the cooperative shear. The cooperative shear mechanism enriches the deformation mechanisms of BMGCs and also deepens the understanding of ω-Ti formation.

miR-143-3p inhibits proliferation and invasion of hepatocellular carcinoma cells by regulating its target gene FGF1

PURPOSE

To explore FGF1 and miR-143-3p expression in hepatocellular carcinoma (HCC) cells and its related mechanisms.

METHODS

Eighty-two HCC patients treated at our hospital from January 2018 to January 2019 were enrolled as Group A, while further 80 healthy people undergoing physical examinations during the same time period were enrolled as Group B. HCC cells and normal human liver cells were purchased, with HepG2 and SMMC-7721 cells transfected with pcDNA3.1-FGF1, si-FGF1, NC, miR-143-3p-inhibitor and miR-143-3p-mimics. FGF1 and miR-143-3p expression was detected by qRT-PCR. The expression of N-cadherin, vimentin, Snail, Slug, E-cadherin and γ-catenin was detected by Western Blotting (WB). Cell proliferation was detected by MTT assay. Cell invasion was detected by Transwell. Cell apoptosis was detected by flow cytometry (FCM).

RESULTS

FGF1 was highly expressed but miR-143-3p was poorly expressed in HCC cells. Areas under the curves (AUCs) of the two indicators were > 0.8. The indicators were correlated with the age, gender, tumor invasion, degree of differentiation, tumor location and TNM staging of the patients. Silencing FGF1 and overexpressing miR-143-3p could promote cell apoptosis, inhibit cell growth, cell epithelial-mesenchymal transition (EMT) and the expression of N-cadherin, vimentin, Snail and Slug, and increase the expression of E-cadherin and γ-catenin. Dual luciferase reporter gene assay (DLRGA) confirmed that FGF1 and miR-143-3p had a targeted relationship. The rescue experiment showed that the proliferation, invasion and apoptosis of HepG2 and SMMC-7721 cells in the miR-143-3p-mimics+pcDNA3.1-FGF1 and miR-143-3p-inhibitor+Si-FGF1 groups were not different from those in the miR-NC group.

CONCLUSION

Inhibiting FGF1 can upregulate miR-143-3p-mediated Hedgehog signaling pathway, and affect cells' EMT, proliferation and invasion, so FGF1 is expected to become a potential therapeutic target for HCC.

[Value of sTREM-1 in serum and bronchoalveolar lavage fluid, APACHE II score, and SOFA score in evaluating the conditions and prognosis of children with severe pneumonia]

OBJECTIVE

To study the significance of the level of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in serum and bronchoalveolar lavage fluid (BALF), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and Sequential Organ Failure Assessment (SOFA) score in evaluating the conditions and prognosis of children with severe pneumonia.

METHODS

A total of 76 children with severe pneumonia who were admitted from August 2017 to October 2019 were enrolled as the severe pneumonia group. According to the treatment outcome, they were divided into a non-response group with 34 children and a response group with 42 children. Ninety-four children with common pneumonia who were admitted during the same period of time were enrolled as the common pneumonia group. One hundred healthy children who underwent physical examination in the outpatient service during the same period of time were enrolled as the control group. The serum level of sTREM-1, APACHE II score, and SOFA score were measured for each group, and the level of sTREM-1 in BALF was measured for children with severe pneumonia. The correlation of the above indices with the severity and prognosis of severe pneumonia in children was analyzed.

RESULTS

The severe pneumonia group had significantly higher serum sTREM-1 level, APACHEII score, and SOFA score than the common pneumonia group and the control group (P<0.05). For the children with severe pneumonia, the non-response group had significant increases in the levels of sTREM-1 in serum and BALF and SOFA score on day 7 after admission, while the response group had significant reductions in these indices, and there were significant differences between the two groups (P<0.05). Positive correlation was found between any two of serum sTREM-1, BALF sTREM-1, and SOFA score (P<0.05). APACHE II score was not correlated with serum sTREM-1, BALF sTREM-1, and SOFA score (P>0.05).

CONCLUSIONS

The level of sTREM-1 in serum and BALF and SOFA score can be used to evaluate the severity and prognosis of severe pneumonia in children.

Effects of dietary energy and protein content and lipid source on growth performance and carcass traits in Pekin ducks

The present study was conducted to determine the impact of dietary energy and protein concentrations and lipid sources on growth performance and carcass traits of Pekin ducks. In Exp. 1, 15-day-old ducks (6 replicate pens, 60 ducks/pen) were randomly assigned to 4 dietary treatments with different metabolizable energy (ME) and crude protein (CP) concentrations (2,850 kcal/kg and 16%, 2,950 kcal/kg and 16.5%, 3,050 kcal/kg and 17.0%, and 3,150 kcal/kg and 17.5%) based on body weight (BW). In Exp. 2, 20-day-old ducks (4 replicate pens, 60 ducks/pen) were randomly allotted to 3 dietary fat sources (soybean oil, lard, and palm oil) with or without emulsifier in a 3 × 2 factorial arrangement. In Exp. 1, increasing ME and CP level improved (P < 0.05) body weight gain (BWG) and cost-to-gain ratio linearly, but reduced (P < 0.05) feed intake (FI) and feed-to-gain ratio (F/G) linearly. Breast skin thickness and liver redness (a*) value increased (P < 0.05) linearly with the increasing ME and CP level. In Exp. 2, no interactions between fat sources and emulsifier were observed. Feeding lard and palm oil diets increased (P < 0.05) final BW and BWG compared to soybean oil. Birds fed soybean oil and palm oil diets had lower (P < 0.05) FI compared to those fed lard diet. F/G in soybean oil and lard groups was higher (P < 0.05) compared to palm oil group. Birds in palm oil and lard groups had higher (P < 0.05) European production efficiency factor than those in soybean oil group. The addition of emulsifier increased (P < 0.05) BWG. In summary, the optimal ME and CP level for roasting was 2,950 kcal/kg ME and 16.5% CP and the palm oil was better than soybean oil and lard in Pekin ducks from 15 to 40 D of age.

Effects of methylsulfonylmethane on growth performance, immunity, antioxidant capacity, and meat quality in Pekin ducks

This study was conducted to determine the effect of methylsulfonylmethane (MSM) on growth performance, immune function, antioxidant capacity, and meat quality in Pekin ducks. A total of 960 female 1-day-old Pekin ducklings (53.3 ± 0.4 g) were randomly allotted to 3 treatments with 8 replicates of 40 birds, based on their body weight (BW). The experiment lasted 6 wks, and dietary treatments included a corn–soybean meal–based diet supplemented with 0%, 0.15%, and 0.3% MSM, that is, CON, MSM1, and MSM2, respectively. Growth performance, serum profiles, and meat quality were determined. During the period of days 22–42, BW gain (BWG) in MSM2 treatment was higher (P < 0.05) and feed-to-gain ratio (F/G) was lower (P < 0.05) than those of CON and MSM1 treatments. BW gain and final BW in MSM2 treatment were increased (P < 0.05) compared with CON and MSM1 treatments during the period of days 1–42. Serum activities of superoxide dismutase and glutathione peroxidase, total antioxidative capacity, and concentrations of interleukin-2 and interleukin-6 were higher (P < 0.05) in MSM2 than in CON treatment. Ducks in the MSM2 treatment group had lower (P < 0.05) serum malondialdehyde, interferon gamma, and tumor necrosis factor-α levels than those in the CON treatment group. The supplementation of MSM increased (P < 0.05) water-holding capacity and redness (a*) and decreased (P < 0.05) values for 2-thiobarbituric acid and drip loss on day 5. Ducks in the MSM2 treatment group had higher (P < 0.05) pH_24h than those in the CON treatment group. Taken together, the inclusion of MSM (0.3%) increased final BW and BWG during periods of days 22–42 and days 1–42, reduced feed-to-gain ratio during the period of days 22–42, and resulted in positive effects on immunity, antioxidant capacity, and meat quality.

[Contrast-enhanced CT and texture analysis of mass-forming pancreatitis and cancer in the pancreatic head]

Objective: To explore the value of contrast-enhanced CT combined with texture analysis in differentiating pancreatic cancer from mass-forming pancreatitis in pancreatic head. Methods: A retrospective study collected 21 patients with pancreatic head mass-forming pancreatitis confirmed by surgery or biopsy and 47 patients with pancreatic ductal adenocarcinoma confirmed by surgery. The patients visited the Affiliated Hospital of Nanjing University of Chinese Medicine and the First Affiliated Hospital of Wannan Medical College between January 2014 and December 2017. Gender, age and CT findings were collected. The parenchymal phase was selected for texture analysis. The minimum absolute shrinkage and selection operator (LASSO) method was applied for dimensionality reduction.Two independent sample t-tests or Mann-Whitney U test were used for continuous variables based on the Shapiro-Wilks normality test results. Categorical variables were tested by Chi-square or Fisher test. By multivariable regression analysis, CT findings, CT texture analysis, CT findings combined with texture analysis prediction models were established. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of individual indicators and each prediction model. The Delong test was used to compare the area under the curve (AUC) of each model. Results: The CT findings prediction model consisted of CT value of lesion on pancreatic parenchymal phase and pancreatic duct penetrating sign. The texture analysis prediction model consists of root mean square and low grey level run emphasis_angle135. The AUC of them were not statistically different (Z=0.150,P>0.05). The combined predictive model had the better diagnostic performance (AUC 0.944, sensitivity 83.0%, specificity 95.2%, +LR 17.43, -LR 0.18) than CT sign prediction model (Z=2.008, P<0.05) and texture analysis prediction model(Z=2.236, P<0.05) were significantly different. Conclusions: The CT findings model and the texture analysis model have equivalent diagnostic performance in the differentiation of mass-forming pancreatitis and pancreatic cancer. The enhanced CT combined with texture analysis model has the best diagnostic efficiency and can further improve the diagnostic ability.

Effects of stale maize on growth performance, immunity, intestinal morphology and antioxidant capacity in broilers

OBJECTIVE

This study was conducted to determine the effects of stale maize on growth performance, immunity, intestinal morphology, and antioxidant capacity in broilers.

METHODS

A total of 800 one-day-old male Arbor Acres broilers (45.4±0.5 g) were blocked based on body weight, and then allocated randomly to 2 treatments with 20 cages per treatment and 20 broilers per cage in this 6-week experiment. Dietary treatments included a basal diet and diets with 100% of control maize replaced by stale maize.

RESULTS

The content of fat acidity value was higher (p<0.05) while the starch, activities of catalase and peroxidase were lower (p<0.05) than the control maize. Feeding stale maize diets reduced (p<0.05) average daily feed intake (ADFI) throughout the experiment, feed conversion ratio (FCR) during d 0 to 21 and the whole experiment as well as relative weight of liver, spleen, bursa of Fabricius and thymus (p<0.05) on d 21. Feeding stale maize diets decreased jejunum villus height (VH) and VH/crypt depth (CD) (p<0.05) on d 21 and 42 as well as ileum VH/CD on d 42. The levels of immunoglobulin G, acid α-naphthylacetate esterase positive ratios and lymphocyte proliferation on d 21 and 42 as well as lysozyme activity and avian influenza antibody H5N1 titer on d 21 decreased (p<0.05) by the stale maize. Feeding stale maize diets reduced (p<0.05) serum interferon-γ, tumor necrosis factor-α, interleukin-2 on d 21 and interleukin-6 on d 21 and 42. Broilers fed stale maize diets had lower levels of (p<0.05) total antioxidative capacity on d 42, superoxide dismutase and glutathione peroxidase on d 21 and 42, but higher (p<0.05) levels of malondialdehyde on d 21 and 42.

CONCLUSION

Feeding 100% stale maize decreased ADFI and FCR, caused adverse effects on immunity and antioxidant function and altered intestinal morphology in broilers.

[Clinicopathological characteristics and differential diagnosis of interdigitating dendritic cell sarcoma]

Objective: To analyze the clinicopathological features and differential diagnosis of interdigitating dendritic cell sarcoma (IDCS). Methods: The clinical pathological features of 7 IDCS were analyzed. Among them, the follow-up results of 6 cases were available. Results: Among the 7 IDCS patients, 4 cases were male and 3 were female. The age of the patients ranged from 26 to 69 years.Three cases were originated from lymph nodes and 4 cases were originated from skin, stomach, adrenal gland and mesentery, respectively. Microscopically, the tumor cells presented as fascicular and storiform proliferation and infiltrated by lymphocytes. The tumor cells were short-spindle or ovoid, with indistinct border of cytoplasm. The immunohistochemistry results showed that tumor cells were S-100, Vim, CD68 and CD163 positive, and AE1/AE3, EMA, CD117, CD34, Desmin, SMA, CD1α, CD21, CD23, CD35, HMB45, Melan-A, MelanPan and ALK negative.The BRAF mutation and clonal rearrangement of T and B cells were not detected. Among the follow-up period of 7 IDCS patients, 3 occurred disease progressions. Conclusions: IDCS is extremely rare with unique pathological features, and its lesion is not limited to the lymph node. The IDCS patients with extensive lesions may have worse prognose. The differential diagnosis of IDCS includes other histiocytic and dendritic cell neoplasms, malignant melanoma and soft tissue neoplasms.

Effects of absorbents on growth performance, blood profiles and liver gene expression in broilers fed diets naturally contaminated with aflatoxin

Objective

The study was conducted to evaluate the effects of the absorbent (a mixture of activated carbon and hydrated sodium calcium aluminosilicate) on growth performance, blood profiles and hepatic genes expression in broilers fed diets naturally contaminated with aflatoxin.

Methods

A total of 1,200 one-day-old male chicks were randomly assigned to 6 treatments with 10 replicate cages per treatment. The dietary treatments were as follows: i) control (basal diets); ii) 50% contaminated corn; iii) 100% contaminated corn; iv) control+1% adsorbent; v) 50% contaminated corn+1% absorbent; vi) 100% contaminated corn+1% absorbent.

Results

During d 1 to 21, feeding contaminated diets reduced (p<0.05) body weight (BW), average daily gain (ADG), and average daily feed intake (ADFI), but increased (p<0.05) feed-to-gain ratio (F/G). The absorbent supplementation increased (p<0.05) BW, ADG, and ADFI. There were interactions (p<0.05) in BW, ADG, and ADFI between contaminated corn and absorbent. Overall, birds fed 100% contaminated diets had lower (p<0.05) final BW and ADG, but higher (p<0.05) F/G compared to those fed control diets. The absorbent addition increased (p<0.05) serum albumin concentration on d 14 and 28 and total protein (TP) level on d 28, decreased (p<0.05) alanine transaminase activity on d 14 and activities of aspartate aminotransferase and alkaline phosphatase on d 28. Feeding contaminated diets reduced (p<0.05) hepatic TP content on d 28 and 42. The contaminated diets upregulated (p<0.05) expression of interleukin-6, catalase (CAT), and superoxide dismutase (SOD), but downregulated (p<0.05) glutathione S-transferase (GST) expression in liver. The absorbent supplementation increased (p<0.05) interleukin-1β, CAT, SOD, cytochrome P450 1A1 and GST expression in liver. There were interactions (p<0.05) in the expression of hepatic CAT, SOD, and GST between contaminated corn and absorbent.

Conclusion

The results suggest that the naturally aflatoxin-contaminated corn depressed growth performance, while the adsorbent could partially attenuate the adverse effects of aflatoxin on growth performance, blood profiles and hepatic genes expression in broilers.

[Effects of moxibustion at 45 ℃ on blood lipoids and serum level of ox-LDL and NO in rats with hyperlipidemia]

OBJECTIVE

To observe the effects of moxibustion at different temperatures (38 ℃ and 45 ℃) on blood lipoids and serum level of oxidized low density lipoprotein (ox-LDL) and nitric oxide (NO) in rats with hyperlipidemia, and to explore the correlation between regulating blood fat and anti-oxidative stress and protection of vascular endothelium of moxibustion at 45 ℃.

METHODS

According to random number table, 60 SD rats were randomly divided into a normal group, a model group, a moxibustion at 38 ℃ group and a moxibustion at 45 ℃ group, 15 rats in each group. The rats in the normal group received no treatment; the rats in the remaining three groups were fed with high-fat diet for 8 weeks to prepare rat models of hyperlipidemia. After successful modeling, the rats in the model group received no treatment; the rats in the moxibustion at 38 ℃ group and moxibustion at 45 ℃ group were treated with moxibustion at "Shenque" (CV 8) and "Zusanli" (ST 36), and the temperature was controlled at (38±1) ℃ and (45±1) ℃, respectively. The moxibustion was given for 10 min at each acupoint, once every two days, and totally 4-week treatment was given. After treatment, the levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured by using biochemical colorimetric method; the levels of ox-LDL and NO were measured by using ELISA method.

RESULTS

① Compared with the normal group, the levels of TC, TG and LDL-C were significantly increased in the model group (all P<0.01); compared with the model group and moxibustion at 38 ℃ group, the levels of TC, TG and LDL-C were significantly decreased in the moxibustion at 45 ℃ group (P<0.01，P<0.05); compared with the model group, the levels of TC, TG and LDL-C were insignificantly decreased in the moxibustion at 38 ℃ group (all P>0.05). ② Compared with the normal group, the level of ox-LDL was increased but that of NO was decreased in the model group (both P<0.01); compared with the model group and moxibustion at 38 ℃ group, the level of ox-LDL was decreased but that of NO was increased in the moxibustion at 45 ℃ group (P<0.01, P<0.05); compared with the model group, the level of ox-LDL was decreased but that of NO was increased in the moxibustion at 38 ℃ group (both P<0.05).

CONCLUSION

Moxibustion at 45 ℃ has regulating effects on blood lipid in rats with hyperlipidemia, which can regulate blood lipid through various ways, such as anti-oxidative stress and protection of vascular endothelium.

[Diagnostic efficiency of NO/ET-1 and HCY level in severe OSAHS patients with cognitive impairment]

Objective:To investigate the diagnostic efficiency of HCY and NO/ET-1 to cognitive dysfunction in patients with severe obstructive sleep apnea hypopnea syndrome, and to interfere with the cognitive function of severe OSAHS patients. Method: Eighty-six patients with OSAHS were divided into mild group (22 cases), moderate group (23 cases), severe group (41 cases) and healthy physical examination group (50 cases). The levels of serum HCY and NO/ET-1 were compared between the four groups. The Montreal cognitive assessment scale was used to evaluate the incidence of mild cognitive impairment in severe OSAHS group, and the correlation between the level of serum HCY, NO/ET-1 and cognitive function in severe OSAHS group was analyzed. Result:The level of serum HCY in patients with severe OSAHS with cognitive impairment was(32.28±3.92)μmol/L, higher than that of the cognitive moderate group(26.34±4.05)μmol/L, and mild group (18.62±3.29)μmol/L. The level of serum NO/ET-1 in patients with severe OSAHS with cognitive impairment was (0.69±0.19), higher than that of the cognitive moderate group(2.76±0.28), and mild group (3.98±0.37), the difference was statistically significant (P<0.05). In severe group, there was a negative correlation between the level of serum HCY and the score of MoCA and its subscores (P<0.05), and there was a positive correlation between the total scores of NO/ET-1 and MoCA and their subscores (P<0.05), and negative correlation between HCY and NO/ET-1 (P<0.05). The area under the ROC curve of predicting serum HCY and NO/ET-1 levels in severe OSAHS patients with cognitive impairment were 0.788(95%CI0.654-0.921) and 0.770 (95%CI0.642-0.899). Conclusion:Serum HCY and NO/ET-1 were the factors influencing the formation of cognitive impairment in severe OSAHS patients. The level of HCY was negatively correlated with the degree of cognitive impairment, and NO/ET-1 was positively correlated with the degree of cognitive impairment.

[Acquired blood coagulation factor Ⅴ deficiency in a patient with severe burn]

In March 2017, a severely burned male patient aged 36 years with hypovolemic shock was admitted to our hospital. The patient received large quantities of antibiotics and blood products and repeated skin graft after admission, and then he suffered wound errhysis and throat congestion. The patient was healthy before without family history of bleeding or thrombosis disease. Laboratory tests showed that prothrombin time and activated partial coagulation time were remarkably prolonged, blood coagulation factor Ⅴ activity was extremely low, and the result of qualitative test of coagulation factor inhibitor was positive. Acquired blood coagulation factor Ⅴ deficiency was diagnosed. After application of dexamethasone (5 mg, twice per day) and infusion of fresh frozen plasma, blood coagulation indicators of patients recovered in 4 days, the result of qualitative test of coagulation factor inhibitor was negative, and bleeding symptoms were improved.

A novel hypertensive crisis rat model established by excessive norepinephrine infusion and the potential therapeutic effects of Rho-kinase inhibitors on it

Hypertension crisis is a severe disease and needs emergency treatment in clinic. It is an important task to discover novel drugs which could lower the blood pressure steadily and quickly. However, animal models for screening anti-hypertensive crisis agents are unsatisfactory. The present study aimed to establish a new hypertensive crisis rat model and then explore the therapeutic effects of three Rho-kinase inhibitors including Fasudil, DL0805-1 and DL0805-2 on such a disease model. The hypertensive crisis symptoms were developed on male Wistar rats by subcutaneously injecting small doses of norepinephrine (NE) for 10 days in the initial stage. A sudden increase in blood pressure (BP) was then induced by excessive NE infusion. Compounds to be tested were intravenously injected into the rats immediately when the rapidly increased systolic blood pressure appeared. The results have shown that after small dose administration with NE, the rats could obtain acute BP increase to a high level without sudden death when a large dose of NE was injected. Fasudil, DL0805-1 and DL0805-2 could lower the blood pressure quickly in a dose dependent manner and improve the survival rate. The compounds also prevent the animals from organ damage. In conclusion, we established a novel hypertensive crisis animal model which could evaluate agents within a short time. In this model, we found that three Rho-kinase inhibitors have potential therapeutic effects on hypertensive crisis. This work might contribute to the discovery and development of new anti-hypertensive crisis drugs.

Effect of probiotics and xylo-oligosaccharide supplementation on nutrient digestibility, intestinal health and noxious gas emission in weanling pigs

OBJECTIVE

This study was conducted to evaluate the effect of probiotics (Bacillus subtilis and Enterococcus faecium) and xylo-oligosaccharide (XOS) supplementation on growth performance, nutrient digestibility, serum profiles, intestinal health, fecal microbiota and noxious gas emission in weanling pigs.

METHODS

A total of 240 weanling pigs ([Yorkshire×Landrace]×Duroc) with an average body weight (BW) of 6.3±0.15 kg were used in this 28-day trial. Pigs were randomly allocated in 1 of the following 4 dietary treatments in a 2×2 factorial arrangement with 2 levels of probiotics (0 and 500 mg/kg probiotics) and XOS (0 and 200 mg/kg XOS) based on the BW and sex.

RESULTS

Administration of probiotics or XOS improved average daily gain (p<0.05) during 0 to 14 d and the overall period, while pigs that were treated with XOS had a greater average daily gain and feed efficiency (p<0.05) compared with unsupplemented treatments throughout 15 to 28 d and the whole experiment. Either probiotics or XOS treatments increased the apparent total tract digestibility of nutrients (p<0.05) during 0 to 14 d. No effects on serum profiles were observed among treatments. The XOS increased villus height: crypt depth ratio in jejunum (p<0.05). The supplementation of probiotics (500 mg/kg) or XOS (200 mg/kg) alone improved the apparent total tract digestibility of dry matter, nitrogen and gross energy on d 14, the activity of trypsin and decreased fecal NH3 concentration (p<0.05). Administration of XOS decreased fecal Escherichia coli counts (p<0.05), while increased lactobacilli (p<0.05) on d 14. There was no interaction between dietary supplementation of probiotics and XOS.

CONCLUSION

Inclusion of XOS at 200 mg/kg or probiotics (Bacillus subtilis and Enterococcus faecium) at 500 mg/kg in diets containing no antibiotics significantly improved the growth performance of weanling pigs. Once XOS is supplemented, further providing of probiotics is not needed since it exerts little additional effects.

[Effects of lappaconitine on intraoperative administration of remifentanil induced postoperative hyperalgesia in general anaesthesia patients]

Objective: To explore the effects of lappaconitine on intraoperative administration of remifentanil induced postoperative hyperalgesia in general anaesthesia patients. Methods: One hundred and twenty patients from March to October 2016 undergoing elective thyroid operation under general anaesthesia at Ningbo NO.2 hospital, American Society of Anesthesiologists(ASA) Ⅰ or Ⅱ grade, aged 20-60, were enrolled in this study and randomly assigned to 3 groups (n=40). Remifentanil was intraoperatively infused at 0.1 μg·kg(-1)·min(-1) (Group S) or 0.3 μg·kg(-1)·min(-1) (Groups L and G), and patients in group G received lappaconitine 8 mg 30 minutes before the ending of surgery. Mechanical pain thresholds, visual analogue scale (VAS) and additional analgesics were recorded at 2, 6 and 24 hours after the operation. Results: There was no significant difference among the VAS and additional analgesics in three groups at 2, 6 and 24 h after operation (all P>0.05). There was no significant difference among the mechanical pain thresholds in three groups before and 2 h after operation (all P>0.05). The mechanical pain thresholds of group S, L and G was (45.7±15.6), (35.8±15.0), (47.6±16.4)g at 6 h and (50.7±17.0), (33.7±14.0), (49.7±13.9 )g at 24 h after operation. There was significant difference among the mechanical pain thresholds in group S, L and G at 6 h and 24 h after operation (F=6.586, 16.089, all P<0.01). Compared to group S, the mechanical pain thresholds significantly decreased in group L at 6 h and 24 h after operation (q=2.837, 5.045, all P<0.01). While there was a significantly increase in pain thresholds at 6 h and 24 h postoperatively in group G, as compared with the group L (q=3.384, 4.770, all P<0.01). Conclusion: Lappaconitine significantly alleviated intraoperative administration of remifentanil induced postoperative hyperalgesia in general anaesthesia patients.

[Effects of benzo(a)pyrene on expressions of insulin-degrading enzyme and neprilysin in neuroglia cells]

OBJECTIVE

To investigate effects of benzo(a)pyrene (BaP) on expressions of insulin-degrading enzyme (IDE) and neprilysin (NEP) which have the ability to degrade β-amyloid (Aβ) in neuroglia cells.

METHODS

Primary mix-neuroglia cells were cultured from newborn SD rats. After exposure to BaP, Aβ_1-42 oligomer or Aβ_1-42 fiber individually or jointly for 24 h, the cell survival rate was measured by cell counting kit-8 (CCK-8). Afterwards, the primary mix-neuroglia cells were divided randomly into six groups: Control group, BaP group (2.00 μmol/L), Aβ_1-42 oligomer group (20.00 mg/L), BaP plus Aβ_1-42 oligomer group, Aβ_1-42 fiber group (20.00 mg/L) and BaP plus Aβ_1-42 fiber group, of which BaP was pretreated for 12 h followed by cotreatment with different aggregated Aβ_1-42. The expressions of IDE and NEP were measured by quantitative real-time polymerase chain reaction (qRT-PCR) for mRNA level and Western blotting for protein level.

RESULTS

The cell survival rate showed no significant differences after treatment with BaP (≤20.00 μmol/L), Aβ_1-42 oligomer (20.00, 40.00 mg/L), Aβ_1-42 fiber (20.00, 40.00 mg/L) or cotreatment with BaP and Aβ_1-42 oligomer or BaP and Aβ_1-42 fiber. Compared with the control group, expressions of IDE and NEP in BaP-treated alone group had no obvious change; however, exposure to Aβ_1-42 oligomer alone significantly increased the mRNA and protein level of IDE (P<0.05), and the BaP pretreatment could significantly inhibit the up-regulated expressions of IDE by Aβ_1-42 oligomer (P<0.05); on the other hand, exposure either to Aβ_1-42 fiber alone or under the BaP pretreatment did not change the mRNA and protein level of IDE and NEP obviously.

CONCLUSION

On the premise of no significant change of cell survival rate, BaP pretreatment inhibited the up-regulated expressions of IDE in primary mixed neuroglia cells under cotreatment with Aβ oligomer, indicating that BaP may disturb degradation of Aβ oligomer and cause deposition of β-amyloid and further induce cognitive decline and acceleration of Alzheimer.