[A phase I study of subcutaneous envafolimab (KN035) monotherapy in Chinese patients with advanced solid tumors]

Objective: To evaluate the safety and antitumor activity of envafolimab monotherapy in Chinese patients with advanced solid tumors. Methods: This open-label, multicenter phase I trial included dose escalation and dose expansion phases. In the dose escalation phase, patients received subcutaneous 0.1, 0.3, 1.0, 2.5, 5.0 or 10.0 mg/kg envafolimab once weekly (QW) following a modified "3+ 3" design. The dose expansion phase was performed in the 2.5 mg/kg and 5.0 mg/kg (QW) dose cohorts. Results: At November 25, 2019, a total of 287 patients received envafolimab treatment. During the dose escalation phase, no dose-limiting toxicities (DLT) was observed. In all dose cohorts, drug-related treatment-emergent adverse events (TEAEs) for all grades occurred in 75.3% of patients, and grade 3 or 4 occurred in 20.6% of patients. The incidence of immune-related adverse reactions (irAE) was 24.0% for all grades, the most common irAEs (≥2%) included hypothyroidism, hyperthyroidism, immune-associated hepatitis and rash. The incidence of injection site reactions was low (3.8%), all of which were grades 1-2. Among the 216 efficacy evaluable patients, the objective response rate (ORR) and disease control rate (DCR) were 11.6% and 43.1%, respectively. Median duration of response was 49.1 weeks (95% CI: 24.0, 49.3). Pharmacokinetic (PK) exposure to envafolimab is proportional to dose and median time to maximum plasma concentration is 72-120 hours based on the PK results from the dose escalation phase of the study. Conclusion: Subcutaneous envafolimab has a favorable safety and promising preliminary anti-tumor activity in Chinese patients with advanced solid tumors.

Unintrusive multi-cancer detection by circulating cell-free DNA methylation sequencing (THUNDER): development and independent validation studies

BACKGROUND

Early detection of cancer offers the opportunity to identify candidates when curative treatments are achievable. The THUNDER study (THe UNintrusive Detection of EaRly-stage cancers, NCT04820868) aimed to evaluate the performance of ELSA-seq, a previously described cfDNA methylation-based technology, in the early detection and localization of six types of cancers in the colorectum, esophagus, liver, lung, ovary and pancreas.

PATIENTS AND METHODS

A customized panel of 161,984 CpG sites was constructed and validated by public and in-house (cancer: n=249; non-cancer: n=288) methylome data, respectively. The cfDNA samples from 1,693 participants (cancer: n=735; non-cancer: n=958) were retrospectively collected to train and validate two multi-cancer detection blood test models (MCDBT-1/2) for different clinical scenarios. The models were validated on a prospective and independent cohort of age-matched 1,010 participants (cancer: n=505; non-cancer: n=505). Simulation using the cancer incidence in China was applied to infer stage-shift and survival benefits to demonstrate the potential utility of the models in the real world.

RESULTS

MCDBT-1 yielded a sensitivity of 69.1% (64.8%‒73.3%), a specificity of 98.9% (97.6%‒99.7%) and tissue origin accuracy of 83.2% (78.7%‒87.1%) in the independent validation set. For early stage (I‒III) patients, the sensitivity of MCDBT-1 was 59.8% (54.4%‒65.0%). In the real-world simulation, MCDBT-1 achieved the sensitivity of 70.6% in detecting the six cancers, thus decreasing late-stage incidence by 38.7%‒46.4%, and increasing 5-year survival rate by 33.1%‒40.4%, respectively. In parallel, MCDBT-2 was generated at a slightly low specificity of 95.1% (92.8%-96.9%) but a higher sensitivity of 75.1% (71.9%-79.8%) than MCDBT-1 for populations at relatively high risk of cancers, and also had ideal performance.

CONCLUSION

In this large-scale clinical validation study, MCDBT-1/2 models showed a high sensitivity, specificity, and accuracy of predicted origin in detecting six types of cancers.

[Roles of the CXCR1/CXCL8 axis in abnormal proliferation of bile duct epithelial cells in primary biliary cholangitis]

Objective: To investigate the role of the CXC chemokine receptor 1 (CXCR1)/CXC chemokine ligand 8 (CXCL8) axis in the abnormal proliferation of bile duct epithelial cells in primary biliary cholangitis (PBC). Methods: 30 female C57BL/6 mice were randomly divided into the PBC model group (PBC group), reparixin intervention group (Rep group), and blank control group (Con group) in an in vivo experiment. PBC animal models were established after 12 weeks of intraperitoneal injection of 2-octanoic acid coupled to bovine serum albumin (2OA-BSA) combined with polyinosinic acid polycytidylic acid (polyI:C). After successful modelling, reparixin was injected subcutaneously into the Rep group (2.5 mg · kg(-1) · d(-1), 3 weeks). Hematoxylin-eosin staining was used to detect histological changes in the liver. An immunohistochemical method was used to detect the expression of cytokeratin 19 (CK-19). Tumor necrosis factor-α (TNF-α), γ-interferon (IFN-γ) and interleukin (IL)-6 mRNA expression were detected by qRT-PCR. Western blot was used to detect nuclear transcription factor-κB p65 (NF-κB p65), extracellularly regulated protein kinase 1/2 (ERK1/2), phosphorylated extracellularly regulated protein kinase 1/2 (p-ERK1/2), Bcl-2-related X protein (Bax), B lymphoma-2 (Bcl-2), and cysteine proteinase-3 (Caspase- 3) expression. Human intrahepatic bile duct epithelial cells were divided into an IL-8 intervention group (IL-8 group), an IL-8+Reparicin intervention group (Rep group), and a blank control group (Con group) in an in vitro experiment. The IL-8 group was cultured with 10 ng/ml human recombinant IL-8 protein, and the Rep group was cultured with 10 ng/ml human recombinant IL-8 protein, followed by 100 nmol/L Reparicin. Cell proliferation was detected by the EdU method. The expression of TNF-α, IFN-γ and IL-6 was detected by an enzyme-linked immunosorbent assay. The expression of CXCR1 mRNA was detected by qRT-PCR. The expression of NF-κB p65, ERK1/2 and p-ERK1/2 was detected by western blot. A one-way ANOVA was used for comparisons between data sets. Results: The results of in vivo experiments revealed that the proliferation of cholangiocytes, the expression of NF-κB and ERK pathway-related proteins, and the expression of inflammatory cytokines were increased in the Con group compared with the PBC group. However, reparixin intervention reversed the aforementioned outcomes (P<0.05). In vitro experiments showed that the proliferation of human intrahepatic cholangiocyte epithelial cells, the expression of CXCR1 mRNA, the expression of NF-κB and ERK pathway-related proteins, and the expression of inflammatory cytokines were increased in the IL-8 group compared with the Con group. Compared with the IL-8 group, the proliferation of human intrahepatic cholangiocyte epithelial cells, NF-κB and ERK pathway-related proteins, and inflammatory indicators were significantly reduced in the Rep group (P < 0.05). Conclusion: The CXCR1/CXCL8 axis can regulate the abnormal proliferation of bile duct epithelial cells in PBC, and its mechanism of action may be related to NF-κB and ERK pathways.

[The Chinese guidelines for the diagnosis and treatment of pancreatic neuroendocrine neoplasms (2020)]

Pancreatic neuroendocrine neoplasms (pNENs) are highly heterogeneous, and the management of pNENs patients can be intractable. To address this challenge, an expert committee was established on behalf of the Group of Pancreatic Surgery, Chinese Society of Surgery, Chinese Medical Association, which consisted of surgical oncologists, gastroenterologists, medical oncologists, endocrinologists, radiologists, pathologists, and nuclear medicine specialists. By reviewing the important issues regarding the diagnosis and treatment of pNENs, the committee concluded evidence-based statements and recommendations in this article, in order to further improve the management of pNENs patients in China.

LncRNA NEAT1 regulates proliferation, apoptosis and invasion of liver cancer

OBJECTIVE

The occurrence and progression of hepatocellular carcinoma (HCC) is a multi-step complex process and the exact molecular mechanisms remain to be elucidated. LncRNA NEAT1 is involved in tumorigenesis and progression. However, the role of LncRNA NEAT1 in HCC remains unclear.

PATIENTS AND METHODS

The tumor tissues and adjacent tissues of HCC patients were collected and LncRNA NEAT1 expression was detected by Real time PCR. The hepatoma cell line HepG2 was cultured and transfected with lnc RNA NEAT1 siRNA or lnc RNA NEAT1 plasmid followed by analysis of LncRNA NEAT1 expression, cell proliferation by MTT assay, as well as Caspase 3 activity. In addition, cell apoptosis and cell cycle were assessed by flow cytometry and cell invasion was measured by transwell chambers. The expression of EGFR, Bax and Bcl-2 was detected by Western blot.

RESULTS

LncRNA NEAT1 expression was significantly increased in HCC tissues compared with adjacent tissues (p < 0.05). Compared with the siRNA group, transfection of lncRNA NEAT1 siRNA into HepG2 cells significantly inhibited cell proliferation, increased Caspase 3 activity and apoptosis, reduced cell invasion, as well as arrested cell cycle (p < 0.05). Meanwhile, lncRNA NEAT1 siRNA also significantly decreased Bcl-2 and EGFR expression and increased Bax expression (p < 0.05). Transfection of lncRNA NEAT1 plasmid in hepatoma cells HepG2 reversed the above changes, compared with vector group, the differences were statistically significant (p < 0.05).

CONCLUSIONS

LncRNA NEAT1 expression is increased in liver cancer tissues. Down-regulation of LncRNA NEAT1 can inhibit EGFR expression and promote hepatoma cell apoptosis, inhibit cell cycle, thus inhibiting tumor proliferation and invasion.

[Analysis of clinical characteristics and prognosis of 235 pancreatic neuroendocrine tumors underwent Sunitinib treatment]

Objective: To investigate the clinical characteristics, treatment, and prognostic factors of pancreatic neuroendocrine tumors (pNETs) patients treated with Sunitinib. Methods: The clinical data of pNETs patients from Pfizer Drug Assistance Program of Cancer Foundation of China from April 2013 to November 2017 were retrospectively analyzed. Follow-up and statistical analysis were performed. Results: A total of 235 patients were enrolled, the patients' overall survival time was between 4 and 252 months, the 3-years and 5-years survival rates were 73.8% and 60.8%, respectively. Univariate analysis showed that factors such as age, Ki-67 index and surgery were associated with the 3-years survival rates of pNETs patients (P<0.05). Multivariate analysis demonstrated that the age, Ki-67 index and surgery were independent prognostic factors for pNETs patients (P<0.05). For patients with liver metastases, univariate analysis revealed that surgery was associated with prognosis (P<0.05). The 5-years survival rate of 124 patients with extending usage of Sunitinib was 53.3%. Conclusion: PNETs are rare tumors with atypical clinical symptoms and the patients often have metastasis at the initiate diagnosis. The age, Ki-67 index and surgery are associated with the prognosis of pNETs patients.

Factors influencing workplace social capital among registered nurses in China

AIM

To examine the modifiable predictors and the level of workplace social capital, transformational leadership, emotional intelligence and organizational justice among registered nurses in Chinese hospitals.

BACKGROUND

Workplace social capital is a relational network developed among nurses and other healthcare professionals that provides social support, and gives value to their working lives. Internationally, cultivating high levels of social capital is critical as it can help improve nurse satisfaction and care, and address nurse turnover. However, knowledge of factors influencing nurses' workplace social capital is limited in China.

METHODS

In this cross-sectional, descriptive predictive study, 344 registered nurses were randomly selected from three urban Chinese hospitals in Zhejiang province. Five standard instruments were applied to collect data. Descriptive statistics were used to present the level of the variables and stepwise multiple regression was performed to identify the predictors of nurses' workplace social capital.

RESULTS

Among eight potential factors, transformational leadership and emotional intelligence positively predicted workplace social capital. Nurses perceived the overall level of workplace social capital, emotional intelligence and unit managers' transformational leadership as high, and the overall level of organizational justice as moderate.

DISCUSSION

Enhancing unit managers' transformational leadership and nurses' emotional intelligence was found to positively influence the development of workplace social capital. Although it is not a predictor of workplace social capital, nurses' organizational justice should be improved due to its importance and current unsatisfactory level.

CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY

Nursing and health policymakers need to consider the enhancement of transformational leadership and emotional intelligence when implementing policies to improve nurses' workplace social capital, nursing retention and job satisfaction.

[Synchronous robotic resection for colorectal liver metastasis]

Surgical resection remains the only curative therapy for colorectal adenocarcinoma and liver metastasis. Synchronous robotic resection for colorectal liver metastasis (CRLM) offers the advantage of avoiding double surgical stress, while providing the benefits of small incision, quicker recovery, shorter hospital stay and faster postoperative adjuvant therapy. Compared with the laparoscopic approach, robotic approach is mostly suitable for rectal cancer liver metastasis, which is associated with low conversion rate, good nerve protection, high success rate for major hepatectomy and resection of difficult segments. Appropriately selected patients, multidisciplinary cooperation and skillful robotic surgeons are the key to success. Current data have demonstrated the feasibility and safety of synchronous robotic resection for CRLM. With the coming randomized controlled trial data and evolution of robotic surgical system, the future of synchronous robotic resection for colorectal liver metastasis is promising.

Luteoloside Ameliorates Palmitic Acid-Induced in Vitro Model of Non-alcoholic Fatty Liver Disease via Activating STAT3-Triggered Hepatocyte Regeneration

Luteoloside (Lute), a bioactive natural ingredient, widely exists in nature and possesses hepatoprotective and hepatocyte proliferation-promoting properties. This study aimed to investigate whether Lute could counteract non-alcoholic fatty liver disease (NAFLD)-caused hepatocyte damage via its stimulation of hepatocyte regeneration efficacy and to explore the involved mechanism. LO2 cells and primary hepatocytes were used to examine the hepatocyte proliferation effects of Lute under physiological conditions and in the palmitic acid (PA)- induced in vitro model of NAFLD. STAT3 and cell cycle-related proteins (cyclin D1, c-myc and p21) were evaluated by Western blot. Under physiological conditions, LO2 cells and primary hepatocytes treated with various concentration of Lute for 12 and 24 h showed increased hepatocyte proliferation, especially with 20 μM treatment for 24 h. More notably, under the model conditions, co-incubation with 20 μM of Lute also markedly reversed PA-induced inhibition of cell proliferation and viability in primary hepatocytes. Mechanistically, Lute could activate STAT3 and subsequently increase cyclin D1 and cmyc expression, which positively regulates cell cycle progression, and decrease expression of p21, an inhibitor of cell cycle progression. Furthermore, Luteinduced hepatocyte proliferation-promoting efficacy was abolished by STAT3 inhibitor stattic. Collectively, Lute can alleviate PA-induced hepatocyte damage via activating STAT3-mediated hepatocyte regeneration.

[Characteristics on molecular epidemiology of Brucella melitensis in Jiangxi province]

Objective: To understand the molecular characteristics and correlation among isolated strains of Brucella melitensis (BM) so as to improve the strategies on prevention and control of the disease in Jiangxi province. Methods: A total of 25 strains of BM isolated from human in 17 counties of Jiangxi province were analyzed by multiple locus variable-number tandem repeat analysis (MLVA) method. Results: A total of 25 strains of BM were classified into 24 independent genotypes with similarities between 67.00% and 100.00% and Simpson index between 0.000 and 0.773. There were 3 genotypes in MLVA8, including 60.00% (15/25) as 42 genotype, 32.00% (8/25) as 43 genotype, and 8.00% (2/25) as 63 genotype, respectively. There were 7 genotypes in MLVA11 identified, with 116 genotype and 125 genotype the main genotypes, accounting for 56.00% (14/25) of all the identified strains. Conclusions: Genes from all the 25 strains of BM that isolated from human being were with high genetic diversities, and various, genotypes. However, no obvious epidemiological correlation was noticed among these strains, indicating the complexity of the source of infection on Brucella in Jiangxi province.

[Experience of teaching and training for medical students at gastrointestinal surgery department under COVID-19 epidemic situation]

In hospitals and medical schools as densely populated sites with high risk of coronavirus disease 2019 (COVID-19), it is vital to adjust the teaching and training strategy for medical students to ensure curriculum completion with safety. This article aims to introduce the experience of teaching and training for medical students under the epidemic situation at Department of Surgery, Shanghai Medical College, Fudan University and Zhongshan Hospital. The content includes exploring diversified online teaching models for undergraduate surgery courses and clinical practice, carrying out online graduate education and dissertation plans, and strengthening comprehensive education of medical humanity combined with knowledge of COVID-19 prevention. Through implementation of the above teaching strategies, scheduled learning plans of medical students can be well completed in an orderly, safe and quality-ensured manner. Our experience provides practical solution of medical teaching and could be advisable for other medical colleges and teaching hospitals.

[Medical diagnosis and treatment strategies for malignant tumors of the digestive system during the outbreak of COVID-19]

Since the outbreak of COVID-19 in December 2019, the diagnosis and treatment of patients with cancer have been facing great challenges. Although oncologists are not fighting on the front line to against the epidemic, during this special period, we should not only protect patients, their families and medical staff from the infection of novel coronavirus, but also minimize the impact of the epidemic on the diagnosis and the treatment of patients with cancer. Combining the guidelines for diagnosis and treatment of tumors with our clinical experience, in this epidemic period, we discuss the strategies for diagnosis, treatment, and follow-up of malignant tumors of the digestive system in this article.

[Risk factors of anastomotic leakage after robotic surgery for low and mid rectal cancer]

Objective: To investigate the risk factors associated with anastomotic leakage after robotic surgery in mid-low rectal cancer. Methods: A retrospective case-control study method was conducted. Inclusion criteria: (1) 18 to 80 years old; (2) pathologically confirmed rectal cancer; (3) distance <10 cm from tumor to anal margin; (4) robotic anterior rectal resection. Patients with previous history of colorectal cancer surgery, distant metastases or other malignant tumors, undergoing emergency surgery, with severe abdominal adhesions or those receiving combined organ resection were excluded. Based on the above criteria, 636 patients undergoing robotic radical sphincter-preserving surgery for mid-low rectal cancer in Zhongshan Hospital from January 2015 to December 2018 were included in this study, including 398 males (62.6%) and 238 females (37.4%) with a mean age of (61.9±11.3) years. Sixty-eight cases (10.7%) received neoadjuvant chemoradiotherapy. Amony the 636 included patients, 123(19.3%) underwent natural orifice specimen extraction surgery (NOSES) and 15 (2.3%) underwent preventive stoma. According to the cirteria developed by the International Rectal Cancer Research Group in 2010, the anastomotic leakage was classified as grade A (no requirement of intervention), B (requirement of intervention), and C (requirement of operation). Logistic regression was used to analyze the relationship between anastomotic leakage and clinicopathological factors. Factors in univariate analysis with P<0.05 were included in the multivariate analysis. Results: Anastomotic leakage occurred in 38 cases (6.0%). The grading of anastomotic leakage was grade A in 13 cases (2.0%), grade B in 19 cases (3.0%), and grade C in 6 cases (0.9%). The 3-year disease-free survival rate of patients with anastomotic leakage and without anastomotic leakage was 83.5% and 83.6% respectively (P=0.862); the 3-year overall survival rate of the two group was 85.1% and 87.5% respectively (P=0.296). The results of univariate logistic regression analysis showed that male (P=0.011), longer operation time (P=0.042), distance ≤5 cm from tumor to anal margin (P=0.012), more intraoperative blood loss (P=0.048) were associated with anastomotic leakage (all P<0.05). NOSES was not associated with anastomotic leakage (P=0.704). Multivariate analysis confirmed that male (OR=3.03, 95%CI: 1.37 to 7.14, P=0.010), operation time ≥180 minutes (OR=2.04, 95%CI: 1.03 to 3.99, P=0.040), distance ≤5 cm from tumor to anal margin (OR=2.56, 95%CI:1.28 to 5.26, P=0.008) were independent risk factors for anastomotic leakage. Conclusion: Male, short distance from tumor to anal margin, and long operation time are independent risk factors for anastomotic leakage in patients undergoing robotic mid-low rectal cancer radical surgeries. These patients need to be cautiously treated during surgery.

[Current status and consideration of robotic surgery for colorectal cancer in China]

Since its inception, the surgical robot system with technical advantages has quickly become a new trend in surgery, and has been widely used at home and abroad. A large number of retrospective studies and a small number of randomized controlled studies have shown that compared with traditional laparoscopic surgery, robotic surgery presented some improvements, such as lower conversion rate, less urinary and sexual dysfunction, and less intraoperative blood loss, though more convincing evidence is needed. Robotic colorectal cancer surgery started late in China, but developed rapidly. Not only the number of surgeries has increased rapidly, but also many new surgeries have been innovated. Meanwhile, many problems emerged, such as lack of unified technical specifications, and excessive dependence on imported surgical robot equipment. Through high-quality clinical researches and big data analyses, the formulation of standardization, the establishment of training system, and the combination of medicine, research and production, robotic surgery will continue to lead the development trend of surgery in the new era.

Nanorectenna spectrally-selective plasmonic hot electron response to visible-light lasers

Active metasurfaces with novel visible and infrared (vis/IR) functionalities represent an exciting, growing area of research. Rectification of vis/IR frequencies would produce needed direct current (DC) with no inherent frequency limitation (e.g. no semiconducting bandgap). However, controlling the materials and functionality of (nano)rectennas for rectifying 100 s of THz to the visible regime is a daunting challenge, because of the small features and simultaneously the need to scale up to large sizes in a scalable platform. An active metasurface of a planar array of nanoscale antennas on top of rectifying vertical diodes is a 'nanorectenna array' or 'microrectenna array' that rectifies very high frequencies in the infrared, or even higher frequencies up to the visible regime. We employ a novel strategy for forming optical nanorectenna arrays using scalable patterning of Au nanowires, demonstrate strong evidence for spectral-selective high-frequency rectification, characteristic of optical antennas. We discover a previously unreported out-of-equilibrium electron energy distribution, i.e. hot electrons arising from plasmonic resonance absorption in an optical antenna characterized by an effective temperature, and how this effect can significantly impact the observed rectification.

Organic trace minerals improve eggshell quality by improving the eggshell ultrastructure of laying hens during the late laying period

The objective of this study was to investigate the effects of low inclusion levels of organic trace minerals (iron, copper, manganese, and zinc) on performance, eggshell quality, serum hormone levels, and enzyme activities of laying hens during the late laying period. A total of 405 healthy hens (HY-Line White, 50-week-old) were randomly divided into 3 treatments, with 9 replications per treatment and 15 birds per replication. The dietary treatments included a basal diet supplemented with inorganic trace minerals at commercial levels (CON), a basal diet supplemented with inorganic trace minerals at 1/3 commercial levels (ITM), and a basal diet supplemented with proteinated trace minerals at 1/3 commercial levels (TRT). The trial lasted 56 D (8 wk). Compared with the CON group, the ITM group showed decrease in (P < 0.05) egg production, eggshell strength, eggshell palisade layer, palisade layer ratio, serum estrogen, luteinizing hormone, glycosaminoglycan concentration, and carbonic anhydrase activity and increase in (P < 0.05) egg loss and mammillary layer ratio. However, the TRT group almost kept all the indices close to the CON group (P > 0.05). Furthermore, hens fed with low inclusion levels of organic trace minerals had smaller mammillary knobs (P < 0.05) than those in the CON and ITM groups. In conclusion, hens fed with low inclusion levels of proteinated trace minerals had better performance and eggshell strength than those fed with identical levels of inorganic compounds; organic trace minerals improved eggshell quality by improving the eggshell ultrastructure of laying hens during the late laying period.

Quasiparticle Screening near a Bosonic Superconductor-Insulator Transition Revealed by Magnetic Impurity Doping

Experiments show that the Cooper pair transport in the insulator phase that forms at thin film superconductor to insulator transitions (SIT) is simply activated. The activation energy T_{0} depends on the microscopic factors that drive Cooper pair localization. To test proposed models, we investigated how a perturbation that weakens Cooper pair binding, magnetic impurity doping, and phase frustration affects T_{0}. The data show that T_{0} decreases monotonically with doping in films tuned farther from the SIT and increases and peaks in films that are closer to the SIT critical point. The observations provide strong evidence that the bosonic SIT in thin films is a Mott transition driven by Coulomb interactions that are screened by virtual quasiparticle excitations. This dependence on underlying fermionic degrees of freedom distinguishes these SITs from those in microfabricated Josephson Junction arrays, cold atom systems, and likely in high temperature superconductors with nodes in their quasiparticle density of states.

[Prognostic analysis of colon and rectal neuroendocrine neoplasm in different stages]

Objective: To explore the survival difference of patients with colon and rectal neuroendocrine neoplasm (NEN) at different stages. Methods: We identified 8 679 patients with colorectal NEN diagnosed between 1988 and 2014 from the Surveillance, Epidemiology, and End Results (SEER) registry, including 5 437 rectal NEN and 3 242 colon NEN ( 1 681 cecum NEN ). Survival curve was drawn by Kaplan-Meier method. Prognostic factors were analyzed by univariate analysis and multivariate Cox regression model. Results: The ratio of male patients with colon and rectal NEN was similar to female (P=0.095). Rectal NEN patients were younger (P<0.001), more highly differentiated (P<0.001), and with earlier stage (P<0.001). Survival analysis showed that the survival of rectal NEN was superior to that of colon NEN, with 10-year tumor-specific survival rates of 86.8% and 44.8% respectively (P<0.001). Multivariate Cox analysis showed that age, gender, marital status, primary tumor site, grade, stage and surgery were independent prognostic factors of colorectal NEN (all P<0.01). The most important factor was stage (HR=3.531), followed by differentiation grade (HR=1.856). Stratified analysis displayed that the survival of rectal NEN in stage Ⅰ, Ⅱ and Ⅳ were better than those of corresponding stage of colon NEN (all P<0.05), but worse in stage Ⅲ (P=0.012). While the survival of rectal NEN were significantly better than those of colon NEN within all stages after excluding 1681 cases of cecal NEN (all P<0.05). Among the patients with well-differentiated NEN, the survival of rectal NEN in stage Ⅰ, Ⅲ and Ⅳ were better than those of corresponding stage of colon NEN (all P<0.05) while there was no significant difference in stage Ⅱ(P=0.169). For poor-differentiated NEN, only the survival of rectal NEN patients in stage Ⅳ (P=0.001) was significant longer than those of colon NEN, while there was no significant difference in stage Ⅰ, Ⅱ and Ⅲ (stage Ⅰ: P=0.760; stage Ⅱ: P=0.181; stage Ⅲ: P=0.313). Conclusions: The survival of NEN patients in colon and rectum is different. Cecum NEN should be considered as a separated tumor for prognostic analysis due to its special clinicopathologic characteristics.

[Current treatment in advanced hepatocellular carcinoma and prospects for immuno-oncology therapy]

Treatment of patients with advanced hepatocellular carcinoma (HCC) remains a huge challenge since a widely accepted therapeutic strategy has not been identified. There are some special features in patients with HCC in China, such as are mainly related to hepatitis B virus infection, often diagnosed as advanced or end-stage disease, and usually have a poorer prognosis compared with patients in western countries. Hence, appropriate treatments are urgently needed for these patients. Notably, immune-oncology therapy has been received increased attention in recent years. Based on promising results observed in clinical trials, immune-oncology therapy has been approved for treatment of various malignant diseases and brings a new hope to the treatment of advanced HCC. The review summarizes the current situation of advanced HCC treatment in China and discusses the prospects of immuno-oncology therapy.

[The value of MRI in early diagnosis of dysbaric osteonecrosis]

Objective: To investigate the value of MRI in the early diagnosis of diagnosis of dysbaric osteonecrosis. Methods: Labor hygiene investigation and occupation health were examined on 52 high pressure operating personnel, were selected for the examination of both shoulders, hips and knees with X-ray and CT scan. Results: The cystic sign in dysbaric osteonecrosis as an important imaging feature, which perform in the MRI examination for T1W I sequence showed low or slightly low signal and T2W I sequence showed high signal, and X-ray and CT have a lower detection rate than MRI. The Kappa consistency test showed a high consistency with the two methods. At the same time MRI examination also can discover the bone marrow cavity necrosis early pathological change. Conclusion: MRI is an effective method for the diagnosis of early dysbaric osteonecrosis, which can improve the early diagnosis rate of dysbaric osteonecrosis.

Correlations between the expression of C-erB-2, CD34 and ER in breast cancer patients and the signs of conventional ultrasonography and ultrasound elastography

OBJECTIVE

This study aims to investigate the correlations between the expression of human epidermal growth factor receptor 2 (C-erB-2), CD34, and estrogen receptor (ER) in breast cancer (BC) patients, and the signs of conventional ultrasonography and ultrasound elastography.

PATIENTS AND METHODS

Clinical data of 88 patients who were pathologically diagnosed as breast cancer were retrospectively analyzed. HI VISION Avius color ultrasound device was used to perform ultrasound and related ultrasound parameters were analyzed. Expressions of C-erB-2, CD34, and ER were detected by immunohistochemistry.

RESULTS

There was a correlation between positive expression of C-erB-2 and the blood supply, lymph node metastasis and microcalcification in patients (p < 0.05). Patients were divided into high expression group and low expression group according to the median expression level of CD34. Expression of CD34 was correlated with the ultrasound sign of lymph node metastasis (p < 0.05). Positive expression of ER was correlated with the morphology, margin, and perimeter of the tumor (p < 0.05). Expression levels of C-erB-2, CD34, and ER were found to be increased in BC patients.

CONCLUSIONS

Combination of upregulated expression of C-erB-2, CD34, and ER and signs of ultrasound can improve the diagnosis of BC.

[A 3.0 T MRI study on the alterations of the volume and morphology of fifteen subcortical nucleus in patients with early post-stroke depression]

Objective: To investigate the alterations of the volumes and 3D shapes of fifteen subcortical nucleus in patients with post-stroke depression (PSD) and to explore the pathogenesis regularity and mechanism of early PSD. Methods: From 2015 to 2017, a total of 28 patients with PSD and 18 stroke patients without depression (PSND), 13 patients with depression (De) and 11 cases of healthy volunteers (NC) were enrolled to perform 3.0 T high resolution MRI.Computer automatic segmentation and vertex analysis were used to segment and measure the volume of bilateral nucleus accumbens, caudate nucleus, putamen, globus pallidus, thalamus, hippocampus, mygdale and brainstem. Results: The volume of bilateral nucleus accumbens and bilateral thalamus, left pallidum were different among groups with statistical difference (P<0.05). The nucleus volume of the PSD group was (415±128) mm(3) (L-Nac)/(303±90) mm(3) (R-Nac), (7 590±867) mm(3) (L-Th)/(7 459±905) mm(3) (R-Th), (1 675±328) mm(3) (L-Pa), which was smaller than that of PSND group (433±100) mm(3) /(307±88) mm(3), (7 999±961) mm(3) /(7 753± 955) mm(3), (1 790±286) mm(3) and other groups.The nuclei with significantly statistical differences between inter-group were found in following: between PSD group and NC group, right accumbens and bilateral thalamus (P<0.01); between PSD group and De group, right accumbens and right thalamus (P<0.001), left accumbens, left pallidum and left thalamus (P<0.01); between PSND group and NC group, right accumbens (P<0.05); between PSND group and De group, right accumbens (P<0.001), left accumbens and right thalamus (P<0.05). Significant differences in morphology changes of nuclei (P<0.05) by F test mainly located on the top and tail of right accumbens, the anterior and middle body of right caudate nucleus, the most part of bilateral thalamus, the ventromedial body of bilateral hippocampus, the anterior and body of left caudate nucleus, especially in left thalamus. Conclusion: PSD has abnormal volume and morphological structure of subcortical nuclei, which supports the role of subcortical structures changes in the pathophysiology and pathogenesis of early PSD.

[Circulating tumor DNA and targeted therapy in colorectal cancer]

The detection of circulating tumor DNA is a quick, low cost and reliable approach of liquid biopsy of cancer. It has a wide range of applications for tumor screening because of its noninvasive, convenient and highly repeatable features. In terms of the targeted therapy in patients with colorectal cancer, serial monitoring of circulating tumor DNA, especially for the specific genetic alterations, can be used for prognosis, monitoring resistance, evaluation of therapeutic effects and screening combined targeted therapy. Therefore, it will guide more precise treatment of colorectal cancer.

Primary antibiotic resistance of Helicobacter pylori in Chinese patients: a multiregion prospective 7-year study

OBJECTIVES

To explore the characteristics of Helicobacter pylori resistance in China and the association between antibiotic resistance and several clinical factors.

METHODS

H. pylori strains were collected from patients in 13 provinces or cities in China between 2010 and 2016. Demographic data including type of disease, geographic area, age, gender and isolation year were collected to analyse their association with antibiotic resistance. Antibiotic resistance was detected using the Etest test and the Kirby-Bauer disc diffusion method.

RESULTS

H. pylori were successfully cultured from 1117 patients. The prevalence of metronidazole, clarithromycin (CLA), azithromycin, levofloxacin (LEV), moxifloxacin, amoxicillin (AMO), tetracycline and rifampicin resistance was 78.2, 22.1, 23.3, 19.2, 17.2, 3.4, 1.9 and 1.5%, respectively. No resistance to furazolidone was observed. The resistance rates to LEV and moxifloxacin were higher in strains isolated from patients with gastritis compared to those with duodenal ulcer and among women. Compared to patients ≥40 years old, younger patients exhibited lower resistance rates to CLA, azithromycin, LEV and moxifloxacin. The resistance rates to CLA and AMO were higher in strains isolated more recently, and we also found that the prevalence of resistance to metronidazole, CLA, azithromycin and AMO were significantly different among different regions of China.

CONCLUSIONS

The resistance rates to metronidazole, CLA and LEV were high in China. Patient age, gender, disease and location were associated with the resistance of H. pylori to some antibiotics. Furazolidone, AMO and tetracycline are better choices for H. pylori treatment in China.

[Surgical treatment of colorectal liver metastases]

Surgical resection of the metastases offers the only opportunity for long-term survival in colorectal liver metastases. However, only 10% to 20% of patients present with resectable disease, and so how to increase surgical patients has been a clinical hotspot. In addition to expanding surgical indications, two-stage hepatectomy and convertible therapy are optional. In convertible therapy, initial treatment regimen decides long-term benefit, and it is important to select appropriate patient population in addition to Ras status when anti-epithelial growth factor receptor monoclonal antibody is used. Minimally invasive surgery can also be used for liver resection and simultaneous resection, and it is safe and effective. For patients with colorectal cancer and unresectable asymptomatic liver metastases, the debate continues over the efficacy of primary resection compared to chemotherapy alone, limited by lack of prospective evidence. Therefore, multidisciplinary team assessment is essential to optimize outcomes in colorectal liver metastases.

The effects of neighborhood views containing multiple environmental features on road traffic noise perception at dwellings

The importance of non-acoustical factors including the type of visual environment on human noise perception becomes increasingly recognized. In order to reveal the relationships between long-term noise annoyance and different types of neighborhood views, 2033 questionnaire responses were collected for studying the effect of perceptions of different combinations of views of sea, urban river, greenery, and/or noise barrier on the annoyance responses from residents living in high-rise apartments in Hong Kong. The collected responses were employed to formulate a multivariate model to predict the probability of invoking a high annoyance response from residents. Results showed that views of sea, urban river, or greenery could lower the probability, while views of noise barrier could increase the probability. Views of greenery had a stronger noise moderation capability than views of sea or urban river. The presence of an interaction effect between views of water and views of noise barrier exerted a negative influence on the noise annoyance moderation capability. The probability due to exposure to an environment containing views of noise barriers and urban rivers would be even higher than that due to exposure to an environment containing views of noise barriers alone.

Evaporating metal nanocrystal arrays

Anodic aluminum oxide (AAO) substrates with a self-ordered triangular array of nanopores provide the means to fabricate multiple forms of nano materials, such as nanowires and nanoparticles. This study focuses on nanostructures that emerge in thin films of metals thermally evaporated onto the surface of AAO. Previous work showed that films of different evaporated metals assume dramatically different structures, e.g. an ordered triangular array of nearly monodisperse nanoparticles forms for lead (Pb) while a polycrystalline nanohoneycomb structure forms for silver (Ag). Here, we present investigations of the effects of substrate temperature and deposition angle that reveal the processes controlling the nano particle array formation. Our findings indicate that arrays form provided the grain nucleation density exceeds the pore density and the atomic mobility is high enough to promote grain coalescence. They introduce a method for producing films with anisotropic grain array structure. The results provide insight into the influence of substrate nano-morphology on thin film growth energetics and kinetics that can be harnessed for creating films with other novel nano-structures.

Driving a Superconductor to Insulator Transition with Random Gauge Fields

Typically the disorder that alters the interference of particle waves to produce Anderson localization is potential scattering from randomly placed impurities. Here we show that disorder in the form of random gauge fields that act directly on particle phases can also drive localization. We present evidence of a superfluid bose glass to insulator transition at a critical level of this gauge field disorder in a nano-patterned array of amorphous Bi islands. This transition shows signs of metallic transport near the critical point characterized by a resistance , indicative of a quantum phase transition. The critical disorder depends on interisland coupling in agreement with recent Quantum Monte Carlo simulations. We discuss how this disorder tuned SIT differs from the common frustration tuned SIT that also occurs in magnetic fields. Its discovery enables new high fidelity comparisons between theoretical and experimental studies of disorder effects on quantum critical systems.

Uptake characteristics of levofloxacin for the eradication of Helicobacter pylori by GES-1 and MGC80-3 cells

OBJECTIVE

The aim of this study was to study the uptake of levofloxacin for the eradication of Helicobacter pylori by human gastric epithelial cell lines, GES-1 and MGC80-3.

MATERIALS AND METHODS

High performance liquid chromatography (HPLC) and coomassie brilliant blue staining, among other methods, were used to study the uptake of levofloxacin in GES-1 and MGC80-3 cells. The effect of time, concentration, temperature, pH, cyclosporine A, verapamil, and cimetidine on uptake was analyzed.

RESULTS

The uptake of levofloxacin by GES-1 and MGC80-3 cells reached a steady state after 15 minutes of incubation, and was enhanced by increasing the extracellular levofloxacin concentration, although not in a linear manner. A maximum uptake was observed at 37 °C and pH 7.4. Cyclosporin A and verapamil enhanced uptake in GES-1 cells by 2.07%-13.23% (p > 0.05), and 17.5%-35.3% in MGC80-3 cells (p < 0.05). The uptake of levofloxacin was not affected by cimetidine.

CONCLUSIONS

P-glycoprotein mediates levofloxacin uptake in MGC80-3 cell. Further, P-glycoprotein may be involved in levofloxacin uptake in GES-1 cells. However, organic cation transporters were not involved in levofloxacin uptake in MGC80-3 and GES-1 cells.

Association between the AGTR1 A1166C polymorphism and risk of IgA nephropathy: a meta-analysis

Numerous studies have evaluated the association between the A1166C polymorphism in the angiotensin II type 1 receptor (AGTR1) gene and immunoglobulin A nephropathy (IgAN) risk. However, this relationship remains controversial. Our aim was to evaluate the relationship between this polymorphism and IgAN susceptibility by performing a meta-analysis. Articles were identified in the PubMed, Google Scholar, and China National Knowledge Infrastructure databases, and after selection, five eligible studies were included. Statistical analyses were carried out using Stata 12.0, combining data from all the relevant studies. The pooled odds ratios (ORs) regarding the association between the AGTR1 A1166C polymorphism and IgAN risk were not statistically significant [A vs C: OR = 0.64, 95% confidence interval (CI) = 0.24-1.68; AA vs AC+CC: OR = 1.02, 95%CI = 0.74-1.39; CC vs AC+AA: OR = 1.20, 95%CI = 0.48-2.98; AC vs AA+CC: OR = 0.96, 95%CI = 0.70-1.31]. In conclusion, the AGTR1 gene A1166C polymorphism may not be correlated with IgAN susceptibility. However, further studies should be performed to confirm this finding.

Ultrasound Findings of Intraductal Papillary Neoplasm in Bile Duct and the Added Value of Contrast-Enhanced Ultrasound

PURPOSE

To investigate the imaging features of intraductal papillary neoplasm in bile duct (IPNB) on baseline ultrasound and contrast-enhanced ultrasound (CEUS).

MATERIALS AND METHODS

The imaging features on baseline ultrasound and CEUS in 16 pathologically proven IPNB lesions in 15 patients were retrospectively analyzed. Real-time contrast specific modes and contrast agent of SonoVue were used for CEUS.

RESULTS

Bile duct dilation was present in all patients. The mean lengths for the intraductal papillary adenomas and adenocarcinomas were 2.5 ± 1.1 (range, 1.2 - 4.2 cm) and 5.6 ± 2.0 cm (range, 3.3 - 9.8 cm) (P = 0.004). Three imaging types of IPNB on ultrasound were depicted: bile duct dilation with intraductal mass (n = 8), bile duct dilation without intraductal mass (n = 3), and cystic-solid mixed type (n = 5). On CEUS, solid components of 13 lesions appeared hyper- (n = 12) or iso-enhancement (n = 1) in the arterial phase whereas all showed hypo-enhancement in the portal and late phases. For 3 lesions of bile duct dilation without intraductal mass, CEUS showed non-enhancement during all phases. Pre-surgical CEUS and conventional ultrasound made correct diagnoses in 12 (75.0 %) and 5(31.3 %) of 16 IPNBs respectively (P = 0.04). For CECT, correct diagnosis was also achieved in 12 (75.0 %) of 16 lesions (P = 1.00, in comparison with CEUS).

CONCLUSIONS

IPNB should be taken into consideration when intraductal mass or cystic-solid mass with bile duct dilation, or remarkable bile duct dilation without intraductal mass, are found on US. Intraductal mass length > 3.0 cm is more commonly found in malignant IPNB. CEUS might facilitate the diagnosis of IPNB by easily excluding the possibility of commonly found sludge, nonshadowing stones, or blood clots.

Blockade of the CXCR6 signaling inhibits growth and invasion of hepatocellular carcinoma cells through inhibition of the VEGF expression

Chemokines have been shown to play a critical role in tumor development and progression. However, little is known about the function and molecular mechanisms of CXCR6 in multiple malignancies. In the present study, we aimed to investigate the role of CXCR6 in human hepatocellular carcinoma (HCC). The expression of CXCR6 was examined by immunohistochemical assay using a tissue microarray procedure. A loss-of-function experiment was performed to explore the effects of lentivirus-mediated CXCR6 shRNA (shCXCR6) on cell proliferation and invasive potential by MTT and Transwell assays in HCC cell line (SMMC-7721). It was found that the expression of CXCR6 protein was significantly increased in HCC tissues compared with that in adjacent non-cancerous tissues (ANCT) (63.04&#x0025; vs 36.96&#x0025;, P=0.019), and correlated with the lymph-vascular space invasion in HCC patients (P=0.038). Knockdown of CXCR6 repressed cell proliferation and invasion of HCC cells followed by the down-regulation of vascular endothelial growth factor (VEGF). Taken together, our findings show that high expression of CXCR6 is positively associated with distant invasion of HCC patients, and blockade of CXCR6 signaling suppresses the growth and invasion of HCC cells through inhibition of the VEGF expression, suggesting that CXCR6 may represent a promising therapeutic target for the treatment of HCC.

A study on dysbaric osteonecrosis in caisson workers

PURPOSE

To study the effects of exposure to compressed air on tunnel workers' health and to investigate the prevalence of dysbaric osteonecrosis (DON) in caisson workers.

METHODS

128 tunnel workers were divided into the exposed group (n = 58) and the control group (n = 70), and their shoulders, hips and knees were examined with X-ray, computed tomography (CT) and magnetic resonance imaging (MRI).

RESULTS

1) 34.5% of the exposed group were diagnosed with DON based on the national diagnostic criteria of decompression sickness. 2) The incidental difference of skeletal cystic changes between the exposed group and the control group was highly statistically significant (p < 0.01). 3) CT and MRI examination could detect early onset of DON lesions, and the cystic changes shown in CT and abnormal signals in MRI were diagnostic indicators in cases.

CONCLUSION

Cystic changes in CT and abnormal signals in MRI are key imaging findings of early DON.

Ag-decorated TiO₂ nanograss for 3D SERS-active substrate with visible light self-cleaning and reactivation

The production of SERS-active substrates which are uniform, sensitive, reproducibile and durable still remains an important issue. Here, we report a strategy for the fabrication of a large-area Ag-decorated TiO₂ nanograss SERS-active substrate by a simple solvothermal approach combined with Ag evaporation. The nanograss consists of dense rutile TiO₂ nanorods of about 5 nm in diameter and the decorated Ag nanoparticles are an average of 8 nm in diameter. The Ag protrusions and gaps between them contribute to three dimensional SERS "hot spots" which can be modulated by simply controlling the Ag evaporating parameters. The Ag-decorated TiO₂ substrate is highly efficient in detecting rhodamine 6G (R6G) and 4-aminothiophenol (4-ATP) molecules and has good homogeneity. An obvious red shift and even high enhancement of b₂ vibration mode were observed in detecting 4-ATP due to the effective charge transfer from the Ag atoms to sulfur atoms. The Ag-decorated TiO₂ substrate can be easily self-cleaned and reactivated by visible light irradiation without obvious degeneration of SERS signals. Our results demonstrate that the Ag-decorated TiO₂ substrate with high and homogeneous SERS activity has potential feasibility as a sensitive SERS probe.

Immediate effects of different schedules of somatostatin on portal pressure in patients with liver cirrhosis

WHAT IS KNOWN AND OBJECTIVE

Somatostatin (SST) is used for the treatment of acute variceal bleeding based on its ability to decrease portal pressure and collateral blood flow. To date, no studies have focused on the immediate-early effects (between 1 and 30 min) of SST. The aim of this study was to compare the efficacy of different schedules of SST therapy with placebo on portal pressure in patients with portal hypertension treated with portal-azygous disconnection and to test whether an increase in bolus or infusion dose can improve the clinical efficacy of SST therapy.

METHODS

  Patients were treated with four different schedules: (a) standard dose (n = 11): one 250 μg bolus + a continuous infusion of 250 μg/h; (b) medium dose (n = 10): 500 μg bolus + a continuous infusion of 250 μg/h; (c) high dose (n = 10): 250 μg bolus + a continuous infusion of 500 μg/h; (d) control (n = 10): an injection of placebo (saline) followed by a placebo infusion. Following SST or placebo administration, portal pressure, central venous pressure (CVP), systemic blood pressure and heart rate (HR) were measured at 1, 3, 5, 7, 10 and 30 min.

RESULTS AND DISCUSSION

  The three schedules of SST induced a marked, rapid and highly significant decrease in portal pressure. The decline in portal pressure was moderate at 1 min (P < 0·040), achieved a peak effect at 5 min (P < 0·009) and remained decreased at 30 min. The effect of SST on portal pressure was significantly greater than placebo from 1 min after administration. There were no significant differences in portal pressure decrease between the three schedules of SST. The three schedules of SST and the placebo schedule did not induce significant changes in HR, systemic blood pressure and CVP.

WHAT IS NEW AND CONCLUSION

  This study shows that SST is effective in decreasing portal pressure within 30 min of administration in patients with liver cirrhosis. The clinical schedule used in this study was reasonable and safe.

Discrimination between neoplastic and non-neoplastic lesions in cirrhotic liver using contrast-enhanced ultrasound

OBJECTIVES

To assess the value of contrast-enhanced ultrasound (CEUS) in differentiating hepatocellular carcinoma (HCC) from non-neoplastic lesion in cirrhotic liver in comparison with baseline ultrasound.

METHODS

A total of 147 nodules (diameter ≤5.0 cm) in 133 cirrhotic patients (mean age±standard deviation: 52±13 years, range 20-82 years; gender: 111 males and 22 females) were examined with CEUS. There were 116 HCCs, 26 macroregenerative nodules and 5 high-grade dysplastic nodules. CEUS was performed with a real-time contrast-specific mode and a sulphur hexafluoride-filled microbubble contrast agent.

RESULTS

Hypervascularity was observed in 94.8% (110/116) HCCs, 3.8% (1/26) macroregenerative nodules and 60.0% (3/5) high-grade dysplastic nodules during arterial phase on CEUS. Detection rates of typical vascular pattern (i.e. hypervascularity during arterial phase and subsequent washout) in HCCs with a diameter of ≤2.0 cm, 2.1-3.0 cm and 3.1-5.0 cm were 69.2% (27/39), 97.1% (33/34) and 100.0% (43/43), respectively. CEUS significantly improved the sensitivity [88.8% (103/116) vs 37.1% (43/116), p<0.001], negative predictive value [70.5% (31/44) vs 31.5% (29/92), p<0.001], and accuracy [91.2% (134/147) vs 49.0% (72/147), p<0.001] in differentiating HCCs from non-neoplastic lesions when compared with baseline ultrasound. However, the sensitivity and accuracy of CEUS for HCCs ≤2.0 cm in diameter were significantly lower than those for HCCs of 2.1-3.0 cm and 3.1-5.0 cm in diameter.

CONCLUSIONS

CEUS improves diagnostic performance in differentiating HCCs from non-neoplastic nodules in cirrhotic patients compared with baseline ultrasound. Diagnosis of HCCs ≤2.0 cm diameter by CEUS is still a clinical concern, and thus needs further investigation.

The role of oxidative stress in neuromelanin synthesis in PC12 cells

Previous research has indicated that neuromelanin (NM) is involved in the pathogenesis of Parkinson's disease (PD). Increased reactive oxygen species (ROS) generation in PD sufferers is thought to be related to enhanced tyrosine hydroxylase (TH) activity and NM production. However, few reports have confirmed this hypothesis. In this study, PC12 cells of all experiments were exposed to 50 μmol/L levodopa (l-DOPA) to generate a model for NM synthesis. Meanwhile, PC12 cells were treated with glucose oxidase (GO) at different concentrations to generate oxidative stress. Finally, cell viability, TH activity, and NM generation in PC12 cells were measured. The results showed that GO dose-dependently stimulated oxidative stress generation in PC12 cells. Moderate increases in oxidative stress enhanced the viability of PC12 cells. However, an excessive level of oxidative stress can lead to the degeneration of PC12 cells. Notably, in the surviving PC12 cells, ROS significantly increased the TH activity, and the NM production was also upregulated. Thus, oxidative stress may upregulate the synthesis of NM, which may be a result of the increased TH activity observed in response to the elevated ROS in l-DOPA-treated PC12 cells.

Observation of giant positive magnetoresistance in a Cooper pair insulator

Ultrathin amorphous Bi films, patterned with a nanohoneycomb array of holes, can exhibit an insulating phase with transport dominated by the incoherent motion of Cooper pairs (CP) of electrons between localized states. Here, we show that the magnetoresistance (MR) of this Cooper pair insulator (CPI) phase is positive and grows exponentially with decreasing temperature T, for T well below the pair formation temperature. It peaks at a field estimated to be sufficient to break the pairs and then decreases monotonically into a regime in which the film resistance assumes the T dependence appropriate for weakly localized single electron transport. We discuss how these results support proposals that the large MR peaks in other unpatterned, ultrathin film systems disclose a CPI phase and provide new insight into the CP localization.

Heritability of metabolic syndrome traits among healthy younger adults: a population based study in China

OBJECTIVE To estimate heritability of metabolic syndrome traits among healthy younger adults in a human population in China, and examine potential sex differences in heritability and parental effect on metabolic syndrome traits. METHODS Using offspring-parent regression, we estimated heritability (h(2)) of metabolic syndrome traits based on 452 child-parent triads identified from a population based random survey on metabolic syndrome among people over 15 years of age in Guangzhou, China. RESULTS Body mass index (BMI), cholesterol, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG) and waist circumference (waist-C) were more heritable (h(2), 0.42-0.545), whereas systolic blood pressure (SBP), diastolic blood pressure (DBP), and triglycerides (TG) were less heritable (h(2), 0.14-0.28). Sons had pronounced increases in heritability for all traits over daughters, particularly for cholesterol (0.653 vs 0.356), FPG (0.602 vs 0.313), LDL-C (0.521 vs 0.329), and TG (0.395 vs 0.187). Offspring-mother seemed to have a higher heritability in every trait except FPG (0.67 vs 0.794) than offspring-father, most notably for DBP (0.308 vs 0.122), SBP (0.288 vs 0.146), TG (0.387 vs 0.239) and waist-C (0.581 vs 0.354). CONCLUSION We estimated the heritability of metabolic syndrome traits in a human population based on a unique population based offspring-parent sample from China, and found important evidence that the maternal and paternal effects on these traits are different and the sex difference in heritability is pronounced.

Computerized endoscopic balloon manometry to detect esophageal variceal pressure

BACKGROUND AND STUDY AIMS

Measuring the variceal pressure is important in predicting esophageal variceal bleeding. However, current noninvasive methods of measuring variceal pressure have not gained wide popularity. We have developed a computerized endoscopic balloon manometry (CEBM) system to detect variceal pressure. The aims of the study were to test the in-vitro accuracy of CEBM and to evaluate the clinical reliability and feasibility of this method.

PATIENTS AND METHODS

The CEBM system, comprising an esophageal variceal manometer and a computer, records variceal pressure and manometry images simultaneously. In the in-vitro study, variceal models were fixed inside an artificial esophagus, into which an endoscope with transparent balloon was inserted for intraluminal pressure measurement. The artificial varix was filled with water and connected to a water column to modulate the intraluminal pressure. This CEBM system was tested blindly in variceal models with different intraluminal pressures. CEBM was also used to measure variceal pressure in 23 patients with liver cirrhosis and esophageal varices, and the results were compared with the hepatic venous pressure gradient (HVPG).

RESULTS

In the in-vitro study, the measured intraluminal pressure correlated significantly with the actual intraluminal pressure for different diameters (R > or = 0.993, P < 0.001). Variceal pressure measurements with CEBM were technically successful in 23 patients. Regression analysis showed a good correlation between variceal pressure measured with CEBM and the HVPG (R = 0.858, P < 0.001).

CONCLUSIONS

Our preliminary results indicate that CEBM is feasible and accurate. CEBM may become a more reliable method for detecting variceal pressure.

Kinetic distribution of 14C-metsulfuron-methyl residues in paddy soils under different moisture conditions

Rice paddy soils undergo several cycles of drying and wetting during a growing season. A laboratory study was conducted to determine the effect of soil moisture conditions on the distribution and kinetics of extractable and bound residues of 14C-metsulfuron-methyl in six Chinese paddy soils during 84 d of incubation at 15 degrees C with moisture contents varying from 20 to 50% of the field water-holding capacity. The amount of extractable residues consistently increased and bound residues decreased with increasing soil moisture content. At the end of the incubation experiments, extractable residues and bound residues accounted for 34.5 to 84.4% and 11.6 to 53.3% of applied radioactivity in soils, respectively. Soil pH and soil microbial biomass carbon were the most predominant factors affecting the formation and relative distribution of herbicide residues between extractable and bound residue forms. In high-pH soils, bound residues decreased and extractable residues increased, suggesting an increased leaching risk for metsulfuron-methyl in alkaline soils. High precipitation rates, along with the common practice of liming in southeastern China, may lead to enhanced herbicide leaching as well as phytotoxicity to rotation plants and should be considered in overall pest management practices.

Induction of tumor necrosis-alpha, p38 and JNK in the spinal cord following acute heart injury in the rat model

BACKGROUND

It is still not known whether the spinal cytokine signaling pathways are involved in the pathophysiologic mechanism of the acute phase of heart disease. This study examines the expression pattern of tumor necrosis factor-alpha (TNF-alpha) and its two related mitogenic-activated protein kinases, p38 and Jun-N-terminal kinase (JNK), in the spinal cord in response to acute cardiac injury (ACI).

METHODS

The ACI rat model was established by intra-myocardial injection of formalin. At the indicated times after the establishment of ACI, the thoracic segments of the spinal cord were harvested and Western blot was performed to determine the expression of TNF-alpha, p38 and JNK. The localization of the cytokine and the kinases was determined by immunohistochemistry and double immunofluorescence.

RESULTS

In response to ACI, TNF-alpha protein was up-regulated and reached a peak level at 6 h after ACI. The up-regulated TNF-alpha was distributed in all the laminae in the spinal cord and mainly localized in the neurons, as determined by immunohistochemistry and double immunofluorescence. In response to ACI, p38 and JNK were also up-regulated in the spinal cord. The expression profiles of p38 and JNK were similar to that of activated TNF-alpha following ACI.

CONCLUSIONS

This study shows that cardiac injury can induce the activation of spinal TNF-alpha, p38 and JNK. The activated spinal cytokine signaling may contribute to disease progression in the acute phase of cardiac injury in clinical practice.

Cobrotoxin-containing analgesic compound to treat chronic moderate to severe cancer pain: results from a randomized, double-blind, cross-over study and from an open-label study

Cobrotoxin produces intense analgesia but it has an onset of response of 1-3 h which hampers its clinical use in cancer pain. Recently, a compound analgesic formulation combining cobrotoxin, tramadol hydrochloride and ibuprofen (Compound Keluoqu, CKLQ) has become available in China. The aim of this study was to evaluate the clinical efficacy of CKLQ for moderate to severe cancer pain. A consecutive series of patients with chronic moderate to severe cancer pain was enrolled into two multicenter trials. Of the 230 eligible patients, 119 were assigned to a randomized, double-blind, cross-over study, while 111 entered an open-label study. They were all of Han-China nationality and had a mean age of 52.0 and 55.4 years and a mean body weight of 55.6 and 52.9 kg, respectively. A total of 11 patients discontinued the study, 6 (54.5%) because of insufficient pain relief and 5 due to the occurrence of adverse events. In the cross-over study, 59 patients were randomized to receive a CKLQ package with 2 CKLQ tablets (each containing 0.16 mg cobrotoxin, 25 mg tramadol hydrochloride and 50 mg ibuprofen) and 2 placebo capsules, a placebo package with 2 placebo tablets and 2 placebo capsules, and an active control package with 2 tramadol hydrochloride capsules (each containing 50 mg tramadol hydrochloride) and 2 placebo tablets (arm A), and 60 to receive a tramadol hydrochloride package, a placebo package and a CKLQ package (arm B), sequentially and only once. Patients in the open-label study only received CKLQ and were given the option to continue for up to 7 days as long as they had satisfactory pain relief. Pain response was classified as CR, PR and NC. CR was defined as 100% pain relief, with a pain score of 0 on a 0-10 VAS. PR was defined as decreased to mild pain, with a pain score of no more than 4 on a 0-10 VAS. NC was defined as pain that either remained unchanged or that was reduced from severe to moderate at baseline, with a VAS pain score of more than 4 after treatment. One hundred and eight patients completed the cross-over study with all the three drug units. The overall rate of pain relief was 93/111 (83.7%) for CKLQ, 75/110 (68.2%) for tramadol hydrochloride (P=0.011) and 39/111 (35.1%) for placebo (P<0.001). The mean duration of pain relief with CKLQ was significantly longer than that of the other two agents (P<0.001). Of the 35 patients who did not respond to tramadol hydrochloride, 27 (77.1%) responded to CKLQ, while of the 18 who did not respond to CKLQ, 8 (55.6%) achieved satisfactory pain control with tramadol hydrochloride. In the open-label study, the overall relief rate of a single-dose of CKLQ was 99/111 (89.2%). A reduction in the percentage of complete relief, an increase in that of PR and a significant decrease in duration of relief were observed after continuous treatment with at least 10 doses of CKLQ. The frequency of adverse events for CKLQ was similar to that of tramadol hydrochloride. The results of the randomized, double-blind, cross-over study and the open-label study of CKLQ in cancer patients with chronic moderate to severe cancer pain suggest that the CKLQ may be valuable for the treatment of chronic moderate to severe cancer pain. However, the tolerance of CKLQ remains to be further defined.

Molecular self-organization in cylindrical nanocavities

We studied molecular organization in cylindrical nanocavities using liquid crystals. NMR analysis shows high surface-induced ordering way above the bulk critical temperature. The surface-order evolution reveals replacement of the isotropic phase by a paranematic phase and surface-induced disordering in the nematic phase. Due to strong surface potential and nanoconfinement, complete wetting and continuous evolution of the surface-order parameter are observed through the nematic-paranematic transition. As we show, the counter-intuitive absence of complete phase transition at the interface while an abrupt phase transition was measured in the averaged order parameter is in good agreement with established theories.

Change of nitric oxide in experimental colitis and its inhibition by melatonin in vivo and in vitro

AIM

To investigate the change of nitric oxide (NO) in rat colitis and its inhibition by melatonin in vivo and in vitro.

METHODS

In vivo, rat colitis was established intracolonically with trinitrobenzenesulphonic acid (TNBS) and ethanol. The animals were randomised into five groups: control group, model group, melatonin group (2.5, 5.0, 10.0 mg/kg), and treated intracolonically with saline, saline and melatonin respectively (once a day, from day 7 after colitis was established to day 28). After the end of the experiment, the mucosal damage index (CMDI) and histology score (HS) were evaluated and the level of myeloperoxidase (MPO) and malondiadehyde (MDA) and NO in the colon tissue were measured. In vitro, the co-culture model of the inflamed colon mucosa (from the colitis) with lipopolysaccharide (LPS), and the colonocytes oxidative injury model by hydroxyl radical, were designed respectively to elucidate the inhibition of NO by melatonin.

RESULTS

After treated with TNBS/ethanol, the extent of CMDI and HS, the levels of MPO, MDA, and NO in the model group, were higher than that in the control group; melatonin ameliorated these parameters effectively. The stimulation of LPS increased the level of NO and MPO and MDA in the co-culture model of inflamed colon mucosa, and melatonin significantly reduced the level of MPO, MDA, and NO. In the coloncyte oxidative injury model by hydroxyl radical, the contents of LDH, MDA, and NO were increased; melatonin reversed this oxidative injury considerably.

CONCLUSION

This study showed that TNBS/ethanol induced colitis was pharmacologically controlled by melatonin in vivo and in vitro.

Risk assessment for safety of soils and vegetables around a lead/zinc mine

Concentrations of heavy metals (Pb, Zn, Cd, Cu) were determined in soils and vegetables (chrysanthemum, spinach and four cultivars of Chinese cabbage from the area adjacent to a Pb/Zn mine in Shaoxing, Zhejiang province, China, and compared with the Chinese National Standards for Soil Environmental Quality. The accumulation of heavy metals in cabbage cv. Siyuegreen was investigated at different distances from the center of the mine. The vegetable plantation soils were polluted with Pb, Cd, Cu and Zn, especially by Pb and Cd. The levels of Pb and Cd were 20 and 30 times higher than the permitted standards, indicating that this Pb/Zn mining area is unsuitable for agricultural use. Chinese cabbage, chrysanthemum and spinach had different enrichment coefficients. The enrichment coefficient of Cd from soil to roots of chrysanthemum was >80% and from roots to leaves of cabbage cv. Shanghaigreen was >120%. These vegetables were polluted by heavy metals and could not be regarded as safe for human consumption. Environmental accumulation of heavy metals in the vegetable plantation soils was proportional to heavy metal accumulation in vegetables and both were inversely proportional to the distance from the lead/zinc mine.

Ultra-high redox enzyme signal transduction using highly ordered carbon nanotube array electrodes

We report on a highly ordered array of carbon nanotubes (CNTs) that serves as a universally direct nanoelectrode interface for redox proteins and provides an efficient conduit for electron transfer. The site-selective, covalent docking of the enzyme glucose oxidase (GO(x)) on the CNT tips is found to have a marked effect on enhancing electron transfer properties, as measured by cyclic voltammetry. A unimolecular electron transfer rate of 1500 s(-1) has been measured for this system, a value exceeding the rate of oxygen reduction by glucose oxidase. Furthermore, the redox enzyme-CNT array conjugate can be utilized as a quantitative, substrate-specific biosensor.

Site-specific assembly of DNA and appended cargo on arrayed carbon nanotubes

We describe a strategy that permits discrete regions of arrayed carbon nanotubes (CNTs) to be functionalized simultaneously and specifically with DNA oligonucleotides. The different chemical properties of two regions on single CNTs and orthogonal chemical coupling strategies have been exploited to derivatize CNTs within highly ordered arrays with multiple DNA sequences. Through duplex hybridization, we then targeted different DNA sequences with appended metal nanoparticles to distinct sites on the CNT architecture with precise spatial control. The materials generated from these studies represent the first CNTs with bipartite functionalization. The approach described provides a high level of precision in parallel and directed assembly of DNA sequences and appended cargo and is useful for the preparation of novel hybrid bionanomaterials.