[Effect of LAG3 deficiency on natural killer cell function and hepatic fibrosis in mice infected with Echinococcus multilocularis]

OBJECTIVE

To investigate the effect of LAG-3 deficiency (LAG3-/-) on natural killer (NK) cell function and hepatic fibrosis in mice infected with Echinococcus multilocularis.

METHODS

C57BL/6 mice, each weighing (20 ± 2) g, were divided into the LAG3-/- and wild type (WT) groups, and each mouse in both groups was inoculated with 3 000 E. multilocularis protoscoleces via the hepatic portal vein. Mouse liver and spleen specimens were collected 12 weeks post-infection, sectioned and stained with sirius red, and the hepatic lesions and fibrosis were observed. Mouse hepatic and splenic lymphocytes were isolated, and flow cytometry was performed to detect the proportions of hepatic and splenic NK cells, the expression of CD44, CD25 and CD69 molecules on NK cell surface, and the secretion of interferon γ (IFN-γ), tumor necrosis factor α (TNF-α), interleukin (IL)-4, IL-10 and IL-17A.

RESULTS

Sirius red staining showed widening of inflammatory cell bands and hyperplasia of fibrotic connective tissues around mouse hepatic lesions, as well as increased deposition of collagen fibers in the LAG3-/-group relative to the WT group. Flow cytometry revealed lower proportions of mouse hepatic (6.29% ± 1.06% vs. 11.91% ± 1.85%, P < 0.000 1) and splenic NK cells (4.44% ± 1.22% vs. 5.85% ± 1.10%, P > 0.05) in the LAG3-/- group than in the WT group, and the mean fluorescence intensity of CD44 was higher on the surface of mouse hepatic NK cells in the LAG3-/- group than in the WT group (t = -3.234, P < 0.01), while no significant differences were found in the mean fluorescence intensity of CD25 or CD69 on the surface of mouse hepaticNK cells between the LAG3-/- and WT groups (both P values > 0.05). There were significant differences between the LAG3-/- and WT groups in terms of the percentages of IFN-γ (t = -0.723, P > 0.05), TNF-α (t = -0.659, P > 0.05), IL-4 (t = -0.263, P > 0.05), IL-10 (t = -0.455, P > 0.05) or IL-17A secreted by mouse hepatic NK cells (t = 0.091, P > 0.05), and the percentage of IFN-γ secreted by mouse splenic NK cells was higher in the LAG3-/- group than in the WT group (58.40% ± 1.64% vs. 50.40% ± 4.13%; t = -4.042, P < 0.01); however, there were no significant differences between the two groups in terms of the proportions of TNF-α (t = -1.902, P > 0.05), IL-4 (t = -1.333, P > 0.05), IL-10 (t = -1.356, P > 0.05) or IL-17A secreted by mouse splenic NK cells (t = 0.529, P > 0.05).

CONCLUSIONS

During the course of E. multilocularis infections, LAG3-/- promotes high-level secretion of IFN-γ by splenic NK cells, which may participate in the reversal the immune function of NK cells, resulting in aggravation of hepatic fibrosis.

Floating-Point Approximation Enabling Cost-Effective and High-Precision Digital Implementation of FitzHugh-Nagumo Neural Networks

The study of neuron interactions and hardware implementations are crucial research directions in neuroscience, particularly in developing large-scale biological neural networks. The FitzHugh-Nagumo (FHN) model is a popular neuron model with highly biological plausibility, but its complexity makes it difficult to apply at scale. This paper presents a cost-saving and improved precision approximation algorithm for the digital implementation of the FHN model. By converting the computational data into floating-point numbers, the original multiplication calculations are replaced by adding the floating-point exponent part and fitting the mantissa part with piecewise linear. In the hardware implementation, shifters and adders are used, greatly reducing resource overhead. Implementing FHN neurons by this approximation calculations on FPGA reduces the normalized root mean square error (RMSE) to 3.5% of the state-of-the-art (SOTA) while maintaining a performance overhead ratio improvement of 1.09 times. Compared to implementations based on approximate multipliers, the proposed method achieves a 20% reduction in error at the cost of a 2.8% increase in overhead.This model gained additional biological properties compared to LIF while reducing the deployment scale by only 9%. Furthermore, the hardware implementation of nine coupled circular networks with eight nodes and directional diffusion was carried out to demonstrate the algorithm's effectiveness on neural networks. The error decreased to 60% compared to the single neuron of the SOTA. This hardware-friendly algorithm allows for the low-cost implementation of high-precision hardware simulation, providing a novel perspective for studying large-scale, biologically plausible neural networks.

Changes in menopausal symptoms comparing oral estradiol versus transdermal estradiol

OBJECTIVE

This study aimed to compare the efficacy and safety of oral and transdermal estradiol in alleviating menopausal symptoms.

METHOD

A total of 257 recently menopausal women were randomized into two groups. The t-E2 group received transdermal estradiol (2.5 g per day) (n = 128) and the o-E2V group received oral estradiol valerate (2 mg per day) (n = 129) for 24 weeks; both groups received micronized progesterone (200 mg per day). The primary outcome measure is the change in the modified Kupperman Menopausal Index (KMI) after 24 weeks of treatment. Menopausal symptoms were recorded at screening and at 4, 12 and 24 weeks using both the KMI and the Menopause Rating Scale (MRS).

RESULTS

Significant amelioration was observed by KMI and MRS scores for both groups after treatment (p < 0.001). The mean KMI scores showed no difference between the two groups. The mean MRS scores were similar between the two groups at baseline and after 4 weeks of treatment. The results showed statistical differences after 12 weeks and 24 weeks of treatment (p = 0.005 and p = 0.011). Both the after-treatment scores minus the baseline scores of KMI and MRS and the incidence of adverse effects showed no difference between the two groups.

CONCLUSIONS

This study shows that both transdermal and oral estradiol are effective in relieving menopausal symptoms, with little difference in treatment efficacy and safety.

CLINICAL TRIAL NUMBER

ChiCTR2300073146.

Impact of digital finance on urban ecological resilience: evidence from the Yangtze River Economic Belt in China

From the emergence of the new coronavirus pandemic to extreme climatic catastrophes, the development and enhancement of urban ecological resilience has evolved into a critical and strategic imperative. Investigating the capacity of digital finance to promote urban ecological resilience bears substantial relevance to the sustainable advancement of urban centers. This study examines the influence of digital finance on urban ecological resilience by applying a benchmark regression model on data from 107 prefecture-level cities within the Yangtze River Economic Belt across 2011-2020. Additionally, this study delves into its mechanism and spatial spillover impacts via a mediating effect model and a spatial effect model. The findings revealed that (1) digital finance strengthens the ecological resilience of the locale and beneficially impacts the surrounding regions; (2) digital finance enhances urban ecological resilience by fostering technological innovation and reducing energy intensity; and (3) in the lower reaches of the Yangtze River, digital finance plays a greater role in improving urban ecological resilience. Cities with high level of traditional financial development, high level of economic development and high intensity of environmental regulation have a more obvious role in promoting urban ecological resilience. Within the paradigm of ecological civilization, it is advisable for governmental bodies to fortify inter-regional digital financial collaboration, refine the green financial infrastructure, and advocate for sustainable, low-carbon, high-quality urban development.

MRI-visible enlarged perivascular spaces in basal ganglia rather than centrum semiovale was associated with aneurysmal subarachnoid hemorrhage

Background

The subarachnoid space is continuous with the perivascular compartment in the central nervous system. However, whether the topography and severity of enlarged perivascular spaces (EPVS) correlates with spontaneous subarachnoid hemorrhage (SAH) remains unknown. Based on the underlying arteriopathy distributions, we hypothesized that EPVS in basal ganglia (BG-EPVS) are more closely associated with aneurysmal subarachnoid hemorrhage (aSAH) than other SAH without aneurysm.

Methods

Magnetic resonance imaging (MRI) scans of 271 consecutive SAH survivors with and without aneurysm were analyzed for EPVS and other markers of imaging data. In the subgroup analysis, we compared the clinical characteristics and EPVS of SAH participants with and without pre-existing known risk factors (hypertension, diabetes, and smoking history) using multivariable logistic regression.

Results

Patients with aSAH (n = 195) had a higher severity of BG-EPVS and centrum semiovale EPVS (CSO-EPVS) than those without aneurysm (n = 76). Importantly, BG-EPVS predominance pattern (BG-EPVS>CSO-EPVS) only existed in aSAH survivors rather than other SAH without aneurysm. In the subgroup analysis, interestingly, we also found that a high degree of BG-EPVS showed an independent relationship with aSAH in patients without pre-existing risk factors (e.g., hypertension).

Conclusion

In this cohort study, BG-EPVS predominance pattern was associated with aSAH patients compared with those without aneurysm. Moreover, BG-EPVS still showed a strong association with aSAH survivors without pre-existing vascular risk factors. Our present study suggested the BG-EPVS as a potential MRI-visible characteristic would shed light on the pathogenesis of glymphatic function at the skull base for aSAH.

[Research and progress in etiology, prevention and treatment strategies of secondary caries]

Secondary caries is one of the main reasons that affect the service life of the restoration. Compared with primary caries, secondary caries have some particularities in etiology, disease progression, clinical manifestation, clinical diagnosis, treatment and prevention. Starting from the above aspects, combined with the latest basic and clinical research on secondary caries, this paper summarizes and analyzes its pathogenesis and prevention strategies, which will lay a certain foundation for in-depth understanding of secondary caries and promoting its clinical prevention and treatment.

A prospective study of drug-drug interaction between antiepileptic drugs and meropenem in patients in a tertiary hospital in China from January 2020 to March 2023

OBJECTIVE

This study aimed to determine the minimum interaction between different antiepileptic drugs (AEDs) and meropenem (MEPM) for clinical treatment.

PATIENTS AND METHODS

The data of 91 patients enrolled in the neurology department from January 2020 to March 2023 for clinical trials were measured and observed. Self-controlled studies were conducted to monitor the trough concentrations of valproic acid (VPA), carbamazepine (CBZ) and levotiracetam (LEV) before and after MEPM usage. Relevant indicators of liver and kidney function were also monitored.

RESULTS

The serum VPA trough concentrations were 36.25±8.22 μg/ml at 24±12 h and 34.99±11.17 μg/ml at 96±12 h after MEPM use; the difference was significant (p<0.05). Decreased CBZ trough concentrations were also identified after MEPM usage (96±12 h), whereas LEV trough concentrations were not affected. An increased liver injury rate (χ2 =8.744, p<0.05) and a decreased kidney injury rate (χ2 =5.393, p<0.05) were found in the VPA group only.

CONCLUSIONS

The interaction between VPA and MEPM decreased serum VPA concentrations, increased liver injury rates, and decreased kidney injury rates. In addition, the co-administration of MEPM and CBZ reduced serum CBZ concentrations. Clinicians should be aware of this potential interaction and closely monitor the relevant biochemical indices and number of seizures.

Achieving High Core Neuron Density in a Neuromorphic Chip Through Trade-off Among Area, Power Consumption, and Data Access Bandwidth

As a crucial component of neuromorphic chips, on-chip memory usually occupies most of the on-chip resources and limits the improvement of neuron density. The alternative of using off-chip memory may result in additional power consumption or even a bottleneck for off-chip data access. This article proposes an on- and off-chip co-design approach and a figure of merit (FOM) to achieve a trade-off between chip area, power consumption, and data access bandwidth. By evaluating the FOM of each design scheme, the scheme with the highest FOM (1.085× better than the baseline) is adopted to design a neuromorphic chip. Deep multiplexing and weight-sharing technologies are used to reduce on-chip resource overhead and data access pressure. A hybrid memory design method is proposed to optimize on- and off-chip memory distribution, which reduces on-chip storage pressure and total power consumption by 92.88% and 27.86%, respectively, while avoiding the explosion of off-chip access bandwidth. The co-designed neuromorphic chip with ten cores fabricated under standard 55 nm CMOS technology has an area of 4.4 mm 2 and a core neuron density of 4.92 K/mm 2, an improvement of 3.39  ∼ 30.56× compared with previous works. After deploying a full-connected and a convolution-based spiking neural network (SNN) for ECG signal recognition, the neuromorphic chip achieves 92% and 95% accuracy, respectively. This work provides a new path for developing high-density and large-scale neuromorphic chips.

Purtscher-like retinopathy in systemic lupus erythematosus: clinical features, risk factors and prognosis

BACKGROUND

Purtscher-like retinopathy (PLR) is a rare ocular manifestation in systemic lupus erythematosus (SLE) with poor prognosis, but its clear risk factors and treatment consensus are still lacking.

AIM

To investigate the clinical features, risk factors and prognosis of PLR in SLE patients.

DESIGN AND METHODS

A retrospective analysis was conducted on SLE patients with PLR admitted at Peking Union Medical College Hospital from 2013 to 2022. Clinical data, including demographic characteristics, lupus-related features, laboratory findings and ophthalmologic examinations, were collected and analyzed. The prognosis was evaluated based on best-corrected visual acuity and ophthalmologic outcomes.

RESULTS

Seventeen SLE patients (32 eyes) diagnosed with PLR were included, along with a random selection of 100 SLE patients without retinopathy and 100 with retinal microvasculopathy as controls. Patients with PLR had a significantly younger age, a higher proportion of hemolytic anemia, a shorter duration of SLE, a higher SLE disease activity index-2000 (SLEDAI-2K) score, higher erythrocyte sedimentation rate (ESR) values and lower hemoglobin (HGB) values than the group without retinopathy (P < 0.05). They also had a significantly higher SLEDAI-2K score, higher ESR values and higher white blood cell values (P < 0.05) than the Microvasculopathy group. The majority of eyes (22/26, 84.62%) achieved stabilization at the last follow-up, with different therapeutic strategies, while a few (4/26, 15.38%) experienced complications or progression.

CONCLUSION

This is the largest reported case series of PLR in SLE, which was associated with higher disease activity and poor visual prognosis. It was also associated with younger age, shorter SLE duration, concomitant hemolytic anemia, lower HGB and higher ESR value. Early recognition and prompt treatment are crucial for improving visual outcomes.

Vogt-Koyanagi-Harada disease in pediatric, adult and elderly: clinical characteristics and visual outcomes

PURPOSE

To depict a whole spectrum of clinical feartures and visual prognosis among pediatric, adult, and elderly Vogt-Koyanagi-Harada disease (VKH) patients.

METHODS

Retrospective chart review was conducted in 2571 VKH patients diagnosed from April 2008 to January 2022. Based on age of disease onset, patients were divided into pediatric (age ≤ 16 years), adult (16 < age < 65 years), and elderly (age ≥ 65 years) VKH group. Ocular and extraocular manifestations were compared among these patients. Visual outcomes and complications were evaluated using logistic regression models and restricted cubic splines analysis.

RESULTS

The median follow-up time was 48 (IQR, 12-60) months. Pediatric, adult and elderly VKH were found in 106 (4.1%), 2355 (91.6%), and 110 (4.3%) patients, respectively. All of the patients showed similar ocular manifestations in the context of disease phasing. The proportion of neurological and auditory manifestations in pediatric (42.3% and 7.5%) VKH patients was significantly lower than that in adults (66.5% and 47.9%) and elderly (68.2% and 50%) (both p < 0.0001). An increased risk of macular abnormalities was seen in adults (OR, 3.43; 95% CI, 1.62-7.29) compared with elderly VKH. An inverted-U-shaped pattern was observed between disease onset age and a poor visual outcome (visual acuity 6/18 or worse) according to OR value in VKH patients. The highest risk of BCVA ≤ 6/18 was observed in 32 years at disease onset (OR, 1.51; 95% CI, 1.18-1.94). A higher risk of visual loss was observed in adult VKH patients (OR, 9.06; 95% CI, 2.18-37.6) compared with elderly VKH patients. And stratified by macular abnormalities, the interaction test was not significant (P = 0.634).

CONCLUSION

Our study identified, for the first time, a whole spectrum of clinical features of VKH based on a large cohort of Chinese patients. Adult VKH patients have an increased risk of poor visual outcomes, possibly due to increased frequency of macular abnormalities.

Assessing China's development zones and carbon emissions

The present article evaluates establishment of development zones and its association with carbon emissions. In the process of industrialization, carbon emissions in underdeveloped regions of the world increase with economic growth. In order to promote economic growth in the western region and strengthen the management of enterprise pollution emissions, the Chinese government has set up hundreds of development zones. Existing research shows that development zone establishment can promote economic growth; however, literature is scarce when the relationship is tested across region. Based on the panel data of five provinces with relatively backward economy in western China from 2001 to 2017, this paper constructs a "multi-period difference-in-difference" (DID) model with the establishment of development zones as a "quasi-natural experiment" to test the relationship. Findings reveal that development zone establishment increases carbon emissions in the region, and has a significant inhibitory effect on carbon emissions at national level. The conclusions of this paper provide empirical evidence and policy implications for reducing carbon emissions in economically underdeveloped areas.

Childhood-Onset Lupus Nephritis in the Childhood Arthritis and Rheumatology Research Alliance Registry: Short-Term Kidney Status and Variation in Care

OBJECTIVE

The goal was to characterize short-term kidney status and describe variation in early care utilization in a multicenter cohort of patients with childhood-onset systemic lupus erythematosus (cSLE) and nephritis.

METHODS

We analyzed previously collected prospective data from North American patients with cSLE with kidney biopsy-proven nephritis enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry from March 2017 through December 2019. We determined the proportion of patients with abnormal kidney status at the most recent registry visit and applied generalized linear mixed models to identify associated factors. We also calculated frequency of medication use, both during induction and ever recorded.

RESULTS

We identified 222 patients with kidney biopsy-proven nephritis, with 64% class III/IV nephritis on initial biopsy. At the most recent registry visit at median (interquartile range) of 17 (8-29) months from initial kidney biopsy, 58 of 106 patients (55%) with available data had abnormal kidney status. This finding was associated with male sex (odds ratio [OR] 3.88, 95% confidence interval [95% CI] 1.21-12.46) and age at cSLE diagnosis (OR 1.23, 95% CI 1.01-1.49). Patients with class IV nephritis were more likely than class III to receive cyclophosphamide and rituximab during induction. There was substantial variation in mycophenolate, cyclophosphamide, and rituximab ever use patterns across rheumatology centers.

CONCLUSION

In this cohort with predominately class III/IV nephritis, male sex and older age at cSLE diagnosis were associated with abnormal short-term kidney status. We also observed substantial variation in contemporary medication use for pediatric lupus nephritis between pediatric rheumatology centers. Additional studies are needed to better understand the impact of this variation on long-term kidney outcomes.

Spatiotemporal divergence and convergence test of green total factor productivity of grain in China: based on the dual perspective of carbon emissions and surface source pollution

The topic of grain production and quality has always been a fundamental issue for the country's livelihood. With the purpose of contributing to high-quality grain development and ensuring national food security, this paper explores the spatial and temporal evolution, regional differences and convergence of grain green total factor productivity (GTFP) in the main grain-producing regions of China from the dual perspectives of carbon emissions and surface pollution with the help of EBM-GML model, kernel density function estimation and convergence methods. The results show that (1) Grain GTFP has generally shown a positive growth trend, although there exists obvious spatial differences. (2) In terms of decomposition indices, technological progress is the source of the increase in grain GTFP. (3) There are σ convergence, absolute β convergence and conditional β convergence in the main producing region as well as in the Yellow River basin and the Yangtze River basin; there are only absolute β convergence and conditional β convergence in the Songhua River basin. Grain GTFP has a single high-efficiency convergence point, and the grain GTFP is enhancing year by year in each province, and the inter-provincial gap is shrinking.

Simulation of anaerobic co-digestion of steam explosion pulping wastewater with cattle manure: Focusing on degradation and inhibition of furfural

In this study, an extended Anaerobic Digestion Model No.1, which considered the degradation and inhibition properties of furfural, was established and implemented to simulate the anaerobic co-digestion of steam explosion pulping wastewater and cattle manure in batch and semi-continuous modes. Batch and semi-continuous experimental data helped calibrate the new model and recalibrate the parameters related to furfural degradation, respectively. The cross-validation results showed the batch-stage calibration model accurately predicted the methanogenic behavior of all experimental treatments (R² ≥ 0.959). Meanwhile, the recalibrated model satisfactorily matched the methane production results in the stable and high furfural loading stages in the semi-continuous experiment. In addition, recalibration results revealed the semi-continuous system tolerated furfural better than the batch system. These results provide insights into the anaerobic treatments and mathematical simulations of furfural-rich substrates.

[Anatomical and histological investigation of the area anterior to the anorectum passing through the levator hiatus]

Objective: To document the anatomical structure of the area anterior to the anorectum passing through the levator hiatus between the levator ani slings bilaterally. Methods: Three male hemipelvises were examined at the Laboratory of Clinical Applied Anatomy, Fujian Medical University. (1) The anatomical assessment was performed in three ways; namely, by abdominal followed by perineal dissection, by examining serial cross-sections, and by examining median sagittal sections. (2) The series was stained with hematoxylin and eosin to enable identification of nerves, vessels, and smooth and striated muscles. Results: (1) It was found that the rectourethralis muscle is closest to the deep transverse perineal muscle where the longitudinal muscle of the rectum extends into the posteroinferior area of the membranous urethra. The communicating branches of the neurovascular bundle (NVB) were identified at the posterior edge of the rectourethralis muscle on both sides. The rectum was found to be fixed to the membranous urethra through the rectourethral muscle, contributing to the anorectal angle of the anterior rectal wall. (2) Serial cross-sections from the anal to the oral side were examined. At the level of the external anal sphincter, the longitudinal muscle of the rectum was found to extend caudally and divide into two muscle bundles on the oral side of the external anal sphincter. One of these muscle bundles angled dorsally and caudally, forming the conjoined longitudinal muscle, which was found to insert into the intersphincteric space (between the internal and external anal sphincters). The other muscle bundle angled ventrally and caudally, filling the gap between the external anal sphincter and the bulbocavernosus muscle, forming the perineal body. At the level of the superficial transverse perineal muscle, this small muscle bundle headed laterally and intertwined with the longitudinal muscle in the region of the perineal body. At the level of the rectourethralis and deep transverse perineal muscle, the external urethral sphincter was found to occupy an almost completely circular space along the membranous part of the urethra. The dorsal part of the external urethral sphincter was found to be thin at the point of attachment of the rectourethralis muscle, the ventral part of the longitudinal muscle of the rectum. We identified a venous plexus from the NVB located close to the oral and ventral side of the deep transverse perineal muscle. Many vascular branches from the NVB were found to be penetrating the longitudinal muscle and the ventral part of rectourethralis muscle at the level of the apex of the prostate. The rectourethral muscle was wrapped ventrally around the membranous urethra and apex of the prostate. The boundary between the longitudinal muscle and prostate gradually became more distinct, being located at the anterior end of the transabdominal dissection plane. (3) Histological examination showed that the dorsal part of the external urethral sphincter (striated muscle) is thin adjacent to the striated muscle fibers from the deep transverse perineal muscle and the NVB dorsally and close by. The rectourethral muscle was found to fill the space created by the internal anal sphincter, deep transverse perineal muscle, and both levator ani muscles. Many tortuous vessels and tiny nerve fibers from the NVB were identified penetrating the muscle fibers of the deep transverse perineal and rectourethral muscles. The structure of the superficial transverse perineal muscle was typical of striated muscle. These findings were reconstructed three-dimensionally. Conclusions: In intersphincteric resection or abdominoperineal resection for very low rectal cancer, the anterior dissection plane behind Denonvilliers' fascia disappears at the level of the apex of the prostate. The prostate and both NVBs should be used as landmarks during transanal dissection of the non-surgical plane. The rectourethralis muscle should be divided near the rectum side unless tumor involvement is suspected. The superficial and deep transverse perineal muscles, as well as their supplied vessels and nerve fibers from the NVB. In addition, the cutting direction should be adjusted according to the anorectal angle to minimize urethral injury.

[Effects of in vivo targeted carboxylesterase 1f gene knockdown on the Kupffer cells polarization activity in mice with acute liver failure]

Objective: To investigate the effect of targeted carboxylesterase 1f (Ces1f) gene knockdown on the polarization activity of Kupffer cells (KC) induced by lipopolysaccharide/D-galactosamine (LPS/D-GalN) in mice with acute liver failure. Methods: The complex siRNA-EndoPorter formed by combining the small RNA (siRNA) carrying the Ces1f-targeting interference sequence and the polypeptide transport carrier (Endoporter) was wrapped in β-1, 3-D glucan shell to form complex particles (GeRPs). Thirty male C57BL/6 mice were randomly divided into a normal control group, a model group (LPS/D-GalN), a pretreatment group (GeRPs), a pretreatment model group (GeRPs+LPS/D-GalN), and an empty vector group (EndoPorter). Real-time fluorescent quantitative PCR and western blot were used to detect Ces1f mRNA and protein expression levels in the liver tissues of each mouse group. Real-time PCR was used to detect the expression levels of KC M1 polarization phenotypic differentiation cluster 86(CD86) mRNA and KC M2 polarization phenotypic differentiation cluster 163 (CD163) mRNA in each group. Immunofluorescence double staining technique was used to detect the expression of Ces1f protein and M1/M2 polarization phenotype CD86/CD163 protein in KC. Hematoxylin-eosin staining was used to observe the pathological damage to liver tissue. A one-way analysis of variance was used to compare the means among multiple groups, or an independent sample nonparametric rank sum test was used when the variances were uneven. Results: The relative expression levels of Ces1f mRNA/protein in liver tissue of the normal control group, model group, pretreatment group, and pretreatment model group were 1.00 ± 0.00, 0.80 ± 0.03/0.80 ± 0.14, 0.56 ± 0.08/0.52 ± 0.13, and 0.26 ± 0.05/0.29 ± 0.13, respectively, and the differences among the groups were statistically significant (F = 9.171/3.957, 20.740/9.315, 34.530/13.830, P < 0.01). The percentages of Ces1f-positive Kupffer cells in the normal control group, model group, pretreatment group, and pretreatment model group were 91.42%, ± 3.79%, 73.85% ± 7.03%, 48.70% ± 5.30%, and 25.68% ± 4.55%, respectively, and the differences between the groups were statistically significant (F = 6.333, 15.400, 23.700, P < 0.01). The relative expression levels of CD86 mRNA in the normal control group, model group, and pretreatment model group were 1.00 ± 0.00, 2.01 ± 0.04, and 4.17 ± 0.14, respectively, and the differences between the groups were statistically significant (F = 33.800, 106.500, P < 0.01). The relative expression levels of CD163 mRNA in the normal control group, the model group, and the pretreatment model group were 1.00 ± 0.00, 0.85 ± 0.01, and 0.65 ± 0.01, respectively, and the differences between the groups were statistically significant (F = 23.360, 55.350, P < 0.01). The percentages of (F4/80(+)CD86(+)) and (F4/80(+)CD163(+)) in the normal control group and model group and pretreatment model group were 10.67% ± 0.91% and 12.60% ± 1.67%, 20.02% ± 1.29% and 8.04% ± 0.76%, and 43.67% ± 2.71% and 5.43% ± 0.47%, respectively, and the differences among the groups were statistically significant (F = 11.130/8.379, 39.250/13.190, P < 0.01). The liver injury scores of the normal control group, the model group, and the pretreatment model group were 0.22 ± 0.08, 1.32 ± 0.36, and 2.17 ± 0.26, respectively, and the differences among the groups were statistically significant (F = 12.520 and 22.190, P < 0.01). Conclusion: Ces1f may be a hepatic inflammatory inhibitory molecule, and its inhibitory effect production may come from the molecule's maintenance of KC polarization phenotypic homeostasis.

[The diagnostic and evaluation value of plasma interleukin 9 in the mucosal healing in patients with inflammatory bowel disease treated with biological agents]

Objective: To investigate the diagnostic and evaluation value of plasma interleukin 9 (IL9) in the mucosal healing (MH) in patients with inflammatory bowel disease (IBD) treated with biological agents. Methods: Cohort study. IBD patients (137 cases) treated in the Affiliated Suzhou Hospital to Nanjing Medical University (Suzhou Municipal Hospital) from September 2019 to January 2022 were prospective selected. Each patient was treated with biological agents [Infliximab (IFX, 56 cases), Adalimumab (ADA, 20 cases), Ustekinumab (UST, 18 cases), Vedolizumab (VDZ, 43 cases)]. According to different therapeutic drugs, the IFX, ADA, UST, and VDZ group were divided. Clinical symptoms, inflammatory indicators and imaging examinations etc. were evaluated every 8 weeks, and the degree of MH was evaluated by endoscopy at the 54th week. The expression of plasma IL9 was detected by ELISA after initial enrollment (W 0) and 8 weeks of biological treatment (W 8). Receiver operating characteristic curve (ROC) was used to evaluate the diagnostic efficacy of IL9 for MH. Select the cut off value for the optimal ROC threshold based on the highest value of the Youden index. Spearman's rank correlation was used to analyze the correlation between IL9 and Simple Endoscopic Score for CD (SES-CD) and Mayo Endoscopic Score (MES), so as to evaluate the predictive value of IL9 for MH in IBD patients treated with biologic agents. Results: Among the 137 patients, there were 97 Crohn's disease (CD) patients, 53 males and 44 females, aged (31.6±10.3) years (18-60 years). There were 40 ulcerative colitis (UC) patients, 22 males and 18 females, aged (37.5±14.7) years (18-67 years). Among the CD patients, 42 cases (43.3%) achieved MH on endoscopy at the 54th week, and 60 patients (61.9%) achieved clinical remission. Among the UC patients, 22 cases (55.0%) achieved MH and 30 cases (75.0%) achieved clinical remission. At W 0, the relative expression of IL9 in patients in IBD patients who achieved MH after 54 weeks of biological treatment was lower than that in the non-MH patients [x¯±s, (127.42±34.43) vs (146.82±45.64) ng/L, (113.01±44.88) vs (146.12±48.66) ng/L, respectively, both P<0.05]. At W 8, the relative expression of IL9 in the MH group was lower than that in the non-MH patients (both P<0.05). The relative expression of IL9 in the MH patients after IFX treatment was lower than that in the non-MH group (P<0.05). There was no significant difference among the other groups between MH and non-MH patients (all P>0.05). IL9 at W 8 showed high value in predicting MH in IBD [CD patients: area under curve (AUC)=0.716(95%CI: 0.616-0.817, P<0.001), sensitivity and specificity were 80.77%(95%CI:67.64%-88.45%) and 48.89%(95%CI: 35.53%-64.47%), respectively; UC patients: AUC=0.821, sensitivity and specificity were 77.78% and 72.73%, respectively]. At W 8, the cut off values for CD and UC patients were IL9>80.77 ng/L and IL9>77.78 ng/L, respectively. IL9 was positively correlated with endoscopic MH score parameters [M(Q₁,Q₃),SES-CD: 3.0(8.5, 18.5); MES: 2.0(1.0, 3.0)] (r=0.55, 0.72, respectively, both P<0.001) at W8. Conclusion: The plasma IL-9 at the week 8 after biological agents treatment can be used to diagnose and evaluate the MH of patients with IBD.

Braille recognition by E-skin system based on binary memristive neural network

Braille system is widely used worldwide for communication by visually impaired people. However, there are still some visually impaired people who are unable to learn Braille system due to various factors, such as the age (too young or too old), brain damage, etc. A wearable and low-cost Braille recognition system may substantially help these people recognize Braille or assist them in Braille learning. In this work, we fabricated polydimethylsiloxane (PDMS)-based flexible pressure sensors to construct an electronic skin (E-skin) for the application of Braille recognition. The E-skin mimics human touch sensing function for collecting Braille information. Braille recognition is realized with a neural network based on memristors. We utilize a binary neural network algorithm with only two bias layers and three fully connected layers. Such neural network design remarkably reduces the calculation burden and, thus, the system cost. Experiments show that the system can achieve a recognition accuracy of up to 91.25%. This work demonstrates the possibility of realizing a wearable and low-cost Braille recognition system and a Braille learning-assistance system.

Interferon-α2a induces CD4+ T cell apoptosis and suppresses Th1/Th17 responses via upregulating IRF1-mediated PDL1 expression in dendritic cells from Behcet's uveitis

Recombinant interferon-α2a (IFNα2a) has been widely used in the treatment of Behcet's uveitis (BU). However, the mechanism underlying its effects remains poorly understood. In this study, we investigated its effect on dendritic cells (DCs) and CD4⁺ T cells, which are essential for the development of BU. Our results showed that the expression of PDL1 and IRF1 was significantly decreased in DCs from active BU patients, and IFNα2a could significantly upregulate PDL1 expression in an IRF1-dependent manner. IFNα2a-treated DCs induced CD4⁺ T cells apoptosis and inhibited the Th1/Th17 immune response in association with reduced secretion of IFN-γ and IL-17. We also found that IFNα2a promoted Th1 cell differentiation and IL-10 secretion by CD4⁺ T cells. Finally, a comparison of patients before and after IFNα2a therapy revealed that the frequencies of Th1/Th17 cells significantly decreased in association with remission of uveitis after IFNα2a therapy. Collectively, these results show that IFNα2a could exert its effects by modulating the function of DCs and CD4⁺ T cells in BU.

[Saliva microbiota and metabolite in individuals with caries or periodontitis]

Objective: To detect and analyze the characteristics of oral microbiota in species composition, function and metabolism among caries, periodontitis and oral healthy individuals, hunting for the microbiome-derived biomarkers with specificity and sensitivity to estimate the occurrence of these two diseases. Methods: Saliva samples were collected from 10 patients with high caries risk [decayed-missing-filled teeth (DMFT)≥6, HC group] in Department of Endodontics, 10 patients with periodontitis of grade Ⅱ A-Ⅲ C (PG group) in Department of Periodontology and 10 oral healthy individuals (HH group) from School of Stomatology, The Fourth Military Medical University during from March 2022 to June 2022. A baseline examination was conducted on all participants, including their oral conditions of caries and periodontal health. Metagenomic sequencing (Illumina PE150 platform) and liquid chromatography-mass spectrometry were used to detect microorganisms and their metabolites in the samples respectively. The sequencing data were analyzed to obtain the information of microbial taxonomic composition, functional genes and metabolites in each group of samples. The basic oral conditions and saliva samples of subjects in each group were evaluated and collected by the same professional endodontist. Results: There were no significant difference in baseline characteristics such as age and sex among the subjects in each group (P>0.05). DMFT in HC group (9.0±1.7) was significantly higher than that in HH group (0) and PG group (0) (F=243.00, P<0.001). Sequencing data analysis showed that the taxonomic compositions of salivary microbiota in each group were mainly Firmicutes, Bacteroidetes, Proteobacteria, Actinobacteria and Fusobacteria at the phylum level, and Streptococcus, Neisseria, Rothia, Prevotella at the genus level. Differential analysis showed that, compared with the HH group, HC group and PG group had significant differences in taxonomic composition (P<0.05), and the most significant among them was Prevotella. At the species level, Prevotella pallens was the most significant change in HC group, and Porphyromonas gingivalis in PG group. Metabolite analysis showed that there were significant differences in metabolites between HC group and PG group. The results showed that, compared with the HH group, the most significant metabolite change was 3-hydroxy-1, 5-diphenylpentan-1-one in HC group (P=0.001) and N1 acetylspermine in PG group (P=0.002) respectively. Compared with the PG group, the metabolite of HC group with the most significant difference is D-glucosamine 6-phosphate (P=0.006). The metabolism gene function analysis showed that, the enrichment of carbohydrate metabolism related genes was highest in HC group, followed with HH group, and it was lowest in PG group. In addition, compared with the HH group, the abundance of functional genes related to glucose metabolism, such as ABC transporter and phosphotransferase system, were significantly decreased in PG group (P<0.05), but significantly increased in HC group (P<0.05). Conclusions: There is a significant correlation between the alternation of carbohydrate metabolism of salivary microbiota with the occurrence of caries and periodontitis. In the future, Prevotella pallens and 3-hydroxy-1, 5-diphenylpentan-1-one may be the potential biomarkers of caries; while Porphyromonas gingivalis and N1 acetylspermine work in the predictions of periodontitis.

An Area- and Energy-Efficient Spiking Neural Network With Spike-Time-Dependent Plasticity Realized With SRAM Processing-in-Memory Macro and On-Chip Unsupervised Learning

In this article, we present a spiking neural network (SNN) based on both SRAM processing-in-memory (PIM) macro and on-chip unsupervised learning with Spike-Time-Dependent Plasticity (STDP). Co-design of algorithm and hardware for hardware-friendly SNN and efficient STDP-based learning methodology is used to improve area and energy efficiency. The proposed macro utilizes charge sharing of capacitors to perform fully parallel Reconfigurable Multi-bit PIM Multiply-Accumulate (RMPMA) operations. A thermometer-coded Programmable High-precision PIM Threshold Generator (PHPTG) is designed to achieve low differential non-linearity (DNL) and high linearity. In the macro, each column of PIM cells and a comparator act as a neuron to accumulate membrane potential and fire spikes. A simplified Winner Takes All (WTA) mechanism is used in the proposed hardware-friendly architecture. By combining the hardware-friendly STDP algorithm as well as the parallel Word Lines (WLs) and Processing Bit Lines (PBLs), we realize unsupervised learning and recognize the Modified National Institute of Standards and Technology (MNIST) dataset. The chip for the hardware implementation was fabricated with a 55 nm CMOS process. The measurement shows that the chip achieves a learning efficiency of 0.47 nJ/pixel, with a learning energy efficiency of 70.38 TOPS/W. This work paves a pathway for the on-chip learning algorithm in PIM with lower power consumption and fewer hardware resources.

Intraarticular steroids as DMARD-sparing agents for juvenile idiopathic arthritis flares: Analysis of the Childhood Arthritis and Rheumatology Research Alliance Registry

BACKGROUND

Children with juvenile idiopathic arthritis (JIA) who achieve a drug free remission often experience a flare of their disease requiring either intraarticular steroids (IAS) or systemic treatment with disease modifying anti-rheumatic drugs (DMARDs). IAS offer an opportunity to recapture disease control and avoid exposure to side effects from systemic immunosuppression. We examined a cohort of patients treated with IAS after drug free remission and report the probability of restarting systemic treatment within 12 months.

METHODS

We analyzed a cohort of patients from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry who received IAS for a flare after a period of drug free remission. Historical factors and clinical characteristics and of the patients including data obtained at the time of treatment were analyzed.

RESULTS

We identified 46 patients who met the inclusion criteria. Of those with follow up data available 49% had restarted systemic treatment 6 months after IAS injection and 70% had restarted systemic treatment at 12 months. The proportion of patients with prior use of a biologic DMARD was the only factor that differed between patients who restarted systemic treatment those who did not, both at 6 months (79% vs 35%, p < 0.01) and 12 months (81% vs 33%, p < 0.05).

CONCLUSION

While IAS are an option for all patients who flare after drug free remission, it may not prevent the need to restart systemic treatment. Prior use of a biologic DMARD may predict lack of success for IAS. Those who previously received methotrexate only, on the other hand, are excellent candidates for IAS.

Ultralight type I transvaginal mesh: an alternative for recurrent severe posterior vaginal prolapse

OBJECTIVE

This study aimed to analyze the medium-term outcomes of ultralight type I mesh for postmenopausal women with recurrent severe posterior vaginal prolapse (PVP).

METHODS

All participants underwent transvaginal ultralight type I mesh repair between April 2016 and April 2021 and were followed until May 2022. Pelvic Organ Prolapse Quantification System (POP-Q) staging, mesh-related complications, Patient Global Impression of Improvement (PGI-I) scale and quality of life questionnaire responses were evaluated. The primary outcome was composite surgical success rate at the last follow-up, composite success being defined as no vaginal bulge symptoms, no POP-Q point at or beyond the hymen and no re-treatment for POP. Secondary outcomes included anatomic outcomes (POP-Q score), symptomatic relief and complications.

RESULTS

The median follow-up was 37.3 months. At the last follow-up, the composite success rate was 75%, and POP-Q scores for the vault and posterior wall and quality of life questionnaire scores were significantly improved (p < 0.01). The subjective satisfaction (PGI-I ≤ 2) rate was 83.3%. There were no mesh-related complications.

CONCLUSIONS

Ultralight mesh can achieve good clinical outcomes and substantially improve the quality of life of patients with severe recurrent PVP in the medium term, and may thus be a viable alternative for treating this condition.

[A 5-year retrospective study of computer aided design and computer aided manufacturing ceramic endocrowns in endodontically treated posterior teeth]

Objective: To evaluate the clinical outcomes of computer aided design and computer aided manufacturing (CAD/CAM) ceramic endocrowns in endodontically treated posterior teeth after five years by a retrospective study. Methods: Patients who received CAD/CAM ceramic endocrowns after endodontically treatment in Department of Endodontics, School of Stomatology, The Fourth Military Medical University between January 2016 and June 2017 were invited for this clinical study. Clinical performance was evaluated in the aspect of color match, anatomic form,marginal adaptation, restoration integrity and secondary caries. Survival rate of the restorations was calculated by the use of Kaplan-Meier method. Log-rank test was applied as well for the sake of analyzing the effect of tooth position, sex and materials to the survival rate of the restorations. Results: Seventy-four patients, 25 men and 49 women with age of (38.8±10.2) years, participated in this study for a total of 101 CAD/CAM ceramic endocrowns after observation period of (62.8±12.0) months. There were 8 failed cases among 101 restorations, 5 were loss of retention, 2 were ceramic fracture and 1 was secondary caries respectively. In particular, 93% (89/96) restorations got score A on anatomic form and 95% (91/96) restorations got score A on marginal adaptation, while 38% (36/96) restorations showed the good color match compared with the abutment teeth. The estimated cumulative survival rate of CAD/CAM ceramic endocrowns in endodontically treated posterior teeth after 5 years was 93.0% (95%CI: 87.9%-98.1%). The single-factor Log-rank analysis demonstrated that there was no statistically significant difference in the survival rate of CAD/CAM ceramic endocrowns among men and women, premolars and molars, position in the dental arch, or different materials (χ²<0.01, P=0.957; χ²=0.64, P=0.422; χ²=0.69, P=0.407; χ²=0.88, P=0.349). Conclusions: Based on this clinical study, the clinical performance of CAD/CAM ceramic endocrowns in endodontically treated posterior teeth after five years is reliable, which could be a general option to restore nonvital teeth.

Impacts of menopause hormone therapy on mood disorders among postmenopausal women

OBJECTIVE

This study aimed to explore the modulatory effects of menopause hormone therapy (MHT) on mood disorders among postmenopausal women.

METHODS

A cross-sectional study was conducted to recruit postmenopausal women, including patients (arranged MHT for over 3 years as the medication group) and non-MHT controls. All participants were asked to respond to the Center for Epidemiological Studies Depression Scale (CES-D) and Generalized Anxiety Disorder Screener (GAD-7) questionnaires to assess their depression and anxiety status.

RESULTS

A total of 230 cases from the two groups were determined based on propensity score matching analysis by matching the menopausal age and menopausal durations. We found that MHT served as a favorable modulator in the depression status of postmenopausal women. Among the four factors of the CES-D questionnaire, our data indicated that the differences between the two groups fell primarily into two aspects: depressive emotion, and somatic symptoms or retarded activities. MHT was mainly involved in improving the depression of overweight women. However, no substantial effects of MHT were observed on the regulation of anxiety.

CONCLUSION

Postmenopausal women, especially the overweight population, who have experienced MHT exhibited an improved depressive status but not their anxiety condition.

Static composting of cow manure and corn stalk covered with a membrane in cold regions

The disposal of livestock wastes is an urgent task in China. Compost is highly regarded for its ability to treat livestock wastes and protect arable land. In particular, some problems of livestock manure in cold regions, such as low efficiency because of low environmental temperature in winter, urgently need to be solved. In order to provide valuable composting information in the cold area at low environmental temperatures, the composting experiments were carried out with cow manure and corn stalk as substrates. The properties and bacterial community of compost samples in different stages were investigated. The electrical conductivity (EC), total nitrogen (TN), total phosphorus (TP), and organic matter (OM) of the final compost were 551 μS/cm, 1.12, 0.77, and 63.5%, respectively. No E. coli or Ascaris eggs were detected. The temperature was the key factor to affect the physical-co-chemical and biological properties. The absolutely dominant genera were Sporosarcina, Virgibacillus, Flavobacterium, and Steroidobacter in heating, high temperature, cooling, and maturing stages, respectively. Also, these bacteria could act as biological indicators during the composting process. Cryobacterium, Caldicoprobacter, Virgibacillus, and Sporosarcina were relatively novel genera in the compost piles in a cold environment. The biodegradation of exogenous substances mainly occurs in the initial and maturing stages. It is proven that composting can be carried out successfully in early spring or later autumn after a harvest.

[Prevalence and trend analysis of severe multiple disabling birth defects in Chongqing City from 2007 to 2020]

Objective: To explore the prevalence and change trend of severe multiple disabling birth defects in Chongqing City from 2007 to 2020, and to provide a basis for comprehensive prevention and control measures of severe multiple disabling birth defects. Methods: Based on hospital monitoring data, 1 103 children with severe multiple disabling birth defects monitored by all birth defects monitoring institutions in Chongqing City from January 2007 to December 2020 were included in the study. They were grouped by year, perinatal gender, maternal permanent residence (urban/rural), maternal age, different regions and other categories. Chi-square test was used to analyze the differences in the incidence of severe multiple disabling birth defects in different categories, and linear trend test was used to analyze the change trend. Results: From 2007 to 2020, a total of 1 022 314 perinatal births and 1 103 severe multiple disabling birth defects were monitored in Chongqing City, with an incidence of 10.79/10 000, including 11.47/10 000 in urban areas and 9.48/10 000 in rural areas, with an incidence higher in urban areas than in rural areas(χ²=8.424,P=0.004). Male was 10.47/10 000, female was 10.97/10 000, there was no significant difference between male and female(χ²=0.606,P=0.436). The incidence of maternal in different age groups was u-shaped, and there was statistical difference in incidence among different age groups (χ²=59.465, P<0.001). The incidence of maternal in<20 years old and ≥35 years old was higher, and in 25-29 years old was lower. The incidence rate was 17.96/10 000 in 2007 and 7.18/10 000 in 2020, which decreased by 60.02% in 2007-2020. The incidence of neural tube defect, chromosome syndrome, limb shortening and abdominal wall defect decreased by 78.12%, 77.38%, 80.55% and 91.30%, respectively. Severe Congenital heart disease rose by 456.16%. From 2007 to 2020, the overall incidence of the disease showed a decreasing trend (χ²_trend =117.046, P<0.001), except for the rise of severe congenital heart disease, (χ²_trend=8.744, P=0.003), the other four types of diseases were on the decline (neural tube defects χ²_trend =48.618, P<0.001; chromosome syndrome χ²_trend=50.999, P<0.001; limb shortening χ²_trend=73.464, P<0.001; abdominal wall defect χ²_trend=79.863, P<0.001). Conclusion: From 2007 to 2020, the incidence of severe disabling birth defects in Chongqing City showed a downward trend, and there were regional and age differences. The incidence of severe congenital heart disease is on the rise.

Killing two birds with one stone: miR-126 involvement in both cancer and atherosclerosis

OBJECTIVE

Both cancer and atherosclerosis are the main causes of morbidity and mortality in the world, and some patients even suffer from both of them. Several studies have shown an association between the pathogenesis of cancer and atherosclerosis. It has been reported that miR-126 may participate in the pathological process of cancer and atherosclerosis. Therefore, we aimed to summarize the role of miR-126 in cancer and atherosclerosis respectively, as well as a possible association between them.

MATERIALS AND METHODS

In this paper, "miR-126" and "microRNA-126" are used as the first group of keywords, "atheromatosis" and "atherosclerosis" are used as the second group of keywords, and "tumor" and "cancer" are used as the third group of keywords. In PubMed, the authors selected one of the first group and the second group of keywords to search the literature related to miR-126 and cancer, and one of the first group and the third group of keywords was selected to search the literature on miR-126 and atherosclerosis. All collected articles are from 2021 and before. Irrelevant, withdrawn and review articles were excluded, and the included literature was mainly in the recent five years.

RESULTS

After collection and summary, miR-126 is found involved in cell apoptosis, proliferation, angiogenesis, inflammation, and other processes in both cancer and atherosclerosis by negatively targeting PI3K, VEGF, VCAM-1, EGFL7, CXCL12-CXCR4 axis, and LRP6. Moreover, we briefly review the prospects of miR-126 as a biomarker for the diagnosis and treatment of cancer and atherosclerosis in clinical applications.

CONCLUSIONS

It has been demonstrated that miR-126 can influence cancer and atherosclerosis by affecting the same or different target genes. Therefore, it facilitates our understanding of the common prevention and treatment strategies of cancer and atherosclerosis by regulating the miR-126-target genes network.

Spatiotemporal Evolution and Factors Influencing Ecological Civilization Development in Chinese Watersheds

The construction of ecological civilization plays an important role in realizing the harmonious coexistence between man and nature. The aims of this study were to explore the development of ecological civilization in China's top 10 river basins from 2004 to 2018 and construct an evaluation index system of ecological civilization. Factor analysis was used for the evaluation, and intergroup gap and panel regression analyses were utilized to determine the evolution of the spatiotemporal patterns and factors affecting the development level of ecological civilization in Chinese river basins. The results show that areas with a high level of ecological civilization development gradually spread to peripheral basins such as the Liaohe, Yellow, and Songhua River basins. The level of ecological civilization in China's watersheds is undergoing continuous development. The degree of opening up, forest cover, and education have markedly positive effects on the development of ecological civilization in the basins, whereas urban development and financial autonomy have significant negative effects. The results of this study provide new ideas for evaluating the level of ecological civilization construction, as well as a reference for the government to formulate policies related to the construction of ecological civilization in river basins.

[Status of HVPG clinical application in China in 2021]

Objective: The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China. Methods: This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems. Results: According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%). Conclusion: Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

[Prediction of trends for fine-scale spread of Oncomelania hupensis in Shanghai Municipality based on supervised machine learning models]

OBJECTIVE

To predict the trends for fine-scale spread of Oncomelania hupensis based on supervised machine learning models in Shanghai Municipality, so as to provide insights into precision O. hupensis snail control.

METHODS

Based on 2016 O. hupensis snail survey data in Shanghai Municipality and climatic, geographical, vegetation and socioeconomic data relating to O. hupensis snail distribution, seven supervised machine learning models were created to predict the risk of snail spread in Shanghai, including decision tree, random forest, generalized boosted model, support vector machine, naive Bayes, k-nearest neighbor and C5.0. The performance of seven models for predicting snail spread was evaluated with the area under the receiver operating characteristic curve (AUC), F1-score and accuracy, and optimal models were selected to identify the environmental variables affecting snail spread and predict the areas at risk of snail spread in Shanghai Municipality.

RESULTS

Seven supervised machine learning models were successfully created to predict the risk of snail spread in Shanghai Municipality, and random forest (AUC = 0.901, F1-score = 0.840, ACC = 0.797) and generalized boosted model (AUC= 0.889, F1-score = 0.869, ACC = 0.835) showed higher predictive performance than other models. Random forest analysis showed that the three most important climatic variables contributing to snail spread in Shanghai included aridity (11.87%), ≥ 0 °C annual accumulated temperature (10.19%), moisture index (10.18%) and average annual precipitation (9.86%), the two most important vegetation variables included the vegetation index of the first quarter (8.30%) and vegetation index of the second quarter (7.69%). Snails were more likely to spread at aridity of < 0.87, ≥ 0 °C annual accumulated temperature of 5 550 to 5 675 °C, moisture index of > 39% and average annual precipitation of > 1 180 mm, and with the vegetation index of the first quarter of > 0.4 and the vegetation index of the first quarter of > 0.6. According to the water resource developments and township administrative maps, the areas at risk of snail spread were mainly predicted in 10 townships/subdistricts, covering the Xipian, Dongpian and Tainan sections of southern Shanghai.

CONCLUSIONS

Supervised machine learning models are effective to predict the risk of fine-scale O. hupensis snail spread and identify the environmental determinants relating to snail spread. The areas at risk of O. hupensis snail spread are mainly located in southwestern Songjiang District, northwestern Jinshan District and southeastern Qingpu District of Shanghai Municipality.

POS0449 CHARACTERISTICS OF GUT MICROBIOTA AND ITS RELATIONSHIP WITH LYMPHOCYTE SUBSETS AND CYTOKINES IN PATIENTS WITH UNDIFFERENTIATED SPONDYLOARTHRITIS

Background

Gastrointestinal microbiota, particularly dysbiosis of gut microbiota composition have been correlated with the progression of autoimmune disorders, such as undifferentiated spondyloarthritis (USPA).

Objectives

This study aimed to identify the changed gut microbiota and its relationship with lymphocyte subsets and cytokines in USPA Patients.

Methods

A total of 210 participants were recruited in this study, comprising 105 USPA patients and 105 age and sex-matched healthy controls (HCs). Microbial genome was extracted from approximately 250mg fresh fecal samples from all participants using QIAamp PowerFecal DNA Kit (Qiagen). The V3-V4 variable regions of bacterial 16S rRNA genes were sequenced with the Illumina Miseq PE300 system. QIIME2 was used to process representative sequence clusters with a similarity cutoff of 100% (ASVs)1. Microbial diversity was estimated by the alpha diversity (observed, chao1, ACE, shannon, simpson, and ivsimpson) and beta diversity (bray distance). Biomarker species were identified based on STEMP between USPA and HC group. Correlations were analyzed with the Spearman rank correlation test.

Results

The alpha-diversity indices have no significant different between two groups (P >0.05, Figure 1A). Gut microbial community structure differed between USPA and HC, as revealed by ASV Bray–Curtis distances (P <0.05, Figure 1B). As for composition of gut microbiota, there were the increased levels of Escherichia_Shigella, Flavonifractor, Hungatella in the USPA group, and Lachnospirales, Roseburia, and Lachnospiraceae in HCs (Figure 1C). The relative abundance of Lachnospiraceae_UCG_001 and Enterobacter was negatively correlated with the absolute numbers of Th17 (P<0.05). Bifidobacterium was positively correlated with the absolute number of Th1 and Tregs (P<0.01, Figure 1D). The relative abundance of Fusobacterium, Incertae_Sedis, and Colidextribacter were negatively correlated with the absolute numbers of Il-10, IL-4, and IL-2 (P<0.05). Prevotella and Enterobacter were positively correlated with the absolute number of IL-6 and IL-4 respectively (P<0.05, Figure 1E). Bifidobacterium and Bilophila were neagtively correlated with the absolute number of NK cell (P<0.05, Figure 1F).

Figure 1.

(A) Comparison of alpha-diversity indexs between HC and USPA groups was shown using boxplot. (B) β diversity of the gut microbiome in USPA patients and HCs. Principal coordinate analysis plot generated from the bray distance analyse. (C) STEMP was used to detect difference in Flora according to USPA and HC. (D-F) Relationship between gut microbiota, and Lymphocyte subsets as well as cytokines. *P<0.05, **P<0.01.

Conclusion

Gut dysbiosis in USPA patients mainly characterized by reduced the diversity and impaired abundance of the intestinal flora, which was closely related to the disturbance of lymphocyte subpopulations and cytokines.

References

[1]Han L, Zhao K, Li Y, et al. A gut microbiota score predicting acute graft-versus-host disease following myeloablative allogeneic hematopoietic stem cell transplantation. Am J Transplant 2020;20(4):1014-27. doi: 10.1111/ajt.15654 [published Online First: 2019/10/13]

Acknowledgements

This work was supported by the National Natural Science Foundation of China (No. 82001740).

Disclosure of Interests

None declared.

Hydraulic Performance and Energy Loss Effect of Pit Structure Optimized Drip Irrigation Emitter

The pit structure optimized drip irrigation emitter (PODE) is a novel type of irrigation emitter that may provide shunts, quick diversion, and mixed flow to maximize energy loss. To study the influence of the geometric parameters of the flow channel on the hydraulic characteristics and energy loss effect, twenty-five sets of orthogonal test schemes were established. Using numerical simulation and verification tests, the flow index and energy loss coefficient were obtained. The results showed that the flow index of the PODE was 0.4632-0.5265, and its hydraulic performance was good. The energy loss coefficient under the pressure head of 5-15 m was 510-2221, which showed that the energy loss effect was obvious. The influence order of the geometric parameters on the flow index was B>P>C>D>A, the optimal solution was P0.6D1.4A85B0.25C0.12. The determination coefficient of the regression model based on geometric parameters and flow index was 0.85. In addition, the verification test showed that the relative error among the test value, simulated value, and estimated value were less than 5%, and the flow index can be estimated reliably. The research can provide a reference for the pre-research and evaluation of the hydraulic performance and energy loss effect of the PODE.

AB0300 REDUCTION OF LACHNOSPIRA IS CLOSELY RELATED TO AUTOIMMUNE DISEASE COMPLICATED WITH PULMONARY FIBROSIS

Background

Autoimmune diseases (AD) are a group of heterogeneous disorders caused by both genetic and environmental factors. Rheumatoid arthritis (RA) and Sjögrens syndrome (SS) are typical autoimmune diseases[1], Pulmonary fibrosis (PF) is the most common complication of AD. Despite the extensive study of the human gut microbiome in AD complicated with PF(AD-PF),the question of whether there are common microbial features characterizing AD-PF still remains[2].

Objectives

This study focused on exploring differences between the microbiota diversity and peripheral lymphocyte subpopulations as well as cytokine in AD with PF is different from that of AD without PF.

Methods

A total of 64 AD patients (44 AD without PF and 20 AD with PF) as well as 100 age- and sex- matched healthy controls (HCs) were enrolled in this study. The peripheral lymphocyte subsets were analyzed by flow cytometry and the gut microbiota were investigated via 16s rRNA sequencing. Alpha and Beta diversity (bray curtis distance-based) analysis was used to define the difference of gut microbiota profiles between patients and HCs. To explore the specific bacterial taxa associated with AD-PF, the STAMP software was used to compare the fecal microbiota composition. Spearman correlation analysis was used to determine the similarities in the microbiota community with clinical meatures among fecal samples.

Results

There is a decrease that the richness and diversity index between HCs, AD and AD-PF patients. Principal co-ordinates analyses suggested that these three microbiota states explained a reasonable proportion of observed variance in gut microbiota composition (ANOSIM R2 = 0.113, p < 0.001; Figure 1b). Compared with HCs, there are obvious differences among 19 species of flora in AD without PF at the genus level, of which 2 species of flora (Lachnospira,Muribaculaceae) belong to AD-PF patients were showed much fewer. The relative abundance of Lachnospira was positive correlated with the absolute numbers of Th17, IL-6 and THF-α (P<0.05,Figure 1D-E)，which indicated Lachnospira may be the most critical among the AD-RF patients’ own species of flora. Therefore, the reduction of Lachnospira may influence the immune status of the intestinal tract of patients by producing less short-chain fatty acids.

Conclusion

Our results suggest that the decrease of Lachnospira may lead to the occurrence of AD with pulmonary interstitial fibrosis, which was closely correlated with lymphocyte subsets and Cytokines, maintaining the flora balance might be a potential therapeutic target for AD-PF.

References

[1]Ma Y, Shi N, Li M, Chen F, Niu H: Applications of Next-generation Sequencing in Systemic Autoimmune Diseases. Genomics Proteomics Bioinformatics 2015, 13(4):242-249.

[2]Belkaid Y, Hand TW: Role of the microbiota in immunity and inflammation. Cell 2014, 157(1):121-141.

Acknowledgements

This work was supported by the National Natural Science Foundation of China (No. 82001740).

Disclosure of Interests

None declared

POS0212 THE REDUCTION OF TURICIBACTER IN GUT MICROBIOTA ASSOCIATED WITH SJOGREN’S SYNDROME SECONDARY TO RHEUMATOID ARTHRITIS

Background

Secondary Sjogren’s syndrome(SS) is a common extra-articular manifestation of rheumatoid arthritis (RA)[1]. RA patients combined with SS have different outcomes from those without SS[2]. However, the studies investigated the characteristics of gut microbiota in patients with RA and SS is limited.

Objectives

To investigate the characteristics of gut microbiome and the associations between flora and peripheral lymphocyte subpopulations in RA patients with or without Sjogren’s syndrome.

Methods

A total of 326 samples from 145 RA patients without SS, 23 RA combined with SS patients(RA-SS) and 168 healthy controls (HCs) were recruit in this study from The Second Hospital of Shanxi Medical University (Taiyuan, Shanxi, China). The gut microbiota were investigated via 16s rRNA sequencing and the peripheral T lymphocyte subsets of these participants were assessed by flow cytometry. The Wilcoxon rank-sum test was used to compare alpha diversity indicesbetween groups. Differential abundance analysis was carried out the STAMP software. Spearman’s correlation analysis was used to assess the correlations between the relative abundances of bacterial genera and clinical meatures.

Results

Patients with RA and RA-SS exhibited a significant reduction in the richness and diversity of gut microbiota compared with those of HCs (Figure 1 A-B, p < 0.05), whereas there was no significant difference between RA and RA-SS patients. Principal co-ordinates analyses based on bray curtis distance suggested that these there microbiota states explained a definable proportion of observed variance in microbiota composition (ANOSIM R2 = 0.074, p < 0.001; Figure 1 C). Compared with HCs, 58 species of flora were discovered to be distinctly different in RA patients without SS at the genus level of which 6 species of flora unique to RA-SS patients were presented much fewer ([Eubacterium]_hallii_group, Anaerostipes, CAG-56, Fusobacterium, Turicibacter and Enterococcus). Among these RA-SS patients‘ unique species of flora, it seems that Turicibacter is the key species of flora, owing to whose has a positive correlation with most of lymphocytes such as T, B, CD4+T, CD8+T and NK cells suggesting a close association with intestinal immunity.(Figure 1 F-G,P<0.05)

Conclusion

RA patients with deficiency of Turicibacter in flora had higer occurrence of Sjögren’s syndrome sjogren’s syndrome complication, which was correlated with peripherial lymphocyte subpopulations and cytokines.

References

[1]Chen Y, Ma C, Liu L, He J, Zhu C, Zheng F, Dai W, Hong X, Liu D, Tang D et al: Analysis of gut microbiota and metabolites in patients with rheumatoid arthritis and identification of potential biomarkers. Aging 2021, 13(20):23689-23701.

[2]Brown LE, Frits ML, Iannaccone CK, Weinblatt ME, Shadick NA, Liao KP: Clinical characteristics of RA patients with secondary SS and association with joint damage. Rheumatology (Oxf) 2015, 54(5):816-820.

Acknowledgements

This work was supported by the National Natural Science Foundation of China (No. 82001740).

Disclosure of Interests

None declared