Efficacy and safety of concurrent chemoradiotherapy with paclitaxel-based or S-1 regimens in treating elderly patients with esophageal squamous cell carcinoma: A multi-center propensity-score matched study

BACKGROUND

Elderly patients with esophageal cancer can benefit from concurrent chemoradiotherapy (CCRT). However, the optimal concurrent chemotherapy regimen remains undetermined. We aimed to compare the efficacy and safety of CCRT with paclitaxel-based or S-1 regimens in treating elderly patients with esophageal squamous cell carcinoma (ESCC).

METHODS

From January 2016 to November 2022, a total of 349 patients aged 70 and above with ESCC were included. The patient population was divided into two treatment groups: patients receiving paclitaxel-based CCRT were allocated to the TP group, and those receiving S-1 regimen CCRT were allocated to the S-1 group. Propensity score matching (PSM) was used to balance potential biases. Survival outcomes, overall response rate, and treatment-related toxicities were assessed.

RESULTS

After PSM, there were 82 patients in each group. The median follow up of the surviving patients was 42.6 months (IQR 28.0-58.8 months). The 2-year overall survival (OS) rate (71.4% vs 65.4%; log-rank P = 0.010) and progression-free survival (PFS) rate (64.4% vs 58.0%; log-rank P = 0.048) were significantly higher in the TP group. Compared with the S-1 group, the TP group experienced a higher rate of grade 3 and above hematologic toxicities, such as leukopenia (47.6% vs 15.9%, P < 0.001) and neutropenia (35.4% vs 6.1%, P < 0.001). One patient in the TP group and two patients in the S-1 group had grade 5 toxic effects.

CONCLUSIONS

Our findings suggest that paclitaxel-based CCRT was well tolerated in elderly patients with ESCC and provided significant survival benefits over S-1 regimen.

Janus sponge/electrospun fibre composite combined with EGF/bFGF/CHX promotes reconstruction in oral tissue regeneration

Guided bone regeneration (GBR) is currently the most widely used bone augmentation technique in oral clinics. However, infection and soft tissue management remain the greatest challenge. In this study, a Janus sponge/electrospun fibre membrane containing epidermal growth factor (EGF), basic fibroblast growth factor (bFGF) and chlorhexidine (CHX) were prepared to optimize its application as a barrier membrane for GBR. The loose sponge part was covalently bonded with the fiber part which has a dense structure. The composed scaffold exhibited superior biocompatibility and antibacterial activity verified by in vitro test. A rat model of unilateral skull bone injury was used to confirm the effectiveness on both hard and soft tissue regeneration. The chitosan sponge on the soft tissue side containing EGF, bFGF and CHX had a loose structure, promoting collagen and cell regeneration and exerting an antibacterial effect. Meanwhile, the dense PLGA/PCL layer on the hard tissue side prevented fibroblast entry into the bone defect, thereby facilitating bone regeneration. The Janus composite scaffold provides a promising strategy for oral tissue restoration.

A novel endoscopic artificial intelligence system to assist in the diagnosis of autoimmune gastritis: a multicenter study

BACKGROUND & AIMS

Autoimmune gastritis (AIG), distinct from Helicobacter pylori-associated atrophic gastritis (HpAG), is underdiagnosed due to limited awareness. This multicenter study aims to develop a novel endoscopic artificial intelligence (AI) system assisting in AIG diagnosis.

METHODS

Patients diagnosed with AIG, as well as HpAG and non-atrophic gastritis (NAG), were retrospectively enrolled from six centers. Endoscopic images with relevant demographic and medical data, were collected for the development of AI-assisted system, SEER-SCOPE AI, based on multi-site feature fusion model. The diagnostic performance of SEER-SCOPE AI was evaluated in the internal and external datasets. Endoscopists' performance with and without AI support was tested and compared using Mann-Whitney U test. Heatmap analysis was performed to interpret SEER-SCOPE AI.

RESULTS

1 070 patients (294 AIG, 386 HpAG, 390 NAG) with 18 828 endoscopy images were collected. SEER-SCOPE AI achieved strong performance for identifying AIG, with 96.9% sensitivity, 92.2% specificity and an AUROC of 0.990 internally, and 90.3% sensitivity, 93.1% specificity and an AUROC of 0.973 externally. The performance of SEER-SCOPE AI (sensitivity 91.3%) was comparable to experts (87.3%) and significantly outperformed non-experts (70.0%). With AI support, the overall performance of endoscopists was improved (sensitivity: 90.3% [95% CI 86.0%-93.2%] vs. 78.7% [95% CI 73.6%-83.2%], p=0.008). Heatmap analysis revealed consistent focus of SEER-SCOPE AI on regions corresponding to atrophic areas.

CONCLUSIONS

SEER-SCOPE AI demonstrated expert-level performance in identifying AIG, and enhanced the diagnostic ability of endoscopists. Its application holds promise as a potent endoscopy-assisted tool for guiding biopsy sampling and early detection of AIG.

Serum Autotaxin Level Positively Associates with Metabolic Associated Fatty Liver Disease and Hyperuricemia in Postmenopausal Women

INTRODUCTION

Autotaxin is an adipokine known to affect energy metabolism and lipid homeostasis. We aimed to evaluate serum autotaxin levels in metabolic associated fatty liver disease (MAFLD) and other metabolic disorders in postmenopausal women.

METHODS

Postmenopausal women who received an annual health examination were included. The metabolic and demographic characteristics of the subjects were collected, including age, gender, weight, height, blood pressure, and biochemical parameters. Serum autotaxin level was determined by ELISA.

RESULTS

This cross-sectional includes 20 postmenopausal women and 20 age-paired healthy controls. MAFLD patients showed significant metabolic disturbance presented with increased BMI, blood pressure (P＜0.001) and decreased HDL-C (P＜0.05), as well as liver injury companied by elevated ALT (P＜0.05). Serum autotaxin levels were statistically higher in MAFLD (253.1±52.1 vs. 202.2±53.2 ng/mL; P < 0.01) and positively correlated with ALT (P＜0.001), GGT and BMI (P＜0.01), SBP and TG (P＜0.05). Higher autotaxin group demonstrated worsen metabolic states with greater proportion of MAFLD, higher BMI (P＜0.01) and ALT (P＜0.05). Logistic regression analysis revealed that serum autotaxin levels would positively independently predicted MAFLD (OR 1.049, 95% CI 1.001-1.098, P＜0.05) with AUC of 0.763. Serum level of autotaxin is significantly elevated in hyperuricemia group (257.3±60.9 vs. 214.5±49.4 ng/mL; P < 0.05), and positively correlated with uric acid level (P＜0.01). Serum autotaxin would also act as diagnosing parameter of hyperuricemia with AUC of 0.706.

CONCLUSIONS

Among postmenopausal women, serum autotaxin level is significantly elevated in MAFLD and related to multiple metabolic characteristics, especially hyperuricemia, which would thus serve as a potential non-invasive biomarker as well as a therapeutic target.

Extracting the femtometer structure of strange baryons using the vacuum polarization effect

One of the fundamental goals of particle physics is to gain a microscopic understanding of the strong interaction. Electromagnetic form factors quantify the structure of hadrons in terms of charge and magnetization distributions. While the nucleon structure has been investigated extensively, data on hyperons are still scarce. It has recently been demonstrated that electron-positron annihilations into hyperon-antihyperon pairs provide a powerful tool to investigate their inner structure. We present a method useful for hyperon-antihyperon pairs of different types which exploits the cross section enhancement due to the effect of vacuum polarization at the J/ψ resonance. Using the 10 billion J/ψ events collected with the BESIII detector, this allows a precise determination of the hyperon structure function. The result is essentially a precise snapshot of theΛ ¯ Σ 0 ( Λ Σ ¯ 0 ) transition process, encoded in the transition form factor ratio and phase. Their values are measured to be R = 0.860 ± 0.029(stat.) ± 0.015(syst.), Δ Φ Λ ¯ Σ 0 = ( 1.011 ± 0.094 ( stat. ) ± 0.010 ( syst. ) ) r a d and Δ Φ Λ Σ ¯ 0 = ( 2.128 ± 0.094 ( stat. ) ± 0.010 ( syst. ) ) r a d . Furthermore, charge-parity (CP) breaking is investigated in this reaction and found to be consistent with CP symmetry.

Antimicrobial Isochroman-Derived Atropo-diastereomeric Dimers from Penicillium steckii SCISO 41228

A pair of unidentified atropisomeric dimers, penicisteckins G (1) and H (2), and twelve known compounds (3-16) were isolated from the marine coral-derived fungus Penicillium steckii SCISO41228. Their structures including the absolute configuration were determined by HR-ESI-MS, ECD, 1D-, and 2D-NMR spectra. Compounds 1 and 2 exhibited potent antibacterial activity against most pathogenic strains, especially for MASA and Micrococcus luteus, with MIC values of 4.0 μg·mL-1. In addition, compounds 2 and 3 exhibit potent antioxidant activity with IC50 values of 10.76 and 8.66 μg·mL-1, respectively.

Macrophages enhance sodium channel expression in cardiomyocytes

Cardiac macrophages facilitate electrical conduction through the atrioventricular-node (AV) in mice. A possible role for cardiomyocyte-macrophage coupling on the effect of antiarrhythmic therapy has not been investigated yet. Holter monitoring was conducted in LysMCrexCsf1rLsL-DTR mice (MMDTR) under baseline conditions and after an elctrophysiological stress test by flecainide. In vivo effects were recapitulated in vitro by patch-clamp experiments. The underlying mechanism was characterized by expression and localization analysis of connexin43 (Cx43) and voltage-gated-sodium-channel-5 (Nav1.5). ECG monitoring in MMDTR mice did not show any significant conduction abnormalities but a significantly attenuated flecainide-induced extension of RR- and PP-intervals. Patch-clamp analysis revealed that the application of flecainide to neonatal rat ventricular cardiomyocytes (CMs) changed their resting-membrane-potential (RMP) to more negative potentials and decreased action-potential-duration (APD50). Coupling of macrophages to CMs significantly enhances the effects of flecainide, with a further reduction of the RMP and APD50, mediated by an upregulation of Cx43 and Nav1.5 surface expression. Macrophage depletion in mice does not correlate with cardiac electric conduction delay. Cardiac macrophages amplify the effects of flecainide on electrophysiological properties of cardiomyocytes in vivo and in vitro. Mechanistically, formation of macrophage-cardiomyocyte cell-cell-contacts via Cx43 facilitates the recruitment of Nav1.5 to the cell membrane increasing flecainide effects.

A novel method of identification of in-ring decay and its application in the half-life estimates of 94mRu44

Isochronous Mass Spectrometry is a practical approach for studying decays of short-lived isomers. However, solely relying on the time stamps between the isomer and ground state does not provide clear sign of decay. To address this issue, we proposed a method for extracting decay time point by analyzing the residuals of time stamps within a window of (20μs, 180μs) after the start of data acquisition. Decay events out of the window were disregarded due to poor accuracy of revolution time. In this paper, we propose a novel approach based on the discrete Fourier transform technique, which was tested by simulation data. We found that the accuracy of the decay time point can be improved, leading to an expanded window of (15μs, 185μs). Furthermore, as the novel method was applied to experimental data, additional five decay events were identified. The newly determined half-life of 94mRu44+ is consistent with the previous value.

Identification of molecular subtypes for endometrial carcinoma using a 46-gene next-generation sequencing panel: a retrospective study on a consecutive cohort

BACKGROUND

Traditional classification tools for endometrial carcinoma (EC), such as DNA sequencing, immunohistochemistry (IHC), or PCR, are cumbersome and time-consuming. Large next-generation sequencing (NGS) panels have simplified testing but are expensive. In this study, we propose a concise NGS panel as an effectively viable approach for classifying EC.

MATERIALS AND METHODS

We retrospectively enrolled a consecutive EC cohort of hysterectomy with bilateral salpingo-oophorectomy from Fudan University Shanghai Cancer Center between 2020 and 2022. A 46-gene NGS panel was utilized to identify POLE exonuclease domain mutations, microsatellite instability-high (MSI-H), TP53 mutations, and other clinically relevant targets.

RESULTS

Tumor tissue samples from 331 EC patients were evaluated, with 284 (85.8%) cases classified as endometrioid endometrial carcinoma. The median follow-up time was 32.6 months (n = 303), during which 23 patients experienced recurrence or disease progression. Using the concise NGS panel, patients were stratified into four molecular subgroups according to the World Health Organization classification criteria: POLE mut (n = 47; 14.2%), mismatch repair deficiency (dMMR) (n = 79; 23.9%), non-specific molecular profile (n = 148; 44.7%), and abnormal p53 expression (p53 abn) (n = 57; 17.2%). POLE mut displayed the most favorable prognosis, while p53 abn had the worst prognosis (P < 0.001). The concordance between NGS and IHC was 91.8% (269/293) for detecting MMR status and 65.3% (201/308) for detecting p53 status. Patients detected solely by NGS had significantly worse prognosis than those detected solely by IHC, indicating higher accuracy of the NGS panel. With the molecular subtyping information, adjuvant treatment plans for 19.6% of patients could potentially be altered, mainly concentrated in the POLE mut and p53 abn subtypes. This panel also aids targeted therapy and poly (ADP-ribose) polymerase (PARP) inhibitor-related gene mutation detection, as well as auxiliary genetic screening.

CONCLUSION

Our study demonstrates that the concise NGS panel is an effective 'one-stop' strategy for precisely classifying EC with high clinical availability.

Observation of New Charmonium or Charmoniumlike States in B^{+}→D^{*±}D^{∓}K^{+} Decays

A study of resonant structures in B^{+}→D^{*+}D^{-}K^{+} and B^{+}→D^{*-}D^{+}K^{+} decays is performed, using proton-proton collision data at center-of-mass energies of sqrt[s]=7, 8, and 13 TeV recorded by the LHCb experiment, corresponding to an integrated luminosity of 9  fb^{-1}. A simultaneous amplitude fit is performed to the two channels with contributions from resonances decaying to D^{*-}D^{+} and D^{*+}D^{-} states linked by C parity. This procedure allows the C parities of resonances in the D^{*±}D^{∓} mass spectra to be determined. Four charmonium or charmoniumlike states are observed decaying into D^{*±}D^{∓}: η_{c}(3945), h_{c}(4000), χ_{c1}(4010), and h_{c}(4300), with quantum numbers J^{PC} equal to 0^{-+}, 1^{+-}, 1^{++}, and 1^{+-}, respectively. At least three of these states have not been observed previously. In addition, the existence of the T_{c[over ¯]s[over ¯]0}^{*}(2870)^{0} and T_{c[over ¯]s[over ¯]1}^{*}(2900)^{0} resonances in the D^{-}K^{+} mass spectrum, already observed in the B^{+}→D^{+}D^{-}K^{+} decay, is confirmed in a different production channel.

Search for Rare Decays of D_{s}^{+} to Final States π^{+}e^{+}e^{-}, ρ^{+}e^{+}e^{-}, π^{+}π^{0}e^{+}e^{-}, K^{+}π^{0}e^{+}e^{-}, and K_{S}^{0}π^{+}e^{+}e^{-}

Using 7.33  fb^{-1} of e^{+}e^{-} collision data collected by the BESIII detector at center-of-mass energies in the range of sqrt[s]=4.128-4.226  GeV, we search for the rare decays D_{s}^{+}→h^{+}(h^{0})e^{+}e^{-}, where h represents a kaon or pion. By requiring the e^{+}e^{-} invariant mass to be consistent with a ϕ(1020), 0.98 Collapse

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One New Quinazoline-Containing Diketopiperazine Isolated from the Marine-Sponge-Derived Fungus Penicillium sp. SCSIO41043

One new quinazoline-containing diketopiperazine (1), along with 24 known compounds including nine alkaloids (2-9, and 25), thirteen lactones (10-22), aspterric acid (23), and catechol (24), were isolated from the marine sponge-derived Penicillium sp. SCSIO41043. Their planar structures were unequivocally elucidated by spectroscopic analysis. The absolute configuration of 1 was determined by a comparison of reported and experimental electronic circular dichroism (ECD) spectra. Compound 16 was found to notably inhibit the growth of five pathogenic bacteria and fungi with MIC values ranging from 0.5-16.0 μg/mL. Compounds 7, 17, 20, and 22 demonstrated moderate activity against Micrococcus luteus with MIC values ranging from 35.6 to 71.1 μg/mL. Moreover, 1-3 displayed different degrees of antioxidant activity with EC50 values of 0.98, 0.60, 0.46 mg/mL, respectively.

Strong and Weak CP Tests in Sequential Decays of Polarized Σ^{0} Hyperons

The J/ψ, ψ(3686)→Σ^{0}Σ[over ¯]^{0} processes and subsequent decays are studied using the world's largest J/ψ and ψ(3686) data samples collected with the BESIII detector. The parity-violating decay parameters of the decays Σ^{0}→Λγ and Σ[over ¯]^{0}→Λ[over ¯]γ, α_{Σ^{0}}=-0.0017±0.0021±0.0018 and α[over ¯]_{Σ^{0}}=0.0021±0.0020±0.0022, are measured for the first time. The strong CP symmetry is tested in the decays of the Σ^{0} hyperons for the first time by measuring the asymmetry A_{CP}^{Σ}=α_{Σ^{0}}+α[over ¯]_{Σ^{0}}=(0.4±2.9±1.3)×10^{-3}. The weak CP test is performed in the subsequent decays of their daughter particles Λ and Λ[over ¯]. Also for the first time, the transverse polarizations of the Σ^{0} hyperons in J/ψ and ψ(3686) decays are observed with opposite directions, and the ratios between the S-wave and D-wave contributions of the J/ψ, ψ(3686)→Σ^{0}Σ[over ¯]^{0} decays are obtained. These results are crucial to understand the decay dynamics of the charmonium states and the production mechanism of the Σ^{0}-Σ[over ¯]^{0} pairs.

Discovery and Bioactivity Evaluation of Citrinin Derivatives from the Mangrove Sediment-Derived Fungus Talaromyces sp. SCSIO 41428

A dimeric citrinin derivative with a unique spiro[chroman-2,3'-isochroman] skeleton, xerucitrinic acid C (1), and a new citrinin derivative, cladosporin E (6), along with ten known polyketides (2-5 and 7-12), were isolated from the mangrove sediment-derived fungus Talaromyces sp. SCSIO 41428. Their structures were elucidated through comprehensive spectral data analysis. The absolute configurations of 1 and 6 were determined by quantum chemical calculations. Compound 1 exhibited significant inhibitory effects on Staphylococcus aureus and Streptococcus suis, with the MIC of 25 μg/mL for both bacterial strains. Xerucitrinin C (3) exhibited significant radical scavenging activity against DPPH, with an IC50 value of 25.4 μM, and also demonstrated inhibitory activity against phosphodiesterase-4 (PDE4). Moreover, cladosporin C (7) notably inhibited prostate cancer cells PC-3 and 22Rv1, with IC50 values of 6.10 and 9.25 μM, respectively.

Search for Time-Dependent CP Violation in D^{0}→π^{+}π^{-}π^{0} Decays

A measurement of time-dependent CP violation in D^{0}→π^{+}π^{-}π^{0} decays using a pp collision data sample collected by the LHCb experiment in 2012 and from 2015 to 2018, corresponding to an integrated luminosity of 7.7  fb^{-1}, is presented. The initial flavor of each D^{0} candidate is determined from the charge of the pion produced in the D^{*}(2010)^{+}→D^{0}π^{+} decay. The decay D^{0}→K^{-}π^{+}π^{0} is used as a control channel to validate the measurement procedure. The gradient of the time-dependent CP asymmetry ΔY in D^{0}→π^{+}π^{-}π^{0} decays is measured to be ΔY=(-1.3±6.3±2.4)×10^{-4}, where the first uncertainty is statistical and the second is systematic, which is compatible with CP conservation.

New Sesquiterpenoids from the Mangrove-Derived Fungus Talaromyces sp. as Modulators of Nuclear Receptors

Four new sesquiterpenoids, talaroterpenes A-D (1-4), were isolated from the mangrove-derived fungus Talaromyces sp. SCSIO 41412. The structures of compounds 1-4 were elucidated through comprehensive NMR and MS spectroscopic analyses. The absolute configurations of 1-4 were assigned based on single-crystal X-ray diffraction and calculated electronic circular dichroism analysis. Talaroterpenes A-D (1-4) were evaluated with their regulatory activities on nuclear receptors in HepG2 cells. Under the concentrations of 200 μM, 1, 3 and 4 exhibited varying degrees of activation on ABCA1 and PPARα, while 4 showed the strongest activities. Furthermore, 4 induced significant alterations in the expression of downstream target genes CLOCK and BMAL1 of RORα, and the in silico molecular docking analysis supported the direct binding interactions of 4 with RORα protein. This study revealed that talaroterpene D (4) was a new potential non-toxic modulator of nuclear receptors.

Two C23-Steroids and a New Isocoumarin Metabolite from Mangrove Sediment-Derived Fungus Penicillium sp. SCSIO 41429

Two new C23-steroids derivatives, cyclocitrinoic acid A (1) and cyclocitrinoic acid B (2), and a new isocoumarin metabolite, (3R,4S)-6,8-dihydroxy-3,4,5-trimethyl-7-carboxamidelisocoumarin (10), together with 12 known compounds (3-9, 11-15) were isolated from the mangrove-sediment fungus Penicillium sp. SCSIO 41429. The structures of the new compounds were comprehensively characterized by 1D and 2D NMR, HRESIMS and ECD calculation. All isolates were evaluated for pancreatic lipase (PL) inhibitory and antioxidant activities. The biological evaluation results revealed that compounds 2, 14 and 15 displayed weak or moderate inhibition against PL, with IC50 values of 32.77, 5.15 and 2.42 µM, respectively. In addition, compounds 7, 12 and 13 showed radical scavenging activities against DPPH, with IC50 values of 64.70, 48.13, and 75.54 µM, respectively. In addition, molecular docking results indicated that these compounds had potential for PL inhibitory and antioxidant activities, which provided screening candidates for antioxidants and a reduction in obesity.

[Optimization of the control strategy and research priorities to combat the resurgence of visceral leishmaniasis in China]

Leishmaniasis is a zoonotic parasitic disease caused by Leishmania infection and transmitted by sandflies. There are three main forms of leishmaniasis, including cutaneous leishmaniasis, visceral leishmaniasis and mucocutaneous leishmaniasis. China is mainly endemic for visceral leishmaniasis, which is a class C notifiable infectious disease in the country. Following concerted efforts, the transmission of visceral leishmaniasis had been controlled in most endemic foci of China by the end of 1958, with a few cases reported in western China. Due to global climate changes and population mobility, resurgence of visceral leishmaniasis has recently occurred in historical endemic areas of central and western China, which is characterized by gradual expansion of endemic areas and remarkable rebounding epidemics. Hereby, we summarize the national and global epidemiology and control strategy of visceral leishmaniasis, propose 8 key research areas and 12 key research topics for visceral leishmaniasis control, and recommend the establishment of the joint prevention and control mechanism of "human-animals-vectors" and the working mechanism of animal prevention for human diseases based on the One Health approach, so as to combat the resurgence of visceral leishmaniasis in China.

New Bioactive Polyketides from the Mangrove-Derived Fungus Penicillium sp. SCSIO 41411

Three new polyketides, including three ester derivatives (1, 3, and 5) and a new natural product, which was a benzoquinone derivative, embelin A (4), together with nine known ones (2 and 6-13), were isolated from the mangrove-derived fungus Penicillium sp. SCSIO 41411. Their structures were determined by detailed NMR and MS spectroscopic analyses. The X-ray single-crystal diffraction analysis of 4 was described for the first time. Compound 9 displayed obvious inhibition against PDE4 with an inhibitory ratio of 40.78% at 10 μM. Compound 12 showed DPPH radical scavenging activity, with an EC50 of 16.21 µg/mL, compared to the positive control (ascorbic acid, EC50, 11.22 µg/mL). Furthermore, compound 4 exhibited cytotoxicity against PC-3 and LNCaP with IC50 values of 18.69 and 31.62 µM, respectively.

Precise Measurement of Born Cross Sections for e^{+}e^{-}→DD[over ¯] at sqrt[s]=3.80-4.95 GeV

Using data samples collected with the BESIII detector at the BEPCII collider at center-of-mass energies ranging from 3.80 to 4.95 GeV, corresponding to an integrated luminosity of 20  fb^{-1}, a measurement of Born cross sections for the e^{+}e^{-}→D^{0}D[over ¯]^{0} and D^{+}D^{-} processes is presented with unprecedented precision. Many clear peaks in the line shape of e^{+}e^{-}→D^{0}D[over ¯]^{0} and D^{+}D^{-} around the mass range of G(3900), ψ(4040), ψ(4160), Y(4260), and ψ(4415), etc., are foreseen. These results offer crucial experimental insights into the nature of hadron production in the open-charm region.

[Three cases of occupational chronic chloropropene poisoning]

Chronic chloropropene poisoning is a disease mainly caused by peripheral nerve damage due to close contact with chloropropene in industrial production, its clinical manifestations include varying degrees of sensory, motor, or tendon reflex disorders in the distal limbs, and neuromyography can show neurogenic damage. This article analyzed and summarized the clinical characteristics, diagnosis and treatment methods of three patients with occupational chronic chloropropene poisoning, in order to enhance the clinical understanding of occupational chronic chloropropene poisoning and provide reference for clinical diagnosis and treatment.

Cardiac magnetic resonance imaging (MRI) for detecting acute myocardial injury of fulminant myocarditis survivors after extracorporeal membrane oxygenation (ECMO) treatment in adults

AIMS

To detect the acute myocardial injury in fulminant myocarditis (FM) survivors after extracorporeal membrane oxygenation (ECMO) and to demonstrate its significant differences from non-FM patients by cardiac magnetic resonance (CMR).

MATERIALS AND METHODS

This retrospective study enrolled 59 patients with acute myocarditis (AM), including 35 non-FM patients, 24 FM patients, and 54 controls. The peak value of cardiac troponin T (cTnT) was recorded. Tissue parameters, including native T1, extracellular volume (ECV), late gadolinium-enhancement (LGE)%, and T2 by CMR were assessed.

RESULTS

The mean age was 35 ± 14 years, and 45.8% of the population were males in the AM group. Patients had higher levels of peak cTnT, peak NT-proBNP and peak C-reactive protein in the FM group (all p<0.05). Comparing with non-FM, the values of T1-based imaging parameters were significantly higher in the FM group (all p<0.05). In contrast, no difference was observed among the two groups in terms of T2 value (p=0.707). The septal area was more frequently involved in FM survivors after ECMO treatment, both in T1 and T2-based images. In addition, the cubic relationship was the relative best fit of LGE% against logcTnT and indicated that cTnT value exceeding 300ng/L exhibited a rapid upward trend of LGE%.

CONCLUSION

Comparing to non-FM, higher myocardial necrosis and fibrosis but similar edema determined by T1 and T2 based imaging was found in FM survivors after ECMO treatment. Furthermore, the inter-ventricular septal area was more frequently involved by acute myocardial injury in FM survivors after ECMO treatment. In addition, LGE% showed an overall increasing trend with cTnT values elevating with rapidly increasing with cTnT exceeding 300 ng/L.

High Dose of Estrogen Protects the Lungs from Ischemia-Reperfusion Injury by Downregulating the Angiotensin II Signaling Pathway

We explored the sex difference in lung ischemia-reperfusion injury (LIRI) and the role and mechanism of estrogen (E2) and angiotensin II (Ang II) in LIRI. We established a model of LIRI in mice. E2, Ang II, E2 inhibitor (fulvestrant), and angiotensin II receptor blocker (losartan) were grouped for treatment. The lung wet/dry weight ratio, natural killer (NK) cells (by flow cytometry), neutrophils (by flow cytometry), expression of key proteins (by Western blot, immunohistochemistry, ELISA, and immunofluorescence), and expression of related protein mRNA (by qPCR) were detected. The ultrastructure of the alveolar epithelial cells was observed by transmission electron microscopy. We found that E2 and Ang II played an important role in the progression of LIRI. The two signaling pathways showed obvious antagonism, and E2 regulates LIRI in the different sexes by downregulating Ang II, leading to a better prognosis. E2 and losartan reduced the inflammatory cell infiltration in lung tissue and key inflammatory factors in serum while fulvestrant and Ang II had the opposite effect. The protective effect of E2 was related with AKT, p38, COX2, and HIF-1α.