Menopausal age and cardiovascular disease risk in American women: evidence from the National Health and Nutrition Examination Survey

OBJECTIVE

Cardiovascular disease (CVD) is a significant contributor to the deaths of females, and premature menopause adds to the risk of CVD in females. Therefore, our study aimed to investigate the age of menopause and CVD incidence in American females using data from the National Health and Nutrition Examination Survey (NHANES).

METHOD

We analyzed data from 6347 females to investigate the association between menopausal age and the risk of CVD using multivariate logistic regression analysis.

RESULTS

The study found that a later menopausal age reduces the risk of developing CVD (odds ratio [OR] = 0.74, 95% confidence interval [CI] = 0.63 - 0.88, p < 0.001). Moreover, females with early-onset CVD had an increased risk of premature menopause before the age of 40 years (OR = 2.44, 95% CI = 1.60 - 3.72, p < 0.001).

CONCLUSION

Menopausal age is associated with the risk of developing CVD in American females. Specifically, if menopause occurs earlier, there is an increased risk of CVD. Additionally, early-onset CVD significantly raises the risk of premature menopause, which in turn has important implications for female reproductive health.

[Clinical effect of modified vertical rectus abdominis myocutaneous flap in repairing skin and soft tissue defects after abdominoperineal resection for rectal cancer]

Objective: To investigate the clinical effect of the modified vertical rectus abdominis myocutaneous flap in repairing the skin and soft tissue defect after abdominoperineal resection for rectal cancer. Methods: This study was a retrospective observational study. From June 2019 to July 2022, five male patients with low rectal cancer who were conformed to the inclusion criteria were admitted to the Department of Basic Surgery of Xiangya Hospital of Central South University, with ages ranging from 65 to 70 years and the sizes of the perianal skin ulcers ranging from 5 cm×4 cm to 11 cm×9 cm, and all of them underwent abdominoperineal resection. The secondary skin and soft tissue defects in the perineum with an area of 8 cm×6 cm-14 cm×12 cm (with the depth of pelvic floor dead space being 10-15 cm) were repaired intraoperatively with transplantation of modified vertical rectus abdominis myocutaneous flaps with the skin area being 9 cm×7 cm-16 cm×12 cm, the volume of the muscle being 18 cm×10 cm×5 cm-20 cm×12 cm×5 cm, and the vessel pedicle being 18-20 cm in length. During the operation, most of the anterior sheath of the rectus abdominis muscle was retained, the flap was transferred to the recipient area through the abdominal cavity, the remaining anterior sheaths of the rectus abdominis muscle on both sides of the donor area were repeatedly folded and sutured, the free edge of the transverse fascia of the abdomen was sutured with the anterior sheath of the rectus abdominis muscle, and the donor area skin was directly sutured. After the operation, the survival of the transplanted myocutaneous flap was observed. The occurrence of complications in the perineal recipient area was recorded within 2 weeks after the operation. The recovery of the perineal recipient area and the abdominal donor area was observed during follow-up, and the occurrence of complications in the donor area of the abdomen as well as the recurrence of tumors and metastasis were recorded. Results: All transplanted myocutaneous flaps in 5 patients survived after surgery. One patient had dehiscence of the incision in the perineal recipient area 2 days after surgery, which healed after 7 d with intermittent dressing changes and routine vacuum sealing drainage treatment. In the other 4 patients, no complications such as incisional rupture, incisional infection, or fat liquefaction occurred in the perineal recipient area within 2 weeks after surgery. Follow-up for 6-12 months after discharge showed that the skin of the perineal recipient area had good color, texture, and elasticity, and was not bloated in appearance; linear scars were left in the perineal recipient area and the abdominal donor area without obvious scar hyperplasia or hyperpigmentation; no complications such as incisional rupture, incisional infection, intestinal adhesion, intestinal obstruction, or weakening of the abdominal wall strength occurred in the abdominal donor area, and the abdominal appearance was good with no localized bulge or formation of abdominal hernia; there was no local recurrence of tumor or metastasis in any patient. Conclusions: The surgical approach of using the modified vertical rectus abdominis myocutaneous flap to repair the skin and soft tissue defects after abdominoperineal resection for rectal cancer is relatively simple in operation, can achieve good postoperative appearances of the donor and recipient areas with few complications, and is worthy of clinical promotion.

Prenatal exome sequencing analysis in fetuses with central nervous system anomalies

OBJECTIVE

To evaluate the utility of prenatal exome sequencing (pES) in fetuses with central nervous system (CNS) abnormalities.

METHODS

This was a retrospective cohort study of fetuses identified to have CNS abnormality on prenatal ultrasound and/or magnetic resonance imaging. All fetuses were first analyzed by chromosomal microarray analysis (CMA). Fetuses with a confirmed aneuploidy or causal pathogenic copy-number variant (CNV) on CMA did not undergo pES analysis and were excluded, while those with a negative CMA result were offered pES testing.

RESULTS

Of the 167 pregnancies included in the study, 42 (25.1%) were identified to have a pathogenic or likely pathogenic (P/LP) variant. The diagnostic rate was significantly higher in fetuses with a non-isolated CNS abnormality than in those with a single CNS abnormality (35.7% (20/56) vs 14.5% (8/55); P = 0.010). Moreover, when a fetus had three or more CNS abnormalities, the positive diagnostic rate increased to 42.9%. A total of 25/42 (59.5%) cases had de-novo mutations, while, in the remaining cases, mutations were inherited and carried a significant risk of recurrence. Families whose fetus carried a P/LP mutation were more likely to choose advanced pregnancy termination than those with a variant of uncertain significance, secondary/incidental finding or negative pES result (83.3% (25/30) vs 41.3% (38/92); P < 0.001).

CONCLUSION

pES improved the identification of genetic disorders in fetuses with CNS anomalies without a chromosomal abnormality or CNV identified on CMA, regardless of the number of CNS anomalies and presence of extracranial abnormality. We also demonstrated that pES findings can significantly impact parental decision-making. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.

Effect of Yttrium on Ce/Ni-Metakaolin Catalysts for CO2 Methanation

In recent years, major economies have implemented carbon reduction and carbon neutrality policies. Furthermore, with advancements in science and technology, carbon dioxide (CO2) is now considered a valuable raw material for producing carbon-based fuels through hydrogenation. Various concentrations of yttrium (referred to as Y hereafter) were introduced to assess their influence on the catalytic performance of CO2 methanation. At a temperature of 300 °C, the catalyst exhibited an impressive CO2 conversion rate of 78.4% and maintained remarkable stability throughout a rigorous 100 h stability assessment. The findings suggest that the inclusion of yttrium (Y) promotes the formation of oxygen vacancies and alkaline sites on the catalyst. This, in turn, enhances the reducibility of nickel species, improves the dispersion of nickel particles, and plays a pivotal role in enhancing thermal stability. Furthermore, it offers an innovative design approach for creating highly efficient composite CO2 methanation catalysts by controlling particle size and harnessing synergistic catalytic effects at the metal/support interface.

HPV Infection Causes Dependence on Alternative DNA Damage Response Pathways Providing Cancer Specific Targets for Radiosensitization

PURPOSE/OBJECTIVE(S)

Cancer-specific radiosensitization is an attractive approach to improving the efficacy of radiotherapy. However, drugs targeting ubiquitous DNA damage response pathways are not cancer specific and can increase radiation related side effects. Thus, there is an unmet need for tumor specific molecular targets. This approach requires an identification of DNA damage signaling pathways that are unique to cancer cells. We hypothesized that by expressing its genome in the host cells HPV infection can rewire DNA damage signaling making HPV-positive tumor cells dependent on alternative pathways to survive radiation, which can be exploited for radiosensitization of HPV-induced cancers.

MATERIALS/METHODS

We have performed a CRISPR/Cas9 screen in HPV-positive SiHa cells that either express HPV16 proteins E6 and E7 or contain a selective knock-out of E6 or E7. We used next-generation sequencing to determine the abundance of gRNA in cells that were mock-treated or irradiated. We identified genes that were required for survival of radiation specifically in the context of E6 or E7 expression. Results of the screen were validated by generating knock-outs of the discovered genes using CRISPR/Cas9. By applying an array of molecular tools to analyze cell survival, cell cycle progression and mitotic progression we assessed the role of these genes in radiation response in HPV-positive cancer cells.

RESULTS

We have identified genes that are required for survival of radiation-induced DNA damage in the context of either E6 or E7 expression. We demonstrate that targeting these genes results in hypersensitization of cervical cancer cells to radiation specifically in the presence of E6 or E7. We show that the gene product required for survival in E6-expressing cells is critical for mitotic progression after radiation exposure serving as a member of a protein complex stabilizing the attachment of mitotic spindle to centromeres.

CONCLUSION

We have uncovered specific genes that are critical for DNA damage response and cell survival after radiation exposure in HPV-positive cells. Our findings suggest that expression of the HPV proteins E6 and E7 rewires DNA damage signaling causing dependence on alternative response pathways. We propose that these pathways can be targeted for a tumor-specific radiosensitization of HPV-induced cancers.

Environmental regulation, green technology progress and haze reduction and carbon reduction

Coordinated efforts to reduce haze and carbon emissions are important in promoting global climate governance and sustainable development. In this paper, based on prefecture-level data of China from 2005 to 2019, we investigate the impact of environmental regulatory intensity on the emissions of the concentration of PM2.5 and carbon dioxide (CO2). The research indicates that environmental regulation facilitates synergistic governance for PM2.5 reduction and carbon mitigation. Green technological advancement emerges as the primary mechanism through which environmental regulation achieves haze reduction and carbon mitigation. This conclusion remains robust after a series of robustness tests. Furthermore, the results from quantile regression reveal that the haze reduction and carbon mitigation effects of environmental regulation are subject to certain conditional dependencies. Environmental regulation exhibits a significant negative impact on carbon emissions across various quantile points. However, their influence on different quantile levels of PM2.5 concentration displays an asymmetric pattern. Finally, threshold regression findings suggest that there is no significant threshold effect of environmental regulation on CO2 emissions, but there are dual threshold effects on the PM2.5 concentration. Therefore, it is recommended that local governments judiciously implement environmental regulatory intensity, establish interregional policies for haze reduction and carbon mitigation, and fully harness the driving force of green technology to promote a comprehensive green transformation of economic and social development.

Enhancing Freeze-Thaw Resistance of Alkali-Activated Slag by Metakaolin

Incorporating metakaolin (MK) into slag to prepare alkali-activated materials can reduce shrinkage and improve the durability of alkali-activated slag (AAS). But its durability under freeze-thaw conditions is unknown. In this paper, the effects of MK content on the freeze-thaw properties of AAS were investigated from the perspective of gel composition and pore solution. The experimental results showed that the addition of MK generates a gel mixture of C-A-S-H and N-A-S-H with a cross-linked structure and decreases the content of bound water and pore water absorption. With the increase of alkali dosage, water absorption decreased to 0.28% and then increased to 0.97%, and the leaching rate of ions was Ca²⁺ > Al³⁺ > Na⁺ > OH^-. When the alkali dosage was 8 wt % and the MK content was 30 wt %, the compressive strength loss rate of AAS was 0.58% and the mass loss rate was 0.25% after 50 freeze-thaw cycles.

[Embedded 3D printing of porous silicon orbital implants and its surface modification]

OBJECTIVE

To prepare customized porous silicone orbital implants using embedded 3D printing and assess the effect of surface modification on the properties of the implants.

METHODS

The transparency, fluidity and rheological properties of the supporting media were tested to determine the optimal printing parameters of silicone. The morphological changes of silicone after modification were analyzed by scanning electron microscopy, and the hydrophilicity and hydrophobicity of silicone surface were evaluated by measuring the water contact angle. The compression modulus of porous silicone was measured using compression test. Porcine aortic endothelial cells (PAOECs) were co-cultured with porous silicone scaffolds for 1, 3 and 5 days to test the biocompatibility of silicone. The local inflammatory response to subcutaneous porous silicone implants was evaluated in rats.

RESULTS

The optimal printing parameters of silicone orbital implants were determined as the following: supporting medium 4% (mass ratio), printing pressure 1.0 bar and printing speed 6 mm/s. Scanning electron microscopy showed that the silicone surface was successfully modified with polydopamine and collagen, which significantly improved hydrophilicity of the silicone surface (P < 0.05) without causing significant changes in the compression modulus (P > 0.05). The modified porous silicone scaffold had no obvious cytotoxicity and obviously promoted adhesion and proliferation of PAOECs (P < 0.05). In rats bearing the subcutaneous implants, no obvious inflammation was observed in the local tissue.

CONCLUSION

Poprous silicone orbital implants with uniform pores can be prepared using embedded 3D printing technology, and surface modification obviously improves hydrophilicity and biocompatibility of the silicone implants for potential clinical application.

In-Situ Transformation of Li-ABW Zeolites Based on Li-Geopolymer

Lithium batteries, as energy storage devices, are playing an increasingly important role in human society. As a result of the low safety of the liquid electrolyte in batteries, more attention has been paid to solid electrolytes. Based on the application of lithium zeolite in a Li-air battery, a non-hydrothermal conversed lithium molecular sieve was prepared. In this paper, in-situ infrared spectroscopy, together with other methods, was used to characterize the transformation process of geopolymer-based zeolite. The results showed that Li/Al = 1.1 and 60 °C were the best transformation conditions for the Li-ABW zeolite. On this basis, the geopolymer was crystallized after 50 min of reaction. This study proves that the formation of geopolymer-based zeolite occurs earlier than the solidification of the geopolymer and shows that the geopolymer is a good precursor for zeolite conversion. At the same time, it comes to the conclusion that the formation of zeolite will have an impact on the geopolymer gel. This article provides a simple preparation process for lithium zeolite, explores the preparation process and mechanism, and provides a theoretical basis for future applications.

Green location-oriented policies and carbon efficiency: a quasi-natural experiment from National Eco-industrial Demonstration Parks in China

This paper investigates how National Eco-industrial Demonstration Parks (NEDP) in China affects carbon emission efficiency. The difference-in-differences (DID) strategy is used for analysis. This paper finds that the construction of NEDP is conducive to the improvement of carbon emission efficiency, and the findings remain robust through placebo tests and propensity score matching. Heterogeneity analysis shows NEDP construction has greater utility on carbon efficiency in non-resource-based cities as well as in environmentally friendly cities. The mechanism analysis found that green technology innovation, industrial restructuring, and the relocation of industrial enterprises are effective ways to improve carbon efficiency in NEDP. Finally, this paper finds that the construction of NEDP has obvious spatial spillover effects on carbon efficiency, which can effectively heighten the carbon efficiency level of this locality and nearby areas.

Low-temperature highly selective water delignification based on geopolymer materials

Delignification pretreatment is the main source of high cost and high pollution in biomass processing. This paper reports on a simple cheap geopolymers-based highly selective and efficient pretreatment process for delignification under low-temperature water-cooking without discharging black liquor. The geopolymer with a SiO₂/Al₂O₃ ratio of 4.4 showed the largest number of acidic sites and highest catalytic activity. Under mild reaction conditions (m_Geopolymer/m_Fiber =1/4, 90 min and 90 °C), the delignification rates of woody (eucalyptus) and herbaceous (bagasse) biomass increased by up to 38.90% and 62.20%, respectively. Moreover, the low-alkali black liquor produced by the new water delignification process facilitates subsequent water treatment, eliminating the need for alkali recovery. This study confirms the immense application prospects of geopolymers for the highly selective delignification of most biomass fibre. This study will develop a low-temperature water-cooking process for the delignification of papermaking or biomass processing without wastewater discharge.

[Repair methods of complex facial defect wounds involving paranasal sinuses and their clinical effectiveness]

Objective: To explore the repair methods of complex facial defect wounds involving paranasal sinuses and their clinical effectiveness. Methods: A retrospective observational study was conducted. From January 2020 to May 2022, 5 patients admitted to the Department of Burns and Plastic Surgery of Xiangya Hospital of Central South University and 4 patients admitted to the Department of Burns and Plastic Surgery of Chenzhou First People's Hospital with complex facial defect wounds involving paranasal sinuses met the inclusion criteria, including 6 males and 3 females, aged 35-69 years, including 4 patients with titanium mesh exposure combined with paranasal sinuses injury and 5 patients with tumor involving paranasal sinuses. After an adequate assessment of the damage by a multiple discipline team, titanium mesh removal, paranasal sinus debridement, and paranasal sinus mucosa removal were performed in patients with exposed titanium mesh, and radical tumor resection was performed in patients with tumors, with postoperative skin and soft tissue defects areas of 5.0 cm×2.5 cm to 18.0 cm×7.0 cm, anterior paranasal sinus wall defects/absence areas of 3 cm×2 cm to 6 cm×4 cm, and sinus cavity depths of 1 to 4 cm. Depending on the perforator course of the descending branch of the lateral circumflex femoral artery, the anterolateral femoral chimeric flap or anterolateral femoral myocutaneous flap (with flap area of 9 cm×4 cm to 19 cm×8 cm, muscle size of 5 cm×3 cm×3 cm to 11 cm×6 cm×3 cm) was transplanted to repair the defect, and the donor site wound was sutured directly. The type of tissue flap transplanted, the blood vessel of the recipient area, and the vascular anastomosis way during the operation, the recovery of the donor and recipient areas and the occurrence of complications after operation were observed. The appearance and blood supply of the recipient area and the recurrence of ulcers and tumors were followed up. Results: The anterolateral femoral myocutaneous flap transplantation was performed in 6 patients, and the anterolateral femoral chimeric flap transplantation was performed in 3 patients. The blood vessels in recipient areas were facial arteries and veins in 3 cases and superficial temporal arteries and veins in 6 cases. The superficial temporal arteries and veins were bridged with blood vessels in tissue flaps by flow-through way in 2 patients, and end-to-end anastomosis of blood vessels in donor and recipient areas was performed in 7 patients. After operation, all the tissue flaps survived, and the facial defect wounds were well repaired without cerebrospinal fluid leakage or paranasal sinus secretion leakage, no intracranial infection occurred, and the wounds in donor areas were healed well. Follow-up of 6-35 months after operation showed that all the patients had good blood supply in the recipient area, and the shape was acceptable; 4 patients with exposed titanium mesh had no recurrence of ulceration, and 5 patients with tumor had no local tumor recurrence or metastasis. Conclusions: Based on an adequate assessment of the extent of paranasal sinuses involved in the facial wound and the nature of the defect, good clinical effects can be achieved by using the anterolateral femoral muscle flap or the anterolateral femoral chimeric flap transplantation to repair complex facial defect wounds with open paranasal sinuses.

[Malaria control knowledge and behaviors and their influencing factors among residents in Banlao Township, Cangyuan County, Yunnan Province]

OBJECTIVE

To investigate the awareness of malaria-related knowledge, the use of mosquito nets and their influencing factors among residents in Banlao Township, Cangyuan County, Yunnan Province.

METHODS

In August 2020, 19 settlement sites in Banlao Township, Cangyuan County, Lincang City, Yunnan Province were selected as study areas, and permanent residents at ages of 10 years and older were enrolled for a questionnaire survey, including residents' demographics, family economic status, malaria control knowledge and use of mosquito nets. In addition, the factors affecting the use of mosquito nets in the night prior to the survey were identified using multivariate logistic regression analysis.

RESULTS

A total of 320 questionnaires were allocated, and all were recovered (a 100% recovery rate). There were 316 valid questionnaires, with an effective recovery rate of 98.75%. The 316 respondents included 152 men and 164 women and 250 Chinese respondents and 66 foreign respondents. The awareness of clinical syndromes of malaria was significantly higher among Chinese residents (71.60%) than among foreign residents (50.00%) (χ² = 11.03, P < 0.01), and the proportions of Chinese and foreign residents sleeping under mosquito nets were 46.00% and 69.70% on the night prior to the survey, respectively (χ² = 11.73, P < 0.01). Multivariate logistic regression analysis identified ethnicity group and type of residence as factors affecting the use of mosquito nets in the night prior to the survey.

CONCLUSIONS

The awareness of malaria control knowledge, the coverage and the use of mosquito nets were low among residents in Banlao Township, Cangyuan County, Yunnan Province. Targeted health education is recommended to improve the awareness of malaria control knowledge and self-protection ability. In addition, improving the allocation of long-lasting mosquito nets and health education pertaining to their uses and increasing the proportion of using mosquito nets correctly is needed to prevent re-establishment of imported malaria.

Efficient preparation of red mud-based geopolymer microspheres (RM@GMs) and adsorption of fluoride ions in wastewater

In this paper, red mud-based geopolymer microspheres (RM@GMs: 75-150 µm) was prepared by dispersion-suspension-solidification method to remove fluoride ions (F^-). It was found that RM@GMs still had good mechanical properties and better F^- removal effect at RM content reached 80 % of the total solid mass. The batch adsorption experiment results showed that the F^- concentration (< 1.5 mg/L) reached the drinking water standard in 45 min at pH = 2 and RM@GMs dosage was 1 g/L. RM@GMs showed maximum adsorption capacity of 76.57 mg/g for F^-, and the adsorption kinetics and isotherm fitted the pseudo-second-order kinetic and Langmuir isotherm model, respectively. RM@GMs exhibited excellent dynamic separation effect at the flow rate of 4 mL/min and column height of 1 cm. In addition, RM@GMs had good selectivity for F^- in the competitive adsorption experiments and followed an order of: PO₄^3- > > SO₄^2- ≈ NO₃^- ≈ Cl^-. In real seawater, natural surface water and tap water, RM@GMs still had excellent F^- removal effect. The adsorption mechanism revealed that RM@GMs removed F^- mainly through the synergistic effect of adsorption and ion exchange. Therefore, this paper provides the potential value for the large-scale utilization of RM in the application of F^--containing wastewater.

Influence of dissolution on the uptake of bimetallic nanoparticles Au@Ag-NPs in soil organism Eisenia fetida

A key aspect in the safety testing of metal nanoparticles (NPs) is the measurement of their dissolution and of the true particle uptake in organisms. Here, based on the tendency of Ag-NP to dissolve and Au-NP to be inert in the environment, we exposed the earthworm Eisenia fetida to Au core-Ag shell NPs (Au@Ag-NPs, Ag-NPs with a Au core) and to both single and combined exposures of non-coated Au-NPs, Ag-NPs, Ag⁺ and Au⁺ ions in natural soil. Our hypothesis was that the Ag shell would partially or completely dissolve from the Au@Ag-NPs and that the Au core would thereby behave as a tracer of particulate uptake. Au and Ag concentrations were quantified in all the soils, in soil extract and in organisms by inductively coupled plasma mass spectrometry (ICP-MS). The earthworm exposed to Au@Ag-NPs, and to all the combinations of Ag and Au, were analyzed by single particle inductively coupled plasma time-of-flight mass spectrometry (spICP-TOFMS) to allow the quantification of the metals that were truly part of a bimetallic particle. Results showed that only 5% of the total metal amounts in the earthworm were in the bimetallic particulate form and that the Ag shell increased in thickness, suggesting that biotransformation processes took place at the surface of the NPs. Additionally, the co-exposure to both metal ions led to a different uptake pattern compared to the single metal exposures. The study unequivocally confirmed that dissolution is the primary mechanism driving the uptake of (dissolving) metal NPs in earthworms. Therefore, the assessment of the uptake of metal nanoparticles is conservatively covered by the assessment of the uptake of their ionic counterpart.

A low-cost photo-evaporation inorganic membrane preparation and treatment of the simulated high salinity radioactive waste water

Solar-driven desalination is an energy-saving and environmentally benign wastewater treatment technology. A method of in situ self-reduction of graphene oxide (rGO) by cheap geopolymer was introduced, and a photo evaporation membrane device (rGOPGC) for treatment of the simulated high salt liquid radioactive waste (HSLRW) was prepared in the present study. Compared with other rGO based photo evaporation membrane materials, geopolymer matrix has the advantages of low cost, reductant free, simple preparation process and mild conditions. After desalination of simulated seawater, the concentrations of Na⁺, K⁺, Ca²⁺ and Mg²⁺ ions reached the WHO standard, and the removal rates of radioactive I^-, Cs⁺ and Sr²⁺ in the simulated high salinity wastewater reached 99.62%, 99.71% and 99.99% respectively; The evaporation rate of rGOPGC remained stable at 1.5 kg/m²/h after 16 cycles in high salinity environment. There was no obvious salt accumulation on the upper surface of the device, indicating its high stability. Furthermore, the evaporation performance at high temperature near the nuclear power plant (NPP) waste water was simulated and tested. Under one solar intensity and 35 °C ambient temperature, the evaporation rate of 1.75 kg/m²/h and the evaporation efficiency of 98.51% were achieved. The results indicated that the rGOPGC device is potential in the concentration evaluation of HSLRW.

Establishment of prediction models for COVID-19 patients in different age groups based on Random Forest algorithm

BACKGROUND

Coronavirus disease 2019 (COVID-19) has rapidly become a global pandemic. Age is an independent factor in death from the disease, and predictive models to stratify patients according to their mortality risk are needed.

AIM

To compare the laboratory parameters of the younger (≤70) and the elderly (>70) groups, and develop death prediction models for the two groups according to age stratification.

DESIGN

A retrospective, single-center observational study.

METHODS

This study included 437 hospitalized patients with laboratory-confirmed COVID-19 from Tongji Hospital in Wuhan, China, 2020. Epidemiological information, laboratory data and outcomes were extracted from electronic medical records and compared between elderly patients and younger patients. First, recursive feature elimination (RFE) was used to select the optimal subset. Then, two random forest (RF) algorithms models were built to predict the prognoses of COVID-19 patients and identify the optimal diagnostic predictors for patients' clinical prognoses.

RESULTS

Comparisons of the laboratory data of the two age groups revealed many different laboratory indicators. RFE was used to select the optimal subset for analysis, from which 11 variables were screened out for the two groups. The RF algorithm were built to predict the prognoses of COVID-19 patients based on the best subset, and the area under ROC curve (AUC) of the two groups is 0.874 (95% CI: 0.833-0.915) and 0.842 (95% CI: 0.765-0.920).

CONCLUSION

Two prediction models for COVID-19 were developed in the patients with COVID-19 based on random forest algorithm, which provides a simple tool for the early prediction of COVID-19 mortality.

Lnc-AC145676.2.1-6-3 can influence STX3-induced abnormal autophagy by sponging hsa-miR-1292-3p in intestinal aGVHD

OBJECTIVE

Intestinal acute graft-versus-host disease (aGVHD) is a serious complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Abnormal autophagy levels in intestinal aGVHD have been confirmed in many studies. LncRNAs exert coregulatory functions and participate in a variety of intracellular regulatory processes. In this study, we investigated how lnc-AC145676.2.1-6-3 regulates dysregulated STX3-related autophagy in aGVHD.

MATERIALS AND METHODS

First, we established a mouse model of aGVHD by transplanting a mononuclear cell suspension from Balb/c donor mice treated with 60Co X-rays into CB6F1 recipient mice. STX3-related indicators were analyzed by Western blotting (WB) and immunohistochemistry which confirmed that STX3 plays an important role in dysregulating autophagy in intestinal aGVHD. TNF-αinduced Caco-2 cells, which is an in vitro model of intestinal barrier dysfunction, were established to verify the effect of STX3. The direct interaction between the partners of lnc-AC145676.2.1-6-3-mediated hsa-miR-1292-3p and STX3 axis was evaluated by the Dual-Luciferase activity assay. We performed PCR, WB, and immunofluorescence in Caco-2 cells to determine whether the abnormal autophagy levels were influenced by lnc-AC145676.2.1-6-3.

RESULTS

The results showed that lnc-AC145676.2.1-6-3 could significantly suppress the number of autophagic vacuoles, the LC3-II/I ratio, and beclin1 levels by increasing STX3 levels.

CONCLUSIONS

Lnc-AC145676.2.1-6-3 may play an important role in intestinal aGVHD by targeting STX3.

Cloning, genome structure and expression analysis of MHC class I gene in Korean quail

1. The major histocompatibility complex (MHC) is a highly polymorphic region of the genome essential to immune responses and animal health. However, avian MHC genetic structure is different from that of mammals. In this study, the structure and expression of Korean quail MHC class I gene was analysed.2. The quail MHC gene consisted of eight exons and seven introns. The open reading frame of the cDNA was 353 amino acids, and the molecular weight was about 38.91 kDa. Exons 1 and 2 coded for leading peptides and alpha 1 regions, respectively. Exons 3 and 4 encoded alpha 2 and alpha 3 regions. Exons 5 to 8 coded for connecting peptides and transmembrane regions/cytoplasmic regions (TM/CY). The Korean quail MHC class I amino acid sequence shared 87% to 99% homology with Japanese quail and 71% to 75% with chicken. The amino acid shared 40% and 43% homology with humans and mice, respectively.3. Real-time quantitative PCR showed that MHC-I was highly expressed in immune tissues such as the bursa of Fabricius. Moreover, the constructed evolutionary tree was consistent with accepted evolutionary pathways.4. MHC-I is closely related to the host's immune system, and these findings may help to better understand the role of Korean quail MHC-I in the immune system.

High urinary excretion rate of glucose attenuates serum uric acid level in type 2 diabetes with normal renal function

AIMS/INTRODUCTION

The relationship between urinary excretion rate of glucose (UEGL) and uric acid (UA) metabolism in adults with type 2 diabetes (T2D) remains unclear to date. This study aimed to investigate the relationships of UEGL with serum UA (SUA), urinary excretion rate of uric acid (UEUA), and renal clearance of uric acid (CLUA) in adults with T2D. We hypothesised that high UEGL increases UA excretion, which in turn leads to lower SUA.

MATERIALS AND METHODS

This was a cross-sectional study of 635 inpatients with T2D recruited between 2018 and 2019. The relationships of UEGL with UEUA, CLUA, and hyperuricaemia were assessed using analysis of covariance and multivariate regression analysis.

RESULTS

Patients in the higher quartile of UEGL tended to have lower SUA levels than those in the lower quartile. In contrast, patients in the higher quartile of UEGL tended to have higher CLUA (p for trend < 0.0001), and a similar trend was observed for UEUA. In adjusted multivariable linear regression model, UEGL was negatively correlated with SUA (β = - 0.023, 95% CI - 0.034 to - 0.013, p < 0.0001). However, positive correlations of UEGL with UEUA (β = 0.046, 95% CI 0.018-0.074, p = 0.001) and CLUA (β = 0.063, 95% CI 0.042-0.085, p < 0.0001) were found. Furthermore, consistent significant inverse associations were observed between quartiles of UEGL and hyperuricaemia in the adjusted multivariate logistic regression model.

CONCLUSIONS

A high UEGL level was positively correlated with UEUA and CLUA. Moreover, it was inversely associated with SUA level, and a consistently increased UEGL level reduced the risk of hyperuricaemia in patients with T2D.

[Repair methods and clinical effects of full-thickness burn wounds deep to tendon or even bone in fingers]

Objective: To explore the repair methods and clinical effects of full-thickness burn wounds deep to tendon or even bone in fingers. Methods: A retrospective non-randomized controlled trial was conducted on the 98 patients with full-thickness finger burns deep to tendon or even bone who met the inclusion criteria and were hospitalized in Xiangya Hospital of Central South University from January 2010 to December 2019. Among the 98 patients, there were 81 males and 17 females, aged from 1 to 72 years, with 160 fingers involved. The wound area of each of affected fingers ranged from 2.0 cm×1.5 cm to 12.0 cm×3.5 cm, and the maximum wound area after merging the affected fingers was 12.0 cm×10.0 cm. For adult hands with multiple full-thickness burn wounds deep to tendon or even bone in multiple fingers or children with full-thickness finger burns deep to tendon or even bone, pedicled abdominal flaps were selected. For adults with single or two fingers with full-thickness burns deep to tendon or even bone, the pedicled internal hand flaps and free tissue flaps were selected. The free tissue flap repair requires good vascular conditions in the recipient area with arteries and veins available for anastomosis. For thumb nail burns deep to tendon or even bone or partial absence of the thumb after burns, the thumbs were reconstructed with the first toenail flap or dorsal foot flap with the second toe. In this study, 45 pedicled abdominal flaps were used to repair the wounds in 91 fingers, 37 pedicled internal hand flaps were used to repair the wounds in 37 fingers, 26 free tissue flaps were used to repair the wounds in 28 fingers, 3 first toenail flaps were used to reconstruct 3 patients' thumb nails and to repair hand wounds, and 1 dorsal foot flap with the second toe was used to reconstruct 1 patient's thumb and to repair hand and wrist wounds. The tissue flap area was from 2.0 cm×1.5 cm to 20.0 cm×10.0 cm. The wound in the donor site was repaired by direct suture or full-thickness skin grafting from the medial upper arm of the affected limb or split-thickness skin grafting from the outer thigh. The postoperative survival of the tissue flap, postoperative complications, and appearance and function of the flap donor site were observed. For the patients who were followed up, their finger functions were evaluated at the last follow-up using the trial criteria for replantation function evaluation of the amputated finger issued by the Hand Surgery Society of the Chinese Medical Association, and the satisfaction of the patients was investigated using the Efficacy Satisfaction Scale. Data were statistically analyzed with Kruskal-Wallis H test and Nemenyi test. Results: Of the 112 tissue flaps, 104 tissue flaps survived completely and had good blood circulation; 1 pedicled thumb dorsal ulnar reverse island flap, 1 pedicled finger artery cutaneous branch reverse island flap, and 1 free grafted anterolateral thigh perforator flap were slightly necrotic at the end, which were repaired with outer thigh split-thickness skin graft after dressing change and granulation tissue growth; 2 free grafted tarsal external artery flaps and 1 pedicled thumb dorsal ulnar reverse island flap suffered from postoperative venous return obstruction, which survived after partial suture removal and heparin saline cleansing of the wound; 1 pedicled modified dorsal metacarpal artery retrograde island flap and 1 free grafted peroneal artery perforator flap were necrotic, which were repaired by a pedicled abdominal flap and a lateral upper arm flap free transplantation respectively in stage Ⅱ. After transplantation, the tissue flaps had good shape, soft texture, and good elasticity, without bloating. There was no functional disorder in the flap donor site, and only slight scar remained. A total of 117 fingers of the 72 patients received 3-24 months of outpatient or telephone follow-up. At the last follow-up, the excellent and good rates of function evaluation of fingers repaired with pedicled abdominal flap, pedicled internal hand flap, and free tissue flap were respectively 77.3% (51/66), 96.3% (26/27), and 95.8% (23/24). The function of fingers repaired with free tissue flap and pedicled internal hand flap was significantly better than that with pedicled abdominal flap (P<0.01). The satisfaction of patients with fingers repaired by free tissue flaps was significantly higher than that by pedicled abdominal flap (P<0.05). Conclusions: According to the specific situation of full-thickness burn wounds deep to tendon or even bone in fingers, the pedicled abdominal flap is used to repair the multiple full-thickness burn wounds deep to tendon or even bone in multiple fingers of adult or the full-thickness burn wounds deep to tendon or even bone in fingers of children, the pedicled internal hand flap or free tissue flap is used to repair the full-thickness burn wounds deep to tendon or even bone in single or two fingers of adult patients, and the first toenail flap or the dorsal foot flap with the second toe is used to reconstruct the thumbs with full-thickness burn deep to tendon or even bone, with high postoperative tissue flap survival rate and few complications. The functional recovery of the affected finger is better after repair with free tissue flap and pedicled internal hand flap, and the patients' satisfaction is the highest after free tissue flap repair.

POS0817 A NOVEL MODEL TO ASSESS DISEASE ACTIVITY IN TAKAYASU ARTERITIS BASED ON 18F-FDG-PET/CT: A CHINESE COHORT STUDY

Background:

Takayasu arteritis (TA) is a condition characterized by major large-vessel vasculitis (LVV), and is most commonly found in young women (age <40 years) of East Asia countries. 18F-FDG-PET/CT has been widely used in the diagnosis and follow-up of cancers to gather functional information based on metabolic activity. In the present study, we evaluated the value of different parameters in 18F-FDG-PET/CT for assessing active TA disease, and we establish a simple, quantifiable, and effective disease activity evaluation model based on 18F-FDG-PET/CT. A comparison in the ability to identify active disease was performed between the established Kerr score and the new 18F-FDG-PET/CT was also performed.

Objectives:

To investigate the utility of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in assessing disease activity in TA.

Methods:

Ninety-one patients with TA, were recruited from a Chinese cohort from October 2017 to January 2019. Clinical data, acute-phase reactants (APRs), and 18F-FDG-PET/CT findings were simultaneously recorded. The Physician Global Assessment was used as the gold standard to assess TA disease activity. The value of using 18F-FDG-PET/CT to identify active disease was evaluated, using erythrocyte sedimentation rate (ESR) as a reference. Disease activity assessment models were constructed and concordance index (C-index), net reclassification index (NRI), and integrated discrimination index (IDI) were evaluated to compare the benefits of the new modes with ESR and Kerr score.

Results:

In total, 64 (70.3%) cases showed active disease. Higher levels of ESR and CRP, and lower interleukin (IL)-2R levels, were observed in active cases. 18F-FDG-PET/CT parameters, including SUVmean, SUVratio1, SUVratio2, sum of SUVmean, and sum of SUVmax, were significantly higher in active disease groups. The C index threshold of ESR to indicate active disease was 0.78 (95% CI: 0.69-0.88). The new activity assessment model combining ESR, sum of SUVmean, and IL-2R showed significant improvement in C index over the ESR method (0.96 vs. 0.78, P < 0.01; NRI 1.63, P < 0.01; and IDI 0.48, P < 0.01). The new model also demonstrated modest superiority to Kerr score assessment (0.96 vs. 0.87, P = 0.03; NRI 1.19, P < 0.01; and IDI 0.33 P < 0.01).

Conclusion:

A novel 18F-FDG-PET/CT-based method that involves combining the sum of SUVmean with ESR score and IL-2R levels demonstrated superiority in identifying active TA compared to conventional methods.

References:

[1]Kerr GS, Hallahan CW, Giordano J, Leavitt RY, Fauci AS, Rottem M, et al. Takayasu arteritis. Ann Intern Med 1994;120:919-29.

[2]Hoffman GS, Ahmed AE. Surrogate markers of disease activity in patients with Takayasu arteritis. A preliminary report from The International Network for the Study of the Systemic Vasculitides (INSSYS). Int J Cardiol 1998;66 Suppl 1:S191-4; discussion S195.

[3]Misra R, Danda D, Rajappa SM, Ghosh A, Gupta R, Mahendranath KM, et al. Development and initial validation of the Indian Takayasu Clinical Activity Score (ITAS2010). Rheumatology (Oxford) 2013;52:1795-801.

[4]Bardi M, Diamantopoulos AP. EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice summary. Radiol Med 2019;124:965-972.

[5]Spick C, Herrmann K, Czernin J. 18F-FDG PET/CT and PET/MRI Perform Equally Well in Cancer: Evidence from Studies on More Than 2,300 Patients. J Nucl Med 2016;57:420-30.

Disclosure of Interests:

None declared

Liposome-paclitaxel and carboplatin combination chemoradiotherapy for patients with locally advanced esophageal squamous cell carcinoma

PURPOSE

The aim of this study was to evaluate the efficacy of liposome-paclitaxel and carboplatin combination chemoradiotherapy for patients with locally advanced esophageal squamous cell carcinoma (ESCC).

PATIENTS AND METHODS

Seventy-nine consecutive patients treated with liposome-paclitaxel based concurrent chemoradiotherapy between January 2015 and December 2019 at Cancer hospital of the University of Chinese Academy of Sciences (Zhejiang cancer hospital) were enrolled in this study. The overall response, toxicities, progression-free survival and overall survival were analyzed with SPSS software.

RESULTS

A total of 302 cycles of weekly chemotherapy were delivered, with a median 4 courses. After concurrent chemoradiotherapy (CCRT), the efficacy was classified as CR in 4 cases (5.1%), PR in 22 cases (28.2%) and SD in 51 cases (65.4%). The median PFS and OS time were 18.2 months and 23.4 months. The 3-year PFS and OS rates were 45.1% and 43.6%, respectively.

CONCLUSIONS

Liposome-paclitaxel and carboplatin concurrent with radiotherapy is a safe and effective modality for locally advanced ESCC. Further clinical investigation are warranted to evaluate the efficacy of this regimen.

Therapeutic effect of qinghuanling on negative symptoms and cognitive function of schizophrenia

Introduction

Therapeutic effect of Qinghuanling on negative symptoms and cognitive function of schizophrenia

Objectives

To evaluate the therapeutic effect of Qinghuanling on cognitive impairment in schizophrenia, and to provide basis for clinical medication.

Methods

24 male patients with schizophrenia were randomly divided into study group and control group. The study group was given quetiapine fumarate combined with Qinghuanling, and the control group was given quetiapine fumarate. The positive and negative symptom scale (PANSS) and adverse event response scale (TESS) were evaluated regularly.

Results

The PANSS score of the study group was significantly lower than the control group from 6th week (64.10 ± 7.64 vs 72.31 ± 11.16; 51.60 ± 7.40 vs 63.23 ± 7.08, P < 0.05). Among them, the score of negative factor in the study group was significantly lower than that in the control group at the end of 6 and 8 weeks (2.16 ± 0.40 vs 2.75 ± 0.38; 1.65 ± 0.42 vs 2.38 ± 0.43, P < 0.01); the score of cognitive factor in the study group was significantly lower than that in the control group at the end of the 8th week (1.87 ± 0.20 vs 2.12 ± 0.27, P < 0.05). Compared with before treatment, PANSS score and symptom cluster factor score of the two groups were significantly decreased from the 2nd weekend to the 8th weekend (P < 0.05).

Conclusions

The combined use of Qinghuanling can significantly improve the therapeutic effect of schizophrenia, especially for the symptom cluster score of negative factors and cognitive factors, with high safety.

Disclosure

No significant relationships.

Research progress of metabonomics of blood endogenous small molecules in depression

Introduction

Depression (MDD) is a serious mental illness, which greatly affects the quality of life of patients. Nowadays, the clinical diagnosis of MDD lacks sufficient objective basis, and the effect of drug treatment is unsatisfactory. Therefore, biomarkers are very important for the risk prediction, classification, diagnosis and prognosis of MDD.

Objectives

Research progress of metabonomics of blood endogenous small molecules in depression

Methods

Metabonomics is a newly developed discipline after genomics and proteomics, and is an important part of system biology. Metabonomics provides a new approach to explore the etiology, mechanism, prognosis and screening potential biomarkers of MDD. Blood contains almost all the small molecule metabolites in the body. The changes of metabolites in blood can represent the changes of metabolites in other body fluids. Moreover, this sample is easy to obtain and has less trauma, so it is the most common biological sample in clinical detection.

Results

At present, there are many studies on the metabonomics of endogenous small molecules in MDD blood, which provides the possibility for further screening of MDD related biomarkers.

Conclusions

In this paper, the research progress of related biomarkers in MDD blood is reviewed.

Disclosure

No significant relationships.

Novel procedure of CO2 capture of the CaO sorbent activator on the reaction of one-part alkali-activated slag

CaO derived naturally from limestone or dolomite is an inexpensive and widely available sorbent. Understanding the mechanisms of CaO carbonation at ambient temperature under the assistance of H2O is important for predicting the reaction of CaO in complex environments and designing novel CaO materials. In this study, we found that the reaction rate of alkali-activated slag is controlled by the CaCO3 layer on a partially carbonized CaO alkali activator. The size of the sorbent increased after the adsorption reaction and the physically adsorbed water in the pores accelerated the carbonation. The carbonation process was governed by CO2 diffusion. When the carbonation conversion rate reached 2-6%, the setting time increased rapidly with the increase in the carbonation rate. This is because the surface of the activator was modified by the thickened CaCO3 product layer, which increased the diffusional resistance and thus prolonged the setting time of the alkali-activated slag.

Peptide transporter-related protein 2 plays an important role in glutathione transport of Streptococcus thermophilus

Streptococcus thermophilus is widely used as a starter culture in the fermentation of yogurt. Glutathione (GSH; γ-glutamyl-cysteinyl-glycine), as a tripeptide, has an important physiological role for Strep. thermophilus. However, the scope of the GSH transport proteins is still unexplored in this species. In the present study, 5 peptide transporter-related proteins (Ptrp) of Strep. thermophilus strain ST-1 were selected and then inactivated by gene insertion, respectively. Through detection and comparison of intracellular GSH content of mutant strain and wild strain, we identified 2 proteins, named Ptrp-2 and Ptrp-4, that might be related to GSH transport. Reverse-transcriptase quantitative PCR was performed to verify the gene expressions of these 2 possible GSH transport-related proteins, and it was finally determined that Ptrp-2 plays an important role in GSH transport of Strep. thermophilus. Milk fermentation experiments were further conducted to test the effect of Ptrp-2 on the characteristics of yogurt. The results showed that the fermented milk hardly curds using the mutant strain, indicating that Ptrp-2 is important for Strep. thermophilus as a yogurt starter.

High-resolution MRI of the vessel wall helps to distinguish moyamoya disease from atherosclerotic moyamoya syndrome

AIM

To evaluate the value of high-resolution magnetic resonance imaging of the vessel wall (VWI) for differentiating moyamoya disease (MMD) from atherosclerotic moyamoya syndrome (AS-MMS).

MATERIALS AND METHODS

Twenty-one patients with MMD or AS-MMS were assessed retrospectively by two independent raters regarding and magnetic resonance angiography (MRA) stage grading score; collateral development in the lateral fissure and basal ganglia on MRA; and pattern of the thickening of the arterial wall; presence, degree, and pattern of enhancement; presence and distribution of deep tiny flow voids (DTFVs) and collateral development in the lateral fissure and basal ganglia on VWI. After univariate analysis between the two groups, logistic regression models based on imaging findings of MRA or VWI were implemented respectively, and receiver operating characteristic (ROC) curves were generated to compare the discriminatory power of the two imaging methods for diagnosis of MMD. Interrater agreement was analysed using an unweighted Cohen's κ or interclass correlation coefficient (ICC).

RESULTS

MMD manifested as more concentric thickening, more homogeneous enhancement, higher presence of DTFV, smaller outer-wall boundary area of stenosis or occlusion, and smaller remodelling index on VWI. After Bonferroni-Holm correction for multiple comparisons, for AS-MMS, collaterals in both the lateral fissure and basal ganglia were not usually present on either MRA or VWI. The diagnostic performance of the multivariate logistic regression model based on VWI with an accuracy of 87.1% for classification was higher than MRA. Interrater agreement was moderate or substantial for all the imaging findings.

CONCLUSIONS

VWI might be a useful and feasible method for differentiating MMD from AS-MMS and a prospective tool for guiding first-line treatment.

Physiological effects of transport duration on stress biomarkers and meat quality of medium-growing Yellow broiler chickens

Pre-slaughter transport exerts negative effects on broilers' welfare, meat yield, and meat quality, but little is known about the effect of transport on medium-growing broiler chickens. This study aimed at evaluating the effects of different durations of transport (0, 0.5, 1, 2, and 3h) on stress biomarkers and meat quality of medium-growing Yellow-feathered broiler chickens. One hundred and eighty Chinese Yellow-feathered broilers aged 75days (marketing age), of 2.02kg average BW, were allotted into five groups; each group contained six replicates (six birds/replicate (crate)). Each crate with dimensions 74×55×27cm (length × width × height) was loaded with six birds, that is, 30kg live BW/m² crate. The tested transport durations increased BW loss (linear, P<0.01), plasma concentrations of ACTH (linear, P<0.10), cortisol and corticosterone (quadratic, P<0.05), and activity of glutathione peroxidase (linear, P<0.05), whereas plasma glucose was not affected. In breast muscle, contents of glycogen, lactic acid, malondialdehyde, and reduced glutathione were not affected (P>0.05), but total antioxidant capacity decreased (linear, P<0.01). The drip loss of breast muscle increased (linear, P<0.01), whereas shear force, pH at 24h postmortem, and breast meat color lightness (L*), redness (a*), and yellowness (b*) scores were not affected. In conclusion, the tested transport durations (from 0.5 to 3h) increased BW loss and some plasma stress biomarkers in 75-day-old Yellow-feathered broiler chickens, but the effect on meat quality attributes was minor.

Effect of Liposome-Encapsulated Zoledronic Acid on Microenvironment of Hepatocellular Carcinoma May Depend on the Ratio Between M1 and M2 Polarized Macrophages

We studied the effect of zoledronic acid encapsulated into liposomes (L-ZOL) on tumorassociated macrophages in the stroma of hepatocellular carcinoma xenograft. Liposomes were prepared from 1,2-dipalmitoyl-sn-glycero-3-phosphocholine, 1,2-dipalmitoyl-snglycero-3-phospho-sn-1-glycerol, and 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[carboxy(polyethylene glycol)-2000] using thin film method and loaded with zoledronic acid. It was shown that L-ZOL promoted apoptosis of RAW264.7 cells, eliminate much more protumoral M2 macrophages than antitumoral M1 macrophages in the tumor xenograft, and did not significantly reduce the size of xenograft in 6 days. Thus, the effect of treatment depends on the ratio between antitumoral M1 and protumoral M2 polarized macrophages in the tumor.

[Establishment and test results of an artificial intelligence burn depth recognition model based on convolutional neural network]

Objective: To establish an artificial intelligence burn depth recognition model based on convolutional neural network, and to test its effectiveness. Methods: In this evaluation study on diagnostic test, 484 wound photos of 221 burn patients in Xiangya Hospital of Central South University (hereinafter referred to as the author's unit) from January 2010 to December 2019 taken within 48 hours after injury which met the inclusion criteria were collected and numbered randomly. The target wounds were delineated by image viewing software, and the burn depth was judged by 3 attending doctors with more than 5-year professional experience in Department of Burns and Plastic Surgery of the author's unit. After marking the superficial partial-thickness burn, deep partial-thickness burn, or full-thickness burn in different colors, the burn wounds were cut according to 224×224 pixels to obtain 5 637 complete wound images. The image data generator was used to expand images of each burn depth to 10 000 images, after which, images of each burn depth were divided into training set, verification set, and test set according to the ratio of 7.0∶1.5∶1.5. Under Keras 2.2.4 Python 2.8.0 version, the residual network ResNet-50 of convolutional neural network was used to establish the artificial intelligence burn depth recognition model. The training set was input for training, and the verification set was used to adjust and optimize the model. The judging accuracy rate of various burn depths by the established model was tested by the test set, and precision, recall, and F1_score were calculated. The test results were visualized to generate two-dimensional tSNE cloud chart through the dimensionality reduction tool tSNE, and the distribution of various burn depths was observed. According to the sensitivity and specificity of the model for the recognition of 3 kinds of burn depths, the corresponding receiver operator characteristics (ROC) curve was drawn, and the area under the ROC curve was calculated. Results: (1) After the testing of the test set, the precisions of the artificial intelligence burn depth recognition model for the recognition of superficial partial-thickness burn, deep partial-thickness burn, or full-thickness burn were 84% (1 095/1 301), 81% (1 215/1 499) and 82% (1 395/1 700) respectively, the recall were 73% (1 095/1 500), 81% (1 215/1 500) and 93% (1 395/1 500) respectively, and the F1_scores were 0.78, 0.81, and 0.87 respectively. (2) tSNE cloud chart showed that there was small overlapping among different burn depths in the test results for the test set of artificial intelligence burn depth recognition model, among which the overlapping between superficial partial-thickness burn and deep partial-thickness burn and that between deep partial-thickness burn and full-thickness burn were relatively more, while the overlapping between superficial partial-thickness burn and full-thickness burn was relatively less. (3) The area under the ROC curve for 3 kinds of burn depths recognized by the artificial intelligence burn depth recognition model was ≥0.94. Conclusions: The artificial intelligence burn depth recognition model established by ResNet-50 network can rather accurately identify the burn depth in the early wound photos of burn patients, especially superficial partial-thickness burn and full-thickness burn. It is expected to be used clinically to assist the diagnosis of burn depth and improve the diagnostic accuracy.

Association of iodine-related knowledge, attitudes and behaviours with urinary iodine excretion in pregnant women with mild iodine deficiency

BACKGROUND

Subsequent to the implementation of the universal salt iodisation policy, China has all but eliminated the iodine deficiency disorders. However, pregnant women are still experiencing mild iodine deficiency. The present study explored factors that could relate to mild iodine deficiency in pregnant women.

METHODS

In total, 2400 pregnant women were enrolled using a multistage, stratified, random sampling method in Shanghai. Data were collected via a standardised questionnaire. The urine samples and household cooking salt samples were collected for the detection of urinary iodine and salt iodine concentrations.

RESULTS

The median urinary iodine concentration (MUIC) was 148.0 μg L^-1 for all participants, and 155.0 μg L^-1 , 151.0 μg L^-1 and 139.6 μg L^-1 in the first, second and third trimesters. The MUIC in the third trimester was significantly lower than that of the first trimester (P < 0.05). The usage rates of iodised salt and qualified-iodised salt were 71.5% and 59.4%, respectively. Iodine-related knowledge score composition ratio was significantly different between the high and low UIC groups (P < 0.05). Participants' MUIC increased significantly with the increases in iodine-related knowledge score (P < 0.001). The third trimester was a significant risk factor for high UIC, whereas high iodine-related knowledge score, actively learning dietary knowledge and having a habit of consuming iodine-rich food were significant protective factors for high UIC (P < 0.05).

CONCLUSIONS

Iodine level is adequate among pregnant women in Shanghai during the first and the second trimesters, although it is is insufficient in the third trimester. Good iodine-related knowledge, attitudes and behaviours are important for pregnant women with respect to maintaining adequate urinary iodine.

Temporal trends in cause-specific readmissions and their risk factors in heart failure patients in Sweden

Background

It remains unclear whether readmissions of patients with heart failure (HF) have decreased over time in an era of improved therapy and management of HF. This study aimed to determine the temporal short- and long-term trends of cause-specific rehospitalization and their risk factors in a Swedish context.

Methods

HF patients in the Swedish Heart Failure Registry (SwedeHF) were investigated. Maximum follow-up time was 1 year. Outcomes included the first occurrence of all-cause, cardiovascular (CV) and HF rehospitalizations. Cox proportional hazards models were performed to determine the impact of increasing years on risk for rehospitalization and its known risk factors.

Results

Totally, 25,644 index-hospitalized HF patients SwedeHF from 2004 to 2011 were enrolled in the study. For 8 years, the incidence risk of 1-year all-cause rehospitalization remained unchanged, whereas the incidence risk of CV (P=0.038) or HF (P=0.0038) rehospitalization decreased. After adjustment for age and sex, a 3% decrease per every second year was observed for 1-year CV and HF rehospitalizations (P&lt;0.05). However, time to the first occurring all-cause, CV and HF rehospitalization did not change significantly from 2004–2011 (P-values 0.13–0.87). When two study periods (2004–2005 vs. 2010–2011) were compared, the risk factor profile for rehospitalization was found to change.

Conclusions

Throughout the 8-year study period, CV- and HF-related rehospitalizations decreased, whereas all-cause rehospitalization remained unchanged, indicating a parallel increase in non-CV rehospitalization in the HF patients.

Funding Acknowledgement

Type of funding source: Foundation. Main funding source(s): The SwedeHF was funded by the Swedish Society of Cardiology and the Swedish Heart-Lung Foundation.

Downregulation of lncRNA SNHG7 inhibits proliferation and invasion of nasopharyngeal carcinoma cells through repressing ROCK1

OBJECTIVE

Recent studies have revealed the important role of long noncoding RNAs (lncRNAs) in the progression of tumorigenesis. This study aimed to identify the biological function of lncRNA small nucleolar RNA host gene 7 (SNHG7) in the progression of nasopharyngeal carcinoma (NPC).

PATIENTS AND METHODS

LncRNA SNHG7 expressions in NPC cell lines and 50 paired NPC tissue samples were detected by Real-time quantitative polymerase chain reaction (RT-qPCR). Transwell assay, wound healing assay and proliferation assay were conducted to evaluate the in vitro function of SNHG7 in NPC cells. Xenograft model was established for determining the in vivo effect of SNHG7 on tumor formation and metastasis of NPC. The underlying mechanism of SNHG7 in mediating the progression of NPC was explored by RT-qPCR and Western blot.

RESULTS

SNHG7 expression was remarkably downregulated in NPC tissues compared with that in adjacent normal samples. Knockdown of SNHG7 attenuated proliferation, invasion and migration of NPC cells. Moreover, tumor size and the number of metastatic nodules were reduced in mice administrated with NPC cells transfected with sh-SNHG7. Knockdown of SNHG7 downregulated ROCK1 at mRNA and protein level. Besides, the expression of ROCK1 in tumor tissues was positively correlated to SNHG7 expression.

CONCLUSIONS

Knockdown of SNHG7 inhibits migration, invasion and proliferation of NPC cells through downregulating ROCK1, which may offer a new therapeutic intervention for NPC patients.

KOH-Activated Geopolymer Microspheres Recycle Co(II) with Higher Adsorption Capacity than NaOH-Activated Ones

A new type of absorbent with high efficiency was synthesized by KOH-activated slag-based geopolymer microspheres (K-SGM), which exhibited higher adsorption capacities for recycling Co(II) (Q _e,K-SGM = 192.31 mg/g, Q _e,Na-SGM = 91.21 mg/g) than NaOH-activated ones (Na-SGM). During the Co(II) adsorption process, these two kinds of geopolymeric adsorbents could be combined with heavy metal ions to optimize each other and form heavy metal-grown aid adsorbents. The morphology of Na-SGM and K-SGM was different which varied from coarse pores to nanonetwork or nanosheets after Co(II) adsorption, and the Brunauer-Emmett-Teller (BET) surface areas of Na-SGM (10.46 m²/g) and K-SGM (22.96 m²/g) increased to 117.38 and 228.73 m²/g after Co(II) adsorption, respectively. The BET surface area of K-SGM is twice that of Na-SGM whether before or after Co(II) ion adsorption. The hydrated ionic radius of K and Na, the alkalinity degree of K⁺ and Na⁺, the electronegativity of Na-SGM and K-SGM surface, the BET surface area and Fourier transform infrared changes of CO₃ ^2- and OH before and after Co(II) adsorption, and X-ray photoelectron spectroscopy analysis like the relative content of geopolymer gel and bridging oxygen bonds in the Na-SGM and K-SGM are the fundamental reasons for the obvious differences in Co(II) adsorption between Na-SGM and K-SGM.

Downregulation of lncRNA SNHG7 inhibits proliferation and invasion of nasopharyngeal carcinoma cells through repressing ROCK1

Since this article has been suspected of research misconduct and the corresponding authors did not respond to our request to prove originality of data and figures, "Downregulation of lncRNA SNHG7 inhibits proliferation and invasion of nasopharyngeal carcinoma cells through repressing ROCK1, by L. Wang, T. Xu, X. Cui, M. Han, L.-H. Zhou, Z.-X. Wei, Z.-J. Xu, Y. Jiang, published in Eur Rev Med Pharmacol Sci 2019; 23 (14): 6186-6193-DOI: 10.26355/eurrev_201907_18432-PMID: 31364118" has been withdrawn. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/18432.

[Open hepatectomy versus laparoscopic in the treatment of primary left-sided hepatolithiasis: a propensity, long-term follow-up analysis at a single center]

To compare short-term and long-term efficacy after laparoscopic left hepatectomy(LLR) to open left hepatectomy(OLH) for primary left-sided hepatolithiasis. Methods: Clinical data of 187 patients with left-sided hepatolithiasis and underwent laparoscopically or open left-sided hepatectomy from October 2014 to October 2019 at the Second Affiliated Hospital of Anhui Medical University were retrospectively analyzed in this propensity score matching (PSM) study and were matched in terms of age, sex, body mass index, liver function, ASA score, comorbidities, history of biliary surgery, and smoking history on the ratio of 1∶1.There were 47 cases in each group and the mean age were (54.7±12.3)years old(range:34 to 75 years old) and (53.2±12.6) years old (range: 34 to 75 years old) in open and laparoscopically group respectively. The data of operation time, intraoperative blood loss, postoperative hospital-stay, complication rate, biliary fistula rate, stone clearance rate, and stone recurrence rate were compared. The quantitative data were compared using t-test or rank-sum test. Count data were analyzed with χ(2) test or Fisher test. Results: No significant difference was observed in the clinical characteristics of included 94 patients in this study(all P>0.05).The length of the postoperative hospital-stay after OLH was significantly higher than that in the LLH group((10.8±3.1) days vs.(8.5±2.2)days, t=4.085, P=0.000). LLR significantly decreased the incidence of postoperative biliary fistula compared with the OLH (6.3% vs.21.2%, χ(2)=4.374, P=0.036) and the rates of postoperative complications in the OLH group was significantly higher than that in the LLH group (48.9% vs.27.6%, χ(2)=4.502, P=0.034). Moreover, the stone recurrence rates in the LLH group was significantly lower than that after OLR (4.2% vs. 17.0%, χ(2)=4.029, P=0.045). OLH (95% CI: 1.55 to 10.75, P=0.004) and postoperative complications (95% CI: 1.29 to 9.52, P=0.013) were independent risk factors for prolonged hospital stay. OLH (95% CI: 1.428 to 44.080, P=0.018) and residual stones (95% CI: 1.580 to 62.379, P=0.014) were independent risk factors for the occurrence of postoperative biliary fistula. Biliary fistula (95% CI: 1.078 to 24.517, P=0.040) was an independent risk factor for the recurrence of stones. Conclusion: Compared with OLH, LLH is safe and effective for the treatment of the primary left-sided hepatolithiasis with the clinical benefits of shorter hospital stay, fewer morbidity and biliary fistula occurrence, and lower stone recurrence rates.

Integrated omics analysis of sweat reveals an aberrant amino acid metabolism pathway in Vogt-Koyanagi-Harada disease

Vogt-Koyanagi-Harada (VKH) disease is an autoimmune disease leading to visual impairment. Its pathogenic mechanisms remain poorly understood. Our purpose was to investigate the distinctive protein and metabolic profiles of sweat in patients with VKH disease. In the present study, proteomics and metabolomics analysis was performed on 60 sweat samples (30 VKH patients and 30 normal controls) using liquid chromatography tandem mass spectrometry. Parallel reaction monitoring (PRM) analysis was used to validate the results of our omics analysis. In total, we were able to detect 716 proteins and 175 metabolites. Among them, 116 proteins (99 decreased and 17 increased) were observed to be significantly different in VKH patients when compared to controls. Twenty-one differentially expressed metabolites were identified in VKH patients, of which 18 included choline, L-tryptophan, betaine and L-serine were reduced, while the rest were increased. Our multi-omics strategy reveals an important role for the amino acid metabolic pathway in the pathogenesis of VKH disease. Significant differences in proteins and metabolites were identified in the sweat of VKH patients and, to some extent, an aberrant amino acid metabolism pathway may be a pathogenic factor in the pathogenesis of VKH disease.

FRI0196 INVOLVEMENT OF THE PULMONARY ARTERIES IN PATIENTS WITH TAKAYASU ARTERITIS

Background:

Takayasu arteritis (TA) is a chronic, granulomatous large-vessel vasculitis. It involves the aorta and its main branches predominantly, and leads to vascular thickness, stenosis and occlusion [1]. Besides the aorta and its branches, pulmonary arteries (PAs) are involved in TA. PAs have been reported to be involved in 6.9% to 80% of TA patients from different populations [2-3].

Objectives:

We investigated the clinical characteristics, pulmonary parenchymal features and cardiac functions in TA patients with PA involvement by combining multiple imaging modalities (MRA, CTA, PET-CT, lung VQ scan, echocardiography and high-resolution computed tomography (HRCT)). Our aim was to elicit better understanding of TA patients with PA involvement to aid rational treatment for these patients and improve their prognosis.

Methods:

We enrolled 216 patients with TA from a large prospective cohort. PAI was assessed in each patient based on data from magnetic resonance angiography/computed tomography angiography. Pulmonary hypertension, cardiac function, and pulmonary parenchymal abnormalities were evaluated further in patients with PAI based on echocardiography, New York Heart Association Functional Classification and pulmonary computed tomography, respectively. These abnormalities related to PAI were followed up to evaluate treatment effects.

Results:

PAI was detected in 56/216 (25.93%) patients, which involved the pulmonary trunk, main PAs and small vessels in the lungs. Among patients with PAI, 28 (50%) patients were accompanied by pulmonary hypertension, which was graded as ‘severe’ in 9 (16.07%), ‘moderate’ in 10 (17.86%) and mild in 9 (16.07%). Forty (71.43%) patients had cardiac insufficiency (IV: 6, 10.71%; III: 20, 35.71%; II: 14, 25.00%). Furthermore, 21 (37.50%) patients presented with abnormal parenchymal features in the area corresponding to PAI (e.g., the mosaic sign, infarction, bronchiectasis). During follow-up, two patients died due to abrupt pulmonary thrombosis. In the remaining patients, the abnormalities mentioned above improved partially after routine treatment.

Conclusion:

PA involvement is very common in TA patients. Physicians should be alerted to PA involvement even if obvious pulmonary symptoms are absent because they can cause PH, cardiac insufficiency as well as pulmonary parenchymal lesions, which will worsen the prognosis.

References:

[1]M.L.F. Zaldivar Villon, J.A.L. de la Rocha, L.R. Espinoza. Takayasu Arteritis: Recent Developments. Curr Rheumatol Rep 2019; 21: 45.

[2]N. Matsunaga, K. Hayashi, I. Sakamoto, et al. Takayasu arteritis: protean radiologic manifestations and diagnosis. Radiographics 1997; 17: 579-594.

[3]M. Bicakcigil, K. Aksu, S. Kamali, et al. Takayasu’s arteritis in Turkey - clinical and angiographic features of 248 patients. Clin Exp Rheumatol 2009; 27: S59-64.

Figure 1.

Imaging of PA lesions in TA patientsA:Dilationof the pulmonary trunk; B: thickness of the pulmonary trunk; C: stenosis of the right main PA; D: embolism of lower PAs on both sides; E: inflammation of the pulmonary-trunk root upon PET–CT; F: absence of left PAs and stenosis of the right main PA; G–I: pulmonary MRA (G), CTA (H) and VQ scan (I) of a patient with TA. MRA shows a fine right main PA and low perfusion in the right lung (G); CTA demonstrates a fine right main PA and fewer PA branches in the right lung (H); lung VQ scan shows multiple arterial emboli in the right lung and obvious less blood supply to the right lung.

Figure 2.

Pulmonary lesions on HRCT.A: Themosaicsign in the left lung; B: Pulmonary infarction of the right middle lobe; C: Mild pleural effusion on the left side; D: Bronchiectasis in the right lung; E–F: Ground-glass opacity (E) in the right upper lobe of a TA patient with an embolism of the right upper pulmonary branches (F); G–I: Cavitation (G) and mass-like consolidation (H) in the patient with severe stenosis of right main pulmonary artery (I).

Acknowledgments:

None

Disclosure of Interests:

None declared

Prepared self-growing supported nickel catalyst by recovering Ni (Ⅱ) from metal wastewater using geopolymer microspheres

Here, new and effective microsphere adsorbents were synthesized by NaOH activating slag based geopolymer (Na-SGS). These microsphere adsorbents upset the adsorption equilibrium with the maximum Ni²⁺ adsorption capacity of 414.38 mg/g which is much larger than that of other geopolymer materials. After Ni²⁺ adsorption from simulated nickel electroplating wastewater, more active positions for the adsorption Ni²⁺ ions on Na-SGS were provided as shifts from the average pore diameter of 22.00-7.44 nm, the pore volume of 0.06 to 0.25 cm³/g, the Brunauer-Emmett-Teller (BET) surface area of 10.46-125.35 m²/g and the apparent change of new morphology. Moreover, the adsorbed Ni²⁺ species were distributed uniformly on Na-SGS. Thermodynamic performance reflected an exothermic, spontaneous and molecular disorder adsorption process, which can be easily controlled by the pH, dosage, initial concentration, contact time and temperature. Through the controllable adsorption, Na-SGS after Ni²⁺ adsorption (Na-SGS-Ni) was recycled and then reduced to be directly supported nickel catalysts (red-Na-SGS-Ni), which showed superior catalytic activity for CO₂ methanation. Although the highest percent of CO₂ conversation (XCO₂ =99.54%) and methane selectivity (SCH₄ =99.5%) are both at 300 °C, red-Na-SGS-Ni performed good XCO₂ (99.48%) and SCH₄ (98.2%) at low temperatures (100 °C).

[Clinical effectiveness of simultaneous reconstructions of multiple joint scar contracture deformity of limb]

Objective: To explore the clinical effects of simultaneous reconstruction of multiple joint scar contracture deformity of limb. Methods: From January 2010 to June 2018, 24 patients with multiple joint scar contracture deformity of the same limb were reconstructed in simultaneous operations in Xiangya Hospital of Central South University, including 16 males and 8 females, aged 3-42 years, with 15 patients having deformities in the upper limbs and 9 patients having deformities in the lower limbs. One operation was performed to repair contracture deformity of axillary fossa and elbow in 3 patients, cubital fossa and palmar of wrist in 4 patients, cubital fossa and hand in 5 patients, palmar of wrist, palm, and palmar of finger in 3 patients, groin and medial knee in 2 patients, popliteal fossa and posterior ankle in 1 patient, and anterior ankle and dorsum of foot in 6 patients. After the release of various joint scar contractures, the area of skin defect was 140 to 580 cm(2). Autologous full-thickness skin grafts were used in 7 patients, autologous medium-thickness skin grafts were used in 4 patients, autologous full-thickness skin grafts combined with local skin flaps were used in 9 patients, and allogeneic acellular dermal matrix and autologous thin skin grafts were used in 4 patients. Comprehensive measures for rehabilitation were taken and the survival of the skin graft was observed after operation. Six months to eight years after the operation, all the patients were followed up for the functions of the affected limbs, among which the functions of the upper limbs were evaluated according to the trial standard for the evaluation of the functions of the upper limbs of the Hand Surgery Society of the Chinese Medical Association. The joint mobility, walking, and squatting function of lower extremity were examined after operation. Recurrence of contractures in all the affected limbs and reoperation were recorded. Results: The grafts survived after operation in 22 patients. Two patients had necrosis in small full-thickness skin area, of which one was healed by skin grafting after debridement, and the other one was healed after dressing changes. The deformity of scar contracture at each repaired joint was completely or partially corrected. During a follow-up for 6 to 96 months, the upper limb functions of 15 patients were rated excellent in 12 patients and good in 3 patients. Among the 9 patients of lower limb scar contractures, except for one 3-year-old child who experienced recurrence of medial knee scar contracture and underwent surgical release and skin grafting 5 years later, the remaining 8 patients basically recovered normal joint functions with pretty good outcomes. Conclusions: For continuous scar contracture deformity of multiple joints of the same limb, simultaneous surgical release and skin grafting can reduce operation frequency and obtain better outcomes of surgical operation.

Impact of mismatches in HbA1c vs glucose values on the diagnostic classification of diabetes and prediabetes

AIMS

To determine whether HbA_1c mismatches (HbA_1c levels that are higher or lower than expected for the average glucose levels in different individuals) could lead to errors if diagnostic classification is based only on HbA_1c levels.

METHODS

In a cross-sectional study, 3106 participants without known diabetes underwent a 75-g oral glucose tolerance test (fasting glucose and 2-h glucose) and a 50-g glucose challenge test (1-h glucose) on separate days. They were classified by oral glucose tolerance test results as having: normal glucose metabolism; prediabetes; or diabetes. Predicted HbA_1c was determined from the linear regression modelling the relationship between observed HbA_1c and average glucose (mean of fasting glucose and 2-h glucose from the oral glucose tolerance test, and 1-h glucose from the glucose challenge test) within oral glucose tolerance test groups. The haemoglobin glycation index was calculated as [observed - predicted HbA_1c ], and divided into low, intermediate and high haemoglobin glycation index mismatch tertiles.

RESULTS

Those participants with higher mismatches were more likely to be black, to be men, to be older, and to have higher BMI (all P<0.001). Using oral glucose tolerance test criteria, the distribution of normal glucose metabolism, prediabetes and diabetes was similar across mismatch tertiles; however, using HbA_1c criteria, the participants with low mismatches were classified as 97% normal glucose metabolism, 3% prediabetes and 0% diabetes, i.e. mostly normal, while those with high mismatches were classified as 13% normal glucose metabolism, 77% prediabetes and 10% diabetes, i.e. mostly abnormal (P<0.001).

CONCLUSIONS

Measuring only HbA_1c could lead to under-diagnosis in people with low mismatches and over-diagnosis in those with high mismatches. Additional oral glucose tolerance tests and/or fasting glucose testing to complement HbA_1c in diagnostic classification should be performed in most individuals.

Molecular correlates of response to capmatinib in advanced non-small-cell lung cancer: clinical and biomarker results from a phase I trial

BACKGROUND

Dysregulation of receptor tyrosine kinase MET by various mechanisms occurs in 3%-4% of non-small-cell lung cancer (NSCLC) and is associated with unfavorable prognosis. While MET is a validated drug target in lung cancer, the best biomarker strategy for the enrichment of a susceptible patient population still remains to be defined. Towards this end we analyze here primary data from a phase I dose expansion study of the MET inhibitor capmatinib in patients with advanced MET-dysregulated NSCLC.

PATIENTS AND METHODS

Eligible patients [≥18 years; Eastern Cooperative Oncology Group (ECOG) performance status ≤2] with MET-dysregulated advanced NSCLC, defined as either (i) MET status by immunohistochemistry (MET IHC) 2+ or 3+ or H-score ≥150, or MET/centromere ratio ≥2.0 or gene copy number (GCN) ≥5, or (ii) epidermal growth factor receptor wild-type (EGFRwt) and centrally assessed MET IHC 3+, received capmatinib at the recommended dose of 400 mg (tablets) or 600 mg (capsules) b.i.d. The primary objective was to determine safety and tolerability; the key secondary objective was to explore antitumor activity. The exploratory end point was the correlation of clinical activity with different biomarker formats.

RESULTS

Of 55 patients with advanced MET-dysregulated NSCLC, 40/55 (73%) had received two or more prior systemic therapies. All patients discontinued treatment, primarily due to disease progression (69.1%). The median treatment duration was 10.4 weeks. The overall response rate per RECIST was 20% (95% confidence interval, 10.4-33.0). In patients with MET GCN ≥6 (n = 15), the overall response rate by both the investigator and central assessments was 47%. The median progression-free survival per investigator for patients with MET GCN ≥6 was 9.3 months (95% confidence interval, 3.8-11.9). Tumor responses were observed in all four patients with METex14. The most common toxicities were nausea (42%), peripheral edema (33%), and vomiting (31%).

CONCLUSIONS

MET GCN ≥6 and/or METex14 are suited to predict clinical activity of capmatinib in patients with NSCLC (NCT01324479).

A Low-Cost Biomimetic Heterostructured Multilayer Membrane with Geopolymer Microparticles for Broad-Spectrum Water Purification

Membranes have received wide interest in water purification. However, the development of a low-cost and eco-friendly membrane with the desired structure for broad-spectrum water purification still remains a great challenge. Inspired by the hierarchical structure and functions of wood, a heterostructured multilayer membrane fabricated through a facile and "green" layer-by-layer self-assembly method was reported in this study. Specifically, the hydrophilic geopolymer microparticles were doped into sodium alginate matrix to construct "xylem" layers with numerous microchannels, and chitosan was used to build "phloem" layers with dense structures. The resultant biomimetic multilayer membrane displayed a distinct heterostructure and provided the desired rejection to different kinds of pollutants including nanoparticles, soluble dyes, and heavy metal ions, as well as emulsified oil droplets. Furthermore, the biomimetic membrane exhibited a superior stability in a long-term operation and an excellent recyclability for multiple usages for oil droplets removal. The proposed biomimetic membrane prepared in a completely "green" way possesses great potential in practical application for water purification and separation.