The value of T2-weighted MRI contrast ratio combined with DWI in evaluating the pathological grade of solid lung adenocarcinoma

AIM

To assess the predictive value of T2-weighted (T2W) magnetic resonance imaging (MRI) in combination with diffusion-weighted imaging (DWI) for determining the pathological grading of solid lung adenocarcinoma.

MATERIALS AND METHODS

The clinical and imaging data from 153 cases of solid lung adenocarcinoma (82 men, 71 women, mean age 63.2 years) confirmed at histopathology in The First Affiliated Hospital of Xi'an Jiaotong University from January 2017 to May 2022 were analysed retrospectively. Adenocarcinomas were classified into low-grade (G1 and G2) and high-grade (G3) groups following the 2020 pathological grading system proposed by the International Association for the Study of Lung Cancer. The T2-weighted contrast ratio (T2CR), calculated as the T2 signal intensity of the lung mass/nodule divided by the T2 signal intensity of the right rhomboid muscle was utilised. Two experienced radiologists reviewed the MRI images independently, measured the T2CR, and obtained apparent diffusion coefficient (ADC) values. The Mann-Whitney U-test was used to compare general characteristics (sex, age, maximum diameter), T2CR, and ADC values between the low-grade and high-grade groups. The non-parametric Kruskal-Wallis test determined differences in T2CR and ADC values among the five adenocarcinoma subtypes. Receiver characteristic curve (ROC) analysis, along with area under the curve (AUC) calculation, assessed the effectiveness of each parameter in distinguishing the pathological grade of lung adenocarcinoma. A Z-test was used to compare the AUC values.

RESULTS

Among the 153 patients with adenocarcinoma, 103 had low-grade adenocarcinoma, and 50 had high-grade adenocarcinoma. The agreement between T2CR and ADC observers was good (0.948 and 0.929, respectively). None of the parameters followed a normal distribution (p<0.05). The ADC value was lower in the high-grade adenocarcinoma group compared to the low-grade adenocarcinoma group (p=0.004), while the T2CR value was higher in the high-grade group (p=0.011). Statistically significant differences were observed in maximum diameter and gender between the two groups (p<0.001 and p=0.005, respectively), while no significant differences were noted in age (p=0.980). Among the five adenocarcinoma subtypes, only the lepidic and micropapillary subtypes displayed statistical differences in ADC values (p=0.047), with the remaining subtypes showing no statistical differences (p>0.05). The AUC values for distinguishing high-grade adenocarcinoma from low-grade adenocarcinoma were 0.645 for ADC and 0.627 for T2CR. Combining T2CR, ADC, sex, and maximum diameter resulted in an AUC of 0.778, sensitivity of 70%, and specificity of 75%. This combination significantly improved diagnostic efficiency compared to T2CR and ADC alone (p=0.008, z = 2.624; p=0.007, z = 2.679).

CONCLUSION

The MRI quantitative parameters are useful for distinguishing the pathological grades of solid lung adenocarcinoma, offering valuable insights for precise lung cancer treatment.

Unveiling intricate transformation pathways of emerging contaminants during wastewater treatment processes through simplified network analysis

As the key stage for purifying wastewater, elimination of emerging contaminants (ECs) is found to be fairly low in wastewater treatment plants (WWTPs). However, less knowledge is obtained regarding the transformation pathways between various chemical structures of ECs under different treatment processes. This study unveiled the transformation pathways of ECs with different structures in 15 WWTPs distributed across China by simplified network analysis (SNA) we proposed. After treatment, the molecular weight of the whole component of wastewater decreased and the hydrophilicity increased. There are significant differences in the structure of eliminated, consistent and formed pollutants. Amino acids, peptides, and analogues (AAPAs) were detected most frequently and most removable. Benzenoids were refractory. Triazoles were often produced. The high-frequency reactions in different WWTPs were similar, (de)methylation and dehydration occurred most frequently. Different biological treatment processes performed similarly, while some advanced treatment processes differed, such as a significant increase of -13.976 (2HO reaction) paired mass distances (PMDs) in the chlorine alone process. Further, the common structural transformation was uncovered. 4 anti-hypertensive drugs, including irbesartan, valsartan, olmesartan, and losartan, were identified, along with 22 transformation products (TPs) of them. OH2 and H2O PMDs occurred most frequently and in 80.81 % of the parent-transformation product pairs, the intensity of the product was higher than parent in effluents, whose risk should be considered in future assessment activity. Together our results provide a macrography perspective on the transformation processes of ECs in WWTPs. In the future, selectively adopting wastewater treatment technology according to structures is conductive for eliminating recalcitrant ECs in WWTPs.

RvE1 Promotes Axin2+ Cell Regeneration and Reduces Bacterial Invasion

Vital pulp therapy and root canal therapy (RCT) are the dominant treatment for irreversible pulpitis. While the success rate of these procedures is favorable, they have some limitations. For instance, RCT leads to removing significant dentin in the coronal third of the tooth that increases root-fracture risk, which forces tooth removal. The ideal therapeutic goal is dental pulp regeneration, which is not achievable with RCT. Specialized proresolving mediators (SPMs) are well known for inflammatory resolution. The resolution of inflammation and tissue restoration or regeneration is a dynamic and continuous process. SPMs not only have potent immune-modulating functions but also effectively promote tissue homeostasis and regeneration. Resolvins have been shown to promote dental pulp regeneration. The purpose of this study was to explore further the cellular target of Resolvin E1 (RvE1) therapy in dental pulp regeneration and the impact of RvE1 in infected pulps. We investigated the actions of RvE1 on experimentally exposed pulps with or without microbial infection in an Axin2Cre-Dox;Ai14 genetically defined mouse model. Our results showed RvE1 promoted Axin2-tdTomato+ cell expansion and odontoblastic differentiation after direct pulp capping in the mouse, which we used to mimic reversible pulpitis cases in the clinic. In cultured mouse dental pulp stem cells (mDPSCs), RvE1 facilitated Axin2-tdTomato+ cell proliferation and odontoblastic differentiation and also rescued impaired functions after lipopolysaccharide stimulation. In infected pulps exposed to the oral environment for 24 h, RvE1 suppressed inflammatory infiltration, reduced bacterial invasion in root canals, and prevented the development of apical periodontitis, while its proregenerative impact was limited. Collectively, topical treatment with RvE1 facilitated dental pulp regenerative properties by promoting Axin2-expressing cell proliferation and differentiation. It also modulated the resolution of inflammation, reduced infection severity, and prevented apical periodontitis, presenting RvE1 as a novel therapeutic for treating endodontic diseases.

SWATH-F: A Novel Nontarget Strategy Based on the SWATH-MS Deconvolution Method Assisting in Annotating PFAS Homologues in Multisample Studies

In order to identify emerging per- and polyfluoroalkyl substances (PFASs) and their alternatives in the environment or population, we need to perform extensive profiling of PFASs to determine their distribution in samples. The sequential window acquisition of all theoretical fragment-ion spectra (SWATH mode) is capable of obtaining a wide range of MS2 spectra but is difficult for direct identification of PFASs due to its complex MS2 spectra, and the nontarget screening method is difficult to identify due to its lack of a priori information. In this study, we demonstrated the great potential of SWATH-F, a nontarget fragment-based homologue screening method in combination with the SWATH-MS deconvolution, for detecting PFASs. We evaluated the application of SWATH-F to gradient spiked samples and real population serum samples, compared it with nontarget homologue screening in the information-dependent acquisition mode (IDA mode), and obtained better results for SWATH-F with 276% improvement (IDA:17 PFASs, SWATH-F: 64 PFASs) in identification. In addition, we automated the screening and identification process of SWATH-F to facilitate its use by researchers. SWATH-F is freely available on GitHub (https://github.com/njuIrene/SWATH-F) under an MIT license.

Chemoradiotherapy Combined with Nab-Paclitaxel plus Cisplatin in Patients with Locally Advanced Borderline Resectable or Unresectable Esophageal Squamous Cell Carcinoma: A Phase I/II Study

PURPOSE/OBJECTIVE(S)

To evaluate the efficacy and safety of nanoparticle albumin-bound paclitaxel (nab-PTX) plus cisplatin as the regimen of conversional chemoradiotherapy (cCRT) in locally advanced borderline resectable or unresectable esophageal squamous cell carcinoma (ESCC).

MATERIALS/METHODS

Patients with locally advanced ESCC (cT3-4, Nany, M0-1, M1 was limited to lymph node metastasis in the supraclavicular area) were enrolled. All the patients received the cCRT of nab-PTX plus cisplatin. After the cCRT, those resectable patients received esophagectomy; those unresectable patients continued to receive the definitive chemoradiotherapy (dCRT). The locoregional control (LRC), overall survival (OS), progression-free survival (PFS), distant metastasis free survival (DMFS), pathological complete response (pCR), R0 resection rate and adverse events (AEs) were calculated.

RESULTS

A total of 45 patients with ESCC treated from October 2019 to May 2021 were finally included. The median follow-up time was 30.3 months. The LRC, OS, EFS, DMFS at 1and 2 years were 81.5%, 86.6%, 64.3%, 73.2% and 72.4%, 68.8%, 44.8%, 52.7% respectively. 21 patients (46.7%) received conversional chemoradiotherapy plus surgery (cCRT+S). The pCR rate and R0 resection rate were 47.6% and 84.0%. The LRC rate at 1 and 2 years were 95.0%, 87.1% in cCRT+S patients and 69.3%, 58.7% in dCRT patients respectively (HR, 5.14; 95% CI, 1.10-23.94; P = 0.021). The OS rate at 1 and 2 years were 95.2% and 84.2% in resectable patients compared to 78.8% and 54.4% in unresectable patients (HR, 3.41; 95% CI, 1.10-10.61; P = 0.024). The toxicities during chemoradiotherapy were tolerated, the most common grade 3-4 toxicities were radiation esophagitis (15.6%).

CONCLUSION

Nab-PTX plus cisplatin were effective and safe as the regimen of conversional chemoradiotherapy of ESCC. The patients receiving conversional chemoradiotherapy plus surgery (cCRT+S) were prone to have a better survival.

[Cardiovascular health status of Chinese adults based on "Life's Essential 8" score]

Objective: To assess the cardiovascular health status of adults in China by using the "Life's Essential 8" score, and provide reference for the development and improvement of cardiovascular disease prevention and control policies and measures. Methods: Chronic Disease and Nutrition Surveillance was conducted in 298 counties/districts in 2015 in 31 provinces (autonomous regions, municipalities) across China, multi-stage stratified cluster random sampling was used to select 45 households in each village or neighborhood, and 20 households were further selected to conduct dietary surveys. In this study, a total of 70 093 adults aged ≥20 years who completed the dietary survey and had complete information were included, their cardiovascular health status were assessed by using the "Life's Essential 8" score, a cardiovascular health scoring standard released by the American Heart Association in 2022. All results were adjusted using complex design-based sampling weights to achieve a better estimate of the population. Results: In 2015, the overall cardiovascular health score of Chinese adults aged ≥20 years was 73.3±12.6, the score was significantly higher in women (77.9±11.6) than in men (68.7±11.8), and higher in urban area (74.5±12.8) than in rural area (71.9±12.2), the differences were significant (P<0.001). It was estimated that about 0.25% (95%CI: 0.16%-0.33%) of adults in China had cardiovascular health score of 100, and 33.0% (95%CI: 31.6%-34.3%), 63.2% (95%CI: 62.1%-64.3%), and 3.9% (95%CI: 3.5%-4.2%) of adults had high, moderate and low cardiovascular health scores, respectively. The proportion of those with high cardiovascular health scores was relatively low in men, those with low education level, those with low income, those living in rural areas, and those living in southwest China (P<0.001). Of the eight factors, diet had the lowest mean score (46.0, 95%CI: 44.7-47.3), followed by blood pressure (59.4, 95%CI: 58.2-60.6) and tobacco exposure (61.4, 95%CI: 60.6-62.2). Conclusions: The cardiovascular health status of two-thirds of adult population in China needs to be improved. Diet, tobacco exposure, and blood pressure are the factors affecting the cardiovascular health of Chinese population, to which close attention needs to be paid, and men, rural residents, and those with lower socioeconomic status are key groups in cardiovascular health promotion.

Potential effects of Ag ion on the host by changing the structure of its gut microbiota

Silver (Ag) can change the structure of the gut microbiota (GM), but how such change may affect host health is unknown. In this study, mice were exposed to silver acetate daily for 120 days. During this period, Ag accumulation in the liver was measured, its effects on GM structure were analyzed, and potential metabolic changes in liver and serum were examined. Although Ag accumulation remained unchanged in most treatments, the ratio of Firmicutes to Bacteroidetes at the phylum level increased and changes in the relative abundance of 33 genera were detected, suggesting that Ag altered the energy metabolism of mice via changes in the gut GM. In serum and liver, 34 and 72 differentially expressed metabolites were identified, respectively. The KEGG pathways thus enriched mainly included those involving the metabolism of amino acids, organic acids, lipids, and purine. Strong correlations were found between 33 % of the microorganisms with altered relative abundances and 46 % of the differentially expressed metabolites. The resulting clusters yielded two communities responsible for host inflammation and energy metabolism. Overall, these results demonstrate potential effects of Ag on the host, by changing its GM structure, and the need to consider them when evaluating the health risk of Ag.

The occurrence, tissue distribution, and PBT potential of per- and polyfluoroalkyl substances in the freshwater organisms from the Yangtze river via nontarget analysis

Numerous emerging per- and polyfluoroalkyl substances (PFASs) occur in the aquatic environment, posing a threat to aquatic ecosystems and human health. In this study, we conducted a nontarget analysis on 3 surface water samples and 92 tissue samples of 16 fish collected from the Yangtze River to investigate the patterns, tissue distribution, and environmental impacts of emerging PFASs. A total of 43 PFASs from 11 classes were identified, including 17 legacy PFASs and 26 emerging PFASs. Among the 43 PFASs, seven PFASs were reported in biota for the first time while five PFASs were reported in the environment for the first time. Chlorine substituted perfluoroalyl ether sulfonic acids were the major emerging PFASs detected in organisms. Our results showed that most emerging PFASs tended to accumulate in the liver whereas perfluorinated sulfonamides tended to accumulate in the blood, and all of the emerging PFASs accumulated less in the muscle. Methods for evaluating the persistence, bioaccumulation, and toxicity (PBT) of PFASs were developed by combining the in-silico methods and experimental methods. Long-chain PFASs were found to have extremely high PBT scores compared to short-chain PFASs. Additionally, most emerging PFASs exhibited comparable PBT characteristics with legacy PFASs, especially Cl-substituted PFASs.

Nontarget Discovery of Antimicrobial Transformation Products in Wastewater Based on Molecular Networks

Antimicrobial transformation products (ATPs) in the environment have raised extensive concerns in recent years due to their potential health risks. However, only a few ATPs have been investigated, and most of the transformation pathways of antimicrobials have not been completely elucidated. In this study, we developed a nontarget screening strategy based on molecular networks to detect and identify ATPs in pharmaceutical wastewater. We identified 52 antimicrobials and 49 transformation products (TPs) with a confidence level of three or above. Thirty of the TPs had not been previously reported in the environment. We assessed whether TPs could be classified as persistent, mobile, and toxic (PMT) substances based on recent European criteria for industrial substances. Owing to poor experimental data, definitive PMT classifications could not be established for novel ATPs. PMT assessment based on structurally predictive physicochemical properties revealed that 47 TPs were potential PMT substances. These results provide evidence that novel ATPs should be the focus of future research.

Beam Energy Dependence of Triton Production and Yield Ratio (N_{t}×N_{p}/N_{d}^{2}) in Au+Au Collisions at RHIC

We report the triton (t) production in midrapidity (|y|<0.5) Au+Au collisions at sqrt[s_{NN}]=7.7-200  GeV measured by the STAR experiment from the first phase of the beam energy scan at the Relativistic Heavy Ion Collider. The nuclear compound yield ratio (N_{t}×N_{p}/N_{d}^{2}), which is predicted to be sensitive to the fluctuation of local neutron density, is observed to decrease monotonically with increasing charged-particle multiplicity (dN_{ch}/dη) and follows a scaling behavior. The dN_{ch}/dη dependence of the yield ratio is compared to calculations from coalescence and thermal models. Enhancements in the yield ratios relative to the coalescence baseline are observed in the 0%-10% most central collisions at 19.6 and 27 GeV, with a significance of 2.3σ and 3.4σ, respectively, giving a combined significance of 4.1σ. The enhancements are not observed in peripheral collisions or model calculations without critical fluctuation, and decreases with a smaller p_{T} acceptance. The physics implications of these results on the QCD phase structure and the production mechanism of light nuclei in heavy-ion collisions are discussed.

TRAF3IP2-IL-17 Axis Strengthens the Gingival Defense against Pathogens

Recent genome-wide association studies have suggested novel risk loci associated with periodontitis, which is initiated by dysbiosis in subgingival plaque and leads to destruction of teeth-supporting structures. One such genetic locus was the tumor necrosis factor receptor-associated factor 3 interacting protein 2 (TRAF3IP2), a gene encoding the gate-keeping interleukin (IL)-17 receptor adaptor. In this study, we first determined that carriers of the lead exonic variant rs13190932 within the TRAF3IP2 locus combined with a high plaque microbial burden was associated with more severe periodontitis than noncarriers. We then demonstrated that TRAF3IP2 is essential in the IL-17-mediated CCL2 and IL-8 chemokine production in primary gingival epithelial cells. Further analysis suggested that rs13190932 may serve a surrogate variant for a genuine loss-of-function variant rs33980500 within the same gene. Traf3ip2 null mice (Traf3ip2^-/-) were more susceptible than wild-type (WT) mice to the Porphyromonas gingivalis-induced periodontal alveolar bone loss. Such bone loss was associated with a delayed P. gingivalis clearance and an attenuated neutrophil recruitment in the gingiva of Traf3ip2^-/- mice. Transcriptomic data showed decreased expression of antimicrobial genes, including Lcn2, S100a8, and Defb1, in the Traf3ip2^-/- mouse gingiva in comparison to WT mice prior to or upon P. gingivalis oral challenge. Further 16S ribosomal RNA sequencing analysis identified a distinct microbial community in the Traf3ip2^-/- mouse oral plaque, which was featured by a reduced microbial diversity and an overabundance of Streptococcus genus bacteria. More P. gingivalis was observed in the Traf3ip2^-/- mouse gingiva than WT control animals in a ligature-promoted P. gingivalis invasion model. In agreement, neutrophil depletion resulted in more local gingival tissue invasion by P. gingivalis. Thus, we identified a homeostatic IL-17-TRAF3IP2-neutrophil axis underpinning host defense against a keystone periodontal pathogen.

Changes in Gut Microbiota Structure: A Potential Pathway for Silver Nanoparticles to Affect the Host Metabolism

Silver nanoparticles (AgNPs) are one of the most widely used NPs. Their adverse effects on either the host or its gut microbiota (GM) have been examined. Nevertheless, whether the GM plays any role in AgNP toxicity to the host remains unclear. In the present study, AgNPs were administered to mice by oral gavage once a day for 120 days. A significant dose-dependent accumulation of Ag in the liver was observed, with a steady state reached within 21 days. The AgNPs changed the structure of the GM, mainly with respect to microorganisms involved in the metabolism of energy, amino acids, organic acids, and lipids, as predicted in a PICRUST analysis. Effects of the AgNPs on liver metabolism were also demonstrated, as a KEGG pathway analysis showed the enrichment of pathways responsible for the metabolism of amino acids, purines and pyrimidine, lipids, and energy. More interestingly, the changes in GM structure and liver metabolism were highly correlated, evidenced by the correlation between ∼23% of the differential microorganisms at the genus level and ∼60% of the differential metabolites. This implies that the metabolic variations in liver as affected by AgNPs were partly attributable to NP-induced changes of GM structure. Therefore, our results demonstrate the importance of considering the roles of GM in the toxicity of NPs to the host in evaluations of the health risks of NPs.

Comprehensive Exposure Studies of Per- and Polyfluoroalkyl Substances in the General Population: Target, Nontarget Screening, and Toxicity Prediction

Novel per- and polyfluoroalkyl substances (PFASs) in the environment and populations have received extensive attention; however, their distribution and potential toxic effects in the general population remain unclear. Here, a comprehensive study on PFAS screening was carried out in serum samples of 202 individuals from the general population in four cities in China. A total of 165 suspected PFASs were identified using target and nontarget analysis, including seven identified PFAS homolog series, of which 16 PFASs were validated against standards, and seven PFASs [4:2 chlorinated polyfluorinated ether sulfonate (4:2 Cl-PFESA), 7:2 chlorinated polyfluorinated ether sulfonate (7:2 Cl-PFESA), hydrosubstituted perfluoroheptanoate (H-PFHpA), chlorine-substituted perfluorooctanoate (Cl-PFOA), chlorine-substituted perfluorononanate (Cl-PFNA), chlorine-substituted perfluorodecanoate (Cl-PFDA), and perfluorodecanedioic acid (PFLDCA n = 8)] were reported for the first time in human serum. The Tox21-GCN model (a graph convolutional neural network model based on the Tox21 database) was established to predict the toxicity of the discovered PFASs, revealing that PFASs containing sulfonic acid groups exhibited multiple potential toxic effects, such as estrogenic effects and stress responses. Our study indicated that the general population was exposed to various PFASs, and the toxicity prediction results of individual PFASs suggested potential health risks that could not be ignored.

[Blood glucose levels and the relationship of body mass index and circumference with blood glucose in China]

Objective: To describe and compare blood glucose levels in adults aged 18 years old and above in China and explore the relationship between BMI and waist circumference with blood glucose. Methods: China Chronic Disease and Risk Factor Surveillance were conducted in 298 counties/districts in China in 2018, covering 31 provinces (autonomous regions, municipalities). A multi-stage stratified cluster random sampling method selected permanent residents aged 18 years and above. Information on demographics, behavior-related risk factors, BMI, waist circumference, and blood glucose were collected through a face-to-face questionnaire, physical measurement, and laboratory examination. After complex weighting of data, they described the blood glucose levels of people with different characteristics and explored the relationship of BMI and waist circumference with blood glucose by multiple linear regression model analysis. Results: A total of 177 816 adults were included in the study. The average fasting blood glucose and average glycosylated hemoglobin were (5.73±1.46) mmol/L and (5.37±0.83) %, with people aged 60 years old and above group highest than that of other, with males higher than females (P<0.001); and urban was higher slightly than rural for the average of average glycosylated hemoglobin (P<0.001). The average fasting blood glucose and average glycosylated hemoglobin increased with increased BMI and waist circumference (P<0.001). Results from multiple linear regression model analysis showed that: 1) for each increase in BMI unit and waist circumference, the fasting glucose levels increased by 0.019 mmol/L and 0.008 mmol/L (all P<0.001) in those not diagnosed with diabetes, 2) by 0.021 mmol/L (P=0.163) and 0.014 mmol/L (P=0.004) in those newly detected as diabetes, and 3) by 0.028 mmol/L (P=0.088) and 0.023 mmol/L (P<0.001) in those self-reported as having been diagnosed as diabetes, respectively. However, glycosylated hemoglobin levels increased: 1) by 0.015% and 0.006% in those not diagnosed as diabetes (all P<0.001), 2) by 0.050% and 0.019% in those newly detected as diabetes (all P<0.001), and 3) by 0.033% and 0.019% in those self-reported as having been diagnosed as diabetes (all P<0.001), respectively. These associations with waist circumference were more robust than with BMI. Conclusions: Adults not diagnosed with diabetes with abnormal BMI or waist circumference are the key population for prevention and control. Measures improving the awareness rate of waist circumference should be taken to maintain average blood glucose in various groups.

[Blood glucose measurement in Chinese adults, 2018]

Objective: To analyze the status of measuring the blood glucose among Chinese residents aged 18 years and above and to provide a scientific basis for evaluating the Healthy China Initiative. Methods: China Chronic Disease and Risk Factor Surveillance were conducted in 298 counties/districts in China in 2018, covering 31 provinces (autonomous regions, municipalities). A multi-stage stratified cluster random sampling method selected permanent residents aged 18 years and above. Questionnaires collected demographic characteristics, blood glucose measurements, and significant chronic disease prevalence. Body measurements were conducted to collect body height, weight, and waist circumference; Fasting venous blood was collected from participants to measure FPG before OGTT-2 h was obtained among participants without a self-reported history of diagnosed diabetes. The analysis included 177 904 residents aged 18 and above. After being weighed, the blood glucose measurement rates of adults in different groups were compared. Results: Among adults who had not been diagnosed with diabetes, The blood glucose measurement rates of regular, prediabetes, and newly detected elevated blood glucose within 12 months were 32.0% (95%CI: 30.5%-33.5%), 39.5% (95%CI: 37.4%-41.6%) and 43.8% (95%CI: 41.0%-46.4%), respectively. The measurement rates were higher in females than males; urban was higher than rural. The blood glucose rates increased with age, education, and BMI. These differences were significant (P<0.05). Among the adults with diabetes, the blood glucose measurement rate within six months was 89.6% (95%CI: 88.4%-90.8%); the measurement rate was higher in females than in males and higher in the west than in east and central regions of China, with statistical significance (P<0.05). Among adults in the study who did not have 1 or 2 or ≥3 major chronic diseases, the blood glucose measurement rates within six months were 19.6% (95%CI: 18.4%-20.7%), 41.8% (95%CI: 40.1%-43.5%), 58.9% (95%CI:57.0%-60.7%),71.9% (95%CI: 69.0%-74.9%), respectively. The blood glucose measurement rate was on the rise and increased with the number of comorbidities (P<0.001). The blood glucose measurement rate of adults who did not have 1 or 2 major chronic diseases was higher in urban areas than in rural areas. The blood glucose rates increased with age, education, and BMI and the differences were significant (P<0.05). The blood glucose measurement rate of adults with ≥3 major chronic diseases was higher in females than in males (P<0.001), and there was no difference among other groups (P>0.05). Conclusion: It is necessary to promote blood glucose measurement in residents aged 18 years and above in China. Relevant departments should strengthen the publicity and education to promote regular blood glucose measurement for high-risk populations to improve the efficiency of preventing and treating diabetes and its complications.

[Awareness and influencing factors on weight and waist circumference among adult Chinese residents in 2018]

Objective: To understand the awareness of weight and waist circumference and their influencing factors among residents aged ≥18 years in China and provide a reference for the development of relevant prevention and treatment policies and evaluation of intervention effects. Methods: We selected 298 counties (districts) from the 31 provinces (autonomous regions and municipalities) which participated in the 2018 China Chronic Disease and Risk Factor Surveillance program and included 194 779 permanent residents aged ≥18 years. To obtain the demographic characteristics of the study population, we used a multi-stage stratified whole-group random sampling method, questionnaires, and physical measurements. In this study, 179 045 people who completed the survey and had complete information on weight and waist circumference awareness were used as the study subjects. The weight awareness rate and waist circumference awareness rate were calculated by gender stratification, age, urban-rural, and education level groups. A multi-factor logistic regression model was used to analyze the influencing factors related to weight and waist circumference awareness of residents aged ≥18 years. Results: The weight awareness rate of adult residents in China in 2018 was 45.4% (95%CI: 41.9%-48.9%), higher among men [46.2% (95%CI: 42.5%-49.8%)] than women [44.6% (95%CI: 41.1%-48.2%)], and in urban areas [54.3% (95%CI: 49.3%-59.3%)]. The highest weight awareness rate appeared in residents with low BMI grouping [49.9% (95%CI: 44.3%-55.6%)], and the weight awareness rate in residents with undiagnosed central obesity, hypertension, and diabetes was higher than that of residents with diagnosed diabetes, with statistically significant differences (P<0.05). The waist circumference awareness rate of adult residents was 11.6% (95%CI: 9.7%-13.4%), higher in women [12.8% (95%CI: 10.8%-14.8%)] than in men [10.3% (95%CI: 8.6%-12.0%)], higher in urban [14.6% (95%CI: 11.7%-17.4%)] than in rural [8.3% (95%CI: 6.5%-10.2%)], and the waist circumference awareness rate was higher among residents with confirmed diabetes than those with undiagnosed diabetes, with statistically significant differences (P=0.020). The difference was statistically significant (P<0.001). The weight and waist circumference awareness rate increased with education level and annual per capita household income. Multi-factor logistic regression analysis suggested that urban, highly educated, high per capita annual household income and health check-up residents may have higher weight and waist circumference awareness rates among adult residents in China. Conclusion: Less than half of the adult residents in China know their weight status, and only about one-tenth know their waist circumference. Rural residents, those with low education levels and low annual per capita household income, and those who are obese need to be given prioritized attention. The relevant government departments should strengthen the popularization of the importance of weight and waist circumference on health and improve the awareness of our residents about their waist circumference and weight.

[Analysis of blood pressure measurement among Chinese adults in 2018]

Objective: To analyze the blood pressure measurement of Chinese adult residents in 2018 and provide a scientific basis for early detection and intervention of hypertension. Methods: In 2018, China Chronic Disease and Risk Factor Surveillance were conducted in 298 counties (districts) of 31 provinces (autonomous regions, municipalities) across the country, using a multi-stage stratified cluster random sampling method to survey permanent residents aged 18 years and above. We selected 184 509 people and carried out a face-to-face questionnaire survey and body measurement method to collect demographic data, major chronic diseases, and blood pressure measurement information of the survey subjects. Blood glucose and blood lipid-related indicators were obtained by laboratory testing. There were 170 551 adult residents included in the study after excluding abnormal and missing data for key variables. After complex weighting, blood pressure detection rates and detection times in people with different blood pressure levels and other diseases were analyzed. SAS 9.4 software was used to perform the χ²-test and trend test. Results: Among adult residents in China, the proportions of those with normal blood pressure, commonly recognized 'high' blood pressure, and newly detected hypertension who had their blood pressure tested within three months were 44.4%, 50.4%, and 52.6%, respectively. The proportions all appeared higher in women than in men (all P<0.05), in urban than in rural areas (all P<0.05), and showed an increasing trend with age (all P<0.001); The proportion of these three populations who had never had their blood pressure measured was 27.6%, 24.2%, and 23.5% respectively. The proportion of people with diagnosed hypertension who had their blood pressure tested within seven days was 44.0%, 51.4% in urban areas, higher than 37.7% in rural areas (P<0.001), and the proportion of people who had their blood pressure tested increased with education, per capita annual income and BMI (all P<0.001). Conclusions: The behavior of regular self-monitoring of blood pressure among adult residents in China still needs to be improved, especially among men and rural areas. Relevant health promotion and education should be strengthened. More targeted policies and measures should be developed to improve blood pressure measurement behavior in people with normal high blood pressure and other high-risk groups to control elevated blood pressure effectively.

MRI-based radiomics analysis in differentiating solid non-small-cell from small-cell lung carcinoma: a pilot study

AIM

To investigate the ability of a T2-weighted (W) magnetic resonance imaging (MRI)-based radiomics signature to differentiate solid non-small-cell lung carcinoma (NSCLC) from small-cell lung carcinoma (SCLC).

MATERIALS AND METHODS

The present retrospective study enrolled 152 eligible patients (NSCLC = 125, SCLC = 27). All patients underwent MRI using a 3 T scanner and radiomics features were extracted from T2W MRI. The least absolute shrinkage and selection operator (LASSO) logistic regression model was used to identify the optimal radiomics features for the construction of a radiomics model to differentiate solid NSCLC from SCLC. Threefold cross validation repeated 10 times was used for model training and evaluation. The conventional MRI morphology features of the lesions were also evaluated. The performance of the conventional MRI morphological features, and the radiomics signature model and nomogram model (combining radiomics signature with conventional MRI morphological features) was evaluated using receiver operating characteristic (ROC) curve analysis.

RESULTS

Five optimal features were chosen to build a radiomics signature. There was no significant difference in age, gender, and the largest diameter. The radiomics signature and conventional MRI morphological features (only pleural indentation and lymph node enlargement) were independent predictive factors for differentiating solid NSCLC from SCLC. The area under the ROC curves (AUCs) for MRI morphological features, and the radiomics model, and nomogram model was 0.69, 0.85, and 0.90 (ROC), respectively.

CONCLUSIONS

The T2W MRI-based radiomics signature is a potential non-invasive approach for distinguishing solid NSCLC from SCLC.

Classification and identification of polar pollutants on microplastics from freshwater using nontarget screening strategy

Microplastics (MPs) cause an increased threat to the freshwater environment by adsorbing pollutants on their large surface area. Considering their adsorption characteristics, non-polar pollutants with high distribution coefficients have been studied extensively. However, comprehensive research on the types of polar pollutants adsorbed by MPs is lacking. In this study, a nontarget screening strategy, including classification and identification, was performed to analyze the pollutants adsorbed by MPs in Tai Lake and the Yangtze River. Compared with the pollutants adsorbed or added to raw plastics, more types of polar pollutants were found on MPs from freshwater. The nontarget classification of 4723 features on MPs from freshwater and 680 features from raw plastics were annotated based on the mass spectrometry spectra. Further identification with multiple platforms identified hundreds of pollutants absorbed by MPs in Tai Lake and Yangtze River, including industrial intermediates, medicines, and surfactants, exceeding those adsorbed by raw plastics, showing an enrichment of the pollutants on MPs in freshwater by secondary adsorption. Our study is the first to use nontarget analysis to comprehensively demonstrate MP adsorption and release of pollutants in freshwater environment, providing a significant reference for the research of MPs and the management of the water environment.

Lesion Volume in Relapsing Multiple Sclerosis is Associated with Perivascular Space Enlargement at the Level of the Basal Ganglia

BACKGROUND AND PURPOSE

Perivascular spaces surround the blood vessels of the brain and are involved in neuroimmune functions and clearance of metabolites via the glymphatic system of the brain. Enlarged perivascular spaces could be a marker of dysfunction in these processes and, therefore, are highly relevant to monitoring disease activity in MS. This study aimed to compare the number of enlarged perivascular spaces in people with relapsing MS with MR imaging markers of inflammation and brain atrophy.

MATERIALS AND METHODS

Fifty-nine patients (18 with clinically isolated syndrome, 22 with early and 19 with late relapsing-remitting MS) were scanned longitudinally (mean follow-up duration = 19.6 [SD, 0.5] months) using T2-weighted, T1-weighted, and FLAIR MR imaging. Two expert raters identified and counted enlarged perivascular spaces on T2-weighted MR images from 3 ROIs (the centrum semiovale, basal ganglia, and midbrain). Baseline and change with time in the number of enlarged perivascular spaces were correlated with demographics and lesion and brain volumes.

RESULTS

Late relapsing-remitting MS had a greater average number of enlarged perivascular spaces at baseline at the level of the basal ganglia (72.3) compared with early relapsing-remitting MS (60.5) and clinically isolated syndrome (54.7) (F = 3.4, P = .042), and this finding correlated with lesion volume (R = 0.44, P = .0004) but not brain atrophy (R = -0.16). Enlarged perivascular spaces increased in number with time in all regions, and the rate of increase did not differ among clinical groups.

CONCLUSIONS

Enlarged perivascular spaces at the level of the basal ganglia are associated with greater neuroinflammatory burden, and the rate of enlargement appears constant in patients with relapsing-remitting disease phenotypes.

Aetiology of tinea capitis in China: A multicentre prospective study

BACKGROUND

Tinea capitis is still common in developing countries, such as China. Its pathogen spectrum varies across regions and changes over time.

OBJECTIVES

This study aimed to clarify the current epidemiological characteristics and pathogen spectrum of tinea capitis in China.

METHODS

A multicentre, prospective descriptive study involving 29 tertiary hospitals in China was conducted. From August 2019 to July 2020, 611 patients with tinea capitis were enrolled. Data concerning demography, risk factors and fungal tests were collected. The pathogens were further identified by morphology or molecular sequencing when necessary in the central laboratory.

RESULTS

Among all enrolled patients, 74.1% of the cases were 2- to 8-year-olds. The children with tinea capitis were mainly boys (56.2%) and more likely to have an animal contact history (57.4% vs. 35.3%, P = 0.012) and zoophilic dermatophyte infection (73.5%). The adults were mainly females (83.3%) and more likely to have anthropophilic agent infection (53.5%). The most common pathogen was zoophilic Microsporum canis (354, 65.2%), followed by anthropophilic Trichophyton violaceum (74, 13.6%). In contrast to the eastern, western and northeastern regions where zoophilic M. canis predominated, anthropophilic T. violaceum predominated in central China (69.2%, P < 0.0001), where the patients had the most tinea at other sites (20.3%) and dermatophytosis contact (25.9%) with the least animal contact (38.8%). Microsporum ferrugineum was the most common anthropophilic agent in the western area, especially in Xinjiang Province.

CONCLUSIONS

Boys aged approximately 5 years were mainly affected. Dermatologists are advised to pay more attention to the different transmission routes and pathogen spectra in different age groups from different regions.

Exposure to legacy and novel perfluoroalkyl substance disturbs the metabolic homeostasis in pregnant women and fetuses: A metabolome-wide association study

BACKGROUND

Perfluoroalkyl substances (PFASs) exist extensively and several of these have been verified to be toxic. Prenatal exposure to PFASs has attracted much attention. Metabolome-wide association analyses can be used to explore the toxicity mechanisms of PFASs by identifying associated biomarkers.

OBJECTIVES

To evaluate associations between the metabolites in maternal and cord serum and internal exposure to several common PFASs.

METHODS

Paired maternal and cord serum samples were collected from 84 pregnant women who gave birth between 2015 and 2016. Seven legacy and two novel PFASs were measured. A nontarget metabolomic method and an iterative metabolite annotation based on metabolic pathways were applied to characterize the metabolic profiles. Linear regression adjusted with the false discovery rate and covariates was used to indicate the associations.

RESULTS

A total of 279 features in maternal serum and 338 features in cord serum were identified as metabolites associated with PFAS exposure. Perfluorooctanoic acid (PFOA) and perfluorohexane sulfonic acid (PFHxS) were two PFASs associated with more metabolites, while the two novel chlorinated polyfluorinated ether sulfonic acids (Cl-PFESAs) showed less relevance to the metabolome. With pathway enrichment analysis, we found that three fatty acid metabolisms and retinol metabolism were correlated with PFAS exposure in maternal blood, and that sterol metabolism showed the correlation in both maternal serum and cord serum.

CONCLUSIONS

We identified metabolites and pathways in pregnant women and fetuses associated with the exposure to several PFAS, indicating a promising application for metabolome-wide association studies. Additional research is needed to confirm causation.

Application of a BMP2-binding heparan sulphate to promote periodontal regeneration

Periodontitis is the most common inflammatory disease that leads to periodontal defects and tooth loss. Regeneration of alveolar bone and soft tissue in periodontal defects is highly desirable but remains challenging. A heparan sulphate variant (HS3) with enhanced affinity for bone morphogenetic protein-2 (BMP2) that, when combined with collagen or ceramic biomaterials, enhances bone tissue regeneration in the axial and cranial skeleton in several animal models was reported previously. In the current study, establishing the efficacy of a collagen/HS3 device for the regeneration of alveolar bone and the adjacent periodontal apparatus and related structures was sought. Collagen sponges loaded with phosphate-buffered saline, HS3, BMP2, or HS3 + BMP2 were implanted into surgically-created intra-bony periodontal defects in rat maxillae. At the 6 week end- point the maxillae were decalcified, and the extent of tissue regeneration determined by histomorphometrical analysis. The combination of collagen/HS3, collagen/BMP2 or collagen/HS3 + BMP2 resulted in a three to four-fold increase in bone regeneration and up to a 1.5 × improvement in functional ligament restoration compared to collagen alone. Moreover, the combination of collagen/HS3 + BMP2 improved the alveolar bone height and reduced the amount of epithelial growth in the apical direction. The implantation of a collagen/ HS3 combination device enhanced the regeneration of alveolar bone and associated periodontal tissues at amounts comparable to collagen in combination with the osteogenic factor BMP2. This study highlights the efficacy of a collagen/HS3 combination device for periodontal regeneration that warrants further development as a point-of-care treatment for periodontitis-related bone and soft tissue loss.

Screening priority indicator pollutants in full-scale wastewater treatment plants by non-target analysis

Wastewater treatment plants (WWTPs) are the main sources of emerging contaminants (ECs) in aquatic environment. However, the standards for limiting emerging pollutants in effluent are extremely lacking. We investigated the occurrence and removal of emerging pollutants in 16 WWTPs in China using non-target analysis. 568 substances screened out were divided into 9 kinds including 167 pharmaceuticals, 113 natural substances, 85 pesticides, 86 endogenous substances, 64 chemical raw materials, 14 personal care products, 17 food additives, 6 hormones and 16 others. And they were divided into 5 fates. Pesticides and pharmaceutical compounds seemed to be the most notable categories, the kinds detected in each sample is the largest compared with other compounds. Besides, the average removal rate of pesticides and pharmaceuticals in all WWTPs were the lowest, at 9.54% and 23.77%, respectively. Priority pollutants were screened by considering distribution of pollutants with different fates. Pollutants with the same fate especially "consistent" in different WWTPs had attracted attention. 4 potential priority pollutants including metoprolol, carbamazepine, 10, 11-dihydro-10, 11-dihydroxycarbamazepine and irbesartan were proposed. And it was found that the 4 compounds, "consistent suspects" and "consistent non-targets" had similar rankings of removal rate in 16 WWTPs, which can reflect the performance of different WWTPs.

Effect of radiomics from different virtual monochromatic images in dual-energy spectral CT on the WHO/ISUP classification of clear cell renal cell carcinoma

AIM

To investigate the effect of radiomics obtained from different virtual monochromatic images (VMIs) in dual-energy spectral computed tomography (CT) on the World Health Organization/International Association for Urological Pathology (WHO/ISUP) classification of clear cell renal cell carcinoma (ccRCC).

MATERIALS AND METHODS

A retrospective study of 99 ccRCC patients who underwent contrast-enhanced dual-energy CT was undertaken. ccRCC was confirmed at surgery or biopsy and graded according to the WHO/ISUP pathological grading criteria as low grade (n=68, grade I and II) or high grade (n=31, grade III and IV). Radiomics risk scores (RRSs) for differentiating high and low grades of ccRCC were constructed from 11 sets of VMI in (40-140 keV, 10 keV interval) the cortical phase. Receiver operating characteristic (ROC) curves were drawn and the area under the curves (AUCs) was calculated to evaluate the discriminatory power of RRS for each VMI. The Hosmer-Lemeshow test was used to evaluate the goodness-of-fit of each model and the decision curve was used to analyse its net benefit to patients.

RESULTS

The AUC values for distinguishing low-from high-grade ccRCC with RRS of 40-140 keV VMIs were all >0.920. The Hosmer-Lemeshow test showed that the p-values of RRS of VMIs were >0.05, suggesting good fits. In the decision curve analysis, RRS from the 40-140 keV VMIs had similar decision curves and provided better net benefits than considering all patients either as high-grade or low-grade.

CONCLUSIONS

The RRS obtained from multiple VMIs in dual-energy spectral CT have high diagnostic efficiencies for distinguishing between low- and high-grade ccRCC with no significant differences between different VMIs.

Doppler-based predictive model for methotrexate resistance in low-risk gestational trophoblastic neoplasia with myometrial invasion: prospective study of 147 patients

OBJECTIVES

This prospective clinical study aimed to evaluate the vascularization characteristics of low-risk gestational trophoblastic neoplasia (GTN) using Doppler imaging and to develop a predictive model for resistance to methotrexate (MTX).

METHODS

Patients with low-risk GTN receiving primary MTX treatment were enrolled from the Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China, from September 2012 to August 2018. The primary endpoint was to develop and internally validate a predictive model for resistance to MTX therapy in these patients. In the training set, clinical features and Doppler hemodynamic parameters before MTX therapy were analyzed using logistic regression to identify independent predictors of MTX resistance, which were integrated into the model. The predictive performance of the model was evaluated by leave-one-out cross-validation in the training dataset and internal validation in an independent-sample test dataset.

RESULTS

The entire imaging protocol was completed by 147 eligible patients, of which 110 comprised the training set and 37 the test set. In the training set, cases with myometrial invasion (81.8%; 90/110) showed vascular-enriched areas in the myometrium and high velocity and low impedance ratios of the uterine artery (UtA) compared to cases without myometrial invasion (18.2%; 20/110). On multivariate logistic regression analysis, time-averaged mean velocity in UtA (UtA-TAmean) and the International Federation of Gynecology and Obstetrics (FIGO) score were identified as independent predictors (P = 0.009 and P = 0.043, respectively) of MTX resistance. The Doppler-based predictive model, developed based on the 90 cases with myometrial invasion, was y = -2.95332 + 0.41696 × FIGO score + 0.03551 × UtA-TAmean. The model showed an area under the curve of 0.757 (95% CI, 0.653-0.862) and the optimal cut-off value was 0.50622, which had 45.2% sensitivity and 96.6% specificity. The model stratified patients with low-risk GTN into low (< 10%), intermediate (10-90%) and high (> 90%) probability of MTX resistance, based on the threshold values of -1.59544 and 0.10046. The model had an accuracy of 74.4% (95% CI, 64.5-82.3%) in the cross-validation and 72.7% (95% CI, 55.8-84.9%) in the internal validation.

CONCLUSIONS

The Doppler-based predictive model, combining a non-invasive marker of tumor vascularity with the FIGO scoring system, can differentiate cases with low from those with high probability of developing MTX resistance and therefore has the potential to guide treatment options in patients with low-risk GTN and myometrial invasion. © 2020 Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Characterization of ecdysteroid biosynthesis in the pond wolf spider, Pardosa pseudoannulata

Ecdysteroids, as the key growth hormones, regulate moulting, metamorphosis and reproduction in arthropods. Ecdysteroid biosynthesis is catalysed by a series of cytochrome P450 monooxygenases (CYP450s) encoded by Halloween genes, including spook (spo), phantom (phm), disembodied (dib), shadow (sad) and shade (shd). The ecdysteroid biosynthesis in insects is clear with 20-hydroxyecdysone (20E) as the main ecdysteroid. However, the information on the major ecdysteroids in arachnids is limited. In this study, Halloween genes spo, dib, sad and shd, but not phm, were identified in the pond wolf spider, Pardosa pseudoannulata. Phylogenetic analysis grouped arachnid and insect Halloween gene products into two CYP450 clades, the CYP2 clan (spo and phm) and the mitochondrial clan (dib, sad, and shd). In P. pseudoannulata, the temporal expression profile of the four Halloween genes in concurrence with spiderling moulting with steady increase in the course of the 2nd instar followed by a rapid dropdown once moulting was completed. Spatially, the four Halloween genes were highly expressed in spiderling abdomen and in the ovaries of female adults. In parallel, ponasterone A (PA), but not 20E, was detected by LC-MS/MS analysis in P. pseudoannulata, and it was demonstrated as a functional ecdysteroid in the spider by accelerating of moulting with PA addition. The present study revealed the different ecdysteroid biosynthesis pathways in spiders and insects.

Role of miR-133a in regulating TGF-β1 signaling pathway in myocardial fibrosis after acute myocardial infarction in rats

OBJECTIVE

The aim of this research was to explore the effect of microRNA-133a (miR-133a) on myocardial fibrosis and cardiac function after myocardial infarction in rats, and to investigate the possible regulatory mechanism.

MATERIALS AND METHODS

Myocardial infarction model was successfully established in rats by ligation of the left anterior descending coronary artery. After miR-133a overexpression in rats myocardium, cardiac function was examined by echocardiography. Meanwhile, the degree of myocardial fibrosis was detected by Masson staining. In addition, the expression of α-smooth muscle actin (α-SMA) in cardiomyocytes was detected by immunohistochemistry. Quantitative Real-time polymerase chain reaction (qRT-PCR) was performed to analyze the expression level of miR-133a in the junction of myocardial infarction. The mRNA expressions of transforming growth factor-β1 (TGF-β1), connective tissue growth factor (CTGF), collagen type 1 (col 1), collagen type 3 (col 3) and α-SMA were measured by qRT-PCR as well. Furthermore, the protein levels of the above genes were detected by Western blotting.

RESULTS

MiR-133a expression in the infarct border zone of myocardial tissue was significantly decreased on the 28th day after myocardial infarction surgery (p<0.05). In addition, up-regulation of miRNA-133a in myocardial tissue of rats with myocardial infarction could remarkably improve cardiac function and reduce collagen volume fraction. Furthermore, the mRNA and protein expression levels of TGF-β1, CTGF, col1, col3, α-SMA in myocardial tissue were obviously decreased after miRNA-133a up-regulation (p<0.001).

CONCLUSIONS

Overexpression of miR-133a down-regulates the mRNA and protein levels of TGF-β1 and CTGF after myocardial infarction. Moreover, this may eventually reduce myocardial collagen deposition, inhibit myocardial fibrosis and improve cardiac function.

Replacing true unenhanced imaging in renal carcinoma with virtual unenhanced images in dual-energy spectral CT: a feasibility study

AIM

To investigate the clinical value of virtual unenhanced (VNC) spectral computed tomography (CT) images to replace the conventional true unenhanced spectral CT images (TNC) in diagnosing renal carcinoma.

MATERIALS AND METHODS

Fifty-six cases of renal carcinoma confirmed by histopathology underwent conventional plain CT and contrast-enhanced spectral CT at arterial phase (AP) and venous phase (VP). VNC images were generated on an AW4.6 workstation. The CT attenuation, image noise, contrast-to-noise ratio (CNR), and signal-noise-ratio (SNR) of the renal lesions and normal kidneys, long and short axis diameters of the lesion were measured from the three image sets and analysed using one-way analysis of variance (ANOVA). Two radiologists evaluated image quality subjectively using a five-point score, and lesion signature using a three-point score. Image quality scores were compared statistically and tested for consistency.

RESULTS

The two reviewers had good agreement for subjective evaluation (Kappa>0.70) and there was no difference in the quality of the scores among the three image groups. The lesion signature scores were all above the acceptable level. The CNR and SNR values in VNC were significantly higher than in TNC (p<0.05). VNC images had lower renal noise than in TNC (p<0.05). There was no difference in the long and short axis diameters of the lesion among the three image groups. VNC had higher CT attenuation values for the lesion and kidney than TNC (p<0.05), but the differences were <5 HU.

CONCLUSION

VNC images in spectral CT may be used to replace the conventional plain CT to reduce imaging duration and radiation dose in diagnosing renal carcinoma.

Non-target and suspect screening of per- and polyfluoroalkyl substances in Chinese municipal wastewater treatment plants

Wastewater treatment plant (WWTP) is one of the major sources of per- and polyfluoroalkyl substances (PFASs) to the aquatic environment. In this study, wastewater samples were collected from 17 WWTPs in 17 cities of China to investigate emerging PFASs in WWTPs. To comprehensively identify PFASs in the wastewater samples, an integrated suspect screening, homologue-based and fragment-based non-target screening method is proposed. Sixty-three PFASs from 13 classes (25 subclasses) were identified, including 14 legacy and 49 emerging PFASs, and this study is the first to report on 12 of these PFASs. We found that emerging PFASs concentration had a significantly positive correlation with the gross domestic product, indicating more substitution of legacy PFASs in the developed area of China. We also analyzed the removal of the 13 PFAS classes, and found that all discovered PFAS classes were not completely removed after the treatment process, whereas the class of perfluoroalkyl ether alcohols significantly increased. All of these results imply that the release of emerging or unknown PFASs from WWTPs is a universal but not negligible problem in China.

[The value of color doppler ultrasonography in the diagnosis of impending ruptured abdominal aortic aneurysm]

Objective: To study the value of color doppler ultrasonography (CDU) in diagnosis of impending ruptured abdominal aortic aneurysm (IRAAA). Methods: A total of 35 cases with IRAAA which were identified by CDU in our department from June 2014 to June 2019 were retrospectively analyzed. All the patients were detected by computed tomographic angiography (CTA). The types, length of the neck of aneurysm, largest diameter, thrombosis, involvement of common iliac artery and impending ruptured conditions were compared. The postoperative patients were followed-up by CDU and CTA (mean time was 2.6 months). Results: Among 35 patients, CDU diagnosed that 5 cases were pararenal types and 30 cases were infrarenal types. CTA showed that 4 cases were pararenal types and 31 cases were infrarenal types. The misdiagnosis rate of CDU was 2.9% (1/35). CDU showed that bilateral common iliac arteries were involved in 21 cases, right common iliac arteries were involved in 3 cases, and left common iliac arteries were involved in 2 cases. CTA detected the same results. There was no statistical difference between CDU and CTA for detection of the largest anteroposterior diameter, transverse diameter and the thickness of thrombosis (P values were 0.354, 0.310 and 0.865). There was statistical difference in the detection of the length of the aneurysm's neck (P=0.006). CDU showed 3 cases of focal wall discontinuity, 4 cases of hyperattenuating crescent sign, 3 cases of thrombus fissuration and 2 cases of saclike protuberance, which were consistent with the detection of CTA. CDU showed that locally thin wall of aneurysm was detected in the rest of 23 cases. CTA showed 2 patients were negative. The misdiagnosis rate of CDU was 5.7% (2/35). Three cases did not undergo surgery. Open repairs (OR) were performed in 5 cases. Endovascular aneurysm repairs (EVAR) were performed in 27 cases. The postoperative patients were followed up by CDU and CTA at 1 month, 3 months, 6 months and 12 months. All the artificial blood vessels and stents were patent. Endoleak was observed in 5 cases. Aneurysm sac thrombosis was found in the rest of the cases. Conclusions: CDU plays an important role in the analysis and diagnosis of the size, range, and the impending ruptured symptoms of the aneurysm. It provides a reliable basis for IRAAA screening, diagnosis and postoperative follow-up, and has important clinical value.

Suspect screening and risk assessment of pollutants in the wastewater from a chemical industry park in China

Owing to the production and use of chemicals in chemical industry parks (CIPs), these areas are considered to be highly polluted. However, the type of pollutants presents in the wastewater from CIPs and the risk posed to the environment due to the release of these pollutants remains unclear. In this study, suspect screening was combined with traceability analysis to determine the type of pollutants present in wastewaters at 9 chemical enterprises and wastewater treatment plants (WWTPs) in the CIPs. Additionally, the distribution of nine pollutants from the WWTPs' effluent stage and the risk they posed to the surrounding river was examined through target analysis. Upon conducting suspect analysis, the presence of 65 and 64 chemicals in the 9 chemical enterprises' wastewaters and WWTPs, respectively, was tentatively identified. Traceability analysis of the compounds screened in the effluent from the WWTPs determined that 41 substances were identified as characteristic pollutants of the chemical enterprises, indicating that the suspect screening strategy enabled relatively more efficient identification of the characteristic pollutants compared to traditional quantitative analysis. Targeting analysis combined with ecological risk assessment showed that metolachlor, carbendazim, atrazine, diuron, and chlorpyrifos posed relatively higher risks to aquatic organisms in the surrounding river. Therefore, the refined management of the wastewater treatment plant in the CIPs is necessary.

Metabolomic insights into the lasting impacts of early-life exposure to BDE-47 in mice

Early-life exposure to toxicants may have lasting effects that adversely impact later development. Thus, although the production and use of a toxicant have been banned, the risk to previously exposed individuals may continue. BDE-47, a component of commercial penta-BDEs, is a persistent organic pollutant with demonstrated neurotoxicity. To investigate the persistent effects of BDE-47 and the mechanisms thereof, we employed a metabolomics approach to analyze the brain, blood and urine of mice exposed to BDE-47 for 28 days and then 3 months post-exposure. In the brain, BDE-47 was detectable just after exposure but was below the limit of detection (LOD) 3 months later. However, the metabolomic alterations caused by early-life exposure to BDE-47 persisted. Potential biomarkers related to these alterations included phosphatidylcholine, lysophosphatidylcholine, sphingomyelin and several amino acids and biogenic amines. The metabolic pathways involved in the response to BDE-47 in the brain were mainly those related to glycerophospholipid metabolism, sphingomyelin metabolism and neurotransmitter regulation. Thus, our study demonstrates the utility of metabolomics, as the omics most closely reflecting the phenotype, in exploring the mechanisms underlying the lasting effects induced by early-life BDE-47 exposure.

Random lasing from optical fibers with phase separated glass cores

A novel random laser, integrating a passive optical fiber with a phase separated aluminosilicate core-silica cladding as the feedback medium, is proposed and presented. The core exhibits greatly enhanced Rayleigh scattering, therefore requiring a significantly reduced length of scattering fiber (4 m) for lasing. With a Yb-doped fiber as the gain medium, the fiber laser operates at 1050 nm with low threshold power and possesses an output that can be amplified through conventional means. Furthermore, the laser was found to have a high degree of spatial coherence, spectral broadening with increasing input power, and temporal spectral variation. The facile setup and results herein pave the way for further study and applications based on low threshold random fiber lasers.

Suspect and non-target screening of pesticides and pharmaceuticals transformation products in wastewater using QTOF-MS

Pesticides and pharmaceuticals are widely used in modern life and are discharged into wastewater after usage. However, a large number of transformation products (TPs) are formed through abiotic (hydrolysis/photolysis, etc.) and biotic (aerobic/anaerobic degradation by micro-organisms) wastewater treatment processes, and the structure and potential risk of TPs are still unclear. In this study, a suspect and non-target screening was performed to monitor these chemicals with HPLC-QTOF-MS. We identified 60 parent compounds by suspect screening in three Chinese wastewater treatment plants with the commercial database of pesticides and pharmaceuticals, and they were confirmed by authentic standards. Then, suspect and non-target screening strategies based on the predicted diagnostic fragment ions were used to screen TPs of the 60 parent compounds. We tentatively identified 50 TPs and confirmed thirteen of them with authentic standards. Among 13 quantified TPs, about 40% of them showed higher concentration than their parent compounds in effluent. Especially, cloquintocet, as a TP of cloquintocet-mexyl, had a concentration ratio TP/parent = 14,809 in effluent. Twenty-five TPs had higher predicted toxicity than the corresponding parent compounds by calculating their LC₅₀ values towards aquatic organisms using toxicity prediction software. Twenty identified TPs were firstly reported in this study. These results indicate the importance of TP analysis in environmental monitoring in wastewater.

Transplacental Transfer of Per- and Polyfluoroalkyl Substances Identified in Paired Maternal and Cord Sera Using Suspect and Nontarget Screening

Novel per- and polyfluoroalkyl substances (PFASs) in various environmental media have attracted increasing attention; however, the information regarding PFASs exposure in pregnant women and fetuses is insufficient. In this study, we built and applied suspect and nontarget screening strategies based on the mass difference of the CF₂, CF₂O, and CH₂CF₂ units to select potential novel PFASs from 117 paired maternal and cord sera. In total, 10 legacy PFASs and 19 novel PFASs from 10 classes were identified to be above confidence levels 3, among which 14 were not previously reported in human serum. Novel PFASs accounted for a considerable percentage of total PFASs in pregnant women and can be transferred to fetuses at non-negligible concentrations (i.e., 27.9% and 30.3% of total PFAS intensities in maternal and cord sera, respectively). The transplacental transfer efficiency (TTE) of PFASs showed a U-shape trend in the series of perfluoroalkyl carboxylic acids, perfluoroalkyl sulfonic acids, and unsaturated perfluorinated alcohols. The TTE of novel PFASs is suggested to be structure-dependent, based on a flexible docking experiment. This study provides comprehensive TTE information on legacy and novel PFASs for the first time, and additional toxicity studies are needed to evaluate the risk of novel PFASs further.

Nontarget Discovery of Per- and Polyfluoroalkyl Substances in Atmospheric Particulate Matter and Gaseous Phase Using Cryogenic Air Sampler

Novel per- and polyfluoroalkyl substances (PFASs) have become a key issue in global environmental studies. Although several novel PFASs have been discovered in atmospheric particulate matter through nontarget analysis, information on the environmental occurrence of novel PFASs in atmospheric gaseous phases and conventional sampling techniques is somewhat deficient. Therefore, this Article describes a new type of air sampler, the cryogenic air sampler (CAS), which was used to collect all atmospheric components simultaneously. Nontarget analysis then was performed through PFASs homologue analysis. A total of 117 PFAS homologues (38 classes) were discovered, 48 of which (13 classes) were identified with confidence Level 4 or above. Eleven chlorinated perfluoropolyether alcohols (3 classes) and four chlorinated perfluoropolyether carboxylic acids (2 classes) have been reported for the first time in this Article. This Article is also the first report of 12 hydrosubstituted perfluoroalkyl carboxylates (H-PFCAs) in the atmosphere. H-PFCAs and chlorinated perfluoropolyether carboxylic acids were mainly distributed in the particular phase. These results are evidence that novel chlorinated polyether PFASs should be the focus of future study.

MicroRNA-298 regulates apoptosis of cardiomyocytes after myocardial infarction

OBJECTIVE

To investigate the role and mechanism of micro ribonucleic acid (miR)-298 in myocardial apoptosis after myocardial infarction.

MATERIALS AND METHODS

In vivo experiments, the rat model of myocardial infarction was established, and miR-298 was up-regulated via lentivirus with miR-298 overexpression. Cardiac function of rats was detected via echocardiography, Bcl-2 associated X protein (BAX) expressions in infarction border zone were detected via Real-time Quantitative PCR (qT-PCR) and Western blot, and TUNEL assay was used to detect the myocardial apoptosis. In vitro experiments, myocardial cells were isolated and cultured, an oxygen-glucose deprivation (OGD) model was established to mimicking the ischemic condition, the relationship between miR-298 and BAX was verified using luciferase reporter vector, lentivirus and small-interfering RNA (siRNA) in BAX.

RESULTS

In vivo experiments showed that the miR-298 expression was down-regulated at 2 and 4 weeks after myocardial infarction. The up-regulation of miR-298 significantly improved the cardiac function, decreased the expressions of BAX, reduced the myocardial apoptosis and inhibit the apoptosis proteins expression including cytochrome-c and cleaved caspase-3. In vitro experiments revealed that BAX was a target gene of miR-298 and further proof that miR-298 could inhibit the cytochrome-c and cleaved caspase-3 expression and myocardial apoptosis through BAX.

CONCLUSIONS

MiR-298 can improve the myocardial apoptosis through the target gene BAX.

Biomonitoring of organophosphate triesters and diesters in human blood in Jiangsu Province, eastern China: Occurrences, associations, and suspect screening of novel metabolites

Since organophosphate (OP) triesters are ubiquitous in environmental matrices, there is an increasing concern regarding human exposure to OP triesters or their metabolites. In this study, we measured levels of 16 OP triesters and 4 OP diesters in n = 99 human blood samples of non-occupationally exposed adults (aged 18-87) from Jiangsu Province, eastern China. Based on the measured concentrations, statistical difference and correlativity were calculated to characterize the population diversity and potential sources of OP triester and diester. Di (2-ethylhexyl) phosphate (DEHP) and 2-ethylhexyl diphenyl phosphate (EHDPP) were found in many participants' blood, with median concentrations of 1.2 (range: n.d. - 44.7, detection frequency: 99%) and 0.85 (n.d. - 28.8, 68%) ng mL^-1, respectively. Blood samples of older participants contained significantly lower concentrations of OP diesters or triesters than their younger counterparts (p < 0.01). Regional- and age-specific differences in the blood concentrations of OP triesters and diesters were attributed to disparities in environmental exposure intensity. EHDPP and tris (phenyl) phosphate (TPHP), the predominant OP triesters, exhibited significant positive correlation (p < 0.01, r = 0.84) suggestive of analogous transport behavior from similar exposure sources to humans. The increased correlations between diphenyl phosphate (DPHP) and TPHP as well as with EHDPP as observed from the multivariate regression suggests that DPHP could be derived from the metabolism of both TPHP (the crucial precursor) and EHDPP. When the blood samples were subsequently screened using high-resolution spectrometry, we detected five novel OP metabolites: glucuronide conjugates of hydroxylated DEHP (OH-DEHP glucuronide conjugate), 2-ethylhexyl monophenyl phosphate (EHMPP), hydroxylated EHMPP (OH-EHMPP), dihydroxylated bis(2-butoxyethyl) phosphate (di-OH-BBOEP), and dihydroxylated tris(butyl) phosphate (di-OH-TNBP). Overall, this study provides novel information regarding the occurrence of OP triesters and diesters, and further suggested several novel OP metabolites in human blood.

Analysis on the correlations of ENOS and ET-2 gene polymorphisms with eclampsia

OBJECTIVE

To explore the correlations of endothelial nitric oxide synthase (eNOS) G894T and endothelin-2 (ET-2) A985G gene polymorphisms with eclampsia.

PATIENTS AND METHODS

A total of 110 eclampsia patients in our hospital from July 2014 to August 2017 were enrolled as the observation group and 100 healthy pregnant women in the same period as the control group. The polymorphisms of eNOS G894T and ET-2 A985G genes in the two groups were analyzed via polymerase chain reaction (PCR), and their correlations with eclampsia risk were investigated.

RESULTS

The distribution frequency of eNOS G894T genotype TT and GT and T allele, as well as the ET-2 A985G genotype GG and AG and G allele, were evidently higher in the observation group than in the control group (p<0.05). ENOS G894T genotype TT and ET-2 A985G genotype GG were significantly associated with the occurrence of eclampsia.

CONCLUSIONS

The polymorphisms of eNOS G894T and ET-2 A985G genes are correlated with the occurrence of eclampsia.

[Application of adaptive statistical iterative reconstruction veo and 80 kv in renal computed tomography angiography]

Objective: To explore the application of adaptive statistical iterative reconstruction Veo (ASIR-V) and 80 kV in renal computed tomography angiography(CTA). Methods: Eighty patients with renal computed tomography angiography were prospectively collected from April 2018 to July 2018 in the Affiliated Hospital of Shaanxi University of Chinese Medicine and randomly divided into group A and group B. The patients in group A adopted tube voltage 120 kV and contrast agent concentration 600 mgI/kg and reconstructed with filtered back projection (FBP), while the patients in group B were scanned with tube voltage 80 kV and contrast agent concentration 350 mgI/kg and reconstructed with FBP and ASIR-V from 10% to 100% with 10% interval. The CT values and standard deviation (SD) of the right renal artery, left renal artery were measured respectively to calculate the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR).The image quality of renal CTA was subjectively scored by two experienced radiologists blindly using a 5-point criteria.The contrast agent,CT volume dose index(CTDI(vol)) and dose length product(DLP) in both groups were recorded and the effective radiation dose(ED) was calculated. Results: The ED ((2.11±0.19)mSv) and contrast agent ((21.9±3.0)g) in group B were 65.1% (P<0.05) and 42.2% (P<0.05) lower than those in group A ((6.04±1.89)mSv and (38.0±3.8)g).With the increase of ASIR-V percentage in group B, CT values showed no significant difference, SD values gradually decreased, SNR values and CNR values gradually increased.The CT values with different reconstruction algorithm showed no statistically significant difference (all P>0.05) between group A and group B. The SD values with 40%ASIR-V to 100%ASIR-V reconstruction in group B were significantly lower than those of group A (all P<0.05).The SNR values with 50% ASIR-V to 100% ASIR-V reconstruction and CNR values with 70%ASIR-V to 100%ASIR-V were significantly higher than those of group A(all P<0.5).Two radiologists had excellent consistency in subjective scores of image quality for renal CTA(all kappa>0.75, P<0.05). The subjective scores with 60% ASIR-V to 90% ASIR-V in group B were significantly higher than those in group A (P<0.05), of which 70%ASIR-V reconstruction achieved the highest subjective score for renal CTA. Conclusion: ASIR-V and 80 kV can significantly reduce radiation dose (about 65.1%) and contrast agent (about 42.2%) in renal CTA, ASIR-V reconstruction can significantly improve the image quality of renal CTA, of which 70% ASIR-V reconstruction achieved the best image quality in 80 kV renal CTA.