Decellularized extracellular matrix enriched with GDNF enhances neurogenesis and remyelination for improved motor recovery after spinal cord injury

Motor functional improvement represents a paramount treatment objective in the post-spinal cord injury (SCI) recovery process. However, neuronal cell death and axonal degeneration following SCI disrupt neural signaling, impeding the motor functional recovery. In this study, we developed a multifunctional decellularized spinal cord-derived extracellular matrix (dSECM), crosslinked with glial cell-derived neurotrophic factor (GDNF), to promote differentiation of stem cells into neural-like cells and facilitate axonogenesis and remyelination. After decellularization, the immunogenic cellular components were effectively removed in dSECM, while the crucial protein components were retained which supports stem cells proliferation and differentiation. Furthermore, sustained release of GDNF from the dSECM facilitated axonogenesis and remyelination by activating the PI3K/Akt and MEK/Erk pathways. Our findings demonstrate that the dSECM-GDNF platform promotes neurogenesis, axonogenesis, and remyelination to enhance neural signaling, thereby yielding promising therapeutic effects for motor functional improvement after SCI. STATEMENT OF SIGNIFICANCE: The dSECM promotes the proliferation and differentiation of MSCs or NSCs by retaining proteins associated with positive regulation of neurogenesis and neuronal differentiation, while eliminating proteins related to negative regulation of neurogenesis. After crosslinking, GDNF can be gradually released from the platform, thereby promoting neural differentiation, axonogenesis, and remyelination to enhance neural signaling through activation of the PI3K/Akt and MEK/Erk pathways. In vivo experiments demonstrated that dSECM-GDNF/MSC@GelMA hydrogel exhibited the ability to facilitate neuronal regeneration at 4 weeks post-surgery, while promoting axonogenesis and remyelination at 8 weeks post-surgery, ultimately leading to enhanced motor functional recovery. This study elucidates the ability of neural regeneration strategy to promote motor functional recovery and provides a promising approach for designing multifunctional tissue for SCI treatment.

In Situ Polymer-Solution-Processed Graphene-PDMS Nanocomposites for Application in Intracranial Pressure Sensors

Polydimethylsiloxane (PDMS) has emerged as a promising candidate for the dielectric layer in implantable sensors due to its exceptional biocompatibility, stability, and flexibility. This study introduces an innovative approach to produce graphene-reinforced PDMS (Gr-PDMS), where graphite powders are exfoliated into mono- and few-layer graphene sheets within the polymer solution, concurrently forming cross-linkages with PDMS. This method yields a uniformly distributed graphene within the polymer matrix with improved interfaces between graphene and PDMS, significantly reducing the percolation threshold of graphene dispersed in PDMS from 10% to 5%. As-synthesized Gr-PDMS exhibits improved mechanical and electrical properties, tested for potential use in capacitive pressure sensors. The results demonstrate an impressive pressure sensitivity up to 0.0273 kpa-1, 45 times higher than that of pristine PDMS and 2.5 times higher than the reported literature value. The Gr-PDMS showcases excellent pressure sensing ability and stability, fulfilling the requirements for implantable intracranial pressure (ICP) sensors.

[Research on epidemiological characteristics of pneumonia and correlative factors of length of hospitalization in the elderly aged 60 years and older in Ningbo]

Objective: To investigate the epidemiological characteristics of pneumonia and the related factors of the length of hospitalization of pneumonia in the elderly aged 60 years and older in Ningbo in 2019. Methods: Data on hospitalized cases of pneumonia in the elderly aged 60 years and older in Ningbo in 2019 were collected through the regional health information platform, and the population data of Ningbo in 2019 were obtained through the Zhejiang Provincial Bureau of Statistics. A descriptive epidemiological analysis was conducted on hospitalized cases of pneumonia in the elderly population, and factors related to the length of hospitalization were explored. Results: A total of 15 956 hospitalized cases of pneumonia aged 60 years and older were reported in Ningbo in 2019, and the incidence of pneumonia requiring hospitalization was 1.02% (15 956/1 571 431). The incidence was 1.13% (8 613/760 357) in males and 0.83% (6 759/811 074) in females, and the ratio of male to female cases was 1.27∶1. The highest incidence was found in the ≥80 age group (2.52%), and the lowest incidence was found in the 60-69 age group (0.58%). March, February, and January were the peak period of pneumonia hospitalization. The main types of pneumonia diagnosed were not specified (65.12%), followed by bacterial pneumonia (34.60%). The M(Q1, Q3) of hospitalized patients with pneumonia was 9 (7, 13) days. The results of multivariate logistic regression analysis showed that gender (female: OR=0.911, 95%CI: 0.849-0.978) and older age (70-79 years old: OR=1.211, 95%CI: 1.111-1.321; ≥80 years old group: OR=1.486, 95%CI: 1.365-1.617), settlement method (self-payment: OR=0.567, 95%CI: 0.464-0.691), higher level of hospitals (Grade Ⅱ: OR=1.902,95%CI:1.723-2.100; Grade Ⅲ: OR=1.546,95%CI:1.407-1.698) were associated with the length of hospitalization for pneumonia in people aged 60 years and older in Ningbo. Conclusions: Hospitalization with pneumonia in people aged 60 years and older was high in winter and spring, men and older adults were in high-risk groups in Ningbo in 2019. Gender, age, billing method, and level of hospitals may be related factors to the length of hospitalization for pneumonia.

A computer vision and residual neural network (ResNet) combined method for automated and accurate yeast replicative aging analysis of high-throughput microfluidic single-cell images

With the rapid development of microfluidic platforms in high-throughput single-cell culturing, laborious operation to manipulate massive budding yeast cells (Saccharomyces cerevisiae) in replicative aging studies has been greatly simplified and automated. As a result, large datasets of microscopy images bring challenges to fast and accurately determine yeast replicative lifespan (RLS), which is the most important parameter to study cell aging. Based on our microfluidic diploid yeast long-term culturing (DYLC) chip that features 1100 traps to immobilize single cells and record their proliferation and aging via time-lapse imaging, herein, a dedicated algorithm combined with computer vision and residual neural network (ResNet) was presented to efficiently process tremendous micrographs in a high-throughput and automated manner. The image-processing algorithm includes following pivotal steps: (i) segmenting multi-trap micrographs into time-lapse single-trap sub-images, (ii) labeling 8 yeast budding features and training the 18-layer ResNet, (iii) converting the ResNet predictions in analog values into digital signals, (iv) recognizing cell dynamic events, and (v) determining yeast RLS and budding time interval (BTI) ultimately. The ResNet algorithm achieved high F1 scores (over 92%) demonstrating the effectiveness and accuracy in the recognition of yeast budding events, such as bud appearance, daughter dissection and cell death. Therefore, the results conduct that similar deep learning algorithms could be tailored to analyze high-throughput microscopy images and extract multiple cell behaviors in microfluidic single-cell analysis.

Severe Hypertensive Response to Atropine Therapy for Bradycardia Associated with Dexmedetomidine: Case Report and Literature Review

Dexmedetomidine is a selective and potent α2-adrenoceptor agonist used for sedation, analgesia, and anxiolysis, with minimal respiratory depression; therefore, it is widely used in clinical practice. Transient hypertension has been reported to be an indication for the use of dexmedetomidine. The authors report three female patients who experienced hypertensive crisis when used atropine to treat bradycardia caused by dexmedetomidine. The transient hypertension is a relatively common side effect of dexmedetomidine, hypertensive crisis seen with coadministration of atropine is much less frequently reported. This is the first report to describe the use of atropine to treat bradycardia induced by dexmedetomidine, which may cause severe hypertension in female patients. They discuss the reason for and treatment of hypertension caused by administration of atropine and dexmedetomidine together and review the relevant literature.

Association between ambient temperature and stroke risk in high-risk populations: a systematic review

Background

Significant associations exist between ambient temperature and stroke risk, but results in high cardiovascular risk populations are lacking. This systemic review summarised current evidence on ambient temperature and overall stroke risk in a high cardiovascular risk population.

Methods

We performed a systematic literature search across MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and GEOBASE, from inception to 3 July 2023, to identify all population-based studies. Eligible studies screened by independent reviewers recruited individuals aged 18 years and over, where minimum 80% of participants had a high cerebral vascular disease (CVD) risk profile. The primary outcomes are stroke morbidity and mortality, while the secondary outcomes are morbidity and mortality of ischaemic stroke (IS), intracranial cerebral haemorrhage (ICH), and subarachnoid haemorrhage (SH).

Results

The database searches identified 9,025 articles. After removing duplicates, 7,647 articles were screened in title and abstract to identify 380 articles for full-text screening. After the full-text screening of 380 articles by two independent reviewers, 23 articles were included in the review.

Conclusion

The evidence for an association between ambient temperature and stroke incidence is that lower temperatures were more likely to increase morbidity and mortality risk of both haemorrhagic and ischaemic stroke in older people. Conversely, higher ambient temperature is significantly associated with intracranial haemorrhage risk, but decreased risk with IS. Higher and lower ambient temperatures consistently increase stroke risks in patients with comorbidities of congestive heart failure and dyslipidaemia. This evidence implies the need to establish clinical guidelines for preventive intervention in patients with high stroke risks during extreme ambient temperatures.

[Epidemiological characteristics and spatiotemporal distribution of schizophrenia in Ningbo, 2018-2022]

Objective: To explore the temporal and spatial distribution characteristics of reported incidence of schizophrenia in Ningbo from 2018 to 2022 and to provide a scientific basis for rational allocation of mental health resources and comprehensive prevention and treatment of schizophrenia. Methods: The reported incidence data of schizophrenia from 2018 to 2022 were collected from Ningbo's mental health information management system, and the reported incidence was calculated by township. The spatial correlation analysis and the spatiotemporal scan analysis were used to study the spatiotemporal distribution of schizophrenia. Results: The reported incidence of schizophrenia decreased from 2018 to 2022, with 4 133 new cases reported, and the annual average reported incidence was 9.76/100 000. Global and local spatial autocorrelation analysis showed positive spatial correlations and hot spots in 2018-2020. The space-time scan analysis showed an incidence cluster in Dongqiao Town, Haishu District, during 2018-2019. The RR was 2.46, and the log-likelihood ratio was 256.89. Conclusions: The reported incidence of schizophrenia in Ningbo has obvious temporal and spatial aggregation, and the high incidence area explored can provide clues for further research on the correlation between environmental factors and the incidence of schizophrenia and has certain guiding significance for the rational allocation of mental health resources in Ningbo.

Comparison of Various Thyroidectomy Approaches: A Retrospective Cross-sectional Study

BACKGROUND

To avoid anterior neck scarring, numerous remote-access techniques to approach the thyroid gland (Remote access approach) have been described, including the transaxillary approach (TA), bilateral axillo-breast approach (BABA), and transoral robotic thyroidectomy (TORT). Popular worldwide, Remote access approachs have unique characteristics, advantages, and disadvantages. Herein, we investigated the characteristics of these distinct thyroidectomy approaches to aid surgeons in selecting the most appropriate method for patients.

PATIENTS AND METHODS

In total, 2351 cases of patients who underwent thyroidectomy between 2019 and 2021 were reviewed, including 1973, 281, 66, and 31 patients who underwent the conventional transcervical approach (TCA), TA, BABA, and TORT, respectively. Demographic characteristics, outcomes, and complications associated with these procedures were compared. The data were analyzed using the Student t test and the χ 2 test. Kruskal-Wallis and Mann-Whitney U tests were used if normality was not found.

RESULTS

Central lymph nodes (LNs) were retrieved mostly in patients who underwent lobectomy through TORT (mean: 9.4, P < 0.001). Metastatic central LNs were found more frequently (mean: 1.9 in lobectomy, 3.7 in total thyroidectomy) in patients who underwent lobectomy through TCA and TORT than in those who underwent lobectomy through other approaches (mean: 1.4 and 2.4, respectively, P < 0.05). BABA group patients had significantly fewer central LNs retrieved than those in other groups in lobectomy and total thyroidectomy (mean: 4.8 and 6.2, respectively, P < 0.05). Stimulated thyroglobulin levels did not differ among the 4 groups. The incidence of transient vocal cord palsy was statistically higher in the BABA group (5 cases, 7.5%) than in the other groups; however, all patients recovered. No difference was found in permanent vocal cord palsy (0.4% in TCA) or hypoparathyroidism (1.3% to 3.1%) among the 4 groups. The tumor size was significantly larger in the BABA group than in the other groups, with 10.6% of the patients having tumors larger than 4 cm. Total thyroidectomy was performed more frequently in the BABA group (51.8%) than in the other groups ( P = 0.005). The path of the external branch of the superior laryngeal nerve was more evident in TA, and the Cernea type was confirmed and preserved in 90.6% of TA cases.

CONCLUSIONS

Owing to the differences in working space and direction of the surgical field, TA was advantageous for preserving the external branch of the superior laryngeal nerve, whereas BABA was effective for total thyroidectomy and excision of large goiters. TORT was beneficial for central compartment neck dissection. These characteristics should be considered when choosing the best approach to improving cosmesis, function, and recurrence.

The Impact of Emotional Care on Poor Mood, Quality of Life and Self-Efficacy in Patients with Chronic Primary Kidney Disease

Objective

To investigate the impact of affective care on poor mood, quality of life, and self-efficacy in patients with chronic primary kidney disease.

Methods

Between January 2020 and January 2021, 112 patients treated in our hospital were divided into a control group (n=55, receiving conventional care) and a research group (n=57, using emotional nursing in addition to conventional care), and the anxiety self-assessment scale (SAS) scores, depression self-assessment scale (SDS) scores, kidney disease quality of life (KDQOL-SF) scores, and the quality of life (KDQOL-SF) scores developed by the Center for Chronic Disease Education, Stanford University, USA were compared before and aftercare. The results of the study group were compared with those of the KDQOL-SF, the Self-Efficacy Scale developed by the Center for Chronic Disease Education and Research, Stanford University, USA, and the adherence to care.

Results

After the intervention, the research group had lower SAS and SDS scores than the control group (P < .05). After the intervention, all KDQOL-SF scores and all self-efficacy scores were higher in the research group than in the control group (P < .05). The research group had a higher nursing care adherence rate of 92.98% than the control group of 78.18% (P < .05).

Conclusion

Emotional nursing can help improve the poor mood of patients with chronic primary kidney disease, improve their quality of life, and strengthen their self-efficacy, and the overall nursing compliance of patients is higher, which is of high clinical application.

Fabrication of β-Ga2O3 Nanotubes via Sacrificial GaSb-Nanowire Templates

β-Ga2O3 nanostructures are attractive wide-band-gap semiconductor materials as they exhibit promising photoelectric properties and potential applications. Despite the extensive efforts on β-Ga2O3 nanowires, investigations into β-Ga2O3 nanotubes are rare since the tubular structures are hard to synthesize. In this paper, we report a facile method for fabricating β-Ga2O3 nanotubes using pre-synthesized GaSb nanowires as sacrificial templates. Through a two-step heating-treatment strategy, the GaSb nanowires are partially oxidized to form β-Ga2O3 shells, and then, the residual inner parts are removed subsequently in vacuum conditions, yielding delicate hollow β-Ga2O3 nanotubes. The length, diameter, and thickness of the nanotubes can be customized by using different GaSb nanowires and heating parameters. In situ transmission electron microscopic heating experiments are performed to reveal the transformation dynamics of the β-Ga2O3 nanotubes, while the Kirkendall effect and the sublimation process are found to be critical. Moreover, photoelectric tests are carried out on the obtained β-Ga2O3 nanotubes. A photoresponsivity of ~25.9 A/W and a detectivity of ~5.6 × 1011 Jones have been achieved with a single-β-Ga2O3-nanotube device under an excitation wavelength of 254 nm.

Evaluation of QSAR models for predicting mutagenicity: outcome of the Second Ames/QSAR international challenge project

Quantitative structure-activity relationship (QSAR) models are powerful in silico tools for predicting the mutagenicity of unstable compounds, impurities and metabolites that are difficult to examine using the Ames test. Ideally, Ames/QSAR models for regulatory use should demonstrate high sensitivity, low false-negative rate and wide coverage of chemical space. To promote superior model development, the Division of Genetics and Mutagenesis, National Institute of Health Sciences, Japan (DGM/NIHS), conducted the Second Ames/QSAR International Challenge Project (2020-2022) as a successor to the First Project (2014-2017), with 21 teams from 11 countries participating. The DGM/NIHS provided a curated training dataset of approximately 12,000 chemicals and a trial dataset of approximately 1,600 chemicals, and each participating team predicted the Ames mutagenicity of each trial chemical using various Ames/QSAR models. The DGM/NIHS then provided the Ames test results for trial chemicals to assist in model improvement. Although overall model performance on the Second Project was not superior to that on the First, models from the eight teams participating in both projects achieved higher sensitivity than models from teams participating in only the Second Project. Thus, these evaluations have facilitated the development of QSAR models.

Morin protects chicks with T-2 toxin poisoning by decreasing heterophil extracellular traps, oxidative stress and inflammatory response

1. Fusarium tritici widely exists in a variety of grain feeds. The T-2 toxin is the main hazardous component produced by Fusarium tritici, making a serious hazard to poultry industry. Morin, belonging to the flavonoid family, can be extracted from mulberry plants and possesses anticancer, antioxidant and anti-inflammatory compounds, but whether morin protects chicks with T-2 toxin poisoning remains unclear. This experiment firstly established a chick model of T-2 toxin poisoning and then investigated the protective effects and mechanism of morin against T-2 toxin in chicks.2. The function of liver and kidney was measured by corresponding alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), blood urea nitrogen (BUN), creatinine (Cre) and uric acid (UA) kits. Histopathological changes were observed by haematoxylin-eosin staining. The status of oxidative stress was measured by MDA, SOD, CAT, GSH and GSH-PX kits. The mRNA levels of TNF-α, COX-2, IL-1β, IL-6, caspase-1, caspase-3 and caspase-11 were measured by quantitative real-time PCR. Heterophil extracellular trap (HET) release was analysed by immunofluorescence and fluorescence microplate.3. The model with T-2 toxin poisoning in chicks was successfully established. Morin significantly decreased T-2 toxin-induced ALT, AST, ALP, BUN, Cre and UA, and improved T-2 toxin-induced liver cell rupture, liver cord disorder and kidney interstitial oedema. Oxidative stress analysis showed that morin ameliorated T-2 toxin-induced damage by reducing malondialdehyde (MDA), increasing superoxide dismutase (SOD), catalase (CAT), glutathione (GSH) and glutathione peroxidase (GSH-PX). The qRT-PCR analysis showed that morin reduced T-2 toxin-induced mRNA expressions of TNF-α, COX-2, IL-1β, IL-6, caspase-1, caspase-3 and caspase-11. Moreover, morin significantly reduced the release of T-2 toxin-induced HET in vitro and in vivo.4. Morin can protect chicks from T-2 toxin poisoning by decreasing HETs, oxidative stress and inflammatory responses, which make it a useful compound against T-2 toxin poisoning in poultry feed.

Genetic Variations in TrkB.T1 Isoform and Their Association with Somatic and Psychological Symptoms in Individuals with IBS

Irritable bowel syndrome (IBS), a disorder of gut-brain interaction, is often comorbid with somatic pain and psychological disorders. Dysregulated signaling of brain-derived neurotrophic factor (BDNF) and its receptor, tropomyosin-related kinase B (TrkB), has been implicated in somatic-psychological symptoms in individuals with IBS. Thus, we investigated the association of 10 single nucleotide polymorphisms (SNPs) in the regulatory 3' untranslated region (UTR) of NTRK2 (TrkB) kinase domain-deficient truncated isoform (TrkB.T1) and the BDNF Val66Met SNP with somatic and psychological symptoms and quality of life in a U.S. cohort (IBS n=464; healthy controls n=156). We found that the homozygous recessive genotype (G/G) of rs2013566 in individuals with IBS is associated with worsened somatic symptoms, including headache, back pain, joint pain, muscle pain, and somatization as well as diminished sleep quality, energy level and overall quality of life. Validation using U.K. BioBank (UKBB) data confirmed the association of rs2013566 with increased likelihood of headache. Several SNPs (rs1627784, rs1624327, rs1147198) showed significant associations with muscle pain in our U.S. cohort. Notably, these SNPs are predominantly located in H3K4Me1-enriched regions, suggesting their enhancer and/or transcription regulation potential. Together, our findings suggest that genetic variation within the 3'UTR region of the TrkB.T1 isoform may contribute to comorbid conditions in individuals with IBS, resulting in a spectrum of somatic and psychological symptoms that may influence their quality of life. These findings advance our understanding of the genetic interaction between BDNF/TrkB pathways and somatic-psychological symptoms in IBS, highlighting the importance of further exploring this interaction for potential clinical applications.

Physical Properties and Clinical Performance of Short Fiber Reinforced Resin-based Composite in Posterior Dentition: Systematic Review and Meta-analysis

OBJECTIVE

This study compares the physical properties and clinical performance of short fiber reinforced composites (SFRC) to those of particulate-filled resin-based composites (PFRC) for class I and II direct restorations in permanent dentition.

METHODS

Systematic review and meta-analysis was conducted using PubMed, Embase (Elsevier), and Dentistry and Oral Sciences Source (EBSCO) databases. The outcomes evaluated were physical properties including flexural strength, flexural modulus, elastic modulus, microhardness, shrinkage, fracture toughness, degree of conversion, and depth of cure. Clinical performance was evaluated with a systematic review.

RESULTS

The meta-analyses favored SFRC for flexural strength and fracture toughness compared to every PFRC subgroup, with a high quality of evidence. For all other properties, the meta-analyses favored SFRC to overall PFRC, with some non-significant differences with certain PFRC subgroups. The most recent clinical trial showed SFRC performed similarly to PFRC, however older studies suggest inferior surface texture and discoloration of SFRC compared to PFRC.

CONCLUSION

This study can aid dental professionals in clinical decision making, supporting that SFRC offers improved physical properties, especially fracture resistance and flexural strength, compared to PFRC.

Hydrothermal Synthesis of Te Nanosheets: Growth Mechanism and Electrical Property

Hydrothermal synthesis is a highly efficient way to yield multiform Te nanosheets. However, the growth mechanisms and property discrepancies between different types of Te nanosheets are still unclear. In this paper, we perform an investigation on this issue by monitoring the hydrothermally synthesized Te nanosheets at different growth stages with transmission electron microscopy and electrical tests. Three main types of Te nanosheets and their variants are revealed including trapezoidal and "V"-shaped configurations. It is found that the different types of Te nanosheets dominate at different reaction stages, indicating a sequential growth scenario. Surfactants and surface energy co-determine the growth kinetics, while the crystallographic attachments lead to specifically included angles of 74° and 41° in the "V"-shaped Te nanosheets. The fractions of the three main types of Te nanosheets as a function of reaction time are statistically tracked, and their crystalline structures, interfaces, and preferential growth orientations are uncovered. Moreover, the electrical properties of the Te nanosheets are tested, and the results show an interface-related feature. These findings provide some new insights into the synthesis and property of low-dimensional Te functional materials.

Predicting the severity of white matter lesions among patients with cerebrovascular risk factors based on retinal images and clinical laboratory data: a deep learning study

Background and purpose

As one common feature of cerebral small vascular disease (cSVD), white matter lesions (WMLs) could lead to reduction in brain function. Using a convenient, cheap, and non-intrusive method to detect WMLs could substantially benefit to patient management in the community screening, especially in the settings of availability or contraindication of magnetic resonance imaging (MRI). Therefore, this study aimed to develop a useful model to incorporate clinical laboratory data and retinal images using deep learning models to predict the severity of WMLs.

Methods

Two hundred fifty-nine patients with any kind of neurological diseases were enrolled in our study. Demographic data, retinal images, MRI, and laboratory data were collected for the patients. The patients were assigned to the absent/mild and moderate-severe WMLs groups according to Fazekas scoring system. Retinal images were acquired by fundus photography. A ResNet deep learning framework was used to analyze the retinal images. A clinical-laboratory signature was generated from laboratory data. Two prediction models, a combined model including demographic data, the clinical-laboratory signature, and the retinal images and a clinical model including only demographic data and the clinical-laboratory signature, were developed to predict the severity of WMLs.

Results

Approximately one-quarter of the patients (25.6%) had moderate-severe WMLs. The left and right retinal images predicted moderate-severe WMLs with area under the curves (AUCs) of 0.73 and 0.94. The clinical-laboratory signature predicted moderate-severe WMLs with an AUC of 0.73. The combined model showed good performance in predicting moderate-severe WMLs with an AUC of 0.95, while the clinical model predicted moderate-severe WMLs with an AUC of 0.78.

Conclusion

Combined with retinal images from conventional fundus photography and clinical laboratory data are reliable and convenient approach to predict the severity of WMLs and are helpful for the management and follow-up of WMLs patients.

Evaluation of extent vs velocity of cortical venous filing in stroke outcome after endovascular thrombectomy

PURPOSE

Abnormal venous drainage may affect the prognosis of patients undergoing endovascular reperfusion therapy (ERT). Herein, time-resolved dynamic computed tomography arteriography (dCTA) was applied to evaluate the relationship between the velocity and extent of cortical venous filling (CVF), collateral status and outcomes.

METHODS

Thirty-five consecutive patients with acute anterior circulation occlusion who underwent ERT within 24 h of onset and successfully recanalized were enrolled. All patients underwent dCTA before ERT. Slow first or end of CVF was considered to occur when the time point of CVF appearance or disappearance on the affected side occurred after than that on the healthy side, whereas an equal CVF, a CVF reduced by ≤ 50%, or by > 50% on the affected side, were considered good, intermediate, and poor CVF extent, respectively.

RESULTS

Slow first CVF (29 patients, 82.8%), slow end of CVF (29, 85.7%), and intermediate extent of CVF (7, 20.0%) were not associated with collateral status or outcomes. Poor extent of CVF (6, 17.1%) was associated with poor collateral status, higher proportion of midline shift, larger final infarct volume, higher modified Rankin Scale (mRS) score at discharge, and higher proportion of in-hospital mortality. All patients with transtentorial herniation had poor extent of CVF, and those with poor CVF extent had an mRS score ≥ 3 at discharge.

CONCLUSION

Poor CVF extent, as assessed by dCTA, is a more accurate and specific marker than slow CVF to identify patients at high risk for poor outcomes after ERT.

Poor Internal Jugular Venous Outflow Is Associated with Poor Cortical Venous Outflow and Outcomes after Successful Endovascular Reperfusion Therapy

Many patients show poor outcomes following endovascular reperfusion therapy (ERT), and poor cortical venous outflow is a risk factor for these poor outcomes. We investigated the association between the outflow of the internal jugular vein (IJV) and baseline cortical venous outflow and the outcomes after ERT. We retrospectively enrolled 78 patients diagnosed with an acute anterior circulation stroke and successful ERT. Poor IJV outflow on the affected side was defined as stenosis ≥50% or occlusion of ipsilateral IJV, and poor outflow of bilateral IJVs was defined as stenosis ≥50% or occlusion of both IJVs. Poor cortical venous outflow was defined as a cortical vein opacification score (COVES) of 0 on admission. Multivariate analysis showed that poor outflow of IJV on the affected side was an independent predictor for hemorrhagic transformation. The poor outflow of bilateral IJVs was an independent risk factor for poor clinical outcomes. These patients also had numerical trends of a higher incidence of symptomatic intracranial hemorrhage, midline shift >10 mm, and in-hospital mortality; however, statistical significance was not observed. Additionally, poor IJV outflow was an independent determinant of poor cortical venous outflow. For acute large vessel occlusion patients, poor IJV outflow is associated with poor baseline cortical venous outflow and outcomes after successful ERT.

[Cost-effectiveness prediction of AIDS interventions among men who have sex with men in Ningbo]

Objective: To provide information reference for resource allocation and decision-making in related fields, the cost-effectiveness of HIV input among men who have sex with men (MSM) in Ningbo. Different intervention coverages were compared. Methods: Taking MSM as the target population, data were collected and modeled by Optima HIV for the corresponding HIV health output and the budget under different intervention coverages. Results: According to the estimated size of the MSM population, which was 19 584 in Ningbo in 2020, if the coverage of 2020 baseline intervention is maintained in the next ten years, the number of HIV cases, new HIV infections, and HIV-related deaths among this population will show an upward trend. It is estimated that from 2021 to 2030, 7.9% of new infections and 1.7% of deaths can be avoided and the relevant funding investment comed to 2.4 time the baseline if the intervention coverage rate expanded to 3.0 times the 2020 baseline. After the coverage rate of intervention expanded to 3 times the baseline, it continued to grow, the health effect did not increase. Conclusions: At present, expanding the baseline coverage of HIV-related intervention projects among MSM in Ningbo and increasing capital investment will still reverse HIV-related death and reduce new infections. Moreover, there is a saturation point of the intervention effect. Researchers and policymakers must explore more effective interventions/combinations to obtain more significant health outcomes.

Thyroid-Stimulating Hormone as a Biomarker for Stress After Thyroid Surgery: A Prospective Cohort Study

BACKGROUND Thyroid-stimulating hormone (TSH), which is regulated by the negative feedback of triiodothyronine (T3) and thyroxine (T4), is affected by cortisol (a stress hormone) and cytokines during allostasis. Thus, we assessed changes in TSH levels under stress and its potential as a stress marker in patients lacking T3 or T4 feedback after thyroid surgery. MATERIAL AND METHODS Three stress questionnaires (Korean version of the Daily Stress Inventory, Social Readjustment Rating Scale, and Stress Overload Scale-Short [SOSS]), an open-ended questionnaire (OQ), and thyroid function tests were administered twice to 106 patients enrolled from January 2019 to October 2020. RESULTS In a multiple generalized linear mixed-effect model (GLMM) involving 106 patients, the T3 and free T4 levels, OQ, body weight, extent of thyroidectomy, and preoperative TSH levels were significantly correlated with log-transformed TSH (lnTSH). The modified SOSS (category) based on recent stressors on OQ interview was significantly associated with lnTSH. In the GLMM with modified SOSS (category), the lnTSH increased by 2.3 and 0.56 in the unconscious high- and high-risk groups, respectively, compared to that in the low-risk group (P<0.05). The calculated power of this study was 0.92 based on alpha=0.05. CONCLUSIONS TSH had a significant relationship with stress and the extent of thyroidectomy. An OQ supported the SOSS to help detect unrecognized stressors. TSH has potential utility as a stress marker combined with the modified SOSS (category) with sufficient power. However, questionnaires on social environments and research on coping strategies for stress are necessary for future studies.

The combined value of mpUS and mpMRI-TRUS fusion for the diagnosis of clinically significant prostate cancer

Objective

To evaluate the combined efficacy of multiparametric ultrasonography (mpUS) and multiparametric magnetic resonance imaging/transrectal ultrasound (mpMRI-TRUS) fusion for detecting clinically significant prostate cancer (csPCa).

Methods

From November 2019 to September 2021, biopsy-naïve patients underwent mpMRI-TRUS fusion imaging combined with mpUS-guided targeted biopsies (TB) and systematic biopsies (SB). To further evaluate the additional diagnostic value of mpUS, the imaging features of 202 focus obtained from fusion imaging were assessed. The diagnostic accuracies of mpMRI-TRUS fusion imaging and the combination of mpMRI-TRUS fusion imaging with mpUS for csPCa were comparatively evaluated.

Results

A total of 202 prostate lesions (160 patients) were included in the final analysis, of which 105 were csPCa, 16 were ciPCa, and 81 were noncancerous. The median patient age was 69 (65–73) years and the median tPSA was 22.07 (11.22–62.80) ng/mL. For csPCa, the detection rate of TB was higher than that of SB (50.0% vs. 45.5%, p < 0.05). The imaging characteristics of mpUS in the PCa and non-PCa groups were significantly different (p < 0.001). When compared with mpMRI-TRUS fusion imaging, the positive predictive value, false positive rate, and area under the curve (AUC) of csPCa diagnosis by mpMRI-TRUS fusion imaging combined with mpUS increased by 11.30%, decreased by 19.58%, and increased from 0.719 to 0.770 (p < 0.05), respectively.

Conclusion

TB can improve the detection rate of csPCa and hence can be effectively used in the diagnosis and risk assessment of csPCa. The mpUS-enriched valuable diagnostic information for mpMRI-TRUS fusion imaging and their combination showed a higher diagnostic value for csPCa, which can guide subsequent clinical treatment.

[FNDC1 is highly expressed in lung adenocarcinoma and closely related with poor prognosis]

OBJECTIVE

To explore the expression of fibronectin type Ⅲ domain containing 1(FNDC1) protein in lung adenocarcinoma and its prognostic significance.

METHODS

The expression of FNDC1 in lung adenocarcinoma was predicted by analysis of data from GEO database and GEPIA, and the results were verified by immunohistochemical staining in 92 pairs of clinical specimens of lung adenocarcinoma and adjacent tissues.We further analyzed the correlation of FNDC1 expression with the clinicopathological features of the patients, and evaluated its prognostic value using Cox survival analysis.

RESULTS

Analysis of the data form GEO database and GEPIA showed a significantly higher expression level of FNDC1 in lung adenocarcinoma than in matched normal tissues (P < 0.05).Kaplan-Meier survival analysis suggested that a high expression of FNDC1 protein was associated with a significantly shorter overall survival time of the patients (P < 0.05).Immunohistochemistry of the clinical specimens also showed a significantly higher protein expression of FNDC1 in lung adenocarcinoma tissues than in paired adjacent tissues (P < 0.001).A high expression of FNDC1 protein was significantly correlated with advanced clinical stage, T stage and N stage (P < 0.05).Cox univariate and multivariate regression survival analysis indicated that an increased expression of FNDC1 was an independent risk factor for poor prognosis of the patients with lung adenocarcinoma (P < 0.05).

CONCLUSION

FNDC1 protein is highly expressed in patients with lung adenocarcinoma and in closely related with the occurrence, progression and prognosis of the tumor, suggesting the value of FNDC1 protein as a potential biomarker for assessment of the survival and prognosis of patients with lung adenocarcinoma.

[Transmission chains of local epidemic of COVID-19 caused by 2019-nCoV Delta variant in Zhenhai district, Ningbo]

Objective: To investigate the local epidemic of COVID-19 caused by 2019-nCoV Delta variant in Zhenhai district of Ningbo, identify the transmission chain and provide reference for the prevention and control of COVID-19 epidemic. Methods: The incidence data of COVID-19 in Zhenhai from 6 to 18 December, 2021 were collected in field investigation. Field epidemiological investigation was conducted to understand the epidemiological characteristics of COVID-19 cases and analyze the transmission chains. Results: The first case might be infected with 2019-nCoV through direct or indirect exposure when passing through a medium-risk area, then a family cluster was caused, and the epidemic spread through close contacts of family members with others such as work, daily life, and moxibustion. The epidemic lasted for 14 days, and 74 confirmed COVID-19 cases were reported. The median incubation period was 4.0(3.0,5.8)d. All the cases were in a chain of transmission for more than 6 generations, and the intergenerational interval was 3.5(2.0,5.3)d. The gene sequencing result indicated that the pathogen was Delta AY.4 variant of 2019-nCoV. Both the epidemiological investigation and the gene sequencing results supported that the local COVID-19 epidemic in Zhenhai was associated with the COVID-19 epidemic in Shanghai. Conclusions: The transmission chain of this epidemic was clear. Delta AY.4 variant has obvious characteristic to cause case clusters in families, places with poor ventilation, and residential communities. It is suggested to strengthen the health management in key areas and key populations, and increase the frequency of nucleic acid testing.

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

BACKGROUND

Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications.

METHODS

We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC).

FINDINGS

In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]).

INTERPRETATION

In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required.

FUNDING

British Journal of Surgery Society.

Oxymatrine-induced Apoptosis in Fibroblast-like Synoviocytes via Regulation of the miR-146a/ TRAF6/JNK1 Axis in Rheumatoid Arthritis

Objective:

Rheumatoid Arthritis （RA）is made when the synovial tissues and joints destroyed by the inflammation refection, especially the chronic inflammatory. the RA-FLS was treated by Oxymatrine, and the influence of miR-146a and TRAF6 /JNK pathway was explored.

Method:

Oxymatrine -treated RA-FLS were harvested to detect cell viability by CCK-8. The expression of miR-146a was detected by qRT-PCR. The expression of IRAK1, TRAF6, JNK1, and p-JNK1 was obtained by western blot.

Results:

The optimum oxymatrine concentration inhibiting RA-FLS was 4mg/ml at 48h. The expression of miR-146a at 48h and 72h was higher than 0 and 24h in RA-FLS treated with 4mg/ml oxymatrine. And IRAK1, TRAF6, and p-JNK at 48h and 72h was lower than 0 and 24h in RA-FLS treated with 4mg/ml oxymatrine. When the miR-146a inhibited, the expression of miR-146a was very low in the miR-146a inhibitor group, no matter oxymatrine existed, the expression of IRAK1, TRAF6 and p-JNK in the miR-146a inhibitor group with or without oxymatrine was higher than the mock group, blank group, and only oxymatrine added group, the cell viability in the miR-146a inhibitor group and oxymatrine + miR-146a inhibitor group was higher than the other groups. When IRAK1 was over expressed, the expression of miR-146a in the oxymatrine + IRAK1 overexpression group was higher than the IRAK1 overexpression group. However, The expression of IRAK1, TRAF6, and p-JNK1 in the IRAK1 overexpression group with or without oxymatrine was higher than the pcDNA3.1 group, blank group and only oxymatrine added group. The cell viability in the IRAK1 overexpression group and oxymatrine + IRAK1 overexpression group was higher than the other groups.

Conclusion:

oxymatrine can inhibit the RA-FLS proliferation via miR146a and IRAK1/TRAF6/JNK1 axis. Hence, oxymatrine may be a drug or adjuvant drug to treat the RA in the future.

BMP-2/CPC scaffold with dexamethasone-loaded blood clot embedment accelerates clinical bone regeneration

Delayed repair caused by prolonged inflammatory response might lead to clinical nonunion and failed bone regeneration. The design of desirable biomaterials requires precise regulation of the initial osteoimmune responses and efficient osteoinductive capacity to facilitate later bone regeneration. Herein, a Dex-loaded blood clot-embedded BMP-2/CPC scaffold (Dex/blood/BMP-2/CPC) was fabricated for clinical bone regeneration with the sequential release of dexamethasone (Dex), a clinical immunosuppression drug, and BMP-2, a potent osteogenic growth factor. The introduction of Dex at a BMP-2/Dex ratio of 1/6 effectively facilitated M2 polarization of macrophages and exerted a synergetic effect on BMP-2-mediated osteogenic differentiation. The highest in vivo bone regenerative efficacy was achieved by Dex/blood/BMP-2/CPC scaffold with a 1/6 BMP-2/Dex dose, exhibiting significantly enhanced endochondral ossification and attenuated bone resorption in an ectopic model, as well as reduced fibrosis at the orthotopic defect site. Blood clot embedment further provides nutrition and cytokines for the endochondral ossification process. On these bases, a pilot clinical trial was carried out and the Dex/blood/BMP-2/CPC scaffold was demonstrated to accelerate fracture healing, improve therapeutic quality, and eliminate local inflammation compared to current bone regenerative treatment. Taken together, this work designed an immunoregulatory and osteoinductive Dex/blood/BMP-2/CPC scaffold, which might provide new insights for future biomaterial development (Trial registration: ChiCTR2100047693).

[Effectiveness of precise prevention and control strategies of dynamic zero COVID-19 in Ningbo, Zhejiang province]

Objective: To evaluate effectiveness of the precise prevention and control strategies of dynamic zero COVID-19 in Ningbo, Zhejiang province. Methods: Based on the incidence data of COVID-19 and case epidemiological survey report in Ningbo in December 2021, the incidence curve of COVID-19 was generated and a dynamics model was developed to estimate the case number of under different intervention measures. The basic reproduction number (R₀) and real-time reproduction number (R_t) were calculated to evaluate intervention effect. Results: A total of 74 cases of COVID-19 had been confirmed in Ningbo as of 17 December, 2021. The R₀ was estimated to be 4.3. With the strengthening of prevention and control measures, the R_t showed a gradual downward trend, dropping to below 1.0 on December 11 and 0.4 on December 14. The model fitting results showed that the actual case number was close to the estimated case number (76 cases) when the effectiveness of intervention was 90%. The number of cases decreased by 98.4% compared with that if no intervention was taken. Conclusion: The precise prevention and control strategies of dynamic zero COVID-19 have obvious effect, which can facilitate the rapid control of COVID-19 epidemic in Ningbo.

Decellularized extracellular matrix scaffolds: Recent trends and emerging strategies in tissue engineering

The application of scaffolding materials is believed to hold enormous potential for tissue regeneration. Despite the widespread application and rapid advance of several tissue-engineered scaffolds such as natural and synthetic polymer-based scaffolds, they have limited repair capacity due to the difficulties in overcoming the immunogenicity, simulating in-vivo microenvironment, and performing mechanical or biochemical properties similar to native organs/tissues. Fortunately, the emergence of decellularized extracellular matrix (dECM) scaffolds provides an attractive way to overcome these hurdles, which mimic an optimal non-immune environment with native three-dimensional structures and various bioactive components. The consequent cell-seeded construct based on dECM scaffolds, especially stem cell-recellularized construct, is considered an ideal choice for regenerating functional organs/tissues. Herein, we review recent developments in dECM scaffolds and put forward perspectives accordingly, with particular focus on the concept and fabrication of decellularized scaffolds, as well as the application of decellularized scaffolds and their combinations with stem cells (recellularized scaffolds) in tissue engineering, including skin, bone, nerve, heart, along with lung, liver and kidney.

Three-dimensional craniofacial changes with maxillary expansion in young adult patients with different craniofacial morphology

Objectives:

Skeletally mature patients with transverse deficiency are best treated with surgically assisted rapid palatal expansion (RPE) procedure. Recent studies have shown that microimplant-assisted RPE (MARPE) appliances can be effective in achieving skeletal expansion in young adults. This retrospective study aimed to evaluate the skeletal and dental alveolar changes in response to treatment with MARPE appliances in three types of anteroposterior skeletal malocclusions using cone-beam computed tomography (CBCT) scans.

Material and Methods:

Seventy-eight subjects diagnosed with maxillary transverse deficiency and treated with the MARPE appliance (mean age of 22.9 ± 4.2 years) were divided into skeletal Class I, II, and III malocclusions with 26 subjects in each group. Pre- and post-treatment CBCT scans were used for superimposition to examine the skeletal and dentoalveolar changes following maxillary expansion treatment.

Results:

Significant lateral separation of the maxilla was found at the levels of the nasal floor, interzygomatic bones, and the inferior palatine margin of the alveolar process (P < 0.05) in the whole sample. Most of the sagittal and vertical variables change significantly in the whole sample and each studied group separately. Intergroup comparisons revealed no significant differences among the three skeletal classes except for the left frontozygomatic angle, left maxillary inclination angle, and torque in the first and second premolars. In Class III patients, the maxilla moved forward significantly in most of the cases (eight of 26 cases) (0.88°, P < 0.05) and the mandible moved downward and backward improving the anteroposterior skeletal relationship. Significant differences were also found in the vertical measurements (N-Me, MMP, and MP/SN, P < 0.05) in all three types of anteroposterior malocclusions.

Conclusion:

Maxillary expansion with the MARPE appliance in young adult patients induced different skeletal and dentoalveolar changes in the anteroposterior and vertical dimensions in each skeletal malocclusion with no significant difference among the three skeletal classes.

[Characteristics and influencing factors of newly HIV infection among newly confirmed HIV/AIDS cases in Ningbo city, 2017-2020]

Objective: To identify the characteristics and influencing factors of local HIV infection among newly confirmed cases in Ningbo from 2017 to 2020 to provide evidence for traceability investigations on critical cases and facilitate the detection procedures and reduce new HIV infection. Methods: From January 1, 2017, to December 31, 2020, the newly confirmed HIV/AIDS in Ningbo were recruited. An epidemiological questionnaire was used to collect relevant information, including demography, sexual behaviors, results of HIV antibody tests, and the route of HIV transmission. According to the HIV testing, history of risk behaviors, and the level of CD4⁺ lymphocytes after confirmation, the HIV infection was acquired in the previous year, or the place was in Ningbo. The EpiData 3.1 and SPSS 23.0 software were used for input, sorting database and statistical analysis. Results: A total of 2 044 HIV/AIDS on-site investigations were completed. The average age of the subjects was (40.6±15.3) years old, including 1 684 males (82.4%), 758 unmarrieds (37.1%), 1 072 (52.5%) registered as permanent residents in Ningbo, 1 253 (61.3%) with junior high school education or below, 979 (47.9%) lived in Ningbo for more than five years. The proportion of local, new HIV infections was 34.34% (702/2 044). Multivariate logistic analysis showed that the proportion of local newly HIV infection was higher among those who were confirmed in 2020 (compared with the 2017 confirmed cases, OR=1.422, 95%CI:1.092-1.851), whose occupations were students/teachers/cadres/retirees (compared to commercial service/catering/public place service personnel, OR=1.682, 95%CI: 1.307-2.165), meeting sex partners via male social software locally in the last year (compared with without using related dating software, OR=1.353, 95%CI: 1.073-1.706). Conclusions: The proportion of local HIV infection of newly confirmed HIV/AIDS was relatively high in Ningbo city from 2017 to 2020. Meeting gay sex partners through local male social software appeared a risk factor for local newly HIV infection. Traceability investigations and internet intervention should be carried out for MSM. While male social software should be focused on identifying and controlling the risk of local newly HIV infection.

[Conducting analysis on HIV tracing and molecular network for promoting precise detection,prevention and control of AIDS]

The current sexual transmission of newly infected HIV cases is complicated in China. It is crucial for interrupting HIV transmission by HIV tracing and molecular network analysis,conducting early detection and precise prevention among HIV-positive individuals. The articles in this issue focused on the global situation of HIV tracing, and molecular network analysis in promoting accurate detection and prevention of AIDS started from analyzing the reported epidemiological characteristics of HIV/AIDS in Ningbo city from 2017 to 2020. Relations of HIV transmission between HIV positive individuals and sex partners by tracing investigation were also, analyzed. Data on HIV transmission mode by combining social and molecular networks were gathered to provide evidence for applied research on precise detection, prevention, and control of AIDS.

[HIV infection and related factors of traceability efficiency among sex partners of HIV positive men who have sex with men]

Objective: To investigate the situation related to HIV infection and influencing factors of traceability efficiency among sex partners of HIV positive men who have sex with men (MSM). Methods: A cross-sectional survey was conducted to investigate the traceability among sex partners of HIV-positive MSM in Ningbo from 2018 to 2020. Limiting-antigen avidity enzyme immunoassay determined recent HIV infection. The classified data was evaluated by chi-square test, and factors of traceability efficiency were analyzed by multivariate logistic regression. Results: A total of 374 newly confirmed HIV-positive MSM were recruited to participate in the HIV test in Ningbo from 2018 to 2020.HIV positive rate of sex partner was 15.7% (75/479,95%CI:12.4%-18.9%). HIV positive rates of sex partner of recent HIV infection MSM was 31.8% (21/66,95%CI:20.3%-43.4%). The proportion of newly confirmed HIV-positive sex partners of recent HIV infection MSM (76.2%) was higher than that of long-term HIV infection MSM (48.1%). The difference was statistically significant (P=0.028). Results from the multivariate logistic regression analysis showed that HIV traceability efficiency was higher in the following subpopulations as; HIV positive MSM who were 36-45 years old (compared with 18-25 years old, OR=3.973,95%CI:1.364-11.569), HIV active detection (compared with HIV passive detection, OR=1.896, 95%CI:1.083-3.319), recent HIV infection MSM (compared with long-term HIV infection MSM, OR=3.733, 95%CI:1.844-7.556). Conclusions: HIV positive rate among partners of HIV positive MSM was very high. The traceability efficiency, which was recent HIV infection MSM and HIV active detection, was high. It is suggested to strengthen the traceability and focus on the newly confirmed HIV-positive MSM in VCT clinics.

Reference ranges of fetal heart function using a Modified Myocardial Performance Index: a prospective multicentre, cross-sectional study

OBJECTIVES

The primary aim of this study was to establish the normal reference ranges of the fetal left ventricular (LV) Modified Myocardial Performance Index (Mod-MPI). A secondary aim was to evaluate the agreement between manual and automatic measurements for fetal Mod-MPI.

DESIGN

A prospective, multicentre, cross-sectional study.

PARTICIPANTS

Normal singleton pregnancies.

METHODS

The LV functions of normal singleton pregnancies were assessed in nine centres covering eight provinces in China using unified ultrasound protocols and settings and standardised measurements by pulsed Doppler at 20-24, 28-32 and 34-38 weeks of gestation. The isovolumetric relaxation time (IRT), isovolumetric contraction time, ejection time (ET) and Mod-MPI were measured both automatically and manually.

RESULTS

This cross-sectional study included 2081 fetuses, and there was a linear correlation between gestational age (GA) and Mod-MPI (0.416+0.001×GA (weeks), p<0.001, r²=0.013), IRT (36.201+0.162× GA (weeks), p<0.001, r²=0.021) and ET (171.418-0.078*GA (weeks), p<0.001, r²=0.002). This finding was verified using longitudinal data in a subgroup of 610 women. The agreement between the manual and automated measurements for Mod-MPI was good.

CONCLUSIONS

We constructed normal reference values of fetal LV Mod-MPI. Automatic measurement can be considered for ease of measurement in view of the good agreement between the automatic and manual values.

Risk of hearing loss among multidrug-resistant tuberculosis patients according to cumulative aminoglycoside dose

SETTING: The ototoxic effects of aminoglycosides (AGs) lead to permanent hearing loss, which is one of the devastating consequences of multidrug-resistant tuberculosis (MDR-TB) treatment. As AG ototoxicity is dose-dependent, the impact of a surrogate measure of AG exposure on AG-induced hearing loss warrants close attention for settings with limited therapeutic drug monitoring.OBJECTIVE: To explore the prognostic impact of cumulative AG dose on AG ototoxicity in patients following initiation of AG-containing treatment for MDR-TB.DESIGN: This prospective cohort study was nested within an ongoing cluster-randomized trial of nurse case management intervention across 10 MDR-TB hospitals in South Africa.RESULTS: The adjusted hazard of AG regimen modification due to ototoxicity in the high-dose group (≥75 mg/kg/week) was 1.33 times higher than in the low-dose group (<75 mg/kg/week, 95%CI 1.09-1.64). The adjusted hazard of developing audiometric hearing loss was 1.34 times higher than in the low-dose group (95%CI 1.01-1.77). Pre-existing hearing loss (adjusted hazard ratio [aHR] 1.71, 95%CI 1.29-2.26) and age (aHR 1.16 per 10 years of age, 95%CI 1.01-1.33) were also associated with an increased risk of hearing loss.CONCLUSION: MDR-TB patients with high AG dose, advanced age and pre-existing hearing loss have a significantly higher risk of AG-induced hearing loss. Those at high risk may be candidates for more frequent monitoring or AG-sparing regimens.

Zhuyu Annao decoction promotes angiogenesis in mice with cerebral hemorrhage by inhibiting the activity of PHD3

Some traditional Chinese decoctions, such as Zhuyu Annao, exert favorable therapeutic effects on acute cerebral hemorrhage, hemorrhagic stroke, and other neurological diseases, but the underlying mechanism remains unclear. This study aimed to determine whether Zhuyu Annao decoction (ZYAND) protects the injured brain by promoting angiogenesis following intracerebral hemorrhage (ICH) and elucidate its specific mechanism. The effect of ZYAND on the nervous system of mice after ICH was explored through behavioral experiments, such as the Morris water maze and Rotarod tests, and its effects on oxidative stress were explored by detecting several oxidative stress markers, including malondialdehyde, nitric oxide, glutathione peroxidase, and superoxide dismutase. Real-time quantitative RT-PCR and WB were used to detect the effects of ZYAND on the levels of prolyl hydroxylase domain 3 (PHD3), hypoxia-inducible factor-1α (HIF-1α), and vascular endothelial growth factor (VEGF) in the brain tissues of mice. The effect of ZYAND on the NF-κB signaling pathway was detected using a luciferase reporter gene. A human umbilical cord vascular endothelial cell angiogenesis experiment was performed to determine whether ZYAND promotes angiogenesis. The Morris water maze test and other behavioral experiments verified that ZYAND improved the neurobehavior of mice after ICH. ZYAND activated the PHD3/HIF-1α signaling pathway, inhibiting the oxidative damage caused by ICH. In angiogenesis experiments, it was found that ZYAND promoted VEGF-induced angiogenesis by upregulating the expression of HIF-1α, and NF-κB signaling regulated the expression of HIF-1α by inhibiting PHD3. ZYAND exerts a reparative effect on brain tissue damaged after ICH through the NF-κB/ PHD3/HIF-1α/VEGF signaling axis.

Contrast-enhanced ultrasound diagnosis of prostatic sarcoma: Two case reports

RATIONALE

Prostatic sarcoma (PS) is a very rare malignant tumor that accounts for <0.1% of prostate malignancies, and Ewing's sarcoma is an extremely rare form of PS.

PATIENT CONCERNS

We reported on a 64-year-old patient with PS and a 36-year-old patient with Ewing's sarcoma, both of whom were examined by contrast-enhanced ultrasonography (CEUS) before surgery.

DIAGNOSES

The 2 cases were proven to be prostatic stromal sarcoma, which was confirmed by imaging manifestations and histopathological findings.

INTERVENTIONS

The 64-year-old patient underwent radical prostatectomy, and the 36-year-old patient underwent chemotherapy combined with local radiotherapy.

OUTCOMES

PS showed diffuse enlargement of the prostate on sonography, and the necrotic liquefying area within the large vessels could be clearly displayed by CEUS. CEUS can be advocated as a valuable noninvasive and safe imaging diagnosis method for PS.

[Epidemic dynamic model based evaluation of effectiveness of prevention and control strategies for COVID-19 in Ningbo]

Objective: To evaluate effectiveness of prevention and control strategies for COVID-19 in Ningbo by using an epidemic dynamic model. Methods: The incidence data and epidemic information of COVID-19 reported in Ningbo as of 9 March, 2020 were collected, and based on the implementation of prevention and control strategies, we developed a SEIR epidemic dynamics model. The basic and real-time reproduction numbers were calculated to evaluate effectiveness of prevention and control. Results: A total of 157 cases of COVID-19 were confirmed, without death, in Ningbo. The proportion of severe cases was 12.1%. The mean incubation period was estimated to be (5.7±2.9) days. The mean interval from illness onset to diagnosis was (5.4±3.7) days. The mean duration from diagnosis to hospital discharge was (16.6±6.5) days. A total of 105 339 contacts had been under medical observation. The infection rates in contacts with home quarantine and centralized quarantine were 0.1% and 0.3%, respectively. In the confirmed cases, those who had been under medical observation before diagnoses accounted for 63.1%. The basic reproduction number was estimated to be 4.8. With the strengthening of prevention and control measures, real-time reproduction number showed a gradual downward trend, dropping to below 1.0 on 4 February, and then continued to drop to 0.2 in mid-February. Conclusion: The effectiveness of the prevention and control measures for COVID-19 in Ningbo can be evaluated by using epidemic dynamic model to provide scientific evidence for the development of the prevention and control strategies.

MiR-129 reduces CDDP resistance in gastric cancer cells by inhibiting MAPK3

Since this article has been suspected of research misconduct and the corresponding authors did not respond to our request to prove originality of data and figures, "MiR-129 reduces CDDP resistance in gastric cancer cells by inhibiting MAPK3, by H.-Y. Cao, C.-H. Xiao, H.-J. Lu, H.-Z. Yu, H. Hong, C.-Y. Guo, J.-F. Yuan, published in Eur Rev Med Pharmacol Sci 2019; 23 (15): 6478-6485-DOI: 10.26355/eurrev_201908_18531-PMID: 31378887" has been withdrawn. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/18531.

Application of spectral CT in the diagnosis of contrast encephalopathy following carotid artery stenting: a case report

BACKGROUND

Contrast encephalopathy is a rare complication of carotid artery stenting (CAS). Contrast encephalopathy is a diagnosis of exclusion that often needs to be distinguished from high perfusion syndrome, cerebral haemorrhage, subarachnoid haemorrhage (SAH), cerebral infarction and so on.

CASE PRESENTATION

In this study, we report on a 70-year-old man who was admitted to the hospital with transient ischaemic attacks presenting paroxysmal weakness of limbs in the previous 2 years. He had severe stenosis of the left internal carotid artery diagnosed by digital subtraction angiography (DSA) and underwent CAS. Two hours after the operation, the patient developed paralysis of the right upper limb, unclear speech, fever and restlessness. Emergency skull computed tomography (CT) showed swelling and a linear high-density area in the left cerebral hemisphere. To clarify the components of this high-density area in the traditional CT, the patient had spectral CT, which made the diagnosis of the leakage of contrast clear. After 1 week of supportive treatment, the patient improved.

CONCLUSIONS

Spectral CT can easily distinguish the components of high-density areas on traditional CT, which is haemorrhage, calcification or iodine contrast leakage. Therefore, spectral CT is worth consideration for the differential diagnosis of complications of vascular intervention.

Artificial intelligence-guided image acquisition on patients with implanted electrophysiological devices: results from a pivotal prospective multi-center clinical trial

Background

A novel, recently FDA-authorized software uses deep learning (DL) to provide prescriptive transthoracic echocardiography (TTE) guidance, allowing novices to acquire standard TTE views. The DL model was trained by &gt;5,000,000 observations of the impact of probe motion on image orientation/quality. This study evaluated whether novice-acquired TTE images guided by this software were of diagnostic quality in patients with and without implanted electrophysiological (EP) devices, focusing on RV size and function, which were thought to be sensitive to EP devices. Some aspects of the study have previously been presented.

Methods

240 patients (61±16 years old, 58% male, 33% BMI &gt;30 kg/m2, 91% with cardiac pathology) were recruited. 8 nurses without echo experience each acquired 10 view TTEs in 30 patients guided by the software. 235 of the patients were also scanned by a trained sonographer without assistance from the software. 5 Level 3 echocardiographers independently assessed the diagnostic quality of the TTEs acquired by the nurses and sonographers to evaluate the effect of EP devices on DL software performance.

Results

Nurses using the AI-guided acquisition software acquired TTEs of sufficient quality to make qualitative assessments of right ventricular (RV) size and function in greater than 80% of cases for patients with and without implanted EP devices (Table). There was no significant difference between nurse- and sonographer-acquired scans.

Conclusion

These results indicate that new DL software can guide novices to obtain TTEs that enable qualitative assessment of RV size even in the presence of implanted EP devices. The results of the comparison to sonographer-acquired exams indicate the software performance is robust to presence of pacemaker/ICD leads visible in the images (Figure).

Nurse-acquired TTE with visible ICD lead

Funding Acknowledgement

Type of funding source: Private company. Main funding source(s): Caption Health, Inc.

MiR-129 reduces CDDP resistance in gastric cancer cells by inhibiting MAPK3

OBJECTIVE

Abnormal expression of mitogen-activated protein kinase 3 (MAPK3) is related to invasion, metastasis, and drug resistance of multiple tumor cells. MiR-129 expression is associated with gastric cancer. Bioinformatics analysis showed a targeting relation between miR-129 and MAPK3. This study investigated whether miR-129 plays a role in regulating MAPK3 expression, affecting proliferation, apoptosis, and cisplatin (CDDP) resistance of gastric cancer cells.

MATERIALS AND METHODS

The dual-luciferase reporter gene assay was used to assess the targeted regulation between miR-129 and MAPK3. The expression of miR-129 and MAPK3 in CDDP-resistant cell line MGC-803/CDDP and the parental MGC-803 cells was measured. MGC-803/CDDP cells were cultured in vitro and divided into miR-NC group and miR-129 mimic group. The expression of MAPK3 and p-MAPK3 protein were detected by Western blot and the effect of CDDP treatment on cell apoptosis and proliferation was detected by flow cytometry.

RESULTS

There was a targeted regulation relation between miR-129 and MAPK3 mRNA. MiR-129 expression in MGC-803/CDDP cells was significantly lower than that in MGC-803 cells and the expression of MAPK3 mRNA and protein was significantly higher than that in MGC-803 cells. Compared with miR-NC group, the expression of MAPK3 and p-MAPK3 in MHC-803/CDDP cells in miR-129 mimic transfection group was significantly decreased, with increased cell apoptosis and reduced cell proliferation.

CONCLUSIONS

The decreased expression of miR-129 and the up-regulation of MAPK3 are associated with CDDP resistance in gastric cancer cells. Overexpression of miR-129 inhibits MAPK3 expression and cell proliferation, it induces cell apoptosis and reduces CDDP resistance.