Predictive value of Global Leadership Initiative on Malnutrition criteria combined with handgrip strength for postoperative outcomes in overweight colorectal cancer patients

BACKGROUND AND AIM

The Global Leadership Initiative on Malnutrition (GLIM) criteria are increasingly used to assess the nutritional status of hospitalized patients and predict the prognosis of patients with malignant tumors; however, malnutrition is often overlooked in overweight individuals, such as colorectal cancer patients. This study aimed to investigate the predictive value of the GLIM criteria combined with handgrip strength (HGS) in overweight colorectal cancer patients.

METHODS

This retrospective study enrolled overweight patients who underwent radical resection for colorectal cancer at two centers between 2015 and 2021. Malnutrition was diagnosed based on the GLIM criteria. Skeletal muscle mass was assessed using the skeletal muscle index, and skeletal muscle function was assessed using the HGS test. The risk factors for complications and survival were also evaluated.

RESULTS

A total of 850 patients were enrolled in the study. The incidence of malnutrition in the GLIM and HGS-GLIM groups was 12.4% and 6.4%, respectively. The incidence of total complications in both the malnutrition groups was significantly higher than that in the control group. Patients in the HGS-GLIM-malnutrition group had worse overall survival and disease-free survival. HGS-GLIM was independently associated with postoperative complications (P = 0.046), overall survival (P = 0.037), and disease-free survival (P = 0.047).

CONCLUSION

The GLIM criteria combined with the HGS test is an effective tool for diagnosing malnutrition. Particularly, these modalities are applicable in overweight colorectal cancer patients. Compared with the standard GLIM criteria, this tool has a better predictive value for postoperative complications and long-term survival.

Nutrient deprivation induces mouse embryonic diapause mediated by Gator1 and Tsc2

Embryonic diapause is a special reproductive phenomenon in mammals that helps embryos to survive various harsh stresses. However, the mechanisms of embryonic diapause induced by the maternal environment is still unclear. Here, we uncovered that nutrient deficiency in uterine fluid was essential for the induction of mouse embryonic diapause, shown by a decreased concentration of arginine, leucine, isoleucine, lysine, glucose and lactate in the uterine fluid of mice suffering from maternal starvation or ovariectomy. Moreover, mouse blastocysts cultured in a medium with reduced levels of these six components could mimic diapaused blastocysts. Our mechanistic study indicated that amino acid starvation-dependent Gator1 activation and carbohydrate starvation-dependent Tsc2 activation inhibited mTORC1, leading to induction of embryonic diapause. Our study elucidates the essential environmental factors in diapause induction.

Clinical impact of sarcopenia for overweight or obese patients with colorectal cancer

BACKGROUND

Sarcopenia, overweight and obesity are all dynamic changes in body composition, which may have a negative effect on the prognosis for patients with colorectal cancer. The aim of this study was to investigate the predictive role of sarcopenia on overweight or obese patients with colorectal cancer.

METHODS

We conducted an observative study on the population of overweight or obese patients with colorectal cancer who underwent curative surgeries in two centers between 2015 and 2021. They were grouped by the presence of sarcopenia. Propensity score match analysis was used to balance the baseline of clinicopathologic characteristics of the two groups. Then, the postoperative outcomes between the two groups were compared. Independent risk factors were evaluated for complications using univariate and multivariate analysis.

RESULTS

Of 827 patients enrolled, 126 patients were matched for analysis. Patients with sarcopenia had a higher incidence of total complication and medical complications, a higher rate of laparoscopic surgery performed and higher hospitalization costs. Old age (≥65 years, P = 0.012), ASA grade (III, P = 0.008) and sarcopenia (P = 0.036) were independent risk factors for total complications. ASA grade (III, P = 0.002) and sarcopenia (P = 0.017) were independent risk factors for medical complications.

CONCLUSIONS

Sarcopenia was prevalent among overweight or obese patients with colorectal cancer and was associated with negative postoperative outcomes. Early recognition of changes in body composition could help surgeons be well prepared for surgical treatment for overweight or obese patients.

Establishment and validation of novel nomograms to predict muscle quality in colorectal cancer patients

OBJECTIVES

The skeletal muscle mass index and skeletal muscle radiodensity have promise as specific diagnostic indicators for muscle quality. However, the difficulties in measuring low skeletal muscle mass index and low skeletal muscle radiodensity limit their use in routine clinical practice, impeding early screening and diagnosis. The objective of this study is to develop a nomogram that incorporates preoperative factors for predicting low skeletal muscle mass index and low skeletal muscle radiodensity.

METHODS

A total of 1692 colorectal cancer patients between 2015 and 2021 were included. The patients were randomly divided into a training cohort (n = 1353) and a validation cohort (n = 339). Nomogram models were calibrated using the area under the curve, calibration curves, and the Hosmer-Lemeshow test to assess their predictive ability. Finally, a decision curve was applied to assess the clinical usefulness.

RESULTS

In a prediction model for low skeletal muscle mass index, age, body mass index, and grip strength were incorporated as variables. For low skeletal muscle radiodensity, age, sex, body mass index, serum hemoglobin level, and grip strength were included as predictors. In the training cohort, the area under the curve value for low skeletal muscle mass index was 0.750 (95% CI, 0.726-0.773), whereas for low skeletal muscle radiodensity, it was 0.763 (95% CI, 0.739-0.785). The Hosmer-Lemeshow test confirmed that both models fit well in both cohorts. Decision curve analysis was applied to assess the clinical usefulness of the model.

CONCLUSIONS

The incorporation of preoperative factors into the nomogram-based prediction model represents a significant advancement in the muscle quality assessment. Its implementation has the potential to early screen patients at risk of low skeletal muscle mass index and low skeletal muscle radiodensity.

Effect of central corneal curvature on corneal material stiffness parameter acquired by dynamic corneal responses

The stress-strain index (SSI) is a measure of corneal material stiffness, which is obtained using the Corvis ST algorithm based on dynamic corneal response parameters. The reduced SSI corresponds to the longer axial length (AL). In a previous study, we found SSI increases as the corneal curvature flattens, whereas a flatter corneal curvature indicates a longer AL (emmetropia or myopia). Therefore, in this cross-sectional study, we aimed to address these contradictory findings. First, we characterized the features of SSI, curvature radius of the anterior corneal surface (CR), and AL and analyzed their correlation with advanced myopia. Next, we compared the relationship between AL and SSI after adjusting for the effect of CR. We found a significant positive correlation between SSI and CR, which contradicts the developmental law of axial myopia. Furthermore, after accounting for the effect of CR, we observed a stronger correlation between SSI and AL than that in the unadjusted model. In conclusion, CR is an independent influencing factor for SSI in addition to AL, which masked the decrease in SSI caused by prolonged AL in axial myopia.

Efficacy of Poria cocos and Alismatis rhizoma against diet-induced hyperlipidemia in rats based on transcriptome sequencing analysis

Hyperlipidemia, a common metabolic disease, is a risk factor for cardiovascular diseases, Poria cocos (PC) and Alismatis rhizoma (AR) serve as a potential treatment. A systematic approach based on transcriptome sequencing analysis and bioinformatics methods was developed to explore the synergistic effects of PC-AR and identify major compounds and potential targets. The phenotypic characteristics results indicated that the high dose (4.54 g/kg) of PC-AR reduced total cholesterol (TC), elevated high-density lipoprotein cholesterol (HDL-C) levels, and improved hepatocyte morphology, as assessed via hematoxylin and eosin (H&E) staining. Transcriptomic profiling processing results combined with GO enrichment analysis to identify the overlapping genes were associated with inflammatory responses. The cytokine-cytokine receptor interaction pathway was found as a potential key pathway using geneset enrichment analysis. Core enrichment targets were selected according to the PC-AR's fold change versus the model. Real-time quantitative PCR analysis validated that PC-AR significantly downregulated the expression of Cxcl10, Ccl2, Ccl4, Cd40 and Il-1β mRNA (P < 0.05). Molecular docking analysis revealed the significant compounds of PC-AR and the potential binding patterns of the critical compounds and targets. This study provides further evidence that the therapeutic effects of PC-AR on hyperlipidemia in rats through the regulation of inflammation-related targets.

A new formula based on new parameters for predicting postoperative vault after posterior chamber intraocular lens implantation: a retrospective study

Background

To investigate the parameters influencing vault after posterior chamber intraocular lens implantation, thereby establishing a formula to predict the vault after operation.

Methods

In this retrospective study, 61 patients (122 eyes) who underwent implantable collamer lens (ICL) implantation were enrolled consecutively from the Qingdao Eye Hospital of Shandong First Medical University, China, between August 2020 and October 2021. Comprehensive optometry, axial length, curvature, anterior chamber depth (ACD), lens thickness (LT), white-to-white distance (WTW), corneal thickness, sulcus-to-sulcus distance (STS), the distance between the sulcus-to-sulcus plane and the anterior crystalline lens surface (STSL), ciliary-to-ciliary distance (CTC) and the distance between the ciliary-to-ciliary plane and the anterior crystalline lens surface (CTCL) were recorded preoperatively. The vault was measured by ultrasound biomicroscopy at 1 month after operation. The correlation among vault, preoperative parameters and ICL size was analyzed. The accuracy and reliability of the prediction formula were verified by analyzing the postoperative correlation coefficient of actual and predicted vaults of the contralateral eye and through the Bland-Altman consistency test.

Results

Parameters significantly influencing the vault at 1 month after operation are ACD (r=0.260, P=0.004), LT (r=-0.338, P<0.001), WTW (r=0.240, P=0.03), STSL (r=-0.394, P<0.001), CTC (r=-0.199, P=0.03), CTCL (r=-0.328, P<0.001), ICL size (r=0.224, P=0.01) and ICL power (r=-0.231, P=0.01). The regression formula was as follows: vault (mm) = -2.179 - 0.227 * CTC (vertical) - 0.783 * CTCL (mean) + 0.472 * ICL size (fitting R=0.853, R2=0.727, adjusted R2=0.705). The predicted vault was 0.50±0.18 mm, and the actual vault was 0.56±0.24 mm. The Bland-Altman scatter plot showed a satisfactory agreement between actual and predicted vaults (-0.06 mm, 95% limits of agreement: -0.45 to 0.32 mm).

Conclusions

ACD, LT, WTW, STSL, CTC, CTCL, ICL size and ICL power were the factors affecting vault after ICL implantation. The prediction formula with the new parameter CTCL was accurate and reliable.

Ultralow Tip-Force Driven Sizable-Area Domain Manipulation through Transverse Flexoelectricity

Deterministic control of ferroelectric domain is critical in the ferroelectric functional electronics. Ferroelectric polarization can be manipulated mechanically with a nano-tip through flexoelectricity. However, it usually occurs in a very localized area in ultrathin films, with possible permanent surface damage caused by a large tip-force. Here it is demonstrated that the deliberate engineering of transverse flexoelectricity offers a powerful tool for improving the mechanical domain switching. Sizable-area domain switching under an ultralow tip-force can be realized in suspended van der Waals ferroelectrics with the surface intact, due to the enhanced transverse flexoelectric field. The film thickness range for domain switching in suspended ferroelectrics is significantly improved by an order of magnitude to hundreds of nanometers, being far beyond the limited range of the substrate-supported ones. The experimental results and phase-field simulations further reveal the crucial role of the transverse flexoelectricity in the domain manipulation. This large-scale mechanical manipulation of ferroelectric domain provides opportunities for the flexoelectricity-based domain controls in emerging low-dimensional ferroelectrics and related devices.

EFFECT OF ANESTHESIA DURATION ON INTRAVITREAL INJECTION PAIN: A double-blinded, randomized, comparative study

PURPOSE

To determine the effect of different durations of topical anesthesia on intravitreal injection (IVI) pain.

METHODS

This was a double-blinded, randomized, comparative study . Three hundred and twelve sequential eyes undergoing IVI were randomized to one of six groups according to the duration of topical anesthesia (from 1 to 30 minutes, one group for every 5-minute range, Groups 1-6). Topical anesthesia before IVI was standardized. Patients graded their pain using the visual analog scale and the Wong-Baker FACES scale at 15 minutes after the procedure.

RESULTS

The pain scores among the six groups were significantly different for the visual analog scale ( P = 0.013) and Wong-Baker FACES scale ( P = 0.024). The mean pain scores for Group 4 were 1.97 ± 1.04 (visual analog scale) and 2.02 ± 1.08 (Wong-Baker FACES scale) and were significantly lower than those of Group 1, 2, 5, or 6.

CONCLUSION

The duration of topical anesthesia significantly correlated with IVI pain. Preoperative 0.5% proparacaine hydrochloride drops were most effective in relieving IVI pain 11 to 20 minutes after topical administration.

Smartphone-Enabled Fluorescence and Colorimetric Platform for the On-Site Detection of Hg2+ and Cl- Based on the Au/Cu/Ti3C2 Nanosheets

Smartphone-assisted fluorescence and colorimetric methods for the on-site detection of Hg²⁺ and Cl^- were established based on the oxidase-like activity of the Au-Hg alloy on the surface of Au/Cu/Ti₃C₂ NSs. The Au nanoparticles (NPs) were constructed via in-situ growth on the surface of Cu/Ti₃C₂ NSs and characterized by different characterization techniques. After the addition of Hg²⁺, the formation of Hg-Au alloys could promote the oxidization of o-phenylenediamine (OPD) to generate a new fluorescence emission peak of 2,3-diaminopenazine (ADP) at 570 nm. Therefore, a turn-on fluorescence method for the detection of Hg²⁺ was established. As the addition of Cl^- can influence the fluorescence of ADP, the fluorescence intensity was constantly quenched to achieve the continuous quantitative detection of Cl^-. Therefore, a turn-off fluorescence method for the detection of Cl^- was established. This method had good linear ranges for the detection of Hg²⁺ and Cl^- in 8.0-200.0 nM and 5.0-350.0 µM, with a detection limit of 0.8 nM and 27 nM, respectively. Depending on the color change with the detection of Hg²⁺ and Cl^-, a convenient on-site colorimetric method for an analysis of Hg²⁺ and Cl^- was achieved by using digital images combined with smartphones (color recognizers). The digital picture sensor could analyze RGB values in concentrations of Hg²⁺ or Cl^- via a smartphone app. In summary, the proposed Au/Cu/Ti₃C₂ NSs-based method provided a novel and more comprehensive application for environmental monitoring.

"One-can" strategy for the synthesis of hydrothermal biochar modified with phosphate groups and efficient removal of uranium(VI)

Significant selectivity, reasonable surface modification and increased structural porosity were three key factors to improve the competitiveness of biochar in the adsorption field. In this study, a hydrothermal bamboo-derived biochar modified with phosphate groups (HPBC) was synthesized using "one-can" strategy. BET showed that this method could effectively increase the specific surface area (137.32 m2 g-1) and simulation of wastewater experiments indicated HPBC had an excellent selectivity for U(VI) (70.35%), which was conducive to removal of U(VI) in real and complex environments. The accurate matchings of pseudo-second-order kinetic model, thermodynamic model and Langmuir isotherm showed that at 298 K, pH = 4.0, the adsorption process dominated by chemical complexation and monolayer adsorption was spontaneous, endothermic and disordered. Saturated adsorption capacity of HPBC could reach 781.02 mg g-1 within 2 h. The introduction of phosphoric acid and citric acid by "one-can" method not only provided abundant -PO4 to assist adsorption, but also activated oxygen-containing groups on the surface of the bamboo matrix. Results showed that adsorption mechanism of U(VI) by HPBC included electrostatic action and chemical complexation involving P-O, PO and ample oxygen-containing functional groups. Therefore, HPBC with high phosphorus content, outstanding adsorption performance, excellent regeneration, remarkable selectivity and green value provided a novel solution for the field of radioactive wastewater treatment.

N, N-bis (2-hydroxyethyl) malonamide based amidoxime functionalized polymer immobilized in biomembranes for highly selective adsorption of uranium(VI)

Amidoxime compounds have been widely used in metal separation and recovery because of their excellent chelating properties to metal ions, especially to uranium (VI). In this study, N, N-bis (2-hydroxyethyl) malonamide was obtained from ethanolamine and dimethyl malonate, and used to prepare a two-dimensional network polymer, then the obtained polymer was immobilized in an environmentally friendly chitosan biomembrane, which enhanced its stability and hydrophobicity, meanwhile the amidoxime functionalization was achieved by oximation reaction of bromoacetonitrile, the application of the material further extends to uranium (VI) separation in solutions. Due to the synergistic action of amide group and amidoxime group, poly (ethanolamine-malonamide) based amidoxime biomembranes (PEA-AOM) showed extraordinary adsorption effect on uranium (VI), among which the saturation adsorption capacity of PEA-AOM-2 was 748.64 mg/g. PEA-AOM-2 also had good reusability (following five cycles of adsorption-desorption, the recovery rate maintained at 88%) and selectivity for uranium (VI), showing satisfactory results in competitive ion coexistence system and simulated seawater experiments. This study demonstrated that PEA-AOM-2 provided a new option for uranium (VI) separation in complex environment and low-concentration uranium background.

Rubochingosides A - J, labdane-type diterpene glycosides from leaves of Rubus chingii

Ten previously undescribed labdane-type triterpenoids, rubochingosides A - J (1-10), were isolated from the leaves of Rubus chingii Hu. Their structures were elucidated by spectroscopic and chemical methods. The cytotoxicity of all isolated compounds was tested against five human tumor cell lines (Bel-7402, Caski, BGC-823, A2780, and HCT-116). Among them, compounds 4 and 8 showed cytotoxic activities against Bel-7402 and A2780 cells with IC₅₀ values of 10.43 ± 0.51 and 29.03 ± 2.94 μM, respectively; Compound 8 exhibited cytotoxic activities against Bel-7402 and HCT-116 cells with IC₅₀ values of 17.78 ± 1.54 and 26.23 ± 6.14 μM, respectively.

Abstract 999: Colocalization of MAGE-A3 and MAGE-A4 in bladder cancer

The treatment of bladder cancers has improved with new immunotherapy such as PD-L1. However, not all bladder cancers respond to PD-L1 immunotherapy which is why new targets are being assessed. Melanoma-associated antigen gene A (MAGE-A) family proteins are expressed in a variety of tumors, with each MAGE-A protein having unique roles in cancer pathogenesis. One advantage of targeting MAGE-A family members is the lack of expression in normal tissues which makes them well-suited for targeted cancer immunotherapy. The challenge with screening the MAGE-A family is to find a specific antibody since the 12-member family has over 60% sequence in homology. In this study, we evaluate multiple MAGE-A3 and MAGE-A4 antibodies using CytoSections, a reproducible alternative to control tissue with an expression of target biomarkers. A series of antibodies specific to each MAGE-A3 and MAGE-A4 protein were discovered and used to screen twenty-five bladder cancer tissues. The results showed that MAGE-A3 was present in 9 of the 25 bladder cancers, while MAGE-A4 was present in 10 of the 25 bladder cancers evaluated; in the meantime, 7 bladder cancers were positive for both targets after double immunofluorescence staining with MAGE-A3 or A4 specific antibodies. The data presented here could be an important development in treatment protocols for pre-screening patients who are at risk. Our findings show that MAGE-A3 and MAGE-A4 can be both present in bladder cancer, suggesting that targeting both genes may be necessary for the success of immunotherapy treatment.

Citation Format: Bailey Gilmore, Rachel Gonzalez, Aubrey Su, Dehe Kong, Eden Zewdu, Jina Yom, Tianli Qu, Zhaoying Guo, Xiaomin Hu, Qi Ren, Ranran Zhang, Eric Christenson, Yan Ma, Dezhong Yin, Patrick Yin, Wei Fu, Xuan Liu, Krishnan Allampallam. Colocalization of MAGE-A3 and MAGE-A4 in bladder cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 999.

Plasma transfusion in critically Ill patients with abnormal coagulation tests before invasive procedures: A propensity-adjusted cohort study

OBJECTIVE

To evaluate the association between plasma transfusion and bleeding complications in critically ill patients with an elevated international normalized ratios undergoing invasive procedures.

METHODS

A retrospective study was conducted to evaluate a consecutive sample of critically ill adult patients undergoing invasive procedures (N = 487) with an international normalized ratio ≥ 1.5 between January 1, 2019 and December 31, 2019. Among the followed patients, 125 were excluded due to incomplete case records and 362 were finally included in this investigation. The exposure was whether plasma had been transfused within 24 h before the invasive procedure. The primary outcome was the occurrence of postprocedural bleeding complications. Secondary outcomes included transfusion of red blood cells within 24 h of the invasive procedure, and additional patient-important outcomes such as mortality and length of stay. Tests were performed with univariate and propensity-matched analyses.

RESULTS

Of the 362 study participants, 99 (27.3 %) received a preprocedural plasma transfusion. In the propensity score-matched analysis, the rate of the occurrence of postprocedural bleeding complications between two groups was not statistically different (OR, 0.605[95 % CI, 0.341-1.071]; P = .085). The rate of postoperative red blood cell transfusion in the plasma transfusion group was higher than that in the non-plasma transfusion group (35.5 % vs 21.5 %; P < .05). No statistically significant difference in mortality was observed between the two groups (29.0 % vs 31.6 %; P = .101).

CONCLUSIONS

Prophylactic plasma transfusion failed to reduce postprocedural bleeding complications in ill critically patients with a coagulopathy. Meanwhile, it was associated with increased red blood cell transfusion after invasive procedures. Findings suggest that abnormal preprocedural international normalized ratios should be managed more conservatively.

A Study of carbon efficiency in the Yangtze River Economic Belt using the synthetic control method

In order to analyze the impact of policy effect on carbon efficiency in the Yangtze River Economic Belt, an experimental group, including 11 regions possessing the features of the Yangtze River Economic Belt, was constructed using the synthetic control method for project evaluation with the single-factor carbon efficiency value as the core study variable in this paper. Several regions were selected from the control group as synthetic objects through a data-driven approach to construct synthetic regions that meet basic requirements before the implementation of the policy by weight ratio and evaluate the policy’s impact on the implementation of carbon efficiency in the Yangtze River Economic Belt. The study shows that the single-factor carbon efficiency is relatively robust. But since 2013, the tail of the Yangtze River Economic Belt has seen an improvement. Sichuan, Hunan, Chongqing and Hubei have exceeded other provinces and cities in the growth of carbon efficiency and Shanghai has also witnessed a significant increase. Upon the inception of the synthetic Yangtze River Economic Belt, there’s a discernible divergence between the curves of the real and the synthetic Yangtze River Economic Belt. Specifically, policy interventions in the Yangtze River Economic Belt didn’t work well in earlier years and even restrained the economic growth of the whole region.

Effect of corneal stiffness decrease on axial length elongation in myopia determined based on a mathematical estimation model

Purpose: To investigate the relationship between the corneal material stiffness parameter stress-strain index (SSI) and axial length (AL) elongation with varying severities of myopia, based on a mathematical estimation model. Methods: This single-center, cross-sectional study included data from healthy subjects and patients preparing for refractive surgery in the Qingdao Eye Hospital of Shandong First Medical University. Data were collected from July 2021 to April 2022. First, we performed and tested an estimated AL model ( A L M o r g a n ) based on the mathematical equation proposed by Morgan. Second, we proposed an axial increment model ( Δ A L ) corresponding to spherical equivalent error (SER) based on A L e m m e t r o p i a ( A L M o r g a n at SER = 0) and subject's real AL. Finally, we evaluated the variations of Δ A L with SSI changes based on the mathematical estimation model. Results: We found that AL was closely associated with A L M o r g a n (r = 0.91, t = 33.8, p < 0.001) with good consistency and SER was negatively associated with Δ A L (r = -0.89, t = -30.7, p < 0.001). The association of SSI with AL, A L e m m e t r o p i a , and Δ A L can be summarized using the following equations: A L = 27.7 - 2.04 × S S I , A L e m m e t r o p i a = 23.2 + 0.561 × S S I , and Δ A L = 4.52 - 2.6 × S S I . In adjusted models, SSI was negatively associated with AL (Model 1: β = -2.01, p < 0.001) and Δ A L (Model 3: β = -2.49, p < 0.001) but positively associated with A L e m m e t r o p i a (Model 2: β = 0.48, p < 0.05). In addition, SSI was negatively associated with Δ A L among subjects with AL ≥ 26 mm (β = -1.36, p = 0.02). Conclusion: AL increased with decreasing SSI in myopia.

[Characteristics and significance of outer retinal thickness changes in reticular macular disease]

Objective: To study the characteristics and significance of changes in the thickness of the outer retinal layer (ORL) outside the macula in patients with reticular macular disease (RMD). Methods: A cross-sectional study was conducted. The clinical data of patients who visited the Department of Ophthalmology of the First Affiliated Hospital of Guangzhou Medical University from February to September 2019 were retrospectively collected. Thirty-one patients with at least one eye (54 eyes in total) diagnosed with early/mid-stage age-related macular degeneration (AMD) were consecutively included in the AMD group, and 33 patients with at least one eye (64 eyes in total) showing subretinal wart-like deposits on optical coherence tomography images were consecutively included in the RMD group. Thirty-two volunteers aged between 50 to 90 years with a normal fundus in both eyes (64 eyes in total) were consecutively included in the healthy control (HC) group. Frequency domain optical coherence tomography was applied to examine and analyze the thickness features of the ORL, inner retinal layer and choroid at the macular fovea (F), 2 mm of the temporal edge (T), the nasal edge (N), the superior edge (S) and inferior edge (I) of the macular fovea in each group. The correlations of the thickness of ORL with the choroidal thickness and the blood flow density of the choriocapillaris layer in patients with RMD were also analyzed. Results: The thickness of ORL at the F, T, S and I sites in the RMD group was significantly thinner than that in the AMD and HC groups. The difference was most obvious at the F site [(90.27±8.93), (98.04±11.7) and (97.19±7.02)μm] in the RMD, AMD and HC groups, respectively; all P<0.01). In the logistic regression model with independent variables of the ORL thickness at the macular F site, gender and age, there was a significant association between the thickness of ORL at the F site and the incidence of RMD (odds ratio=0.926, P<0.05). The ORL and choroid in the eyes of patients with RMD were significantly thinner at the F site [(90.27±8.93) and (163.21±72.43) μm, respectively; both P<0.01] compared with the AMD [(98.04±11.7) and (235.34±64.15) μm, respectively] and HC [(97.19±7.02) and (240.08±62.27) μm, respectively] groups. However, the ORL and choroidal thickness did not show significant and strong linear correlations at multiple sites. In contrast, there was a significant linear correlation between the blood flow density of the choriocapillaris layer and the thickness of ORL at the F, T and S sites in patients with RMD (r=0.487, 0.722, 0.467, respectively; all P<0.05). Conclusions: The thickness of ORL outside the macula of eyes with RMD is thinner than that of healthy eyes and eyes with early/mid-stage AMD. The thinning of ORL outside the macula is related to the decrease in the blood flow density of the choriocapillaris layer in patients with RMD.

[Value of high-flow oxygen therapy after weaning for successful extubation of critical ill patients with mechanical ventilation]

OBJECTIVE

To investigate the value of high-flow oxygen therapy after weaning in successful extubation of critically ill patients with mechanical ventilation.

METHODS

A retrospective study was conducted. The weaned patients who were older than 18 years old and underwent mechanical ventilation for the first time due to cerebrovascular accidents, surgical operations, cardiovascular diseases, and pneumonia admitted to the department of critical care medicine of Zhejiang Hospital from January 2018 to June 2020 were enrolled. Among the patients, 40 cases received high-flow oxygen therapy after weaning, and 37 cases received Venturi combined with the humidifier. The patient's gender, age, primary disease, severity score, duration of mechanical ventilation before weaning, heart rate (HR), blood pressure, pulse oxygen saturation (SpO₂) at 0, 6, 12, 18, and 24 hours after weaning, and pH value, arterial partial pressure of oxygen (PaO₂), arterial partial pressure of carbon dioxide (PaCO₂) at 6, 12, 18, and 24 hours after weaning, the rate of performing mechanical ventilation after weaning, extubation time after weaning, and the rate of reintubation after extubation for 72 hours were collected.

RESULTS

There was no significant difference in baseline data such as gender, age, primary disease, severity score, and duration of mechanical ventilation before weaning between the two groups. After weaning, the vital signs of the two groups were stable, and there was no significant difference in HR, systolic blood pressure (SBP), diastolic blood pressure (DBP) or SpO₂ at each time point between the two groups. After weaning, the pH of arterial blood gas analysis in the two groups and the fluctuations of PaO₂ and PaCO₂ in the high-flow group were not obvious. In the Venturi group, PaO₂ gradually decreased after weaning, PaCO₂ increased significantly at 12 hours, and slowly decreased after 12 hours. The PaO₂ from 6 hours and PaCO₂ from 12 hours in the high-flow group were significantly lower than those in the Venturi group, and continued to 24 hours [PaO₂ (mmHg, 1 mmHg ≈ 0.133 kPa): 112.34±38.25 vs. 156.76±68.44 at 6 hours, 110.92±38.66 vs. 150.64±59.07 at 12 hours, 111.12±36.77 vs. 141.30±39.05 at 18 hours, 110.82±39.37 vs. 139.65±41.50 at 24 hours; PaCO₂ (mmHg): 41.30±7.51 vs. 47.42±7.54 at 12 hours, 40.97±6.98 vs. 45.83±8.63 at 18 hours, 40.10±7.06 vs. 46.14±9.15 at 24 hours, all P < 0.01]. The rate of performed mechanical ventilation after weaning and the rate of reintubation after extubation for 72 hours in the high-flow group were significantly lower than those in the Venturi group [17.5% (7/40) vs. 40.5% (15/37), 6.2% (2/32) vs. 31.8% (7/22), both P < 0.05], and the extubation time after weaning was significantly shorter than that in the Venturi group (hours: 22.43±11.72 vs. 28.07±10.42, P < 0.05).

CONCLUSIONS

Using high-flow oxygen therapy to the extubation process of critically ill mechanical ventilation patients can reduce the incidence of carbon dioxide retention and the rate of performed mechanical ventilation after weaning, shorten the extubation time after weaning, and reduce the rate of reintubation after extubation for 72 hours.

Giant ferroelectric polarization in a bilayer graphene heterostructure

At the interface of van der Waals heterostructures, the crystal symmetry and the electronic structure can be reconstructed, giving rise to physical properties superior to or absent in parent materials. Here by studying a Bernal bilayer graphene moiré superlattice encapsulated by 30°-twisted boron nitride flakes, we report an unprecedented ferroelectric polarization with the areal charge density up to 10¹³cm⁻², which is far beyond the capacity of a moiré band. The translated polarization ~5 pC m⁻¹ is among the highest interfacial ferroelectrics engineered by artificially stacking van der Waals crystals. The gate-specific ferroelectricity and co-occurring anomalous screening are further visualized via Landau levels, and remain robust for Fermi surfaces outside moiré bands, confirming their independence on correlated electrons. We also find that the gate-specific resistance hysteresis loops could be turned off by the other gate, providing an additional control knob. Furthermore, the ferroelectric switching can be applied to intrinsic properties such as topological valley current. Overall, the gate-specific ferroelectricity with strongly enhanced charge polarization may encourage more explorations to optimize and enrich this novel class of ferroelectricity, and promote device applications for ferroelectric switching of various quantum phenomena.

Interfacial ferroelectricity may emerge in moiré superlattices. Here, the authors find that the polarized charge is much larger than the capacity of the moiré miniband and the associated anomalous screening exists outside the band.

First Detection and Molecular Identification of Entamoeba bovis in Farm-Raised Sika Deer from Anhui Province, China

BACKGROUND

Protozoans of Entamoeba spp. are one of the most common enteric parasites that infect humans and diverse animals including deer.

PURPOSE

However, data regarding the prevalence and species/genotypes of Entamoeba spp. in deer in China is scarce. This study investigated the prevalence and species distribution of Entamoeba spp. in sika deer (Cervus nippon) in Anhui Province.

METHODS

In our survey, 336 fecal samples were collected from five sika deer farms in different regions of Anhui Province. All samples were examined for the presence of Entamoeba spp. by PCR and phylogenetic analysis of the conserved 18S rRNA gene.

RESULTS

106/336 (31.5%) fecal samples were positive for Entamoeba spp. A statistically significant difference in the prevalence of Entamoeba spp. infection was observed between sampling farms (p < 0.001), and the prevalence of Entamoeba spp. in male and female sika deer showed no significant difference (p > 0.05). Sequence and phylogenetic analysis revealed the single species, E. bovis, was identified in this study.

CONCLUSION

This is the first report about the identification of E. bovis in farm-raised sika deer in China, and these results expand our understanding of host range and species distribution of Entamoeba spp. in ruminants.

The relationship between axial length/corneal radius of curvature ratio and stress–strain index in myopic eyeballs: Using Corvis ST tonometry

Purpose: This study aimed to investigate the correlation of axial length/corneal radius of curvature ratio with stress–strain index (SSI).

Methods: Retrospective analysis was conducted to compare the right eyes of those with high myopia (HM, n = 132; age and 10–48 years) with those without high myopia (NHM, n = 135; age and 7–48 years), where the baseline axial length, corneal radius of curvature ratio, and central corneal thickness were analyzed; the differences in two groups were compared; and the relationship of axial length and axial length/corneal radius of curvature ratio with SSI were explored.

Results: Compared with AL &lt; 26mm, SSI significantly decreased when AL ≥ 26 mm (p = 0.001), while there was no correlation with AL in the NHM group (r = -0.14, p = 0.12) or HM group (r = -0.09, p = 0.32). AL/CR was significantly associated with SSI in both the NHM (r = -0.4, p &lt; 0.001) and HM (r = -0.18, p = 0.04) groups. In the NHM group, AL/CR was significantly associated with SSI (unstandardized beta = -0.514, se = 0.109, p &lt; 0.001) with the adjustment of age and gender. Additionally, a significant association of SSI with AL/CR was also found after adjusting for age and gender (unstandardized beta = -0.258, se = 0.096, and p = 0.0082) in the HM group.

Conclusion: SSI showed a significant negative correlation with AL/CR in patients without high myopia and in patients with high myopia. However, SSI exhibited no decrease with the worsening of myopia, but it gradually remained stable at a low level. The findings of this study validate, to some extent, the possibility of analyzing the dynamic changes in ocular wall stiffness during the development of myopia by measuring in vivo corneal biomechanical parameters.

Effects of a standardized patient-based simulation in anaphylactic shock management for new graduate nurses

Background

Patients may be endangered if new graduate nurses cannot recognize and manage anaphylactic shock. Consequently, enhancing the new graduate nurses’ understanding of their roles and responsibilities during the rescue of a patient with anaphylactic shock is important. However, due to its inherent limitations, traditional classroom-based teaching makes it difficult to explore the potential of the students. Although popular simulation teaching has several notable advantages, it has not been proven to be effective in training inexperienced nurses on anaphylactic shock. We investigated the effect of a standardized patient-based simulation on the behaviors of new graduate nurses’ during anaphylactic shock rescue to identify an effective and safe method for contemporary nursing education.

Methods

Except for the ill or pregnant, all the new graduate nurses were included in the study as students to undergo a standardized patient-based simulation conducted in the clinical skills center of a general hospital. The simulation training was designed to teach students to recognize the signs and symptoms of anaphylactic shock, place the patient in the correct position, stop the ongoing intravenous infusion of the antibiotic which triggers the anaphylactic shock, restart an intravenous infusion on a new infusion apparatus, give 100% oxygen via a nasal cannula or mask, preserve airway patency, call the rapid response team, and correctly administer the medications prescribed by the clinicians. Before and after the training, the instructors evaluated each student’s skills and behaviors using a clinical competency evaluation list. After the training, all students completed the Chinese version of the Simulation Design Scale (SDS) to demonstrate their satisfaction with the program and then participated in semi-structured interviews with their instructors.

Results

All 104 graduate nurses had a significant improvement on the 6 competencies of the clinical competency evaluation list after the simulation training (P < 0.001). The SDS scores revealed that the students were highly satisfied with all the aspects of the simulation training (the 20 satisfaction rates were all above 90.00%). During the semi-structured interviews, most of the new graduate nurses reported that simulation training in the management of anaphylactic shock was critical and would guide them in clinical practice.

Conclusion

Simulation training in anaphylactic shock is a potentially viable and effective method for teaching new graduate nurses to manage clinical incidents.

Abstract 3695: Overexpression of HSD17B13 induced G1 arrest in hepatic cell lines detected by anti-HSD17B13 recombinant rabbit monoclonal antibody

Hepatocellular carcinoma (HCC) is one of the most prevalent tumors worldwide. Hydroxysteroid 17-beta dehydrogenase 13 (HSD17B13), which was newly identified as a liver lipid droplet associated protein, was recently found to be down-regulated in HCC. However, the effects of HSD17B13 on the underlying mechanisms of HCC have not yet been fully explored. For this purpose, HSD17B13 gene was knockdown with CRISPER/Cas9 technique in several HCC cell lines. HSD17B13 expression was detected by Flow cytometry and Western blotting with recombinant rabbit monoclonal antibodies (clone OTIR3G2 and OTIR5C10) against HSD17B13 which were screened for use in immunohistochemistry, western blot, and ELISA application. Overexpressed HSD17B13 induces hepatic cell line G1 capture and increases several G1 arrest-related protein expression, including p21, p27, MMP2 and MMP3. Then the proliferation and cell cycle were suppressed. HSD17B13 gene knockdown will reverse the suppression. These data indicated that HSD17B13 play important roles in the progression of HCC lesions. HSD17B13 might be a potential immune-oncology marker for HCC.

Citation Format: Tianli Qu, Lipeng Wu, Jina Yom, Zhaoying Guo, Xiaomin Hu, Qi Ren, Qian Niu, Ruei-Shiuan Lin, Dezhong Yin, Xuan Liu, Fu Wei. Overexpression of HSD17B13 induced G1 arrest in hepatic cell lines detected by anti-HSD17B13 recombinant rabbit monoclonal antibody [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3695.

Abstract 2803: A renewable IHC control tool CytoSections࣪ for defining MAGEA3, MAGEA4, and MAGEA9 antibody specificity

Melanoma-associated antigen gene A (MAGEA) family proteins are expressed in a variety of tumors with each MAGEA protein having unique roles in cancer pathogenesis. The MAGEA members lack of expression in normal tissue and their role in cancer make them well suited for targeted cancer immunotherapy. Thus, knowing which MAGEA protein expression exists in a tumor is important. However, the MAGEA family shares sequence similarity that makes it difficult to find antibodies that are specific to just one family member. It is also challenging to source tissue generally with HIPAA regulation and even more so to get tissue representation of all 12 MAGEA family members. Here we present CytoSections as an alternative to patient control tissues. CytoSections are formalin fixed, paraffin embedded (FFPE) section of over-expression cell pellets. These cells were transfected with expression plasmids coding for genes of individual MAGES family. In this study, CytoSections are used to screen antibodies to all 12-member MAGEA family of proteins. The MAGEA family members were initially shown positive by targeted protein expression in western and immunohistochemistry using DDK tag antibody. Then multiple MAGEA3, MAGEA4, MAGEA9 antibodies were assessed by IHC to determine their specificity to their intended target. Using MAGEA family as a pilot project, we show that CytoSections is a verified, reproducible, and renewable alternative to human control tissues and serves as an ideal tool for antibody specificity assessment.

Citation Format: Eden B. Zewdu, Rachel M. Gonzalez, Yan Ma, Derek Ling, Xiaomin Hu, Qi Ren, Ranran Zhang, Li-Hui Lei, Krishnan Allampallam, Dezhong Yin, Xuan Liu, Wei Fu. A renewable IHC control tool CytoSections࣪ for defining MAGEA3, MAGEA4, and MAGEA9 antibody specificity [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2803.

Evaluation of crossed cerebellar diaschisis after cerebral infarction in MCAO rats based on DKI

OBJECTIVE

To observe the expression of N-methyl-D-aspartate (NMDA), apoptosis and the effect on neurological function recovery in rat model with middle cerebral artery occlusion (MCAO). Diffusion kurtosis imaging (DKI) was used to evaluate crossed cerebellar diaschisis (CCD) and to provide experimental and theoretical basis for the clinical treatment.

MATERIALS AND METHODS

The MCAO models were established in rats. Eighty-four rats were randomly and evenly divided into 7 groups, including control group, 6-h group, 12-h group, 24-h group, 48-h group, 7-day group and 14-day group. The rats were scanned by MRI at the above time points. Then, rats were sacrificed for H&E staining, immunohistochemical staining and TUNEL staining to detect the expression of NMDA in the core infarct area and cerebellum. At the end, the discussion of relationships between molecular biology and MRI parameters (ADC derived from DWI, and MD, MK and FA derived from DKI) was performed.

RESULTS

The values of MD, ADC and FA in MCAO rats were all lower than those in the control group. All MRI parameters of the contralateral cerebellum were lower than those of the ipsilateral cerebellum (p < .05). The parameters reached the lowest value at 12 h, except that the MK reached the highest at 12 h. The expression of NMDA showed a fluctuation along time in the MCAO group. Overall, it is higher in the MCAO group than in the control group, reaching the maximum at 24 h (p < .05). At the same time, the expression of NMDA in the contralateral cerebellum was higher than in the ipsilateral cerebellum.

CONCLUSION

It is found that NMDA and DKI of CCD have the same changing trend, which indicates that the intervention of NMDA receptor apoptosis may become a new target for the treatment of cerebral infarction, and MRI parameters can predict the occurrence and development of CCD.

Demirjian method and Willems method to study the dental age of adolescents in Shanghai before and after 10 years

BACKGROUND

The aim of this study is to assess the validity of whether the difference in dental age between 2009 to 2011 and 2021 is affected by environmental factors such as environmental pollution, floating population, and dietary habits. Demirjian and Willems dental age estimation methods were conducted for a Han population of children aged 8 to 14 in Shanghai, China. A total of 1,259 digital panorama radiographs of children aged 8.00-14.99 was estimated. All digital panorama radiographs were estimated using the Demirjian and Willems methods.

MATERIALS AND METHODS

Both 2009 to 2011 and 2021 were statistically analyzed by paired t-tests. The results show that the Demirjian method overestimates 2009 to 2011 and underestimates 2021 than children's chronological age. According to the Willms method, males are overestimated and females are underestimated from 2009 to 2011, and both genders were underestimated in 2021.

CONCLUSIONS

In conclusion, the difference in dental age between 2009 to 2011 and 2021 was statistically significant. Factors such as environment and dietary habits have been found to be affected by dental development. However, there are disputes among some researchers about the exact factors, so it is suggested to further study the effects of environmental factors on tooth development.

Rapamycin reduces podocyte damage by inhibiting the PI3K/AKT/mTOR signaling pathway and promoting autophagy

Objective: Rapamycin is a potent inducer of autophagy in podocytes. However, we still understand very little about how autophagy is regulated under podocyte injury conditions. This study aimed to investigate the role of autophagy in podocyte injury and the regulatory mechanism of the PI3K/Akt/mTOR signaling pathway in this process. Methods: The podocytes were cultured in vitro, and the apoptosis rate of each group was determined by flow cytometry. The protein expression and distribution of LC3-II were examined by immunofluorescence. The phosphorylation levels of Akt, LC3-II, mTOR, 4EBP1, and P70S6K were measured using Western Blot. Transmission electron microscopy was used to examine the changes in autophagosomes in each group. Results: Compared with the control group, the puromycin group (PAN) increased podocyte apoptosis, decreased numbers of autophagosomes, and downregulated LC3-II protein expression. Compared with the PAN group, the podocyte apoptosis rate decreased in the Rapamycin group (RAPA), the number of autophagosomes increased, and LC3-II protein expression was upregulated. In addition, PAN evoked an increase in p-Akt expressions, RAPA treatment induced a reversal of PAN-induced p-Akt upregulation, and the phosphorylation levels of mTOR, 4EBP1, and P70S6K were downregulated. Conclusion: PAN can damage podocytes by inhibiting podocyte autophagic activity and promoting apoptosis. Rapamycin can ameliorate PAN-induced podocyte damage by activating autophagy. This effect may be related to rapamycin-mediated PI3K/AKT/mTOR signaling pathway and autophagy.

Interaction between the HIF-1α gene rs1957757 polymorphism and CpG island methylation in the promoter region is associated with the risk of anti-tuberculosis drug-induced liver injury in humans: A case-control study

WHAT IS KNOWN AND OBJECTIVE

HIF-1α gene polymorphisms, including rs11549465, rs11549467, rs1957757 and rs10873142, cause liver cell damage or pulmonary disease. The aim of this study was to analyse the association between the polymorphisms of the loci of the HIF-1α gene and its CpG island methylation in the promoter region with the risk of anti-tuberculosis drug-induced liver injury (ADLI).

METHODS

286 patients with tuberculosis (TB) and ADLI (case group) and 286 patients with TB but without liver injury (control group) were matched one-to-one, among the 1728 TB patients recruited from July 2019 to July 2020. Genotyping of the four loci of the HIF-1α gene was confirmed using PCR-RFLP technology. Methylation of the HIF-1α gene was measured using the MSP method. The comparison of risk factors, HIF-1α genotype and methylation status between the case group and the control group was all achieved through univariate and multivariate conditional logistic regression.

RESULTS AND DISCUSSION

Univariate analysis showed that the frequency of rs1957757 mutation genotype and CpG island methylation was significantly higher in the case group than in the control group (P<0.001, all). In contrast, there was no statistical difference in the frequency of mutated genotypes at the other three loci between the two groups (p = 0.21, p = 0.12 and p = 0.55, respectively). Further, multivariate analysis showed that CpG islands were methylated, the mutation genotype of the rs1957757 locus was independently associated with the high risk of ADLI, and the adjusted OR (95%CI) reached 1.92 (1.32-2.63) and 2.01 (1.32-2.83), respectively. Furthermore, taking the rs1957757 locus wild genotype and CpG islands without methylation as the reference group, the mutation genotype and CpG island methylation increased the risk of ADLI, and the probability of ADLI could reach 4.73 times that of the reference group.

WHAT IS NEW AND CONCLUSION

This is the first demonstration of the association of HIF-1α gene polymorphism and CpG island methylation with ADLI risk stratification. The interaction between CpG islands methylated in the promoter region of the HIF-1α gene and its rs1957757 locus mutant genotype was associated with a higher risk of ADLI.

A possible dose-response equation: Viral load after plasma infusion in COVID-19 patients and anti-SARS-CoV-2 antibody titers in convalescent plasma

BACKGROUND

Clinical trials of convalescent plasma therapy for coronavirus disease 2019 (COVID-19) are extensive, but the relationship between antibody titers, infused volume of plasma and virus clearance in patients remains unknown. This study proposed a possible estimating equation for clinical use of high antibody titer convalescent plasma.

METHODS

A total of 38 patients were recruited in the Guanggu District Maternal and Child Health Hospital of Hubei Province from March 1 to 30, 2020. COVID-19 convalescent plasma was collected and high-titer (≥1:640) anti-S-RBD units used. The SARS-CoV-2 nucleic acid viral load was measured 24 h before and 72 h after convalescent plasma infusion.

RESULTS

Convalescent plasma therapy was associated with reduced viral load in patients with moderate and severe severity. The viral negative rate at 72 h was 65.8%. The disappearance of viral nucleic acid in study patients was positively correlated with infuscate antibody titer and volume (r = 0.3375, p = 0.04). A possible estimation equation was as follows: Log₁₀ (Reduction in viral load) = 0.18 + 0.001 × (Log₂ S-RBD antibody titer × Plasma infusion volume) (r = 0.424, p = 0.009). In a single case, the viral nucleic acid persisted 14 days after the fourth plasma infusion.

CONCLUSIONS

This study proposes a potential dose-response equation that adds a convenient way to estimate the dose of convalescent plasma product. It is beneficial to facilitate the rational allocation of plasma with high antibody titers and provide an individualised use strategy for convalescent plasma therapy.

Screening differential circular RNA expression profiles reveals the regulatory role of circMARS in anti-tuberculosis drug-induced liver injury

Tuberculosis (TB) treatment is plagued by liver damage, which often leads to treatment interruptions. Circular RNAs (circRNAs) are a special class of non‐coding RNAs abundant in body fluids with important biological functions. However, the role of circRNA in anti‐tuberculosis drug‐induced liver injury (ADLI) is unclear. We explored ADLI‐specific circRNAs in TB patients using circRNA microarrays and verified circMARS in a cohort of 300 individuals. In addition to the value assessment of circMARS in patients using a receiver operating characteristic (ROC) curve, cell experiments were also performed under the guidance of bioinformatics analyses. In particular, we found that circMARS acts as a miRNA sponge by binding to miRNAs. Compared with the blank group, the expressions of circMARS, KMT2C gene, and EGFR protein in the ADLI group were increased, while miR‐6808‐5p, miR‐6874‐3p, and miR‐3157‐5p were decreased. Furthermore, when si‐circMARS was used in the ADLI groups, circMARS demotion manifested the opposite results. Subsequently, a self‐controlled cohort of 35 participants was used to verify the circMARS–miR‐6808‐5p/‐6874‐3p/‐3157‐5p–KMT2C–EGFR function axis. Therefore, circMARS may participate in the compensatory repair mechanism of ADLI through the function axis, and may be a potential biomarker for ADLI diagnosis in TB patients.

The role of PTEN in puromycin aminonucleoside-induced podocyte injury

Podocytes are specialized cells of the glomerulus that play important structural and functional roles in maintaining the filtration barrier. Loss and injury of podocytes are leading factors of glomerular disease and kidney failure. Recent studies found that phosphatase and tensin homolog (PTEN) may play a critical role in maintaining the normal structure and function in podocytes. However, we still understand very little about how PTEN is regulated under podocyte injury conditions. In this study, We therefore investigated whether PTEN could play a role in podocyte injury induced by puromycin aminonucleoside (PAN), and whether dexamethasone (DEX) alleviates podocyte injury by PTEN/PI3K/Akt signaling. Our results showed that PI3K/Akt pathway was activated in podocytes exposed to PAN conditions, accompanied by down-regulation of the PTEN and microtubule-associated light chain 3 (LC3) expression.podocyte-specific knockout of PTEN significantly promoted podocyte injury, The potential renoprotection of overexpressed PTEN in podocytes was partly attributed with an improvement in autophagy and the inhibition of apoptosis.These novel findings also suggest that targeting PTEN might be a novel and promising therapeutic strategy against podocyte injury.

Successful Application of Extracorporeal Membrane Oxygenation in an Acute Tonsillitis Patient Complicated with Acute Respiratory Distress Syndrome: A Case Report

Cases of acute tonsillitis, a common disease in the emergency department, are mostly mild and those complicated by severe pneumonia and acute respiratory distress syndrome are rarely reported.

TANC1 methylation as a novel biomarker for the diagnosis of patients with anti-tuberculosis drug-induced liver injury

We aimed to elucidate the differences in genomic methylation patterns between ADLI and non-ADLI patients to identify DNA methylation-based biomarkers. Genome-wide DNA methylation patterns were obtained using Infinium MethylationEPIC (EPIC) BeadChip array to analyze 14 peripheral blood samples (7 ADLI cases, 7 non-ADLI controls). Changes in the mRNA and DNA methylation in the target genes of another 120 peripheral blood samples (60 ADLI cases, 60 non-ADLI controls) were analyzed by real-time polymerase chain reaction and pyrosequencing, respectively. A total of 308 hypermethylated CpG sites and 498 hypomethylated CpG sites were identified. Significantly, hypermethylated CpG sites cg06961147 and cg24666046 in TANC1 associated with ADLI was identified by genome-wide DNA methylation profiling. The mRNA expression of TANC1 was lower in the cases compared to the controls. Pyrosequencing validated these two differentially methylated loci, which was consistent with the results from the EPIC BeadChip array. Receiver operating characteristic analysis indicated that the area under the curve of TANC1 (cg06961147, cg24666046, and their combinations) was 0.812, 0.842, and 0.857, respectively. These results indicate that patients with ADLI have different genomic methylation patterns than patients without ADLI. The hypermethylated differentially methylated site cg06961147 combined with cg24666046 in TANC1 provides evidence for the diagnosis of ADLI.

The global profiling of alkaloids in Aconitum stapfianum and analysis of detoxification material basis against Fuzi

Aconitum alkaloids are versatile in chemical structures and are well known for their bioactivity and toxicity. Cases of analogs with closely similar structures or positional isomers are widespread in herbs of the Aconitum genus. It is still challenging to rapidly identify unknown compounds via mass spectrometry, especially positional isomers. Herein, to profile the alkaloids of Aconitum stapfianum that possess bioactivity against intoxication by the lateral root of Aconitum carmichaelii (Fuzi), a strategy was developed by carefully determining the fragmentation pathways of authentic standards. A series of rules was summarized and involved charge site effects, hydrogen bonding effects, competitive channels between charge-remote reactions and charge migration reactions, and fragment patterns exhibiting a "diamond shape". Accordingly, a total of 124 alkaloids in A. stapfianum were tentatively characterized, including 85 potential new compounds and 24 sets of isomers. On the other hand, to explore the material basis of detoxification, a chemical constituent comparison was made between A. stapfianum and Fuzi, and principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA) were performed to identify markers that were different between the two . In total, 25 characteristic markers were identified to discriminate between these two herbal medicines, of which 14 compounds were specific for A. stapfianum and most of them were characteristic for a para-substituted benzoic acid ester at C-14.

[Urinary retinol binding protein and β2-microglobulin were associated with urinary albumin to creatinine ratio and renal function in hospitalized diabetic patients]

Objective: To explore the associations of urinary retinol binding protein (RBP) and β₂-microglobulin (β₂-MG) with urinary albumin to creatinine ratio (UACR) and renal function in hospitalized patients with type 2 diabetes mellitus (T2DM). Methods: A total of 1 030 Chinese patients with T2DM were included in this study. The subjects were divided into the UACR normal group (<30 mg/g), microalbuminuria group (30-300 mg/g) and macroalbuminuria group (>300 mg/g). Patients with normal UACR were further divided into two groups according to the estimated glomerular filtration rate (eGFR): the eGFR low group (<90 ml·min^-1·1.73m^-2) and the normal eGFR group (≥90 ml·min^-1·1.73m^-2). Urine RBP and β₂-MG levels among the groups were compared. Multiple linear regression analyses were applied to evaluate risk factors of urine RBP and β₂-MG. Results: In all patients (n=1 030), urine RBP and β₂-MG increased gradually with the increase of UACR across the three groups, the proportions of abnormal urine RBP (>0.7 mg/L) and β₂-MG (>370 μg/L) in these groups were 3.8%, 8.5%, 39.0% (P<0.001), and 12.9%, 26.7%, 46.8% (P<0.001), respectively. In the UACR normal group (n=788), 12.2% of the patients were with eGFR<90 ml·min^-1·1.73m^-2. The proportion of abnormal β₂-MG (>370 μg/L) was higher in the eGFR low group than that in the eGFR normal group (29.2% vs. 10.7%, P<0.001). Multivariate linear stepwise regression analyses were performed using natural logarithm of urine RBP or β₂-MG as dependent variable, and showed that urine RBP was independently associated with UACR (β=0.0005, P<0.001), serum creatinine (β=0.006, P<0.001) and glycosylated hemoglobin A1c (β=0.050, P=0.001), and β₂-MG was independently correlated with UACR (β=0.000 4, P<0.001), serum creatinine (β=0.011, P<0.001), systolic blood pressure (β=0.005, P=0.031) and fasting blood-glucose (β=0.027, P=0.046). Conclusions: Urine RBP and β₂-MG are positively associated with high UACR and impaired renal function in T2DM patients, and these changes could occur before UACR and eGFR turned out to be abnormal. It is recommended that urine RBP and β₂-MG be detected as early as possible to identify diabetic kidney disease in patients with normal UACR and eGFR.

Thermo-Responsive Shape Memory Behavior of Methyl Vinyl Silicone Rubber/Olefin Block Copolymer Blends via Co-Crosslinking

Shape memory polymers (SMPs) are developed by blending and cross-linking polymers which include crystalline domains and cross-linked networks. In this paper, we describe the morphology, thermal and shape memory behavior of methyl vinyl silicone rubber (MVMQ)/olefin block copolymer (OBC) blends prepared by a melt-blending and chemical cross-linking method. MVMQ without crystalline domains could not hold its temporary shape. After introducing the OBC, the obtained blends exhibited excellent dual shape memory properties. The cross-linking networks of MVMQ acted as reversible domains, while crystalline regions of OBC worked as fixed domains. When the blending ratio of MVMQ/OBC was 50/ 50, the blend had both a high shape fixity ratio and shape recovery ratio.

Orbital competition of Mn3+ and V3+ ions in Mn1+x V2-x O4

The structural and magnetic properties of Mn1+x V2-x O4 (0 < x ⩽ 1) have been investigated by the heat capacity, magnetization, x-ray diffraction and neutron diffraction measurements, and a phase diagram of temperature versus composition was built up. For x ⩽ 0.3, a cubic-to-tetragonal (c > a) phase transition was observed. For x > 0.3, the system maintained the tetragonal lattice. Although the collinear and noncollinear magnetic transitions of V3+ ions were obtained in all compositions, the canting angles between the V3+ ions decreased with Mn3+-doping, and the ordering of the Mn3+ ions was only observed as x > 0.4. In order to study the dynamics of the ground state, the first principles simulation was applied to analyze not only the orbital effects of Mn2+, Mn3+, and V3+ ions, but also the related exchange energies.

A novel potential target of IL-35-regulated JAK/STAT signaling pathway in lupus nephritis

BACKGROUND

In this study, we have investigated the potential regulatory mechanisms of IL-35 to relieve lupus nephritis (LN) through regulating Janus kinase (JAK)/signal transducers and activators of transcription (STAT) signaling pathway in mesangial cells.

RESULTS

Among 105 significant differentially expressed proteins (DEPs) between juvenile systemic lupus erythematosus (JSLE) patients with LN and healthy controls, LAIR1, PDGFRβ, VTN, EPHB4, and EPHA4 were downregulated in JSLE-LN. They consist of an interactive network with PTPN11 and FN1, which involved in IL-35-related JAK/STAT signaling pathway. Besides, urinary LAIR1 was significantly correlated with JSLE-LN clinical parameters such as SLEDAI-2K, %CD19+ B, and %CD3+ T cells. Through bioinformatics analysis of co-immunoprecipitation with mass spectrometry results, including GO, KEGG, and STRING, five genes interacted with Lair1 were upregulated by IL-35, but only Myh10 was downregulated. Therefore, we presumed an interactive network among these DEPs, JAK/STAT, and IL-35. Moreover, the downregulated phosphorylated (p)-STAT3, p-p38 MAPK, and p-ERK, and the upregulated p-JAK2/p-STAT1/4 in IL-35 overexpressed mesangial cells, and RNA-sequencing results validated the potential regulatory mechanisms of IL-35 in alleviating JSLE-LN disease. Moreover, the relieved histopathological features of nephritis including urine protein and leukocyte scores, a decreased %CD90+ αSMA+ mesangial cells and pro-inflammatory cytokines, the inactivated JAK/STAT signals and the significant upregulated Tregs in spleen, thymus and peripheral blood were validated in Tregs and IL-35 overexpression plasmid-treated lupus mice.

CONCLUSIONS

Our study provided a reference proteomic map of urinary biomarkers for JSLE-LN and elucidated evidence that IL-35 may regulate the interactive network of LAIR1-PTPN11-JAK-STAT-FN1 to affect JAK/STAT and MAPK signaling pathways to alleviate inflammation in JSLE-LN. This finding may provide a further prospective mechanism for JSLE-LN clinical treatment.

Effects of Huatan Jiangzhuo decoction on diet-induced hyperlipidemia and gene expressions in rats

Huatan Jiangzhuo decoction (HJD) is a combination of six traditional Chinese medicines that were used for lipid metabolism-related disorders, but its efficacy and underlying mechanisms have not been explored by modern research strategies. This study aimed to investigate the therapeutic role of HJD in determining the transcriptome level. Hyperlipidemia model was established by feeding Sprague-Dawley rats with high-fat diet. Differentially expressed genes (DEGs) were detected by high-through transcriptome sequencing, followed by gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. The total cholesterol (TC) and triglyceride (TG) levels in hyperlipidemia model rats were significantly increased, whereas high-density lipoprotein (HDL) concentration decreased when compared to normal rats, and HJD significantly downregulated TC concentrations and liver coefficient in the hyperlipidemia rats. Histology staining showed that HDJ greatly recovered the lipid accumulation in rat hepatic stellate cells and aortic arch vascular wall thickness of hyperlipidemia rats. One thousand nine hundred and thirty-six DEGs were identified in the HJD-treated hyperlipidemia rats, which were associated with various biological processes and signaling pathways such as peroxisome proliferator-activated receptors, AMP-activated Protein Kinase , and insulin signaling pathways. Quantitative reverse transcription-polymerase chain reaction further confirmed the downregulated expression of cholesterol 7-α-hydroxylase(CYP7A1), liver orphan receptor(LXRα),peroxisome proliferator-activated receptor gamma(PPARγ),andSterol Response Element-Binding Protein 1c(SREBP1c) genes in hyperlipidemia rats treated with HJD. Our data first elucidated the gene expression profile of high-fat diet-induced hyperlipidemia in rats after HJD treatment, and lipid metabolism-related genes (CYP7A1, LXRα, PPARγ, and SREBP1c) may be potentially biomarkers for HJD-alleviated hyperlipidemia.

[Investigation of nurses' attitude towards open visitation policy in intensive care unit and analysis of influence factors]

OBJECTIVE

To investigate the nurses' attitude towards open visitation policy in intensive care unit (ICU) and its potential influence factors, and further to provide evidence for carrying out this policy in ICU.

METHODS

A self-designed, anonymous online questionnaire of "attitude of ICU nurses to open visiting system in ICU" was performed in 31 provinces, autonomous regions and municipalities in China from October to December 2019, using convenient sampling method approach. Only nurses working in ICU (including specialized ICU, but excluding the critical ward in general ward) and willing to participate in the survey were included. The survey included 35 items, including the general information of each participant, the attitude towards the implementation of the open visitation system in ICU and its potential influencing factors. Ordinal Logistic regression analysis was used to identify the significant influencing factors.

RESULTS

A total of 1 558 questionnaires were sent out and 1 546 effective questionnaires were retrieved, with a response rate of 99.2%. Overall, 32.2% of them agreed with the policy, 41.3% of them disagree with the policy and 26.5% of them were uncertain. The Ordinal Logistic regression analysis showed that the independent influencing factors of ICU nurses' attitude towards open visitation policy including the possibility of increasing healthcare-associated infection [disagree: β = 1.327, 95% confidence interval (95%CI) was 0.242 to 2.413, P = 0.017; uncertain: β = 0.697, 95%CI was 0.244 to 1.151, P = 0.003], the improvement of nurses' job satisfaction (disagree: β = -1.406, 95%CI was -1.750 to -1.062, P = 0.000; uncertain: β = -0.748, 95%CI was -1.030 to -0.466, P = 0.000), the information support for medical staffs from family members (disagree: β = -0.644, 95%CI was -1.048 to -0.240, P = 0.002; uncertain: β = -0.422, 95%CI was -0.721 to -0.124, P = 0.006), the feasibility that the family members can assist the nurses in the basic nursing for patients (uncertain: β = -0.465, 95%CI was -0.729 to -0.202, P = 0.001), reducing the time that a nurse spent on caring for the patients (uncertain: β = 0.349, 95%CI was 0.052 to 0.646, P = 0.021), improving early rehabilitation (disagree: β = -0.593, 95%CI was -1.166 to -0.019, P = 0.043), and getting psychological support for patients from family members (disagree: β = 1.293, 95%CI was 0.426 to 2.159, P = 0.003), family members' satisfaction (disagree: β = -0.981, 95%CI was -1.431 to -0.531, P = 0.000).

CONCLUSIONS

ICU nurses in China have realized that open visitation policy has positive effect on patients' early rehabilitation, willing to live and satisfaction; meanwhile, this policy may need more improvement in many ways such as healthcare-associated infection control, disinfection and isolation, allocation of human resources and time spent treating and caring for patients.

Olfactory ensheathing cells seeded decellularized scaffold promotes axonal regeneration in spinal cord injury rats

Spinal cord decellularized (DC) scaffolds can promote axonal regeneration and restore hindlimb motor function of spinal cord defect rats. However, scarring caused by damage to the astrocytes at the margin of injury can hinder axon regeneration. Olfactory ensheathing cells (OECs) integrate and migrate with astrocytes at the site of spinal cord injury, providing a bridge for axons to penetrate the scars and grow into lesion cores. The purpose of this study was to evaluate whether DC scaffolds carrying OECs could better promote axon growth. For these studies, DC scaffolds were cocultured with primary extracted and purified OECs. Immunofluorescence and electron microscopy were used for verification of cells adhere and growth on the scaffold. Scaffolds with OECs were transplanted into rat spinal cord defects to evaluate axon regeneration and functional recovery of hind limbs. Basso, Beattie, and Bresnahan (BBB) scoring was used to assess motor function recovery, and glial fibrillary acidic protein (GFAP) and NF200-stained tissue sections were used to evaluate axonal regeneration and astrological scar distribution. Our results indicated that spinal cord DC scaffolds have good histocompatibility and spatial structure, and can promote the proliferation of adherent OECs. In animal experiments, scaffolds carrying OECs have better axon regeneration promoting protein expression than the SCI model, and improve the proliferation and distribution of astrocytes at the site of injury. These results proved that the spinal cord DC scaffold with OECs can promote axon regeneration at the site of injury, providing a new basis for clinical application.

A poly(N,N-dimethylaminoethyl methacrylate-co-ethylene glycol dimethacrylate) monolith for direct solid-phase extraction of benzodiazepines from undiluted human urine

A novel polymeric monolith using N,N-dimethylaminoethyl methacrylate as the monomer and ethylene glycol dimethacrylate as the crosslinker was successfully synthesized in a syringe and applied for direct solid-phase extraction of four benzodiazepines (bromazepam, triazolam, midazolam and diazepam) from undiluted urine samples prior to high performance liquid chromatography. The monolith was characterized by scanning electron microscopy, Fourier transform infrared spectroscopy and nitrogen adsorption-desorption experiments. Moreover, extraction parameters, including loading, washing and eluting conditions were optimized. Under the optimized conditions, the proposed method obtained linear ranges of 2.0-500 ng mL^-1 with correlation coefficients (r) higher than 0.9997. The limits of detection (S/N = 3) and limits of quantification (S/N = 10) were 0.4-0.6 ng mL^-1 and 1.4-2.0 ng mL^-1, respectively. The recoveries at three spiked levels ranged from 83.7% to 103% with the intra- and inter-day precisions from 0.6-7.6% to 2.7-9.8%. The present monolith allowed direct loading of crude urine samples without any filtration or dilution step. Besides, the sorbent offered an enhancement factor of 16.7-20.6 and was stable enough for ten replicate cycles of extraction/desorption of urine samples. The developed method presented an alternative strategy for the accurate and convenient determination of benzodiazepines in urine samples.