Artificial Photosynthetic System with Spatial Dual Reduction Site Enabling Enhanced Solar Hydrogen Production

Although S-scheme artificial photosynthesis shows promise for photocatalytic hydrogen production, traditional methods often overly concentrate on a single reduction site. This limitation results in inadequate redox capability and inefficient charge separation, which hampers the efficiency of the photocatalytic hydrogen evolution reaction. To overcome this limitation, a double S-scheme system is proposed that leverages dual reduction sites, thereby preserving energetic photo-electrons and holes to enhance apparent quantum efficiency. The design features a double S-scheme junction consisting of CdS nanospheres decorated with anatase TiO2 nanoparticles coupled with graphitic C3 N4 . The as-prepared catalyst exhibits a hydrogen evolution rate of 26.84 mmol g-1  h-1 and an apparent quantum efficiency of 40.2% at 365 nm. This enhanced photocatalytic hydrogen evolution is ascribed to the efficient charge separation and transport induced by the double S-scheme. Both theoretical calculations and comprehensive spectroscopy tests (both in situ and ex situ) affirm the efficient charge transport across the catalyst interface. Moreover, substituting the reduction-type catalyst CdS with other similar sulfides like ZnIn2 S4 , ZnS, MoS2 and In2 S3 further confirms the feasibility of the proposed double S-scheme configuration. The findings provide a pathway to designing more effective double S-scheme artificial photosynthetic systems, opening up fresh perspectives in enhancing photocatalytic hydrogen evolution performance.

Functional MXenes: Progress and Perspectives on Synthetic Strategies and Structure-Property Interplay for Next-Generation Technologies

MXenes are a class of 2D materials that include layered transition metal carbides, nitrides, and carbonitrides. Since their inception in 2011, they have garnered significant attention due to their diverse compositions, unique structures, and extraordinary properties, such as high specific surface areas and excellent electrical conductivity. This versatility has opened up immense potential in various fields, catalyzing a surge in MXene research and leading to note worthy advancements. This review offers an in-depth overview of the evolution of MXenes over the past 5 years, with an emphasis on synthetic strategies, structure-property relationships, and technological prospects. A classification scheme for MXene structures based on entropy is presented and an updated summary of the elemental constituents of the MXene family is provided, as documented in recent literature. Delving into the microscopic structure and synthesis routes, the intricate structure-property relationships are explored at the nano/micro level that dictate the macroscopic applications of MXenes. Through an extensive review of the latest representative works, the utilization of MXenes in energy, environmental, electronic, and biomedical fields is showcased, offering a glimpse into the current technological bottlenecks, such asstability, scalability, and device integration. Moreover, potential pathways for advancing MXenes toward next-generation technologies are highlighted.

Enhancing Photocatalytic Hydrogen Evolution by Synergistic Benefits of MXene Cocatalysis and Homo-Interface Engineering

Photocatalytic water splitting holds great promise as a sustainable and cost-effectiveness alternative for the production of hydrogen. Nevertheless, the practical implementation of this strategy is hindered by suboptimal visible light utilization and sluggish charge carrier dynamics, leading to low yield. MXene is a promising cocatalyst due to its high conductivity, abundance of active sites, tunable terminal functional groups, and great specific surface area. Homo-interface has perfect lattice matching and uniform composition, which are more conducive to photogenerated carriers' separation and migration. In this study, a novel ternary heterogeneous photocatalyst, a-TiO2 /H-TiO2 /Ti3 C2 MXene (MXTi), is presented using an electrostatic self-assembly method. Compared to commercial P25, pristine anatase, and rutile TiO2 , as-prepared MXTi exhibit exceptional photocatalytic hydrogen evolution performance, achieving a rate of 0.387 mmol h-1 . The significant improvement is attributable to the synergistic effect of homo-interface engineering and Ti3 C2 MXene, which leads to widened light absorption and efficient carrier transportation. The findings highlight the potential of interface engineering and MXene cocatalyst loading as a proactive approach to enhance the performance of photocatalytic water splitting, paving the way for more sustainable and efficient hydrogen production.

A Kind of (t, n) Threshold Quantum Secret Sharing with Identity Authentication

Quantum secret sharing (QSS) is an important branch of quantum cryptography. Identity authentication is a significant means to achieve information protection, which can effectively confirm the identity information of both communication parties. Due to the importance of information security, more and more communications require identity authentication. We propose a d-level (t,n) threshold QSS scheme in which both sides of the communication use mutually unbiased bases for mutual identity authentication. In the secret recovery phase, the sharing of secrets that only the participant holds will not be disclosed or transmitted. Therefore, external eavesdroppers will not get any information about secrets at this phase. This protocol is more secure, effective, and practical. Security analysis shows that this scheme can effectively resist intercept-resend attacks, entangle-measure attacks, collusion attacks, and forgery attacks.

Hybrid Exercise Program Enhances Physical Fitness and Reverses Frailty in Older Adults: Insights and Predictions from Machine Learning

PURPOSE

The declining physical condition of the older adults is a pressing issue. Wu Qin Xi exercise, despite being low-intensity, is highly effective among older adults. Inspired by its characteristics, we designed a new exercise program for frail older adults, combining strength, endurance, and Wu Qin Xi. Furthermore, we employed machine learning to predict whether frailty can be reversed in older adults after the intervention.

METHODS

A total of 181 community-dwelling frail older adults aged 65 years or older participated in this single-center, randomized controlled study, with 54.7% (n=99) being female. The study assessed the effectiveness of several exercise modalities in reversing frailty. The Fried's frailty criterion was used to assess the degree of frailty of the subjects. Participants were assigned a three-digit code 001-163 and randomly assigned (1:1:1) by computer to three different groups based on the study participant number: the Wu Qin Xi group (WQX), the strength exercise mixed with endurance exercise training group (SE), and the WQXSE hybrid exercise group incorporated the above two. Body composition and frailty-related physical fitness factors were measured before and after a 24-week intervention. The measurements included Body height, Body mass, Timed Up and Go Test (TUGT), grip strength assessment (GS), 6min walk test (6 min WT), and 10 m maximum walk speed (10 m MWS). Data were analyzed using repeated measures ANOVA to determine group and time interaction effects and machine learning models were used to predict program effectiveness.

RESULTS

A total of 163 participants completed the study, with 53.9% (n=88) of them being female. The two items, 10 m maximum walking speed (10 m MWS) and grip strength, were significantly affected by the interaction of group and time. Compared to the other two groups, the WQXSE group showed the most improvement in the item 10 m MWS. In addition, following 24 weeks of training, 68 (41.7%) of the initially frail older adults had reversed their frailty status. Among them, 19 (36.5%) were in the WQX group, 24 (44.4%) were in the WQXSE group, and 25 (43.9%) were in the SE group. The stacking model exhibited superior performance when compared to other algorithms.

CONCLUSION

A hybrid exercise regimen comprising the Wu Qin Xi routine and exercises focused on both strength and endurance holds the potential to yield greater improvements in the physical fitness of older adults, as well as reducing frailty. Leveraging a stacking model, it is possible to forecast the likelihood of older adults successfully reversing their frailty status following participation in a prevention exercise program.

[The effect of red blood cell folate on the prognosis of high-risk human papillomavirus infection: a community-based cohort study]

Objective: To investigate the effect of red blood cell folate on the prognosis of high-risk human papillomavirus (HR-HPV) infection. Methods: A total of 564 participants with low-grade cervical intraepithelial neoplasias (CINⅠ) were selected from the community-based married women cohort established in 2014. The general baseline information and factors related to HPV infection were collected. Meanwhile, HPV genotyping and levels of folate were measured. The subjects were divided into different levels of exposure group according to the folate levels and followed up for 24 months to observe the changes of HR-HPV infection status. There were four changes, including persistent infection, infection turned negative, from negative to positive and constant negative by comparing HR-HPV infection status at baseline and follow-up to 24 months. Results: 483 participators completed 24 months of follow-up observation, with a follow-up rate of 85.64% (483/564). The rates of persistent infection, infection turned negative, from negative to positive, and the constant negative were 52.45% (75/143), 47.55% (68/143), 19.71% (67/340), 80.29% (273/340), respectively. Our results demonstrated that the risk of persistent infection (aRR=2.50, 95%CI: 1.55-4.02) and from negative to positive (aRR=4.55, 95%CI: 2.52-8.23) in the low level of folate were significantly higher than that in the high level of folate, especially the risk of homotype persistent infection (aRR=2.72, 95%CI: 1.51-4.90). The risk of persistent infection (trend χ²=20.62, P<0.001), from negative to positive (trend χ²=31.76, P<0.001), persistent homotypic infection (trend χ²=20.09, P<0.001) increased with the decrease of red blood cell folate level. On the contrary, no similar results were found in persistent heterotypic infection. Conclusions: A low level of red blood cell folate could increase the risk of HR-HPV persistent infection and from negative to positive. In women with HR-HPV infection, the risk of persistent homotypic infection is higher.

[Effects of polycyclic aromatic hydrocarbons exposure on prognosis of high risk human papillomavirus infection: a prospective cohort study]

Objective: To investigate the effects of polycyclic aromatic hydrocarbons (PAHs) exposure on the prognosis of high risk human papillomavirus (HR-HPV) infection. Methods: In this prospective study, 564 patients with low-grade cervical intraepithelial neoplasia confirmed by pathology were selected from the natural cohort population established by our research group in Shanxi province in 2014. Based on the baseline data of demographic characteristics and factors related to HPV infection, the concentrations of 1-hydroxypyrene in urine samples of the patients were determined by high performance liquid chromatography to define the exposure level of PAHs. At baseline survey and follow-up after 24 months, flow-through hybridization was used to detect HPV infection types, and to evaluate the prognosis of HR-HPV (persistent infection, negative conversion, positive conversion and persistent negative status). Results: Of the 564 subjects, 483 completed the follow-up, with a follow-up rate of 85.6% (483/564). Among them, the persistent infection rate was 52.4% (75/143), the persistent homotype infection rate was 35.7% (51/143), the negative conversion rate was 47.6% (68/143), the positive conversion rate was 19.7% (67/340), and the persistent negative rate was 80.3% (273/340). The follow-up results showed that the persistent infection rate (aRR=3.22, 95%CI: 1.85-5.62) and positive conversion rate (aRR=2.84, 95%CI: 1.64-4.94) of HR-HPV in high PAHs exposure group were higher than those in low PAHs exposure group, while the persistent negative rate (aRR=0.55, 95% CI: 0.43-0.70) of HR-HPV in high PAHs exposure group were lower than those in low PAHs exposure group. Based on restrictive cubic spline analysis, the results showed that the effects of PAHs exposure on persistent HR-HPV infection and persistent homotype infection showed an ascending linear dose-response relationship, while on HR-HPV positive conversion and persistent negative status showed an ascending and declining nonlinear dose-response relationship respectively (P<0.01). Conclusions: High PAHs exposure could promote persistent HR-HPV infection and persistent homotypic infection. Reducing PAHs exposure might conducive to HR-HPV continuous negative maintenance. Active prevention and control of PAHs exposure is of great significance to prevent HR-HPV infection and persistent infection.

[Relationship between serum folate and CIN1 prognosis and its interaction with HR-HPV infection]

Objective: To evaluate the relationship between serum folate and the prognosis of cervical intraepithelial neoplasia grade I (CIN1) and the interaction between folate and high risk human papillomavirus (HR-HPV) infection. Methods: From a community-based married women cohort established in Jiexiu and Yangqu County of Shanxi Province from June to December 2014, a total of 564 eligible women with CIN1 by pathologically diagnosed were recruited. The pathological examination was performed again 12 months later. According to the prognosis of CIN1, participants were divided into CIN1 regression group, persistence and progression group, respectively. Nested case-control study was used to explore the relationship between serum folate and CIN1 prognosis, and additive model was used to analyze the interaction between serum folate and HR-HPV infection. Results: Among 564 CIN1 patients, 479 cases underwent pathological examination again, 331 were divided in CIN1 regression group and other 148 in persistence and progression group. The levels of serum folate in CIN1 regression group and persistence and progression group were (18.890±8.360) and (15.640±5.550) nmol/L, respectively, and the difference was statistically significant (Z=-6.937, P<0.001). HPV infection was detected in 154 patients, including 148 cases of HR-HPV infection and 6 cases of low risk human papillomavirus (LR-HPV) infection. Univariate analysis showed that there were significant differences in the age, passive smoking, frequency of pudendal cleaning, frequency of cleaning after sex, frequency of changing underwear, serum folate and HR-HPV infection between regression group and persistence and progression group (P<0.05). Multivariate logistic regression analysis showed that the frequency of pudendal cleaning (OR=0.422, 95%CI: 0.238-0.750), frequency of changing underwear (OR=0.574, 95%CI: 0.355-0.928), serum folate (13.06-16.78nmol/L: OR=4.806, 95%CI: 2.355-9.810; ≤13.05nmol/L: OR=8.378, 95%CI: 4.024-17.445), HR-HPV infection (OR=1.852, 95%CI: 1.170-2.933) were the independent influencing factors of CIN1 prognosis. Interaction analysis showed that the relative excess risk of low serum folate level and HR-HPV infection for the CIN1 persistence and progression was 4.992 (95%CI: 0.189-9.796), attributable proportion due to interaction was 0.552 (95%CI: 0.279-0.824), synergy index was 2.632 (95%CI: 1.239-5.588), aOR of serum folate≤16.78 nmol/L and HR-HPV infection positive was 9.055 (95%CI: 4.878-16.807). Conclusion: Low serum folate level could increase the risk of CIN1 persistence and progression, and might enhance the risk when combined with HR-HPV infection.

[Effect of dietary water-soluble vitamins on the poor prognosis of low-grade cervical intraepithelial neoplasia-a prospective cohort study]

Objective: To explore the effect of dietary water-soluble vitamins on the poor prognosis of low-grade cervical intraepithelial neoplasia (CINⅠ). Methods: A total of 564 participants with CINⅠ were selected from a community-based married women cohort established in 2014. The general baseline information was collected, and HPV genotyping was detected. A food frequency questionnaire was used to investigate dietary water-soluble vitamins' consumption and determine their exposure levels. The follow-up program was carried out for 12 months, and the regression, persistence, and progression of CINⅠ was determined according to histopathological results at 12-month. Results: The low-levels of dietary water-soluble vitamins could promote CINⅠ's persistence and progression, showing the increasing tendency of CINⅠ poor prognosis with the decrease of water-soluble vitamin levels. Especially folate, VB1, VB2, VB6, niacin, biotin, and VC (RR values were 15.22, 1.86, 1.92, 2.11, 2.98, 2.14, 2.19, respectively) played an important role. Considering the status of high-risk human papillomavirus (HR-HPV) infection, our results showed that the low levels of folate, niacin, biotin could promote the poor prognosis of CINⅠ. Conclusions: The low-level of dietary water-soluble vitamins could facilitate the poor prognosis of CINⅠ. In addition, folate, niacin, biotin were more effective on HR-HPV positive women.

[The optimal model of diagnosis to low-grade cervical intraepithelial neoplasia by combined detecting vaginal micro-environmental factors, based on the high-risk HPV infection]

Objective: To investigate the diagnostic value of different vaginal micro-environmental factors in low-grade cervical intraepithelial neoplasia (CIN Ⅰ) and determine the optimal model in high-risk human papillomavirus (HR-HPV) infection. Methods: A total of 926 women, including 623 with normal cervical (NC) condition and 303 CINⅠ patients, had undergone pathological examinations, and were enrolled in the study. All the women were from a community previously established cohort. Vaginal cleanliness, pH, H₂O₂, β-glucuronidase, coagulase, sialidase, and leukocyte esterase (LE) were detected by the combined detection method aerobic vaginitis/bacterial vaginosis in vaginal secretions. HPV genotyping was performed by using the flow-through hybridization technology. The data were analyzed by SAS 9.2 and SPSS 23.0. Results: The vaginal cleanliness, pH, sialidase, and LE were determined as the representative vaginal micro-environment factors by principal component analysis. Based on logistic regression theory to analyze the ROC curve, the results showed that the highest sensitivity was with pH value (76.2%), and the highest specificity was with sialidase (90.9%). The area under ROC curve were higher in combination detection modes of sialidase+LE (0.714), pH+sialidase+LE (0.719), vaginal cleanness+sialidase+LE (0.713) and pH+vaginal cleanness+sialidase+LE (0.709). According to HR-HPV infection status, the TOPSIS method was used to analyze the combined detection optimal model. Specifically, we found that the best diagnostic model was pH+sialidase +LE (C_i=0.585) in the HR-HPV positive group and vaginal cleanness+sialidase+LE (C_i=0.641) in the negative group. Conclusions: The combined detection of vaginal microenvironment factors could be used for auxiliary diagnosis for CINⅠ. It would be more effective when detecting pH, sialidase, and LE in HR-HPV positive women while vaginal cleanness, sialidase, and LE in HR-HPV negative women at the same time.

[Prognosis of high-risk HPV infection and its influences by vaginal micro-environmental factors]

Objective: To describe the characteristics of high-risk human papillomavirus (HR-HPV) infection and its influences by vaginal micro-environmental factors. Methods: A total of 421 women with HR-HPV infection and normal cervix diagnosed by pathology were selected from a community cohort established earlier by our research group for a 24-month follow-up. The baseline data were collected at enrollment. The vaginal micro-environmental factors were detected by using the combined detection kit of aerobic vaginitis and bacterial vaginosis. And the HPV was detected by using the flow-through hybridization technology. According to the HR-HPV infection status in baseline and 24 months of follow-up, with the prognosis characteristics of HR-HPV infection described, the impact of vaginal micro-environmental factors on the prognosis of HR-HPV infection was explored as well. Results: Among 390 HR-HPV infected women who completed 24 months of follow-up, the top five types of persistent HR-HPV infection rate appeared as HPV16 (24.1%), HPV58 (22.2%), HPV53 (21.7%), HPV52 (20.0%), and HPV39 (11.8%), respectively. The results showed that women with abnormal vaginal pH (aOR=1.74, 95%CI: 1.08-2.80), abnormal neuraminidase (aOR=2.70, 95%CI: 1.52-4.83), or abnormal leucocyte esterase (aOR=3.41, 95%CI: 2.13-5.44), the risk of HR-HPV persistent infection increased. The abnormalities of neuraminidase and leukocyte esterase could increase the risk of persistent infection of homotype and heterotypic HR-HPV. Conclusions: HPV16 was prone to persistent infection. Abnormalities of vaginal pH, neuraminidase, and leukocyte esterase might increase the risk of HR-HPV persistent infection. Both the abnormalities of neuraminidase and leukocyte esterase play an essential role in the HR-HPV persistent infection.

A Biomimetic Biphasic Scaffold Consisting of Decellularized Cartilage and Decalcified Bone Matrixes for Osteochondral Defect Repair

It is challenging to develop a biphasic scaffold with biomimetic compositional, structural, and functional properties to achieve concomitant repair of both superficial cartilage and subchondral bone in osteochondral defects (OCDs). This study developed a biomimsubchondraletic biphasic scaffold for OCD repair via an iterative layered lyophilization technique that controlled the composition, substrate stiffness, and pore size in each phase of the scaffold. The biphasic scaffold consisted of a superficial decellularized cartilage matrix (DCM) and underlying decalcified bone matrix (DBM) with distinct but seamlessly integrated phases that mimicked the composition and structure of osteochondral tissue, in which the DCM phase had relative low stiffness and small pores (approximately 134 μm) and the DBM phase had relative higher stiffness and larger pores (approximately 336 μm). In vitro results indicated that the biphasic scaffold was biocompatible for bone morrow stem cells (BMSCs) adhesion and proliferation, and the superficial DCM phase promoted chondrogenic differentiation of BMSCs, as indicated by the up-regulation of cartilage-specific gene expression (ACAN, Collagen II, and SOX9) and sGAG secretion; whereas the DBM phase was inducive for osteogenic differentiation of BMSCs, as indicated by the up-regulation of bone-specific gene expression (Collagen I, OCN, and RUNX2) and ALP deposition. Furthermore, compared with the untreated control group, the biphasic scaffold significantly enhanced concomitant repair of superficial cartilage and underlying subchondral bone in a rabbit OCD model, as evidenced by the ICRS macroscopic and O’Driscoll histological assessments. Our results demonstrate that the biomimetic biphasic scaffold has a good osteochondral repair effect.

Porous fish collagen for cartilage tissue engineering

Cartilage defects repair is still a challenge in clinical practice until now. Although many breakthroughs have been achieved in cartilage repair using tissue engineering technology, there are still no scaffolds available for large-scale clinical applications. Currently, fish collagen (FC) is a natural source that is considered as an alternative to mammal-derived collagen in engineering cartilage tissue due to its excellent biocompatibility, suitable biodegradability, lack of immunogenicity, rich sources, low cost and minimal risk of transmitting zoonoses, which implies great potential for use in cartilage regeneration. Herein, we successfully prepared three-dimensional porous FC scaffolds from three different concentrations of FC (0.5%, 1% and 2%) by freeze-drying technology. Our results indicated that increasing the FC concentration resulted in comparable levels of suitable biodegradability and good biocompatibility but lead to a concurrent decrease in pore size and porosity and a significant increase in water absorption capacity and mechanical properties; further, initial scaffold dimension was only sustained in the 2% FC concentration. Moreover, the in vivo immunological evaluation suggested that the FC scaffold evoke low immunogenicity. In addition, our results confirmed that the porous FC scaffold facilitated cartilage formation both in vitro and when placed subcutaneously in rabbits. The gross and autopsy outcomes at 12 weeks postoperation suggested that the porous FC scaffold achieved superior cartilage repair effect than what was observed in the empty group with no scaffold. Overall, our results demonstrated that porous FC scaffolds represent a promising prospective natural material for use in engineering cartilage for clinical applications.

Influence of Insurance Status on Curve Magnitude in Adolescent Idiopathic Scoliosis in Mainland China

STUDY DESIGN

Retrospective cohort study.

OBJECTIVES

To determine whether there is an association between insurance status and curve magnitude in idiopathic scoliosis pediatric patients in mainland China.

METHODS

Medical records of patients with adolescent idiopathic scoliosis in 4 tertiary spine centers across China from January 2013 to December 2017 were analyzed. Data was extracted on insurance status, curve magnitude, recommended treatment at presentation, source of referral, and treatment initiated. Additional information was collected for patients requiring corrective surgery, including time from recommendation for surgery to surgery and clinically relevant parameters such as, postoperative complications, and pre-/postoperative Scoliosis Research Society-22 scores were also collected for patients requiring corrective surgery.

RESULTS

Of the 1785 patients included, 1032 were Urban Resident Basic Medical Insurance Scheme (URBMS) insured and 753 were New Rural Cooperative Medical Scheme (NRCMS) insured. NRCMS patients presented with a larger major curve than URBMS patients (32.9° ± 15.1° vs 29.3° ± 12.6°, P = .028). For patients having surgery recommended, NRCMS patients presented with a larger mean Cobb angle at the first presentation (57.7° vs 50.9°, P < .0001) and at time of surgery (61.3° vs 52.2°, P < .0001), and experienced a significantly longer time from surgery recommendation to decision for surgery. Complication rates were comparable between the 2 groups, except for pulmonary complications (NRCMS 7.3% vs URBMS 2.8%, P = .04). Postoperatively, patients covered by NRCMS insurance experienced greater overall improvement in health-related quality of life and were less satisfied with the treatments.

CONCLUSIONS

This study shows that health insurance may influence the severity of scoliosis on presentation, with implications on early diagnosis and surgery time.

Transfer of Sciatic Nerve Motor Branches in High Femoral Nerve Injury: A Cadaver Feasibility Study and Clinical Case Report

BACKGROUND

Femoral nerve injury causes knee dysfunction, and high femoral nerve injury is difficult to repair.

OBJECTIVE

To evaluate the anatomic feasibility of transferring the sciatic nerve motor branches in high femoral nerve injury.

METHODS

The femoral nerve was exposed in both lower extremities of 3 adult fresh-frozen cadavers; each branch was noninvasively dissected to its proximal nerve fiber intersection point and distal muscle entry point. The branches of the sciatic nerve were also exposed. The length, diameter, and number of myelinated fibers were measured in each femoral and sciatic nerve branch. The feasibility of tension-free direct suture between the femoral and sciatic nerve branches was evaluated. One patient was treated with transfer of a nerve branch innervating the semitendinosus muscle to the femoral nerve branch and was followed up for 18 mo.

RESULTS

The diameters and numbers of myelinated fibers in the femoral nerve branches matched those of the sciatic nerve branches. In the single patient, a combined femoral nerve bundle (comprising the rectus femoris and vastus lateralis branches) was used as a graft. The branch of the sciatic nerve was sutured with the muscle branch of the femoral by using a sural nerve as a nerve graft. The knee joint straightening strength reached medical research council grade 4+.

CONCLUSION

The proximal motor branches of the sciatic nerve may be transferred as donor nerves to repair high femoral nerve injury. A femoral nerve bundle comprising the rectus femoris and vastus lateralis branches may be used as the receptor nerve.

Noninvasive prenatal diagnosis for pregnancies at risk for β-thalassaemia: a retrospective study

OBJECTIVE

To evaluate the clinical feasibility of noninvasive prenatal diagnosis (NIPD) for β-thalassaemia using circulating single molecule amplification and re-sequencing technology (cSMART).

DESIGN

Through carrier screening, 102 pregnant Chinese couples carrying pathogenic HBB gene variants were recruited to the study. Pregnancies were managed using traditional invasive prenatal diagnosis (IPD). Retrospectively, we evaluated the archived pregnancy plasma DNA by NIPD to evaluate the performance of our cSMART assay for fetal genotyping.

SETTING

Chinese prenatal diagnostic centres specialising in thalassaemia testing.

POPULATION

Chinese carrier couples at high genetic risk for β-thalassaemia.

METHODS

Fetal cell sampling was performed by amniocentesis and HBB genotypes were determined by reverse dot blot. NIPD was performed by a newly designed HBB cSMART assay and fetal genotypes were called by measuring the allelic ratios in the maternal cell-free DNA.

MAIN OUTCOME MEASURES

Concordance of HBB fetal genotyping between IPD and NIPD and the sensitivity and specificity of NIPD.

RESULTS

Invasive prenatal diagnosis identified 29 affected homozygotes or compound heterozygotes, 54 heterozygotes and 19 normal homozygotes. Compared with IPD results, 99 of 102 fetuses (97%) were correctly genotyped by our NIPD assay. Two of three discordant samples were false positives and the other sample involved an incorrect call of a heterozygote carrier as a homozygote normal. Overall, the sensitivity and specificity of our NIPD assay was 100% (95% CI 88.06-100.00%) and 97.26% (95% CI 90.45-99.67%), respectively.

CONCLUSIONS

This study demonstrates that our cSMART-based NIPD assay for β-thalassaemia has potential clinical utility as an alternative to IPD for pregnant HBB carrier couples.

TWEETABLE ABSTRACT

A new noninvasive test for pregnancies at risk for β-thalassaemia.

Exploring the Pathological Role of Collagen in Paravertebral Muscle in the Progression of Idiopathic Scoliosis

BACKGROUND

Paravertebral muscle (PVM) is considered as a contributing factor of idiopathic scoliosis (IS); collagen is crucial for maintaining the mechanical properties of PVM, but only a few researches have described this field. In this study, we observed the muscle stiffness of PVM and the curvature of the spine by adjusting the content of collagen in PVM of rats and explored the role of collagen in the progression of IS.

METHODS

32 female Sprague Dawley rats were randomly divided into four groups: neutralizing antibody (NA) group (group 1), normal control group (group 2), IS group (group 3), and IS with NA group (group 4). TGF-β1 NA was injected into PVM in group 1 and group 4, while Normal saline in group 2 and group 3. The Cobb angle and muscle stiffness were measured before and after injection; the rats were sacrificed at one week after injection, and performed histological, Western Blot, and qRT-PCR examinations.

RESULTS

X-rays showed that scoliosis occurred in group 1 and relieved in group 4. The stiffness of PVM was decreased significantly on the convex side in group 1, while on the concave side in group 4. The expression of TGF-β1 and COL1 on the concave side in IS rats (group 3) was significantly increased than that in normal rats (group 2), the concentration of COL1 and COL3 in group 3 was significantly higher than that in group 2, and the addition of TGF-β1 NA significantly downregulated COL1 and COL3 in group 1 and group 4. The concentration of COL1 in convex PVM was negatively related to Cobb angle in group 1 and group 2, and in concave PVM was positively related to Cobb angle in group 3 and group 4. However, no significant correlation was found between COL3 and Cobb angle in group 3 and group 4.

CONCLUSIONS

Asymmetric biomechanical characteristics of PVM was an important etiological factor of IS, which was directly correlated with collagen, it could be adjusted by local intramuscular injecting of TGF-β1 NA, and finally had an effect on the shape of the spine.

Are Linear Measurements of the Nucleus Basalis of Meynert Suitable as a Diagnostic Biomarker in Mild Cognitive Impairment and Alzheimer Disease?

BACKGROUND AND PURPOSE

Cell loss within the nucleus basalis of Meynert is an early event in Alzheimer disease. The thickness of the nucleus basalis of Meynert (NBM) can be measured on structural MR imaging. We investigated NBM thickness in relation to cognitive state and biochemical markers.

MATERIALS AND METHODS

Mean bilateral nucleus basalis of Meynert thickness was measured on coronal T1-weighted MR imaging scans from the Alzheimer's Disease Neuroimaging Initiative dataset. Three hundred and fifteen scans (80 controls, 79 cases of early mild cognitive impairment, 77 cases of late mild cognitive impairment and 79 cases of Alzheimer disease) were assessed. Alzheimer's Disease Assessment Scale-Cognitive scores, CSF tau, and amyloid quantification were extracted. Group differences in NBM thickness, their correlates and measurement reliability were assessed.

RESULTS

Mean NBM thickness ± SD progressively declined from 2.9 ± 0.3, 2.5 ± 0.3, and 2.3 ± 0.3 to 1.8 ± 0.4 mm in healthy controls, patients with early mild cognitive impairment, late mild cognitive impairment and Alzheimer disease respectively (P < .001). NBM thickness was negatively correlated with Alzheimer's Disease Assessment Scale-Cognitive scores (r = -0.53, P < .001) and weakly positively correlated with CSF amyloid (r = 0.250, P < .001) respectively. No association with CSF tau was found. NBM thickness showed excellent diagnostic accuracy to differentiate Alzheimer disease (area under the curve, 0.986) and late mild cognitive impairment from controls (area under the curve, 0.936) with excellent sensitivity, but lower specificity 66.7%. Intra- and interrater reliability for measurements was 0.66 and 0.47 (P < .001).

CONCLUSIONS

There is progressive NBM thinning across the aging-dementia spectrum, which correlates with cognitive decline and CSF markers of amyloid-β pathology. We show high diagnostic accuracy but limited reliability, representing an area for future improvement. NBM thickness is a promising, readily available MR imaging biomarker of Alzheimer disease warranting diagnostic-accuracy testing in clinical practice.

Large-scale network dysfunction in vascular cognitive disorder supports connectional diaschisis in advanced arteriosclerosis

BACKGROUND AND PURPOSE

The interrelation of cognitive performance, cerebrovascular damage and brain functional connectivity (FC) in advanced arteriosclerosis remains unclear. Our aim was to investigate the associations between FC, white matter damage and cognitive impairment in carotid artery disease.

METHODS

Seventy-one participants with a recent cerebrovascular event and with written informed consent underwent resting-state functional magnetic resonance imaging and the Addenbrooke's Cognitive Examination - Revised (ACE-R). Network and inter-hemispheric FC metrics were compared between cognitively normal and impaired subjects, and interrelated with cognition. In order to explore the nature of FC changes, their associations with microstructural damage of related white matter tracts and cognitive performance were investigated, followed by mediation analysis.

RESULTS

Participants with global cognitive impairment showed reduced FC compared to the cognitively intact subjects within the central executive network (CEN), and between hemispheres. Patients with executive dysfunction had decreased CEN FC whilst patients with memory loss demonstrated low FC in both the CEN and the default mode network (DMN). Global performance correlated with connectivity metrics of the CEN hub with DMN nodes, and between hemispheres. Cingulum mean diffusivity (MD) was negatively correlated with ACE-R and CEN-DMN FC. The cingulum MD-cognition association was partially mediated by CEN-DMN FC.

CONCLUSIONS

Long-range functional disconnection of the CEN with DMN nodes is the main feature of cognitive impairment in elderly subjects with symptomatic carotid artery disease. Our findings provide further support for the connectional diaschisis concept of vascular cognitive disorder, and highlight a mediation role of functional disconnection to explain associations between microstructural white matter tract damage and cognitive impairment.

Cerebral blood flow abnormalities in neuropsychiatric systemic lupus erythematosus

OBJECTIVE

To investigate the clinical characteristics, imaging changes and early diagnostic methods of neuropsychiatric systemic lupus erythematosus (NPSLE).

METHODS

Thirty-five SLE patients, of which 16 had overt neuropsychiatric symptoms, underwent examination for multiple autoantibodies, including anti-double-stranded DNA (anti-dsDNA) antibody, anti-nucleosome antibody, anti-cardiac-phospholipid antibody (aCL)-IgG, aCL-IgM, anti-β2-glycoprotein I antibody and anti-ribosomal P antibody, and the SLEDAI score of every patient was recorded. All patients further received neuropsychological tests, including the Mini-Mental State Examination, the Self-Rating Anxiety Scale and the Self-Rating Depression Scale. Imaging examination using 3D arterial spin labeling was performed on 3.0 T MRI scanners. After processing the 3D arterial spin labeling image, the cerebral blood flow map was obtained and the cerebral blood flow value was calculated.

RESULTS

The values of anti-dsDNA, anti-nucleosome antibody, aCL-IgG and anti-β2-glycoprotein I antibodies were significantly higher in the NPSLE group than those in the SLE group. The SLEDAI scores of the NPSLE group were significantly higher than those of the SLE group. There were no significant differences between the NPSLE group and the SLE group in the directional ability, memory, attention, numeracy, recall ability or language ability scores on the Mini-Mental State Examination scale. Furthermore, there were no symptoms of anxiety or depression in any of the patients, according to the Self-Rating Anxiety Scale and Self-Rating Depression Scale. In the 35 patients with SLE, decreases in blood perfusion were seen in some areas, and were unilateral and asymmetrically distributed. There was obvious asymmetry between sides in areas including the frontal lobe, temporal lobe, parietal lobe and occipital lobe. The incidence of perfusion decreases in frontal lobe in the NPSLE group was significantly higher than in the SLE group.

CONCLUSION

Neurological lesions in SLE patients can be detected by arterial spin labeling. Cerebral blood flow abnormalities may be helpful for the early diagnosis of neurological lesions in NPSLE.

A novel phytoextraction strategy based on harvesting the dead leaves: Cadmium distribution and chelator regulations among leaves of tall fescue

The treatment of large amount of hazardous plant residues from phytoextraction is costly and has been a burden for the society. This experiment was designed to evaluate the possibility of cadmium (Cd) phytoextraction by harvesting the dead leaves instead of the whole plant in tall fescue (Festuca arundinacea). Results showed that Cd was preferentially distributed in the senescent and dead leaves. EDTA, DTPA and EGTA enhanced Cd accumulations in the dead leaves which could be associated to the increase of the water-soluble inorganic Cd and Cd-organic acid complexes in shoots. The dead leaves were only 12.6-16.3% of the total shoot biomass but accumulated 73.4-87.2% of the total shoot Cd. The results indicate that a novel strategy of Cd phytoextraction based on harvesting the dead leaves is feasible to save the high treatment cost of hazardous plant residues while maintaining the acceptable phytoextraction efficiency.

Transferring of femoral nerve motor branches for high-level sciatic nerve injury: a cadaver feasibility study

BACKGROUND

Sciatic nerve injuries cause significant disability. We propose here a novel reconstructive procedure of transferring the motor branches of the femoral nerve as donor nerves to reconstruct both the peroneal and tibial nerve function as a novel approach to treat high sciatic nerve injury.

METHODS

The autopsies of donor nerves (vastus lateralis nerve branch (VLN), vastus medialis nerve branch (VMN), saphenous nerve (SAN)) and respective recipient nerves (deep peroneal nerve branch (DPN), medial gastrocnemius nerve branch (MGN), sural nerve (SN)) were conducted in six fresh-frozen lower limbs. The distance between the origin or bifurcation points of the nerves to the head of fibula and the diameter of the end at the coaptation site were measured. The feasibility of tensionless direct suturing or grafting between the donor nerves and the recipient was evaluated. Finally, the nerve end at the coaptation site was harvested for observation with toluidine blue staining and nerve fiber count.

RESULTS

The mean diameter of the VMN, VLN, MGN, DPN, SAN, and SN nerves were 1.5 ± 0.1, 1.4 ± 0.1, 1.3 ± 0.1, 2.3 ± 0.1, 2.1 ± 0.3, and 1.3 ± 0.2 mm, respectively. Histological observation showed that the abovementioned six nerve bundles had a respective nerve fiber number of 392 ± 27, 205 ± 520, 219 ± 67, 394 ± 50, 308 ± 77, and 335 ± 49. A total of 5/6 specimens needed grafting for a length ranging from 5 to 15 cm to bridge the VMN-MGN, 6/6 needed a graft length of 10-20 cm for VLN-DPN bridging, and 2/6 needed a graft length of 0-4 cm for SAN-SN bridging.

CONCLUSION

The study demonstrated the feasibility of the transferring femoral nerve branches to sciatic nerve branches to restore the function for sciatic injury.

A clinical comparison study of three different methods for treatment of transverse patellar fractures

BACKGROUND

Tension bands structures are widely used to treat transverse patellar fractures. However, many implants-related complications have been reported. The purpose of this study is to evaluate effects and compare complications of three methods used to treat transverse patellar fractures, including titanium cable tension bands, compression screws with titanium cable cerclage, and X-shaped plating technique.

METHODS

From January 2010 to March 2016, 120 cases of transverse patellar fracture received open reduction and internal fixation with one of three methods: titanium cable tension band (group A), compression screws with titanium cable cerclage (group B), and X-shaped plating technique (group C). Of these, 108 cases were followed for >2 years. Clinical and radiographic data were retrospectively collected and statistically compared.

RESULTS

Final analysis included 108 patients (n = 38 in group A, 36 in B, and 34 in C). Reduction was satisfactory in all patients after surgery. No significant differences were noted in age, gender, time from injury to surgery, postoperative articular step-off, Lysholm score, and range of motion at 24 months among all groups. At final follow-up, 12 (31.6%) symptomatic implant complications were encountered in group A, along with 6 (16.7%) and 2 (5.9%) in groups B and C, respectively (p < 0.05).

CONCLUSION

All three methods could achieve the goal of rigid fixation and early functional rehabilitation. However, the X-plate technique had the lowest risk of symptomatic implant complications and could thus be a safe and effective alternative for internal fixation of transverse patellar fractures.

[Biomechanics test of fixation of star-shaped six-part patellar fractures with petal-shaped poly-axial locking plate]

Objective

To compare the biomechanical difference between petal-shaped poly-axial locking plate and tension band wire cerclage in fixing star-shaped 6-part patellar fractures in cadaver model, and provide the experimental data for clinical use.

Methods

The paired 12 knee specimens from 6 human cadavers were randomly divided into 2 groups (the control group and the test group) after a star-shaped 6-part patellar fracture model was established. The specimens were weighted, and the control group was fixed with tension band wire cerclage and the test group was fixed with petal-shaped poly-axial locking plate. The specimens were connected to CMT5105 biomechanics test machine by a customized fixture, the total fracture gap of patellar fracture blocks was measured before testing. The knee extensor load test was performed to record the extensor load of knees at 90° flexion to extension. Then the anti gravity physiological knee extension process at 90° flexion was stimulated according to the knee extensor load. The cyclic times until failure and the total fracture gap of patellar fracture blocks after failure were recorded.

Results

The specimens weight and the total fracture gap of patellar fracture blocks before testing between 2 groups had no significant difference ( t=0.410, P=0.690; t=0.650, P=0.530). In the biomechanical test, there was no significant difference of knee extension load between 2 groups ( t=0.490, P=0.638). The total fracture gap after failure in test group was significantly smaller than that in control group ( t=3.026, P=0.013), and the cyclic times until failure in test group was significantly more than that in control group ( t=2.277, P=0.046). The failure reasons in control group were all the wires slipped off the Kirschner wires, while the failure reasons in test group were the screws pulled out from the upper pole in 5 cases (83.3%) and from the lower pole in 1 case (16.7%).

Conclusion

The petal-shaped poly-axial locking plate has better biomechanical stiffness to fix the star-shaped 6-part patellar fractures when compared with tension band wire cerclage method. However, this type of fracture is a serious comminuted type, and the early excessive activity still carries the risk of displacement.

[A finite element analysis of petal-shaped poly-axial locking plate fixation in treatment of Y-shaped patellar fracture]

Objective

To establish the finite element model of Y-shaped patellar fracture fixed with titanium-alloy petal-shaped poly-axial locking plate and to implement the finite element mechanical analysis.

Methods

The three-dimensional model was created by software Mimics 19.0, Rhino 5.0, and 3-Matic 11.0. The finite element analysis was implemented by ANSYS Workbench 16.0 to calculate the Von-Mises stress and displacement. Before calculated, the upper and lower poles of the patella were constrained. The 2.0, 3.5, and 4.4 MPa compressive stresses were applied to the 1/3 patellofemoral joint surface of the lower, middle, and upper part of the patella respectively, and to simulated the force upon patella when knee flexion of 20, 45, and 90°.

Results

The number of nodes and elements of the finite element model obtained was 456 839 and 245 449, respectively. The max value of Von-Mises stress of all the three conditions simulated was 151.48 MPa under condition simulating the knee flexion of 90°, which was lower than the yield strength value of the titanium-alloy and patella. The max total displacement value was 0.092 8 mm under condition simulating knee flexion of 45°, which was acceptable according to clinical criterion. The stress concentrated around the non-vertical fracture line and near the area where the screws were sparse.

Conclusion

The titanium-alloy petal-shaped poly-axial locking plate have enough biomechanical stiffness to fix the Y-shaped patellar fracture, but the result need to be proved in future.

Mesiotemporal atrophy and hippocampal diffusivity distinguish amnestic from non-amnestic vascular cognitive impairment

Background and purpose

The role of clinical factors, cerebral infarcts and hippocampal damage in vascular cognitive impairment (VCI) subtypes remains unclear.

Methods

Non‐demented patients with carotid stenosis and recent transient ischemic attack/stroke had cognitive assessment and brain magnetic resonance imaging (MRI). Amnestic VCI was defined as memory impairment; non‐amnestic VCI was any other subdomain impairment. Associations of MRI metrics [log‐transformed total ischemic lesion load (log TILL), mesiotemporal atrophy (MTA) score, hippocampal mean diffusivity (hipMD)] with cognitive performance were assessed.

Results

A hundred and eight patients, 47 with amnestic VCI and 21 with non‐amnestic VCI, were assessed. A higher MTA (odds ratio 12.89, P = 0.001) and left hipMD (odds ratio 4.43, P = 0.003) contributed to amnestic VCI versus normal. Age‐adjusted fluency correlated with log TILL (P = 0.002). Age‐adjusted memory was associated with left hipMD (P = 0.001), MTA (P < 0.001) but not log TILL (P = 0.14). Left hipMD, MTA and smoking showed classification potential between amnestic VCI versus normal (area 0.859, P < 0.001).

Conclusions

Neuroimaging assists stratification in amnestic VCI characterized by hippocampal changes and in non‐amnestic VCI by higher ischemic burden. MTA and hippocampal diffusivity show diagnostic biomarker potential.

IL-22 Impedes the Proliferation of Schwann cells: Transcriptome Sequencing and Bioinformatics Analysis

Schwann cells (SCs) proliferation is crucial for nerve regeneration following nerve injury. This study aims to investigate effects of interleukin-22 (IL-22) on SCs proliferation in vitro, as well as the corresponding mechanism. Rat SCs were treated with 100 ng/ml rat IL-22 for 48 h, and cell proliferation and apoptosis were detected using fluorescent staining and flow cytometry. After transcriptome sequencing, raw reads were filtered and mapped to reference genome rn5. Then, differentially expressed genes (DEGs) and long non-coding RNAs (DElncRNAs) between IL-22 and control groups were identified (tool: Cuffdiff). Functional and pathway enrichment analyses were performed (tool: GOFunction), and protein-protein interaction (PPI) network was constructed (tool: STRING and Cytoscape). Furthermore, Pearson's correlations between DEGs and DElncRNAs were analyzed, and regulatory network of DEGs, DElncRNAs, and transcription factors (TFs) was constructed. IL-22 significantly inhibited proliferation (p value < 0.05) and promoted apoptosis of Schwann cells. Totally, 932 DEGs and 118 DElncRNAs were identified, among which Ccl2 and Ccna2 were hub genes in PPI network. Up-regulated DEGs were enriched in apoptosis related terms, whereas down-regulated DEGs were enriched in proliferation related terms. DElncRNAs like NONRATT023505, NONRATG020400, and NONRATT022748 were correlated with multiple DEGs enriched in cell cycle and division. Moreover, up-regulated TFs Egr1, Cebpd, and Atf4 play crucial roles in regulatory network, and NONRATG020400-Cebpd-Ccl2, NONRATT023505/NONRATT022748-Atf4-Ccna2, and NONRATT022748-Egr1-Id1/Aldoc/Eno2/F3/Serpine1 regulatory pathways were identified in SCs after IL-22 treatment. IL-22 might influence SCs proliferation and apoptosis via regulating lncRNA-TF-gene pathways in SCs. However, more studies are required to confirm these results.

MicroRNA-203 inhibits tumour growth and metastasis through PDPN

OBJECTIVE

MicroRNAs play an important role in regulating hypopharyngeal cancer development. miR-203 has been previously shown to possess antitumour capabilities in many cancers, but not in hypopharyngeal cancer.

DESIGN

Using human normal and hypopharyngeal cancer specimens, we explored the expression levels of miR-203 in the two groups and further correlated them with different stages of cancer and lymph node metastasis.

SETTING AND PARTICIPANTS

Applying human pharynx FaDu cancer cells and lentiviral transduction technique, we investigated the effects of miR-203 on cancer cell viability, migration and invasion. Moreover, we studied the novel relationship between miR-203 and podoplanin (PDPN) in hypopharyngeal cancer.

RESULTS

The downregulated levels of miR-203 in human hypopharyngeal cancer tissues were associated with advanced cancer stages and lymph node metastasis. High levels of miR-203 inhibited cell viability, migration and invasion of hypopharyngeal cancer cells. Further studies suggested miR-203 directly targeted and inhibited PDPN expression. PDPN silencing suppresses hypopharyngeal cancer cell abilities. In addition, PDPN overexpression was able to reverse miR-203 inhibitory effects on cell viability, migration and invasion.

CONCLUSION

PDPN acts as an oncogene to promote hypopharyngeal cancer cell viability, migration and invasion. miR-203 directly targets PDPN to suppress its expression, thus exerting inhibitory effects on cancer metastasis.

MicroRNA-1280 modulates cell growth and invasion of thyroid carcinoma through targeting estrogen receptor α

Thyroid cancer (TC) is one of the most common endocrine malignancies, with a steadily increasing incidence and lethality over the last several decades. ERα is a nuclear hormone receptor that has a key role in different cellular process and participates in the development and progression of thyroid cancer. ERα is the predicted target gene of microRNA-1280 (miR-1280). The present study was designed to delineate the role and underlying mechanism of miR-1280 in regulating thyroid cancer through targeting ERα. In our study, we analyzed the expression level of miR-1280 in thyroid cancer and detected significantly lower miR-1280 levels in TC tissue and cell lines compared with adjacent normal tissue or healthy cell line. We then overexpressed miR-1280 by miRNA mimic transfection and inhibited miR-1280 by miRNA inhibitor transfection. The inhibition of miR-1280 significantly elevated proliferation and invasion ability, whereas overexpression of miR-1280 inhibited cell growth and invasion in TC cells. Additionally, the luciferase reporter assay confirmed a targeting reaction between miR-1280 and ERα. Furthermore, overexpression of miR-1280 inhibited ERα and ERK pathway expression in TC cells, indicating that miR-1280 acts as a tumor suppressor by inhibiting the expression of ERα. Taken together, we demonstrated that overexpressed miR-1280 levels in TC cells may promote cell proliferation and invasion by inhibiting ERα, which might provide a new therapeutic target for thyroid cancer.

The association between high-sensitivity C-reactive protein concentration and diabetic nephropathy: a meta-analysis

OBJECTIVE

To explore the association between high-sensitivity C-reactive protein (hs-CRP) concentration and diabetic nephropathy (DN).

MATERIALS AND METHODS

We systematically searched Pubmed, Medline and Embase databases up to September, 2014 for the relevant studies. Heterogeneity across studies was evaluated by Cochran's Q test and I2 statistic. The standard mean difference (SMD) and the corresponding 95% confidence interval (CI) were combined to evaluate the effect size. Sensitivity analysis was also performed by omitting each study to evaluate the stability of the results. In addition, publication bias was tested by Egger's test.

RESULTS

A total of 11 studies containing 1 331 cases and 1 779 controls were included in this study. Significant heterogeneities were observed in our results. The result of meta-analysis showed that the hs-CRP concentrations in DN patients were significantly higher than that in controls of healthy people and diabetes mellitus (DM) patients without nephropathy. In addition, the hs-CRP concentration in macroalbuminuria (D3) group was significantly higher than that in microalbuminuria (D2) group and non-albuminuria group (D1). Sensitivity analysis revealed that the results were stable. As well, no publication bias was observed in our results.

CONCLUSIONS

We suggest that hs-CRP concentration can be an indicator of DN in DM patients.

Tetracycline-encapsulated P(3HB) microsphere-coated 45S5 Bioglass(®)-based scaffolds for bone tissue engineering

Bioglass(®)-based scaffolds for bone tissue engineering have been developed, which can also serve as carriers for drug delivery. For this, P(3HB) microspheres (PMSs) loaded with tetracycline were fabricated and immobilised on the scaffold surfaces by a modified slurry dipping technique. The sustained drug delivery ability in simulated body fluid was confirmed by using UV-Vis absorption spectroscopy measurements. The MTT assay using mouse fibroblast cells provided evidence that the tetracycline loaded microspheres produced in this study show limited cytotoxicity. The scaffolds developed in this work provide mechanical support, adequate 3D surface roughness, bioactivity and controlled drug delivery function, and are thus interesting candidates for bone tissue engineering applications.

Percentage of circulating CD8+ T lymphocytes is associated with albuminuria in type 2 diabetes mellitus

T lymphocytes have been demonstrated to play a role in the development of diabetic proteinuria. However, the alteration of circulating T lymphocytes has not been investigated in a type 2 diabetic cohort. A cross-sectional study was conducted in Peking University Aerospace Center Hospital. 510 participants were type 2 diabetes mellitus, 30-70 years of age. Patients with immune disease, medical conditions that affect immune function, infection, or end-organ damage were excluded. The percentage of circulating CD8+ T lymphocytes was significantly associated with albuminuria in the cohort. The impact of albuminuria to CD8+ T lymphocytes in a multivariate linear regression model was indicated by the B- coefficient (95% confidence interval) 1.812 (0.204-3.421, P=0.03). Our data first showed that the percentage of circulating CD8+ T cells is associated with albuminuria in type 2 diabetes mellitus, which may support the rationality of systemic inhibition of T lymphocytes in treating albuminuria in these patients.

Abstract P4-11-10: A Study of Intraoperative Radiotherapy with Electrons in Breast-Conserving Surgery in China: 3 Year Results

Background:The standard treatment for most localised breast cancer patients is the breast-conservating sugery followed by postoperative radiation worldwide. Preliminary studies of intraoperative radiotherapy with electrons(ELIOT) in selected patients, mainly in Europe since 1999, have shown good local control, less toxicity and satisfatory cosmetic apperance. However few studies have been conducted among non-western populations. To investigate the feasibility of ELIOT in China, we introduced ELIOT in selected early breast cancer patients. Risk of local relapse is the main outcome objective, toxicity and cosmetic results are also studied.

Patients and Methods:From June 2007 to May 2010, 51 patients diagnosed with unifocal breast carcinoma up to a diameter of 3cm received a wide excision of the primary tumor followed by a radiotherapy of 21Gy delivered to the breast tissue at the surface of the tumor bed, biologically equivalent to 58 to 60 Gy in standard fractionation.

The median age of the treated patients was 47 years, with 38/51(74.5%) patients younger than 50. 8 patients(15.7%) were found to have positive axillary I-nodes(six patients had one node involved, one patient had two and one had three positive nodes). Pathologic free margins ≥10 mm were obtained in all patients. Patients were evaluated semiannunally after surgery, and thereafter every 6 months for cosmetic results, complications and other events.

Results: After a follow-up from 4 to 36 months(median time12 months), 3 patients developed fat deliquescence, 16 patients showed wound edema and excess fluid and no one had incision infection or hematoma. Two patients developed local relapses. One was comfirmed unrecognised multi-focal cancer in other quadrants of the breast remain dormant. The other patient was confirmed ipsilateral positive axillary III-nodes and no relapse was found in the same quadrant. Neither contralateral breast cancer nor distant metastases were observed. No replase was found in patients aged &lt;50. Accodring to the JCRT standard, cosmetic result was excellent in 73.1% and 90.9% patients at one year and two year checkup respectively, and good was found in 15.4% and 9.1% patients.

Conclusion:The incidence of breast cancer remains to increase in China with the aging of society and changes of lifestyle, and the highest incidence is found in the age group 45-50 years.Our study suggested the toxicity and cosmetic evalution were good. Data on local control were encouraging, especially for those under 50. ELIOT of 21Gy was a well-tolerated treatment in early stage Chinese breast cancer patients. And further follow up is still needed.

Sonographic Assessment of Ceftriaxone-Associated Biliary Pseudolithiasis in Chinese Children

In this randomized, single-blind, case-controlled, prospective study, the incidence and outcome of ceftriaxone-associated biliary pseudolithiasis in Chinese children was evaluated via ultrasonography. A total of 108 children diagnosed with hepatobiliary infection or pneumonia were randomized to receive ceftriaxone or ceftazidime. Serial gallbladder sonograms were obtained on days 1, 5 − 7 and 10 − 14 of therapy. Gallstones were detected in 43.10% of patients in the ceftriaxone-treated group and in 2.00% of the ceftazidime-treated group. The incidence of pseudolithiasis was significantly higher in the ceftriaxone-treated than the ceftazidime-treated group. Biliary precipitation abnormalities appeared after 2 − 7 days of treatment. After gallstones were found, the drug was stopped and symptoms resolved within 1 − 2 days. This study suggests that the risk of ceftriaxone-associated biliary pseudolithiasis should be considered when treating Chinese children.

Exploring the interplay of barrier function and leukocyte recruitment in intestinal inflammation by targeting fucosyltransferase VII and trefoil factor 3

Intestinal mucosal integrity is dependent on epithelial function and a regulated immune response to injury. Fucosyltransferase VII (Fuc-TVII) is an essential enzyme required for the expression of the functional ligand for E- and P-selectin. Trefoil factor 3 (TFF3) is involved in both protecting the intestinal epithelium against injury as well as aiding in wound repair following injury. The aim of the present study was to assess the interplay between barrier function and leukocyte recruitment in intestinal inflammation. More specifically, we aimed to examine how targeted disruption of Fuc-TVII either in wild-type or TFF3(-/-) mice would alter their susceptibility to colonic injury. TFF3 and Fuc-TVII double-knockout mice (TFF3/Fuc-TVII(-/-) mice) were generated by mating TFF3(-/-) and Fuc-TVII(-/-) mice. Colitis was induced by administration of dextran sodium sulfate (DSS) (2.5% wt/vol) in the drinking water. Changes in baseline body weight, diarrhea, and fecal blood were assessed daily. Upon euthanasia, extents of colonic inflammation were assessed macroscopically, microscopically, and through quantification of myeloperoxidase (MPO) activity. Colonic lymphocyte subpopulations were assessed at 6 days after administration of DSS by flow cytometry and immunohistochemistry. No baseline intestinal inflammation was found in TFF3/Fuc-TVII(-/-), TFF3(-/-), Fuc-TVII(-/-), or wild-type mice. Loss of Fuc-TVII resulted in a reduction in disease severity whereas TFF3(-/-) mice were markedly more susceptible to DSS-induced colitis. Remarkably, the loss of Fuc-TVII in TFF3(-/-) mice markedly decreased the severity of DSS-induced colitis as evidenced by reduced weight loss, diarrhea, decreased colonic MPO levels and improved survival. Furthermore, the loss of TFF3 resulted in increased severity of spontaneous colitis in IL-2/beta-microglobulin-deficient mice. These studies highlight the importance of the interplay between factors involved in the innate immune response, mucosal barrier function, and genes involved in regulating leukocyte recruitment and other aspects of the immune response.

Competing causes of death in NCIC CTG MA.17, a placebo-controlled trial of letrozole as extended adjuvant therapy for breast cancer patients

540

Background: Risk of death from other malignancies (OM) and other causes (OC) than breast cancer (BC) increases with age. Effects of baseline factors on type of death were assessed with competing risks analyses. Methods: In NCIC CTG MA.17, 5,187 women free of recurrent breast cancer after 5 years of tamoxifen were randomized to letrozole (L, 2,593 women) or placebo (P, 2,594 women). The primary endpoint was disease free survival (DFS), and secondary, overall survival (OS). Follow-up was to October 9, 2005: median 3.9 years, range <0.1 to 7.0 years. Effects of competing risks were examined for endpoints of BC, OM, and OC for 11 baseline trial factors: treatment, age, menopausal status, duration of prior tamoxifen, adjuvant radiotherapy, bone fracture, osteoporosis, cardiovascular disease, hormone receptor status, nodal status, adjuvant chemotherapy. Lagakos’ hierarchical method (Lagakos, Appl. Statist. 1978; 27:235–241) was used to test for differential effects of baseline factors on type of death (BC, OM, OC). Results: Rate of censoring was 97.8%, with 256 deaths (BC, 102; OM, 50; OC, 100; unknown, 4). Non-breast cancer deaths accounted for 60% of known deaths; 72%, for those ≥70 years; and 48%, for those <70 years. Two baseline factors differentially affected type of death. Women with cardiovascular disease were more likely to die from OC (p=0.02), while those with osteoporosis were more likely to die of OM (p=0.03). Age and nodal status had directionally similar effects. Older women had shorter survival from all 3 causes of death (p=0.01). Lymph node positivity was associated with worse survival (p=0.003). Conclusions: Extended L provides similar proportional benefit in improving DFS for all ages of women (Muss ref abstract SABCS 2006). However, the magnitude of competing non-breast cancer, and non-treatment related, causes of death needs to be considered more frequently, since with early detection and improved therapies, breast cancer patients may increasingly be expected to survive their disease to die from another cause. The novel association between baseline osteoporosis and other malignancies is being explored quantitatively.

No significant financial relationships to disclose.

Insulin resistance, estimated by serum C-peptide level, is associated with reduced event-free survival for postmenopausal women in NCIC CTG MA.14 adjuvant breast cancer trial

524

Background: NCIC CTG MA.14 is a randomized multi-centre trial of tamoxifen versus combined tamoxifen and octreotide LAR therapy in the adjuvant treatment of breast cancer in post-menopausal women. Planned secondary analyses included investigation of baseline metabolic factors that might influence survival. Laboratory and clinical studies indicate that insulin resistance is associated with adverse outcome in breast cancer. Insulin resistance elevates C-peptide levels. Methods: In MA.14, trial patients with stage I or II postmenopausal breast cancer were randomized from September, 1996 until July, 2000 to receive 20 mg tamoxifen PO daily for 5 years with/without the administration of the somatostatin analogue Octreotide LAR 90 mg depot injection monthly for 2 years. Event-free survival (EFS), the trial’s primary outcome measure, was defined as time from randomization to time of recurrence of primary disease, time of second malignancy or death due to any cause. We investigated the effect of baseline IGF-I, IGFBP-3, and C-peptide levels on EFS. Kaplan-Meier univariate and Cox step-wise multivariate regressions were performed with/without adjustment for the stratification factors of adjuvant chemotherapy, nodal status, and hormone receptor status, and included patient age (years) and tumour size (T-status). Results: These results are based on analysis of patient serum for the trial’s 667 patients. Median follow-up for those alive is 6.1 years; patients experienced 165 events. Higher C-peptide levels were associated with significantly worse EFS in adjusted, and unadjusted, univariate and multivariate analyses. Final efficacy analyses are expected within a few months. Updated analyses for the effects of baseline metabolic markers and body mass index on EFS will be presented. Conclusions: This is the largest data set, and the first clinical trial, linking higher serum C-peptide levels to adverse outcome in patients with early breast cancer. These results raise concern in the context of increasing population prevalence of insulin resistance. Potential novel adjuvant therapies exist as insulin resistance is modifiable.

[Table: see text]

Estrogen receptor beta-subtype selective tetrahydrofluorenones: use of a fused pyrazole as a phenol bioisostere

Synthesis of a series of fused pyrazole tetrahydrofluorenone analogs which are potent, ERbeta subtype selective ligands is described. Analogs possessing subnanomolar ERbeta binding, greater than 100-fold ERbeta-selectivity, and oral bioavailability are reported.

Inhibition of growth and increase of alkaline phosphatase activity in cultured human oral cancer cells by all-trans retinoic acid

In this study, the effects of all-trans retinoic acid (ATRA) on human oral cancer cells with regard to cell growth, the cell cycle, and alkaline phosphatase (ALP) activity were evaluated. Human oral cancer KB cells were treated with various concentrations of ATRA, and cell growth was then determined using the MTT viability assay. The cell-cycle distribution and ALP activity were analysed using a flow cytometer and chemical analyser, respectively. The KB cells were inhibited by ATRA at concentrations of 1-16 microM (1 microM, P<0.05; 2 microM, P<0.01; 4, 8 and 16 microM, P<0.001) in a dose-dependent manner. ATRA arrested KB cells in the G0/G1 phase. The ALP activity in KB cells was increased by ATRA. This is one of the first studies to focus on the expression of ALP in human head-and-neck carcinoma cells treated with retinoids. These findings suggest that the anti-tumour effects of ATRA on human oral cancer are associated with G0/G1 phase arrest and an increase in ALP activity.

[Curative effect of soybean lecithin on cerebral infarction]

OBJECTIVE

To investigate the clinical curative effect of soybean lecithin on cerebral infarction.

METHODS

542 patients with cerebral infarction within 48 h after the onset with the nervous function defect scores of 31-35 were divided into 3 groups: basic treatment group, 60 cases, with conventional treatment; citicoline group, 122 patients, with conventional treatment and citicoline; and soybean lecithin group, 360 patients, with conventional treatment and soybean lecithin 10 g tid. For all patients, treatment began sometime within 48 hours after the onset. The treatment course lasted 28 days.

RESULTS

When the course was over, the infarct volumes in basic group citicoline group, and soybean lecithin group, were 7.6 cm3 +/- 2.9 cm3, 7.3 cm3 +/- 3.1 cm3, and 6.4 cm3 +/- 2.7 cm3 respectively (F = 7.371, P = 0.0007). The basic group and citicoline group being compared with the soybean group by Dunnett test, t = 4.387 and 3.969 respectively, P < 0.01. The nervous function defect integral in the 3 groups decreased 14.2 +/- 10.93, 15.0 +/- 9.0, and 18.5 +/- 10.9 respectively. Two-way analysis of variance of drug kind and beginning time of treatment showed the value of F in drugs as 6.250, P = 0.0021, and value of F in times as 0.9417, P = 0.4201. In the order of death,deterioration, no improvement, improvement, significant improvement, and recovery, the Ridit values for the comprehensive curative effect in the 3 groups were 0.4003, 0.4118, and 0.54 5 respectively; chi2 = 27.89, P < 0.001.

CONCLUSION

Soybean lecithin is effective in treatment of acute cerebral infarction. The mechanism may be that soybean lecithin lowers the decrease of brain phospholipid content in brain ischemia.

Taxol and discodermolide represent a synergistic drug combination in human carcinoma cell lines

Recently, three natural products have been identified, the epothilones, eleutherobin, and discodermolide, whose mechanism of action is similar to that of Taxol in that they stabilize microtubules and block cells in the mitotic phase of the cell cycle. In this report, we have compared and contrasted the effects of these new agents in Taxol-sensitive and -resistant cell lines. We also have taken advantage of a human lung carcinoma cell line, A549-T12, that was isolated as a Taxol-resistant cell line and found to require low concentrations of Taxol (2-6 nM) for normal cell division. This study then examined the ability of these new compounds to substitute for Taxol in sustaining the growth of A549-T12 cells. Immunofluorescence and flow cytometry have both indicated that the epothilones and eleutherobin, but not discodermolide, can substitute for Taxol in this Taxol-dependent cell line. In A549-T12 cells, the presence of Taxol significantly amplified the cytotoxicity of discodermolide, and this phenomenon was not observed in combinations of Taxol with either the epothilones or eleutherobin. Median effect analysis using the combination index method revealed a schedule-independent synergistic interaction between Taxol and discodermolide in four human carcinoma cell lines, an effect that was not observed between Taxol and epothilone B. Flow cytometry revealed that concurrent exposure of A549 cells to Taxol and discodermolide at doses that do not induce mitotic arrest caused an increase in the hypodiploid population, thereby indicating that a possible mechanism for the observed synergy is the potentiation of apoptosis. Our results suggest that Taxol and discodermolide may constitute a promising chemotherapeutic combination.

Discovery Through Total Synthesis-Epimerization at C7 in the CP Compounds: Is (7S)-CP-263,114 a Fermentation Product?

Sometimes a surprise can occur in a total synthesis. The preparative investigation of the title compound CP-263,114 and of CP-225,917 (1)-both natural products that were first isolated in 1997 by Pfizer-has shown that CP compounds of the 7R series can be converted into the 7S series (for example, 2); (7S)-CP-263,114 is itself apparently a fermentation product.