Novel variants and uncommon cases among southern Chinese children with X-linked hypophosphatemia

PURPOSE

X-linked hypophosphatemia (XLH) is the most common inherited renal phosphate wasting disorder and is often misdiagnosed as vitamin D deficiency. This study aims to provide clinical and mutational characteristics of 65 XLH pediatric patients in southern China.

METHODS

In this work, a combination of DNA sequencing and qPCR analysis was used to study the PHEX gene in 80 pediatric patients diagnosed with hypophosphatemia. The clinical and laboratory data of confirmed 65 XLH patients were assessed and analyzed retrospectively.

RESULTS

In 65 XLH patients from 61 families, 51 different variants in the PHEX gene were identified, including 23 previously reported variants and 28 novel variants. In this cohort of XLH patients, the c.1601C>T(p.Pro534Leu) variant appears more frequently. Fourteen uncommon XLH cases were described, including four boys with de novo mosaic variants, eight patients with large deletions and a pair of monozygotic twins. The clinical manifestations in this cohort are very similar to those previously reported.

CONCLUSION

This study extends the mutational spectrum of the PHEX gene, which will contribute to accurate diagnosis. This study also suggests a supplementary qPCR or MLPA assay may be performed along with classical sequencing to confirm the gross insertion/deletion.

A numerical study of spin torque oscillators based on IMA/PMA bilayer nano-pillars

In this paper, the magnetization dynamics of bilayer structured nano-pillars containing a fixed layer with perpendicular magnetic anisotropy (PMA) and a free layer with in-plane magnetic anisotropy (IMA) are studied using the micro-magnetic simulation method. Unlike typical sandwich-structured spin-torque nano-pillar oscillators (STNOs), the proposed structure does not contain any nonmagnetic spacer layer. It is found that a stable oscillation with a significant amplitude can be established fast after driving out the vortex core by an in-plane magnetic pulse field. The oscillation frequency and amplitude can be easily manipulated by adjusting the side-length of the nanopillar, the thickness and saturation magnetization of the IMA layer, and an applied magnetic field along z axis. In an array with an adequate inter-pillar distance, the mutual interaction between the nano-pillars will lead the oscillations to be phase-locked, resulting in a considerable enhancement of total amplitude. As it is easy to fabricate these kinds of bi-layer nano-pillars and assemble them in arrays, they may have widespread applications in STNOs.

Metallic Glacial Glass Formation by a First-Order Liquid-Liquid Transition

The glacial phase, with an apparently glassy structure, can be formed by a first-order transition in some molecular-glass-forming supercooled liquids. Here we report the formation of metallic glacial glass (MGG) from the precursor of a rare-earth-element-based metallic glass via the first-order phase transition in its supercooled liquid. The excellent glass-forming ability of the precursor ensures the MGG to be successfully fabricated into bulk samples (with a minimal critical diameter exceeding 3 mm). Distinct enthalpy, structure, and property changes are detected between MGG and metallic glass, and the reversed "melting-like" transition from the glacial phase to the supercooled liquid is observed in fast differential scanning calorimetry. The kinetics of MGG formation is reflected by a continuous heating transformation diagram, with the phase transition pathways measured at different heating rates taken into account. The finding supports the scenario of liquid-liquid transition in metallic-glass-forming liquids.

A higher level of total bile acid in early mid-pregnancy is associated with an increased risk of gestational diabetes mellitus: a prospective cohort study in Wuhan, China

PURPOSE

To assess the longitudinal associations between maternal total bile acid (TBA) levels during early mid-pregnancy and the subsequent risk of gestational diabetes mellitus (GDM).

METHODS

In a prospective cohort study, pregnant women who were enrolled prior to gestational week 16 were followed until delivery. TBA levels were tested during weeks 14-18 of gestation. Using logistic regression, we analyzed the associations between quartiles of TBA and GDM based on a 75-g oral glucose tolerance test (OGTT) at 24-28 gestational weeks.

RESULTS

The GDM rate was 7.9% (114/1441). The mean TBA level was higher in women with GDM than in those without GDM (2.1 ± 2.0 vs 1.5 ± 1.0 µmol/L, P = 0.000). The highest TBA level quartile (2.1-10.7 µmol/L) had a 1.78-fold (95% CI 1.01, 3.14) increased risk of GDM compared with that of the lowest quartile (0.0-0.8 µmol/L) after adjusting for pre-pregnancy body mass index (BMI), gestational, age at TBA test and other confounders. High TBA levels were involved in the fasting glucose level rather than that at 1 h and 2 h after OGTT in all participants.

CONCLUSIONS

Pregnant women with higher serum TBA levels during early mid-pregnancy have a higher risk of developing GDM. TBA may be a new risk factor for GDM.

The effects of feeding yeast bioactives to broiler breeders and/or their offspring on growth performance, gut development, and immune function in broiler chickens challenged with Eimeria

Yeast bioactives (YB) may stimulate broiler breeders (BB) to increase deposition of immunoglobulins (Ig) in eggs. We investigated the effects of feeding YB (mixture of derivatives from whole yeast subjected to enzymatic hydrolysis) to BB and/or their offspring on growth performance, gut development, and immune function in broiler chickens challenged with Eimeria. The BB (Ross 708 ♀ and Ross ♂) were assigned to 2 groups (60 ♀ and 10 ♂) and fed basal or basal diet supplemented with 500 g of YB/Mt. A total of 250 fertile eggs per treatment were collected, incubated, hatched, and sexed. Additional egg samples were analyzed for IgA and IgY contents. A total of 160 broiler chicks (80 ♀ and 80 ♂) from each breeder experimental group were placed in cages based on sex and BW resulting in 32 cages for each BB treatment group. Cages (16 per BB treatment group) were allocated to basal broiler chick diet or basal diet supplemented with 500 g of YB/Mt. On day 9, half of each BB by broiler chick dietary treatments was challenged with 1 mL of Eimeria culture (100,000 oocysts of Eimeria acervulina and 25,000 oocysts of Eimeria maxima). On day 14, all birds were necropsied for intestinal lesion scores and samples. Feeding YB to BB increased (P < 0.05) IgA concentration in egg yolk. Eimeria challenge decreased (P < 0.05) pancreas weight, jejunal villus height (VH), and growth performance but increased spleen weight, intestinal mass and jejunal mucosa IgA concentration. Independent of Eimeria challenge, feeding YB to BB and/or to chicks resulted in higher (P < 0.001) jejunal VH compared with feeding it to BB only or not at all. In conclusion, Eimeria challenge reduced growth performance and had negative effects on indices of intestinal function and health. Feeding YB to BB increased deposition of IgA in hatching eggs and improved jejunal VH independent of Eimeria challenge when fed to BB and/or to broiler chicks.

Laser-engineered heavy hydrocarbons: Old materials with new opportunities

Polycyclic heavy hydrocarbons (HHs) such as coal, tar, and pitch are a family of materials with extremely rich and complex chemistry, representing a massive opportunity for their use in a range of potential applications. The present work shows that optimal selection of initial HHs based on molecular constituents is essential in tuning the material for a particular and targeted electronic application. Combining the selection of feedstock chemistry (H:C and aromatic content) and controlling variable laser treatment parameters (laser power, speed, and focus) lead to full control over the H:C ratio, sp² concentration, and degree of graphitic stacking order of the products. The broad intertunability of these factors results from a wide distribution of carbon material crystallinity from amorphous to highly graphitic and a broad distribution of electrical conductivity up to 10³ S/m.

Regulating a novel domain wall oscillator with a steady frequency by changing the current density

The dynamic behaviors of a domain wall (DW) pinned by a notch pair or a single notch with different notch depths are studied. It is found that, in a relatively large current density range, the oscillation frequency of the DW becomes frozen and independent of current density when pinned by a notch pair with a notch depth larger than 12 nm. The current density range for freezing the frequency can be tuned by the notch depth. A chain of notch pairs is designed to introduce more pinned DWs into the nanowire. By increasing the number of DWs and applying a proper magnetic field, the oscillation amplitude can be greatly enhanced. Our finding suggests that nanowires with a series of deep notch pairs may have an important application in the development of DW based spin-transfer nano-oscillators with a high tolerance for current fluctuation.

A lateral flow-based portable platform for determination of reproductive status of cattle

Our objective was to develop and validate a tool integrating a disposable fluorescence-based lateral flow immunoassay (LFIA) coupled with a portable imaging device for estimating circulating plasma concentrations of progesterone (P4). First, we developed and optimized a competitive LFIA test strip to measure P4 in bovine plasma. The LFIA design included a sample pad, a conjugate pad that stores R-phycoerythrin-anti-P4 conjugates, a glass-fiber spacer pad, a nitrocellulose membrane with printed test and control lines, and a cellulose-fiber absorbent pad. To perform a test, 20 µL of plasma and 50 µL of running buffer were added on the sample pad. After 3 min, 45 µL of running buffer was added to initiate sample flow. After allowing 15 min to stabilize the colorimetric signal, strips were introduced in an LFIA portable reader wirelessly linked to a laptop to determine P4 concentration based on test-to-control-line signal (T/C ratio). In a series of experiments (n = 6), the ability of the LFIA to differentiate plasma samples with ≥1 or <1 ng/mL of P4 was evaluated. For each experiment, a calibration curve was constructed using plasma with known concentrations of P4 (0.1 to 3.7 ng/mL; n = 5). The resulting linear equation was then used to determine a T/C ratio cutoff to differentiate samples with ≥1 or <1 ng/mL of P4. In addition, to evaluate the ability of the platform to assign samples to P4 concentration groups without a calibration curve for individual batches, we performed a receiver operating characteristic analysis to identify a single cutoff value for T/C ratio that could potentially be used for all batches. Overall, calibration curves showed a linear relationship between T/C ratio and P4 levels (mean coefficient of determination = 0.74; range 0.42 to 0.99). Next, plasma samples from lactating dairy cows (n = 58) were tested in triplicate to determine the ability of the LFIA system to differentiate plasma samples with ≥1 or <1 ng/mL of P4 using a RIA for P4 as reference test. Overall, the LFIA assay correctly classified 90% of the samples, with 97% sensitivity, 83% specificity, 85% positive predictive value, and 96% negative predictive value. Agreement between the tests was substantial (kappa = 0.79; 95% confidence interval 0.64 to 0.95). When using a single cutoff value for T/C ratio selected by receiver operating characteristic analysis, sensitivity and specificity to determine CL presence were 97 (95% confidence interval 82 to 99) and 79% (95% confidence interval 60 to 92), respectively. These data suggest that the developed portable LFIA system can accurately differentiate plasma samples with ≥1 or <1 ng/mL of P4.

Dietary Inflammatory Index and Leukoaraiosis in Patients with Ischemic Stroke

OBJECTIVES

Diet may change the chronic levels of systemic inflammation, which in turn influence the development of leukoaraiosis (LA). This study aimed to examine the association between dietary inflammatory index (DII) and LA in patients with ischemic stroke.

METHODS

Patients with first-ever ischemic stroke were enrolled from two centers. A semi-quantitative food frequency questionnaire (FFQ) was used to evaluate diet contents. The DII score of each patient was calculated based on the reported diet contents. Presence and degree of LA were evaluated with a magnetic resonance imaging (MRI) scan. LA was graded according to Fazekas scale.

RESULTS

Of the 497 enrolled patients, 337 (67.8%) were detected with LA. Patients with LA had a higher DII score (0.23 vs -0.88, P < 0.001). Logistic regression analysis detected that patients with highest quartile of DII score had an OR of 3.61 (95% CI: 2.05-6.36, P < 0.001) for LA compared with those with lowest quartile of DII. After adjusting for major confounders, the highest DII quartile remained as an independent predictor for LA (OR = 2.66, 95% CI: 1.41-5.00, P = 0.008).

CONCLUSIONS

A pro-inflammatory diet pattern, as indicated by higher DII values, appears to be associated with a higher risk of LA. This result suggested that dietary-mediated inflammation may involved in the pathogenesis of LA, which warrant further study.

Increased fat synthesis and limited apolipoprotein B cause lipid accumulation in the liver of broiler chickens exposed to chronic heat stress

Chronic heat stress can enhance fat synthesis in broilers, and excessive triglyceride (TG) synthesized by the liver needs to be transported to extrahepatic tissues by very low density lipoprotein (VLDL) otherwise will accumulate in the liver, which may even result in hepatic steatosis. To investigate the molecular mechanisms by which chronic heat stress enhances fat synthesis and results in lipid accumulation in the liver of chickens, 144 broilers (Arbor Acres, 28-day-old) were randomly allocated to the normal control (NC, 22°C), heat stress (HS, consistent 32°C), or pair-fed (PF, 22°C) groups for a 14-D trial. The 7 D of heat exposure significantly increased the respiratory rate, relative weight of abdominal fat, the levels of glucose, TG, corticosterone, insulin, and VLDL in plasma, as well as the levels of TG, total cholesterol, acyl-CoA carboxylase (ACC), and fatty acid synthase (FAS) in the liver, and mRNA expression levels of carbohydrate response element-binding protein (ChREBP), ACC, FAS, and microsomal triglyceride transfer protein (MTTP) in comparison with the other 2 groups. After 14 D of heat exposure, the relative weights of abdominal fat and liver and levels of TG and FAS in the liver were significantly higher in the HS group than in the other 2 groups, and there were no significant differences in the respiratory rate, plasma corticosterone concentration, apolipoprotein B (ApoB) level in the liver, and mRNA expression levels of key genes of fat synthesis among the 3 groups. In conclusion, chronic heat exposure activated LXRα pathway and enhanced fat synthesis in the liver after 7 D of heat exposure. After 14 D of heat exposure, heat-stressed broilers exhibited an adaptation to the high temperature in parameters of stress and fat synthesis gene expression levels. Moreover, chronic heat stress resulted in lipid accumulation in the liver of broilers, which is probably because the limited ApoB was not enough to transport the excessive TG synthesized by the liver in chronic heat-stressed broilers.

Dietary taurine supplementation enhances antioxidative capacity and improves breast meat quality of broiler chickens

1. The aim of this study was to determine the effect of dietary taurine supplementation on growth performance, meat quality and antioxidant responses in breast muscle of broiler chickens.2. A total of 72 Arbor Acres broiler chickens (28-day-old) with similar body weight were randomly allocated into two groups, and fed either 0 g/kg (control; C) or 5 g/kg taurine-supplemented diets (TS) for 14 days.3. The results showed that TS had no effect on growth performance or chemical composition of breast muscle in broilers. The drip and cooking losses were significantly decreased (P < 0.05), and the pH_24h of breast muscle were increased (P < 0.05) in the TS group. Meanwhile, broilers in the TS group exhibited significantly higher (P < 0.05) scavenging activities of superoxide and 2,2-diphenyl-1-picrylhydrazyl radicals, and lower (P < 0.05) contents of carbonyl, malondialdehyde, and 4-hydroxynonenal. TS increased (P < 0.05) total antioxidant capacity and superoxide dismutase activities. Moreover, TS significantly upregulated (P < 0.05) the mRNA expressions of nuclear factor erythroid 2-related factor 2 (Nrf2), heme oxygenase 1, NAD(P)H quinone dehydrogenase 1, superoxide dismutase, catalase, and glutathione peroxidase.4. These findings suggested that TS enhanced antioxidative capacity and improved breast meat quality of broilers via activating the Nrf2 pathway.

Monitoring and automatic tuning and stabilization of a 2×2 MZI optical switch for large-scale WDM switch networks

Large-scale optical switch networks employ wavelength division multiplexing to expand and facilitate multiple input and outputs. Such networks can be implemented with the Mach-Zehnder interferometer (MZI) as the building block. A fully-loaded MZI switch, meaning one with two optical signals at its two inputs and one that is capable of simultaneously switching those inputs to its two outputs, reduces the number building blocks within the network, and as a result makes them more power and area efficient. However, for practical operation, such MZI switches need to be automatically controlled for overcoming fabrication and thermal variations. We present an interference-based monitoring method that enables automatically switching, tuning, and stabilizing of a fully-loaded 2×2 MZI optical switch and demonstrate a prototype on an SOI platform. Using the proposed device and off-the-shelf electronics, we demonstrate automatic tuning and stabilization of an MZI switch with 12.5 Gb/s and 25 Gb/s data rates and channel spacing as small as 1 nm.

Prognostic factors in Asian and white American patients with cervical cancer, considering competing risks

Background

Cervical cancer is the 2nd most common malignant tumour in women worldwide. Previous research studies have given little attention to its prognostic factors in the rapidly growing Asian American population. In the present study, we explored prognostic factors in Asian and white American patients with cervical cancer, considering competing risks.

Methods

The study included 58,780 patients with cervical cancer, of whom 54,827 were white and 3953 were Asian American, and for all of whom complete clinical information was available in the U.S. Surveillance, Epidemiology, and End Results database. Death from cervical cancer was considered to be the event of interest, and deaths from other causes were defined as competing risks. The cumulative incidence function and the Fine-Gray method were applied for univariate and multivariate analysis respectively.

Results

We found that, for all patients (white and Asian American combined), the cumulative incidence function was associated with several factors, such as age at diagnosis, figo (Fédération internationale de Gynécologie et d'Obstétrique) stage, registry area, and lymph node metastasis. Similar results were found when considering white patients only. However, for Asian American patients, registry area was not associated with the cumulative incidence function, but the other factors (for example, figo stage) remained statistically significant. Similarly, in multivariate analyses, we found that age at diagnosis, figo stage, lymph node metastasis, tumour histology, treatment method, and race were all associated with prognosis.

Conclusions

Survival status differs for white and Asian American patients with cervical cancer. Our results could guide the treatment of, and facilitate prognostic judgments about, white and Asian American patients with cervical cancer.

Current driven spin oscillation in PMA/IMA composite nanowires-a novel spin torque based nano-oscillators

The spin dynamics in composite nanowires possessing both perpendicular magnetic anisotropy and in-plane magnetic anisotropy (IMA) regions are studied. It is found that, driven by proper currents, spin waves can be excited and propagate along the nanowires, leading to sustained oscillations of the magnetic moments. The frequency and amplitude strongly depend on the length of the longitudinal magnetized part (L _IMA), and can be effectively tuned by applied current. The assistance of an applied field may help to obtain large frequencies and amplitudes simultaneously. Considering their ease of manufacture, these kinds of composite nanowires hold great promise for nano-oscillator applications.

Transcriptome analysis of the endometrium from Chinese Erhualian sows that differ in calcium ion concentration and litter size

Embryonic survival rate, an important factor in the fecundity of sows, is affected by endometrium-secreting histotroph. A higher concentration of calcium ion has been observed in the uterus of highly prolific Erhualian sows (EH) compared with those of less prolific (EL) sows. This suggests that EH sows have better establishment and maintenance of pregnancies, thus increasing embryonic survival rate during the peri-implantation period. To understand the mechanisms of how the endometrium-secreting histotroph affects embryonic survival rate during the Erhualian peri-implantation period, the expression patterns of endometrial mRNA in the EH and EL sows on day 12 of gestation were analyzed using RNA sequencing technology. A total of 164 differentially expressed genes (DEGs) were identified (P_adj  < 0.05, |log₂ (FC)| ≥ 1), including 46 upregulated and 118 downregulated genes in EH compared to EL. Gene Ontology enrichment indicated that a subset of DEGs was involved in calcium ion binding and cell adhesion. Solute carrier family 8 member A3 and solute carrier family 24 member 4, identified as upregulated genes (P_adj  < 0.05) in EH, were considered key candidate genes expressed in the endometrium affecting embryonic survival rate during the peri-implantation period. The results improve understanding of the genetic mechanism underlying the variation in litter size of Erhualian pigs during the peri-implantation period.

Ray sum image: its efficacy in renal tract calculus detection

AIM

To determine the efficacy of a ray sum image derived from computed tomography of the kidneys, ureters and bladder (CT KUB) in detecting renal tract calculi and whether this can replace the baseline abdominal radiograph (AXR).

MATERIALS AND METHODS

This is a retrospective study performed at a tertiary referral centre examining adult patients referred for urolithiasis who had undergone AXR within 24 hours of the diagnostic CT KUB. AXR and ray sum image for calculus visibility were reviewed blindly by two readers. Anteroposterior thickness of the patient, presence of excess gas/faecal material, calculus size, location, and mean attenuation were analysed to determine effect on the AXR and ray sum sensitivity.

RESULTS

One hundred and fifty-two calculi were examined with ray sum image sensitivity of 44% (95% confidence interval [CI]: 36-52) and AXR 30% (95% CI: 22-38). Calculus size and mean attenuation significantly affected sensitivities of both ray sum and AXR. There was substantial agreement between the two techniques with κ(Kappa)=0.70 (95% CI: 0.58-0.81, p<0.001).

CONCLUSION

Ray sum image as a post-processed image derived from CT KUB dataset may be a viable alternative to the baseline AXR in patients with CT proven urolithiasis. This would reduce patient radiation dose and streamline workflow in busy radiology and emergency departments.

Eimeria challenge adversely affected long bone attributes linked to increased resorption in 14-day-old broiler chickens

There is limited information on the effects of enteric pathogen on bone quality in rapidly growing broiler chicks. We examined tibia and femur attributes (length, diameter, relative weight of ash content [AC] to the BW, ash concentration [AP]) and serum bone-turnover markers including receptor activator of nuclear factor kappa-B ligand (RANKL) for resorption, alkaline phosphatase (ALP) for mineralization, and selected serum metabolites in 14-day-old broilers challenged with Eimeria. A total of 160 (80 males and 80 females) 1-day-old Ross × Ross 708 chicks were used. Based on BW, birds were placed within sex in cages (5 birds per cage) and fed chick starter diets to day 9 of age. On day 9, half of the cages were orally gavaged with 1 mL of Eimeria culture (100,000 oocysts of E. acervulina and 25,000 oocysts of E. maxima) and the other half (unchallenged control) received 1 mL 0.9% saline in distilled water. On day 14, 2 birds were randomly selected and necropsied for intestinal lesion score, blood, tibia, and femur samples. Data were analyzed in a 2 (challenged vs. unchallenged) × 2 (males vs. females) factorial arrangement. There was no interaction (P > 0.05) between Eimeria and sex on any measurement. Whereas there were no intestinal lesions in unchallenged birds, Eimeria resulted in lesion score (0 to 4) of 3.35, 2.59 and 0.11 in duodenum, jejunum and ileum, respectively. Eimeria challenge decreased (P < 0.05) tibia AC and AP by 10 and 8.2%, respectively but had no (P > 0.10) effect on femur attributes. Generally, males showed (P < 0.05) longer and wider bones with more AC compared with the female. Circulating serum RANKL concentration increased (P = 0.017) in response to Eimeria challenge and was negatively correlated with tibia AC (-0.731; P = 0.021). Our findings showed that Eimeria damage to the intestinal physiology had adverse effects on long bone attributes linked to increased resorption.

Phenoloxidases are required for the pea aphid's defence against bacterial and fungal infection

The pea aphid, Acyrthosiphon pisum, has an incomplete immune system compared to those of other insect species; some conserved components and pathways in other species are missing in its genome. As a core component of the insect immune system, prophenoloxidase (PPO) genes are retained in the pea aphid. Early studies have also shown the presence of phenoloxidase activity in specific tissues or cells in the pea aphid and suggested its involvement in response to immune challenges. In this study, we knocked down the expression of PPO genes in the pea aphid using double-stranded RNA-based interference, and quantitative PCR analysis and an enzyme activity assay confirmed our success in the PPO gene knockdown. In bacterial and fungal infection experiments, we observed that the knockdown of PPO resulted in more live bacterial cells and fungal spores in the body of the aphids and higher mortality of the aphids after infection. Our study provides evidence supporting a critical role of PPO in the defence of the pea aphid.

[Effects of preoperative percutaneous transhepatic biliary drainage on surgical treatment of type Ⅲ and Ⅳ hilar cholangiocarcinoma]

Objective: To investigate the effects of preoperative percutaneous transhepatic biliary drainage on surgical treatment of type Ⅲ and Ⅳ hilar cholangiocarcinoma. Methods: Clinical data of 72 patients with hilar cholangiocarcinoma of the Bismuth-Corlette type Ⅲ and Ⅳ treated at Department of General Surgery,First Affiliated Hospital of Bengbu Medical College from January 2010 to December 2017 were analyzed retrospectively.Patients were divided into two groups based on whether PTBD was performed:a drained group and an undrained group.In the drained group,there were 31 patients,20 males and 11 females,aged (59.9±9.7)years (range: 39-73 years).Among them,14 patients underwent hepatectomy with half or more than half of the liver removed (extended hepatectomy)and 17 patients underwent non-anatomical hepatectomy in the hilar region (limited hepatectomy).In the undrained group,there were 41 patients, 26 males and 15 females, aged (60.8±7.8)years(range: 45-75 years).Among them, 17 patients underwent hepatectomy with half or more than half of the liver removed (extended hepatectomy)and 24 patients underwent non-anatomical hepatectomy in the hilar region (limited hepatectomy).Percutaneous transhepatic biliary drainage(PTBD)was used in the drained group.Under the guidance of ultrasound,one or more hepatobiliary ducts could be sufficiently drained,which had good effect and was not restricted by the obstruction location of hilar cholangiocarcinoma.The analysis of the measurement data was performed using t test,and the analysis of the count data was performed using χ(2) test,and the survival curve was plotted using Kaplan-meier method. Results: In total, 72 jaundiced patients with hilar cholangiocarcinoma underwent surgical treatment: 31 had PTBD prior to operation while 41 did not had PTBD.There were significant differences in ALT((93.2±21.4)U/L vs.(207.4±65.1)U/L),AST((87.6±18.1)U/L vs.(188.9±56.6)U/L)and total bilirubin((68.8±12.6)μmol/L vs.(227.5±87.7)μmol/L)between the patients after treatment and those before treatment(t=10.958, P=0.000; t=10.845, P=0.000; t=10.386, P=0.000).Compared with those in the undrained group, the operation time was shorter, the amount of intraoperative bleeding and the incidence of complications were lower in the drained group(t=-2.840, P=0.006; t=-3.698, P=0.000; χ(2)=4.108, P=0.043).There were no perioperative death cases in drained group and 2 perioperative death cases in undrained group.There was no significant difference in R0 resection rate between the two groups(χ(2)=0.778,P=0.378).The 1-,3-,5-year survival rate of patients in the drained group and the undrained group was 72.7%,34.2%, 13.7% and 72.8%, 31.5%, 11.8%, respectively.The difference was not statistically significant(all P>0.05). Conclusions: The preoperative percutaneous transhepatic biliary drainage in patients with hilar cholangiocarcinoma of Bismuth-Corlette type Ⅲ and Ⅳ could effectively shorten operative time, reduce amount of intraoperative bleeding and incidence of postoperative complications,but have no significant effect on the R0 resection rate and survival rate.

Rapid Fabrication of High-Performance CaO-Based Integral Ceramic Mould by Stereolithography and Non-Aqueous Gelcasting

A high-performance CaO-based integral ceramic mould was fabricated for investment casting by stereolithography (SLA) and non-aqueous gelcasting. The rheology of tert-butyl alcohol (TBA)-based CaO slurries and the effect of gelation parameters on the gelation time and strength of the green body were investigated to obtain a high-quality green body of the CaO-based integral ceramic mould. Then the pre-sintering and sintering processes were optimized to avoid cracks, reduce the sintering shrinkage, and improve the strength of CaO-based ceramic mould. The results showed that the CaO-based slurry with 56 vol % solid loading and 3 wt % dispersant content exhibited high stability and good flowability. The optimized gelation parameters were determined to be a monomer content of 20 wt %, a ratio of crosslinker to monomer of 0.06, an initiator content of 1 wt % and a gelation temperature of 40 °C. A reasonable sintering regime was identified to avoid cracks and guarantee a low shrinkage of 0.6%, a room temperature bending strength of 14.12 MPa and a high temperature (1200 °C) strength of 8.22 MPa. The CaO-based integral ceramic mould fabricated in this study has many advantages including excellent thermal stability, reaction-resistance to molten active alloys, ease of dissolution, and enhanced efficiency and economy in comparison to SiO₂ or Al₂O₃ ceramic moulds.

The alleviative effects and related mechanisms of taurine supplementation on growth performance and carcass characteristics in broilers exposed to chronic heat stress

To investigate the alleviative effects and molecular mechanisms of taurine supplementation on growth performance and carcass characteristics in broilers exposed to chronic heat stress, 144 male Arbor Acres broilers (28 d old) were randomly distributed to positive control (PC, 22°C, basal diet), heat stress (HS, consistent 32°C, basal diet), or heat stress + taurine (HS + T, consistent 32°C, basal diet + 5.00 g/kg taurine) groups, with 6 cages per group and 8 birds per cage. Chronic heat stress significantly decreased body weight, average daily gain, and average daily feed intake, and increased cloacal temperature and feed conversion ratio (FCR, P < 0.05). Though taurine supplementation tended to decrease the FCR in the HS + T group compared with the HS group after 14 d of heat exposure (P = 0.071), there were no significant alleviative effects of taurine supplementation on the increased cloacal temperature and decreased growth performance in chronic heat-stressed broilers (P > 0.05). After 7 and 14 d of heat exposure, taurine supplementation significantly increased the proportion of breast muscle and hormone-sensitive lipase activity in the abdominal fat (P < 0.05), and decreased the mRNA expressions of muscle atrophy F-box protein (MAFbx) and muscle ring-finger protein-1 (MuRF1) in breast muscle compared with the HS group (P < 0.05). After 7 d of heat exposure, taurine supplementation significantly increased serum non-esterified fatty acid concentration (P < 0.05), and decreased the mRNA expressions of acetyl-CoA carboxylase 1c (ACC) and muscular isoform of carnitine palmitoyl transferase 1 (M-CPT1) compared with the HS group (P < 0.05). In addition, the mRNA expressions of M-CPT1 and ribosomal protein S6 kinase, 70 kDa (p70S6K) in the HS + T group were significantly higher than those of the other two groups after 14 d of heat exposure (P < 0.05). In conclusion, taurine supplementation can improve carcass characteristics of chronic heat-stressed broilers by facilitating lipolysis for energy, enhancing protein synthesis, and suppressing protein degradation of the breast muscles.

WxNbMoTa Refractory High-Entropy Alloys Fabricated by Laser Cladding Deposition

W_xNbMoTa refractory high-entropy alloys with four different tungsten concentrations (x = 0, 0.16, 0.33, 0.53) were fabricated by laser cladding deposition. The crystal structures of W_xNbMoTa alloys are all a single-phase solid solution of the body-centered cubic (BCC) structure. The size of the grains and dendrites are 20 μm and 4 μm on average, due to the rapid solidification characteristics of the laser cladding deposition. These are much smaller sizes than refractory high-entropy alloys fabricated by vacuum arc melting. In terms of integrated mechanical properties, the increase of the tungsten concentration of W_xNbMoTa has led to four results of the Vickers microhardness, i.e., H_v = 459.2 ± 9.7, 476.0 ± 12.9, 485.3 ± 8.7, and 497.6 ± 5.6. As a result, NbMoTa alloy shows a yield strength (σ_b) and compressive strain (ε_p) of 530 Mpa and 8.5% at 1000 °C, leading to better results than traditional refractory alloys such as T-111, C103, and Nb-1Zr, which are commonly used in the aerospace industry.

Prognostic value of inflammation-based markers in advanced or metastatic neuroendocrine tumours

Background

The role of systemic inflammation-based markers remains uncertain in advanced or metastatic neuroendocrine tumours (nets).

Methods

Systemic inflammatory factors, such as levels of circulating white blood cells and other blood components, were combined to yield inflammation-based prognostic scores [high-sensitivity inflammation-based Glasgow prognostic score (hsgps), neutrophil:lymphocyte ratio (nlr), platelet:lymphocyte ratio (plr), high-sensitivity inflammation-based prognostic index (hspi), and prognostic nutritional index (pni)], whose individual values as prognostic markers were retrospectively determined. Univariate and multivariate analyses were used to examine the association of inflammatory markers with overall survival (os).

Results

The study included 135 patients. Univariate analysis revealed that elevated white blood cell count, elevated neutrophil count, low serum albumin, elevated high-sensitivity C-reactive protein, and elevated hspi, hsgps, and nlr scores were significantly associated with worse os. Multivariate analyses demonstrated that, apart from pathology grade and original site of the tumour, elevated hspi (p = 0.004) was an independent prognostic factor for worse os.

Conclusions

In the present study, elevated pretreatment hspi was observed to be an independent predictor of shorter os in patients with inoperable advanced or metastatic net. The hspi might thus provide additional guidance for therapeutic decision-making in such patients.

Pan-Asian adapted ESMO Clinical Practice Guidelines for the management of patients with metastatic oesophageal cancer: a JSMO-ESMO initiative endorsed by CSCO, KSMO, MOS, SSO and TOS

The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of oesophageal cancer was published in 2016, and covered the management and treatment of local/locoregional disease, limited disease, locally advanced disease and the management of advanced/metastatic disease. At the ESMO Asia Meeting in November 2017 it was decided by both ESMO and the Japanese Society of Medical Oncology (JSMO) to convene a special guidelines meeting immediately after the JSMO Annual Meeting in 2018. The aim was to adapt the ESMO 2016 guidelines to take into account the ethnic differences associated with the treatment of metastatic oesophageal cancer in Asian patients. These guidelines represent the consensus opinions reached by experts in the treatment of patients with metastatic oesophageal cancer representing the oncological societies of Japan (JSMO), China (CSCO), Korea (KSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence, and was independent of both the current treatment practices and the drug availability and reimbursement situations in the individual participating Asian countries.

Pan-Asian adapted ESMO Clinical Practice Guidelines for the management of patients with metastatic gastric cancer: a JSMO-ESMO initiative endorsed by CSCO, KSMO, MOS, SSO and TOS

The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of gastric cancer (GC) was published in 2016, and covered the management and treatment of local, locoregional, locally advanced and metastatic disease. At the ESMO Asia Meeting in November 2017 it was decided by both ESMO and The Japanese Society of Medical Oncology (JSMO) to convene a special guidelines meeting immediately after the JSMO Annual Meeting in 2018. The aim was to adapt the ESMO 2016 guidelines to take into account the ethnic differences associated with the treatment of metastatic GC in Asian patients. These guidelines represent the consensus opinions reached by experts in the treatment of patients with metastatic GC representing the oncological societies of Japan (JSMO), China (CSCO), Korea (KSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence and was independent of both the current treatment practices and the drug availability and reimbursement situations in the individual participating Asian countries.

Detection of novel mutations associated with independent resistance and cross-resistance to isoniazid and prothionamide in Mycobacterium tuberculosis clinical isolates

OBJECTIVES

Prothionamide, a structural analogue of isoniazid, is used mainly for treating multidrug-resistant tuberculosis (MDR-TB). Both drugs have a common target InhA, so prothionamide can be ineffective against isoniazid-resistant (INH^R) Mycobacterium tuberculosis. We aimed to investigate the prevalence of mutations in katG, ethA, ndh, ethR, mshA, inhA and/or its promoter associated with independent resistance and cross-resistance to INH^R and/or prothionamide-resistant (PTO^R) M. tuberculosis isolates.

METHODS

We sequenced the above genes in 206 M. tuberculosis isolates with susceptibility testing against ten drugs.

RESULTS

Of the 173 INH^R PTO^R isolates, 170 (98.3%) harboured mutations in katG, 111 (64.2%) in ethA, 58 (33.5%) in inhA or its promoter, 5 (2.9%) in ndh, 3 (1.7 %) in ethR and 2 (1.2%) in mshA. Among the 18 INH^R PTO^S isolates, mutations in katG were found in all of them; one had a mutation in the inhA promoter and another in ndh. Of the five INH^S PTO^R isolates, four showed mutations in ethA and two in the inhA promoter. Notably, 55 novel non-synonymous mutations were found in them and 20.2% of the PTO^RM. tuberculosis isolates harboured no known mutations.

CONCLUSIONS

This is the first report to investigate cross-resistance between INH^R and/or PTO^R isolates. Among INH^R (94.4% MDR-TB) M. tuberculosis isolates, the high diversity of mutations for independent resistance and cross-resistance with prothionamide highlight the importance of both phenotypic susceptibility and genotypic diagnosis when using it to treat patients with INH^R-TB. The high proportion (one-fifth) of PTO^RM. tuberculosis isolates showed no known mutation related to PTO^R genes, so uncovered resistance mechanism(s) of prothionamide exist.

Targeting NEDD8-activating enzyme is a new approach to treat canine diffuse large B-cell lymphoma

Canine diffuse large B-cell lymphoma (DLBCL), the most common hematologic malignancy of dogs, is associated with poor overall survival. The lack of conventional chemotherapies with sustainable efficacy warrants investigation of novel therapies. Pevonedistat (MLN4924) is a potent and selective small molecule NEDD8-activating enzyme inhibitor. In human activated B-cell-like (ABC) diffuse large B-cell lymphoma, pevonedistat induces lymphoma cell apoptosis, DNA damage and G1 cell cycle arrest by inhibiting the nuclear factor-κB (NF-κB) pathway. Genomic and transcriptomic studies showed that the NF-κB pathway is deregulated in canine DLBCL. Our results showed that pevonedistat treatment significantly reduces the viability of canine DLBCL cells by inducing G1 cell cycle arrest and apoptosis. Pevonedistat treatment inhibits NF-κB pathway activation and downregulates NF-κB target genes in canine DLBCL. Moreover, administration of pevonedistat to mice bearing canine DLBCL xenograft tumours resulted in tumour regression. Our in vivo and in vitro studies provide justification for future clinical application of pevonedistat as a potential new anti-cancer therapy that may benefit both canine and human species.

Optimized cultural conditions of functional yogurt for γ-aminobutyric acid augmentation using response surface methodology

Yogurt, a functional dairy food product, is an effective medium for delivering beneficial functional ingredients. One ingredient, γ-aminobutyric acid (GABA), has growing appeal in the development of functional foods for its potential in reducing the risk of diabetes, hypertension, and stress as a bioactive agent. However, the concentration of GABA in existing food products is remarkably low. We developed a functional yogurt rich in GABA using Streptococcus thermophilus fmb5. The GABA yield of yogurt was enhanced by optimization of culture conditions using single factor and response surface methods. The results showed that culture temperature, monosodium glutamate concentration, and culture time are the 3 main factors that affect GABA yield. The optimal culture conditions were determined as follows: 38.8°C for culture temperature, 20 g/L of monosodium glutamate, and 120 h of culture time. Under the above optimal conditions, the actual yield of GABA production was maximized at 9.66 g/L, which was 1.2 times or higher than that of from any single factor treatment. The GABA concentration, viable bacteria number, and water-holding capacity of GABA-rich yogurt were stable throughout the whole storage time. The results show that producing yogurt with Streptococcus thermophilus fmb5 and the optimized culture conditions will achieve high GABA concentrations that maximize health benefits to consumers.