MRgFUS ablation of a recurrent tenosynovial giant cell tumor in the foot using ExAblate 2100 system in combination with patient immobilization device

INTRODUCTION

Magnetic Resonance-guided Focused Ultrasound (MRgFUS) treatment for certain anatomy locations can be extremely challenging due to patient positioning and potential motion. This present study describes the treatment of a recurrent tenosynovial giant cell tumor of the plantar forefoot using the ExAblate 2100 system in combination with patient immobilization device.

METHODS

Prior to the treatment, several patient immobilization devices were investigated. Vacuum cushions were selected and tested for safety and compatibility with the treatment task and the MR environment.

RESULTS

During the treatment, one vacuum cushion immobilized the patient's right leg in knee flexion and allowed the bottom of the foot to be securely positioned on the treatment window. Another vacuum cushion supported the patient upper body extended outside the scanner bore. 19 sonications were successfully executed. The treatment was judged to be successful. No immediate complications were observed.

CONCLUSIONS

MRgFUS treatment of a recurrent tenosynovial giant cell tumor of the right plantar forefoot was successful with the use of patient immobilization vacuum cushions.

IMPLICATIONS FOR PRACTICE

The immobilization system could be utilized to aid future MRgFUS treatment of lesions in challenging anatomic locations. Various sizes of the vacuum cushions are available to potentially better accommodate other body parts and treatment configurations.

Novel Biomimetic "Spider Web" Robust, Super-Contractile Liquid Crystal Elastomer Active Yarn Soft Actuator

In nature, spider web is an interwoven network with high stability and elasticity from silk threads secreted by spider. Inspired by the structure of spider webs, light-driven liquid crystal elastomer (LCE) active yarn is designed with super-contractile and robust weavability. Herein, a novel biomimetic gold nanorods (AuNRs) @LCE yarn soft actuator with hierarchical structure is fabricated by a facile electrospinning and subsequent photocrosslinking strategies. Meanwhile, the inherent mechanism and actuation performances of the as-prepared yarn actuator with interleaving network are systematically analyzed. Results demonstrate that thanks to the unique "like-spider webs" structure between fibers, high molecular orientation within the LCE microfibers and good flexibility, they can generate super actuation strain (≈81%) and stable actuation performances. Importantly, benefit from the robust covalent bonding at the organic-inorganic interface, photopolymerizable AuNRs molecules are uniformly introduced into the polymer backbone of electrospun LCE yarn to achieve tailorable shape-morphing under different light intensity stimulation. As a proof-of-concept illustration, light-driven artificial muscles, micro swimmers, and hemostatic bandages are successfully constructed. The research disclosed herein can offer new insights into continuous production and development of LCE-derived yarn actuator that are of paramount significance for many applications from smart fabrics to flexible wearable devices.

Protein Supplements with Short Peptides Are Better than Complex Protein-Based Supplements on Improving Early Fat-Free Mass Loss Following Bariatric Surgery: A Retrospective Cohort Study

INTRODUCTION

Bariatric surgery (BS) patients are advised to consume protein supplements to prevent fat-free mass (FFM) loss. However, limited research has explored the efficacy of diverse protein presentations on FFM preservation. This study assesses if short peptide-based (SPB) supplements surpass complex protein-based (CPB) supplements in reducing early FFM loss post-surgery.

METHODS

In this retrospective cohort study, 138 patients who underwent BS other than Roux-en-Y-gastric bypass (RYGB) between January 2021 and March 2021 at the Department of Bariatric Surgery of the Third People's Hospital of Chengdu were included for analysis. Patients were divided into two groups based on their consumption of protein supplements after surgery: SPB group and CPB group. Multiple linear regressions separated by sex were employed to examine the associations between SPB supplements and FFM loss and percentage of FFM (%FFM) loss, respectively.

RESULTS

Among participants, 69.6% were female, with a mean age of 33.3 years. In multiple linear regression analyses, SPB supplements were significantly and positively associated with a lower FFM loss in both female (ꞵ =  - 1.14, P = 0.047) and male (ꞵ =  - 2.36, P = 0.024), and were positively associated with a lower %FFM loss in both female (ꞵ =  - 1.83) and male (ꞵ =  - 2.26) but only significant in male (P = 0.049).

CONCLUSION

SPB supplements may be more effective in preventing early FFM loss after BS, compared to CPB supplements, particularly among male patients. Therefore, SPB supplements may be recommended to patients undergoing BS. Further research is needed to validate these findings.

Development and validation of a point-of-care nursing mobile tool to guide the diagnosis of malnutrition in hospitalized adult patients: a multicenter, prospective cohort study

Malnutrition is a prevalent and severe issue in hospitalized patients with chronic diseases. However, malnutrition screening is often overlooked or inaccurate due to lack of awareness and experience among health care providers. This study aimed to develop and validate a novel digital smartphone-based self-administered tool that uses facial features, especially the ocular area, as indicators of malnutrition in inpatient patients with chronic diseases. Facial photographs and malnutrition screening scales were collected from 619 patients in four different hospitals. A machine learning model based on back propagation neural network was trained, validated, and tested using these data. The model showed a significant correlation (p < 0.05) and a high accuracy (area under the curve 0.834-0.927) in different patient groups. The point-of-care mobile tool can be used to screen malnutrition with good accuracy and accessibility, showing its potential for screening malnutrition in patients with chronic diseases.

Flexible Self-Supporting MOF-Based Bean Pod Cube Hollow Nanofibers for Ultralong Cycling and High Rate Na Storage

Sodium-ion batteries (SIBs) have garnered significant attention due to their potential as an emerging energy storage solution. Tin sulfide (SnS) has emerged as a promising anode material for SIBs due to its impressive theoretical specific capacity of 1022 mA h g-1 and excellent electrical conductivity. However, its practical application has been hindered by issues such as large volume expansion, which adversely affects cycling stability and rate performance during the charge/discharge processes. In this study, a novel approach to address these issues by synthesizing the bean pod cube hollow metal-organic framework (MOF)-SnSx/NC@N-doped carbon nanofibers through a process involving electrospinning, PDA coating, and calcination. The Sn-MOF serves as a self-sacrificing template, facilitating the simultaneous dissociation of MOF and polymerization of dopamine, leading to the creation of hollow intermediates that retain tin components. Subsequent sulfidation results in the integration of the hollow MOF-SnSx/NC nanoparticles within 3D nitrogen-doped carbon nanofibers, forming the distinctive bean pod cube composite structure. This unique configuration effectively shortens the diffusion path and mitigates volume expansion for sodium ions, ultimately yielding an exceptional high rate performance of 130 mA h g-1 (10 A g-1) and an ultralong cycling performance of 328 mA h g-1 even after 3500 cycles (2 A g-1) as the anode for SIBs.

Multi-Pleated Alkalized Ti3 C2 Tx MXene-Based Sandwich-Like Structure Composite Nanofibers for High-Performance Sodium/Lithium Storage

The volume expansion of CoFe2 O4 anode poses a significant challenge in the commercial application of lithium/sodium-ion batteries (LIBs/SIBs). However, metal-organic-frameworks (MOF) offer superior construction of heterostructures with refined interfacial interactions and lower ion diffusion barriers in Li/Na storage. In this study, the CoFe2 O4 @carbon nanofibers derived from MOF are produced through electrospinning, in situ growth followed by calcination, which are then confined within an MXene-confined MOF-derived porous CoFe2 O4 @carbon composite architecture under alkali treatment. The CoFe2 O4 nanofibers anchor on the alkalized MXene that is decorated with the NaOH solution to form a multi-pleated structure. The sandwich-like structure of the composite effectively alleviates the volume expansion and shortens the Li/Na-ion diffusion path, which displays high capacity and outstanding rate performance as anode materials for LIBs/SIBs. As a consequence, the obtained CoFe2 O4 @carbon@alkalized MXene composite anode shows satisfied rate performance at current density of 10 A g-1 for LIBs (318 mAh·g-1 ) and 5 A g-1 for SIBs (149 mAh g-1 ). The excellent cycling performance is further demonstrated at a high current density, where it maintains a discharge capacity of 807 mAh g-1 at 2 A g-1 after 400 cycles for LIBs and 130 mAh g-1 at 1 A g-1 even after 1000 cycles for SIBs.

Establishing a machine learning model for predicting nutritional risk through facial feature recognition

Background

Malnutrition affects many worldwide, necessitating accurate and timely nutritional risk assessment. This study aims to develop and validate a machine learning model using facial feature recognition for predicting nutritional risk. This innovative approach seeks to offer a non-invasive, efficient method for early identification and intervention, ultimately improving health outcomes.

Methods

We gathered medical examination data and facial images from 949 patients across multiple hospitals to predict nutritional status. In this multicenter investigation, facial images underwent preprocessing via face alignment and cropping. Orbital fat pads were isolated using the U-net model, with the histogram of oriented gradient (HOG) method employed for feature extraction. Standardized HOG features were subjected to principal component analysis (PCA) for dimensionality reduction. A support vector machine (SVM) classification model was utilized for NRS-2002 detection. Our approach established a non-linear mapping between facial features and NRS-2002 nutritional risk scores, providing an innovative method for evaluating patient nutritional status.

Results

In context of orbital fat pad area segmentation with U-net model, the averaged dice coefficient is 88.3%. Our experimental results show that the proposed method to predict NRS-2002 scores achieves an accuracy of 73.1%. We also grouped the samples by gender, age, and the location of the hospital where the data were collected to evaluate the classification accuracy in different subsets. The classification accuracy rate for the elderly group was 85%, while the non-elderly group exhibited a classification accuracy rate of 71.1%; Furthermore, the classification accuracy rate for males and females were 69.2 and 78.6%, respectively. Hospitals located in remote areas, such as Tibet and Yunnan, yielded a classification accuracy rate of 76.5% for collected patient samples, whereas hospitals in non-remote areas achieved a classification accuracy rate of 71.1%.

Conclusion

The attained accuracy rate of 73.1% holds significant implications for the feasibility of the method. While not impeccable, this level of accuracy highlights the potential for further improvements. The development of this algorithm has the potential to revolutionize nutritional risk assessment by providing healthcare professionals and individuals with a non-invasive, cost-effective, and easily accessible tool.

Eliminate the hardware: Mobile terminals-oriented food recognition and weight estimation system

Food recognition and weight estimation based on image methods have always been hotspots in the field of computer vision and medical nutrition, and have good application prospects in digital nutrition therapy and health detection. With the development of deep learning technology, image-based recognition technology has also rapidly extended to various fields, such as agricultural pests, disease identification, tumor marker recognition, wound severity judgment, road wear recognition, and food safety detection. This article proposes a non-wearable food recognition and weight estimation system (nWFWS) to identify the food type and food weight in the target recognition area via smartphones, so to assist clinical patients and physicians in monitoring diet-related health conditions. In addition, the system is mainly designed for mobile terminals; it can be installed on a mobile phone with an Android system or an iOS system. This can lower the cost and burden of additional wearable health monitoring equipment while also greatly simplifying the automatic estimation of food intake via mobile phone photography and image collection. Based on the system's ability to accurately identify 1,455 food pictures with an accuracy rate of 89.60%, we used a deep convolutional neural network and visual-inertial system to collect image pixels, and 612 high-resolution food images with different traits after systematic training, to obtain a preliminary relationship model between the area of food pixels and the measured weight was obtained, and the weight of untested food images was successfully determined. There was a high correlation between the predicted and actual values. In a word, this system is feasible and relatively accurate for one automated dietary monitoring and nutritional assessment.

A Digital Smartphone-Based Self-administered Tool (R+ Dietitian) for Nutritional Risk Screening and Dietary Assessment in Hospitalized Patients With Cancer: Evaluation and Diagnostic Accuracy Study

BACKGROUND

Malnutrition is a common and severe problem in patients with cancer that directly increases the incidence of complications and significantly deteriorates quality of life. Nutritional risk screening and dietary assessment are critical because they are the basis for providing personalized nutritional support. No digital smartphone-based self-administered tool for nutritional risk screening and dietary assessment among hospitalized patients with cancer has been developed and evaluated.

OBJECTIVE

This study aims to develop a digital smartphone-based self-administered mini program for nutritional risk screening and dietary assessment for hospitalized patients with cancer and to evaluate the validity of the mini program.

METHODS

We have developed the R+ Dietitian mini program, which consists of 3 parts: (1) collection of basic information of patients, (2) nutritional risk screening, and (3) dietary energy and protein assessment. The face-to-face paper-based Nutritional Risk Screening (NRS-2002), the Patient-Generated Subjective Global Assessment Short Form (PG-SGA-SF), and 3 days of 24-hour dietary recall (3d-24HRs) questionnaires were administered according to standard procedure by 2 trained dietitians as the reference methods. Sensitivity, specificity, positive predictive value, negative predictive value, κ value, and correlation coefficients (CCs) of nutritional risk screened in R+ Dietitian against the reference methods, as well as the difference and CCs of estimated dietary energy and protein intakes between R+ Dietitian and 3d-24HRs were calculated to evaluate the validity of R+ Dietitian.

RESULTS

A total of 244 hospitalized patients with cancer were recruited to evaluate the validity of R+ Dietitian. The NRS-2002 and PG-SGA-SF tools in R+ Dietitian showed high accuracy, sensitivity, and specificity (77.5%, 81.0%, and 76.7% and 69.3%, 84.5%, and 64.5%, respectively), and fair agreement (κ=0.42 and 0.37, respectively; CC 0.62 and 0.56, respectively) with the NRS-2002 and PG-SGA-SF tools administered by dietitians. The estimated intakes of dietary energy and protein were significantly higher (P<.001 for both) in R+ Dietitian (mean difference of energy intake: 144.2 kcal, SD 454.8; median difference of protein intake: 10.7 g, IQR 9.5-39.8), and showed fair agreement (CC 0.59 and 0.47, respectively), compared with 3d-24HRs performed by dietitians.

CONCLUSIONS

The identified nutritional risk and assessment of dietary intakes of energy and protein in R+ Dietitian displayed a fair agreement with the screening and assessment conducted by dietitians. R+ Dietitian has the potential to be a tool for nutritional risk screening and dietary intake assessment among hospitalized patients with cancer.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR1900026324; https://www.chictr.org.cn/showprojen.aspx?proj=41528.

Heterostructure Fe2O3 nanorods@imine-based covalent organic framework for long cycling and high-rate lithium storage

Fe₂O₃ as an anode for lithium-ion batteries has attracted intense attention because of its high theoretical capacity, natural abundance, and good safety. However, the inferior cycling stability, low-rate performance, and limited composite varieties hinder the application of Fe₂O₃-based materials. In this work, an Fe₂O₃@COF-LZU1 (FO@LZU1) anode was prepared via an imine-based covalent organic framework (COF-LZU1) covering on the exterior surface of Fe₂O₃ after rational optimization. With its unique heterostructure, the COF-LZU1 layer not only effectively alleviated the volume expansion during cycling but also improved the charge-transfer capability because of the π-conjugated system. Moreover, the organic functional group (CN, benzene ring) for COF-LZU1 provided more redox-active sites for Li⁺ storage. Under the contributions of both Fe₂O₃ nanorods and COF-LZU1, the FO@LZU1_50% exhibited an ultrahigh initial capacity and long-term cycling performance with initial discharge capacities of 2143 and 2171 mA h g^-1 after 300 cycles under 0.1 A g^-1, and rate performance of 1310 and 501 mA h g^-1 at 0.3 and 3 A g^-1, respectively. In addition, a high retention capacity of 1185 mA h g^-1 was achieved at 1 A g^-1 after 500 cycles. Furthermore, a full-cell with the FO@LZU1_50% anode and LiCoO₂ cathode exhibited superior cycling and rate performance, which still maintained a reversible capacity of 260 mA h g^-1 after 200 cycles even at a current density of 1 A g^-1. The proposed strategy offers a new perspective for exploring the high-rate capability and designability of Fe₂O₃-based electrode materials.

[Mortality trend of chronic respiratory diseases in China, 1990-2019]

Objective: To analyze mortality and its trend of chronic respiratory diseases (CRD) in China from 1990 to 2019. Methods: Based on the provincial results of China from the 2019 Global Burden of Disease (GBD) study, the average annual percent change (AAPC) of standardized mortality rates of different CRDs were analyzed by using Joinpoint 4.8.0.1, and the age-standardized mortality rate of CRD was calculated by using the GBD 2019 world standard population. Based on the comparative risk assessment theory of GBD, the attributable deaths due to 12 CRD risk factors were estimated, including smoking, indoor air pollution, occupational gas exposure, particulates and smog exposure, environmental particulate pollution, low temperature, passive smoking, ozone pollution, occupational exposure to silica, occupational asthma, high body mass index, high temperature and occupational exposure to asbestos. Results: From 1990 to 2019, the number of deaths and standardized mortality of chronic obstructive pulmonary disease (COPD) showed a downward trend (P<0.001). The number of COPD deaths decreased from 1 244 000 (912 000 - 1 395 000) in 1990 to 1 037 000 (889 000 - 1 266 000) in 2019. AAPC=-0.9% (95%CI: -1.5% - -0.3%), P<0.001; The standardized mortality rate decreased from 217.9/100 000 (163.3/100 000 - 242.0/100 000) in 1990 to 65.2/100 000 (55.5/100 000 - 80.1/100 000) in 2019. AAPC= -4.2% (95%CI:-5.2% - -3.2%), P<0.001. The number of deaths from asthma decreased from 40 000 (30 000 - 58 000) in 1990 to 25 000 (20 000 - 31 000) in 2019. AAPC=-2.0% (95%CI: -2.6% - -1.4%), P<0.001; The standardized mortality rate of asthma decreased from 6.4/100 000 (4.7/100 000 - 9.5/100 000) in 1990 to 1.5/100 000 (1.2/100 000 - 1.9/100 000) in 2019. AAPC=-5.1% (95%CI: -5.8% - -4.4%), P<0.001. The number of pneumoconiosis deaths decreased from 11 000 (8 000 - 14 000) in 1990 to 10 000 (8 000 - 14 000) in 2019, AAPC=-0.2%(95%CI:-0.4% - 0.1%), P=0.200; The standardized mortality rate of pneumoconiosis decreased from 1.4/100 000 (1.0/100 000 - 1.7/100 000) in 1990 to 0.5/100 000 (0.4/100 000 - 0.7/100 000) in 2019. AAPC=-3.1% (95%CI: -3.4% - -2.8%), P<0.001. The number of deaths from pulmonary interstitial diseases and pulmonary sarcoidosis increased from 3 000 (3 000 - 6 000) in 1990 to 8 000 (6 000 - 10 000) in 2019, AAPC=3.5% (95%CI: 2.7% - 4.2%), P<0.001; The corresponding standardized mortality rate changed little from 1990 to 2019, and AAPC was not statistically significant.The age-standardized mortality rates of different CRDs were higher in men than those in women. In 1990 and 2019, the mortality rates of COPD, asthma, pneumoconiosis and interstitial pulmonary disease and pulmonary sarcoidosis increased with age. In 2019, the population attributable fractions (PAFs) for smoking, environmental particulate pollution, occupational gas exposure, particulate and smog exposure, low temperature exposure and passive smoking were 71.1% (68.0% - 74.3%), 24.7% (20.1% - 30.0%), 19.3% (13.0% - 25.4%), 15.7% (13.6% - 18.3%) and 8.8% (4.5% - 13.1%) respectively in men, and the PAFs for environmental particulate pollution, smoking, low temperature exposure, occupational gas exposure, particulate and smog exposure, and passive smoking were 24.1% (19.6% - 29.3%), 21.9% (18.7% - 25.2%), 16.4% (14.0% - 19.2%), 15.6% (10.2% - 21.1%) and 14.7% (7.9% - 21.3%) respectively in women. Conclusions: During 1990-2019, the overall death level of CRD decreased significantly in China, but it is still at high level in the world. Active prevention and control measures should be taken to reduce the death level caused by CRD.

Metal–organic framework-derived porous CoFe2O4/carbon composite nanofibers for high-rate lithium storage

Upon assembled into full cells, metal–organic frameworks derived porous CoFe2O4/carbon composite nanofibers achieved long-cycling and high-rate performance, and a series of LED bulbs can be lit to demonstrate its potential in real applications.

Nature-Inspired Hierarchical Protrusion Structure Construction for Washable and Wear-Resistant Superhydrophobic Textiles with Self-Cleaning Ability

The use of toxic components and short longevity greatly restricted the commercial application of superhydrophobic surfaces in oil-water separation, antifouling, and self-cleaning. To address these concerns, a durable, robust, and fluorine-free superhydrophobic fabric is prepared on account of inspiration of nature. In this work, submicrometer-sized silica particles with different particle sizes are deposited onto cotton fabrics, followed by hydrophobic modification of poly(dimethylsiloxane) (PDMS), and consequently bonded the substrate and coating via powerful covalent bonds through a simple dip-coating technique. The rough surface with an imitated lotus-leaf-like hierarchical protrusion structure is constructed by deposited submicrometer-sized particles with different particle sizes, while the fabric with a low surface energy is achieved by the hydrophobic modification of PDMS. Ultimately, the fabricated fabric exhibits extraordinary superhydrophobicity with a high water contact angle (WCA) of 161° and a small sliding hysteresis angle (SHA) of 2.4°. Besides, considerable mechanical stability to withstand 130 sandpaper abrasion cycles and 40 washing cycles, and chemical resistance with sustained superhydrophobic property in various harsh environments (e.g., boiling water, strong acid/base solutions, and various organic solvents), are presented. Moreover, higher than 90% separation efficiency with a contact angle >150 ° is produced even after 50 cycles when the fabricated fabric serves as a filter during the oil-water separation besides its outstanding staining resistance and self-cleaning property.

An LCI-like protein APC2 protects ginseng root from Fusarium solani infection

AIMS

We aimed to purify an antimicrobial protein from Bacillus amyloliquefaciens FS6 culture supernatant, verify its antimicrobial activity against Fusarium solani and evaluate its biocontrol potential for ginseng root rot.

METHODS AND RESULTS

The antimicrobial protein was purified from FS6 culture supernatant using ammonium sulphate precipitation, anion exchange and gel chromatography. Based on mass spectrometry results, the purified protein was identified as an antimicrobial protein of the LCI family and was designated APC₂ . The APC₂ recombinant protein expressed in Escherichia coli (BL21) significantly inhibited F. solani and decreased the infection and spread of F. solani in ginseng root. An overexpressing APC₂ strain FS6-APC₂ was constructed and shown to have enhanced antimicrobial activity compared to the wild-type strain FS6.

CONCLUSIONS

The APC₂ protein shows strong antimicrobial activity against F. solani, reduces the incidence and severity of ginseng root rot caused by F. solani and exhibits a great biocontrol potential.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study reports the inhibitory activity of APC₂ protein (LCI family) against F. solani and its protective efficacy on ginseng root rot. These findings provide a scientific basis for future research on the biocontrol mechanism, as well as the development and application of FS6.

Hyponatremia in neuromyelitis optica spectrum disorders: Literature review

Hyponatremia is a potentially serious electrolyte abnormality observed in neuromyelitis optica spectrum disorders (NMOSDs), and its most common cause is syndrome of inappropriate antidiuretic hormone secretion (SIADH). Another potential cause of hyponatremia is cerebral salt-wasting syndrome (CSWS), although CSWS has not previously been reported in NMOSDs. Accurate and early differentiation between SIADH and CSWS is difficult. However, the two conditions have important implications for the selection of therapy. Here, we describe two patients with aquaporin-4 antibody (AQP4-Ab)-positive NMOSDs who developed hyponatremia as a result of CSWS and SIADH, respectively. Additionally, we review all previously reported studies of hyponatremia in patients with NMOSDs and propose several potential pathophysiological mechanisms of hyponatremia. In conclusion, NMOSDs accompanied by hyponatremia are not actually rare, but have previously been given little attention. Furthermore, SIADH should not be the only consideration, before the exclusion of rare but significant CSWS.

Effect of mitochondrial ATP-sensitive potassium channel opening on the translocation of protein kinase C epsilon in adult rat ventricular myocytes

This study aimed to investigate the effects of mitochondrial ATP-sensitive potassium (MitoKATP) channel opening on the translocation of protein kinase C epsilon (PKCε). In addition, we aimed to determine the relationship between PKCε translocation and the production of reactive oxygen species (ROS). PKCε protein expression in cultured adult rat ventricular myocytes was investigated by immunofluorescence and Western blotting. Diazoxide (DZ), a selective MitoKATP channel activator, caused a significant translocation to myofibrillar-like structures in cultured adult rat ventricular myocytes. N-2-Mercaptopropionylglycine, a free radical scavenger, could partially inhibit the translocation of PKCε induced by DZ. By contrast, chelerythrine, a selective PKC inhibitor, could completely block the translocation of PKCε induced by DZ. The opening of MitoKATP channels might activate and cause PKCε to translocate into myofibrillar-like structures. PKCε activation occurred downstream of the MitoKATP channel, possibly as a result of ROS production that occurred after the MitoKATP channels opened.

Manual cataract extraction via a subconjunctival limbus oblique incision for mature cataracts

Aims:

To report the technique and outcomes of sutureless manual cataract extraction via a subconjunctival limbus oblique incision for mature cataracts.

Materials and Methods:

This retrospective study comprised of 112 eyes of 83 patients with mature cataract who all had manual cataract extraction via a subconjunctival limbus oblique incision. A transconjunctival tunnel is fashioned with a 3.0 mm keratome, 0.5 mm behind the limbal vascular arcades. A limbal tunnel, with a transverse extent of 9 mm in the cornea and 7.0 mm in the limbus, is created beneath the conjunctival/Tenon's tissue using an angled bevel-up crescent blade. Outcome measures included visual acuity, intraoperative complications, surgically induced astigmatism, endothelial cell loss rate and surgery time.

Results:

Self-sealing wound was achieved in 112 eyes (98.2%). The nucleus was delivered in whole in 108 eyes (96.4%). Intraoperative complications included hyphema in 3 eyes (2.7%), iridodialysis in 2 eyes 1.8%), posterior capsular rupture and zonular dialysis in 2 eyes (1.8%). At the 3-month follow-up, 91% patients achieved a best-corrected visual acuity of 20/20 or better, the mean of surgically induced astigmatism was -0.62 ± 0.41 Diopters and endothelial cell loss was 4.2%. Average surgical time was 3.75 min per case.

Conclusion:

This subconjunctival limbus oblique incision has the potential to serve as safe and effective technique for mature cataracts.

Predicting transient particle transport in enclosed environments with the combined computational fluid dynamics and Markov chain method

To quickly obtain information about airborne infectious disease transmission in enclosed environments is critical in reducing the infection risk to the occupants. This study developed a combined computational fluid dynamics (CFD) and Markov chain method for quickly predicting transient particle transport in enclosed environments. The method first calculated a transition probability matrix using CFD simulations. Next, the Markov chain technique was applied to calculate the transient particle concentration distributions. This investigation used three cases, particle transport in an isothermal clean room, an office with an underfloor air distribution system, and the first-class cabin of an MD-82 airliner, to validate the combined CFD and Markov chain method. The general trends of the particle concentrations vs. time predicted by the Markov chain method agreed with the CFD simulations for these cases. The proposed Markov chain method can provide faster-than-real-time information about particle transport in enclosed environments. Furthermore, for a fixed airflow field, when the source location is changed, the Markov chain method can be used to avoid recalculation of the particle transport equation and thus reduce computing costs.

The prognostic significance of apoptosis-related biological markers in Chinese gastric cancer patients

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Background: The prognosis varied among the patients with the same stage, therefore there was a need for new prognostic and predictive factors. The aim of this study was to evaluate the relationship of apoptosis-related biological markers such as P21, P27, P53, Bcl-2, Bax, and c-myc, and clinicopathological features and their prognostic value.

Methods: From January 1996 to December 2007, 4,426 patients had undergone gastrectomy for gastric cancer at Fudan University Shanghai Cancer Center. Among 501 patients, the expression levels of P21, P27, P53, Bcl-2, Bax, and c-myc were examined by immunohistochemistry. The prognostic value of biological markers and the correlation between biological markers and other clinicopathological factors were investigated.

Results: There were 339 males and 162 females (2.09:1) with a mean age of 57. The percentages of positive expression of P21, P27, P53, Bcl-2, Bax, and c-myc were 73%, 25%, 65%, 22%, 43%, and 58%, respectively. There was a strong correlation between P21, P53, Bax, and c-myc expression (p = 0.00). There was significant association between P27, Bcl-2, and Bax expression (p < 0.05). The P21 expression correlated with male (p = 0.00), histological grade (p = 0.00), Borrmann type (p = 0.02), tumor location (p = 0.01); the P53 expression with histological grade (p = 0.01); Bcl-2 expression with pathological stage (p = 0.01); Bax expression with male (p = 0.02), histological grade (p = 0.01), Borrmann type (p = 0.01), tumor location (p = 0.00), lymph node metastasis (p = 0.03), pathological stage (p = 0.01); c-myc expression with Borrmann type (p = 0.00). Bcl-2 expression was related with good survival in univariate analysis (p = 0.01). Multivariate analysis showed that Bcl-2 expression and pathological stage were defined as independent prognostic factors for gastric cancers. There was significant differences of overall 5-year survival rates according to Bcl-2 expression or not in stage III (p = 0.00).

Conclusions: The expressionof Bcl-2 was an independent prognostic factor for Chinese patients with gastric cancer; it might be a candidate for the gastric cancer staging system.

No significant financial relationships to disclose.

Cloning, mapping and mutation analysis of human geneGJB5 encoding gap junction protein beta-5

By homologous EST searching and nested PCR a new human geneGJB5 encoding gap junction protein beta-5 was identified.GJB5 was genetically mapped to human chromosome 1p33-p35 by FISH. RT-PCR revealed that it was expressed in skin, placenta and fetal skin. DNA sequencing ofGJB5 was carried out in 142 patients with sensorineural hearing impairment and probands of 36 families with genetic diseases, including erythrokeratodermia (5 families), Charcot-Marie-Tooth disease (13), ptosis (4), and retinitis pigmentosa and deafness (14). Two missense mutations (686A-->G, H229R; 25C-->T, L9F) were detected in two sensorineural hearing impairment families. A heterologous deletion of 18 bp within intron was found in 3 families with heredity hearing impairment, and in one of the 3 families, a missense mutation (R265P) was identified also. But the deletion and missense mutation seemed not segregating with hearing impairment in the family. No abnormal mRNA or mRNA expression was detected in deletion carriers by RT-PCR analysis in skin tissue. Mutation analysis in 199 unaffected individuals revealed that two of them were carriers with the same 18 bp deletion.

Non-viral ex vivo transduction of human hepatocyte cells to express factor VIII using a human ribosomal DNA-targeting vector

BACKGROUND

In gene therapy, one of the most important issues is the choice of the vectors. pHrneo is a human-derived vector previously constructed by our group, which can target a foreign gene into a human ribosomal DNA (hrDNA) locus.

METHODS AND RESULTS

In this study, we inserted an expression cassette of reconstructive hFVIII (hFVIII-BDDAK39) to pHrneo to construct a targeting vector: pHrneo-BDDAK39. Through electroporation of pHrneo-BDDAK39 into HL7702 cells (human hepatocyte), we identified the homologous recombinants using polymerase chain reaction, and tested the expression of hFVIII-BDDAK39 located at the hrDNA locus. The hFVIII-BDDAK39 was successfully targeted into the hrDNA locus of HL7702 by pHrneo-BDDAK39, and the efficiency of site-specific integration was 1.1 x 10(-5). The hFVIII-BDDAK39 at the hrDNA locus of HL7702 was found to be able to express efficiently (4.3 +/- 0.9 ng 10(-6) cells 24 h(-1)).

CONCLUSION

It has been indicated that the targeting vector pHrneo-BDDAK39 can be used in gene therapy for hemophilia A.

[Effects of vitamin A and iron supplementation on the improvement of iron status and immunological function in preschool children]

OBJECTIVE

In order to understand the changes in immunological function in rural preschool children with lower levels of vitamin A and iron, and the effect of vitamin A and iron supplementation on the improvement of iron status and immunological function.

METHODS

Serum vitamin A concentration and hemoglobin (Hb), serum iron (SI), transferrin saturation (TS), serum ferritin (SF) were determined in 270 rural preschool children aged 3-7 years in Beijing, and the subjects were divided into four groups based on their determinations: control, lower serum vitamin A, lower iron, and both lower iron and serum vitamin A. Forty subjects were selected from each group, and serum IgA, IgG, IgM and interleukin-2 (IL-2) were determined for them. Forty-one subjects who had lower iron and lower serum vitamin A (< 1.12 mumol/L) were divided into two groups: one of them supplemented with 30 mg iron element (ferrous sulfate 0.15 g) once a day for 8 weeks, and the other group supplemented with iron and 12,500 IU vitamin A twice a week for 8 weeks. After supplementation of vitamin A and iron, their serum vitamin A, hematological iron index and serum immunological index were determined again for the two groups.

RESULTS

Serum IgM were (1,260 +/- 310) mg/L in both lower iron and serum vitamin A groups, significantly higher than that in normal group (1,070 +/- 170) mg/L (P < 0.05). But there were no significant differences in serum levels of IgG, IgA and IL-2. After supplementation of iron and vitamin A, their serum TS increased to (26.5 +/- 8.6)%, significantly higher than that before supplementation and that supplemented with iron only (22.3 +/- 3.8)%. And, their serum IL-2 were (278.9 +/- 117.7) ng/L after supplementation, significantly higher than that before supplementation (161.6 +/- 90.3) ng/L and that in those supplemented with iron only (189.5 +/- 89.3) ng/L. There was no significant difference in other biochemical indices of iron and immunological indices.

CONCLUSIONS

Supplementation with vitamin A and iron was helpful to improve body iron nutritional status and immunological function obviously in preschool children with iron-deficiency and sub-clinical deficiency of vitamin A.

Determination of D- and L-aspartate in cell culturing medium, within cells of MPT1 cell line and in rat blood by a column-switching high-performance liquid chromatogrpahic method

HPLC fluorometric methods have been used to analyze trace amounts of D-amino acids in biological samples. In this study, we established an expedient column-switching fluorometric HPLC system that would improve the analysis of D-amino acids, in particular D-aspartate (Asp). Our system consists of the fluorogenic derivatization of amino acids with NBD-F and two chromatographic steps, one that separates individual amino acids in reverse phase mode and another that separates the chiral forms of each amino acid in normal-phase mode. The two separation steps are linked through a trapping column by an automated column-switching system. In addition, sample preparation is simplified and improved, where trichloroacetic acid is used for deproteinization, and borate buffer, pH 9.5 is employed for the fluorescent derivatization. The detection limit for D-Asp in culturing medium is 5 nM. The resulting peak heights correlated well with concentrations that ranged from 12.5 to 250 nM for both D- and L-Asp. The present method was applied to determine D- and L-Asp levels in cell culturing medium, and within cells of MPT1 cell line. The detected cellular levels of D- and L-Asp agree with those detected by our previous method. In addition, this method was used to measure D- and L-Asp levels in rat blood samples, and the results are consistent with the reported values.

[Changes of serum transferrin receptor in children with iron deficiency and its response to iron supplementation]

OBJECTIVES

To study the level of serum transferrin receptor (sTfR) in children with different stages of iron deficiency, as well as in the normal children, to observe its response to iron supplementation, and to explore the role of sTfR in surveillance of iron status and assessment of iron supplementation in population.

METHODS

By determining iron status index, 1,006 children aged 6-14 years in Fangshan District, Beijing were divided into four groups, control group, iron depletion (ID) group, iron deficiency erythropoiesis (IDE) group and iron deficiency anemia (IDA) group, and 239 of them were measured for sTfR with Quintikine enzyme immunoassay (R&D system, Minneapolis, MN) and sTfR/logserum ferratin (SF) was estimated. Iron supplementation (NaFeEDTA capsules, containing 60 mg iron element per capsule) was administered for the children with ID and IDE per capsule once weekly and for the children with IDA per capsule thrice weekly for nine weeks. Iron status index and sTfR were measured before and after iron supplementation.

RESULTS

The levels of sTfR and sTfR/log SF in children with ID, IDE and IDA were (20.03 +/- 2.33) nmol/L, (24.52 +/- 1.07) nmol/L, (33.28 +/- 6.09) nmol/L and (18.15 +/- 5.31), (20.98 +/- 8.88), (29.08 +/- 8.57), respectively, significantly higher than those in the control group [sTfR(18.74 +/- 3.06) nmol/L and sTfR/log SF(9.89 +/- 1.74)]. Statistical analysis showed that sTfR correlated to free erythrocyte protoporphyrin and hemoglobin. sTfR levels in normal children was (12.5-23.5) nmol/L. After iron supplementation, sTfR levels in children with ID was (16.37 +/- 3.10) nmol/L, significantly decreased than those before iron supplementation, but no change in sTfR was observed in children with IDE and IDA. sTfR/log SF were decreased significantly in all children with ID group(11.42 +/- 3.12), IDE (16.54 +/- 4.70) and IDA (23.59 +/- 9.93).

CONCLUSION

sTfR is a specific indicator for identifying IDE and IDA, and sTfR/log SF is a sensitive index for assessing the effects of iron supplementation.

[Effects of cactus, alove veral, momorcica charantia on reducing the blood glucose of diabetic mice]

The effects of cactus, alove veral and momorcica charantia on reducing the blood glucose level of mice were observed. The diabetic model with no symptom in mice was established by injection of streptozotocin(STZ) 80 mg/kg BW into abdominal cavity for 11 days. The diabetic mice were randomly divided into 8 groups: STZ diabetic model, diet A, diet B, cactus, alove veral, momordica charantia and glyburide groups. Cactus (60 g/kg BW), alove veral (60 g/kg BW), and momordica charantia (30 g/kg BW) were administrated orally each day to the diabetic mice for another 21 days. Serum glucose of mice fasting for 12 hours and 2 hours after meal was determined with the method of glucose-oxidase at the 21th day of the experiment. The results showed that serum glucose levels of diabetic mice were significantly higher than the normal control group (P < 0.01). After giving diet A, cactus, alove veral and momorcica charantia juice for 21 days, the serum glucose concentration of these diabetic mice were significantly lower than STZ diabetic model group (P < 0.01) but still higher than the normal control group.

Occurrence of D-Amino Acids and a pyridoxal 5'-phosphate-dependent aspartate racemase in the acidothermophilic archaeon, Thermoplasma acidophilum

Free D-amino acid content in some archaea was investigated and D-forms of several amino acids were found in them. In the acidothermophilic archaeon, Thermoplasma acidophilum, the proportion of D-aspartate (D-Asp) to total Asp was as high as 39.7%. Crude extracts of Thermoplasma acidophilum had Asp-specific racemase activity that was pyridoxal 5'-phosphate (PLP)-dependent. The relative insensitivity to a SH-modifying reagent distinguished this activity from those of the PLP-independent Asp racemases found in other hyperthermophilic archaea (Matsumoto, M., et al., J. Bacteriol. 181, 6560-6563 1999). Thus, high levels of d-Asp should be produced by a new type(s) of Asp-specific racemase in Thermoplasma acidophilum, although the function of d-Asp in this archaeon remains unknown.

Localization, Transport, and Uptake of -Aspartate in the Rat Adrenal and Pituitary Glands

Large amounts of D-aspartate (D-Asp) are present in the rat adrenal and pituitary glands. D-Asp is thought to be synthesized in the mammalian body and also accumulates in various tissues following intraperitoneal or intravenous administration. This report examines the origins of D-Asp in the adrenal and pituitary glands. We administered D-Asp to male rats intraperitoneally and immunolocalized this exogenous D-Asp in adrenal and pituitary tissue, using an anti-D-Asp antiserum which was previously developed in our laboratory. D-Asp levels in the rat adrenal gland have been shown to undergo a transient increase at 3 weeks of age and to decrease rapidly thereafter. We found that in the adrenal gland, exogenous D-Asp administered intraperitoneally was incorporated into the same region of the adrenal cortex in which endogenous D-Asp was present. By Northern and Western blot analysis and immunohistochemistry of glutamate (Glu) transporter, we also found that expression of the Glu transporter (GLAST), which has an affinity for D-Asp, transiently increased at 3 weeks of age and that localization patterns of the Glu transporter within the tissue were almost coincident with those of endogenous D-Asp. These observations suggest that D-Asp in the adrenal cortex of 3-week-old male rats is primarily acquired by uptake from the vascular system. We have previously shown that D-Asp is specifically localized in prolactin (PRL)-containing cells in the anterior lobe of the adult rat pituitary gland. Here we report that in the pituitary gland, exogenous D-Asp accumulated in endothelial cells, but not in PRL-containing cells. Northern and Western blot analysis and immunohistochemistry of Glu transporter revealed that developmental changes in the Glu transporter (GLAST) expression did not correlate with tissue levels of D-Asp and that the Glu transporter was not expressed in PRL-containing cells. These observations suggest that, in contrast to the adrenal gland, most of the D-Asp in the pituitary gland of adult male rats originates inside the gland itself.

Antiretroviral agents inhibit infection of human cells by porcine endogenous retroviruses

The efficacy of antiretroviral drugs against porcine endogenous retroviruses (PERV) that may be harbored in pig organs intended for transplantation was examined in human cells in vitro. The nucleoside analogs zidovudine and dideoxyinosine were found to effectively inhibit PERV replication.

d-Aspartate in a prolactin-secreting clonal strain of rat pituitary tumor cells (GH(3))

d-Aspartate (d-Asp) is found in prolactin (PRL)-containing cells of the rat anterior pituitary gland [Lee et al., Brain Res. 838, 193-199, 1999]. In order to determine whether d-Asp is actually produced by the anterior pituitary gland and whether it plays a physiological role in PRL function, a PRL-secreting clonal strain of rat pituitary tumor cells (GH(3)) was employed in this study. HPLC analysis and immunocytochemical staining detected the presence and synthesis of d-Asp in the cytoplasm of these cells. In addition, thyrotropin-releasing hormone-stimulated PRL secretion was increased in a dose-dependent fashion by d-Asp from these cells. These results suggest that the anterior pituitary gland synthesizes d-Asp and that d-Asp acts as a messenger in this gland.

Infection by porcine endogenous retrovirus after islet xenotransplantation in SCID mice

Animal donors such as pigs could provide an alternative source of organs for transplantation. However, the promise of xenotransplantation is offset by the possible public health risk of a cross-species infection. All pigs contain several copies of porcine endogenous retroviruses (PERV), and at least three variants of PERV can infect human cell lines in vitro in co-culture, infectivity and pseudotyping experiments. Thus, if xenotransplantation of pig tissues results in PERV viral replication, there is a risk of spreading and adaptation of this retrovirus to the human host. C-type retroviruses related to PERV are associated with malignancies of haematopoietic lineage cells in their natural hosts. Here we show that pig pancreatic islets produce PERV and can infect human cells in culture. After transplantation into NOD/SCID (non-obese diabetic, severe combined immunodeficiency) mice, we detect ongoing viral expression and several tissue compartments become infected. This is the first evidence that PERV is transcriptionally active and infectious cross-species in vivo after transplantation of pig tissues. These results show that a concern for PERV infection risk associated with pig islet xenotransplantation in immunosuppressed human patients may be justified.

[A clinicopathological study of mediastinal lymph node metastasis of lung cancer]

BACKGROUND

To investigate the characteristics of mediastinal lymph node metastasis of lung cancer from a view of pathology.

METHODS

Radical pulmonectomy or lobectomy combined with extensive dissection of mediastinal lymph node was carrived out in 398 patients with lung cancr. N2 disease was diagnozed in 160 cases, and total 352 groups of mediastinal lymph node invaded were analyzed.

RESULTS

N2 disease appeared as single group, multi-groups and jumping-form groups, comprising 41.2%,58.8% and 29.3% respectively. The highest metastatic site of lymph node was group 7 mediastinal lymph node, the followings were group 4, 3 and 5 lymph nodes, comprising 45.6%, 31.3% and 25.6% respectively. The N2 metastasis was highly correlated with the site, size, histological classification and cell differentiation of the cancer. An another characteristic of N2 metastasis was that the metastatic lymph node could invaded into the bronchial wall, especially in adenocarcinoma.

CONCLUSIONS

It is necessary to dissect the lymph nodes of the hilar and upper and lower mediastinum at the homolateral thoracic cavity extensively and completely. Attention should be paid to the bronchial wall invasion by the metastatic lymph nodes, too.

Occurrence of free D-amino acids and aspartate racemases in hyperthermophilic archaea

The occurrence of free D-amino acids and aspartate racemases in several hyperthermophilic archaea was investigated. Aspartic acid in all the hyperthermophilic archaea was highly racemized. The ratio of D-aspartic acid to total aspartic acid was in the range of 43.0 to 49.1%. The crude extracts of the hyperthermophiles exhibited aspartate racemase activity at 70 degrees C, and aspartate racemase homologous genes in them were identified by PCR. D-Enantiomers of other amino acids (alanine, leucine, phenylalanine, and lysine) in Thermococcus strains were also detected. Some of them might be by-products of aspartate racemase. It is proven that D-amino acids are produced in some hyperthermophilic archaea, although their function is unknown.

A phase 1-2 clinical trial of gene therapy for recurrent glioblastoma multiforme by tumor transduction with the herpes simplex thymidine kinase gene followed by ganciclovir. GLI328 European-Canadian Study Group

This study has investigated the effects of herpes simplex thymidine kinase gene (HSV-tk) transfer followed by ganciclovir treatment as adjuvant gene therapy to surgical resection in patients with recurrent glioblastoma multiforme (GBM). The study was open and single-arm, and aimed at assessing the feasibility and safety of the technique and indications of antitumor activity. In 48 patients a suspension of retroviral vector-producing cells (VPCs) was administered by intracerebral injection immediately after tumor resection. Intravenous ganciclovir was infused daily 14 to 27 days after surgery. Patients were monitored for adverse events and for life by regular biosafety assaying. Tumor changes were monitored by magnetic resonance imaging (MRI). Reflux during injection was a frequent occurrence but serious adverse events during the treatment period (days 1-27) were few and of a nature not unexpected in this population. One patient experienced transient neurological disorders associated with postganciclovir MRI enhancement. There was no evidence of replication-competent retrovirus in peripheral blood leukocytes or in tissue samples of reresection or autopsy. Vector DNA was shown in the leukocytes of some patients but not in autopsy gonadal samples. The median survival time was 8.6 months, and the 12-month survival rate was 13 of 48 (27%). On MRI studies, tumor recurrence was absent in seven patients for at least 6 months and for at least 12 months in two patients, one of whom remains recurrence free at more than 24 months. Treatment-characteristic images of injection tracks and intracavity hemoglobin were apparent. In conclusion, the gene therapy is feasible and appears to be satisfactorily safe as an adjuvant to the surgical resection of recurrent GBM, but any benefit appears to be marginal. Investigation of the precise effectiveness of this gene therapy requires prospective, controlled studies.

In vitro analysis of transformation potential associated with retroviral vector insertions

While replication-defective retroviral vectors provide excellent vehicles for the long-term expression of therapeutic genes, they also harbor the potential to induce undesired genetic changes by random insertions into the host genome. The rate of insertional mutagenesis for retroviral vectors has been determined in several different assay systems; however, the rate at which such events induce cellular transformation has not been directly determined. Such measurements are critical to determining the actual risk of carcinogenesis resulting from retroviral gene therapy. In this study, the ability of a replication-defective retroviral vector, GlnBgSvNa, to induce cellular transformation in the BALB/c-3T3 in vitro transformation assay was assessed. The transformation frequency observed in vector-transduced BALB/c-3T3 cells, which contained one to six copies of integrated provirus, was not significantly different from that of untreated control cells. The finding that GlnBgSvNa was nontransforming in this assay indicates that the rate of transformation induced by retroviral insertions is less than the spontaneous rate of cellular transformation by BALB/c-3T3 cells, or less than 1.1 x 10(-5). These results are the first to define an upper limit for the rate of transformation induced by retroviral vectors.

Search for cross-species transmission of porcine endogenous retrovirus in patients treated with living pig tissue. The XEN 111 Study Group

Pig organs may offer a solution to the shortage of human donor organs for transplantation, but concerns remain about possible cross-species transmission of porcine endogenous retrovirus (PERV). Samples were collected from 160 patients who had been treated with various living pig tissues up to 12 years earlier. Reverse transcription-polymerase chain reaction (RT-PCR) and protein immunoblot analyses were performed on serum from all 160 patients. No viremia was detected in any patient. Peripheral blood mononuclear cells from 159 of the patients were analyzed by PCR using PERV-specific primers. No PERV infection was detected in any of the patients from whom sufficient DNA was extracted to allow complete PCR analysis (97 percent of the patients). Persistent microchimerism (presence of donor cells in the recipient) was observed in 23 patients for up to 8.5 years.