Efficacy of Polyethylene Glycol Electrolyte Powder Combined with Linaclotide for Colon Cleansing in Patients with Chronic Constipation undergoing colonoscopy: a Multi-centre, single-blinded, Randomized-Controlled Trial

BACKGROUND AND AIMS

Constipation is an independent risk factor for poor bowel preparation. This study aimed to evaluate the bowel-cleansing efficacy and safety of polyethylene glycol (PEG) combined with linaclotide (lin) for colonoscopy in patients with chronic constipation.

METHODS

This single-blinded, randomized, controlled and multicenter study was conducted from July 2021 to December 2022 at seven hospitals. Patients with chronic constipation who underwent colonoscopies were enrolled and randomly assigned to 4 groups with split -PEG regimens: 4L-PEG group, 4L-PEG+1d-Lin group, 3L-PEG+1d-Lin group, and 3L-PEG+3d-Lin group. The primary outcome was rates of adequate bowel preparation, defined as a total BBPS score ≥6 and a score ≥2 for each segment. Secondary outcomes were adverse effects, sleep quality, willingness to repeat the colonoscopy, adenoma detection rate, and polyp detection rate.

RESULTS

502 patients were enrolled. The rates of adequate bowel preparation (80.0% vs. 60.3%, P<0.001; 84.4% vs. 60.3%, P<0.001) and the total BBPS scores (6.90±1.28 vs. 6.00±1.61, P<0.001; 7.03±1.24 vs. 6.00±1.61, P<0.01) in 4L-PEG+1d-Lin group and 3L-PEG+3d-Lin group were superior to that in 4L-PEG group. Compared with 4L-PEG group, 4L-PEG+1d-Lin group (66.7% vs. 81.7%, P=0.008) and 3L-PEG+3d-Lin group (75.0% vs. 81.7%, P=0.224) had a lower percentage of mild adverse events. No statistically significant difference in willingness to repeat the colonoscopy, sleep quality, polyp detection rate, or adenoma detection rate was observed among groups.

CONCLUSIONS

PEG combined with linaclotide might be an effective method for bowel preparation before colonoscopy in patients with chronic constipation.

Association between pro-inflammatory diet and abdominal pain: Cross-sectional and case-control study from UK biobank and NHANES 2017-2020

BACKGROUND

There is a close association between diet and abdominal pain, however, relationship between inflammatory diet and characteristics of abdominal pain has not been characterized yet.

METHODS

This study analyzed baseline data from the UK Biobank, 3-item DHQ-Abdominal Pain Questionnaire (DHQ-3Q) which including abdominal pain in the past three months, severity of abdominal pain, and frequency of abdominal pain, and data from the National Health and Nutrition Examination Survey (NHANES) from 2017 to 2020. Energy-adjusted Dietary Inflammatory Index (E-DII), constructed based on 26 or 27 nutrients, was analyzed using continuous or categorical methods. Logistic regression and restricted cubic spline analyses examined the association between E-DII and abdominal pain.

RESULTS

In UK Biobank, compared to participants in the lowest quintile of E-DII, the adjusted ORs for the highest quintile were 1.12 (95% CI 1.02-1.24; p = 0.022), 1.05 (95% CI 1.00-1.09; p = 0.030), 1.26 (95% CI 1.17-1.36; p < 0.001), and 1.10 (95% CI 1.00-1.20; p = 0.044) for chronic abdominal pain, abdominal pain in the past three months, severity of abdominal pain, and frequency of abdominal pain, respectively. In NHANES, compared to participants in the lowest quintile of E-DII, the adjusted ORs for the highest quintile were 1.46 (95% CI 1.20-1.77; p < 0.001), 1.75 (95% CI 1.20-2.60; p = 0.005), 1.45 (95% CI 1.14-1.87; p = 0.003), and 1.18 (95% CI 0.82-1.72; p = 0.380) for abdominal pain in the past year, upper left abdominal pain, upper middle abdominal pain, and upper right abdominal pain. Additionally, there was a nonlinear correlation between E-DII score and DHQ-3Q (p nonlinear <0.001).

CONCLUSION

Following a pro-inflammatory diet is linked to a higher likelihood of experiencing abdominal pain, as well as increased severity and frequency of such pain. Therefore, further longitudinal studies are necessary to investigate this relationship.

Risk analysis of air pollutants and types of anemia: a UK Biobank prospective cohort study

Previous studies have suggested that exposure to air pollutants may be associated with specific blood indicators or anemia in certain populations. However, there is insufficient epidemiological data and prospective evidence to evaluate the relationship between environmental air pollution and specific types of anemia. We conducted a large-scale prospective cohort study based on the UK Biobank. Annual average concentrations of NO2, PM2.5, PM2.5-10, and PM10 were obtained from the ESCAPE study using the Land Use Regression (LUR) model. The association between atmospheric pollutants and different types of anemia was investigated using the Cox proportional hazards model. Furthermore, restricted cubic splines were used to explore exposure-response relationships for positive associations, followed by stratification and effect modification analyses by gender and age. After adjusting for demographic characteristics, 3-4 of the four types of air pollution were significantly associated with an increased risk of iron deficiency, vitamin B12 deficiency and folate deficiency anemia, while there was no significant association with other defined types of anemia. After full adjustment, we estimated that the hazard ratios (HRs) of iron deficiency anemia associated with each 10 μg/m3 increase in NO2, PM2.5, and PM10 were 1.04 (95%CI: 1.02, 1.07), 2.00 (95%CI: 1.71, 2.33), and 1.10 (95%CI: 1.02, 1.20) respectively. The HRs of folate deficiency anemia with each 10 μg/m3 increase in NO2, PM2.5, PM2.5-10, and PM10 were 1.25 (95%CI: 1.12, 1.40), 4.61 (95%CI: 2.03, 10.47), 2.81 (95%CI: 1.11, 7.08), and 1.99 (95%CI: 1.25, 3.15) respectively. For vitamin B12 deficiency anemia, no significant association with atmospheric pollution was found. Additionally, we estimated almost linear exposure-response curves between air pollution and anemia, and interaction analyses suggested that gender and age did not modify the association between air pollution and anemia. Our research provided reliable evidence for the association between long-term exposure to PM10, PM2.5, PM2.5-10, NO2, and several types of anemia. NO2, PM2.5, and PM10 significantly increased the risk of iron deficiency anemia and folate deficiency anemia. Additionally, we found that the smaller the PM diameter, the higher the risk, and folate deficiency anemia was more susceptible to air pollution than iron deficiency anemia. No association was observed between the four types of air pollution and hemolytic anemia, aplastic anemia, and other types of anemia. Although the mechanisms are not well understood, we emphasize the need to limit the levels of PM and NO2 in the environment to reduce the potential impact of air pollution on folate and iron deficiency anemia.

Boosting Material Utilization via Direct Growth of Zn2 (V3 O8 )2 on the Carbon Cloth as a Cathode to Achieve a High-Capacity Aqueous Zinc-Ion Battery

Aqueous zinc-ion batteries (AZIBs) have attracted the attention of researchers because of their high theoretical capacity and safety. Among the many vanadium-based AZIB cathode materials, zinc vanadate is of great interest as a typical phase in the dis-/charge process. Here, a remarkable method to improve the utilization rate of zinc vanadate cathode materials is reported. In situ growth of Zn2 (V3 O8 )2 on carbon cloth (CC) as the cathode material (ZVO@CC) of AZIBs. Compared with the Zn2 (V3 O8 )2 cathode material bonded on titanium foil (ZVO@Ti), the specific capacity increases from 300 to 420 mAh g-1 , and the utilization rate of the material increases from 69.60% to 99.2%. After the flexible device is prepared, it shows the appropriate specific capacity (268.4 mAh g-1 at 0.1 A g-1 ) and high safety. The method proposed in this work improves the material utilization rate and enhances the energy density of AZIB and also has a certain reference for the other electrochemical energy storage devices.

Efficacy of press needle on immune function and quality of life in female breast cancer patients after radical mastectomy: study protocol for a randomized controlled trial

Radical mastectomy may lead to suppression of cellular immune function in patients with malignant tumors, and affect the quality of life (QOL) of patients. Immune suppression is a common cause of complications and adverse reactions in adjuvant therapy after radical mastectomy of breast cancer. Currently, there are few proven effective treatments for immune suppression. Therefore, it's necessary to develop a new treatment method. Press needle is widely used in clinical practice. However, there have been relatively few studies that evaluate the effects of press needle on postoperative immune function. The aim of the present study is to assess the effects of press needle on immune function and QOL in female breast cancer patients undergoing radical mastectomy. This study will be a single-center, randomized and single-blinded trial. Totally 78 eligible patients will be randomized in a ratio of 1:1 to the press needle group or the sham press needle group. During the treatment phase, patients will undergo five times weekly of verum press needle or sham press needle for 2 weeks. The primary outcome measures will be the peripheral blood levels of CD8+, CD4+, CD3+, and CD4+/CD8+ T cells. The secondary outcome measures will be the changes of patients' QOL, evaluated by the Karnofsky Performance Scale score and the EORTC core quality of life questionnaire (EORTC QLQ-C30). Furthermore, 5-year survival rate and recurrence rate will be evaluated. Safety and adverse events will be assessed at each visit. The results of this on-going study will provide clinical evidence for the effects and safety of press needle on immune function and QOL in patients after breast cancer resection compared with sham press needle. Trial registration: Chinese Clinical Trial Registry, ChiCTR2000040100. Registered on 21 November 2020.

Sulforaphane is a reversible covalent inhibitor of 3-chymotrypsin-like protease of SARS-CoV-2

The ongoing pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has posed a major public health threat worldwide and emphasizes an urgent need for effective therapeutics. Recently, Ordonez et al. identified sulforaphane (SFN) as a novel coronavirus inhibitor both in vitro and in mice, but the mechanism of action remains elusive. In this study we independently discovered SFN for its inhibitory effect against SARS-CoV-2 using a target-based screening approach, identifying the viral 3-chymotrypsin-like protease (3CL^pro ) as a target of SFN. Mechanistically, SFN inhibits 3CL^pro in a reversible, mixed-type manner. Moreover, enzymatic kinetics studies reveal that SFN is a slow-binding inhibitor, following a two-step interaction. Initially, an encounter complex forms by specific binding of SFN to the active pocket of 3CL^pro ; subsequently, the isothiocyanate group of SFN as "warhead" reacts covalently to the catalytic cysteine in a slower velocity, stabilizing the SFN-3CL^pro complex. Our study has identified a new lead of the covalent 3CL^pro inhibitors which has potential to be developed as a therapeutic agent to treat SARS-CoV-2 infection. This article is protected by copyright. All rights reserved.

CCL13 and human diseases

CCL13/MCP-4 belongs to the CC chemokine family, which induces chemotaxis in many immune cells. Despite extensive research into its function in numerous disorders, a thorough analysis of CCL13 is not yet accessible. The role of CCL13 in human disorders and existing CCL13-focused therapies are outlined in this study. The function of CCL13 in rheumatic diseases, skin conditions, and cancer is comparatively well-established, and some studies also suggest that it may be involved in ocular disorders, orthopedic conditions, nasal polyps, and obesity. We also give an overview of research that found very little evidence of CCL13 in HIV, nephritis, and multiple sclerosis. Even though CCL13-mediated inflammation is frequently linked to disease pathogenesis, it's fascinating to note that in some conditions, like primary biliary cholangitis (PBC) and suicide, it might even act as a preventative measure.

Causal association between inflammatory bowel disease and IgA nephropathy: A bidirectional two-sample Mendelian randomization study

Background: An association between inflammatory bowel disease (IBD) [which includes ulcerative colitis (UC) and Crohn's disease (CD)] and IgA nephropathy (IgAN) has been discovered in observational studies, but the causal relationship is still unknown. The aim of this study was to clarify the causal link between IBD (which includes UC and CD) and IgAN via a two-sample Mendelian randomization (MR) analysis. Methods: Eligible single-nucleotide polymorphisms (SNPs) were selected as instrumental variables (IVs) for analyses and were obtained from the publicly available genome-wide association study (GWAS) summary statistics. Inverse-variance weighting (IVW), Mendelian randomization-Egger (MR-Egger) regression, the Mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO) test, and the weighted median were utilized to obtain the results. The MR-PRESSO test and MR-Egger regression were also performed to detect and correct horizontal pleiotropy. The Cochran's Q test and "leave-one-out" analysis were also conducted to assess the stability and reliability of the MR results. Results: This study found that IBD, UC, and CD all had significant positive causal effects on IgAN risk (IBD: OR = 1.58, 95% CI 1.15-2.16, p = 4.53 × 10-3; UC: OR = 1.55, 95% CI 1.14-2.11, p = 4.88 × 10-3; CD: OR = 1.57, 95% CI 1.21-2.03, p = 5.97 × 10-4). No significant horizontal pleiotropic effect was found for the causal association between IBD, UC, CD, and the risk of IgAN. Cochran's Q test identified no evidence of heterogeneity for the IV estimates. The "leave-one-out" sensitivity analysis also revealed that the MR results were robust. Conclusion: The results of this two-sample MR analysis supported that IBD, UC, and CD were causally associated with the risk of IgAN, while there was no sufficient evidence for the causal effect of IgAN on IBD, UC, or CD. Our findings provide theoretical support and a new perspective for the diagnosis and treatment of these two diseases.

An Additive Consistency and Consensus Approach for Group Decision Making With Probabilistic Hesitant Fuzzy Linguistic Preference Relations and Its Application in Failure Criticality Analysis

In this article, probabilistic hesitant fuzzy linguistic preference relations (PHFLPRs) are proposed to present the qualitative pairwise preference information of decision makers (DMs) with hesitation and probability uncertainty assessments. The measurements and improvements of additive consistency and consensus of PHFLPRs are investigated in group decision making (GDM). First, a new concept of probabilistic hesitant fuzzy linguistic term sets is defined. Second, the consistency and consensus measurements are established to survey the additive consistency and consensus levels of PHFLPRs. Subsequently, an optimization model is developed to improve the unacceptably additive consistent PHFLPR. By optimizing the unacceptable consensual PHFLPRs with repeating additive consistency improvement, the acceptably additive consistent and consensual PHFLPRs are obtained, based on which DMs' weights are determined objectively and then, the collective PHFLPR is aggregated from individual PHFLPRs. Alternatives' priority weights are derived from the collective PHFLPR as GDM. Finally, an example about failure criticality analysis is given, and a comparison analysis is presented.

Na+-Activation Engineering in the Na3V2(PO4)3 Cathode with Boosting Kinetics for Fast-Charging Na-Ion Batteries

Na superionic conductor-structured phosphates have attracted wide interest due to their high working voltage and fast Na⁺ migration facilitated by the robust 3D open framework. However, they usually suffer from low-rate capability and inferior cycling stability due to the low intrinsic electronic conductivity and limited activated Na⁺ ions. Herein, a doping protocol with Na⁺ in the V³⁺ site is developed to activate extra electrochemical Na⁺ ions and expand the migration path of Na⁺, leading to the improvement of the electronic conductivity and diffusion kinetics. It is also disclosed that the generated stronger Na-O bonds with high ionicity significantly conduce to the enhanced structural stability in the Na⁺-substituted Na_3.05V_1.975Na_0.025(PO₄)₃/C cathode. The obtained composite can deliver an excellent rate capacity of 83.8 mA h g^-1 at 20 C and a moderate cycling persistence of 91.3% over 1500 cycles at 10 C with great fast-charging properties. The reversible structure evolution is confirmed by the ex situ XRD, XPS, and ICP characterization. This work sheds light on awakening electroactive Na⁺ ions and designing phosphates with superior electrochemical stability for practical Na-ion batteries.

[Clinical characteristics and prognosis of 83 children with newly treated hepatoblastoma]

Objective: To investigate the clinical features, survival and prognostic risk factors of children with hepatoblastoma (HB). Methods: Clinical data of 83 children with newly treated HB at the Department of Hematology and Oncology, Children's Hospital, the First Affiliated Hospital of Zhengzhou University from January 2012 to October 2019 were analyzed retrospectively. The sex, age, first clinical manifestations, pretreatment extent of disease (PRETEXT) stages, pathological types, initial alpha-fetoprotein (AFP), treatment methods and treatment outcome of all patients were summarized. The children diagnosed before 2018 were treated with "Wuhan Protocol", and those who diagnosed after 2018 were treated with the "Expert Consensus for Multidisciplinary Management of Hepatoblastoma"(CCCG-HB-2016) protocol. Kaplan-Meier survival analysis was used to calculate the survival rate, Log-Rank test was used in univariate analysis, and the Cox regression model was used in multivariate prognosis analysis. Results: Among 83 cases, there were 51 males and 32 females. The age of onset was 25.2 (9.0, 34.0) months old, and 64 cases (77%) were under 3 years old. The most common first clinical manifestation was abdominal mass in 45 cases (54%). There were 8 cases of PRETEXT stage Ⅰ, 43 cases of stage Ⅱ, 20 cases of stage Ⅲ and 12 cases of stage Ⅳ. During the follow-up period of 40 (17, 63) months, the 1-year overall survival (OS) rate and event-free survival (EFS) rate were (84±4) % and (79±5) %, respectively, and 5-year OS rate and EFS rate were (78±5) % and (76±5) %, respectively. Fifty-five cases were treated with "Wuhan Protocol", and the 5-year OS and EFS rate were (73±6) % and (71±6) %, respectively. Twenty-eight cases were treated with CCCG-HB-2016 protocol, and the 5-year OS and EFS rate were (88±7) % and (82±9) %, respectively. Multivariate COX regression analysis showed that AFP did not turn negative after 3 courses of postoperative chemotherapy (HR=9.228, 95%CI 1.017-83.692) and PRETEXT stage Ⅳ (HR=6.587, 95%CI 1.687-25.723) were independent risk factors affecting the prognosis of children with HB. Conclusions: The "Wuhan Protocol" and CCCG-HB-2016 protocol were effective in the treatment of children with HB. AFP did not turn negative after 3 courses of postoperative chemotherapy and PRETEXT stage Ⅳ were independent risk factors affecting the prognosis of children with HB.

Binder-free three-dimensional interconnected CuV2O5•nH2O nest as cathodes for high-loading aqueous zinc-ion batteries

In large-scale energy storage applications, aqueous zinc ion batteries (ZIBs) with low cost, safety, high theoretical capacity, and environmentally friendly have wide application prospects. In the reported cathode materials, the...

V2O5/NaV6O15nanocomposites synthesized by molten salt method as a high-performances cathode material for aqueous zinc-ion batteries

Aqueous zinc-ion batteries (ZIBs) is a potential energy storage system due to its advantages of low cost, good safety, and high theoretical capacity (820 mAh g^-1). However, the lack of cathode materials with long cycle stability severely restricts the development of ZIBs. In this paper, V₂O₅/ NaV₆O₁₅nanocomposites are synthesized by molten salt method in one step and used as cathode material for ZIBs, which have good electrochemical performances. The specific capacity of the materials remain 160 mAh g^-1when the current density is 0.5 A g^-1after 1000 cycles, and the capacity retention rate is 102.03% when the current density is 5 A g^-1for 1000 cycles. This is mainly due to the large number of active sites generated by crystal defects and the synergistic interaction between the dual-phase materials, which reduces the stress of ions inserted/extracted during the Zn²⁺storage process and improves the electrochemical performance.

Notoginsenoside R1 Protects Against High Glucose-Induced Cell Injury Through AMPK/Nrf2 and Downstream HO-1 Signaling

Notoginsenoside R1 (NGR1), the primary bioactive compound found in Panax notoginseng, is believed to have antihypertrophic and antiapoptotic properties, and has long been used to prevent and treat cardiovascular diseases. However, its potential role in prevention of diabetic cardiomyopathy remains unclear. The present study aimed to investigate the mechanism of NGR1 action in high glucose-induced cell injury. H9c2 cardiomyocytes were cultured in a high-glucose medium as an in-vitro model, and apoptotic cells were visualized using TUNEL staining. Expression of Nrf2 and HO-1 was measured using Western blotting or reverse transcription-quantitative PCR (RT-qPCR). The Nrf2 small interfering (si) RNA was transfected into cardiomyocytes using Opti-MEM containing Lipofectamine^® RNAiMAX. NGR1 protected H9c2 cardiomyocytes from cell death, apoptosis and hypertrophy induced by high glucose concentration. Expression of auricular natriuretic peptide and brain natriuretic peptide was remarkably reduced in NGR1-treated H9C2 cells. Western blot analysis showed that high glucose concentration markedly inhibited AMPK, Nrf2 and HO-1, and this could be reversed by NGR1 treatment. However, the cardioprotective effect of NGR1 was attenuated by compound C, which reverses Nrf2 and HO-1 expression levels, suggesting that AMPK upregulates Nrf2 and HO-1 gene expression, protein synthesis and secretion. Transfection of H9C2 cells with Nrf2 siRNA markedly reduced the cardioprotective effect of NGR1 via reduced expression of HO-1. These results indicated that NGR1 attenuated high glucose-induced cell injury via AMPK/Nrf2 signaling and its downstream target, the HO-1 pathway. We conclude that the cardioprotective effects of NGR1 result from upregulation of AMPK/Nrf2 signaling and HO-1 expression in cardiomyocytes. Our findings suggest that NGR1 treatment might provide a novel therapy for diabetic cardiomyopathy.

Altered Expression of Aggrecan, FAM20B, B3GALT6, and EXTL2 in Patients with Osteoarthritis and Kashin-Beck Disease

OBJECTIVE

The objective of this study was to investigate the expression of enzymes involved in synthesis and modification of chondroitin sulfate (CS) in knee cartilage tissue of patients with osteoarthritis (OA) and Kashin-Beck disease (KBD).

METHODS

The knee articular cartilage samples were obtained from 18 age- and gender-matched donors with 6 each in KBD, OA, and control groups. Hematoxylin and eosin (HE) staining, toluidine blue (TB) staining, and immunohistochemical (IHC) staining were performed to estimate the expression level and localization of aggrecan, along with FAM20B, GalT-II, and EXTL2, which are associated with CS synthesis and modification. Rank-based analyses of variance test was used for the multiple comparisons of discrepancy in the positive staining rate among the 3 groups.

RESULTS

In HE and TB staining results, damaged morphology, decreased chondrocyte numbers and proteoglycans were observed in OA and KBD groups compared with the control group. In line with these trends, the positive staining rates of aggrecan were lower in KBD and OA groups than in the control group. Meanwhile, the positive staining rates of CS chain modifying enzymes FAM20B, GalT-II, and EXTL2 decreased in OA and KBD groups.

CONCLUSIONS

In conclusion, it was demonstrated that altered expression of CS chain modifying enzymes in OA and KBD groups influenced the synthesis procession of CS and could contribute to the damage of cartilage. Further investigation of these enzymes can provide new theoretical and experimental targets for OA and KBD pathogenesis studies.

Metformin attenuates angiotensin II-induced cardiomyocyte hypertrophy by upregulating the MuRF1 and MAFbx pathway

Pathological cardiac hypertrophy induced by aging and neurohumoral activation, such as angiotensin II (Ang II) activation, is an independent risk factor for heart failure. The muscle really interesting new gene-finger protein-1 (MuRF1) and muscle atrophy F-box (MAFbx) pathway has been previously reported to be an important mechanism underlying the pathogenesis of cardiac hypertrophy. Metformin is currently the first-line blood glucose-lowering agent that can be useful for the treatment of cardiovascular diseases. However, the potential role of metformin in the modulation of MuRF1 and MAFbx in cardiomyocyte hypertrophy remains poorly understood. The present study used H9c2 cells, a cardiomyocyte cell model. The surface area of cultured rat H9c2 myoblasts was measured and the expression levels of MuRF1 and MAFbx were quantified using western blot or reverse transcription-quantitative PCR. H9c2 cells were transfected with MuRF1 and MAFbx small interfering (si) RNA. The present study revealed that Ang II treatment significantly increased the cell surface area of model cardiomyocytes. Additionally, atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) mRNA and protein expression was increased following this treatment. Ang II also downregulated MuRF1 and MAFbx protein and mRNA expression. In the H9C2, treatment with metformin attenuated hypertrophic remodeling. In addition, expression of ANP and BNP was significantly reduced in metformin-treated H9C2 cells. The results indicated that metformin increased the activity of MuRF1 and MAFbx and upregulated their expression, the knockdown of which resulted in deteriorative Ang II-induced cell hypertrophy, even following treatment with metformin. Taken together, data from the present study suggest that metformin can prevent cardiac hypertrophy through the MuRF1 and MAFbx pathways.

Research Progress on Species Identification of Sarcosaprophagous Flies

Abstract

Estimation of postmortem interval （PMI） has always been one of the difficult problems for forensic scientists. It is especially hard to estimate the PMI of highly decomposed corpses in the wild or in secluded houses with conventional methods. Therefore, application of insect evidence at the scene is usually required for estimation. Sarcosaprophagous flies of different species have totally different developmental rates. In actual cases, direct measurement of the body length of the larvae, calculation of accumulated temperature and succession stages without species identification, or calculation based on incorrect species identification would often lead to a large deviation between the calculated results and the real PMI. This mistake would also mislead the case investigation. Therefore, accurate species identification should be implemented before any PMI estimation of decomposed corpses with forensic entomological methods. This article reviews the general and ultramicroscopic species identification and molecular biological species identification methods of different stages of sarcosaprophagous flies, in order to provide new ideas and methods for related research and practice, and provide reference for the application and promotion of forensic entomology in the front line of public security.

A novel non-enzymatic glucose electrochemical sensor with high sensitivity and selectivity based on CdIn2O4nanoparticles on 3D Ni foam substrate

Due to the poor conductivity of Fe based, Cu based and Co based electrode materials commonly used in the electrochemical detection of glucose, and the uneven stirring and poor conductivity of the traditional preparation method based on glassy carbon electrode. In order to solve the above problems, in this work, CdIn₂O₄with high electrical conductivity was directly grown on three-dimensional (3D) Ni foam to prepare electrode materials for non-enzymatic glucose sensors. CdIn₂O₄nanoparticles is prepared from cadmium acetate and indium nitrate hydrate in benzyl alcohol by non-aqueous sol-gel method. The electrocatalytic oxidation performances of CdIn₂O₄electrode material for non-enzymatic glucose are studied. The results show that the proposed CdIn₂O₄electrode material has good electrochemical properties and sensing performance for glucose detection. The electrochemical response of CdIn₂O₄electrode material to glucose is recorded that calibration plot for glucose concentrations ranging from 1.0μM to 1.0 mM (R² = 0.99), a limit detection of 0.08μM, an excellent sensitivity of 3.2925 mA.mM^-1.cm^-2, a rapid response time of 1.58 s, a good selectivity and a good long-term stability. These demonstrate the significant potential of CdIn₂O₄electrode material based on 3D Ni foam as non-enzymatic glucose sensors, which makes it possible to use it as a practical glucose detector. This work could introduce a new concept of nanoparticles modified electrode material grown directly on 3D Ni foam, thus a simple and reliable electrochemical glucose sensor platform is realized. This study was completed in 2019 in the school of materials and energy, Yunnan University.

One-dimensional In2O3nanorods as sensing material for ppb-level n-butanol detection

Effectively and quantificationally detecting hazardous gas n-butanol is very significant in daily life, which can bring about a safe living condition for humans. In this study, the one-dimensional In₂O₃nanorods were successfully synthesized via hydrothermal route and post-heat treatment. Noticeably, one-dimensional nanorods structures were obtained and the products presented a superior growth orientation along with (222) plane. Additionally, systematical gas-sensing measurements of the sensor made from In₂O₃nanorods towards hazardous n-butanol gas were conducted. Results exhibited that the fabricated sensor showed excellent n-butanol sensing properties, with aspects to a superior response value of 342.20 with concentration 100 ppm at 240 °C, remarkable selectivity, fast response/recovery times (77.5/34.2 s) and good stability. More interestingly, the detection limit of sensor as low as 500 ppb and a good linearity relationship between response values and n-butanol concentrations was presented. Gas-sensitive properties of this sensor are better than previously reported in n-butanol detection. All results demonstrate that one-dimensional In₂O₃nanorod is a promising sensor material to practical applications in effectively detecting n-butanol gas.

Hyperhomocysteinemia exacerbates ischemia-reperfusion injury-induced acute kidney injury by mediating oxidative stress, DNA damage, JNK pathway, and apoptosis

Background

Hyperhomocysteinemia (HHcy) plays an important role in the progression of many kidney diseases; however, the relationship between HHcy and ischemia-reperfusion injury (IRI)-induced acute kidney injury (IRI-induced AKI) is far from clear. In this study, we try to investigate the effect and possible mechanisms of HHcy on IRI-induced AKI.

Methods

Twenty C57/BL6 mice were reared with a regular diet or high methionine diet for 2 weeks (to generate HHcy mice); after that, mice were subgrouped to receive sham operation or ischemia-reperfusion surgery. Twenty four hour after reperfusion, serum creatinine, blood urea nitrogen, and Malondialdehyde (MDA) were measured. H&E staining for tubular injury, western blot for γH2AX, JNK, p-JNK, and cleaved caspase 3, and TUNEL assay for tubular cell apoptosis were also performed.

Results

Our results showed that HHcy did not influence the renal function and histological structure, as well as the levels of MDA, γH2AX, JNK, p-JNK, and tubular cell apoptosis in control mice. However, in IRI-induced AKI mice, HHcy caused severer renal dysfunction and tubular injury, higher levels of oxidative stress, DNA damage, JNK pathway activation, and tubular cell apoptosis.

Conclusion

Our results demonstrated that HHcy could exacerbate IRI-induced AKI, which may be achieved through promoting oxidative stress, DNA damage, JNK pathway activation, and consequent apoptosis.

[Clinical manifestation and genetic analysis of a child with early infantile epileptic encephalopathy 42]

OBJECTIVE

To analyze the clinical phenotype and genetic characterization of a child with early infantile epileptic encephalopathy.

METHODS

The proband was subjected to history taking and was diagnosed based on his clinical manifestation, magnetic resonance imaging (MRI) and whole exome sequencing (WES). Sanger sequencing was carried out to determine the origin of pathogenic variant.

RESULTS

The proband unconsciously tilts his head to one side with squint, which revealed an abnormal discharge. MRI indicated suspicious abnormal signal shadow in the left posterior frontal cortex in addition with inflammation signs in the right maxillary sinus and ethmoid sinus. WES revealed that the proband has carried a heterozygous c.5789G>A variant in the CACNAIA gene. The result of Sanger sequencing was in keeping with that of WES. Neither of his parents has carried the same variant.

CONCLUSION

The heterozygous c.5789G>A variant of the CACNAIA gene probably underlay the early infantile epileptic encephalopathy 42 in the proband, which has a de novo origin.

[Clinical analysis of 33 cases of chronic liver diseases overlapping with CMV infection]

Objective: To understand the clinical features and outcomes of chronic liver diseases overlapping with CMV infection. Methods: Clinical characteristics, treatment and outcome of patients of chronic liver diseases overlapping with CMV infection were analyzed retrospectively. T-test was used for measurement data and χ (2) test was used for count data. All measurement data were expressed by (x ± s). P > 0.05 was not determined as significant. P < 0.05 was regarded as statistically significant. Results: Chronic liver diseases overlapping with CMV infections had similar clinical features. Etiopathogenic treatment + symptomatic supportive treatment + CMV overlapping infection treatment (including antiviral therapy, corticosteroids consideration, clearing heat and traditional Chinese choleretic medicine, etc) were the primary principles of therapy. The incidence of cytomegalovirus infection accounted for 4.125% during the corresponding hospitalization period. Cytomegalovirus infection had relatively caused liver function damage in patients with milder clinical symptoms and signs. Biochemical indicators before and after treatment showed that there was no significant difference in total bilirubin (TBil) before (262.93 ± 178.944) μmol/L and after one week of treatment (245.08 ± 179.332) μmol/L (P > 0.05). However, when TBIL was compared with three (156.58 ± 147.461) μmol/L and four weeks (103.39 ± 102.218) μmol/L) of treatment, the decrease was significant (P < 0.05, P < 0.01). Alanine aminotransferase (ALT) after one week (293.57 ± 467.438) U/L (P < 0.01) of treatment was significantly lower than before treatment (782.34 ± 828.801) U/L. Gamma-glutamyl transferase (GGT) after treatment (202.52 ± 155.174)U/L was significantly lower than before treatment(280.69 ± 205.619)U/L). Total bile acid (TBA) was increased after treatment (198.04 ± 155.174)μmol/L, when compared with that of before treatment (62.93 ± 178.944)μmol/L. Biochemical indicators of liver diseases had shown typical features of cholestasis, and the slow and reduced flow of bile acid was tracked and observed. Compared with the advanced group (182.45 ± 214.169) umol/L, the total bilirubin in inflammation group (50.36 ± 26.282) umol/L was decreased (P < 0.05). Moreover, advanced group (122.18 ± 106.780) umol/L (P < 0.05) had elevated total bile acid normalization rate than that of bile acid group (54.82 ± 56.123) umol/L, and the inflammatory phase had significantly better outcome than those with advanced-stage. Conclusion: Chronic liver diseases overlapping with cytomegalovirus infection has a good therapeutic outcome in the inflammatory phase, but in the advanced-stage; the therapeutic efficacy and outcome is poor and perilous.

[Development and performance test of the environment scale of unintentional injury in the home for children aged 0-6 years old in urban area of China]

Objective: To develop the environment scale of unintentional injury in the home for children aged 0-6 years living in urban area of China, and test its validity and reliability. Methods: The content of the environment scale was established through the literature review, expert consultation and pilot study. A total of 1 104 children aged 0-6 years in urban area of Changsha were enrolled in this study by using a multi-stage stratified cluster random sampling method. The questionnaire was used to collect the basic information of children, the incidence of unintentional injury and the status of home environment. The reliability of the scale was tested by using Cronbach's α coefficient and split-half reliability coefficient. The content validity and construct validity were tested by using Pearson correlation analysis and factor analysis. All children were divided into two groups according to the incidence of unintentional injury in the home and the discrimination validity of the scale was tested by using t-test. Results: The scale had 54 items in 6 dimensions. The number of eligible questionnaires was 1 074, including 554 (51.6%) from boys and 519 (48.3%) from children under 3 years old. The incidence rate of unintentional injury and in-home injury was 18.34% (197 children) and 10.71% (115 children). The internal consistency reliability (Cronbach's α) coefficient for the scale was 0.87 and the split-efficacy reliability coefficient was 0.82, both meeting the standard of reliability above 0.70. The Pearson correlation coefficient between each dimension and the whole scale ranged from 0.53 to 0.84 (all P values <0.001). The common factor cumulative variance contribution rate of the scale was 58.34%. There were 54 items with factor loadings greater than 0.30. The root mean square error of approximation, comparative fit index and goodness-of-fit index were 0.07, 0.61 and 0.71, respectively. The score of scale in children with injury was significantly higher than that in children without injury (P=0.022). Conclusion: The validity and reliability of the environment scale for unintentional injury in the home for children aged 0-6 years old in the urban area of China are good.

Sustainable modulation of anaerobic malodorous black water: The interactive effect of oxygen-loaded porous material and submerged macrophyte

Depleted oxygen (O₂) in the sediment and overlying water of malodorous black water poses a potential threat to aquatic ecosystems. This study presents a method for sustainable regulation of the dissolved oxygen (DO) levels towards the malodorous black water. Oxygen-loaded natural porous materials were prepared by vacuum degassing to remove air from the pores and fill them with pure O₂. Capping anaerobic sediment with the prepared 6 oxygen-loaded porous materials was effective in prompting the DO concentration of the malodorous black water. Although granules activated carbon (GAC) displayed the highest oxygen-loading capability, oxygen-loaded volcanic stone additive was more efficient for long-lasting combating of the anaerobic condition because the DO level at sediment-water interface (SWI) and the DO penetration depth showed approximately 5.38- and 3.75-fold increase, respectively, compared with the untreated systems. The improvement in DO was substantially enhanced in the presence of submerged macrophyte (Vallisneria natans), during which the release of O₂ from oxygen-loaded volcanic stone facilitated the plant growth. With the joint efforts of the O₂ released from volcanic stone and photosynthesis by the macrophytes, the DO levels were maintained at approximately 6.80 mg/L after a 41-day incubation, which exceeded (P < 0.05) the value in only oxygen-loaded volcanic stone or macrophytes added treatments. In addition to the elevated DO level, the combined employment of oxygen-loaded volcanic stone and macrophytes triggered a negative ammonia (NH₄⁺-N) flux across the SWI and an 85.82% reduction of methane (CH₄) production compared with those without treatment, accompanied by a decrease in total inorganic carbon and a 2.55- fold increasing of submerged macrophyte biomass, which is presumably attributed to nitrification, remineralization, and assimilation. The results obtained here shed a degree of light on the sustainable modulation of the anaerobic condition in malodorous black water.

Multi-Objective Optimization for Grinding Parameters of 20CrMnTiH Gear with Ceramic Microcrystalline Corundum

(1) The alloy material 20CrMnTiH is widely used in gear manufacturing, but difficult to process, and its quantity (efficiency) and quality (surface quality) are generally negative correlation indicators. As a difficult but realistic problem, it is of important practical significance to explore how to efficiently grind high-precision low-carbon alloy gear workpieces. (2) Firstly, the pixel method was applied to analyze the grinding principles and explore the grinding parameters-the grinding wheel speed and grinding wheel frame moving speed-as well as the feed rate, which impacts the grinding indicators. Secondly, based on the ceramic microcrystalline corundum grinding wheel and the 20CrMnTiH gear workpiece, controlled experiments with 28 groups of grinding parameters were conducted. Moreover, the impact curves of the grinding parameters on the grinding indicators-the grinding efficiency, grinding wheel life, and surface roughness-were obtained by the multiple linear regression method. Finally, the multi-objective optimization method was used to comprehensively optimize the grinding process. (3) Compared with the traditional grinding process, under optimized grinding parameters, the 20CrMnTiH gear workpieces have a lower surface roughness and a longer grinding wheel life, and require a shorter time to achieve grinding accuracy. (4) The grinding experiments showed that the grinding parameters are linearly related to the grinding indicators. The optimization results show that the precision, efficiency, and economy of the 20CrMnTiH gear grinding process have been improved via the comprehensive optimization of the grinding parameters.

Abstract P6-22-01: Repurposing sulindac sulfide as a notch inhibitor to target cancer stem-like cells in triple negative breast cancer

Triple negative breast cancer (TNBC) is a heterogeneous group of clinically aggressive breast cancers. TNBC patients have a high risk of recurrence and metastasis, and current treatment options remain limited. There is strong evidence supporting the involvement of Notch signaling in TNBC progression. Expression of Notch1 and its ligand Jagged1 correlate with poor prognosis. Emerging evidence suggests that cancer stem-like cells (CSCs) that escape chemo or radiation therapy in TNBC are often Notch-dependent. At the same time, there is evidence that active tumor immunity predicts good response to neo-adjuvant chemotherapy in TNBC. Notch inhibitors, including Gamma Secretase Inhibitors (GSIs) are quite effective in preclinical models of TNBC, where they eliminate CSCs resistant to chemotherapy. However, the success of GSIs in clinical trials is limited by their intestinal toxicity and adverse immunological effects. CD4 and CD8 T-cells, necessary to adaptive tumor immunity, require Notch1 for activation. Our overarching goal is to replace GSIs with agents that lack their systemic toxicity and adverse immunological effects. We identified Sulindac Sulfide (SS), the active metabolite of FDA-approved NSAID Sulindac, as a potential candidate to replace GSI. SS has Gamma Secretase Modifier (GSM) activity. We confirmed that SS inhibits Notch1 cleavage in TNBC cells. SS significantly inhibited mammosphere growth in all human and murine TNBC models we tested: 1) human MDA-MB-231 cells; 2) murine TNBC model C0321, from targeted conditional knockout of Lunatic Fringe (LFng-/-); and 3) Two TNBC patient-derived xenograft models, 2K1 and 4IC. In contrast, SS did not inhibit Notch expression or cleavage in murine T cells. In C0321 tumors, which recapitulate human mesenchymal TNBC, we found that SS had remarkable single-agent anti-tumor activity and virtually eliminated Notch1 expression in tumors. SS caused an increase in intra-tumoral CD11c+ dendritic cells, but decreased CD4 cells, which in this model are largely PD-1 positive (exhausted). CD8 cells were modestly increased. SS did not affect the number of tumor infiltrating macrophages or myeloid-derived suppressor cells (MDSC). However, SS blocked the immunosuppressive function of bone marrow-derived MDSC. We are currently investigating the mechanisms of this anti-tumor activity. Our data support further investigation of SS for the treatment of TNBC, with standard of care or with immunotherapy agents. Repurposing an FDA-approved, safe agent for the treatment of TNBC would be significantly easier and more cost-effective than developing unproven investigational agents.

Citation Format: Hossain F, Ucar D, Majumder S, Xu K, Ran Y, Minter L, Xi Y, Burow M, Golde T, Osborne B, Miele L. Repurposing sulindac sulfide as a notch inhibitor to target cancer stem-like cells in triple negative breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-22-01.

Application of mini-clinical evaluation exercise for assessing the integrated-based learning during physical diagnostic course

Medical education paradigm has been questioned for the requirements of improving the quality and quantity of medical students. This study was to explore the efficiency of integrated-based learning (IBL) used mini-clinical evaluation exercise (mini-CEX) during physical diagnostics course. One hundred and eleven volunteered students were randomly divided into three groups: lecture-based learning (LBL), case-based learning (CBL), and IBL. Nephrotic syndrome was the teaching content. In the IBL group, students were provided the guideline and additional interpretation from the instructor about the basic knowledge related to disease as vertical integration curriculum. Their performance was evaluated by mini-CEX and theoretical examination, respectively. All subjects have completed the study. The difference of five factors (medical interview, physical examination, clinical judgment, organizational effectiveness, and competence) in mini-CEX between IBL, CBL, and LBL were statistically significant (p <0.05). Sample sizes of below, meets, and above the expectations of mini-CEX in different instructional groups were statistically significant (X² =17.842, p =0.001). The final exam scores in IBL group and the CBL group were significantly higher than that of LBL group (F =41.553, p =0.000). And the relationship of final exam score only in the IBL group was positive existed with medical interview (R =0.466, p =0.004), physical examination (R =0.328, p =0.048), professional attitude (R =0.366, p =0.026), and communication skill (R =0.412, p =0.011). Therefore, our study revealed the effect of IBL on the medical students' skills. It highlights IBL could improve the physical examination, organizational effectiveness, and competence and the application of basic knowledge. © 2018 International Union of Biochemistry and Molecular Biology, 46(5):417-423, 2018.

Synthesis of PbS and Ag2S Nanorods via Polyol Process

PbS and Ag2S nanorods have been synthesized using a polyol process in the presence of poly(vinylpyrrolidone) (PVP). First, the production of Pb or Ag was realized via the thermal decomposition of a lead/silver salt. Then the Pb or Ag precursor was directly combined with S power under heating, leading to the formation of the final products. The samples were characterized by X-ray powder diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM) and energy dispersive X-ray spectroscopy (EDS). PbS cubes and cubes with a hole in the center were prepared under different reaction conditions. Possible formation mechanisms of different PbS or Ag2S morphologies have briefly been discussed.

Synthesis and Electrochemical Performance of NiCO₂S₄ as Anode for Lithium-Ion Batteries

NiCO2S4 with different morphology was controllably fabricated by a facile hydrothermal and solvothermal route. The as-obtained samples were analyzed and characterized by X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), and scanning electron microscopy (SEM). The results reveal that the sample (NCS-1) prepared by hydrothermal method manifest a mixture of nanorods and nanospheres. The sample (NCS-2) synthesized by solvothermal process takes on spherical nanoparticles (NPs). It is found that the morphology of the sample has much influence on the electrochemical property. When applied as anode for lithium-ion batteries (LIBs), the NiCO2S4 NPs (NCS-2) possess the highest reversible discharge capacity of 1469.8 mAh g-1 compared with other two samples at the current density of 100 mA g-1 in the voltage window of 0.01-3 V. Additionally, it remains a specific capacity of 1163.7 mAh g-1 at a current density of 100 mAg-1 after 100 cycles. This excellent electrochemical performance arises from its unique mesoporous structure, which can reduce the transport lengths of both lithium ions and electrons. The mesoporous NiCO2S4 NPs show the great potential development of high-capacity anode materials for LIBs.

Downregulation of miR-218-5p promotes invasion of oral squamous cell carcinoma cells via activation of CD44-ROCK signaling

The invasion front of oral squamous cell carcinoma (OSCC) harbors the most aggressive cells of the tumor and is critical for cancer invasion and metastasis. MicroRNAs (miRNAs) play important roles in OSCC progression. In this study, we modelled the OSCC invasion front on a microfluidic chip, and investigated differences in miRNA profiles between cells in the invasion front and those in the tumor mass by small RNA sequencing. We found that miR-218-5p was downregulated in invasion front cells and negatively regulates OSCC invasiveness by targeting the CD44-ROCK pathway. Thus, miR-218-5p may serve as a useful therapeutic target for OSCC. Moreover, invasion front cell isolation based-on microfluidic technology provided a useful strategy for cancer invasion study.

[Role of Rac1 signaling pathway of azathioprine and peptidoglycan in the regulation of monocyte-macrophage apoptosis in Crohn's disease]

Objective: To evaluate the changes of macrophages and expression of Rac1 in the inflammatory site of Crohn's disease, and to investigate the effects of 6-thioguanine (6-TG) and peptidoglycan on apoptosis of human peripheral blood monocyte-macrophage by regulating Rac1 signaling pathway. Methods: Ten patients with Crohn's disease and eight healthy controls diagnosed were enrolled at Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital from January 2013 to January 2014. The number of macrophages, apoptosis and expression of Rac1 in the inflammation sites and non-inflammation sites of intestinal mucosa were detected in both patients and controls. Peripheral blood mononuclear cells (PBMCs) were sorted by CD₁₄ immunomagnetic beads. The apoptosis of monocytes, expression of Rac1 and related apoptosis signaling molecules were detected in patients treated with peptidoglycan, 6-TG and Rac1 inhibitor NSC23766 and another 15 healthy donors. Results: The number of macrophages and apoptotic cells significantly increased in the inflammatory group of Crohn's disease patients compared with the non-inflammatory group. The expression of PAK1, downstream molecular of Rac1 signaling pathway of macrophages was also significantly higher in the inflammatory group of Crohn's disease patients than that in healthy controls and non-inflammatory group. Compared with control group, anti-apoptotic signals (NF-κB, Bcl-xL and STAT-3) in PBMCs increased in the peptidoglycan group, while slightly decreased in 6-TG group. 6-TG and NSC23766 significantly promoted peptidoglycan-related anti-apoptosis [peptidoglycan group (8.6±3.7)%, peptidoglycan+ 6-TG group (42.0±2.7)%, peptidoglycan+ NSC23766 group (58.5±6.9)%, P<0.05]. Conclusions: Peptidoglycan plays a role in the pathogenesis of Crohn's disease by recruiting macrophages. However, 6-TG inhibits peptidoglycan-induced activation of Rac1 signaling pathway leading to macrophage apoptosis.

Discovery of a highly selective JAK3 inhibitor for the treatment of rheumatoid arthritis

Janus tyrosine kinase 3 (JAK3) is expressed in lymphoid cells and is involved in the signalling of T cell functions. The development of a selective JAK3 inhibitor has been shown to have a potential benefit in the treatment of autoimmune disorders. In this article, we developed the 4-aminopiperidine-based compound RB1, which was highly selective for JAK3 inhibition, with an IC₅₀ of value of 40 nM, but did not inhibit JAK1, JAK2 or tyrosine kinase 2 (TYK2) at concentrations up to 5 µM. Furthermore, RB1 also exhibited favourable selectivity against a panel of representative kinases. In a battery of cytokine-stimulated cell-based assays, this potent inhibitor of JAK3 activity with good selectivity against other kinases could potently inhibit JAK3 activity over the activity of JAK1 or JAK2 (over at least 100-fold). A combination of liquid chromatography-mass spectrometry (LC-MS) experiments validated that RB1 covalently modified the unique cysteine 909 residue in JAK3. In vivo, RB1 exerted significantly improved pathology in the joints of a collagen-induced arthritis mouse model. The reasonable pharmacokinetics properties (F = 72.52%, T1/2 = 14.6 h) and favourable results of toxicology experiments (LD₅₀ > 2 g/kg) suggest that RB1 has the potential to be an efficacious treatment for RA.

Associations of carboxypeptidase 4 with ALDH1A1 expression and their prognostic value in esophageal squamous cell carcinoma

Esophageal cancer is an aggressive disease with poor prognosis because of early metastasis when diagnosed and recurrence after surgery. This study is aimed at investigating the expression of carboxypeptidaseA4 (CPA4) and aldehyde dehydrogenase 1A1 (ALDH1A1) in esophageal squamous cell carcinoma (ESCC) tumor tissues and analyzed their association and clinical significance. The expression of CPA4 and ALDH1A1 was determined by immunohistochemistry using the corresponding primary antibodies on two commercial tissue arrays. High level of CPA4 was observed in 87/150 (58%) ESCC samples and was significantly associated with histologic grade, lymph node metastasis, and TNM Classification of Esophageal cancer stage. The expression level of ALDH1A1 was much higher in ESCC than their corresponding normal epithelial tissues, with 66% positive rate. And, high levels of ALDH1A1 were significantly associated with lymph nodes metastasis (P < 0.05) and TNM stage (P < 0.05). Correlation analysis showed the expression level of CPA4 positively correlated with that of ALDH1A1 (r = 0.416, P < 0.01). In Kaplan-Meier survival analysis, either CPA4 or ALDH1A1 was significantly correlated with poor overall survival of ESCC patients. Multivariate Cox regression model showed that high expression of CPA4 was an independent prognostic factor for ESCC patients. In conclusion, our present study demonstrated for the first time that CPA4 might be used as an independent poor prognostic factor in ESCC. This study demonstrated for the first time that CPA4 was aberrantly expressed in ESCC tissues. Overexpression of CPA4 was closely associated with the putative cancer stem cell marker ALDH1A1 and might be used as an independent prognostic factor in ESCC.