Maximizing mesh mileage: evaluating the long-term performance of a novel hybrid mesh for ventral hernia repair

PURPOSE

The objective of this study is to evaluate the safety and long-term outcomes of GORE Synecor™ in ventral hernia repair (VHR).

METHODS

This retrospective, single-center case review analyzed outcomes in patients who underwent VHR with Synecor from May 2016 to December 2022. Primary outcomes were hernia recurrence and mesh infection rates. Secondary outcomes were 30-day morbidity, 30-day mortality, 30-day readmission, re-operation, surgical-site infection (SSI) and occurrence (SSO) rates, and occurrences requiring intervention (SSOI).

RESULTS

278 patients were identified. Mean follow-up was 24.1 (0.2-87.1) months. Mean hernia defect size was 63.4 (± 77.2) cm2. Overall hernia recurrence and mesh infection rates were 5.0% and 1.4% respectively. No mesh infections required full explantation. We report the following overall rates: 13.3% 30-day morbidity, 4.7% 30-day readmission, 2.9% re-operation, 7.2% SSI, 6.1% SSO, and 2.9% SSOI. 30-day morbidity was significantly higher in non-clean (42.1% vs 11.2%, p < 0.01), onlay (OL) mesh (37.0% vs preperitoneal (PP) 16.4%, p = 0.05 vs retrorectus (RR) 15.0%, p < 0.05 vs intraperitoneal (IP) 5.2%, p < 0.001), and open cases (23.5% vs 3.1% laparoscopic vs 4.4% robotic, p < 0.01). SSI rates were significantly higher in non-clean (31.6% vs 5.4%, p < 0.001), OL mesh (29.6% vs RR 11.3%, p < 0.05 vs PP 5.5%, p < 0.01 vs IP 0.0%, p < 0.001), and open cases (15.2% vs 0% laparoscopic vs 0% robotic, p < 0.05).

CONCLUSION

Long-term performance of a novel hybrid mesh in VHR demonstrates a low recurrence rate and favorable safety profile in various defect sizes and mesh placement locations.

[Characteristics and treatment strategies for hepatocellular carcinoma caused by nonalcoholic fatty liver disease]

In recent years, nonalcoholic fatty liver disease (NAFLD) incidence has rapidly increased, and it is gradually becoming a major contributor to liver cirrhosis and hepatocellular cancer (HCC). The degree of liver fibrosis, diabetes mellitus (DM), obesity, age, and gender are the main risk factors for nonalcoholic steatohepatitis (NASH) progression to HCC. Patients with NASH-related HCC are predominantly male, and almost all of them have at least one metabolic disorder (obesity, DM, dyslipidemia, hypertension, etc.). Most HCCs manifest as solitary tumor nodules and a significant number of NASH-related HCCs are non- cirrhotic. Case fatality rates are similar across patients with cirrhotic and noncirrhotic HCC, despite the fact that patients with noncirrhotic HCC tend to be older, have a single macronodular tumor, and have lower incidence of type 2 diabetes and liver transplantation. Controlling the risk factors for NASH might thereby minimize the likelihood of developing HCC. The BCLC staging system should be used as a guide to treat patients with NASH-related HCC. The long-term outcomes of NAFLD-related HCC treatment are similar to those for other HCCs of different etiologies. However, patients combined with metabolic syndrome are at high perioperative risk, so apporpriate preoperative preparation, especially cardiac examination, is essential to avoid this risk.

[Analysis on the infection source of the first local cluster epidemic caused by the VOC/Gamma variant of SARS-CoV-2 in China]

Objective: To investigate a SARS-CoV-2 epidemic reported in Rongcheng City, Weihai, Shandong Province. Methods: The SARS-CoV-2 nucleic acid positive patients and their close contacts were investigated, and the whole genome sequencing and genetic evolution analysis of 9 variant viruses were carried out. An infection source investigation and analysis were carried out from two sources of home and abroad, and three aspects of human, material and environment. Results: A total of 15 asymptomatic infections were reported in this epidemic, including 13 cases as employees of workshop of aquatic products processing company, with an infection rate of 21.67% (13/60). Two cases were infected people's neighbors in the same village (conjugal relation). The first six positive persons were processing workers engaged in the first process of removing squid viscera in the workshop of the company. The nucleic acid Ct value of the first time were concentrated between 15 and 29, suggesting that the virus load was high, which was suspected to be caused by one-time homologous exposure. The whole genome sequence of 9 SARS-CoV-2 strains was highly homologous, belonging to VOC/Gamma (Lineage P.1.15). No highly homologous sequences were found from previous native and imported cases in China. It was highly homologous with the six virus sequences sampled from May 5 to 26, 2021 uploaded by Chile. The infection source investigation showed that the company had used the squid raw materials captured in the ocean near Chile and Argentina from May to June 2021 over the last 14 days. Many samples of raw materials, products and their outer packages in the inventory were tested positive for nucleic acid. Conclusion: This epidemic is the first local epidemic caused by the VOC/Gamma of SARS-CoV-2 in China. It is speculated that the VOC/Gamma, which was prevalent in South America from May to June 2021, could be imported into China through frozen squid.

[Mechanism of hepatic fibrosis associated with Echinococcus: a review]

Echinococcosis is a zoonotic parasitic disease caused by Echinococcus infections, and this disorder may cause fibrosis of multiple vital organs, which may further progress into cirrhosis. Early-stage hepatic fibrosis is reversible, and unraveling the mechanisms underlying hepatic fibrosis induced by Echinococcus infections is of great significance for the prevention and treatment of early-stage hepatic fibrosis. Recently, the studies pertaining to hepatic fibrosis associated with Echinococcus infections focus on cytokines and immune cells. This review summarizes the advances in the mechanisms underlying host immune cells- and cytokines-mediated hepatic fibrosis in humans or mice following Echinococcus infections.

Advances in the study of molecular identification technology of Echinococcus species

The larvae of Echinococcus (hydatidcyst) can parasitize humans and animals, causing a serious zoonotic disease-echinococcosis. The life history of Echinococcus is complicated, and as the disease progresses slowly after infection, early diagnosis is difficult to establish. Due to the limitations of imaging and immunological diagnosis in this respect, domestic and foreign scholars have established a variety of molecular detection techniques for the pathogen Echinococcus over recent years, mainly including nested polymerase chain reaction (PCR), multiplex PCR, real-time quantitative PCR, and nucleic acid isothermal amplification technology. In this article, the research progress of molecular detection technology for Echinococcus infection currently was reviewed and the significance of these methods in the detection and diagnosis of hydatid and hydatid diseases was also discussed.

[Outcomes at discharge of preterm infants born <34 weeks' gestation]

Objective: To investigate the incidence and trend of short-term outcomes among preterm infants born <34 weeks' gestation. Methods: A secondary analysis of data from the standardized database established by a multicenter cluster-randomized controlled study "reduction of infection in neonatal intensive care units (NICU) using the evidence-based practice for improving quality (REIN-EPIQ) study". This study was conducted in 25 tertiary NICU. A total of 27 192 infants with gestational age <34 weeks at birth and admitted to NICU within the first 7 days of life from May 2015 to April 2018 were enrolled. Infants with severe congenital malformation were excluded. Descriptive analyses were used to describe the mortality and major morbidities of preterm infants by gestational age groups and different admission year groups. Cochran-Armitage test and Jonckheere-Terpstra test were used to analyze the trend of incidences of mortality and morbidities in 3 study-years. Multiple Logistic regression model was constructed to analyze the differences of outcomes in 3 study-years adjusting for confounders. Results: A total of 27 192 preterm infants were enrolled with gestational age of (31.3±2.0) weeks at birth and weight of (1 617±415) g at birth. Overall, 9.5% (2 594/27 192) of infants were discharged against medical advice, and the overall mortality rate was 10.7% (2 907/27 192). Mortality for infants who received complete care was 4.7% (1 147/24 598), and mortality or any major morbidity was 26.2% (6 452/24 598). The incidences of moderate to severe bronchopulmonary dysplasia, sepsis, severe intraventricular hemorrhage or periventricular leukomalacia, proven necrotizing enterocolitis, and severe retinopathy of prematurity were 16.0% (4 342/27 192), 11.9% (3 225/27 192), 6.8% (1 641/24 206), 3.6% (939/25 762) and 1.5% (214/13 868), respectively. There was a decreasing of the overall mortality (P<0.001) during the 3 years. Also, the incidences for sepsis and severe retinopathy of prematurity both decreased (both P<0.001). However, there were no significant differences in the major morbidity in preterm infants who received complete care during the 3-year study period (P=0.230). After adjusting for confounders, infants admitted during the third study year showed significantly lower risk of overall mortality (adjust OR=0.62, 95%CI 0.55-0.69, P<0.001), mortality or major morbidity, moderate to severe bronchopulmonary dysplasia, sepsis and severe retinopathy of prematurity, compared to those admitted in the first study year (all P<0.05). Conclusions: From 2015 to 2018, the mortality and major morbidities among preterm infants in Chinese NICU decreased, but there is still space for further efforts. Further targeted quality improvement is needed to improve the overall outcome of preterm infants.

Strength-fracture toughness synergy strategy in ostrich tibia's compact bone: Hierarchical and gradient

Ostriches are the fastest bipeds in the world, but their tibias are very thin. How the thin tibia can withstand the huge momentum impacts of the heavy body during running? The present work revealed that the combination of hierarchical and gradient design strategies was the main reason for their high strength and fracture toughness. The microstructure of ostrich's tibias compact bone was self-assembled into the 6-level hierarchical structure from the hydroxyapatite (HAP) crystals, collagen fiber (sub-nano), mineralized collagen fiber (nano-), mineralized collagen fiber bundle (sub-micro), lamellae (micro-) and osteon (macro-scales). The most distinctive design in the ostrich compact bone was that the HAP crystals were embedded in collagen fibers as well as wrapped in the outer layer of mineral collagen fibers (MCFs) in the form of HAP nanocrystals, thus achieving a high degree of soft and hard combination from the nanoscale. The bending strength was gradient-structure dependent and up to 787.2 ± 40.5 MPa, 4 times that of a human's compact bone. The fracture toughness (K_Jc) is 5.8 ± 0.1 MPa m^1/2. Several toughening mechanisms, such as crack deflection/twist, bridging, HAP fibers pulling-out, and fracture of the MCF bundles were found in the compact bone.

Author Correction: Correlation between expression levels of lncRNA UCA1 and miR-18a with prognosis of hepatocellular cancer

Correction to: European Review for Medical and Pharmacological Sciences 2020; 24 (7): 3586-3591-DOI: 10.26355/eurrev_202004_20820-PMID: 32329833, published online on 15 April 2020. After publication, the authors noticed some mistakes in the manuscript and applied to issue the following changes: the legend of Table I, the date of enrollment of the patients in the section titled "Baseline Characteristics of HCC Patients", the date of follow-up reported in the abstract and in the section entitled "Postoperative Follow-Up". The authors also applied to modify the survival curve of Figure 3 due to misuse of data in the statistical analysis. There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/20820.

MicroRNA-1-3p inhibits the growth and metastasis of ovarian cancer cells by targeting DYNLT3

OBJECTIVE: The purpose of this study was to explore the role of microRNA-1-3p in the progression of ovarian cancer (OVC) and its possible molecular mechanisms.

PATIENTS AND METHODS

For the purpose of exploring the specific mechanism of the oncogene dynein light chain Tctex-type 3 (DYNLT3) in OVC, bioinformatics techniques were applied to predict miRNAs that might bind to DYNLT3, and then microRNA-1-3p was selected. After measuring the expression levels of microRNA-1-3p and DYNLT3 in 60 pairs of OVC tissue samples, the Pearson correlation analysis was used to calculate the expression correlation of microRNA-1-3p and DYNLT3. In addition, Dual-Luciferase reporting assay was used to verify the combination of the two in OVC cells. Furthermore, microRNA-1-3p NC, microRNA-1-3p mimics, and microRNA-1-3p mimics+ DYNLT3-OE (overexpression) were transfected into ES-2 and SKOV-3 cells, respectively. Subsequently, real-time quantitative polymerase chain reaction (qPCR) was performed to examine microRNA-1-3p level in each group of cells, followed by cell counting kit-8 (CCK-8), 5-Ethynyl-2'-deoxyuridine (EdU) test, and transwell assay to verify the impact of microRNA-1-3p on the proliferation, migration ability, and invasiveness of OVC cells. Finally, the mRNA and protein levels of DYNLT3 were examined by qPCR and Western blot in OVC, respectively.

RESULTS

Bioinformatics prediction results showed that a total of three possible miRNAs bound to the oncogene DYNLT3. Then, microRNA-1-3p was selected for further validation. qPCR results revealed that microRNA-1-3p was down-regulated in OVC tissues and cells, while DYNLT3 was up-regulated in OVC tissues. In addition, Pearson correlation analysis indicated that microRNA-1-3p was negatively correlated with DYNLT3 expression, and the Dual-Luciferase reporter assay confirmed that microRNA-1-3p was able to bind directly to the 3'-UTR of DYNLT3. Besides, microRNA-1-3p-mimics transfection remarkably decreased the mRNA and protein expressions of DYNLT3. On the contrary, transfection of microRNA-1-3p-mimics remarkably inhibited the proliferation, migration ability, and invasiveness of OVC cells. Moreover, the transfection of microRNA-1-3p-mimics+DYNLT3-OE partially reversed the inhibitory effect of microRNA-1-3p-mimics on the proliferative, migrate ability, and invasiveness of OVC cells.

CONCLUSIONS

MicroRNA-1-3p is under expressed either in OVC tissues or in cell lines, and overexpression of microRNA-1-3p may inhibit proliferative and migrate ability and invasiveness of OVC cells by modulating DYNLT3, which make microRNA-1-3p a potential therapeutic target for OVC.

LncRNA DANCR regulates osteosarcoma migration and invasion by targeting miR-149/MSI2 axis

OBJECTIVE

As a new LncRNA, anti-differentiated non-coding RNA (DANCR) plays an important role in tumorigenesis and development, and its molecular mechanism in osteosarcoma is unclear. In this study, by investigating osteosarcoma tissue and cells, we explored the molecular mechanism by which lncRNA DANCR regulates the occurrence and development of osteosarcoma by targeting the miR-149 / MSI2 axis.

PATIENTS AND METHODS

In this study, osteosarcoma tissues and adjacent tissues in 109 patients were collected, and the relative expression of DANCR was detected by qPCR. The correlation between DANCR expression and clinical classification was statistically analyzed. In order to explore the potential molecular mechanism of DANCR related to tumor migration and invasion, an overexpression and silencing test was performed on the osteosarcoma cell line Saos-2, and then qPCR method was used to test the expression of miR149, and cell scratch test was used to detect invasion after DANCR silencing and miR149 overexpression. Transwell assay was used to detect the invasion after DANCR silencing and miR149 overexpression. Finally, Western blot was used to verify the expression of MSI2 protein after overexpression and silencing of miR-149.

RESULTS

DANCR was significantly up-regulated in both osteosarcoma tissue and cells. The high expression of DANCR was significantly positively correlated with tissue typing and advanced TNM stage. DANCR can significantly reduce the migration and invasion of osteosarcoma cells. miRNA overexpression significantly reduced osteosarcoma cell migration and invasion. When miR-149 was overexpressed, MSI2 protein expression was significantly down-regulated. When miR-149 was silenced, MSI2 protein was significantly up-regulated.

CONCLUSIONS

LncRNA DANCR plays an important regulatory role in the occurrence and development of osteosarcoma. It may be used as a potential target in the treatment of osteosarcoma in the future, by targeting the miR-149/MSI2 axis to regulate the occurrence and development of osteosarcoma.

Correlation between expression levels of lncRNA UCA1 and miR-18a with prognosis of hepatocellular cancer

OBJECTIVE

To uncover the prognostic potentials of long non-coding RNA (lncRNA) UCA1 and miR-18a in hepatocellular cancer (HCC).

PATIENTS AND METHODS

Expression levels of UCA1 and microRNA-18a (miR-18a) in HCC tissues and adjacent normal ones harvested from 55 HCC patients were determined by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Clinical data of HCC patients were recorded, including pathological grading, tumor staging, intrahepatic metastasis, serum level of α-fetoprotein (AFP), tumor size, tumor number, recurrence, etc. Based on the median levels of UCA1 and miR-18a, enrolled HCC patients were classified into high-level and low-level group. Potential correlation between expression levels of UCA1 and miR-18a with survival of HCC patients was analyzed. The 5-year follow-up data of HCC patients were collected for analyzing factors that may influence prognosis in HCC patients by the Cox regression model.

RESULTS

UCA1 was upregulated and miR-18a was downregulated in HCC tissues. HCC patients with stage III-IV, tumor size ≥5 cm or multiple tumors expressed high level of UCA1. Besides, HCC patients with stage I-II, non-intrahepatic metastasis or primarily diagnosed expressed a relatively low level of miR-18a. High-level UCA1 and low-level miR-18a predicted worse prognosis in HCC patients. Cox regression analysis revealed that tumor node metastasis (TNM) staging, intrahepatic metastases, postoperative recurrences, and UCA1 were risk factors for HCC, while miR-18a was the protective factor.

CONCLUSIONS

LncRNA UCA1 is upregulated and miR-18a is downregulated in HCC tissues. High-level UCA1 and low-level miR-18a are closely linked to poor prognosis in HCC.

Hsa_circ_0011946 promotes the migration and invasion of hepatocellular carcinoma by inducing EMT process

OBJECTIVE

Recently, the vital role of circular RNAs is discovered in many diseases including tumor progression and metastasis. Hepatocellular carcinoma (HCC) is one of the most ordinary malignant tumors. The purpose of our study is to detect the potential function of hsa_circ_0011946 in HCC to offer new biomarkers and targets.

PATIENTS AND METHODS

The level of hsa_circ_0011946 in HCC tissues and cell lines was monitored by Real Time Quantitative Polymerase Chain Reaction (RT-qPCR). Pearson's Chi-square test was used to determine the association between hsa_circ_0011946 expression and several clinicopathological factors. Then, hsa_circ_0011946 was knocked down in HCC cells to uncover its function in metastasis of HCC. Cell migrated and invaded ability was measured through transwell assay, Matrigel assay and wound healing assay. Western blot assay was performed to analyze the effect of hsa_circ_0011946 on the epithelial-to-mesenchymal transition (EMT) process.

RESULTS

In this research, the expression level of hsa_circ_0011946 was significantly increased in HCC tissues compared to that in adjacent samples. The expression of hsa_circ_0011946 was also increased in HCC cell lines. The hsa_circ_0011946 expression was associated with lymphatic metastasis in HCC patients. Knockdown of hsa_circ_0011946 led to the inhibition of cell migration and invasion in HCC. In addition, results of further experiments revealed that the EMT-related proteins were regulated via the knockdown of hsa_circ_0011946 in HCC.

CONCLUSIONS

The hsa_circ_0011946 could enhance cell migration and invasion of HCC by inducing the EMT process.

Role of miR-541-3p/TMPRSS4 in the metastasis and EMT of hepatocellular carcinoma

OBJECTIVE

The aim of this study was to investigate the role of miR-541-3p in hepatocellular carcinoma (HCC), and to explore the possible underlying mechanism.

PATIENTS AND METHODS

80 pairs of cancerous and para-cancerous tissues were collected in this study. Human HCC SMMC-7721 cells and normal liver HL-7702 cells were enrolled as well. Quantitative Polymerase Chain Reaction (qPCR) was performed to detect the expression level of miR-541-3p in tissues and cells. Potential target genes of miR-541-3p were screened and confirmed by online prediction websites and Dual-Luciferase reporter gene assay, respectively. SMMC-7721 cells were used for functional experiments in vitro. Cell proliferation was detected by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) assay. The invasion and migration of the cells were evaluated by transwell and scratch wound-healing assay, respectively. Furthermore, the epithelial-mesenchymal transition (EMT) associated markers were measured by Western blot assay.

RESULTS

MiR-541-3p was lowly expressed in both HCC tissues and cells. Transmembrane protease serines 4 (TMPRSS4) was defined as a functional target of miR-541-3p. The miR-541-3p/TMPRSS4 axis showed containment in HCC cells, such as proliferation, invasion and migration. These effects might be manifested by altering the expressions of EMT-related molecular proteins, including TGF-β, E-cadherin and N-cadherin.

CONCLUSIONS

Our data indicated that miR-541-3p suppressed the invasion and migration of HCC cells by directly targeting and inhibiting TMPRSS4 protein expression. Furthermore, the newly identified miR-541-3p/TMPRSS4 axis provided new insight into the pathogenesis of HCC. It might also serve as a novel potential therapeutic target for HCC treatment.

MicroRNA-328-3p inhibits malignant progression of hepatocellular carcinoma by regulating MMP-9 level

OBJECTIVE

This study aims to explore the influence of microRNA-328-3p on proliferative and apoptotic abilities of hepatocellular carcinoma (HCC) cells, and the potential regulatory mechanisms.

PATIENTS AND METHODS

Quantitative Real Time Polymerase Chain Reaction (qRT-PCR) was performed to detect the expression of microRNA-328-3p in 52 tumor tissue samples and paracancerous ones of HCC patients. The potential interaction between microRNA-328-3p level and clinical indicators of HCC patients was analyzed. Subsequently, the microRNA-328-3p overexpression model was established. In addition, the influence of microRNA-328-3p on the biological functions of the HCC cells was analyzed by the cell counting kit-8 (CCK-8), colony formation assay, and flow cytometry. Finally, the potential downstream gene of microRNA-328-3p was explored by bioinformatics analysis. Recovery experiments were performed to explore the regulation mechanism.

RESULTS

QRT-PCR results revealed that microRNA-328-3p level in tumor tissue specimens of HCC patients was remarkably lower than that in adjacent ones, and the difference was statistically significant. Compared with patients with high expression of microRNA-328-3p, those with low expression of miR-328-3p had more advanced pathological staging and lower overall survival. The overexpression of microRNA-328-3p decreased the proliferative capacity and increased apoptotic rate in HCC cells. Subsequently, MMP-9 expression was found to be highly expressed in HCC tissues and cells, and negatively correlated with microRNA-328-3p level. In addition, microRNA-328-3p overexpression significantly down-regulated the protein expressions of CD31, Ki-67, c-Myc, MMP-2, and MMP-9. In the cell reverse experiment, the overexpression of MMP-9 could counteract the influence of the overexpressed microRNA-328-3p on proliferation and apoptosis in HCC cells, so as to regulate the malignant progression of HCC.

CONCLUSIONS

MicroRNA-328-3p could inhibit the malignant progression of HCC. Its level is remarkably associated with the pathological staging and prognosis of HCC patients. In addition, it is found that microRNA-328-3p might suppress the proliferative ability and promote apoptosis of HCC cells via modulating MMP-9.

Long noncoding RNA UCA1 regulates proliferation and apoptosis in multiple myeloma by targeting miR-331-3p/IL6R axis for the activation of JAK2/STAT3 pathway

OBJECTIVE

We attempted to clarify the regulatory mechanism of UCA1/miR-331-3p/IL6R on cell progression in multiple myeloma (MM).

PATIENTS AND METHODS

The expression of UCA1, miR-331-3p, and IL6R in tumor tissues and cells was measured by qRT-PCR. Cell Counting Kit-8 (CCK-8) was conducted to detect cell proliferation, and flow cytometry assay was applied to examine cell apoptosis. Protein expression of L6R, p-JAK2, p-STAT3, c-Myc, CyclinD1, Bcl-2, and Bax was detected by Western blot assay. The interaction among miR-331-3p, UCA1, and IL6R was determined by Luciferase reporter system. Murine xenograft assay was performed to confirm the biological function of UCA1 in vivo.

RESULTS

The expression of UCA1 and IL6R was up-regulated, while miR-331-3p was down-regulated in MM tumors and cell lines compared with normal tissues and cells. By calculation, miR-331-3p was correlated with UCA1 or IL6R inversely. In addition, UCA1 knockdown suppressed cell proliferation and promoted apoptosis in vitro and in vivo. Luciferase reporter system confirmed the interaction between miR-331-3p and UCA1 or IL6R. More importantly, UCA1 restored miR-331-3p mediated inhibition of proliferation and promotion on apoptosis of MM cells. Consistently, IL6R rescued UCA1 knockdown caused repression on MM cell growth and elevation on apoptosis. Besides, UCA1 facilitated the activation of the JAK2/STAT3 signaling pathway by enhancing IL6R expression via targeting miR-331-3p.

CONCLUSIONS

UCA1 accelerates proliferation and suppresses apoptosis in MM by targeting miR-331-3p/IL6R axis to activate JAK2/STAT3 pathway, providing potential targets for the diagnosis and therapy of MM.

Association of PRKCA expression and polymorphisms with layer duck eggshell quality

1. Eggshell quality is important for the poultry industry. Calcium is deposited during eggshell formation, and protein kinase C alpha (PRKCA) is involved in transmembrane transport of calcium ions in cells. However, the biological function of PRKCA in poultry is still not understood. Therefore, the aim of this study was to explore the association of mRNA expression and single nucleotide polymorphisms (SNPs) of the PRKCA gene with eggshell quality in laying ducks. 2. The mRNA expression and SNPs of the PRKCA gene were detected by real-time fluorescence quantitative PCR (qRT-PCR) and sequencing of PCR products in 45-week-old female Sansui ducks, which is a high production layer duck breed in China. The association of mRNA expression and SNPs in the PRKCA gene with layer duck eggshell traits was analysed using SPSS (v18.0) software. 3. The results demonstrated that PRKCA mRNA was widely expressed in all examined tissues, and expression was highest in kidney and lowest in the gizzard. Furthermore, the PRKCA mRNA level in uterus was significantly positively correlated with eggshell strength and eggshell weight (P < 0.05). Three novel SNPs, the synonymous mutations of g.9571770 T > C in exon 5, g.9583222 C > T and g.9583227 G > A in exon 7, were found in the PRKCA gene, giving four haplotypes and 10 diplotypes, which affected the mRNA secondary structure and free energy. The g.9583222 C > T and g.9583227 G > A mutations were significantly associated with eggshell strength (P < 0.05). Diplotype H1H1 was advantageous for increasing the strength and thickness of an eggshell. 4. In conclusion, the study showed that the mRNA transcription and genetic variation in the PRKCA gene could significantly affect the strength of duck eggshell and that the PRKCA gene is an important candidate gene for improving eggshell quality in poultry.

Accelerated aging effects on color, microhardness and microstructure of ICON resin infiltration

OBJECTIVE

Infiltration resins provide an ideal treatment alternative for white spot lesions on teeth. The icon infiltrant has been widely used as a dental material for a few years, but there are some studies on the in vitro accelerated aging process and the change of hardness and microstructure on this material. The innovation of this work is to aim at investigating characteristics associated with this infiltrant resin and comparing the Icon infiltrant with universal Filtek Z350 and flowable Filtek Z350 resins when exposed to artificial accelerated aging.

MATERIALS AND METHODS

Materials were prepared as disc-shaped specimens sized to 12 mm × 2.2 mm and were aged through exposure to 150 kJ/m2 in an artificial accelerated aging machine. Two-time points, 24 h after aging and 96 h after aging, were selected for evaluation in the following trials. The morphology was observed using a scanning electron microscopy. The standard CIEL*a*b* color system was employed for color measurements. Microhardness of all specimens was analyzed by a Knoop indenter. Chemical components were examined by Fourier transform infrared spectroscopy.

RESULTS

Compared with universal Z350 and flowable Z350, the ICON infiltrant resin presented a uniform, slightly scratched surface before and after accelerated aging. The 24 h artificial accelerated aging of the three investigated materials resulted in acceptable color alterations, a ΔE* range of 2.52±0.63 for universal Z350, 2.43±0.59 for flowable Z350 and 3.31±0.32 for ICON. After 96 h aging, significant color changes were noted for universal Z350 (7.51±0.63) and ICON (4.70±0.69). The ICON infiltrant displayed reduced microhardness when compared to universal Z350 and flowable Z350. The absorption peaks of the chemical bonds were significantly altered after the accelerated aging process.

CONCLUSIONS

Composed in a triethylene glycol dimethacrylate (TEGDMA) monomer-based network, the color stability and microhardness of the infiltrant resin provided suitable material for treating white spot lesions (WSLs), yet presented susceptibility under accelerated aging. Thus, osmotic resin therapy has strict limitations to be most effective.

[Effects of double-catheter epidural analgesia by lidocaine injection respectively on the delivery outcomes and maternal-infant complications for persistent posterior or lateral occipital position of protracted active phase]

Objective: To evaluate the effect of dual-tube epidural segmental injection of lidocaine analgesia on the delivery outcome and maternal and infant complications of persistent posterior occipital position postpartum or lateral occipital position postpartum patients with protracted active phase. Methods: The full and single-term primiparas (n=216, 37 to 42 weeks gestation, 22 to 35 years) diagnosed as persistent posterior or lateral occipital position during the active period were selected from the Department of Obstetrics of Qingdao Municipal Hospital from January 2015 to October 2019. The subjects were randomly assigned into two groups: double-tube epidural block group (n=108) and single-tube epidural block group (n=108), 1% lidocaine was used for epidural analgesia respectively under ultrasound guidance. Senior midwife or obstetricians implement new partogram, and guide women to perform position management, and push or rotate the fetal head in a timely manner. Observation indicators: general condition, the use of non-pharmacological analgesic measures, analgesia related conditions and pain visual analogue scale (VAS) score, delivery-related indicator, cesarean section indication, anesthesia-related indicator, maternal and child complications. Results: (1) General condition: the age, weight, height, gestational age, the ratio of persistent lateral or posterior occipital position, cephalic score, and neonatal birth weight between the two groups of women were not statistically significant (all P>0.05). (2) The use of non-pharmacological analgesic measures: the women's Lamaze breathing method, Doula delivery companionship, percutaneous electrical stimulation, and other measures between two groups were compared, and there were not significant differences (all P>0.05). (3) Analgesia related conditions and VAS scores of women undergoing vaginal delivery: compared with the single-tube epidural block group (n=40), the second-partum time of the women in the double-tube epidural block group (n=59) was significantly shortened [(124±44) vs (86±33) minutes, P<0.01]; after 30 minutes of analgesia (4.4±0.5 vs 0.9±0.5, P<0.01), during forced labor in the second stage of labor (5.7±0.6 vs 1.3±0.4, P<0.01), the VAS scores of pain were also significantly reduced (P<0.01). (4) Labor-related indicators: compared with the single-tube epidural block group, the natural delivery rate (21.3% vs 49.1%) and the delivery experience satisfaction rate (51.9% vs 98.1%) of women in the double-tube epidural block group were significantly increased (all P<0.01), cesarean section rate (63.0% vs 45.4%), instrument assisted rate (15.7% vs 5.6%) decreased significantly (all P<0.05). (5) Cesarean section indications: compared with the single-tube epidural block group, the cesarean section rate caused by prolonged labor or protracted active phase of women in the double-tube epidural block group was significantly reduced (38.0% vs 22.2%； P<0.05), and the fetal distress, intrauterine infection, and social factors caused by cesarean section between the two groups were compared, while the differences were not statistically significant (all P>0.05).(6) Anesthesia related indexes: the block planes of the maternal upper tube administration in the double-tube epidural block group were mostly T7, T8, T9-L2 and L3,While,the block planes in the single-tube epidural block group were mostly T10, T11-S1, S2, S3, and the modified Bromage score were all 0. (7) Maternal and child complications: compared with the single-tube epidural block group, the postpartum hemorrhage rate (18.5% vs 7.4%), the perineal lateral cut rate (20.4% vs 5.6%), the neonatal asphyxia rate (12.0% vs 3.7%), ICU rate of transferred neonates (13.9% vs 4.6%) in the double-tube epidural block group were significantly reduced (all P<0.05). Soft birth canal injury rate, puerperal disease rate and neonatal birth rate between two groups were compared, and there were not statistically significant differences (all P>0.05). Conclusion: Dual-tube epidural segmental injection of lidocaine analgesia could increase the natural delivery rate of women with posterior occipital or lateral occipital position with active stagnation, reduce the rate of cesarean section and the rate of transvaginal instruments, and reduce the complications of mother and child.

Involvement of nNOS in the antinociceptive activity of melatonin in inflammatory pain at the level of sensory neurons

OBJECTIVE

The efficacy of melatonin as an analgesic agent has been well documented in animals and humans. However, the underlying mechanisms by which melatonin exerts antinociceptive effects on inflammatory pain are poorly understood. Here, we investigated the potential of melatonin to ameliorate inflammatory pain.

MATERIALS AND METHODS

In vitro, ND7/23 neurons were treated with capsaicin. We used PCR and Western blot analyses to detect the expression of neuronal nitric oxide synthase (nNOS) in response to melatonin. Orofacial inflammatory pain was induced by 4% formalin administration on the right whisker pad of Sprague Dawley (SD) rats. The analgesic effect of melatonin was evaluated using mechanical threshold analyses. The expression level of nNOS in the trigeminal ganglion (TG) and trigeminal nucleus caudalis (Vc) neurons was assessed by RNAscope and immunohistochemistry.

RESULTS

In vitro, capsaicin upregulated the expression of nNOS, which was dose-dependently reversed by melatonin pretreatment (p < 0.001). In a rat model of orofacial inflammatory pain, melatonin pretreatment significantly attenuated mechanical allodynia in both the acute and chronic phases (p < 0.05). Furthermore, melatonin decreased the formalin-evoked elevated nNOS mRNA and protein levels in the TG and Vc neurons in the acute and chronic phases (p < 0.05).

CONCLUSIONS

Taken together, these results suggest that nNOS may play an active role in both peripheral and central processing of nociceptive information following orofacial inflammatory pain induction. The regulatory effect of melatonin on nNOS in inflammatory pain may have potential implications for the development of novel analgesic strategies.

[Significance of microRNA 216a, 324-5p and 29a expression in peripheral blood in patients with acute pancreatitis and their correlation with liver injury]

Objective: To investigate the significance of microRNA (miR)-216a, miR-324-5p, miR-29a expression in peripheral blood in patients with acute pancreatitis (AP) and their correlation with liver injury. Methods: It was a case-control study design. To select 130 AP patients admitted from June 2017 to May 2019 in the First People's Hospital of Shangqiu, and the patients were divided into mild AP group (MAP group) and moderately severe AP group (SAP group) according to the disease severity, or 54 patients in the liver injury group (20 were MAP and 34 were SAP) and 76 in the non-liver injury group(all were MAP) according to liver injury. And another 40 healthy volunteers were selected as the healthy group. The expressions of miR-216a, miR-324-5p and miR-29a in peripheral blood of MAP group, SAP group, healthy group and liver injury group, non-liver injury group were compared, and the correlation between the miRNA levels and clinical indexes was analyzed. The predictive value of miRNA levels in peripheral blood for AP complicated with liver injury was analyzed by receiver operating characteristic (ROC) curve. Results: The levels of miR-216a and miR-29a in MAP group and SAP group were higher than those in healthy group, and the level of miR-324-5p was lower than that in healthy group (all P<0.01). The levels of miR-216a and miR-29a in SAP group were higher than those in MAP group, and the level of miR-324-5p was lower than that in healthy group (all P<0.01). Balthazar CT Score, acute physiology and chronic health evaluations (APACHE Ⅱ) score, C-reactive protein level, length of hospital stay were positively correlated with the levels of miR-216a and miR-29a in peripheral blood (all P<0.05), and negatively correlated with the levels of miR-324-5p (P<0.05). The levels of miR-216a and miR-29a in the peripheral blood in the liver injury group were higher than those in the non-liver injury group, and they were higher inSAP patients than those in MAP patients in the liver injury group (all P<0.05). The level of miR-324-5p in the peripheral blood in the liver injury group was lower than that in the non-liver injury group, and it was lower in SAP patients than that in MAP patientsin the liver injury group (all P<0.05). The area under ROC curve of miR-216a, miR-324-5p, and miR-29a in peripheral blood to predicate the AP complicated with liver damage was 0.694, 0.750 and 0.814, respectively. Conclusions: The levels of miR-216a and miR-29a increase in peripheral blood and the level of miR-324-5p decreases in patients with AP, and they are closely related to Balthazar CT score, APACHEⅡ score, C-reactive protein and length of hospital stay. The levels of miR-216a, miR-324-5p, miR-29a has certain predictive value for AP with liver injury, of which miR-29a has the highest predictive value.

[Clinical analysis of 7 cases with anti-Caspr2 antibody-associated autoimmune encephalitis]

Objective: To investigate the clinical features, laboratory tests, imaging features, electroencephalogram (EEG) manifestations, treatment and prognosis of anti-CASPR2 antibody-associated autoimmune encephalitis with the purpose to improve the understanding of the disease. Methods: Seven patients diagnosed with CASPR2 antibody-associated encephalitis in the Fifth and first Affiliated Hospital of Zhengzhou University from January 2017 to January 2019 were selected. The clinical manifestations, course of disease, imaging, treatment plan and prognosis of the patients were retrospectively analyzed. Results: Of the 7 patients, 4 were male and 3 were female. The median age of onset was 34 years old (range, 11-66 years). Seizures (6/7), memory decline(5/7), and neuropsychiatric disorders (4/7) were common clinical manifestations. CASPR2 antibody was detected in the CSF of 3 patients (3/7) and the serum of all patients (7/7). Notable imaging changes were observed in 5 patients (5/7). All patients received immunotherapy and were followed up for 1 month to 2 years. One patient was diagnosed with rectal cancer with a poor prognosis; all the others got a good prognosis. Conclusions: CASPR2 antibody-related encephalitis is a rare autoimmune disease. It is considered to present with seizures, memory loss, psychiatric symptoms, dizziness and sleep disorders as the main clinical manifestations. Early identification and treatment of the disease can help the patients achieve a good prognosis.

Effects of Talaromyces marneffei infection on mortality of HIV/AIDS patients in southern China: a retrospective cohort study

OBJECTIVE

Talaromyces marneffei is an opportunistic infection with high morbidity among human immunodeficiency virus (HIV)/AIDS patients in Southeast Asia and southern China. Its effects on mortality in HIV/AIDS patients has not been clearly elucidated.

METHODS

We conducted a retrospective cohort study of hospitalized HIV-infected individuals at the Fourth People's Hospital of Nanning, Guangxi, China during 2012-2015. Kaplan-Meier analyses were used to calculate the cumulative mortality. Cox proportional hazard models and 1:1 propensity score matching (PSM) were used to evaluate the effects of T. marneffei infection on mortality of HIV/AIDS patients.

RESULTS

In total, 6791 HIV/AIDS patients were included, 1093 of them (16.1%) with documented T. marneffei co-infection. The mortality of T. marneffei-infected patients (25.0 per 100 person-months, 95% CI 21.5-26.7) was the highest among all AIDS-associated complications and was significantly higher than that of T. marneffei-uninfected HIV/AIDS patients (13.8 per 100 person-months, 95% CI 12.5-15.1; adjusted hazard ratio (AHR) 1.80, 95% CI 1.48-2.16). The results using PSM were similar (AHR 4.52 95% CI 2.43-8.42). The mortality of T. marneffei-infected patients was also significantly higher than that of patients without any complications. When stratified by demographic characteristics, T. marneffei infection has higher mortality risk in all stratifications. Co-infection with T. marneffei carries a higher mortality risk in patients at any CD4⁺ T-cell count.

CONCLUSIONS

Talaromyces marneffei infection is commonly found in hospitalized HIV/AIDS patients in southern China and was associated with a higher mortality rate than most HIV-associated complications. These results highlight the need for improved diagnosis, treatment and prevention of infection by this neglected fungal pathogen in southern China.

Prognostic value of pathologic grade for patients with oral squamous cell carcinoma

OBJECTIVE

The purposes of this study were to explore both the prognostic value of pathologic grade and the relationships between differentiation and clinicopathological characteristics in oral squamous cell carcinoma.

METHODS

This retrospective cohort study included the records of 2036 patients with oral squamous cell carcinoma who were surgically treated from June 1999 to December 2011. Chi-square test, Kaplan-Meier analysis, and Cox proportional hazards regression model were performed for statistical analysis.

RESULTS

Many clinicopathological characteristics were associated with pathologic grade. Kaplan-Meier analysis showed that well-differentiated tumors had a better prognosis than the other two grades. Cox regression model showed that differentiation was an independent risk factor for prognosis in patients with early stage, but not with advanced stage. The predictive abilities of pathologic grade, T stage, N status, and lymph node ratio were similar, but the presence of extracapsular spread and perineural invasion were stronger prognostic factors than pathologic differentiation.

CONCLUSIONS

Pathologic grade was found to be an independent risk factor for early-stage oral squamous cell carcinoma, but not for advanced stage. Many important clinicopathological characteristics were associated with histological classification; however, its prognostic value was limited.

The effect of somatostatin retained enema in the treatment of pancreatic ileus

OBJECTIVE

To analyze the therapeutic effects of somatostatin retained enema in the treatment of pancreatic ileus in the clinic.

PATIENTS AND METHODS

79 patients randomly divided into 41 cases in the observation group and 38 cases in the control group were analyzed. The control group applied basic treatment plan. The observational group applied the same treatment combined with somatostatin retained enema, conducted twice every day and at least 30 minutes every time. Every 7 days' treatment made a course. The clinical therapeutic effects were compared.

RESULTS

The levels of the hemo diastase and urinary amylase in both groups were decreased prominently after treatment. The levels of blood calcium were prominently increased (p<0.05) with even more improvement in the observation group (p<0.05). The relief times of the abdominal ache and distention, the recovery time of bowel sound and the first defecation time in the observation group were shorter (p<0.05) than those in the control group. The levels of blood serum IL-6 and TNF-α in the two groups were prominently decreased (p<0.05) after treatment, with even more obvious improvement in the observation group. The therapeutic effective rate of the observational group was prominently higher (p<0.05) than that in the control group. The occurrence rate of the complications was lower.

CONCLUSIONS

The application of somatostatin retained enema in the treatment of pancreatic ileus is preferably safe and effective, and it deserves clinical promotion and application.

Assessments of M-mode color echocardiography on fetal right ventricular diastolic function with umbilical cord around neck

OBJECTIVE

To investigate the fetal right ventricular diastolic function under the condition of umbilical cord around neck (UCAN), and analyze the changes of the right ventricular propagation velocity (Vp), then discuss the clinical value of the color M-mode echocardiography in the evaluation of fetal ventricular diastolic function quantitatively.

PATIENTS AND METHODS

All patients enrolled were with singleton pregnancy from Cangzhou Central Hospital from December 2013 to December 2015 as the experimental group. The control group consisted of normal fetuses without UCAN and the experimental group consisted of the fetuses with UCAN. Besides, this paper analyzed values of Tei index of the left and right ventricle as well as Vp of the right ventricle diastole using color M-mode echocardiography.

RESULTS

The Vp values of the experimental group were significantly lower than those of the control group (p < 0.05); the Tei index of the right ventricle of the experimental group was significantly higher than that of the control group (p < 0.05); the Tei indexes of the left and right ventricles of the experimental group had no statistical difference (p > 0.05). The heart function and the right ventricular diastolic function were reduced in fetuses with UCAN; however, the effect of the left and the right ventricular diastolic function had no significant changes in fetuses with UCAN.

CONCLUSIONS

It had great significance to select the appropriate index of cardiac function for estimating the right ventricular diastolic function and the whole heart function of UCAN, and it is of huge practical application value in clinical practice.

Genome-wide studies of von Willebrand factor propeptide identify loci contributing to variation in propeptide levels and von Willebrand factor clearance

Essentials Variants at ABO, von Willebrand Factor (VWF) and 2q12 contribute to the variation in plasma in VWF. We performed a genome-wide association study of plasma VWF propeptide in 3,238 individuals. ABO, VWF and 2q12 loci had weak or no association or linkage with plasma VWFpp levels. VWF associated variants at ABO, VWF and 2q12 loci primarily affect VWF clearance rates.

SUMMARY

Background Previous studies identified common variants at the ABO and VWF loci and unknown variants in a chromosome 2q12 linkage interval that contributed to the variation in plasma von Willebrand factor (VWF) levels. Whereas the association with ABO haplotypes can be explained by differential VWF clearance, little is known about the mechanisms underlying the association with VWF single-nucleotide polymorphisms (SNPs) or with variants in the chromosome 2 linkage interval. VWF propeptide (VWFpp) and mature VWF are encoded by the VWF gene and secreted at the same rate, but have different plasma half-lives. Therefore, comparison of VWFpp and VWF association signals can be used to assess whether the variants are primarily affecting synthesis/secretion or clearance. Methods We measured plasma VWFpp levels and performed genome-wide linkage and association studies in 3238 young and healthy individuals for whom VWF levels had been analyzed previously. Results and conclusions Common variants in an intergenic region on chromosome 7q11 were associated with VWFpp levels. We found that ABO serotype-specific SNPs were associated with VWFpp levels in the same direction as for VWF, but with a much lower effect size. Neither the association at VWF nor the linkage on chromosome 2 previously reported for VWF was observed for VWFpp. Taken together, these results suggest that the major genetic factors affecting plasma VWF levels, i.e. variants at ABO, VWF and a locus on chromosome 2, operate primarily through their effects on VWF clearance.

Sintering Behavior and Effect of Silver Nanowires on the Electrical Conductivity of Electrically Conductive Adhesives

In this paper, two kinds of silver nanowires with a 160 nm average diameter ranging from 30 to 90 µm length and a 450 nm average diameter up to 100 µm length were successfully synthesized by a polyol process with FeCl3 and Na₂S as reaction inhibitor, respectively. The experimental results indicate that the morphologies and sintering behaviors of both of silver nanowires are impacted by glutaric acid and sintering temperature. The isotropically conductive adhesives (ICAs) filled with micro-sized silver flakes and silver nanowires as hybrid fillers were fabricated and the electrical properties were investigated based on the fraction of the silver nanowires of the total of silver fillers and the curing temperature, etc. The in situ monitoring the variation in electrical resistance of the ICAs explores that silver nanowires have influence on the curing behavior of the ICAs. Silver nanowires synthesized with Na2S as reaction inhibitor and treated with glutaric acid can significantly improve the electrical conductivity of the ICAs in the case of the low loading of silver fillers in the appropriate proportion range of the weight ratio of micro-sized silver flakes and silver nanowires, primarily as a result of connecting effect. When the loading of silver fillers in the ICAs is high, the electrical conductivity is also enhanced slightly in the case of the proper fraction of silver nanowires of the total of silver fillers. The effect of the curing temperature on the electrical conductivity relates to the fraction of silver nanowires and the total loading of silver fillers. The electrical conductivity of the ICAs filled with micro-sized silver flakes and silver nanowires synthesized with FeCl₃ as reaction inhibitor is greatly damaged, indicating that the size of silver nanowires also is one of main factor to impact the electrical conductivity of the ICAs doped with silver nanowires. The electrical property of the ICAs filled with micro-sized silver flakes and silver nanowires results mainly from the synergy of silver flakes and nanowires, forming the conductive pathways.

Glucosamine: fructose-6-phosphate amidotransferase in the white shrimp Litopenaeus vannamei: characterization and regulation under alkaline and cadmium stress

Heavy metal residues and chemical contaminators considered as relevant sources of aquatic environmental pollutants have a generally immunosuppressive effect on aquatic organisms, depressing metabolic activities and immune response. Glutamine: fructose-6-phosphate aminotransferase (GFAT, EC2.6.1.16) is the first, and rate-limiting, enzyme in the hexosamine biosynthetic pathway, and is involved in the regulation of chitin biosynthesis and glycosylation of proteins. We have isolated and characterized GFAT from the white shrimp Litopenaeus vannamei. Amino acid sequence similarity of the Lv-GFAT (L.vannamei-GFAT) was highest to GFATs isolated from insects and mammals (83 % similarity to that of Haemaphysalis longicornis). The open-reading frame of the Lv-GFAT codes for a protein of 41.6 kDa with a calculated isoelectric point of 5.03. RT-PCR assays showed that endogenous Lv-GFAT mRNA is most strongly expressed in the intestine. Further analysis of Lv-GFAT gene expression in hepatopancreas by quantitative real-time PCR demonstrated that Lv-GFAT transcript levels increased when the shrimp were exposed to alkaline pH (9.3) and cadmium stress, but the time when its mRNA expression level peaked differed under these stresses. We also first expressed the recombinant protein of GFAT from shrimps in Escherichia coli. Western blot analyses confirmed that the Lv-GFAT protein was strongly expressed in the hepatopancreas after exposure to the LC-Cd stress. These results suggest that Lv-GFAT expression is stimulated by alkaline pH and cadmium stress and that it may play important roles in resistance of shrimp to environmental stresses.

Capability of GaN based micro-light emitting diodes operated at an injection level of kA/cm²

Different size InGaN/GaN based micro-LEDs (μLEDs) are fabricated. An extremely high injection level above 16 kA/cm2 is achieved for 10 μm-diameter LED. The lateral current density and carrier distributions of the μLEDs are simulated by APSYS software. Streak camera time resolved photoluminescence (TRPL) results show clear evidence that the band-gap renormalization (BGR) effect is weakened by strain relaxation in smaller size μLEDs. BGR affects the relaxation of free carriers on the conduction band bottom in multiple quantum wells (MQWs), and then indirectly affects the recombination rate of carriers. An energy band model based on BGR effect is made to explain the high-injection-level phenomenon for μLEDs.

Medically inoperable peripheral lung cancer treated with stereotactic body radiation therapy

Background

Lung cancer is the most frequent cause of cancer-related death in North America. There is wide variation between patients who are medically inoperable and those managed surgically. The use of stereotactic body radiotherapy (SBRT) has narrowed the gap in survival rates between operative and non-operative management for those with early stage disease. This retrospective study reports outcomes for the treatment of peripheral non-small cell lung carcinoma (NSCLC) with SBRT from a single community practice.

Methods

Sixty-seven consecutive patients (pts) with inoperable, untreated peripheral lung tumors were treated from 2010 through 2012 and included in this study. Stereotactic targeting was facilitated by either spine or lung-based image guidance, either with or without fiducial marker tracking with a frameless robotic radiosurgery system. Peripheral tumors received a median biological effective dose (BED) of 105.6 Gy₁₀ or in terms of a median physical dose, 48 Gy delivered over 4 daily fractions. Survival was measured using the Kaplan-Meier method to determine rates of local control, progression of disease and overall survival. The Cox proportional hazards regression model was used to study the effects of tumor size, stage, histology, patient age, tumor location (lobe), tracking method, and BED on the survival distributions.

Results

The median follow-up for this cohort was 24.5 months (range: 2.4–50.3) with an overall (OS) 3-year survival of 62.4 % (95 % CI: 74.3-47.3). The median progression-free survival was 28.5 months (95 % CI: 15.8 months to not reached). Local control (LC), defined as a lack of FDG uptake on PET/CT or the absence of tumor growth was achieved in 60 patients (90.9 %) at the time of first follow-up (median 3 months, range: 1–6). Local control at one year for the entire cohort was 81.8 % (95 % CI, 67.3-90.3). The one-year OS probability among those who achieved local control at first follow-up was 86.2 % (95 % CI, 74.3-92.9) but no patients who did not achieve LC at first follow-up survived one year. Of the 60 pts that achieved initial LC, 16 have died. The rates of local control, progression-free survival and overall survival were not statistically different for patients treated using a fiducial target tracking system versus non-invasive guidance. (p = 0.44, p = 0.97 and p = 0.66, respectively). No National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE-4) grade 3 or greater toxicity was observed.

Conclusion

SBRT is an effective treatment for medically inoperable NSCLC patients with peripherally located tumors. This therapy appears to be well tolerated with low toxicity, and patient outcomes when using non-invasive tumor tracking systems are not inferior to traditional fiducial-based techniques.

Electronic supplementary material

The online version of this article (doi:10.1186/s13014-015-0423-7) contains supplementary material, which is available to authorized users.

Circadian dysregulation of clock genes: clues to rapid treatments in major depressive disorder

Conventional antidepressants require 2-8 weeks for a full clinical response. In contrast, two rapidly acting antidepressant interventions, low-dose ketamine and sleep deprivation (SD) therapy, act within hours to robustly decrease depressive symptoms in a subgroup of major depressive disorder (MDD) patients. Evidence that MDD may be a circadian-related illness is based, in part, on a large set of clinical data showing that diurnal rhythmicity (sleep, temperature, mood and hormone secretion) is altered during depressive episodes. In a microarray study, we observed widespread changes in cyclic gene expression in six regions of postmortem brain tissue of depressed patients matched with controls for time-of-death (TOD). We screened 12 000 transcripts and observed that the core clock genes, essential for controlling virtually all rhythms in the body, showed robust 24-h sinusoidal expression patterns in six brain regions in control subjects. In MDD patients matched for TOD with controls, the expression patterns of the clock genes in brain were significantly dysregulated. Some of the most robust changes were seen in anterior cingulate (ACC). These findings suggest that in addition to structural abnormalities, lesion studies, and the large body of functional brain imaging studies reporting increased activation in the ACC of depressed patients who respond to a wide range of therapies, there may be a circadian dysregulation in clock gene expression in a subgroup of MDDs. Here, we review human, animal and neuronal cell culture data suggesting that both low-dose ketamine and SD can modulate circadian rhythms. We hypothesize that the rapid antidepressant actions of ketamine and SD may act, in part, to reset abnormal clock genes in MDD to restore and stabilize circadian rhythmicity. Conversely, clinical relapse may reflect a desynchronization of the clock, indicative of a reactivation of abnormal clock gene function. Future work could involve identifying specific small molecules capable of resetting and stabilizing clock genes to evaluate if they can rapidly relieve symptoms and sustain improvement.

[Correlation between urinary sediment spectra and pathological patterns of renal biopsies]

OBJECTIVE

To investigate the clinical value of urinary sediment analysis, a non-invasive diagnostic means, in the evaluation of pathological patterns of renal diseases.

METHODS

A total of 1 140 pairs of matched renal biopsies and fresh fasting morning urine specimens were collected from hospitalized patients in Peking University First Hospital. Their urinary sediments were examined with phase-contrast microscopy; the 24 h urine proteins were measured. Based on urinary sediment features combined with urine protein amount, the spectra of the urine sediments were classified into four types, Type I: hematuria-dominant, with multiple cells and casts; Type II: proteinuria-dominant, with hyaline or fine-granular casts but scanty cells; Type III: renal tubular epithelial cell(RTEC)-dominant, minor proteinuria; Type IV: non-specificurine sediments,minor proteinuria. According to the pathological lesions detected in renal biopsies, the renal diseases were classified into three patterns: proliferative glomerulopathy(P-GP), non-proliferative glomerulopathy (NP-GP) and tubulointerstitial nephropathy(TIN). The urinary sediment spectra of different pathological patterns and the correlation between urinary sediment types and pathological patterns were analyzed. Statistical analyses were performed using kappa test, and χ(2) test, and significance was accepted at P<0.05.

RESULTS

(1) Of the 840 cases of matched urine samples and renal biopsies, 419 cases were diagnosed with P-GP; 375 cases with NP-GP; 46 cases with TIN respectively. (2) The spectra of urine sediments were associated with pathological patterns of the renal biopsies, and 84.0% of the patients with P-GP manifested type I urine sediments; 93.1% of the patients with NP-GP had type II urine sediments; 67.4% of the patients with TIN had type III urine sediments. (3) The correlation between the urinary sediment types and renal pathological patterns was validated in an additional 300 matched samples. The positive predictive values of urinary sediment spectra in predicting renal pathological lesions were 84.8% for typeI to P-GP, 86.0% for type II to NP-GP and 73.7% for type III to TIN, respectively.

CONCLUSION

As a non-invasive diagnostic means, the urinary sediment analysis is valuable in the evaluation of pathological patterns of renal diseases.

Pan-European early switch/early discharge opportunities exist for hospitalized patients with methicillin-resistant Staphylococcus aureus complicated skin and soft tissue infections

The objective of this study was to document pan-European real-world treatment patterns and healthcare resource use and estimate opportunities for early switch (ES) from intravenous (IV) to oral antibiotics and early discharge (ED) in hospitalized patients with methicillin-resistant Staphylococcus aureus (MRSA) complicated skin and soft tissue infections (cSSTIs). This retrospective observational medical chart review study enrolled 342 physicians across 12 European countries who collected data from 1542 patients with documented MRSA cSSTI who were hospitalized (July 2010 to June 2011) and discharged alive (by July 2011). Data included clinical characteristics and outcomes, hospital length of stay (LOS), MRSA-targeted IV and oral antibiotic use, and ES and ED eligibility according to literature-based and expert-validated criteria. The most frequent initial MRSA-active antibiotics were vancomycin (50.2%), linezolid (15.1%), clindamycin (10.8%), and teicoplanin (10.4%). Patients discharged with MRSA-active antibiotics (n = 480) were most frequently prescribed linezolid (42.1%) and clindamycin (19.8%). IV treatment duration (9.3 ± 6.5 vs. 14.6 ± 9.9 days; p <0.001) and hospital LOS (19.1 ± 12.9 vs. 21.0 ± 18.2 days; p 0.162) tended to be shorter for patients switched from IV to oral treatment than for patients who received IV treatment only. Of the patients, 33.6% met ES criteria and could have discontinued IV treatment 6.0 ± 5.5 days earlier, and 37.9% met ED criteria and could have been discharged 6.2 ± 8.2 days earlier. More than one-third of European patients hospitalized for MRSA cSSTI could be eligible for ES and ED, resulting in substantial reductions in IV days and bed-days, with potential savings of €2000 per ED-eligible patient.

Dual-targeting non-viral vector based on polyethylenimine improves gene transfer efficiency

Polyethylenimine (PEI) is the polymer most commonly used for transferring plasmids into eukaryotes, but its gene-transfer efficiency is lower compared to viral vectors. Receptors targeting PEI combined with ligands can enhance efficiency of gene transfer into the corresponding receptor-positive cells. Using the double-receptor-mediated pathway of viral infection, in this study we synthesized a novel non-viral vector based on PEI combined with two peptides recognizing FGF receptors (peptide YC25) and integrins (peptide CP9) on the cell surface. The dual targeting vector showed a physicochemical character similar to that of PEI, such as pDNA formation, particle size, zeta potential and lower toxicity. In vitro gene transfer showed that the dual-receptor targeted vector (YC25-PEI-CP9) exhibited a markedly higher transgene efficiency in cell lines with positive expression of FGF receptors and integrins, compared with single-peptide-modified PEI or unmodified PEI. In the cells with only integrin-positive expression, YC25-PEI-CP9 mediated a higher transgene expression than PEI but lower than CP9-PEI. The corresponding free peptides could inhibit the transgene efficiency of the peptide-coupled PEI. In vivo gene transfer in tumor-bearing nude mice also demonstrated that the dual-targeting vectors showed a significantly enhanced transfection efficiency in tumors with positive expression of FGF receptors and integrins. The synthesized polymer YC25-PEI-CP9 has the prospect to act as a novel kind of non-viral vector in gene therapy.

QTL consistency and meta-analysis for grain yield components in three generations in maize

Grain yield is the most important and complex trait in maize. In this study, a total of 258 F(9) recombinant inbred lines (RIL), derived from a cross between dent corn inbred Dan232 and popcorn inbred N04, were evaluated for eight grain yield components under four environments. Quantitative trait loci (QTL) and their epistatic interactions were detected for all traits under each environment and in combined analysis. Meta-analysis was used to integrate genetic maps and detected QTL across three generations (RIL, F(2:3) and BC(2)F(2)) derived from the same cross. In total, 103 QTL, 42 pairs of epistatic interactions and 16 meta-QTL (mQTL) were detected. Twelve out of 13 QTL with contributions (R(2)) over 15% were consistently detected in 3-4 environments (or in combined analysis) and integrated in mQTL. Only q100GW-7-1 was detected in all four environments and in combined analysis. 100qGW-1-1 had the largest R(2) (19.3-24.6%) in three environments and in combined analysis. In contrast, 35 QTL for 6 grain yield components were detected in the BC(2)F(2) and F(2:3) generations, no common QTL across three generations were located in the same marker intervals. Only 100 grain weight (100GW) QTL on chromosome 5 were located in adjacent marker intervals. Four common QTL were detected across the RIL and F(2:3) generations, and two between the RIL and BC(2)F(2) generations. Each of five important mQTL (mQTL7-1, mQTL10-2, mQTL4-1, mQTL5-1 and mQTL1-3) included 7-12 QTL associated with 2-6 traits. In conclusion, we found evidence of strong influence of genetic structure and environment on QTL detection, high consistency of major QTL across environments and generations, and remarkable QTL co-location for grain yield components. Fine mapping for five major QTL (q100GW-1-1, q100GW-7-1, qGWP-4-1, qERN-4-1 and qKR-4-1) and construction of single chromosome segment lines for genetic regions of five mQTL merit further studies and could be put into use in marker-assisted breeding.

Identification of differentially expressed genes at two key endosperm development stages using two maize inbreds with large and small grain and integration with detected QTL for grain weight

Maize endosperm accounts for more than 80% of the grain weight. Cell division and grain filling are the two key stages for endosperm development. Previous studies showed that gene expression during differential stages in endosperm development is greatly different. However, information on systematic identification and characterization of the differentially expressed genes between the two stages are limited. In this study, suppression subtractive hybridization (SSH) was used to generate four subtracted cDNA libraries for the two stages using two maize inbreds with large and small grain. Totally, 4,784 differentially expressed sequence tags (ESTs) were sequenced and 902 were non-redundant, which consisted of 344 unique ESTs. Among them 192 had high sequence similarity to the GenBank entries and represent diverse of functional categories, such as metabolism, cell growth/division, transcription, signal transduction, protein destination/storage, protein synthesis and others. The expression patterns of 75.7% SSH-derived cDNAs were confirmed by reverse Northern blot and semi-quantitative reverse transcription polymerase chain reaction, and exhibited the similar results (75.0%). Genes differentially expressed between two key stages for the two inbreds were involved in diverse physiological process pathway, which might be responsible for the formation of grain weight. 43.8% (70 of the 160 unique ESTs) of the identified ESTs were assigned to 39 chromosome bins distributed over all ten maize chromosomes. Eleven ESTs were found to co-localize with previous detected QTLs for grain weight, which might be considered as the candidate genes of grain weight for further study.

First Report of Neofusicoccum parvum Causing Dieback Disease of Chinese Weeping Cypress in China

Cupressus funebris Endl. (Chinese weeping cypress) is native to southwestern and central China. In June 2008, blighted shoots of Chinese weeping cypress trees were observed in Yunnan Province (southwestern China). Symptomatic trees were located in an ornamental planting established approximately 8 to 12 years ago. Additional samples were collected from 11 locations in the provinces of Sichuan, Yunnan, Guizhou, and Chongqing. Disease symptoms included yellowing and wilting of leaves on several branches, followed by sudden death within 6 to 8 weeks. Cross sections on trunks and branches revealed darkened zones. Tissue from diseased samples was plated on potato dextrose agar (PDA) and incubated at 25°C. Fungal isolates developed copious, white, aerial mycelium that became dark gray after 4 to 6 days and formed black pycnidia after 25 days. Conidia were hyaline, ellipsoidal to fusiform, externally smooth, thin walled, nonseptate, and measured 12.5 to 18.5 × 4.0 to 6.5 μm. Identity was confirmed by analysis of the rDNA internal transcribed spacer region (ITSI-5.8S-ITS2) and the translation elongation factor 1-alpha (EF1-α). BLAST searches at GenBank showed a high identity with reference sequences (ITS: >99%; EF1-α: 100%). Representative sequences of both regions were deposited in GenBank (ITS: Accession No. FJ842960 and FJ842961; EF1-α: Accession No. GU811148). Morphological and molecular results confirmed this species as Neofusicoccum parvum, reported as the anamorph of Botryosphaeria parva. Pathogenicity tests were conducted by stem inoculation of 2-year-old C. funebris seedlings. Mycelial plugs (4 mm in diameter) of N. parvum from actively growing colonies were applied to same-size bark wounds on the middle point of the stems. Control seedlings were inoculated with sterile PDA plugs. Inoculated and control seedlings (five each) were kept in a greenhouse and watered as needed. After 5 weeks, all C. funebris seedlings showed leaf wilting and dark vascular stem tissue. N. parvum was reisolated from all inoculated, symptomatic tissues, fulfilling Koch's postulates; no symptoms were visible in the control seedlings. N. parvum has previously been reported to cause canker and dieback disease of avocado (3), mango (2), and magenta cherry (Syzygium paniculatum) (1). To our knowledge, this is the first report of N. parvum causing dieback of C. funebris in China. References: (1) R. C. Ploetz et al. Plant Pathol. 58:801, 2009. (2) B. Slippers et al. Mycologia 97:99, 2005. (3) T. Zea-Bonilla et al. Plant Dis. 91:1052, 2007.

Health-related quality of life in patients with metastatic renal cell carcinoma treated with sunitinib vs interferon-alpha in a phase III trial: final results and geographical analysis

BACKGROUND

In a randomised phase III trial, sunitinib significantly improved efficacy over interferon-alpha (IFN-alpha) as first-line therapy for metastatic renal cell carcinoma (mRCC). We report the final health-related quality of life (HRQoL) results.

METHODS

Patients (n=750) received oral sunitinib 50 mg per day in 6-week cycles (4 weeks on, 2 weeks off treatment) or subcutaneous IFN-alpha 9 million units three times weekly. Health-related quality of life was assessed with nine end points: the Functional Assessment of Cancer Therapy-General and its four subscales, FACT-Kidney Symptom Index (FKSI-15) and its Disease-Related Symptoms subscale (FKSI-DRS), and EQ-5D questionnaire's EQ-5D Index and visual analogue scale. Data were analysed using mixed-effects model (MM), supplemented with pattern-mixture models (PMM), for the total sample and the US and European Union (EU) subgroups.

RESULTS

Patients receiving sunitinib reported better scores in the primary end point, FKSI-DRS, across all patient populations (P<0.05), and in nine, five, and six end points in the total sample, in the US and EU groups respectively (P<0.05). There were no significant differences between the US and EU groups for all end points with the exception of the FKSI item 'I am bothered by side effects of treatment' (P=0.02). In general, MM and PMM results were similar.

CONCLUSION

Patients treated with sunitinib in this study had improved HRQoL, compared with patients treated with IFN-alpha. Treatment differences within the US cohort did not differ from those within the EU cohort.

Multi-residue determination of pesticides in vegetables by gas chromatography/ion trap mass spectrometry

To monitor possible contamination of edible vegetables by common pesticides, an analytical method using gas chromatography combined with ion trap spectrometry (GC-IT/MS) was developed to measure simultaneously up to 39 pesticide residues, belonging to organophosphors, organochlorines, pyrethroids or carbamates classes, left on four kinds of popular vegetables. The procedure entails addition of acetone, dichloromethane, and sodium chloride to a small amount of vegetable, then the mixture was shaken intensively and centrifuged for phase separation. An aliquot of the organic layer was cleanup using solid-phase extraction (SPE) cartridges filled with graphitized carbon black (GCB) in combination with acidic aluminum oxide. Gas chromatography with ion trap mass spectrometer was then used for qualitative and quantitative determination of the pesticides. The GCB combination with acidic aluminum oxide was found more suitable than florisil, aluminum oxide and silicon dioxide for sample cleanup with recoveries above 70% for most pesticides in removing the majority of co-extracted matrices. Variation coefficients of the repeatability typically smaller than 20% have been achieved for a wide range of the investigated pesticides. A set of critical instrument parameters for the GC-IT/MS Varian system in the MS mode was established. Based on optimization work conducted in this study, the 39 pesticides were separated successively with the limits of detection between 0.02 and 0.1 mg/kg.

Analysis of imazaquin in soybeans by solid-phase extraction and high-performance liquid chromatography

An analytical method for the determination imazaquin residues in soybeans was developed. The developed liquid/liquid partition and strong anion exchange solid-phase extraction procedures provide the effective cleanup, removing the greatest number of sample matrix interferences. By optimizing mobile-phase pH water/acetonitrile conditions with phosphoric acid, using a C-18 reverse-phase chromatographic column and employing ultraviolet detection, excellent peak resolution was achieved. The combined cleanup and chromatographic method steps reported herein were sensitive and reliable for determining the imazaquin residues in soybean samples. This method is characterized by recovery >88.4%, precision <6.7% CV, and sensitivity of 0.005 ppm, in agreement with directives for method validation in residue analysis. Imazaquin residues in soybeans were further confirmed by high performance liquid chromatography-mass spectrometry (LC-MS). The proposed method was successfully applied to the analysis of imazaquin residues in soybean samples grown in an experimental field after treatments of imazaquin formulation.

Stress-induced changes in primate prefrontal profiles of gene expression

Stressful experiences that consistently increase cortisol levels appear to alter the expression of hundreds of genes in prefrontal limbic brain regions. Here, we investigate this hypothesis in monkeys exposed to intermittent social stress-induced episodes of hypercortisolism or a no-stress control condition. Prefrontal profiles of gene expression compiled from Affymetrix microarray data for monkeys randomized to the no-stress condition were consistent with microarray results published for healthy humans. In monkeys exposed to intermittent social stress, more genes than expected by chance appeared to be differentially expressed in ventromedial prefrontal cortex compared to monkeys not exposed to adult social stress. Most of these stress responsive candidate genes were modestly downregulated, including ubiquitin conjugation enzymes and ligases involved in synaptic plasticity, cell cycle progression and nuclear receptor signaling. Social stress did not affect gene expression beyond that expected by chance in dorsolateral prefrontal cortex or prefrontal white matter. Thirty four of 48 comparisons chosen for verification by quantitative real-time polymerase chain reaction (qPCR) were consistent with the microarray-predicted result. Furthermore, qPCR and microarray data were highly correlated. These results provide new insights on the regulation of gene expression in a prefrontal corticolimbic region involved in the pathophysiology of stress and major depression. Comparisons between these data from monkeys and those for ventromedial prefrontal cortex in humans with a history of major depression may help to distinguish the molecular signature of stress from other confounding factors in human postmortem brain research.

Evaluation of transdermal permeability of pentoxifylline gel: in vitro skin permeation and in vivo microdialysis using Wistar rats

The aim of the present work was to evaluate the transdermal permeability of pentoxifylline gel in vitro and in vivo. Gel was prepared with carbomer 934 as the base, and the Wistar rat was chosen as an animal model. The effects of percutaneous enhancers on the transdermal permeability of pentoxifylline gel were investigated by in vitro permeation experiments. Cumulative permeation at different times was determined by HPLC. 3% Azone and 5% propylene glycol were used as collaborative enhancers in an optimal formulation. Topical concentrations at different times were measured by microdialysis in vivo. The transdermal process of pentoxifylline fits to a zero-order kinetic equation, and its release profile remains of the zero-order despite the addition of enhancers. In addition, a good in-vitro-in-vivo correlation was achieved.