[Preliminary observation of wearable balance diagnosis and treatment system in evaluating dynamic and static balance function in patients with vestibular vertigo]

A newly developed wearable balance diagnosis and treatment system was studied to evaluate the indexes of the abnormal balance function in patients with vestibular vertigo. A cross-sectional study was carried out. A total of 30 patients diagnosed with non-acute vestibular vertigo in the outpatient department of Eye, Ear, Nose and Throat Hospital Affiliated to Fudan University from July 2022 to May 2023 were selected as the vertigo group, including 13 males and 17 females, and aged (45.7±13.9) years. Meanwhile, 20 healthy controls (8 males and 12 females) were included as the control group, with a mean age of (43.6±8.0) years. The static balance and limits of stability (LOS) function of all subjects were assessed with wearable balance diagnosis and treatment system developed under the leadership of Eye & ENT Hospital of Fudan University. In the static balance test, the ratio of eyes open with cushions to eyes open without cushions in the vertigo group was less than that of the control group[1.20% (0.92%, 1.53%) vs 1.49% (1.22%, 1.81%), P=0.008], indicating that patients with non-acute vestibular vertigo may compensate static balance ability earlier. In vertigo group, the directional control in 8 directions, the maximum excursion in anterior, posterior, right anterior and right posterior directions, the endpoint excursion in the posterior, right posterior, and left posterior directions were all smaller than those of the control group (all P<0.05). The reaction time in the left posterior direction of vertigo group was longer than that of the control group (all P<0.05). Those results indicated that the directional control, maximum excursion and endpoint excursion of LOS could be considered as important reference indexes for dynamic balance function.

CircSTRBP contributes to H2O2-induced lens epithelium cell dysfunction through increasing NOX4 mRNA stability by recruiting IGF2BP1

Previous studies have shown that the development of age-related cataract (ARC) is involved in lens epithelium dysfunction, which is associated with abnormally expressed circular RNAs (circRNAs). The current work aims to probe the role of circSTRBP (hsa_circ_0088,427) in hydrogen peroxide (H2O2)-induced lens epitheliums. Lens epithelium tissues were harvested from ARC or normal subjects (n = 23). CircSTRBP, spermatid perinuclear RNA binding protein (STRBP), and nicotinamide adenine dinucleotide phosphate oxidase subunit 4 (NOX4) levels were measured using quantitative reverse transcription polymerase chain reaction (qRT-PCR). Cell proliferation, cycle progression, and apoptosis were assessed using 5-ethynyl-2'-deoxyuridine (EdU), Cell Counting Kit-8 (CCK-8), and flow cytometry assays. Caspase 3 activity, reactive oxygen species (ROS), malondialdehyde (MDA), and Glutathione peroxidases (GSH-PX) levels were detected using corresponding kits. NOX4 protein level was determined using Western blot. The interaction between insulin-like growth factor 2 mRNA-binding protein 1 (IGF2BP1) and circSTRBP or NOX4 was assessed through RNA immunoprecipitation (RIP). CircSTRBP and NOX4 abundances were increased in lens epithelium samples from ARC patients and H2O2-treated SRA01/04 cells. CircSTRBP knockdown might abolish H2O2-triggered SRA01/04 cell proliferation repression and apoptosis and oxidative stress promotion. In mechanism, circSTRBP is bound with IGF2BP1 and improves the stability and expression of NOX4 mRNA in SRA01/04 cells. CircSTRBP facilitated H2O2-induced SRA01/04 cell apoptosis and oxidative stress through by enhancing NOX4 mRNA stability via recruiting IGF2BP1, providing novel insights for ARC progression and treatment.

Efficacy and safety of intrathecal pemetrexed for TKI-failed leptomeningeal metastases from EGFR+ NSCLC: an expanded, single-arm, phase II clinical trial

BACKGROUND

This study aimed to evaluate the efficacy and safety of intrathecal pemetrexed (IP) for treating patients with leptomeningeal metastases (LM) from non-small-cell lung cancer (NSCLC) who progressed from epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) treatment in an expanded, prospective, single-arm, phase II clinical study (ChiCTR1800016615).

PATIENTS AND METHODS

Patients with confirmed NSCLC-LM who progressed from TKI received IP (50 mg, day 1/day 5 for 1 week, then every 3 weeks for four cycles, and then once monthly) until disease progression or intolerance. Objectives were to assess overall survival (OS), response rate, and safety. Measurable lesions were assessed by investigator according to RECIST version 1.1. LM were assessed according to the Response Assessment in Neuro-Oncology (RANO) criteria.

RESULTS

The study included 132 patients; 68% were female and median age was 52 years (31-74 years). The median OS was 12 months (95% confidence interval 10.4-13.6 months), RANO-assessed response rate was 80.3% (106/132), and the most common adverse event was myelosuppression (n = 42; 31.8%), which reversed after symptomatic treatment. The results of subgroup analysis showed that absence of brain parenchymal metastasis, good Eastern Cooperative Oncology Group score, good response to IP treatment, negative cytology after treatment, and patients without neck/back pain/difficult defecation had longer survival. Gender, age, previous intrathecal methotrexate/cytarabine, and whole-brain radiotherapy had no significant influence on OS.

CONCLUSIONS

This study further showed that IP is an effective and safe treatment method for the EGFR-TKI-failed NSCLC-LM, and should be recommended for these patients in clinical practice and guidelines.

Characterization of a chlorine resistant and hydrophilic TiO2/calcium alginate hydrogel filtration membrane used for protein purification maintaining protein structure

The development of membranes for protein purification has stringent requirement of disinfection resistance, low protein adsorption and anti-fouling, without changing protein structure. In this study, hydrophilic titanium dioxide (TiO2)/calcium alginate (TiO2/CaAlg) hydrogel membranes were prepared by a simple ionic cross-linking method. The effects of the porogenic agent polyethylene glycol (PEG) concentration, the molecular weight of PEG, and the concentration of TiO2 on the filtration properties were systematically investigated. The TiO2/CaAlg membrane exhibited excellent bovine serum albumin (BSA) rejection and anti-fouling properties. The mechanical properties and surface energy of the TiO2/CaAlg membrane were significantly improved. The chemical bonding mechanism of TiO2 and NaAlg was investigated by molecular dynamic simulation. The TiO2/CaAlg membrane had good chlorine resistance and could be disinfected or cleaned with sodium hypochlorite. The TiO2/CaAlg hydrogel membrane loaded with polyhydroxybutyrate (PHB) nanofibers maintained high flux (136.7 L/m2h) and high BSA rejection (98.0 %) at 0.1 MPa. The results of circular dichroism and synchronous fluorescence indicated that the secondary structure of BSA was maintained after membrane separation. This study provides one method for the preparation of green and environmentally friendly membrane for protein purification.

A bibliometric analysis of Barrett's esophagus

OBJECTIVE

Esophageal adenocarcinoma is known to have a high incidence and poor prognosis in the population and is a serious threat to public health. As a precancerous lesion of esophageal adenocarcinoma, early intervention of Barrett's esophagus is key to the prevention and treatment of esophageal adenocarcinoma.

MATERIALS AND METHODS

Research publications on Barrett's esophagus (BE) were searched in the Web of Science Core Collection, and the extracted publications were screened to obtain relevant data. The included articles were analyzed bibliometrically using Microsoft Excel 2019, Citespace V, and VOSviewer 1.6.18. The keywords used for the search can be categorized into 4 clusters: endoscopic therapy, clinical screening, risk factors, and drug therapy.

RESULTS

A total of 3,497 publications from 83 countries and 3,319 research institutions were retrieved. Since 1983, there has been a rapid increase in publications in this field. The United States (n = 1,941) and Mayo Clinic (n = 218) were the most productive countries and institutions, respectively, and the most prominent author was Kenneth K. Wang, who published 89 papers.

CONCLUSIONS

In this study, we were able to perform a comprehensive and systematic analysis of literature related to BE. Endoscopic resection and radiofrequency ablation may emerge as research hotspots for BE in the future. Our findings provide insight into the current trends in the management of BE and facilitate the choice of appropriate measures to improve the prognosis of patients.

[Efficacy and safety of bendamustine-rituximab combination therapy for newly diagnosed indolent B-cell non-Hodgkin's lymphoma and elderly mantle cell lymphoma: a multi-center prospective phase II clinical trial in China]

Objectives: This study aimed to assess the efficacy and safety of bendamustine in combination with rituximab (BR regimen) for the treatment of newly diagnosed indolent B-cell non-Hodgkin's lymphoma (B-iNHL) and elderly mantle cell lymphoma (eMCL) . Methods: From December 1, 2020 to September 10, 2022, a multi-center prospective study was conducted across ten Grade A tertiary hospitals in Shandong Province, China. The BR regimen was administered to evaluate its efficacy and safety in newly diagnosed B-iNHL and eMCL patients, and all completed at least four cycles of induction therapy. Results: The 72 enrolled patients with B-iNHL or MCL were aged 24-74 years, with a median age of 55 years. Eastern Cooperative Oncology Group (ECOG) performance status scores of 0-1 were observed in 76.4% of patients, while 23.6% had scores of 2. Disease distribution included follicular lymphoma (FL) (51.4% ), marginal zone lymphoma (MZL) (33.3% ), eMCL (11.1% ), and the unknown subtype (4.2% ). According to the Ann Arbor staging system, 16.7% and 65.3% of patients were diagnosed with stage Ⅲ and stage Ⅳ lymphomas, respectively. Following four cycles of BR induction therapy, the overall response rate was 98.6%, with a complete response (CR) rate of 83.3% and a partial response (PR) rate of 15.3%. Only one eMCL patient experienced disease progression during treatment, and only one FL patient experienced a relapse. Even when evaluated using CT alone, the CR rate was 63.9%, considering the differences between PET/CT and CT assessments. The median follow-up duration was 11 months (range: 4-22), with a PFS rate of 96.8% and an OS rate of 100.0%. The main hematologic adverse reactions included grade 3-4 leukopenia (27.8%, with febrile neutropenia observed in 8.3% of patients), grade 3-4 lymphopenia (23.6% ), grade 3-4 anemia (5.6% ), and grade 3-4 thrombocytopenia (4.2% ). The main non-hematologic adverse reactions such as fatigue, nausea/vomiting, rash, and infections occurred in less than 20.0% of patients. Conclusion: Within the scope of this clinical trial conducted in China, the BR regimen demonstrated efficacy and safety in treating newly diagnosed B-iNHL and eMCL patients.

In-Situ Fabrication of Electroactive Cu2+-Trithiocyanate Complex and Its Application for Label-Free Electrochemical Aptasensing of Thrombin

The preparation of an electroactive matrix for the immobilization of the bioprobe shows great promise to construct the label-free biosensors. Herein, the electroactive metal-organic coordination polymer has been in-situ prepared by pre-assembly of a layer of trithiocynate (TCY) on a gold electrode (AuE) through Au-S bond, followed by repetitive soaking in Cu(NO₃)₂ solution and TCY solutions. Then the gold nanoparticles (AuNPs) and the thiolated thrombin aptamers were successively assembled on the electrode surface, and thus the electrochemical electroactive aptasensing layer for thrombin was achieved. The preparation process of the biosensor was characterized by an atomic force microscope (AFM), attenuated total reflection-Fourier transform infrared (ATR-FTIR), and electrochemical methods. Electrochemical sensing assays showed that the formation of the aptamer-thrombin complex changed the microenvironment and the electro-conductivity of the electrode interface, causing the electrochemical signal suppression of the TCY-Cu²⁺ polymer. Additionally, the target thrombin can be label-free analyzed. Under optimal conditions, the aptasensor can detect thrombin in the concentration range from 1.0 fM to 1.0 μM, with a detection limit of 0.26 fM. The spiked recovery assay showed that the recovery of the thrombin in human serum samples was 97.2-103%, showing that the biosensor is feasible for biomolecule analysis in a complex sample.

Anti-Leucine-rich glioma-inactivated Protein 1 antibody-associated encephalitis complicated by minimal change nephrotic syndrome: a case report

BACKGROUND

The aim of the study was to summarize the clinical features, diagnosis and treatment of leucine-rich glioma inactivation protein 1 (LGI-1) antibody-associated encephalitis coexistence of minimal change nephrotic syndrome (MCNS), moreover, to strengthen the awareness of the disease. Increasing number of studies describe coexistence of autoimmune encephalitis and other systemic autoimmune diseases.

CASE REPORT

Here we report a case of a patient with anti- LGI1 antibody-associated encephalitis, who presented with cognitive dysfunction, faciobrachial dystonic seizures (FBDS), sleep disturbance, and hyponatremia. Treatment with immunoglobulins, corticosteroids, levetiracetam and oxcarbazepine was proven effective for this patient. The patient had a history of MCNS diagnosed by renal biopsy and responded to treatment with low dose of oral corticosteroids.

CONCLUSIONS

This case expanded the spectrum of autoimmune comorbidities in patients with anti-LGI1 encephalitis.

[Clinicopathological characteristics and differential diagnosis of 6 cases of congenital granular cell tumor]

To provide references for the diagnosis and treatment of congenital granular cell tumor (CGCT), by comprehensive analysis of the clinical data, histopathological and immunohistochemical results. Patients with CGCT were involede, from March 2015 to November 2020, at the Department of Oral and Maxillofacial Surgery of the First Affiliated Hospital of Zhengzhou University. A total of 6 children, aged 3-16 days, 1 male and 5 female, 5 maxillary and 1 mandibular, with maximum tumor diameter of 6-70 mm, were included. The lesions of CGCT were single and connected to the alveolar ridge by a pedicle. The surface of the tumor was covered with a vascular network, and two cases had ulcers on the surface of the tumor. All 6 cases had the tumor removed surgically and there was no recurrence or metastasis in the follow-up visit. Although CGCT is rare, it is a benign tumor and generally does not recur or metastasize after surgery, and has a good prognosis. The prenatal imaging, clinical manifestations after delivery, pathological characteristics and immunohistochemical analyses may provide reference for early diagnosis and treatment of CGCT.

Experimental Investigation of the Effect of the Bubble Cone on the Cooling Jets used in the Blown Film Manufacturing Process

An experimental investigation was performed to characterize the flow field produced by a dual-lip air ring used in the blown-film manufacturing process for a solid model with a blow-up ratio of 3.5 similar to the shape of a typical LLDPE bubble. Distributions of the static and fluctuating pressure on the model and the flow field above the forming cone were measured for a range of settings on the dual-lip air ring. It was found that the distribution of the pressure on the bubble below the forming cone had many features similar to the measurements for a bubble with a blow-up ratio of 2.5 [1]. In the region above the forming cone, the upper jet appeared to merge with the lower jet rather than entraining the lower jet as was observed for a bubble with a blow-up ratio of 2.5 [1]. This resulted in a smaller local maximum in the normalized fluctuating pressure in the region above the forming cone and would likely result in less heat transfer in this region. It was also found that the initial angle of the upper jet exiting the air ring changed when the height of the bubble cone was adjusted for the bubble with the blow-up ratio of 3.5. This affected the static pressure in the region below the location where the upper jet attaches to the bubble and the pressure fluctuations in the region where the upper jet attaches to the surface. Finally, unlike the bubble with the blow-up-ratio of 2.5 [1], the presence of the bubble cone caused a region of negative gauge pressure in the region above the forming cone that should act to stabilize the bubble against the bubble cone. The pressure in this region and the region below the forming cone both decreased when the porosity of the bubble cone was reduced.

[Assessment of the quality of life of mandibular ameloblastoma patients after reconstruction with double-barrel fibula flap]

Objective: To analyse the quality of life of patients receiving repair of bone defect with folded fibula flap after removal of mandibular ameloblastoma. Methods: The case data of 39 patients with ameloblastoma admitted to the First Affiliated Hospital of Zhengzhou University from August 2013 to April 2016 were retrospectively analysed, including 21 males and 18 females, from 18 to 58 years old. 3D printing and digital technology were used in flap preparation before surgery in all patients. The folded fibular flaps were used to repair mandibular defects and the implants were placed between 6-9 months after surgery. The short form-36 health survey questionnaire (SF-36) and the university of Washington quality of life questionnaire (UW-QOL) were applied to evaluate the quality of life of patients before surgery and at 6 months and 24 months after surgery. The higher the score, the better the condition. SPSS 20.0 was adopted for statistical analysis. Results: The SF-36 survey showed that the mean score of body role before surgery (72.4±11.7) was significantly higher than that at 6 months after surgery (39.6±11.1, t=23.580, P<0.05) or that at 24 months after surgery (59.8±6.4, t=8.358, P<0.001). Compared with the preoperative mean scores of Physical Pain (73.0±11.0), General Health (73.4±10.4) and Health Changes (79.2±3.9) before surgery, the mean scores Physical Pain (53.1±7.7), General Health (53.5±7.5) and Health Changes (63.9±11.7) at 6 months after surgery were decreased significantly respectively (t=13.068, 13.756 and 10.880, respectively, all P<0.05), but the mean scores Physical Pain (78.8±14.0), General Health (80.9±12.6) and Health Changes (84.4±4.6) at 24 months after surgery were increased significantly respectively (t=-2.904, -4.027 and -7.586, respectively, all P<0.05), with significant differences in the mean scores of Physical Pain, General Health and Health Changes between 6 and 24 months after surgery (t=-14.241, -16.490, -14.294, respectively, all P<0.001). The UW-QOL survey showed that the mean scores of chewing, language and taste functions decreased at 6 months after surgery (53.1±6.7, 53.0±7.7 and 62.2±9.9, respectively), but improved at 24 months after surgery (67.9±3.9, 63.9±2.9 and 68.4±11.1, respectively), with statistically significant difference (t=-16.765, -11.675 and 2.498, respectively, all P<0.001). Conclusion: The application of folded fibula flaps to repair bone defects after sugery of mandibular ameloblastoma can better meet the needs of language and chewing functions and improve the quality of life of patients.

Clinical value of contrast-enhanced ultrasonography in focal hypoechogenic lesions of thyroid

OBJECTIVE

The objectives of this study were to analyze the accuracy of contrast-enhanced ultrasonography (CE-US) in diagnosing focal hypoechogenic lesions of the thyroid (FHLT), and to explore the clinical value of CE-US in the diagnosis of FHLT.

METHODS

Patients undergoing CE-US and ultrasound-guided fine needle aspiration (US-FNA) of FHLT at First Hospital of China Medical University between January 2017 and December 2018 were selected for the study; this included patients with papillary thyroid carcinoma (PTC), subacute thyroiditis (SAT) and focal Hashimoto thyroiditis (FHT). All patients underwent color Doppler ultrasonography (CD-US) after which thyroid image reporting and data system (TI-RADS) grading were done. Then, each patient underwent CE-US and US-FNA. The results of the CE-US were analyzed using descriptive statistics. The cytopathological results from the US-FNAs were the gold standard used to confirm the diagnoses.

RESULTS

A total of 56 patients were selected for the study. In the PTC group (n = 16), grading was as follows: TI-RADS4a, n = 3; TI-RADS4b, n = 12; and TI-RADS4c, n = 1. More patients with PTC showed heterogeneous hypoenhancement (n = 15) than heterogeneous isoenhancement (n = 1) on CE-US. In the SAT group (n = 24), grading was as follows: TI-RADS3, n = 1; TI-RADS4a, n = 18; TI-RADS4b, n = 5. Fewer patients with SAT showed heterogeneous hypoenhancement (n = 2) than heterogeneous isoenhancement (n = 22) on CE-US. In the FHT group (n = 16), grading was as follows: TI-RADS3, n = 1; TI-RADS4a, n = 11; TI-RADS4b, n = 4. Of those in the FHT group, one patient showed heterogeneous isoenhancement, one patient showed heterogeneous hypoenhancement, and 14 showed uniform isoenhancement on CE-US. The diagnostic accuracy of CD-US alone differed significantly from that of CD-US + CE-US (p < 0.05).

CONCLUSION

CE-US has a high diagnostic accuracy for FHLT and can be used to identify PTC, SAT, and FHT.

Non-invasive SERS serum detection technology combined with multivariate statistical algorithm for simultaneous screening of cervical cancer and breast cancer

Surface-enhanced Raman scattering (SERS), as a rapid, reliable and non-destructive spectral detection technology, has made a series of breakthrough achievements in screening and pre-diagnosis of various cancerous tumors. In this paper, high-performance gold nanoparticles/785 porous silicon photonic crystals (Au NPs/785 PSi PhCs) active SERS substrates were specially designed for serum testing, and realized highly sensitive detection of serum from healthy people, patients with cervical cancer and breast cancer. Based on the SERS spectra of the three groups of serum, the significant differences between the healthy group and cancer group at 1030 cm^-1 and 1051 cm^-1 were analyzed, and the similar but different serum SERS spectra of cervical cancer and breast cancer patients were compared. In addition, the spectral difference detected by SERS technology combined with a multivariate statistical algorithm was used to distinguish three kinds of serum. The serum SERS spectral sensitive bands were extracted by recursive weighted partial least squares (rPLS), and the three classification diagnosis models were established by combining orthogonal partial least squares discriminant analysis (OPLS-DA), linear discriminant analysis (LDA) and principal component analysis support vector machine (PCA-SVM) for synchronous classification and discrimination of the three groups of serum. The diagnostic results showed that the overall screening accuracy of three models were 93.28%, 97.77% and 94.78%, respectively. These above results confirmed that the Au NPs/785 PSi PhCs can realize super-sensitive detection of serum, and the established diagnostic model has great potential for pre-diagnosis and simultaneous screening of cervical cancer and breast cancer.

Correlations of IL-6 and IL-10 gene polymorphisms with childhood acute lymphoblastic leukemia

OBJECTIVE

The aim of this study was to investigate the correlations between interleukin-6 (IL-6) and IL-10 gene polymorphisms with childhood acute lymphoblastic leukemia.

PATIENTS AND METHODS

Specimens were collected from 200 children with acute lymphoblastic leukemia (disease group) and 200 normal children (control group) in our hospital. DNA was extracted from peripheral blood nucleated cells in both groups to detect the gene polymorphisms rs2069830 and rs2069836 of IL-6, as well as rs3024489 and rs3024493 of IL-10. Then, the content of serum IL-6 and IL-10 was determined via enzyme-linked immunosorbent assay (ELISA).

RESULTS

It was found that there were differences in the distribution of alleles of IL-6 gene polymorphism rs2069830 (p=0.000) and IL-10 gene polymorphism rs3024493 (p=0.007) between the disease group and control group. The frequency of T allele of IL-6 gene polymorphism rs2069830 was higher, while that of IL-10 gene polymorphism rs3024493 was lower in the disease group. Besides, the differences in the distribution of genotypes of IL-6 gene polymorphism rs2069830 (p=0.000) and IL-10 gene polymorphism rs3024493 (p=0.000) were also observed between the disease group and control group. Moreover, the disease group had higher frequencies of TT genotype of IL-6 gene polymorphism rs2069830 and TA genotype of IL-10 gene polymorphism rs3024493. The frequencies of dominant model of IL-6 gene polymorphism rs2069830 (p=0.048) and recessive model of IL-10 gene polymorphism rs3024493 (p=0.000) in the disease group were different from those in the control group. In addition, the frequency of CC + CT dominant model of IL-6 gene polymorphism rs2069830 was lower, and the frequency of TA + AA recessive model of IL-10 gene polymorphism rs3024493 was higher in the disease group. There were differences in haplotypes CG (p=0.001), CT (p=0.007), and TG (p=0.000) of IL-6 gene, as well as haplotypes AA (p=0.002) and AT (p=0.005) of IL-10 gene between disease group and control group. Furthermore, the content of IL-6 in the serum was associated with the genotypes of IL-6 gene polymorphism rs2069830 (p<0.05), whereas the children with acute lymphoblastic leukemia carrying CT genotype had remarkably higher content of serum IL-6. The genotypes of IL-6 gene polymorphism rs2069830 was notably related to white blood cell (WBC) (p=0.002), and the WBC level was higher in children with CT genotype. The genotypes of IL-10 gene polymorphism rs3024489 had prominent correlations with platelet (PLT) (p=0.043), and the children with AA genotype had a higher PLT level. In addition, the genotypes of IL-10 gene polymorphism rs3024493 were evidently correlated with hemoglobin, which was significantly higher in children carrying TA genotype.

CONCLUSIONS

The gene polymorphisms of IL-6 and IL-10 are significantly correlated with the susceptibility to and pathogenesis of childhood acute lymphoblastic leukemia.

[Application of the posteromedial thigh flap for oral and maxillofacial defect reconstruction]

To explore the feasibility of using the posteromedial thigh flap as an alternative source for oral and maxillofacial reconstruction. During January 2019 to January 2020, twenty-three patients underwent oral and maxillofacial tumor ablation and defect reconstruction with 23 posteromedial thigh flaps were enrolled in the Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhengzhou University. Thirteen of the patients were male and ten were female, with age of (54.5±9.7) years (33-72 years). The numbers and types of perforators, the dimension of flap and the vascular pedicle length were measured. The outcomes of flaps and donor-site complication were recorded. The patients' satisfaction with donor-site cosmesis were evaluated by the visual analogue scale (VAS). More than one sizable perforators was found in each case and the median number of perforators was 2 (range, 1 to 4), and all of the perforators were musculocutaneous. The pedicle length was (9.8±1.5) cm (range, 7.3 to 13.4 cm). The diameters of artery and the larger vein were 2.0 mm (range, 1.5 to 2.5 mm) and 2.0 mm (range, 1.5 to 3.0 mm), respectively. The dimension of the flaps ranged from 8 cm×6 cm to 12 cm×8 cm, and the donor sites were all closed primarily. All of the flaps were clinically survived, only one patient experienced partial wound dehiscence of donor site 14 days postoperatively and no donor site infection or permanent muscular weakness was reported. The VAS scores of the patients' satisfaction with donor-site cosmesis were all more than 8. The perforators of the posteromedial thigh flap is consistent and the donor-site scar is well concealed, which make the posteromedial thigh flap an excellent option for oral and maxillofacial reconstruction.

Associations of BRAF V600E, clinical pathology and imaging factors with the recurrence rate of papillary thyroid microcarcinoma

In the present study, the recurrence rate of papillary thyroid microcarcinoma (PTMC) was assessed by analyzing postoperative follow-up data of affected patients and its associations with BRAF V600E, clinical pathology and imaging factors were explored. A total of 506 patients with PTMC were selected who underwent surgery from January 2014 to March 2016. The maximal diameter of thyroid nodules was ≤1 cm and all patients who underwent BRAF V600E testing and evaluation for lymph node metastasis. Postoperatively, each patient was regularly followed up to detect recurrence. Categorical variables were comparatively analyzed using univariate Cox linear regression analysis to screen for protective and adverse factors influencing recurrence of PTMC. A stepwise Cox proportional hazards regression model analysis was performed to explore risk factors affecting recurrence. Among the 506 patients, 477 were followed up, 29 were lost to follow-up and 26 patients experienced recurrence. The 5-year recurrent rate of PTMC was 5.45%. The univariate Cox regression analysis indicated that PTMC recurrence was influenced by BRAF V600E, sex, multifocality, capsular invasion and lateral cervical lymph node metastasis (P<0.05), but not by age, tumor location on the thyroid, size, single central lymph node metastasis, distant metastasis and operative approach (P>0.05). The significant factors associated with recurrent PTMC were subjected to stepwise multivariate Cox proportional hazards regression model analysis and the results indicated that BRAF V600E, sex, multifocality and lateral cervical lymph node metastasis were independent factors influencing recurrence in patients with PTMC, with a statistically significant difference (P<0.05). In conclusion, BRAF V600E, sex, multifocality and lateral cervical lymph node metastasis are independent risk factors for recurrent PTMC.

[Pleural effusion as the first manifestation of pleural isolated myeloid sarcoma: a case report and literature review]

Objective: To analyze the clinic features of isolated myeloid sarcoma (IMS) involving the pleural cavity. Methods: A case of pleural isolated myeloid sarcoma (PIMS) with pleural effusion as the first manifestation was described. The related cases in literatures were reviewed with"myeloid sarcoma"and"pleural effusions"as the keywords to search China HowNet, Wanfang database and PubMed database. Results: A 59-year-old man complained of right chest pain for 2 months and worsening pain with distress and shortness of breath for 2 weeks. The chest CT scan showed pleural effusion on the right side. Flow cytometric analysis of pleural fluid showed that a population of blasts with CD₃₄ expressing was 37.6% of the total nucleated cells. The pleural biopsy through medical thoracoscopy indicated lymphoproliferative lesions by pathological examination. Immunohistochemistry was performed on pleural histological sections and cell blocks of pleural effusions, which showed CD₃₄ and CD₁₁₇ positive expression. The diagnosis of PIMS was finally made. Two literature papers with 2 complete cases were found and reviewed. The 3 cases were analyzed. There were 2 males and 1 female. The age was 59, 51, 56 years respectively. One case was a patient with 3 weeks of right upper quadrant and epigastric pain, nausea, and weight loss. Cytological examination of the pleural fluid showed numerous poorly differentiated malignant cells. Histology from an open laparotomy in duodenal biopsies, gallbladder, and mesenteric lymph nodes supported the diagnosis of IMS. The other case was a patient with 6 weeks of dyspnea and a large swelling in the upper vestibular region. Thoracentesis showed 82% myeloid blasts in the pleural fluid. A gingival biopsy showed a diffuse infiltration by cells with a blastic appearance and supported IMS. Conclusion: PIMS was a very rare cause of pleural effusions. The cytological and histopathological evidences were useful to diagnose IMS involving the pleural cavity.

Synthetic MUC1 breast cancer vaccine containing a Toll-like receptor 7 agonist exerts antitumor effects

Adjuvant immunotherapy has recently emerged as a potential treatment strategy for breast cancer. The tumor-associated protein mucin 1 (MUC1) has received increasing attention due to its high expression in numerous types of common tumors, in which MUC1 acts as a cancer antigen. However, the simple mixed composition of an adjuvant and a peptide is not a sufficient rationale for a MUC1 peptide-based vaccine. The present study developed a novel Toll-like receptor 7 (TLR7) agonist-conjugated MUC1 peptide vaccine (T7-MUC1), which elicited an effective immune response and a robust antitumor effect in a mouse breast cancer model. In vitro, T7-MUC1 significantly increased the release of cytokines in mouse bone marrow dendritic cells and spleen lymphocytes, and induced the dendritic cell-cytokine-induced killer response against tumor cells with high MUC1 expression. In vivo, it was observed that the 4T1 tumor weights in mice immunized with the T7-MUC1 conjugate were reduced by ≥70% compared with those in the control group. Furthermore, the therapeutic responses in vivo were attributed to the increase in specific humoral and cellular immunity, including high antibody titers, antibody-dependent cell-mediated cytotoxicity and cytotoxic T-lymphocyte activity. The percentages of CD3⁺/CD8⁺ T-cells were significantly higher in the T7-MUC1 treatment group compared with those in the control group. Therefore, the results of the present study suggested that the T7-MUC1 vaccine inhibited tumor growth in mice and thus may have potential as a therapeutic candidate in clinical trials for breast cancer immunotherapy.

Correlation between FAK and EGF-Induced EMT in Colorectal Cancer Cells

Epithelial-mesenchymal transition (EMT) plays an important role in the invasion and metastasis of colorectal cancer, which is mediated by FAK and EGF. However, whether FAK participates in EMT in colorectal cancer cells through the EGF/EGFR signaling pathway remains unknown. The aim of this study was to investigate the effector mechanisms of FAK in the process of EGF-induced EMT in colorectal cancer cells and to determine whether miR-217 is involved in this process. Caco-2 cancer cells were routinely cultured with and without treatment with 100 ng/mL EGF, and changes in cell morphology were observed using an inverted microscope. In addition, a transwell assay was used to detect cell migration under the condition of EGF treatment. The expression of FAK, pFAK, E-cadherin, vimentin, and β actin was assessed by western blotting, and the expression of miR-217 was assessed using real-time PCR. We found that EGF induced EMT in colorectal cancer cells and enhanced cell migration and invasion ability. Moreover, FAK was involved in the EGF-induced EMT of colorectal cancer cells. EGF upregulated the expression of E-cadherin in colorectal cancer cells by activating FAK, and miR-217 was found to participate in EGF-induced EMT in colorectal cancer cells. Our findings indicate that EGF induces EMT in colorectal cancer cells by activating FAK, and miR-217 is involved in the EGF/FAK/E-cadherin signaling pathway.

Association of SOX11 gene expression withclinical features and prognosis of mantle cell lymphoma

OBJECTIVE

To study the expression of SOX11 in the patients with mantle cell lymphoma (MCL) and explore the clinical values of SOX11 in MCL.

PATIENTS AND METHODS

In the paraffin-embedded MCL tissues of 75 patients diagnosed in the Department of Hematology, Shanxi Tumor Hospital, were performed the immunohistochemical labeling of Ki67 and SOX11 by the EnVision method. Meanwhile, the expression of SOX11 mRNA was also detected by reverse transcriptase-polymerase chain reaction (RT-PCR), and the association of SOX11 with such prognostic indexes as pathological typing, staging, immunophenotyping, and MIPI was analyzed using the statistical method.

RESULTS

The immunohistochemistry showed that 97% of cases expressed SOX11 positive, and the RT-PCR results showed that the expression of SOX11 mRNA in the MCL patients was significantly higher than those with reactive hyperplasia lymphoid [3.097 (1.311, 6.216) and 1.058 (0.302, 2.623, respectively (p<0.05). Higher expression of SOX11 mRNA was positively correlated with some good prognostic factors such as ECOG<2, no bone marrow involvement and low-risk according to the International Prognostic Index (IPI). The comparison of the survival curves between group SOX11 mRNA <M and SOX11 mRNA≥M showed the median survival in the former was shorter than that in the latter, which was 27 months and 50 months, respectively. There was a significant difference between the two groups.

CONCLUSIONS

The expression of SOX11 in MCL patients is significantly higher than normal controls, which can be used as a diagnostic index. Upregulated SOX11 may be a good prognostic factor in MCL patients.

Creation and annihilation of topological meron pairs in in-plane magnetized films

Merons which are topologically equivalent to one-half of skyrmions can exist only in pairs or groups in two-dimensional (2D) ferromagnetic (FM) systems. The recent discovery of meron lattice in chiral magnet Co₈Zn₉Mn₃ raises the immediate challenging question that whether a single meron pair, which is the most fundamental topological structure in any 2D meron systems, can be created and stabilized in a continuous FM film? Utilizing winding number conservation, we develop a new method to create and stabilize a single pair of merons in a continuous Py film by local vortex imprinting from a Co disk. By observing the created meron pair directly within a magnetic field, we determine its topological structure unambiguously and explore the topological effect in its creation and annihilation processes. Our work opens a pathway towards developing and controlling topological structures in general magnetic systems without the restriction of perpendicular anisotropy and Dzyaloshinskii–Moriya interaction.

A meron is one half of a skyrmion but whether a single meron pair can be created and stabilized remains a challenging question. Here, Gao et al. develop a method to create and stabilize individual pairs of merons in a continuous Py film by local vortex imprinting from Co disks.

Targeting the HMGA2 oncogene by miR-498 inhibits non-small cell lung cancer biological behaviors

OBJECTIVE

Previous study reported that miR-498 served as a tumor suppressor in non-small cell lung cancer (NSCLC), but the underlying mechanism remains largely unknown. The aim of this study is to investigate the role of miR-498 and its target gene HMGA2 in NSCLC progression.

PATIENTS AND METHODS

The expression of miR-498 was assessed in clinical NSCLC specimens and cell lines using RT-PCR. Overexpression of miR-498 and transfection of pLenti-HMGA2 were performed in A549 cells. Cell proliferation, apoptosis, migration, and invasion were determined using cell counting kit-8 (CCK-8) assay, clone formation assay, flow cytometry, and transwell assay, respectively. Luciferase reporter assays were performed to analyze the regulation of putative target of miR-498. Western blot was used to detect the levels of HMGA2 in A549 cells.

RESULTS

MiR-498 was found to be down-regulated in NSCLC tissues and cell lines. After miR-498 mimics transfection, cell proliferation, migration, and invasion were significantly suppressed in the NSCLC cells. Mechanistically, bioinformatic analysis predicted that miR-498 may target the 3'-UTR of HMGA2 and suppressed its translation, and was further confirmed by luciferase assay. Furthermore, restoration of HMGA2 expression completely rescued the inhibitory effect of miR-498 in NSCLC cells.

CONCLUSIONS

This paper revealed that miR-498 may serve as a tumor suppressor in NSCLC through targeting HMGA2, suggesting that miR-498 could represent a novel target for effective therapies.

[Correlation study of peripheral blood inflammatory factors in patients with sudden deafness]

Objective:The aim of this study is to compare the difference of inflammatory factors in peripheral blood between sudden deafness patients and normal people, and to evaluate the predictive value of inflammatory factors in hearing recovery of sudden deafness patients. Method:Seventy-two inpatients with sudden deafness and 19 healthy persons were included. At the beginning of treatment in our hospital, audiometry was performed and peripheral blood was collected. The levels of IL-1β, IL-6, IL-17α, TGF-β1 and TNF-α in peripheral blood were detected by ELISA. The treatment was intravenous steroid（not applied if patients with contraindication of systemic steroid application）+ intratympanic steroid injection+ microcirculation improvement or neurotrophic therapy+ hyperbaric oxygen. At the end of the treatment, audiometry was performed again. A total of 26 patients were collected to test the levels of inflammatory factors in peripheral blood again at the end of the treatment. Result:The mean levels of inflammatory factors IL-1β, IL-6, IL-17α, TGF-β1 and TNF-α in peripheral blood of patients were （2.66±9.57） pg/ml, （4.71±6.91） pg/ml, （19.33±32.27） pg/ml, （50 018.37±14 660.72） pg/ml, （1.52±2.40） pg/ml, respectively. And the level of these five inflammatory factors in normal persons were （3.61±9.82） pg/ml, （3.58±4.49） pg/ml, （11.64±13.29） pg/ml, （45 199.98±11 956.09） pg/ml，（1.09±1.08） pg/ml respectively. Statistical analysis showed no significant difference between these two groups. A total of 45 cases were effective（hearing threshold increased ≥15 dB） and 27 cases were ineffective（hearing threshold increased<15 dB）. There was no significant difference in the levels of inflammatory factors between the two groups. Among 26 patients with blood samples before and after treatment, the level of TGF-β1 after treatment was significantly lower than that before treatment. Conclusion:The levels of these five inflammatory factors including IL-1β, IL-6, IL-17α, TGF-β1 and TNF-αin peripheral blood could not predict the recovery of sudden hearing loss. The role of inflammation in the development of sudden deafness needs further confirmation. TGF-β1 may be involved in the development of sudden deafness.

Evaluation and comparison of the diagnostic performance of routine blood tests in predicting liver fibrosis in chronic hepatitis B infection

Background & aims: Biopsy is the gold standard for staging liver fibrosis, but it may be accompanied by complications. As an alternative, non-invasive markers such as transient elastography (for liver fibrosis) and certain combinations of routine blood markers (liver function tests, full blood count) have been developed although their clinical significance remains controversial. Here, we compare the diagnostic values of non-invasive markers for liver fibrosis in patients with chronic hepatitis B infection. Methods: Transient elastography and routine laboratory tests were performed in 196 patients. Diagnostic performances were compared and were assessed based on the area under the curve (AUC) of a receiver operating characteristic (ROC) analysis. Results: Elevated GGT to platelet ratio (GPR), the fibrosis index FIB-4 [based on age, AST, platelets and ALT], platelet to lymphocyte ratio (PLR) and total bilirubin were independent predictors of liver stiffness defined by transient elastography (all P < 0.001). The AUCs of GPR in predicting both advanced fibrosis and cirrhosis were significantly larger than that of FIB-4 (P = 0.037 and P = 0.008, respectively) and AST-to-platelet ratio index (APRI) (P = 0.008 and P = 0.005). FIB-4, APRI and red cell volume distribution width-to-platelet ratio (RPR) had similar diagnostic values in discriminating different levels of liver fibrosis. Conclusions: GPR showed the best diagnostic value and RPR and PLR are easily available and inexpensive markers in evaluating fibrosis and cirrhosis. The diagnostic values of these laboratory markers are useful in diagnosing advanced fibrosis or cirrhosis, and in confirming the different levels of liver fibrosis.

A novel rice grain size gene OsSNB was identified by genome-wide association study in natural population

Increasing agricultural productivity is one of the most important goals of plant science research and imperative to meet the needs of a rapidly growing population. Rice (Oryza sativa L.) is one of the most important staple crops worldwide. Grain size is both a major determinant of grain yield in rice and a target trait for domestication and artificial breeding. Here, a genome-wide association study of grain length and grain width was performed using 996,722 SNP markers in 270 rice accessions. Five and four quantitative trait loci were identified for grain length and grain width, respectively. In particular, the novel grain size gene OsSNB was identified from qGW7, and further results showed that OsSNB negatively regulated grain size. Most notably, knockout mutant plants by CRISPR/Cas9 technology showed increased grain length, width, and weight, while overexpression of OsSNB yielded the opposite. Sequencing of this gene from the promoter to the 3’-untranslated region in 168 rice accessions from a wide geographic range identified eight haplotypes. Furthermore, Hap 3 has the highest grain width discovered in japonica subspecies. Compared to other haplotypes, Hap 3 has a 225 bp insertion in the promoter. Based on the difference between Hap 3 and other haplotypes, OsSNB_Indel2 was designed as a functional marker for the improvement of rice grain width. This could be directly used to assist selection toward an improvement of grain width. These findings suggest OsSNB as useful for further improvements in yield characteristics in most cultivars.

Grain weight, including grain length and grain width, is a complex trait, and hundreds of quantitative trait loci (QTLs) were detected in different genetic rice populations. However, only about 10 genes have been isolated and characterized until now. Nine QTLs for grain size were identified by genome-wide association study in a natural rice population. The novel grain size gene OsSNB was identified from qGW7 based on the difference of expression levels between two different varieties with significantly different grain width. OsSNB is an AP2 transcription factor that is negatively regulated grain size. However, OsSNB was found to regulate the transition from the spikelet meristem to the floral meristem and the floral organ development in previous study. Compared to other haplotypes, Hap 3 has a 225 bp insertion in the promoter. Based on the difference between Hap 3 and other haplotypes, OsSNB_Indel2 was designed as a functional marker for the improvement of rice grain width. This can be directly used to assist selection for grain width improvement.

An outbreak of strangles associated with a novel genotype of Streptococcus equi subspecies equi in donkeys in China during 2018

BACKGROUND

Strangles is a highly contagious respiratory disease of equids caused by the bacterium Streptococcus equi subspecies equi.

OBJECTIVES

To identify the cause of an outbreak of strangles that occurred on donkey farms within the Shandong Province of China and determine the prevalence of the disease.

STUDY DESIGN

Cross-sectional.

METHODS

Samples were taken from clinically affected animals to measure the prevalence of strangles within the population of donkeys at six intensive farms in China and identify the SeM type of isolate recovered from affected animals. Diagnosis was confirmed by bacterial isolation, biochemical tests and PCR. Epidemiological data were analysed using Chi-square test and a Fisher's exact two-sided test. The SeM gene of S. equi isolates recovered from affected animals was determined and compared with the SeM database PubMLST-seM.

RESULTS

In July and August 2018, an outbreak of strangles occurred on six donkey farms within the Shandong Province of China. The overall prevalence of disease within the different donkey herds was 13.4%. Younger animals were worst affected with 40.3% (83/206) of donkey foals aged under 1 year exhibiting clinical signs compared with 12.5% (191/1525) of donkeys aged one to 2 years and 3.8% (17/442) of donkeys over 2 years of age. Analysis of SeM sequencing data identified that the farms were affected by the same strain of S. equi, SD201807, which contains the novel 136 allele of SeM.

MAIN LIMITATIONS

Healthy donkeys were not sampled in this study.

CONCLUSIONS

The number of intensive donkey breeding farms in China has risen recently. The higher numbers of animals that are in closer proximity to one another raise the potential for the transmission of infectious diseases such as strangles. This is the first description of a strangles outbreak among donkey herds in China. The Summary is available in Chinese - see Supporting information.

Association between rs1800629 polymorphism in tumor necrosis factor-α gene and dilated cardiomyopathy susceptibility: Evidence from case-control studies

OBJECTIVE

Several published studies have investigated the association between the -308G/A (rs1800629) polymorphism in the tumor necrosis factor-α (TNF-α) gene and the risk of dilated cardiomyopathy (DCM). However, the TNF-α gene polymorphism has a controversial role in the pathogenesis of DCM among different populations. In the present study, a meta-analysis was performed to resolve this inconsistency.

METHODS

Potentially eligible papers reporting an association between the TNF-α rs1800629 polymorphism and DCM susceptibility were searched in 4 databases including PubMed, EMBASE, Chinese Biomedical Database (CBM), and the Cochrane Library up to April 1, 2018. The odds ratio (OR) with its 95% confidence interval (CI) was used to estimate the strength of the associations. Subgroup analysis based on the ethnicity, studies with or without ischemic and valvular DCM was conducted. Publication bias detection was conducted using Begg test.

RESULTS

Nine papers detailing case-control studies were included, reporting a total of 1339 DCM cases and 1677 healthy controls. The meta-analysis results indicated that TNF-α rs1800629 was associated with increased DCM susceptibility in the populations studied under the heterozygous model (AG vs GG: OR = 1.91, 95% CI = 1.05-3.50, P = .035) and dominant model (AG + AA vs GG: OR = 1.87, 95% CI = 1.01-3.45, P = .046). In the subgroup analysis for ethnicity, rs1800629 polymorphism was significantly associated with the susceptibility of DCM for Asians under the 5 models (A vs G: OR = 2.87, 95% CI = 1.56-5.30, P = .001; AA vs GG: OR = 3.95, 95% CI = 1.13-13.82, P = 0.031; AG vs GG: OR = 3.8, 95% CI = 1.57-9.19, P = .003; AA vs GG + AG: OR = 2.51, 95% CI = 1.41-4.49, P = .002; AG + AA vs GG: OR = 3.77, 95% CI = 1.54-9.20, P = .004).

CONCLUSION

There may be a moderate association between TNF-α rs1800629 polymorphism and DCM susceptibility in the whole populations studied; however, TNF-α rs1800629 polymorphism was significantly associated with the susceptibility of DCM for Asians, which indicates that such associations may be different between ethnicities.

[Observation and prevention measures against adverse reaction to intratympanic corticosteroid injections]

Objective:To investigate clinical characteristic and incidence of the adverse reaction to tympanic injection. The incidence rates of adverse reaction were also compared after improvement of anesthetic method and changed ratio of methylprednisolone. Method: A retrospective analysis of 712 cases (1 928 injections) of receiving injection in a medical center, to explore the overall and classified adverse reactions, as well as effects of age and gender and frequency on adverse reactions. According to the clinical characteristics of the early stage, the incidence of adverse reaction was observed after the application of anesthesia warming method and the change of methylprednisolone ratio. Result: Adverse reaction was found in 76 cases which included 62 cases of mild reactions, 4 cases of severe reactions and 10 cases of glucocorticoid-related reactions. Overall, 10.67% of patients had adverse reactions. There was no correlation between adverse reactions and age, gender or frequency. The incidence of vertigo was decreased after the application of improved anesthesia (P<0.05). The incidence of pain of joint methylprednisolone-and-lidocaine injection was lower than that of methylprednisolone injection (P<0.05). Conclusion: Intratympanic injection is a safe treatment, to some extent, although there is low incidence of adverse effects of it. At the same time, anesthetic warming method and changing the ratio of methylprednisolone can further reduce the incidence of vertigo and pain.

[Assessment of the quality of life of mandible defect after reconstruction with fibula flap]

Objective: To evaluate the quality of life (QOL) of patients who underwent resection of mandible and reconstruction by fibula flap. Methods: A total of seventy six patients who underwent resection of mandible and reconstruction by fibula flap admitted to The First Affiliated Hospital of Zhengzhou University from January 2013 to August 2016 were prospectively analyzed. In the preoperative and postoperative 3 month, 12 months, the QOL of these patients were assessed by using the 14-item oral health impact profile questionnaires (OHIP), The University of Washington quality of life (UW-QOL) and the European organization for research and treatment of cancer quality of life questionnaire head and neck module (EORTC-QLQ-H&N). Results: The OHIP-14 questionnaire showed the highest score of the three months after surgery was mental discomfort (73.0±11.9) and psychological disorder (72.1±11.9), and it was difficult to be relieved over time. In the 12 months after surgery, the lowest scores were physiological pain (35.0±8.6) and disability (37.5±10.2), and 87% (66/76) patients thought that the flap repair worked well. The UW-QOL questionnaire showed that the scores of the patients' chewing, taste and salivary were significantly reduced by 3 months after the operation, and they were still unable to recover to preoperative level 12 months after surgery. The EORTC-QLQ-H&N35 questionnaire showed that swallowing, language, and diet scored higher in the three months after surgery, but could be restored to preoperative levels 12 months after surgery. The score was higher in 12 months after the operation than before surgery and was related to radiotherapy in some patients. Conclusions: Using fibula flap to repair the mandible defect can restore the patient's jaw function and improve the quality of life of the patients.

Corneal integrity and thickness of central fovea after phacoemulsification surgery in diabetic and nondiabetic cataract patients

INTRODUCTION

Here we intended to investigate the changes in corneal endothelial cells and foveal thickness after phacoemulsification surgery on the eyes of diabetic and non-diabetic cataract patients.

MATERIAL AND METHODS

A total of 120 cataract patients who were scheduled for phacoemulsification surgery and intraocular lens implantation were recruited and divided into 2 categories according to the diagnosis of diabetes mellitus. Changes in integrity, endothelial cell density (ECD), coefficient of variation (CV), percentage of hexagonal cells (PHC), central corneal thickness (CCT), and central foveal thickness (CFT) were all recorded at preoperative day 1 and postoperative day 3, 1 week, 1 month, 3 months and 6 months.

RESULTS

None of the recorded variables showed any difference between the nondiabetic and diabetic groups before surgery (p > 0.05). During the postoperative 6 months, ECD and PHC decreased and CV increased in both groups (all p_time < 0.05), whereas CCT and CFT fluctuated in both groups significantly (both p_time < 0.05), with their individual peaks at postoperative 1 week in the diabetic group. The groups differed significantly in ECD, PHC, and CV at each time point postoperatively (all p_group < 0.05). Furthermore, the diabetic group had improved CFT during the postoperative 1 month and higher CCT during the 6 months postoperatively than the nondiabetic group (all p_group < 0.05). The time and group interactions were significant for ECD, CV, PHC, CCT and CFT (all p_{group × time} < 0.05).

CONCLUSIONS

The diabetic group had more changes in corneal endothelial cells and foveal thickness than the nondiabetic group postoperatively.

Gastric cancer vaccines synthesized using a TLR7 agonist and their synergistic antitumor effects with 5-fluorouracil

Background

Vaccines play increasingly important roles in cancer treatment due to their advantages of effective targeting and few side effects. Our laboratory has attempted to construct vaccines by conjugating TLR7 agonists with tumor-associated antigens. Furthermore, immunochemotherapy has recently become an appealing approach to cancer therapy. 5-fluorouracil (5-FU), a commonly used chemotherapeutic agent, can reportedly potently and selectively kill tumor-associated MDSCs in vivo.

Methods

Gastric cancer vaccines were synthesized by the covalent attachment of our TLR7 agonist with the gastric cancer antigen MG7-Ag tetra-epitope, leading to T7 − ML (linear tetra-epitope) and T7 − MB (branched tetra-epitope). Cytokines induced by the vaccines in vitro were assessed by ELISA. A tumor challenge model was created by treating BALB/c mice on either a prophylactic or therapeutic vaccination schedule. 5-FU was simultaneously applied to mice in the combination treatment group. CTL and ADCC activities were determined by the LDH method, while CD3⁺/CD8⁺, CD3⁺/CD4⁺ T cells and MDSCs were evaluated by flow cytometry.

Results

In vitro, rapid TNF-α and IL-12 inductions occurred in BMDCs treated with the vaccines. In vivo, among all the vaccines tested, T7 − MB most effectively reduced EAC tumor burdens and induced CTLs, antibodies and ADCC activity in BALB/c mice. Immunization with T7 − MB in combination with 5-FU chemotherapy reduced tumor sizes and extended long-term survival rates, mainly by improving T cell responses, including CTLs, CD3⁺/CD8⁺ and CD3⁺/CD4⁺ T cells. 5-FU also enhanced the T7 − MB efficiency by reversing immunosuppressive factors, i.e., MDSCs, which could not be validly inhibited by the vaccines alone. In addition, T7 − MB repressed tumor growth and immune tolerance when the therapeutic schedule was used, although the effects were weaker than those achieved with either T7 − MB alone or in combination with 5-FU on the prophylactic schedule.

Conclusions

A novel effective gastric cancer vaccine was constructed, and the importance of branched multiple antigen peptides and chemical conjugation to vaccine design were confirmed. The synergistic effects and mechanisms of T7 − MB and 5-FU were also established, observing mainly T cell activation and MDSC inhibition.

Electronic supplementary material

The online version of this article (10.1186/s12967-018-1501-z) contains supplementary material, which is available to authorized users.

[Assessment of the quality of life of tongue base cancer patients after reconstruction with anterolateral thigh perforator flap]

Objective: To evaluate the quality of life (QOL) of patients who underwent resection of tongue base cancer and reconstruction by anterolateral thigh perforator free flap(ALTFF). Methods: A total of 77 patients with tongue cancer who underwent glossectomy and reconstruction by ALTFF were retrospectively analyzed in this work. At intervals of 3-month before operation, as well as both 3-month and 12-month post-operation, the QOL of these patients was assessed by using the 14-item Oral Health Impact Profile questionnaires(OHIP-14) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Module(EORTC-QLQ-H&N35). Results: The OHIP-14 questionnaire showed the physiological pain can be significantly alleviated at 3 months postoperatively. The highest score were psychological discomfort and psychological disorders at 3 months postoperatively. Functional limitations cannot be restored to preoperative level at 12 months postoperatively, although lower than that in 3 months postoperatively(40.6±10.3 vs 39.2±10.6, t=-0.812, P=0.948). The EORTC-QLQ-H & N35 survey showed that swallowing, language and diet were higher at 3 months postoperatively, and improved significantly at 12 months postoperatively. Teeth and mouth opening was lower before and after surgery, and no significant difference was observed. Conclusion: The use of ALTFF to repair tongue base cancer, can restore the patient's appearance, language and chewing function of the basic needs and improve the quality of life of patients.

The anteroposterior diameter of nodules in the risk assessment of papillary thyroid microcarcinoma

This study investigates the application of ultrasound, especially the anteroposterior diameter of nodules in the malignancy and metastasis risk assessment of papillary thyroid microcarcinoma through a retrospective analysis of 500 cases of thyroid nodule ultrasonography.We selected 500 patients with thyroid nodules (maximum nodule diameter ≤2.0 cm) that had been diagnosed clinically and graded TI-RADS 4c by ultrasonography and surgically treated. Among these, there were 258 cases of pathologically diagnosed papillary thyroid microcarcinoma, 72 cases of nodular goiter or adenoma, 137 cases of papillary thyroid carcinoma, 28 cases of acinar cell carcinoma, and 5 cases of undifferentiated carcinoma. In all cases, color Doppler ultrasonography had been performed preoperatively to determine the size and number of nodules, surrounding lymph node metastasis, and TI-RADS grading. Cases of papillary thyroid microcarcinoma diagnosed by pathology were selected as the study group, and cases of nodular goiter or adenoma as the control group. Each group was further subdivided based on the anteroposterior, vertical, and transverse nodule diameters. Intergroup statistical analysis was also performed. Receiver operating characteristic (ROC) curve analysis was conducted on the study and control groups based on the anteroposterior nodule diameters, and the optimal critical value for malignancy risk was determined. Thyroid nodules in the study group were divided into groups based on the presence or absence of lymph node metastasis. Based on the anteroposterior nodule diameter, ROC curve analysis was performed, and the optimal critical value for metastasis risk was determined.There were 500 cases of malignant nodules diagnosed by ultrasound. Among these, there were 428 cases of malignant nodules diagnosed by pathology. The coincidence rate of the ultrasound diagnosis with pathological diagnosis was 85.60%. While, interestingly, There was a significant statistical difference between the study and control groups based on the anteroposterior nodule diameter. When the anteroposterior nodule diameter was 0.7 cm, sensitivity of malignant diagnosis was 76.70% and specificity of that was 66.70%, and the Youden index was the highest. The lymph node metastasis rate for papillary thyroid microcarcinoma was 13.95%. Within this group, the lymph node metastasis rate for nodules ≥0.9 cm (anteroposterior diameter) was 38.46%. When the anteroposterior nodule diameter was equal to 0.9 cm, sensitivity of diagnosis was 83.30%, and specificity of that was 77.80%, and the Youden index was the highest.The anteroposterior diameter of thyroid nodules is more suitable for assessing their malignancy with 0.7 cm, which can be used as the critical value. Nodules ≥ 0.7 cm require surgical treatment, and those <0.7 cm can be observed. An anteroposterior diameter of 0.9 cm can be used as the critical value for assessing the metastasis risk of malignant thyroid nodules. During surgery, the dissection of central cervical lymph nodes is required for nodules ≥0.9 cm.

[Implant restoration on folded fibular graft for the repair of mandibular defect]

Objective: To discuss the key points of implant restoration on folded fibular graft for mandibular defect. Methods: Fifteen patients with mandibular ameloblastoma were treated by segmental resection of the mandible.The mandibular defect was reconstructed with vascularized folded fibular graft. Implant restoration on the graft was conduced 6-9 months after operation.The results were evaluated. Results: All patients had no tenderness in the temporomandibular joint region. The mouth opening reached 3.1-3.9 cm and the occlusion relationship was good. There was no obvious abnormality in masticatory and swallowing function. After 12-48 months of follow-up, the implants were all survived. Conclusions: The application of folded fibula for both mandible defect repair and postoperative implant restoration could achieve satisfactory results in restoration of the facial appearance and physiological function of oral cavity.

Down-regulation of fibronectin and the correlated expression of neuroligin in hirschsprung disease

AIM

The goal of this study was to investigate the expression of fibronectin (FN) and the correlated abundance of neuroligins (NLs) in the enteric nervous system (ENS) and to find a novel diagnostic marker in the serum of Hirschsprung disease (HSCR) patients.

METHODS

The expression levels of FN, neuroligin-1 and neuroligin-2 were detected in 114 children with or without HSCR. The expression and localization of the NLs and FN were assessed morphologically by immunohistochemical staining. Western blot analysis and real-time fluorescence quantitative PCR (qPCR) were performed to examine the correlated expression of the NLs and FN in aganglionic, transitional, and normal ganglionic colon tissues. An enzyme-linked immunosorbent assay (ELISA) was performed to evaluate and compare serum FN levels between HSCR and non-HSCRand between long-type HSCR and short-type HSCR.

RESULTS

These studies showed that both neuroligin-1 and neuroligin-2 were expressed at low levels in aganglionic segments and at intermediate levels in transitional segments compared to their high level of expression in normal tissue. In contrast, FN expression was negatively correlated, with expression in these three samples transitioning from highest to lowest. The serum FN level was higher in HSCR than in non-HSCR, but no significant difference between short-type HSCR and long-type HSCR was observed.

CONCLUSION

FN affects the expression of both neuroligin-1 and neuroligin-2 in HSCR, which may lead to the hypoplasia of ganglion cells in the ENS. This correlation may play a key role in the pathogenesis, diagnosis, or classification of HSCR.

New understanding of nano-scale interstitial dislocation loops in BCC iron

Complex states of nanoscale interstitial dislocation loop can be described by its habit plane and Burgers vector. Using atomistic simulations, we provide direct evidences on the change of the habit plane of a 1/2〈1 1 1〉 loop from {1 1 1} to {1 1 0} and {2 1 1}, in agreement with TEM observations. A new {1 0 0} habit plane of this loop is also predicted by simulations. The non-conservation of the Burgers vector is approved theoretically for: (1) dislocation reactions between loops with different Burgers vectors and (2) the transition between 〈1 0 0〉 loops and 1/2〈1 1 1〉 loops. The rotation from a 1/2〈1 1 1〉 to a 〈1 0 0〉 loop has also been explored, which occurs at 570 K for time on the order of 10 s. The dislocation-precipitate phase duality and change of habit plane are then proposed as new features for nano-scale dislocation loops.