Polyphenol-mediated defect patching of graphene oxide membranes for sulfonamide contaminants removal and fouling control

Graphene oxide (GO)-based laminar membranes are promising candidates for next-generation nanofiltration membranes because of their theoretically frictionless nanochannels. However, nonuniform stacking during the filtration process and the inherent swelling of GO nanosheets generate horizontal and vertical defects, leading to a low selectivity and susceptibility to pore blockage. Herein, both types of defects are simultaneously patching by utilizing tannic acid and FeⅢ. Tannic acid first partially reduced the upper GO framework, and then coordinated with FeⅢ to form a metal-polyphenol network covering horizontal defects. Due to the enhanced steric hindrance, the resulting membrane exhibited a two-fold increase in sulfonamide contaminants exclusion compared to the pristine GO membrane. A non-significant reduction in permeance was observed. In terms of fouling control, shielding defects significantly alleviated the irreversible pore blockage of the membrane. Additionally, the hydrophilic metal-polyphenol network weakened the adhesion force between the membrane and foulants, thereby improving the reversibility of fouling in the cleaning stage. This work opens up a new way to develop GO-based membranes with enhanced separation performance and antifouling ability.

Energy-efficient trehalose-based polyester nanofiltration membranes for zero-discharge textile wastewater treatment

Recovery of water, salts, and hazardous dye from complex saline textile wastewater faces obstacles in separating dissolved ionic substances and recovering organic components during desalination. This study realized the simultaneous fractionation, desalination, and dye removal/recovery treatment of textile wastewater by using trehalose (Tre) as an aqueous monomer to prepare polyester loose nanofiltration (LNF) membrane with fine control microstructure via interfacial polymerization. Outperforming the NF270 commercial membrane, the Tre-1.05/TMC optimized membrane achieves zero-discharge textile wastewater treatment, cutting energy consumption by 295% and reducing water consumption by 42.8%. This efficiency surge results from remarkable water permeability (130.83 L m-2 h-1 bar-1) and impressive dye desalination (NaCl/ Direct Red 23 separation factor of 275) of the Tre-1.05/TMC membrane. For a deeper comprehension of filtration performance, the sieving mechanism of polyester LNF membranes was systematically elucidated. This strategic approach offers significant prospects for energy conservation, carbon emission mitigation, and enhanced feasibility of membrane-based wastewater treatment systems.

Prediction of Fuhrman grade of renal clear cell carcinoma by multimodal MRI radiomics: a retrospective study

AIM

To explore the value of multimodal magnetic resonance imaging (MRI) radiomics combined with traditional radiologist-defined semantic characteristics and conventional (cMRI) and functional MRI (fMRI) texture features in predicting Fuhrman grade of clear cell renal cell carcinoma (ccRCC).

MATERIALS AND METHODS

The data of 89 patients with histopathologically proven ccRCC (low-grade, 54; high-grade, 35) were collected. Texture features were extracted from cMRI (T1- and T2-weighted imaging) and fMRI (Dixon-MRI; blood-oxygen-level dependent [BOLD]-MRI; and susceptibility-weighted imaging [SWI]) images, and the traditional characteristics (TC) were evaluated. Logistic regression analysis was performed to develop models based on TC, cMRI, and fMRI texture features for grading. Receiver operating characteristic (ROC) curve analysis and leave-group-out cross-validation (LGOCV) were performed to test the reliability of combined models.

RESULTS

Two T2-weighted imaging-based, two Dixon_W-based, one Dixon_F-based, one BOLD-based, and three SWI-based texture features, and three TC were extracted for feature selection. TC, cMRI, fMRI, cMRI+fMRI, cMRI+TC, fMRI+TC, and cMRI+fMRI+TC models were constructed. The AUC of the cMRI+fMRI+TC model for differentiating high- from low-grade ccRCC was 0.74, with 81.42% accuracy, 75.93% sensitivity, and 91.43% specificity. The fMRI+TC model exhibited a performance similar to that of the cMRI+fMRI+TC model (p>0.05). The areas under the curve (AUCs) of the fMRI+TC and cMRI+fMRI+TC models were significantly higher than those of the other five models (all p<0.05). For the cMRI+fMRI+TC model, the mean accuracy was 85.40% after 100 LGOCV for the test sets.

CONCLUSION

Multimodal MRI radiomics combined with TC, cMRI, and fMRI texture features may be a reliable quantitative approach for differentiating high-grade ccRCC from low-grade ccRCC.

[Clinical implications of Naples prognostic scores in patients with resectable Siewert type II-III adenocarcinoma of the esophagogastric junction]

Objective: To evaluate the clinical value of preoperative Naples prognostic scores (NPS) in patients with resectable Siewert type II-III esophagogastric junction adenocarcinoma (AEG). Methods: In this retrospective observational study we collected and analyzed relevant data of patients with Siewert Type II-III AEG treated in the Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital from January 2014 to December 2018. NPS were calculated using preoperative albumin concentration, total cholesterol concentration, neutrophil/lymphocyte ratio, and lymphocyte/monocyte ratio and used to allocate patients into three groups: NTS-0 (0 points), NTS-1 (1-2 points) and NTS-2 (3-4 points). Kaplan-Meier was used to calculate disease-free survival (DFS) and overall survival (OS) in each NPS group and the log-rank test to compare these groups. Univariate and multivariate survival analyes were performed using the Cox regression model. Time-dependent receiver operating characteristic curves were constructed to compare the relationships between four commonly used tools for evaluating inflammatory responses and nutritional status:NPS, systemic inflammatory response scores, nutrient control status (CONUT), and prognostic nutrition index (PNI). Results: The study cohort comprised 221 patients with AEG of median age 63.0 (36.0-87.0) years. There were 190 men (86.0%) and 31 women (14.0%). As to pTNM stage, 47 patients (21.3%) had Stage I disease, 68 (30.8%) Stage II, and 106 (48.0%) Stage III. One hundred and forty-seven patients (66.5%) had Siewert Type II disease and 74 (33.5%) Siewert type III. There were 45 patients (20.4%) in the NPS-0, 142 (64.2%) in the NPS-1 and 34 (15.4%) in the NPS-2 groups. Higher NPS scores were significantly associated with older patients (χ²=5.056, P=0.027) and higher TNM stages (H=5.204,P<0.001). The median follow-up was 39 (6-105) months; 16 patients (7.2%) were lost to follow-up. The median OS in the NPS-0, NPS-1, and NPS-2 groups were 78.4, 63.1, and 37.0 months, respectively; these differences are statistically significant (P=0.021). Univariate and multivariate Cox regression analysis identified the following as independently and significantly associated with OS in patients with Siewert Type II-III: TNM stage (Stage II: HR=2.182, 95%CI: 1.227-3.878, P=0.008; Stage III: HR=3.534, 95%CI: 1.380-6.654, P<0.001), tumor differentiation (G3: HR=1.995, 95%CI: 1.141-3.488, P=0.015), vascular invasion (HR=2.172, 95%CI: 1.403-3.363, P<0.001), adjuvant chemotherapy (HR=0.326, 95%CI: 0.200-0.531, P<0.001), NPS (NPS-1: HR=2.331, 95%CI: 1.371-3.964, P=0.002; NPS-2: HR=2.494, 95%CI: 1.165-5.341, P=0.019), SIS group (NPS-1: HR=2.170, 95%CI: 1.244-3.784, P=0.006; NPS-2: HR=2.291, 95%CI: 1.052-4.986, P=0.037), and CONUT (HR=1.597, 95% CI: 1.187-2.149, P=0.038). The median DFS in the NPS-0, NPS-1, and NPS-2 groups was 68.6, 52.5, and 28.3 months, respectively; these differences are statistically significant (P=0.009). Univariate and multivariate Cox regression analysis identified the following as independently and significantly associated with DFS in patients with Siewert Type II-III AEG: TNM stage (StageⅡ: HR=2.789, 95%CI:1.210-6.428, P=0.016; Stage III: HR=10.721, 95%CI:4.709-24.411, P<0.001), adjuvant chemotherapy (HR=0.640, 95% CI: 0.432-0.946, P=0.025), and NPS (NPS-1: HR=1.703, 95%CI: 1.043-2.782, P=0.033; NPS-2: HR=3.124, 95%CI:1.722-5.666, P<0.001). Time-dependent receiver operating characteristic curves showed that NPS was more accurate in predicting OS and DFS in patients with Siewert Type II-III AEG than were systemic inflammatory response scores, CONUT, or PNI scores. Conclusion: NPS is associated with age and TNM stage, is an independent prognostic factor in patients who have undergone resection of Siewert type II-III AEG, and is better than SIS, CONUT, or PNI in predicting survival.

[The characteristics of gut microbiota in type 2 diabetes mellitus patients with hypertriglyceridemia]

Objective: To investigate the characteristics of gut microbiota in type 2 diabetes mellitus (T2DM) patients with hypertriglyceridemia (HTG). Methods: Eighty-one patients first diagnosed with T2DM were enrolled in the Third Xiangya Hospital of Central South University from January 2018 to December 2020, including 58 patients [46 males and 12 females, aged (43±13) years] with HTG [HTG group, triglyceride (TG)≥1.7 mmol/L]. There were 23 cases without HTG (NTG group), including 20 males and 3 females, aged (46±13) years. According to the severity of HTG, the patients of HTG group were divided into severe HTG group (STG group, TG ≥5.6 mmol/L) and mild HTG group (MTG group, 1.7 mmol/L≤TG<5.6 mmol/L). Thirty healthy controls were matched accordingly, including 21 males and 9 females, aged (45±6) years. Clinical laboratory indicators and feces of the subjects were collected and 16S rRNA sequencing was performed to compare the differences in intestinal flora among the groups. Results: The Shannon and Simpson indexes in HTG group were lower than those in NTG group and healthy control group (5.02±0.91 vs 5.45±0.55 and 5.60±0.63, P=0.003; 0.90±0.06 vs 0.93±0.04, 0.94±0.04, P=0.002). Compared with healthy control group and NTG group, the abundance of intestinal P_Proteobacteria, g_Escherichia_Shigella, s_Escherichia_Coli and g_Clostridium_sensu_stricto_1 increased in HTG group, while the abundance of p_Firmicutes, g_Faecalibacterium and Faecalibacterium_prausnitzii decreased. The abundance of g_Clostridium_sensu_stricto_1 in the STG group was higher than that of NTG and MTG groups, while the abundance of g_Faecalibacterium decreased. Spearman correlation analysis suggested that g_Clostridium_sensu_stricto_1 was positively correlated with glycosylated hemoglobin (r=0.22, P=0.044), fasting blood glucose (r=0.36, P=0.001), TG (r=0.27, P=0.015) and total cholesterol (r=0.44, P<0.001). Logistic regression analysis indicated that g_Faecalibacterium was a protective factor for T2DM with HTG(OR=0.90, 95%CI:0.83-0.97, P=0.006). Conclusions: The intestinal flora of T2DM patients with HTG was dysregulated, which was manifested as decreased diversity, increased abundance of P_Proteobacteria and decreased abundance of p_Firmicutes. g_Faecalibacterium is a protective factor for T2DM with HTG.

[Endoscopic diagnosis and treatment of early colorectal cancer and precancerous lesions: current status and future prospects]

Early detection of colorectal cancer and precursor lesions under colonoscopy, and timely and optimal treatment remain the crucial means for reducing colorectal cancer-related deaths. In this article, we focused on the hot spots in recent years, reviewed the progress of endoscopic diagnosis and treatment of serrated lesions and inflammatory bowel disease (IBD)-related dysplasia, the application of endocytoscopy and the management of early colorectal cancer/precancerous lesions, and provided new prospects for future studies.

Positively charged membranes for dye/salt separation based on a crossover combination of Mannich reaction and prebiotic chemistry

With the advent of increasingly loose nanofiltration membranes for dye desalination, synthesis methods based on interfacial polymerization and bio-inspired materials such as polydopamine (pDA) have been investigated. However, the long polymerization time of pDA greatly limits the synthesis and application of fast dye/salt separation membranes. In this work, prebiotic chemistry-inspired aminomalononitrile (AMN) was used as a binder to co-deposit the Mannich reaction of tetrakis(hydroxymethyl)phosphonium chloride (THPC) and polyethyleneimine (PEI) to form the positively charged selective layer rapidly. The optimum membrane had a water permeance of 30.7 LMH bar^-1 and a rejection of positively charged Victoria blue B (VBB, 200 ppm) and Na₂SO₄ (1 g/L) of 99.5 % and 9.9 %, respectively. Moreover, the results of a practical application test showed that it had excellent separation performance towards various positively charged dyes and salts. In addition, the actual application test results show that the membrane has good long-term stability during application. In terms of antifouling and antibacterial, the membrane has excellent antibacterial and antifouling properties., Further antibacterial tests were carried out, and the inactivation effect of the membrane on E. coli was also confirmed. The preparation method proposed in this work provides technical support for developing new dye/salt separation membranes.

A PEI/TMC membrane modified with an ionic liquid with enhanced permeability and antibacterial properties for the removal of heavy metal ions

Heavy metal ions in drinking water severely threaten public health in various places worldwide. Nanofiltration (NF) membrane technology is an attractive option for heavy metal ions removal; however, improving NF membrane filtration performance is required to make their industrial application viable. In this study, a positively charged THPC/PEI-TMC NF membrane was designed via simple one-step incorporation of Tetrakis (hydroxymethyl) phosphonium chloride (THPC) biocide on the surface of PEI-TMC membranes, significantly optimizing surface morphology, roughness, hydrophilicity, and zeta potential of PEI-TMC membranes. It was found that the pure water permeability (11.6 Lm^-2h^-1bar^-1) of the THPC modified membrane was three times larger than that of the original PEI-TMC membrane (3.4 Lm^-2h^-1bar^-1) while maintaining a high level of ion rejections (around 95% for Zn²⁺, Cd²⁺, Ni²⁺, Cu²⁺ and about 90% for Pb²⁺). Additionally, the incorporation of the THPC on the original PEI-TMC membrane surface also conferred good antibacterial properties, which protect the organic membrane from bacterial growth and prolong the lifespan of the membrane.

A novel ceramic-based thin-film composite nanofiltration membrane with enhanced performance and regeneration potential

The rational design of a ceramic-based nanofiltration membrane remains a significant challenge due to its performance and fabrication cost. Herein, we report a high-performance ceramic-based thin-film composite (TFC) membrane fabricated via a typical interfacial polymerization on an interwoven net substrate assembled by titanium dioxide (TiO₂) nanowires. The chemical properties and morphologies were systematically investigated for ceramic substrates and their corresponding TFC membranes. Due to the significantly improved hydrophilicity of the TiO₂ framework, more reactive amine monomers were uniformly adsorbed on the modified surface of the ceramic substrate, yielding an ultrathin polyamide layer with less resistance. In addition, the smooth surface and decreased pore size of the TiO₂ framework contributed to forming a defect-free polyamide layer. As a result, the obtained ceramic-based TFC membrane evinced high permeance of 26.4 L m^-2 h^-1 bar^-1 and excellent salt rejection efficiency, leading to simultaneous improvements compared with the control TFC membrane without the TiO₂ framework. Notably, the potential regeneration ability of the ceramic-based TFC membrane could be achieved via facile low-temperature calcination and re-polymerization process due to the varied thermostability between the polyamide layer and the robust ceramic substrate. The operation of regeneration helped to prolong the lifetime and decrease the cost for the ceramic-based TFC membrane. This research provides a feasible protocol to fabricate sustainable ceramic-based nanofiltration membranes with enhanced performance for water treatment.

Low-pressure highly permeable polyester loose nanofiltration membranes tailored by natural carbohydrates for effective dye/salt fractionation

With the continuous pressure of water contamination caused by textile industry, loose nanofiltration (LNF) membranes prepared by green materials with an extraordinary water permeability are highly desirable for the recovery and purification of dyes and salts. In this work, low-pressure LNF membranes with ultrahigh permeability were fabricated via one-step interfacial polymerization (IP), in which inexpensive natural carbohydrate-derived sugars with large size and low reactivity were utilized as aqueous monomers to design selective layer. A systematic characterization by chemical analysis and optical microscopy demonstrated that the formed polyester film features not only loosen the structure, but also results in a hydrophilic and negatively charged surface. The optimized sucrose-based membrane (Su0.6/TMC0.1) with an excellent water permeability of 52.4 LMH bar^-1 was found to have a high rejection of dyes and a high transmission of salts. In addition, the sugar-based membrane manifested an excellent anti-fouling performance and long-term stability. Furthermore, the non-optimized Gl0.6/TMC0.1 and Ra0.6/TMC0.1 membranes also shown a high water permeability, while maintaining a competitive dye/salt separation performance, which confirmed the universal applicability of the membrane design principle. Therefore, the proposed new strategy for preparing next-generation LNF membranes can contribute towards the textile wastewater treatment.

[Preliminary application of the Asia-Pacific colorectal screening score combined with the quantitative fecal occult blood in colorectal neoplasia screening]

To evaluate the efficacy of the Asia-Pacific colorectal screening (APCS) score combined with the quantitative fecal immunochemical test in colorectal neoplasia screening. Subjects who appointment to receive colonoscopy were recruited from August 2017 to May 2019 in the digestive endoscopy center. Before the colonoscopy, all subjects were scored by the Asia Pacific colorectal cancer screening scoring system and measured by quantitative fecal immunochemical test (QFIT). The detection rates of colorectal neoplasia were compared to evaluate the efficacy of the combined assay in colorectal neoplasia screening between APCS score and QFIT. A total of 1 420 subjects were enrolled in this study, APCS score medium-risk (MR) and high-risk (HR) groups were 847 (59.7%) and 573 (40.4%) and 26 cases (1.8%) of colorectal cancer, 196 cases (13.8%) of advanced adenoma, and 395 cases (27.8%) of non-advanced adenoma were detected. With the combination of APCS score and QFIT, participants were classified into 4 groups high-risk with positive QFIT result group G1, high-risk with negative QFIT result group G2, medium-risk with positive QFIT group G3, medium-risk negative QFIT group G4. The prevalence of colorectal neoplasia was 64.3%, 16.4%, 55.0%, and 9.8%, respectively. The prevalence of advanced neoplasia in high-risk with QFIT results was significantly higher than that in other 3 groups. HR and positive QFIT were the indicators for further colonoscopy, and MR with FIT negative group could postpone colonoscopy and conduct annual QFIT follow-up. The combination of APCS score and QFIT for colorectal neoplasia screening can reduce unnecessary colonoscopy, improve colonoscopy compliance and screening efficiency, and has important clinical significance and promotion value in colorectal tumor screening.

[Analysis of 39 children with acute necrotizing encephalopathy]

Objective: To investigate the risk factors for death in children with acute necrotizing encephalopathy (ANE) in pediatric intensive care unit (PICU). Methods: This was a multicenter retrospective study. Thirty-nine children with ANE were from PICUs in 4 centers from December 1, 2014 to December 1, 2020. The 4 participating centers were Beijing Children's Hospital, Shengjing Hospital of China Medical University, Hebei Children's Hospital, and Bao'an Maternity & Child Health Hospital. Patients were divided into survival and non-survival groups by the outcome at discharge, and the differences in clinical data between the two groups were compared. Risk factors for death in children with ANE and the odds ratios (OR) were analyzed by univariable Logistic regression. Results: Thirty-nine children with ANE were included. There were 18 males and 21 females. The median onset age was 30 months. The mortality at discharge was 41% (16/39). The onset age of most patients (74%, 29/39) was younger than 4 years old. Influenza virus was the most common precursor infection (80%, 20/25). Patients with shock at PICU admission were more common in the non-survival group (12/16 vs. 17% (4/23), P=0.001). Glasgow coma score (GCS) at PICU admission was significantly lower in the non-survival group than survival group (3 (3, 6) vs. 6 (5, 7), Z=-2.598, P=0.009). The optimal cut-off value was 4. The proportion of patients with GCS ≤ 4 at PICU admission was higher in the non-survival group (10/16 vs. 22% (5/23), P=0.018). ANE severity score (ANE-SS) at PICU admission was significantly higher in the non-survival group (5 (2, 6) vs. 2 (1, 4), Z=-2.436, P=0.015). The proportion of patients with high risk ANE-SS was higher in non-survival group than the survival group (9/16 vs. 22% (5/23), P=0.043). The proportion of application of high-dose methylprednisolone (20 mg/(kg·d)) was significantly higher in survival group than non-survival group (43% (10/23) vs. 1/13, P=0.031). Univariable Logistic regression indicated that risk factors for death in children with ANE were shock (OR=14.250, 95%CI 2.985-68.018, P=0.001), GCS≤4 (OR=6.000, 95%CI 1.456-24.733, P=0.013) and high risk ANE-SS (OR=4.629, 95%CI 1.142-18.752, P=0.032) at PICU admission. Conclusions: ANE usually occurs in children under 4 years old after influenza infection. Shock, GCS≤4 and high risk ANE-SS at PICU admission were risk factors for death in children with ANE. High-dose methylprednisolone may improve the prognosis of children with ANE.

An incremental feeding pattern for Guangdong Small-ear Spotted gilts during gestation: effects on stillbirth rate and muscle weight of progeny

While an appropriate feed intake is crucial for the reproductive performance of sows, there is a lack of recommendations currently for feed allowance of Guangdong Small-ear Spotted gilts during gestation. The effects of 2 different feeding patterns during gestation on the reproductive performance of Guangdong Small-ear Spotted gilts were investigated by assigning 80 gilts to 2 feeding pattern groups with a randomized complete block design in accordance with initial body weight and back fat thickness, followed by treatment with an incremental feeding pattern (IFP) and a concaved feeding pattern, respectively, with no difference in total feed intake. The IFP group showed a significant decrease in the stillbirth rate (P < 0.05) and an upward trend in piglet mean birth weight (P = 0.06). Furthermore, the IFP group exhibited an increase in the weights of stomach, supraspinatus tendon, triceps, and psoas minor in neonatal piglets (P < 0.05). Overall, the results of the present investigation showed that IFP could significantly reduce the stillbirth rate of Guangdong Small-ear Spotted gilts and increase the muscle weight of progeny.

Tailoring Charged Nanofiltration Membrane Based on Non-Aromatic Tris(3-aminopropyl)amine for Effective Water Softening

High-performance positively-charged nanofiltration (NF) membranes have a profound significance for water softening. In this work, a novel monomer, tris(3-aminopropyl)amine (TAEA), with one tertiary amine group and three primary amine groups, was blended with trace amounts of piperazine (PIP) in aqueous solution to fabricate a positively-charged NF membrane with tunable performance. As the molecular structures of TAEA and PIP are totally different, the chemical composition and structure of the polyamine selective layer could be tailored via varying the PIP content. The resulting optimal membrane exhibited an excellent water permeability of 10.2 LMH bar⁻¹ and a high rejection of MgCl₂ (92.4%), due to the incorporation of TAEA/PIP. In addition, this TAEA NF membrane has a superior long-term stability. Thus, this work provides a facile way to prepare a positively charged membrane with an efficient water softening ability.

1062 The Role of Sleep in Sex and Racial/Ethnic Differences in 10-Year CVD Risk in the Sleep Heart Health Study: The Use of Machine-Learnt and Precision Insights to Understand Racial/Ethnic and Sex Differences in Sleep-CVD Disparity

Introduction

The current study investigated whether insufficient sleep (&lt;7 hrs.) explains differences in 10-year CVD risk, using Framingham risk (FRS) and Reynolds risk (RRS) scores, between blacks and whites and characterized risk and protective CVD risk profiles.

Methods

Using the Sleep Heart Health Study (SHHS) (N=6,441) data, we investigated the independent role of insufficient sleep in explaining differences in 10-years CVD between blacks and whites via a proportional odds model of four 10-year CVD risk groups: low (&lt;5%), low-medium (5% to &lt;10%), medium-high (10% to &lt;20%) and high (≥20%), adjusting for age, sex, and apnea-hypopnea index (AHI). We performed two levels of cluster analyses; via hierarchical cluster algorithm with entire sample (Level 1), and latent profiles in the low (protective profiles) and high (risk profiles) CVD risk groups (Level 2) to determine overall CVD risk, and risk and protective CVD profiles.

Results

Blacks had a higher prevalence of smoking behavior, diabetes, mean systolic blood pressure, body mass index, total cholesterol compared to whites. Conversely, whites had a higher mean HDL cholesterol, sleep hours, and sleep efficiency compared to blacks. Men had higher 10-year CVD risk than women. AHI and race/ethnicity-sleep interaction were positively associated, while sleep was negatively associated with FRS and RRS. Across all CVD risk groups, whites who slept less than 5.5 hrs. had a higher CVD risk and those who slept more than 6.5 hrs. had a lower CVD risk compared to blacks. In Level 1 cluster analyses, we found two clusters: Cluster 1 (n= 3233): 6.17 sleep hours, apnea-index 11.84, age 59, SBP 125.43, total cholesterol 209, HDL 51.39, BMI 29.03, and slightly more than 50% female; and Cluster 2 (n=1657): 5.61 sleep hours, apnea-index 13.41, age 74, SBP 131, total cholesterol 204, HDL 50.30, BMI 26.45, and slightly less than 50% female. In Level 2 cluster analyses, we found two profiles within the low and high CVD risk groups.

Conclusion

These findings suggest that blacks may not receive full protection from long-term CVD risk with longer sleep duration, as their white counterparts.

Support

K01HL135452, R01MD007716, R01HL142066, K07AG052685

[The optimal thresholds of the quantitative fecal immunochemical test for opportunistic screening of colorectal neoplasia]

Objective: To investigate the significance of quantitative fecal immunochemical test (FIT) for opportunistic screening of colorectal neoplasia, and to propose the most optimal thresholds to improve the screening level of early colorectal neoplasia. Methods: The opportunistic screening participants were recruited from the Department of Gastroenterology & GI Endoscopy Center of the Seventh Medical Center of PLA General Hospital, and stool sample was collected before colonoscopy and the quantitative FIT was analyzed by OC-MICRO analysator for each patient. We assessed test performance in detecting colorectal neoplasia (advanced adenoma and CRC)with different thresholds on sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Results: A total of 1 448 objects were enrolled in this study, including 714 male (49.3%)and 734 female (50.7%).All participants were classified according to the result of colonoscopy and pathology, and 242 cases of colorectal neoplasia were found, containing 157 advanced adnoma and 85 colorectal cancer. The FIT threshold increased from 50 μg/L to 200 μg/L, while the positivity rate dropped from 11.5% to 8.6% and the sensitivity in detecting colorectal neoplasia dropped from 47.9% to 38.8%. However, the specificity increased from 96.8% to 98.2% and the positive predictive value increased from 82.3% to 87.0%.The miss rate of colorectal cancer increased from 11.8% (n=10) to 17.6% (n=15) along with the increase in FIT thresholds, but the miss rate of 100 μg/L and 150 μg/L was the same as 12.9% (n=11). Conclusions: Quantitative FIT,which is simple and fast,with the threshold of 100 μg/L for opportunistic screening, has a high sensitivity and specificity for the diagnosis of colorectal neoplasia,and is an important index in screening and diagnosis of colorectal neoplasia.

[Analysis the features of familial benign paroxysmal positional vertigo]

Objective:The family heredity of BPPV disease was preliminarily discussed in order to guide the clinical practice, prevent early and shorten the course of BPPV disease in the future. Method:Familial BPPV patients were enquired and registered in detail, including gender, age at first onset, occupation, inducing factors, symptoms, diagnosis, sleep status and clinical manifestations. Analysis of the clinical data. Result:Nine patients with idiopathic BPPV from four families had no definite pathogenic factors, accounting for 0.4% of the patients with idiopathic BPPV, including 3 males and 6 females; the age of first onset ranged from 31 to 66 years old. the course of disease ranged from 2 days to 8 years; the duration of nystagmus ranged from seconds to 1 minute. The main clinical symptoms were dizziness and visual rotation related to position transformation. Family 1, 3 and 4 patients had a history of fatigue. Family 2 patients had a predisposing factor of forced lateral decubitus due to lumbar discomfort. All patients had nystagmus lasting less than 1 minute and were single-tube involvement, all patients were canalithiasis. Different patients in the same family have different pathogenic locations. Conclusion:Familial BPPV is urgent to attract the attention of clinicians and the public. Early clinical test for suspected familial BPPV can play a role in early prevention and shorten the process of disease, so as to improve the life quality of patients.

[Clonal evolution and clinical significance of trisomy 8 in acquired bone marrow failure]

Objective: To analyze clonal evolution and clinical significance of trisomy 8 in patients with acquired bone marrow failure. Methods: The clinical data of 63 patients with acquired bone marrow failure accompanied with isolated trisomy 8 (+8) from June 2011 to September 2018 were analyzed retrospectively, the clonal evolution patterns and relationship with immmunosuppressive therapy were summarized. Results: Totally 24 male and 39 female patients were enrolled, including 39 patients with aplastic anemia (AA) and 24 patients with relatively low-risk myelodysplastic syndrome (MDS) . Mean size of+8 clone in MDS patients[65% (15%-100%) ]was higher than that of AA patients[25% (4.8%-100%) , z=3.48, P=0.001]. The patients were was divided into three groups (<30%, 30%-<50%,and ≥50%) according to the proportion of+8 clone. There was significant difference among the three groups between AA[<30%:55.6% (20/36) ; 30-50%: 22.2% (8/36) ; ≥50%22.2% (8/36) ]and MDS patients[<30%:19.0% (4/21) ; 30%-<50%:19.0% (4/21) ; ≥50%61.9% (13/21) ] (P=0.007) . The proportion of AA patients with+8 clone <30% was significantly higher than that of MDS patients (P=0.002) ; and the proportion of AA patients with+8 clone ≥50%was significantly lower than that of MDS patients (P=0.002) . The median age of AA and MDS patients was respectively 28 (7-61) years old and 48.5 (16-72) years old. Moreover, there was no correlation between age and+8 clone size in AA or MDS (r(s)=0.109, P=0.125; r(s)=-0.022, P=0.924, respectively) . There was statistical difference in total iron binding capacity, transferrin and erythropoietin between high and low clone group of AA patients (P=0.016, P=0.046, P=0.012, respectively) , but no significant difference in MDS patients. The immunosuppressive therapy (IST) efficacy of AA and MDS patients was respectively 66.7% and 43.8% (P=0.125) . Comparing with initial clone size (27.3%) , the +8 clone size (45%) of AA patients was increased 1-2 year after IST, but no statistical difference (z=0.83, P=0.272) . Consistently, there was no significant change between initial clone size (72.5%) and 1-2 year clone size (70.5%) after IST in MDS patients. There was no significant difference in IST efficient rate between +8 clone size expansion and decline group of in AA patients at 0.5-<1, 1-2 and>2 years after IST. We found four dynamic evolution patterns of +8 clone, which were clone persistence (45%) , clone disappearance (30%) , clone emergence (10%) and clone recurrence (15%) . Conclusions: AA patients had a low clone burden, while MDS patients had a high burden of +8 clone. The +8 clone of AA patients didn't significantly expanded after IST, and the changes of +8 clone also had no effect on IST response.

Histopathological features of antrochoanal polyps in Chinese patients

BACKGROUND

The pathogenesis and etiology of antrochoanal polyps (ACP) are unclear. The aim of this study is to characterize the features of inflammatory cellular infiltration, the epithelial remodeling patterns and their associations to clinical parameters in ACP.

METHODS

A detailed histological study employing classic immunohistochemistry was performed. 33 ACPs, 49 classic bilateral nasal polyps (BNP) and 50 controls were obtained. The histological patterns and inflammatory cells infiltration were evaluated and analyzed for associations with clinical characteristics.

RESULTS

Less severe epithelial hyperplasia and goblet cell hyperplasia were found in ACP compared to BNP. In ACP, 87.9% of cases demonstrated neutrophilia. Elevated proportions of macrophages and CD8+ T cells, and elevated infiltration of mast cells was observed. Eosinophil infiltration was found to be positively corelated with a history of asthma; macrophages proportion was analyzed to have a significantly negative correlation with epithelial hyperplasia and goblet cell hyperplasia; the infiltration of CD8+ T cell and squamous metaplasia were found to have a positive correlation.

CONCLUSION

Inflammation potentially has important roles in ACP. ACP may differ in its pathogenesis from classic bilateral nasal polyps.

Correction to: CDK5 Regulates PD-L1 Expression and Cell Maturation in Dendritic Cells of CRSwNP

The article CDK5 Regulates PD-L1 Expression and Cell Maturation in Dendritic Cells of CRSwNP, written by C. C. Liu, H. L. Zhang, L. L. Zhi, P. Jin, L. Zhao, T. Li, X. M. Zhou, D. S. Sun, G. H. Cheng, Q. Xin, L. Shi, and M. Xia was originally published electronically on the publisher's internet.

The MTHFR polymorphism affect the susceptibility of HCC and the prognosis of HCC liver transplantation

BACKGROUND

Methylenetetrahyfrofolate reductase (MTHFR) is the key enzyme for one carbon and folate metabolism. Previous studies have drawn different conclusions about the relationship between the mutation of MTHFR and hepatocellular carcinoma (HCC) occurrence. MTHFR polymorphisms' influence on liver transplantation for HCC recurrence has yet not been reported. Aim of this study was to clarify the impact of MTHFR polymorphism on hepatocarcinogenesis and the prognosis of liver transplant recipient with HCC.

METHODS

This study enrolled 244 HCC patients and 487 healthy individuals in Chinese Han population to analyze the influence of MTHFR polymorphism on HCC susceptibility first. Furthermore, this research choose another 100 donors' and 104 recipients' specimens to detect the association between polymorphism of MTHFR and post-transplant HCC recurrence.

RESULT

rs1801131 polymorphism A to C was associated with the occurrence of HCC in Chinese Han population (p < 0.05), especially in age exceeding 50 years (p < 0.01). No association was observed with rs1801133 polymorphism and HCC occurrence. The mean tumor-free survival for recipients with donor liver graft rs1801133 C to T variants was shorter than CC type (12.63 ± 3.84 vs 22.43 ± 4.74 months, p < 0.05). Multivariate analysis revealed that Donor rs1801133 and Hangzhou criteria were two independent prognostic factors for tumor-free survival (p < 0.05). Neither donor rs1801131 polymorphism nor recipients' MTHFR polymorphisms was associated with HCC recurrence.

CONCLUSION

This study demonstrated that MTHFR polymorphism was associated with HCC occurrence and post-transplant HCC recurrence. rs1801131 mutation A to C is a valuable molecular biomarker for predicting HCC occurrence in Chinese Han population. Donor MTHFR rs1801133 C to T polymorphism could present as a promising prognostic biomarkers for HCC recurrence in liver transplant recipients.

Surface modification of poly(vinylidene fluoride) hollow fibre membranes for biogas purification in a gas-liquid membrane contactor system

The wetting of hollow fibre membranes decreases the performance of the liquid-gas membrane contactor for CO₂ capture in biogas upgrading. To solve this problem, in this work, a poly(vinylidene fluoride) (PVDF) hollow fibre membrane for a liquid-gas membrane contactor was coated with a superhydrophobic layer composed of a combination of hydrophobic SiO₂ nanoparticles and polydimethylsiloxane (PDMS) by the method of spray deposition. A rough layer of SiO₂ deposited on the PVDF membrane resulted in an enhanced surface hydrophobicity. The surface structure of the pristine PVDF significantly affected the homogeneity of the generated SiO₂ layer. A uniform surface coating on the PVDF upper layer resulted from the presence of micrometre and nanometre-sized roughness on the surface of the PVDF membrane, which was achieved with a SiO₂ concentration of 4.44 mg ml^-1 (0.2 g/45 ml) in the coating solution. As a result, the water contact angle of the modified surface was recorded as 155 ± 3°, which is higher than that of the pristine surface. The high contact angle is advantageous for reducing the wetting of the membrane. Additional mass transfer resistance was introduced by the superhydrophobic layer. In addition, continuous CO₂ absorption tests were carried out in original and modified PVDF hollow fibre membrane contactors, using monoethanolamine (MEA) solution as the absorbent. A long-term stability test revealed that the modified PVDF hollow fibre membrane contactor was able to outperform the original membrane contactor and demonstrated outstanding long-term stability, suggesting that spray deposition is a promising approach to obtain superhydrophobic PVDF membranes for liquid-gas membrane absorption.

Effect of Retrievable Stent Size on Endovascular Treatment of Acute Ischemic Stroke: A Multicenter Study

BACKGROUND AND PURPOSE

In clinical practice, stent diameter is one of the variable properties important for endovascular treatment. A consensus guideline for stent retriever size selection has yet to be established. The aim of this study was to investigate the effects of different diameters of Solitaire retrievers on outcomes.

MATERIALS AND METHODS

Of 628 patients enrolled from the Endovascular Treatment for Acute Anterior Circulation Ischemic Stroke Registry, 256 were treated with the Solitaire 4-mm device and 372, with the 6-mm device. We matched patients treated with the 2 stent sizes using propensity score analysis. The successful outcome was reperfusion as measured by the modified Thrombolysis in Cerebral Infarction score immediately postprocedure and the dichotomized modified Rankin Scale score at 90 days. Symptomatic intracerebral hemorrhage and in-hospital mortality were also recorded.

RESULTS

After propensity score analysis, group outcomes did not differ. In addition, in patients with atherosclerosis-related occlusion, a higher reperfusion rate (P = .021) was observed in the Solitaire 4 group, as well as a shorter time interval (P = .002) and fewer passes (P = .025). Independent predictors of successful reperfusion in patients with atherosclerotic disease on logistic analysis were the small stent (OR, 3.217; 95% CI, 1.129-9.162; P = .029) and the propensity score acting as a covariate (OR, 52.84; 95% CI, 3.468-805.018; P = .004).

CONCLUSIONS

We found no evidence of a differential effect of intra-arterial therapy based on the size of Solitaire retrievers. In patients with atherosclerotic disease, favorable reperfusion was associated with deployment of a small stent.

[Prevalence of hearing disorders in China: a population-based survey in four provinces of China]

Objective: To investigate the prevalence, severity of hearing disorders and demographics of people with hearing disorders based on the whole population in Jilin, Guangdong, Shannxi and Gansu provinces in China. Methods: According to " WHO Ear and Hearing Disorders Survey Protocol" , 144 clusters were chosen with probability proportional sampling(PPS) method from the four provinces covering 194, 688, 061 residents. Audiological test, otological examination and questionnaire surveying were conducted for all samples from August, 2014 to September, 2015. The hearing disorders were classified according to WHO criteria and classification. Results: Among 47 511 targeted residents, 45, 052 individuals (94.82% response rate) participated in the survey. The standardized prevalence rates of hearing disorders and disabling hearing disorders were 15.84 % and 5.17 % respectively. Almost 50% of people with hearing disorders had no awareness of it or its starting time. There was significant difference in the prevalence among people of different ages, genders, occupations, provinces, marital status and education levels. The prevalence of hearing disorders increased significantly as age grew. People above 60 years old occupied 55.31% of the total hearing disorders. The prevalence of hearing disorders among male, people of low education and those who lost husband or wife, as well as workers and farmers was relatively higher. Conclusions: The prevalence of hearing disorders is high, and hearing disorders are " invisible" . Demographics and socioeconomic factors significantly influence the prevalence of hearing disorders.

Identification of a novel LEMD3 Y871X mutation in a three-generation family with osteopoikilosis and review of the literature

INTRODUCTION

Osteopoikilosis is a rare and benign autosomal dominant genetic disorder, characterized by a symmetric but unequal distribution of multiple hyperostotic areas in different parts of the skeleton. Recent studies have reported loss-of-function mutations in the LEM domain containing 3 (LEMD3) gene, encoding an inner nuclear membrane protein, as a cause of osteopoikilosis.

METHODS

We investigated LEMD3 gene in a three-generation family from China, with six patients affected with osteopoikilosis. Peripheral blood samples were collected from family members and 100 healthy controls. All exons of the LEMD3 gene and adjacent exon-intron sequences were amplified by PCR and subsequently sequenced.

RESULTS

A novel heterozygous c.2612_2613insA (p.Y871X) mutation in exon 13 of LEMD3 was identified, which resulted in a frame shift predicted to generate a premature stop codon at amino acid position 871. The mutation co-segregates with the osteopoikilosis phenotype and was not found in 100 ethnically matched controls.

CONCLUSION

We identified a new mutation in LEMD3 gene, accounting for the familial case of osteopoikilosis. In addition we also review the clinical manifestation, diagnosis and treatment of osteopoikilosis.

Bone marrow stromal cells inhibits HMGB1-mediated inflammation after stroke in type 2 diabetic rats

High-mobility group box 1 (HMGB1), a ligand of receptor for advanced glycation endproducts (RAGE), functions as a proinflammatory factor. It is mainly involved in inflammatory activation and contributes to the initiation and progression of stroke. By using a model of transient middle cerebral artery occlusion (MCAo) in type 2 diabetic rats, we investigated the changes of pro-inflammation mediators, blood-brain barrier (BBB) leakage and functional outcome after stroke. Type 2 diabetic rats did not show an increased lesion volume, but exhibited significantly increased expression of HMGB1 and RAGE, BBB leakage, as well as decreased functional outcome after stroke compared with control rats. Injection of bone marrow stromal cells (BMSCs) into type 2 diabetic rats significantly reduced the expression of HMGB1 and RAGE, attenuated BBB leakage, and improved functional outcome after stroke. BMSCs-treated type 2 diabetic rats inhibited inflammation and improved functional outcome after stroke. Furthermore, in vitro data support the hypothesis that BMSCs-induced reduction of HMGB1 and RAGE in T2DM-MCAo rats contributed to attenuated inflammatory response in the ischemic brain, which may lead to the beneficial effects of BMSCs treatment. Further investigation of BMSCs treatment in type 2 diabetic stroke is warranted.

Solar-thermochromism of a hybrid film of VO2 nanoparticles and CoII–Br–TMP complexes

This work reports a VO₂/Co^II–Br–TMP hybrid film with excellent optical performance and an evident temperature-dependent colour change.

Correction of image drift and distortion in a scanning electron microscopy

Continuous research on small-scale mechanical structures and systems has attracted strong demand for ultrafine deformation and strain measurements. Conventional optical microscope cannot meet such requirements owing to its lower spatial resolution. Therefore, high-resolution scanning electron microscope has become the preferred system for high spatial resolution imaging and measurements. However, scanning electron microscope usually is contaminated by distortion and drift aberrations which cause serious errors to precise imaging and measurements of tiny structures. This paper develops a new method to correct drift and distortion aberrations of scanning electron microscope images, and evaluates the effect of correction by comparing corrected images with scanning electron microscope image of a standard sample. The drift correction is based on the interpolation scheme, where a series of images are captured at one location of the sample and perform image correlation between the first image and the consequent images to interpolate the drift-time relationship of scanning electron microscope images. The distortion correction employs the axial symmetry model of charged particle imaging theory to two images sharing with the same location of one object under different imaging fields of view. The difference apart from rigid displacement between the mentioned two images will give distortion parameters. Three-order precision is considered in the model and experiment shows that one pixel maximum correction is obtained for the employed high-resolution electron microscopic system.