Prediction of tumor origin in cancers of unknown primary origin with cytology-based deep learning

Cancer of unknown primary (CUP) site poses diagnostic challenges due to its elusive nature. Many cases of CUP manifest as pleural and peritoneal serous effusions. Leveraging cytological images from 57,220 cases at four tertiary hospitals, we developed a deep-learning method for tumor origin differentiation using cytological histology (TORCH) that can identify malignancy and predict tumor origin in both hydrothorax and ascites. We examined its performance on three internal (n = 12,799) and two external (n = 14,538) testing sets. In both internal and external testing sets, TORCH achieved area under the receiver operating curve values ranging from 0.953 to 0.991 for cancer diagnosis and 0.953 to 0.979 for tumor origin localization. TORCH accurately predicted primary tumor origins, with a top-1 accuracy of 82.6% and top-3 accuracy of 98.9%. Compared with results derived from pathologists, TORCH showed better prediction efficacy (1.677 versus 1.265, P < 0.001), enhancing junior pathologists' diagnostic scores significantly (1.326 versus 1.101, P < 0.001). Patients with CUP whose initial treatment protocol was concordant with TORCH-predicted origins had better overall survival than those who were administrated discordant treatment (27 versus 17 months, P = 0.006). Our study underscores the potential of TORCH as a valuable ancillary tool in clinical practice, although further validation in randomized trials is warranted.

Small extracellular vesicles facilitate epithelial-mesenchymal transition in chronic rhinosinusitis with nasal polyps via the miR-375-3p/QKI axis

BACKGROUND

Epithelial-mesenchymal transition (EMT) plays a crucial role in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP). However, the involvement of small extracellular vesicles (sEVs) in EMT and their contributions to CRSwNP has not been extensively investigated.

METHODS

SEVs were isolated from nasal mucosa through ultracentrifugation. MicroRNA sequencing and reverse-transcription quantitative polymerase chain reaction were employed to analyze the differential expression of microRNAs carried by sEVs. Human nasal epithelial cells (hNECs) were used to assess the EMT-inducing effect of sEVs/microRNAs. EMT-associated markers were detected by western blotting and immunofluorescence. Dual-luciferase reporter assay was performed to determine the target gene of miR-375-3p. MicroRNA mimic, lentiviral, and plasmid transduction were used for functional experiments.

RESULTS

In line with the greater EMT status in eosinophilic CRSwNP (ENP), sEVs derived from ENP (ENP-sEVs) could induce EMT in hNECs. MiR-375-3p was elevated in ENP-sEVs compared to that in control and nonENP. MiR-375- 3p carried by ENP-sEVs facilitated EMT by directly targeting KH domain containing RNA binding (QKI) at seed sequences of 913-919, 1025-1033, and 2438-2444 in 3'-untranslated region. Inhibition of QKI by miR-375-3p overexpression promoted EMT, which could be reversed by restoration of QKI. Furthermore, the abundance of miR-375-3p in sEVs was closely correlated with the clinical symptom score and disease severity.

CONCLUSIONS

MiR-375-3p-enriched sEVs facilitated EMT by suppressing QKI in hNECs. The association of miR-375-3p with disease severity underscores its potential as both a diagnostic marker and a therapeutic target for the innovative management of CRSwNP.

Enantioselective [2π + 2σ] Cycloadditions of Bicyclo[1.1.0]butanes with Vinylazaarenes through Asymmetric Photoredox Catalysis

Here we present a highly enantioselective [2π + 2σ] photocycloaddition of bicyclo[1.1.0]butanes (BCBs). The reaction uses a variety of vinylazaarenes as partners and is catalyzed by a polycyclic aromatic hydrocarbon (PAH)-containing chiral phosphoric acid as a bifunctional chiral photosensitizer. A wide array of pharmaceutically important bicyclo[2.1.1]hexane (BCH) derivatives have been synthesized with high yields, enantioselectivity, and diastereoselectivity. In addition to the diverse 1-ketocarbonyl-3-substituted BCBs, α/β-substituted vinylazaarenes are compatible with such an unprecedented photoredox catalytic pathway, resulting in the successful assembly of an all-carbon quaternary stereocenter or two adjacent tertiary stereocenters on the product.

Plasmonic Multi-Layered Built-in Hotspots Nanogaps for Effectively Activating Analytes

Multi-layered plasmonic nanostructures are able to highly promote the near-field confinement and effectively activate analytes, which are of predominate significance but are extremely challenging. Herein, the semi-open Au core@carved AuAg multi-shell superstructure nanoparticles (multi-Au@Ag-Au NPs, multi = mono, bi, tri, tetra, and penta) are reported with a high designability on electromagnetic field and capability of effectively capturing analytes. By controlling synthetic parameters such as the number of galvanic exchange and Ag growth, multi-Au@Ag-Au NPs are successfully obtained, with tunable layer numbers and asymmetric nanoholes. Due to collective plasmon oscillations of multi-layered built-in nanogaps, the electromagnetic field strength of a single penta-Au@Ag-Au entity reach 48841. More importantly, the penta-Au@Ag-Au NPs show a remarkable light-harvesting capability, which is adaptive to different Raman lasers, supporting high-diversity detection. Additionally, the structural specificity allows analytes to be sufficiently captured into interior hotspots, and further achieve highly sensitive detection with limit of detection down to 3.22 × 10-12  M. This study not only provides an effective pathway for integrating abundant hotspots and activating target molecules in single plasmonic superstructure, but stimulates advancements in SERS substrates for various applications.

Phosphorus/sulfur co-doped heterogeneous NiCoPxSy nanoarrays boosting overall water splitting

In the large-scale implementation of renewable energy devices, the availability of stable and highly catalytic non-precious metal catalysts for the hydrogen evolution reaction (HER) and oxygen evolution reaction (OER) is crucial. Meanwhile, integrating bifunctional electrocatalysts simultaneously on both the anode and cathode still faces challenges. To address this, a stepped preparation strategy was adopted on a nickel foam (NF) substrate to synthesize P, S co-doped NiCoPxSy nanowire array catalysts. The prepared NiCoPxSy catalysts demonstrated a small Tafel slope of 72.5 mV dec-1 for HER and 72.3 mV dec-1 for OER by requiring only 37 mV (326 mV) overpotential to achieve a current density of 10 mA cm-2 (50 mA cm-2). Moreover, when assembled into an electrolytic cell in 1 M KOH, the NiCoPxSy catalysts achieved a low voltage of 1.55 V at 10 mA cm-2 current density and exhibited long-term stability. The outstanding electrocatalytic performance can be attributed to the influence of doped anions on the electronic states and distribution among different atoms, which thereby positively affected the electrocatalytic activity. This research provides an effective method for designing innovative catalysts and paving the way to produce clean energy.

Signal-enhanced multi-core fiber-based WaveFlex biosensor for ultra-sensitive xanthine detection

In this work, we introduce a novel multimode fiber (MMF) - seven core fiber (SCF) - MMF (MCM) optical fiber biosensor, also known as the WaveFlex biosensor (plasma wave assisted fiber biosensor), based on localized surface plasmon resonance (LSPR) for qualitative detection of xanthine. Xanthine is a purine base widely distributed in human blood and tissues, and commonly used as an indicator for various disease detections. The MCM sensor incorporates a tapered optical fiber structure, fabricated using the combiner manufacturing system (CMS), and is designed with SCF and MMF. By effectively harnessing LSPR, the sensor boosts the attachment points of biomolecules on the probe surface through immobilized tungsten disulfide (WS2)-thin layers, gold nanoparticles (AuNPs), and carbon nitride quantum dots (C3N-QDs). The functionalization of xanthine oxidase (XO) on the sensing probe further enhances the sensor's specificity. The proposed WaveFlex biosensor exhibits a remarkable sensitivity of 3.2 nm/mM and a low detection limit of 96.75 µM within the linear detection range of 100 - 900 µM. Moreover, the sensor probe demonstrates excellent reusability, reproducibility, stability, and selectivity. With its sensitivity, biocompatibility, and immense potential for detecting human serum and fish products, this WaveFlex biosensor presents a promising platform for future applications.

Rich-grain-boundary Ni-Co-Se nanowire arrays for fast charge storage in alkaline electrolyte

In this work, the one-dimensional (1D) Ni-Co-Se nanowire arrays with rich grain-boundaries were prepared through the solvothermal method and gas-phase selenizaiton. The results showed that the structure and crystallization of the Ni-Co-Se nanowire arrays could be modulated through the optimization of selenizaiton time. The optimal Ni-Co-Se electrode sample displayed an area specific capacitance of 242.6μAh cm-2at 30 mA cm-2with a current retention rate of 68.34%. The assembled Ni-Co-Se/Active carbon (AC) electrode-based asymmetric supercapacitor (ASC) showed the area specific capacitances of 329.2μAh cm-2and 225.8μAh cm-2at 3 mA cm-2and 30 mA cm-2, respectively. A 73.33% retention rate of capacitance was observed after 8000 charge/discharge cycles. Besides, the further fabricated all-solid ASC delivered the power densities of 342.94 W kg-1and 3441.33 W kg-1at the energy densities of 37.62 Wh kg-1and 25.81 Wh kg-1, respectively. Those results suggested the potentials of the obtained Ni-Co-Se nanowire arrays as electrode material for the high-performance pseudocapacitors.

[Risk factors analysis of protein energy wasting in children with chronic kidney disease]

Objective: To analyze the clinical characteristics and risk factors of protein energy wasting (PEW) in children with chronic kidney disease (CKD). Methods: Clinical data of 231 children with chronic kidney disease hospitalized in Beijing Children's Hospital affiliated to Capital Medical University from January 2018 to January 2023 were retrospectively analyzed to explore the incidence of PEW. According to the diagnostic criteria of CKDPEW, they were divided into a CKDPEW group and a non PEW group. The comparison between the groups was performed by independent-sample t test and Chi-squared test, and the risk factors were analyzed by multivariate Logistic regression. Results: Among the 231 children, there were 138 males and 93 females, with a visiting age of 9.9 (7.9, 16.0) years; 6 cases were in stage 1, 14 cases in stage 2, 51 cases in stage 3, 36 cases in stage 4, and 124 cases in stage 5. A total of 30 children (13.0%) with CKD PEW were diagnosed at the age of 7. 1 (3.8, 13.2) years, including 1 case in stage 1, 1 case in stage 2, 5 cases in stage 3, 5 cases in stage 4, and 18 cases in stage 5. There were a total of 201 cases (87.0%) in the non PEW group, diagnosed at the age of 11.8 (8.5, 12.2) years, including 5 cases in stage 1, 13 cases in stage 2, 46 cases in stage 3, 31 cases in stage 4, and 106 cases in stage 5. The Chi-squared test and t test showed that the systolic blood pressure, diastolic blood pressure, birth weight and carbon dioxide binding capacity of the CKD PEW group were lower than those of the non PEW group ((109±22) vs. (120±20) mmHg (1 mmHg=0.133 kPa), (72±19) vs. (79±16) mmHg, (2.9±0.5) vs. (3.2±0.6) kg, (17±4) vs. (19±4) mmol/L,t=2.85, 2.14, 0.67, 2.63, all P<0.05). Multivariate logistic regression analysis showed that carbon dioxide binding capacity and birth weight were independent protective factors of CKDPEW in children (OR=0.81 and 0.36, 95%CI=0.73-0.90 and 0.17-0.77, respectively; both P<0.01); the risk of PEW in CKD children decreased by 0.187 times for every 1 mmol/L increment in carbon dioxide binding capacity, and 0.638 times for every 1 kg increment in birth weight. Conclusions: The incidence of protein energy expenditure in children with chronic kidney disease is lower than that in the previous researches. PEW can appear in CKD 1-2 stage, and attention should be paid to it in the early stage of CKD in clinical practice. Low birth weight CKD children are susceptible to PEW, and actively correcting metabolic acidosis can reduce the risk of CKDPEW.

Modulating surface electron density of Ni(OH)2 nanosheets with longitudinal Ti3C2Tx MXenenanosheets by Schottky effect toward enhanced hydrogen evolution reaction

Due to their low cost and excellent electrocatalytic performance, nickel-based hydroxides are widely used as hydrogen evolution catalysts for large-scale hydrogen production by water electrolysis. In this study, a heterostructured composite with improved electron transport and modulated electron surface density was prepared by combining Ni(OH)₂ with two-dimensional layered Ti₃C₂T_x (Ti₃C₂T_x-MXene). Ni(OH)₂ nanosheets were formed on nickel foam (NF) substrates using acid etching, followed by the longitudinal growth of negatively charged Ti₃C₂T_x-MXene on positively charged Ni(OH)₂/NF via electrophoretic deposition. The resulting structure facilitates spontaneous electron transfer from Ti₃C₂T_x-MXene to Ni(OH)₂/NF by means of the Mott-Schottky heterostructure effect and establishes a continuous electron transport path which effectively increases the concentration of active sites, improving hydrogen evolution during water electrolysis. The obtained electrode is characterized by an HER overpotential of 66 mV (vs. RHE) and a Tafel slope of +105 mV dec^-1 at a current density of 10 mA cm^-2, combined with good electrochemical stability.

[A comparative study of the curative effects between butterfly-shaped flap and propeller flap based on the dorsal branch of digital artery in repairing the wound in volar aspect of finger]

Objective: To compare the curative effects of butterfly-shaped flap based on the dorsal branch of digital artery (hereinafter referred to as butterfly-shaped flap) and propeller flap based on the dorsal branch of digital artery (hereinafter referred to as propeller flap) in repairing the wound in volar aspect of finger. Methods: A retrospective cohort study was conducted. From August 2018 to April 2022, 16 patients with finger palmar wounds admitted to Ruijin Hospital of Shanghai Jiao Tong University School of Medicine and 7 patients with finger palmar wounds admitted to General Hospital of PLA Central Theater Command met the inclusion criteria, including 14 males and 9 females, aged 25 to 64 years. After debridement or resection of skin benign tumor, the wounds ranged from 0.5 cm×0.5 cm to 1.5 cm×1.5 cm. According to the different rotation axes of flap pedicle during wound repair, the patients were divided into butterfly-shaped flap group (8 cases) and propeller flap group (15 cases), and their wounds were repaired by butterfly-shaped flap (with area of 0.5 cm×0.5 cm-1.5 cm×1.3 cm) or propeller flap (with area of 0.7 cm×0.5 cm-1.5 cm×1.5 cm) , respectively. In propeller flap group, wounds in the donor sites were repaired by full-thickness skin grafts taken from the palms of wrists or the groin. The surgical time, postoperative complications, flap survival, and wound healing time of patients in the two groups were recorded. Data were statistically analyzed with independent sample t test, Mann Whitney U test, or Fisher's exact probability test. Results: The surgical time and postoperative wound healing time of patients in butterfly-shaped flap group ((43±9) min and (13.1±0.8) d, respectively) were both significantly shorter than those in propeller flap group ((87±16) min and (16.7±4.6) d, respectively, with t values of -7.03 and -2.86, respectively, P<0.05). The postoperative flap survival and complications of patients between the two groups were both similar (P>0.05). Conclusions: For repairing the wound in volar aspect of finger, the butterfly-shaped flap has more advantages in comparison with the traditional propeller flap. The butterfly-shaped flap has a short surgical time and fast postoperative recovery, which is worthy of clinical promotion.

Mangrove degradation retarded microplastics weathering and affected metabolic activities of microplastics-associated microbes

Currently, information on microplastics (MPs) weathering characteristics and ecological functions driven by MPs-associated microbes in mangrove ecosystems remains unclear, especially in the degraded areas. Herein, we compared the weathering characteristics of MPs in both undegraded and degraded mangrove sediments, and then explored the potential interactions between their weathering characteristics and microbially-driven functions. After 70 days of incubation, different MPs (including polyethylene PE, polystyrene PS, and polylactic acid PLA) were strongly weathered in mangrove sediments, with significant erosion features. Interestingly, more obvious weathering characteristics were found for MPs in the undegraded mangrove sediments. O/C ratio value of MPs in the undegraded sediments was 2.3-3.0 times greater than that in the degraded ones. Besides, mangrove degradation reduced network complexity among MPs-associated microorganisms and affected their metabolic activities. Bacteria involved in carbon cycle process enriched on nondegradable MPs, whereas abundant bacteria responsible for sulphur cycle were observed on PLA-MPs. Moreover, these relevant bacteria were more abundant on MPs in the undegraded mangrove sediments. Mangrove degradation could directly and indirectly affect MPs weathering process and microbially-driven functions through regulating sediment properties and MPs-associated microbes. During weathering, contact angle and roughness of MPs were key factors influencing the colonisation of hydrocarbon degradation bacteria on MPs.

[Endoscopic resection of type D trigeminal schwannoma through nasal sinus approach]

Objective: To examine the feasibility and surgical approach of removing type D trigeminal schwannoma through nasal cavity and nasal sinus under endoscope. Methods: Eleven patients with trigeminal schwannoma who were treated in the Department of Otorhinolaryngology, Qilu Hospital of Shandong University from December 2014 to August 2021 were analyzed retrospectively in this study. There were 7 males and 4 females, aged (47.5±13.5) years (range: 12 to 64 years). The neoplasm involved the pterygopalatine fossa, infratemporal fossa, ethmoidal sinus, sphenoid sinus, cavernous sinus, and middle cranial fossa. The size of tumors were between 1.6 cm×2.0 cm×2.0 cm and 5.7 cm×6.0 cm×6.0 cm. Under general anesthesia, the tumors were resected through the transpterygoid approach in 4 cases, through the prelacrimal recess approach in 4 cases, through the extended prelacrimal recess approach in 2 cases, and through the endoscopic medial maxillectomy approach in 1 case. The nasal endoscopy and imaging examination were conducted to detect whether neoplasm recurred or not, and the main clinical symptoms during follow-up. Results: All the surgical procedures were performed under endonasal endoscope, including Gross total resection in 10 patients. The tumor of a 12-year-old patient was not resected completely due to huge tumor size and limited operation space. One patient was accompanied by two other schwannomas located in the occipital region and the ipsilateral parotid gland region originating from the zygomatic branch of the facial nerve, both of which were removed concurrently. After tumor resection, the dura mater of middle cranial fossa was directly exposed in the nasal sinus in 2 cases, including 1 case accompanied by cerebrospinal fluid leakage which was reconstructed by a free mucosal flap obtained from the middle turbinate, the other case was packed by the autologous fat to protect the dura mater. The operation time was (M(IQR)) 180 (160) minutes (range: 120 to 485 minutes). No complications and deaths were observed. No recurrence was observed in the 10 patients with total tumor resection during a 58 (68) months' (range: 10 to 90 months) follow-up. No obvious change was observed in the facial appearance of all patients during the follow-up. Conclusion: Type D trigeminal schwannoma involving pterygopalatine fossa and infratemporal fossa can be removed safely through purely endoscopic endonasal approach by selecting the appropriate approach according to the size and involvement of the tumor.

Interfacial Regulation of ZIF-67 on Bacteria to Generate Bifunctional Sensing Material on Chip for Qualifying Cell-Released Reactive Oxygen Species

Cell's activities are highly dependent on signal molecules, of which reactive oxygen species of the superoxide anion (O₂^•-) and hydrogen peroxide (H₂O₂) are important ones that always work together to regulate biological processes such as apoptosis and oxidative stress. It is of significance to realize simultaneous qualification of O₂^•- and H₂O₂ but it still faces challenges particularly in live-cell assay with a complex environment. We report the design of a bifunctional sensing material by interfacially regulating ZIF-67 on bacteria Shewanella putrefaciens to generate cobalt nanoparticles/nitrogen-doped porous carbon nanorods (Co/N-doped CNRs) and its sensing chip for qualifying cell-released O₂^•- and H₂O₂. Co/N-doped CNRs exhibit unique properties including porous structure for significantly increased reaction surface area and coordinating Co nanoparticles for rich active sites. The bifunctional Co/N-doped CNRs is used to fabricate the electrochemical sensing chip, which achieves a fast response time (0.5 s for O₂^•-, 1.9 s for H₂O₂), a low detection limit (0.69 nM for O₂^•-, 2.25 μM for H₂O₂), and a remarkably high sensitivity (792.30 μA·μM^-1·cm^-2 for O₂^•-, 153.91 μA·mM^-1·cm^-2 for H₂O₂), among the best of reported bifunctional nanozymes.

Electroacupuncture ameliorates depression-like behaviors comorbid to chronic neuropathic pain via Tet1-mediated restoration of adult neurogenesis

Although electroacupuncture (EA) stimulation is a widely used therapy for chronic pain and comorbid psychiatric disorders, its long-term effects on chronic neuropathic pain-induced depression and the underlying mechanisms remain elusive. In the present study, we found that EA stimulation was able to restore adult neurogenesis in the ventral dentate gyrus (DG), by both increasing neuronal differentiation and restoring the normal morphology of newborn dendrites, in mice with spared nerve injury (SNI) surgery. By ablating the Nestin + neural stem cells (NSCs) via DTA expression, we further proved that neurogenesis in the ventral DG was crucial to the long-term, but not the immediate antidepressant effect of EA, nor was it associated with nociception. Furthermore, we found that the restoration of neurogenesis was dependent on Tet1-mediated epigenetic modification upon EA treatment. Tet1 could bind to the promoter of the Prox1 gene, thus catalyzing its demethylation and facilitating its expression, which finally contributed to the restoration of neurogenesis and amelioration of depression-like behaviors induced by chronic neuropathic pain. Thus, we conclude that EA stimulation restores inhibited Tet1 expression in hippocampal NSCs of mice with chronic neuropathic pain, and increased Tet1 expression ameliorates hypermethylation of Prox1 and restores normal adult neurogenesis in the ventral DG, which contributes to the long-term antidepressant effect of EA.

Novel 2-Benzo[d]thiazolyl-4-quinolinylphenol Skeleton-Based Turn-on Fluorescent Probe for H2S Detection and its Multiple Applications in Water Environment, Foodstuffs, and Living Organisms

Hydrogen sulfide (H₂S) has comprehensive contributions to maintaining the normal operation and stability of organisms, and it also occurs in the wastewater environment and is related to the deterioration of foodstuffs. Therefore, developing high-sensitive detection techniques for tracing H₂S is promising and meaningful. Inspired by this, a novel nopinone-based fluorescent probe NPS for the recognition of H₂S was designed and synthesized with excellent sensitivity, low limit of detection (79 nM), good selectivity, and wide pH range (5-9). NPS could emit strong yellow fluorescence and its emission intensity showed a remarkable augmentation at 520 nm upon the supplement of H₂S. Furthermore, the recognition mechanism of NPS for H₂S was verified by the HRMS analysis, ¹H NMR spectra titration, and DFT computation. What is more, NPS also had broad applications in the monitoring of real water samples, red wine, beer, and eggs samples, which showed its development prospect and value in environmental pollution, foodstuffs quality analysis fields. NPS also was applied to monitor trace exogenous H₂S and bioimaging in living cells and zebrafish.

Electrically responsive photonic crystals with bistable states for low-power electrophoretic color displays

Electrically responsive photonic crystals are promising materials for electrophoretic color displays with better brightness and color saturation. However, electric field must always be applied to maintain the specific colors, which brings concerns about the power consumption and signal stability and reversibility. Here, we show an electrically responsive photonic crystal with two stable states at 0 V, which are the colored state or the colorless state with ordered or disordered particle arrangement. The color state can be reversibly switched by applying a short-time electrical field, just like in the case of commercial electrophoretic ink. With optimized recipe and electric field, the photonic crystals encapsulated in the prototype display panel are proved to have potentials in high resolution, multi-color, and greyscale display, which lays down a firm basis for reflective displays with low power consumption and good visibility.

Diagnosis of mediastinal cysts: the role and safety of EUS–FNA with 19-gauge needle: a retrospective cohort study

Background

Mediastinal cysts are uncommon, and their diagnosis remains a clinical challenge, especially for patients with a solid mass on computed tomography (CT). Endoscopic ultrasound (EUS) is considered a valuable method to differentiate mediastinal cysts and EUS-fine needle aspiration (FNA) is a strategy for obtaining specimens from the cysts for cytological diagnosis. This study aims to evaluate the safety and utility of EUS-FNA for diagnosis of mediastinal cysts.

Methods

This was a retrospective analysis of patients who underwent EUS-FNA with 19-gauge needle at Tianjin Medical University Cancer Institute and Hospital and were further diagnosed with mediastinal cysts confirmed by cytological and surgical pathological results between January 2016 and December 2020. Safety was estimated by the incidence of reported adverse events (AEs). Patients were followed for 48 hours and 1 week after the EUS-FNA procedure to evaluate AEs.

Results

A total of 20 patients were diagnosed with mediastinal cysts using EUS-FNA, yet only 5 were diagnosed by CT. There were 15 patients diagnosed with bronchogenic cyst, 4 with enteric cyst, and 1 with pericardial cyst. The EUS appearance of cyst content varied, ranging from anechoic (4 cases) to hypoechoic (16 cases). AEs occurred in 2/20 (10%) patients after the EUS-FNA indicating an acceptable low rate of AEs. For all anechoic cysts that underwent complete FNA drainage, 3 patients had good prognosis, whereas 1 experienced recurrence. For 16 patients with hypoechoic cysts, adequate tissue was obtained for cytological examination. No patient developed an infection-related complication.

Conclusions

For the diagnosis of mediastinal cysts, EUS-FNA was more accurate than CT. The EUS-FNA of mediastinal cysts is safe with an acceptable low rate of AEs when antibiotic prophylaxis is used postoperatively. Cysts containing free-flowing fluid can be achieved with complete needle drainage by a single pass with a 19-gauge needle.

Endoscopic ultrasound-guided fine needle aspiration for smooth benign appearing malignant esophageal stricture: a cross-sectional study

Background

Endoscopic biopsy is standard for the diagnosis of esophageal malignancy. However, few cases are difficult to diagnose as they present with smooth esophageal stricture with negative biopsy results. We aimed to evaluate the effectiveness and safety of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in the diagnosis of biopsy-negative suspected malignant esophageal strictures.

Methods

We retrospectively analyzed cases of esophageal stricture with negative biopsies. From September 2016 to November 2021, 50 patients were enrolled. All the patients accepted the EUS-FNA examination. And histological and cytological specimens were obtained from all patients. Clinical, endoscopic, imaging, cytological, and histopathological results were noted and analyzed.

Results

A total of 50 patients (40 male and 10 female) were enrolled in this study. The 19G puncture needle was used in 6 cases and the 22G puncture needle was used in 44 cases; an average of 2.7 needles were used per case. Satisfactory specimens were obtained by EUS-FNA for all subjects. All patients were diagnosed as malignant tumor. The diagnosis was confirmed by EUS-FNA biopsies in 98% of patients. Based on the surgical pathology results, there were 16 cases of esophageal squamous cell carcinoma, 2 cases of esophageal metastatic carcinoma, 1 case of esophageal sarcoma, 22 cases of lung cancer, 6 cases of mediastinal lymph node metastasis, and 3 cases of mediastinal tumor. No obvious complications were observed. A total of 5 cases were treated with surgery, 28 with chemotherapy, 3 with chemotherapy + surgery, and 12 with radiotherapy; 2 patients ceased treatment. No obvious complications, such as bleeding and mediastinal infection, were observed.

Conclusions

EUS-FNA is effective and safe for the diagnosis of malignant esophageal strictures with smooth overlying esophageal mucosa. EUS-FNA is effective and safe for patients with smooth esophagus stenosis for whom satisfactory cytological and histological specimens can be obtained, and the diagnosis can be confirmed by cytological, histological, and immunohistochemical examinations. It can be used as the first choice for diagnosis and treatment.

POS0320 EPIDEMIOLOGY AND HEALTHCARE RESOURCE UTILIZATION OF PATIENTS WITH EGPA IN THE UNITED KINGDOM

Background

Eosinophilic granulomatosis with polyangiitis (EGPA) is characterized by eosinophilic inflammation of small with or without medium arteries. EGPA is a rare disease with varying prevalence and incidence rates globally. To date, limited information is available on the prevalence, incidence and burden of disease in the United Kingdom (UK).

Objectives

The objectives were to estimate the prevalence and incidence of EGPA, and to describe the healthcare resource utilization (HCRU) among patients with EGPA in the UK.

Methods

This retrospective database study used the UK-based Clinical Practice Research Datalink (CPRD)-AURUM database linked to the Hospital Episode Statistics (HES). Prevalence was estimated from 2005 to 2019, and incidence was estimated from 2006 to 2019. HCRU was assessed in the 12-months following the first recorded diagnosis of EGPA (index date), and included hospitalizations, emergency room visits, procedures, outpatient specialist visits, primary care visits, and oral corticosteroid use.

Results

764 people were identified with EGPA in the UK. The prevalence of EGPA, reported in the database, increased from 22.7 to 45.6 per 1,000,000 persons from 2005 to 2019 (Figure 1), whereas the incidence of EGPA from 2006 to 2019 ranged from 2.28 to 4.00 per 1,000,000 person-years. 377 patients with EGPA were successfully linked to the CPRD-HES database. Patient characteristics were as follows: mean age (SD) was 57 years (14.2); 49% were male; 81% had asthma; and 11% had peripheral neuropathy prior to the index date. For patients with EGPA, 19% had an EGPA-related hospitalization and 50% had any-cause hospitalization within 1 year of the index date (Table 1). The mean length of stay was, 18 days and 16 days for EGPA-related and any-cause hospitalizations, respectively. 52% of patients with EGPA had undergone a medical procedure, 89% of patients with EGPA had an outpatient visit to a specialist. Almost all patients with EGPA visited a general practitioner within 1 year of their EGPA diagnosis (97%) and averaged 16.0 visits in 1 year. A significant proportion of the EGPA population were prescribed OCS; most EGPA patients had a prescription in the 0–3 months after the index date (64%), and patients on average had a prescription for OCS for 6 out of the 12 months after the index date.

Table 1.

HCRU among patients with EGPA

HCRUNumber of patients N (%) [total days]Number of events per patient, Mean (SD)Total EGPA cohort (N)377 EGPA-specific hospitalizations72 (19.10)1.2 (1) EGPA-specific hospitalizations  length of stay[1283]17.8 (23.3) Any-cause hospitalizations188 (49.87)1.7 (1) Any-cause hospitalizations length of stay[2992]15.9 (23.7) Any-cause A & E events19 (5.04)1.8 (2) Any-cause outpatient visits334 (88.59)9.8 (7) Any procedures undertaken196 (51.99)6.8 (6) General Practitioner visits366 (97.08)16.0 (11)

A&E, Accident and Emergency; EGPA, eosinophilic granulomatosis with polyangiitis; HCRU, healthcare resource utilization.

Figure 1.

Prevalence of EGPA in the UK from 2005 to 2019

Prevalence is expressed as cases per 1,000,000 persons. EGPA, eosinophilic granulomatosis with polyangiitis; UK, United Kingdom.

Conclusion

The prevalence of EGPA increased over the study period in the UK, and the data show significant HCRU within 1 year of the first recorded diagnosis of EGPA. Almost all of the patients with EGPA were found to frequently visit the primary care physician and seek specialist care, and almost half required hospitalization. Funding: GSK [207888]

Acknowledgements

Funding: GSK [207888]

Disclosure of Interests

Jeremiah Hwee Shareholder of: GSK, Employee of: GSK, Qinggong Fu Shareholder of: GSK, Employee of: GSK, Lorraine Harper Speakers bureau: Viopharm (2021), Roche (2017), Consultant of: GSK (2021), Viopharm (2021), Grant/research support from: Viopharm (researcher initiated project), MSD (researcher initiated project), Krishnarajah Nirantharakumar Consultant of: Boehringer Ingelheim (Consultancy on real world evidence), Grant/research support from: AstraZeneca, Vifor and Boehringer Ingelheim (Investigator led grants), Ruchika Goel: None declared, Rupert Jakes Shareholder of: GSK, Employee of: GSK

High-Precision Colorimetric Sensing by Dynamic Tracking of Solvent Diffusion in Hollow-Sphere Photonic Crystals

Expensive instruments and complicated data processing are often required to discriminate solvents with similar structures and properties. Colorimetric sensors with high selectivity, low cost, and good portability are highly desirable to simplify such detection tasks. Herein, we report the fabrication of a photonic crystal sensor based on the self-assembled resorcinol formaldehyde (RF) hollow spheres to realize colorimetric sensing of polar solvents, including homologs and isomers based on the saturated diffusion time. The diffusion of solvent molecules through the photonic crystal film exhibits a unique three-step diffusion profile accompanied by a dynamic color change, as determined by the physicochemical properties of the solvent molecules and their interactions with the polymer shells, making it possible to accurately identify the solvent type based on the dynamic reflection spectra or visual perception. With its superior selectivity and sensitivity, this single-component colorimetric sensor represents a straightforward tool for convenient solvent detection and identification.

[Comparison of clinical features between sporadic pancreatic neuroendocrine tumors and those associated with multiple endocrine neoplasia type 1]

Objective: To compare the clinical features of multiple endocrine adenoma type 1 (MEN-1) associated pancreatic neuroendocrine neoplasms (pNENs) as well as sporadic pNENs. Methods: The clinical data of 28 sporadic pNENs patients and 10 MEN-1-related pNENs patients admitted to the First Affiliated Hospital of Nanjing Medical University from January 2010 to June 2021 were collected. Meanwhile, by searching PubMed database and reviewing the clinical data of 20 foreign patients with MEN-1-related pNENs which were reported at the same time.Compare and analyze the similarities and differences between MEN1-associated pNENs and sporadic pNENs in clinical features, such as family history, blood tests, pathological diagnostic indicators, tumor grade, stage and metastasis, treatment and prognosis and so on. Results: A total of 58 pNENs patients were included, and there were 30 MEN1-related pNENs patients and 28 sporadic pNENs patients. Eighteen patients (60%) had a family history of MEN1-related pNENs, and the mean age of onset was (35.3±13.0)years. There were no patients (0) with family history of sporadic pNENs, and the mean age of onset was(55.3±13.4)years. In contrast, the differences in family history, age of onset and NSE were statistically significant(all P<0.05).Among the pathological diagnostic indicators, there were 19 patients (63.3%) with Grade G2 of MEN1-related pNENs, and 25 patients (83.3%) with somatostatin receptor 2(SSTR2) negative. In sporadic pNENs, there were 16 patients (57.1%) with Grade G2 and 9 patients (32.1%) with SSTR2 negative. The differences in pathological grade, immunohistochemistry (Chromogranin A, CD56, and somatostatin receptor 2, SSTR2) between the two groups were statistically significant(all P<0.05). In terms of tumor staging and metastasis, 21 patients with MEN-1-related pNENs had metastasis (70%) and 20 patients with stage Ⅰ and Ⅱ AJCC (71%) in all. Eight patients with sporadic pNENs had metastasis (26.7%) and 8 patients were with stage Ⅰ and Ⅱ AJCC (28.6%). By contrast, the differences in total metastasis rate, AJCC stage and distant metastasis between the two groups were statistically significant(all P<0.05). In terms of treatment and prognosis, there was no statistical significance in the differences between surgical treatment and prognosis (P>0.05), and the difference was also not statistically significant in survival rate between them (P>0.05). Conclusions: There are no significant differences between MEN1-related pNENs and sporadic pNENs in terms of treatment, prognosis, and survival rate, but there are significant differences in clinical features, pathological features and the staging and grading of tumors. The rate of tumor grade, stage and metastasis of sporadic pNENs is higher.

Ultrafast and Irreversibly Thermochromic SiO2 -PC/PEG Double Layer for Green Thermal Printing

Traditional thermochromic photonic crystal (PC) usually has a slow and reversible thermal response, which limits its application in thermal printing. Here, the authors develop a thermochromic "SiO₂ -PC/PEG" double layer structure with a responding time of milliseconds for fast thermal printing. Controlled by the print-head, the polyethylene glycol (PEG) melts, infiltrates, and solidifies within the interparticle voids, which instantly and irreversibly changes the refractive index and produces the PC pattern. Multicolor printing can be realized by tuning the size and type of colloidal particles. Resolution as high as 300 DPI is achieved to print the high-resolution patterns and then the grayscale patterns based on the control of pixel densities. Different from fiber thermal paper, the "SiO₂ -PC/PEG" film has no toxic bisphenol A and possesses superior light stability for keeping the images longer. It is fully compatible with the commercial printer, which provides a mature solution for fast and convenient preparation of PC patterns.

Caregivers' mind-mindedness and rural left-behind young children's insecure attachment: The moderated mediation model of theory of mind and family status

BACKGROUND

China's rapid development and urbanization since the early 1980s have compelled many rural residents to move from rural to urban areas for work, leaving thousands of children at home.

OBJECTIVE

This study tested the mediating effect of children's theory of mind on the relationship between caregivers' mind-mindedness and their children's insecure attachment differently depending on the different family status (the moderator) of left-behind and non-left-behind.

PARTICIPANTS

The participants were 3 to 6 years old 74 left-behind children (LBHC) and 89 non-left-behind children (NLBHC).

SETTINGS

Participants were from rural counties of central China in Henan province that has experienced a large labor migration.

METHODS

A cross-sectional moderated mediation model linked mind-mindedness (independent variable) and insecure attachment (dependent variable) through the theory of mind (mediator) and family status (moderator: left-behind/non-left-behind), controlling for age, gender, and siblings.

RESULTS

First, LBHC scored higher on insecure-disorganized attachment than NLBHC. Second, the early childhood theory of mind mediated the relationship between the caregiver's mind-mindedness and young children's insecure attachment. Third, family status moderated the effects of the theory of mind on insecure attachment. The mediating role was established only for the left-behind family, and the lower theory of mind ability was associated with the greater insecure attachment of LBHC.

CONCLUSIONS

Our findings highlight the critical role of mind-mindedness, theory of mind, and family status in the attachment theory and clarify the association between different levels of young children's theory of mind and insecure attachment based on family status.

Clinical analysis of diagnosis and treatment of necrotizing fasciitis

It is difficult to diagnose necrotizing fasciitis early. In addition, untimely or incorrect treatment worsens the disease, which may then develop into severe necrotizing fasciitis. A retrospective analysis of the clinical data of 35 patients with severe necrotizing fasciitis admitted to the Burn Department of Gansu Provincial Hospital from 1 January 2015, to 1 January 2020, and the etiology, causes and diagnosis of their aggravated conditions was performed. Thirty cases were directly or indirectly related to trauma, 4 cases were pressure sores caused by long-term paraplegia, and 1 case was from mosquito bites on the left side of the chest. The preliminary diagnosis of 24 patients was unclear, and these cases were misdiagnosed as cellulitis or skin infections; 11 patients were diagnosed at the early stage, but due to the incorrect treatment or failure of timely treatment, their condition was further aggravated and developed into critical necrotizing fasciitis. 1. The diagnosis of necrotizing fasciitis mainly depends on clinical manifestations, and early diagnosis is key; 2. When the patient has local trauma accompanied by local inflammation, fever or hypothermia, necrotizing fasciitis should be highly suspected, and a differential diagnosis should be made between necrotizing fasciitis and cellulitis. The affected tissue should be thoroughly debrided and drained to avoid necrosis spreading to the distal limb along the fascial space. 3. Necrotizing fasciitis should be treated with systemic comprehensive treatment, rational use of antibiotics, correction of water and electrolyte disturbance, early active and thorough debridement and effective wound closure.

[Prognostic significance of DEK-NUP214 fusion gene in patients with acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation]

Objective: To investigate the dynamic change and clinical impact of DEK-NUP214 fusion gene in patients with acute myeloid leukemia (AML) receiving allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods: Real-time quantitative polymerase chain reaction (RQ-PCR) and multicolor flow cytometry (FCM) were used to detect DEK-NUP214 gene expression and leukemia-associated immunophenotype (LAIP) in 15 newly diagnosed patients with positive DEK-NUP214 and receiving allo-HSCT from September 2012 to September 2017 at Peking University People's Hospital. The clinical outcome was analyzed using Kaplan-Meier survival curves. The impact of DEK-NUP214 expression was analyzed by log-rank test. Results: The subjects were followed-up with a median period of 657 (62-2 212) days. The median DEK-NUP214 expression level at diagnosis was 488% (274%-1 692%). Thirteen patients achieved complete remission before allo-HSCT. Thirteen patients had a residual DEK-NUP214 expression of 0.38% (0.029%-738.9%) before allo-HSCT. After allo-HSCT, DEK-NUP214 expression in 9/13 patients remained positive, which dropped by around 500 folds (5.7-5 663.0 folds) within a month post-transplant. Five patients died and 2 patients relapsed. The 3-year cumulative incidence of relapse in patients with positive DEK-NUP214 before transplant was 17.5%±11.3% and the 3-year overall survival was 60.5%±13.8%. After allo-HSCT, DEK-NUP214-negative patients had a better outcome. Conclusion: Quantitative monitor of DEK-NUP214 fusion gene could be a sensitive indicator of MRD status after allo-HSCT.

POS0885 HIGH INCIDENCE AND MORTALITY OF PNEUMOCYSTIS JIROVECI INFECTION IN ANTI-MDA5-ANTIBODY POSITIVE DERMATOMYOSITIS: EXPERIENCE FROM A SINGLE CENTER

Background:

Idiopathic inflammatory myopathies (IIM) was associated with a significantly higher risk of opportunistic infections that including Pneumocystis jiroveci pneumonia(PJP) which is potentially fatal opportunistic infection. However, no prior studies have evaluated the PJP infection in subtypes of IIM.

Objectives:

To investigate the incidence rate and mortality rate of PJP infection in subgroups of IIM patients according to myopathy specific antibodies.

Methods:

In the first part, we reviewed 463 consecutive patients with IIM retrospectively to analyze incidence of PJP infection. In the next part, we enrolled 30 consecutive PJP infection patients with any rheumatic disease was to identify the mortality rate and risk factors. Kaplan-Meier curve with log rank test was used to access differences in survival. Univariate and multivariate analyses were performed to identify prognostic factors using Cox regression.

Results:

We found that 12(7.5%) PJP cases occurred in 160 anti-MDA5-ab-positive DM patients, while only two (0.7%) PJP cases were found in 303 anti-MDA5-ab-negtive DM/PM patients(P < 0.05). PJP infection typically happened in the first two months of the treatment for anti-MDA5-ab-positive DM patients who have a significant decrease in the CD4+ T cell counts and Lymphocyte counts (P < 0.05). Only two (16.7%) anti-MDA5-ab-positive DM patients recover from PJP, with lethally higher mortality than those PJP infection with other rheumatic diseases (83.3% vs. 38.9%, P < 0.05). We found no association between the time to anti-PJP treatment and treatment outcomes in anti-MDA5-ab-positive DM; yet we confirmed in PJP infection with other rheumatic diseases that anti-PJP treatment within 6 days crucially increased the survival (P < 0.05).

Conclusion:

PJP infection has alarming high incidence and mortality in anti-MDA5-ab-positive DM patients. Unlike PJP infection with other rheumatic diseases, timely treatment for PJP doesn’t improve the prognosis of this particular subtype. Therefore, the necessity of further study of PJP prophylaxis treatment in anti-MDA5-ab-positive DM patients is verified.

References:

[1]Hsu CY, et al. Comparing the burdens of opportunistic infections among patients with systemic rheumatic diseases: a nationally representative cohort study. ARTHRITIS RES THER 2019, 21(1):211.

Acknowledgements:

The authors thank Dr. An Sun,

Disclosure of Interests:

None declared

Effects of lipids and surfactants on the fermentation production of echinocandin B by Aspergillus nidulans

AIMS

Echinocandin B (ECB) is a kind of lipopeptide antifungal antibiotic, as well as the key precursor of antifungal drug Anidulafungin. Its efficient bioproduction plays an important role in promoting the industrial production of Anidulafungin.

METHODS AND RESULTS

In this study, methyl oleate and Tween 80 were firstly used to enhance the ECB fermentation by Aspergillus nidulans, the results showed that the ECB titre was significantly enhanced with the addition of methyl oleate and Tween 80. Among the lipids, methyl oleate was found to play a pivotal role in increasing the ECB titre to 2123 mg l^-1 , which was more than five times higher than that of the control. The addition of Tween 80 in the medium resulted in ECB titre increased to 2584 mg l^-1 . The scanning electron microscope (SEM) and N-phenyl-1-naphthylamine (NPN) assay indicated that Tween 80 could influence the cell membrane permeability of A. nidulans, and enhance the intracellular and extracellular substance exchange, therefore lead to the increasing of ECB titre.

CONCLUSIONS

Methyl oleate and Tween 80 are optimal carbon sources and surfactants for efficient ECB biosynthesis respectively.

SIGNIFICANCE AND IMPACT OF THE STUDY

Surfactant was used in ECB fermentation for the first time, which provided feasible ideas for optimizing the fermentation process of other fungi.

[Correlation of cerebrospinal fluid amyloid β-protein 42 and neurofilament light protein levels with postoperative neurocognitive dysfunction in elderly patients]

OBJECTIVE

To detect cerebrospinal fluid levels of amyloid beta- protein 42 (Aβ42) and neurofilament light protein (NFL) and explore their correlation with postoperative neurocognitive dysfunction (PNCD) in elderly patients.

OBJECTIVE

A total of 90 elderly patients undergoing hip or knee replacement with joint epidural anesthesia in our Hospital between January, 2017 and December, 2018 were recruited in this study. The levels of Aβ42 and NFL in the cerebrospinal fluid were detected using ELISA. Simple cognitive status assessment scale (MMSE) was used to evaluate the cognitive status of the patients 1 day before and 7 days after the surgery. All the patients underwent neurocognitive function tests, and the z-score method was used to determine the occurrence of PNCD. Spearman rank correlation analysis was used to analyze the correlation of Aβ42 and NFL levels in the cerebrospinal fluid with MMSE scores. Receiver operating characteristic curve (ROC) was used to analyze the predictive value of cerebrospinal fluid Aβ42 and NFL levels for PNCD.

OBJECTIVE

PNCD occurred in 38 of the 90 elderly patients, with an incidence of 42.2%. The level of Aβ42 in the cerebrospinal fluid was significantly lower in PNCD group than in the nonPNCD group (1.96 vs 2.54 ng/mL; t=3.29, P < 0.05); the concentration of NFL in the cerebrospinal fluid was significantly higher in PNCD group than in non- PNCD group (4.59 vs 3.16 ng/mL; t=3.72, P < 0.05). Aβ42 level in the cerebrospinal fluid was positively correlated while NFL was negatively correlated with the MMSE score of the patients (r=-0.659, P < 0.05; r=-0.626, P < 0.05). ROC curve analysis showed that the area under the curve (AUC) of cerebrospinal fluid Aβ42 and NFL levels were 0.744 and 0.768, respectively; the AUC of their combination was 0.847 for prediction of PNCD.

OBJECTIVE

Elderly patients with PNCD have significantly higher levels of Aβ42 and NFL in the cerebrospinal fluid than those without PNCD. Both Aβ42 and NFL levels in the cerebrospinal fluid can help to predict the occurrence of POCD in elderly patients, and their combination has a higher diagnostic value.

[The effect of donor cytomegalovirus serological status on the outcome of allogeneic stem cell transplantation]

Objective: Donor cytomegalovirus (CMV) serological negative status may have an adverse effect on the outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT), while there is inadequate data for Chinese people. This study is to explore the impact of donor CMV serological status on the outcome of CMV seropositive patients receiving allo-HSCT. Methods: Our study retrospectively analyzed 16 CMV seropositive patients with hematological malignancies receiving allogeneic grafts from CMV seronegative donors (antibody IgG negative) at Peking University People's Hospital from March 2013 to March 2020, which was defined as D^-/R⁺ group. The other 64 CMV seropositive patients receiving grafts from CMV seropositive donors at the same period of time were selected as matched controls through a propensity score with 1∶4 depending on age, disease state and donor-recipient relationship (D⁺/R⁺ group). Results: Patients in D^-/R⁺ group developed CMV DNAemia later than patients in the D⁺/R⁺ group (+37 days vs. +31 days after allo-HSCT, P=0.011), but the duration of CMV DNAemia in D^-/R⁺ group was longer than that of D⁺/R⁺ group (99 days vs. 34 days, P=0.012). The rate of CMV reactivation 4 times or more in D^-/R⁺ group was 4/16, significantly higher than that of D⁺/R⁺ group (4.7%, 3/64, P=0.01). The incidences of refractory CMV DNAemia (14/16 vs. 56.3%, P=0.021) and CMV disease (4/16 vs. 4.7%, P=0.01) in D^-/R⁺ group were both higher than those in D⁺/R⁺ group. In addition, the application of CMV-CTL as the second-line antiviral treatment in D^-/R⁺ group was more than that in D⁺/R⁺ group. Univariate analysis and multivariate analysis suggested that CMV serological negativity is an independent risk factor for refractory CMV DNAemia and the duration of CMV infection. The cumulative incidence of aGVHDⅡ-Ⅳ, cGVHD, 3-year probability of NRM, overall survival, and the cumulative incidence of relapse were all comparable in two groups. Conclusions: Although there is no significant effect on OS and NRM, the incidence of refractory CMV DNAemia, the frequency of virus reactivation, and the development of CMV disease in D^-/R⁺ group are higher than those in controls. Therefore, CMV seropositive donors are preferred for CMV seropositive patients.

Metal-Organic Framework-Coated Photonic Crystals for High-Performance Thin-Layer Chromatography

Traditional SiO₂ gel-based thin-layer chromatography (TLC) is unable to separate substances with close structures, and its detection requires dyeing when the sample has neither fluorescence nor ultraviolet (UV) absorption signals. Here, high-performance TLC was developed based on metal-organic framework-coated photonic crystal (MOF/PC) films. Using the MIL-100/PC as the TLC plate, the cresol isomers can now be separated in a 2 cm development distance due to the enhanced adsorption-desorption and the good selectivity from the micropores. Meanwhile, the cresol changes the refractive index of MOF/PC, which produces color changes for sample recognition. Compared to the traditional TLC, the MOF/PC TLC shows much higher selectivity toward the analytes, which fully compensates its limited plate numbers and ensures a high-resolution separation. It also provides a convenient solution for chemical analysis as the detection based on structural color change does not require UV irradiation or dyeing treatment.

[Therapeutic effect of tonsillectomy on IgA nephropathy after kidney transplantation]

Objective: To observe the clinical effect of tonsillectomy on IgA nephropathy (IgAN) after renal transplantation. Methods: From March 2011 to July 2018, 201 kidney transplantation recipients who were diagnosed of IgAN by transplant renal biopsy in the Department of Organ Transplantation of the First Affiliated Hospital of Sun Yat-sen University were retrospectively reviewed, of which 18 patients underwent tonsillectomy after renal biopsy. The clinical data of the 18 patients were collected, patient and kidney survival time and function of the transplanted kidney were analyzed. Results: Of the 18 recipients, 13 were male and 5 were female, with an average age of (36.0±10.9) years. All 18 patients survived during follow-up. Two patients returned to dialysis treatment 10 months and 14 months after tonsillectomy, respectively. The creatinine was 94 (78, 133) μmol/L, 95 (74, 139) μmol/L, 106 (87, 158) μmol/L and 95(81, 147) μmol/L before tonsillectomy, 3 months, 1 year and 2 years after tonsillectomy, respectively (P=0.206). Urinary protein quantification was 0.31 (0.16, 1.38) g/24 h, 0.34 (0.10, 1.42) g/24 h, 0.33 (0.11, 0.56) g/24 h and 0.25 (0.10, 0.50) g/24 h at the same time points, respectively (P=0.104). The two patients who returned to dialysis were diagnosed of IgAN by transplant renal biopsy because of elevated creatinine, proteinuria and hematuria, 9 years and 4 years after kidney transplant respectively. Renal biopsy suggested that glomerular and segmental sclerosis were 7/24, 5/24 and 1/6, 2/6, respectively. Additionally, interstitial fibrosis and tubular atrophy (IF/TA) were both occupied 30% in the biopsies, and tonsillectomy was performed 461 days and 1 077 days after diagnosis of IgAN, respectively. Conclusions: Tonsillectomy can maintain the stability of renal function and prevent the aggravation of proteinuria in IgAN patients after renal transplantation. However, if pathology suggests obvious glomerulosclerosis or IF/TA, tonsillectomy may not be effective.

[Effects of FoxO6 on proliferation and invasion of colorectal cancer cells]

Objective: To investigate the effects and the mechanism of FoxO6 on the proliferation and invasion of colorectal cancer cells. Methods: FoxO6 siRNA was transfected into colorectal cancer cell HCT116 and SW480. The overexpression vector pcDNA.3.1-c-Myc was constructed and co-transfected into HCT116 and SW480 cells with FoxO6 siRNA. Real-time fluorescent quantitative PCR (RT-qPCR) and western blot were used to detect the mRNA and protein expressions of FoxO6, c-Myc, and p21 in HCT116 and SW480 cells. Bromodeoxyuridine (BrdU) was used to detect cell proliferation and Transwell assay was performed to detect the invasion ability of these cells. SW480 cells transfected with FoxO6 shRNA lentivirus (LV-FoxO6) and were injected into the right armpit of BAL b/c nude mice to construct a tumor-bearing mode and the tumor volumes were measured on the days of 10, 13, 16, 19, 22, and 25 after injection. Results: The FoxO6 mRNA were 0.91±0.04, 1.72±0.07, and 2.03±0.06, and protein expression were 0.70±0.04, 1.35±0.08, and 1.56±0.07 in normal colon cell FHC, colorectal cancer cells HT116 and SW480, respectively. The protein and mRNA levels of FoxO6 in HCT116 and SW480 were significantly higher than those in FHC (both P<0.05). Knockdown of FoxO6 in HCT116 and SW480 cells decreased the mRNA and protein expressions of FoxO6 (both P<0.05), the cell proliferation ability (absorbances were 0.26±0.07 and 0.27±0.06, both P<0.05), cell invasion ability (the invaded cell numbers were 42.3±3.3 and 45.7±4.1, both P<0.05), and the mRNA and protein expressions of c-Myc, while increased the mRNA and protein expressions of p21 (both P<0.01). Overexpression of Myc in FoxO6 silenced HCT116 and SW480 cells decreased the expression of p21, while increased the cell proliferation ability (absorbances were 0.54±0.09 and 0.58±0.07, both P<0.01) and invasion ability (the invaded cell numbers were 79.2±5.9 and 80.5±6.4, both P<0.01). On the 25th day after cell inoculation in nude mice, the tumor volume of LV-FoxO6 group was (190.6±36.2) mm(3), significantly lower than (437.8.6±69.2) mm(3) of LV-NC group (P<0.05). Conclusion: FoxO6 promotes the proliferation and invasion of colorectal cancer cells through facilitating c-Myc mediated p21 expression inhibition.

Influence of built environment on quality of life changes in African-American patients with non-metastatic breast cancer

Research links the built environment to health outcomes, but little is known about how this affects quality of life (QOL) of African American breast cancer patients, especially those residing in disadvantaged neighborhoods. Using latent trajectory models, we examined whether the built environment using Google Street View was associated with changes in QOL over a 2-year follow-up in 228 newly diagnosed African American breast cancer patients. We measured QOL using the RAND 36-Item Health Survey subscales. After adjusting for covariates, improvement in emotional well-being and pain over time was greater for women living on streets with low-quality (vs. high-quality) sidewalks.

Detection of hepatitis E virus genotypes 3 and 4 in donkeys in northern China

BACKGROUND

Hepatitis E virus (HEV) is the causative agent of acute self-limiting hepatitis in humans in developing countries. Hepatitis E virus RNA was first detected in donkeys in Spain, but little is known about the possible presence of HEV in donkeys in China.

OBJECTIVES

To investigate the prevalence of HEV in donkeys in northern China.

STUDY DESIGN

Investigation of the prevalence of HEV in donkeys using serological, molecular and phylogenetic approaches.

METHODS

A total of 401 donkey serum specimens were tested for serological and molecular detection of HEV via enzyme-linked immunosorbent assay and quantitative reverse transcription polymerase chain reaction. The amplified products were cloned in pMD18-T vector and sequenced. The alignment and phylogenetic analysis of partial HEV ORF2 genes were compared with the corresponding sequences of the obtained HEV representative strains.

RESULTS

Serological results showed that 49 donkeys (12.22%, 95% CI: 9.18-15.83%) were positive for anti-HEV-specific antibodies, and 17 donkeys (4.24%, 95% CI: 2.49-6.70%) were positive for HEV viral RNA. On the basis of sequence alignment and phylogenetic analysis, all isolated HEV strains belonged to genotype 3 (HEV-3) or HEV-4, sharing more than 76.2-96.3% identities with 67 other HEV representative strains of HEV-1 to HEV-8.

MAIN LIMITATIONS

Further studies about the prevalence of HEV in organs or faecal samples from donkeys are needed to evaluate the possible role of HEV reservoir and to determine the risk factors associated with the transmission of this zoonotic virus in donkeys in China.

CONCLUSIONS

This is the first report documenting the molecular analysis of donkey HEV strains worldwide and the serological evidence of HEV infection in donkeys in northern China. The results suggest that young donkeys are more susceptible to HEV infection compared with older donkeys. Further investigation is required to determine whether donkeys should be considered reservoirs for zoonotic HEV. The Summary is available in Chinese - see Supporting information.

The human central nervous system transmits common synaptic inputs to distinct motor neuron pools during non-synergistic digit actions

Key points

Neural connectivity between distinct motor neuronal modules in the spinal cord is classically studied through electrical stimulation or multi‐muscle EMG recordings.

We quantified the strength of correlation in the activity of two distinct populations of motor neurons innervating the thenar and first dorsal interosseous muscles during tasks that required the two hand muscles to exert matched or un‐matched forces in different directions.

We show that when the two hand muscles are concurrently activated, synaptic input to the two motor neuron pools is shared across all frequency bandwidths (representing cortical and spinal input) associated with force control.

The observed connectivity indicates that motor neuron pools receive common input even when digit actions do not belong to a common behavioural repertoire.

Abstract

Neural connectivity between distinct motor neuronal modules in the spinal cord is classically studied through electrical stimulation or multi‐muscle EMG recordings. Here we quantify the strength of correlation in the activity of two distinct populations of motor neurons innervating the thenar and first dorsal interosseous muscles in humans during voluntary contractions. To remove confounds associated with previous studies, we used a task that required the two hand muscles to exert matched or un‐matched forces in different directions. Despite the force production task consisting of uncommon digit force coordination patterns, we found that synaptic input to motor neurons is shared across all frequency bands, reflecting cortical and spinal inputs associated with force control. The coherence between discharge timings of the two pools of motor neurons was significant at the delta (0–5 Hz), alpha (5–15 Hz) and beta (15–35 Hz) bands (P < 0.05). These results suggest that correlated input to motor neurons of two hand muscles can occur even during tasks not belonging to a common behavioural repertoire and despite lack of common innervation. Moreover, we show that the extraction of activity from motor neurons during voluntary force control removes cross‐talk associated with global EMG recordings, thus allowing direct in vivo interrogation of spinal motor neuron activity.

Neural connectivity between distinct motor neuronal modules in the spinal cord is classically studied through electrical stimulation or multi‐muscle EMG recordings.

We quantified the strength of correlation in the activity of two distinct populations of motor neurons innervating the thenar and first dorsal interosseous muscles during tasks that required the two hand muscles to exert matched or un‐matched forces in different directions.

We show that when the two hand muscles are concurrently activated, synaptic input to the two motor neuron pools is shared across all frequency bandwidths (representing cortical and spinal input) associated with force control.

The observed connectivity indicates that motor neuron pools receive common input even when digit actions do not belong to a common behavioural repertoire.

[Periostin regulated by let-7/miR-98 family mediates the apoptosis and epithelial-mesenchymal transition of colon cancer]

Objective: To observe the expressions of periostin (Postn) in colon cancer tissues and cells, and to investigate its biological effect and mechanism in colon cancer cells. Methods: Real-time quantitative polymerase chain reaction (RT-qPCR) and western blot were used to detect the expressions of Postn, let-7a and miR-98 in 20 pairs of colon cancer tissues and adjacent normal tissues, colon cancer cell lines including SW480, HT-29, HCT-116 and human normal colon epithelial cell NCM460. Small interfering RNAs (siRNAs) of Postn, pcDNA3.1-Postn plasmids, let-7a mimic and its negative control let-7a mimic-NC, miR-98 mimic and its negative control miR-98 mimic-NC were transfected into HCT-116 cells. 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2H tetrazolium bromide (MTT) was used to detect cell viability. Flow cytometry was used to detect cell apoptosis. Luciferase reporter gene assay was used to determine the targeting relationship between miRNAs and Postn. Results: Compared with adjacent normal tissues, Postn expression was up-regulated (P<0.05) while let-7a/miR-98 expression was down-regulated (P<0.05) in colon cancer tissues. Compared with NCM460 cells, Postn expression was up-regulated (P<0.05) while let-7a/miR-98 expression was down-regulated (P<0.05) in SW480, HT-29 and HCT-116 cells. In colon cancer tissues, the expression of Postn was negatively correlated with the expressions of let-7a and miR-98 (r=-0.69, P<0.001; r=-0.80, P<0.001). Inhibition of Postn in vitro reduced the viability of HCT-116 cells [(53.73±7.63)%, P<0.05], increased the apoptotic rate [(22.88±3.40)%, P<0.05], enhanced the expression of epithelial-mesenchymal transition (EMT) marker E-cadherin (2.44±0.39, P<0.05), while down-regulated the expressions of N-cadherin and Vimentin (0.44±0.07 and 0.38±0.06, P<0.05). Overexpression of Postn in vitro enhanced the cell viability of HCT-116 cells [(134.41±8.82) %, P<0.05], decreased the expression of E-cadherin (0.55±0.09, P<0.05), increased the expressions of N-cadherin and Vimentin (2.93±0.42 and 2.24±0.34, P<0.05), but had no effect on the apoptotic rate (P>0.05). Overexpression of let-7a or miR-98 partially reversed the biological effects of Postn overexpression in colon cancer cells, which implicated that Postn was a target gene of let-7a/miR-98. Conclusions: Postn is a cancer-promoting molecule of colon cancer, and inhibition of Postn expression can increase the apoptotic rate of colon cancer cells and repress EMT. Postn expression and function is regulated by let-7a/miR-98.