Implant resonance and the mechanostat theory: Applications of therapeutic ultrasound for porous metallic scaffolds

The development of treatment strategies for improving secondary stability at the bone-implant interface is a challenge. Porous implants are one solution for improving long-term implant stability, but the osteoconduction process of implants into the bone can be slow. Strain-driven osteogenesis from the mechanostat theory offers insight into pathways for post-operative treatment but mechanisms to deliver strain to the bone-implant interface need refinement. In this work, the use of therapeutic ultrasound is simulated to induce resonance into a porous implant structure. Local strains through the scaffold are measured by varying systemic variables such as damping ratio, applied vibrational force, primary bone-implant stability, and input frequency. At the natural frequency of the system with applied forces of 0.5 N and a damping ratio of 0.5%, roughly half of the nodes in the simulated environment exceed the microstrain threshold of 1000 με required for new bone formation. A high degree of sensitivity was noted upon changing input frequency, with minor sensitivities arising from damping ratio and applied vibrational force. These findings suggest that the application of therapeutic resonance to improve osseointegration of the bone-implant interface may be viable for applications including dental implants or segmental bone defects.

[Clinical effects of anterograde sural neurovascular flap in repairing skin and soft tissue defect around the knee]

Objective: To explore the clinical effects of anterograde sural neurovascular flap in repairing skin and soft tissue defect around the knee. Methods: Nine patients with skin and soft tissue defect around the knee admitted to Beijing Fengtai YouAnMen Hospital from May 2011 to December 2018, were included in this retrospective descriptive study, including 8 males and 1 female, aged 16 to 65 years. The wound area after debridement ranged from 8 cm×5 cm to 18 cm×10 cm. Anterograde sural neurovascular flap was used to repair the wounds in 9 patients, with the area ranging from 9 cm×6 cm to 20 cm×12 cm. The donor sits of flaps in 2 patients were closed and sutured directly, and the donor sits of flaps in 7 patients were repaired with medial split-thickness skin graft of the ipsilateral thigh. The flap survival, complications, and follow-up after operation were recorded. Results: The flaps survived and the blood supply was good in 8 patients and the wounds were closed. One patient developed skin ischemic necrosis which was cured after three weeks of dressing change. All the skin grafts in the donor site of flap in 7 patients survived. In 6 months to 5 years of follow-up after surgery, the skin flap had good texture, color, and shape, and normal sensation. Except for one patient whose knee had poor recovery of function, the knee joint function of the other patients recovered well. Conclusions: The anterograde sural neurovascular flap has the advantages of high survival rate, satisfactory appearance and functional recovery post surgery, and is an ideal flap for repairing the skin and soft tissue defect around the knee.

Factors associated with the progression of gastric intestinal metaplasia: a multicenter, prospective cohort study

Background and study aims  Gastric cancer (GC) is usually preceded by premalignant gastric lesions (GPLs) such as gastric intestinal metaplasia (GIM). Information on risk factors associated with neoplastic progression of GIM are scarce. This study aimed to identify predictors for progression of GIM in areas with low GC incidence. Patients and methods  The Progression and Regression of Precancerous Gastric Lesions (PROREGAL) study includes patients with GPL. Patients underwent at least two upper endoscopies with random biopsy sampling. Progression of GIM means an increase in severity according to OLGIM (operative link on gastric intestinal metaplasia) during follow-up (FU). Family history and lifestyle factors were determined through questionnaires. Serum Helicobacter pylori infection, pepsinogens (PG), gastrin-17 and GC-associated single nucleotide polymorphisms (SNPs) were determined. Cox regression was performed for risk analysis and a chi-squared test for analysis of single nucleotide polymorphisms. Results  Three hundred and eight patients (median age at inclusion 61 years, interquartile range (IQR: 17; male 48.4 %; median FU 48 months, IQR: 24) were included. During FU, 116 patients (37.7 %) showed progression of IM and six patients (1.9 %) developed high-grade dysplasia or GC. The minor allele (C) on TLR4 (rs11536889) was inversely associated with progression of GIM (OR 0.6; 95 %CI 0.4-1.0). Family history (HR 1.5; 95 %CI 0.9-2.4) and smoking (HR 1.6; 95 %CI 0.9-2.7) showed trends towards progression of GIM. Alcohol use, body mass index, history of H. pylori infection, and serological markers were not associated with progression. Conclusions  Family history and smoking appear to be related to an increased risk of GIM progression in low GC incidence countries. TLR4 (rs11536889) showed a significant inverse association, suggesting that genetic information may play a role in GIM progression.

Selective Voronoi tessellation as a method to design anisotropic and biomimetic implants

The geometry of a metallic scaffold is important for the success of bone implants, where the introduction of porosity can reduce stress shielding effects and allow for bone tissue integration. In this work, porous scaffolds were designed to closely mimic the natural structure of trabecular bone using selective Voronoi tessellation with preferential seeding. A workflow to generate these structures is introduced, where voided regions of seeds in the starting volume create preferential texture during polyhedral expansion, resulting in modified strut orientation in the implant. Anisotropy was digitally characterized by mean-intercept length and star volume distribution measurements to determine similarity to trabecular orientation. This work demonstrates that selective Voronoi tessellation is an effective method to generate biomimetic porous scaffolds with increased anisotropy and tunable strut architecture in three dimensions as a suitable alternative to patient-derived bone geometries.

Effects of Early Transplantation of the Faecal Microbiota from Tibetan Pigs on the Gut Development of DSS-Challenged Piglets

The present study was conducted to investigate the effects of early transplantation of the faecal microbiota from Tibetan pigs on the gut development of dextran sulphate sodium- (DSS-) challenged piglets. In total, 24 3-day-old DLY piglets were divided into four groups (n = 6 per group); a 2 × 2 factorial arrangement was used, which included faecal microbiota transplantation (FMT) (from Tibetan pigs) and DSS challenge. The whole trial lasted for 55 days. DSS infusion increased the intestinal density, serum diamine oxidase (DAO) activity, and colonic Escherichia coli count (P < 0.05), and decreased the Lactobacillus spp. count and mRNA abundances of epidermal growth factor (EGF), glucagon-like peptide-2 (GLP-2), insulin-like growth factor 1 (IGF-1), occludin, mucin 2 (MUC2), regeneration protein IIIγ (RegIIIγ), and interleukin-10 (IL-10) in the colon (P < 0.05). FMT increased the Lactobacillus spp. count and mRNA abundances of GLP-2, RegIIIγ, and IL-10 in the colon (P < 0.05), and decreased the intestinal density, serum DAO activity, and colonic E. coli number (P < 0.05). In addition, in DSS-challenged piglets, FMT decreased the disease activity index (P < 0.05) and attenuated the effect of DSS challenge on the intestinal density, serum DAO activity, and colonic E. coli number (P < 0.05). These data indicated that the faecal microbiota from Tibetan pigs could attenuate the negative effect of DSS challenge on the gut development of piglets.

MicroRNA-486 inhibits cell proliferation, invasion and migration via down-regulating the TENM1 expressions and affecting ERK and Akt signaling pathways and epithelial-to-mesenchymal transition in papillary thyroid carcinoma

OBJECTIVE

Papillary thyroid carcinoma (PTC) is one of the general thyroid malignancies. Recently, microRNAs (miRNAs) have identified as pivotal gene regulators in PTC tumorigenesis. The aim of this study was to investigate the role of miR-486 in PTC and its underlying mechanism.

PATIENTS AND METHODS

Fifty-six pairs of PTC tissue and matched normal tissue samples were collected from PTC patients who underwent surgery at our hospital from March 2015 to September 2017. Human thyroid epithelial cell line Nthy-ori3-1and PTC cell lines (BCPAP, K1, HTH83, and TPC-1) were cultured. The mRNA and protein expression level were detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) and Western blot, respectively. Additionally, the proliferation and migration abilities were checked by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) method and transwell assay, respectively. Furthermore, dual-luciferase reporter assay was performed to confirm the combination of miR-486 and TENM1. Xenograft Model experiments were performed to assess the effects of miR-486 on tumor growth in vivo.

RESULTS

MiR-486 expression was significantly reduced in PTC, which was associated with the poorer clinicopathologic characteristics and overall survival (OS) of PTC patients. Moreover, miR-486 restoration in PTC cells was confirmed to markedly inhibit proliferation, invasion, and migration via the regulation of extracellular-signal-regulated kinase (ERK) and protein kinase B (Akt) signaling pathways and epithelial-mesenchymal transition (EMT). In the meantime, teneurin transmembrane protein 1 (TENM1) was identified as a direct functional target for miR-486 in PTC cells on the basis of bioinformatic analysis and luciferase reporter assays. Additionally, we also verified that miR-486 restoration could prominently repress the PTC growth in vivo.

CONCLUSIONS

MiR-486 exerted anti-tumor functions in PTC progression and served as promising biomarkers for the PTC treatment.

Predictors of plaque erosion in current smokers and non-current smokers presented with ST-segment elevation myocardial infarction: an optical coherence tomography study

Background

Plaque erosion with subsequent coronary thrombosis is considered as an important cause of ST-segment elevation myocardial infarction (STEMI). Smoking is a major risk factor for acute coronary thrombosis. However, the relationship between current smoking status and plaque erosion has not been systematically investigated.

Purpose

The present study aimed to investigate predictors of plaque erosion in current smokers and non-current smokers with STEMI by using optical coherence tomography (OCT).

Methods

Between January 2015 to December 2017, a total of 1313 STEMI patients underwent pre-intervention OCT of culprit lesion were enrolled and divided into two groups based on current smoking status: current smoking group (n=713) and non-current smoking group (n=600). Using established criteria, quantitative and qualitative underlying plaque characteristics were assessed by OCT. Clinical, angiographic and OCT characteristics of all enrolled patients were recorded. Univariable and multivariable logistic regression analyses were used to identify predictors of plaque erosion in two groups.

Results

Plaque erosion were found in 30.9% (220/713) culprit lesions in current smoking group and 20.8% (125/600) of those in non-current smoking group detected by OCT. In multivariate regression analysis, the predictors that strongly related to plaque erosion in the current smoking group were nearby bifurcation (OR: 4.84; 95% CI:2.38–9.87; p&lt;0.001); the minimum fiber cap thickness (FCT, OR:1.05; 95% CI:1.03–1.08; p&lt;0.001); thin-cap fibroatheroma (TCFA, OR: 0.22; 95% CI: 0.07–0.67; p=0.007) and lipid core length (OR: 0.91; 95% CI: 0.84–0.97; p=0.007). The predictors in the non-current smoking group were nearby bifurcation (OR: 4.84; 95% CI: 2.38–9.87; p=0.006); the minimal FCT (OR: 1.09; 95% CI: 1.06–1.13; p&lt;0.001); multi-vessel disease (MVD, OR: 0.43; 95% CI: 0.19–0.97; p=0.042) and dyslipidemia (OR: 0.34; 95% CI: 0.14–0.84; p=0.020).

Conclusions

Predictors of plaque erosion causing STEMI onset are different between current smokers and non-current smoker, with nearby bifurcation and thicker minimal FCT both predicting plaque erosion in two groups of patients.

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Key Research and Development Program of China, National Natural Science Foundation of China.

Coronary plaque characteristics associated with reduced thrombolysis in myocardial infarction flow in st-segment elevation myocardial infarction patients with plaque erosion

Background

It has been reported that the lumen factors of the culprit lesions are related to Thrombolysis in Myocardial Infarction (TIMI) flow grade in ST-Segment–Elevation Myocardial Infarction (STEMI) patients, but the factors of reduced TIMI flow in plaque erosion have not been studied.

Methods

329 STEMI patients with plaque erosion who underwent pre-intervention optical coherence tomography after thrombectomy were included and divided into 2 groups according to preprocedural TIMI flow grade [TIMI 0–1 (n=219) and TIMI 2–3 (n=110)].

Results

The patients with older age (55.7±11.1yrs vs. 51.8±10.6yrs, P=0.003) and diabetes patients (18.3% vs. 8.2%, P=0.015) had poorer TIMI flow, and the patients with reduced TIMI flow grade have lower initial cTnI (1.2ng/mL vs. 2.1ng/mL, P=0.023). The lesion in the LAD had better blood flow than the lesion in RCA (P=0.003), and the patients in TIMI 0–1 grade had more lipid plaques (53.9% vs. 41.8%, P=0.039), more macrophage (59.8% vs. 41.8%, P=0.002), and more calcification (34.2% vs. 21.8%, P=0.020). There was no statistically significant difference in the descriptive indicators of lipid or lumen between the two groups. And In a multivariate logistic regression model, the independent correlation factors of reduced TIMI flow grade in erosion patients were age, diabetes mellitus, lesion vessel, and macrophage.

Conclusions

In STEMI patients with plaque erosion non-lumen factors greatly affect flow, which suggests that systemic treatment is as important as local treatment for plaque erosion.

Flow Chart

Funding Acknowledgement

Type of funding source: Foundation. Main funding source(s): National Natural Science Foundation of China (81827806, 81801861), National Key R&D Program of China (2016YFC1301100)

Morphological characteristics of plaque erosion with noncritical coronary stenosis: an optical coherence tomography study

Background

Plaque erosion is a frequent and important mechanism of acute coronary thrombosis only secondary to plaque rupture. Recent studies suggested plaque erosion with noncritical stenosis could be treated conservatively that distinct from those with critical stenosis. However, characteristics of plaque erosions with different coronary stenosis remain unknown.

Purpose

The present study aimed to investigate morphological features of plaque erosions with different coronary stenosis using optical coherence tomography (OCT).

Methods

Consecutive ST-segment elevated myocardial infarction (STEMI) patients with OCT images of culprit lesion between August 2014 and December 2017 were enrolled and 348 cases presented with plaque erosion identified by OCT. Based on the severity of lumen area stenosis [calculated by (1-minimal lumen area/reference lumen area) * 100%], all culprit plaque erosions were divided into three groups: Group A (area stenosis&lt;50%, n=50, 14.4%); Group B (50%≤area stenosis&lt;75%, n=146, 42.0%); Group C (area stenosis≥75%, n=152, 43.7%). Clinical characteristics, lesion features detected by coronary angiography and OCT were compared among three groups.

Results

Of all 348 STEMI patients with plaque erosions, patients in Group A were youngest (p=0.008) and had the lowest frequency of hypertension (p=0.029) as compared with those in Group B and C. Angiographic analysis showed 72.0% of plaque erosions in Group A located in LAD, while 67.8% in Group B and 53.9% in Group C (p=0.039). OCT findings (Figure 1-A) showed the prevalence of fibrous plaque was significantly highest in Group A than those in Group B and C (82.0% vs. 54.8% vs. 34.9%, p&lt;0.001), whereas lipid rich plaque was most frequent in Group C (16.0% vs. 43.8% vs. 62.5%, p&lt;0.001). The prevalence of macrophage (p&lt;0.001), microvessel (p=0.009) and cholesterol crystals (p&lt;0.001) increased gradually from plaque erosion with lumen area stenosis &lt;50% to 50–75% to ≥75%. Notably, compared with Group B and C, nearby bifurcation was most common in Group A (72.0% vs. 67.1% vs. 55.3%, p=0.036). Multivariable regression analyses (Figure 1-B) showed fibrous plaque and nearby bifurcation were independently associated with plaque erosion with noncritical stenosis (area stenosis&lt;75%).

Conclusion

56.3% plaque erosion in STEMI patients presented with noncritical stenosis, having distinct morphological features from erosion with critical stenosis. Fibrous plaque and nearby bifurcation were independently associated with the presence of noncritically stenotic plaque erosion, remaining a desire to tailor treatment therapy to individual patients.

Figure 1

Funding Acknowledgement

Type of funding source: Foundation. Main funding source(s): National Key R&D Program of China

Relation of microchannel identified by optical coherence tomography to clinical, angiography and other plaque morphological characteristics in ST-segment Elevation myocardial infarction patients

Background

Previous studies have suggested that Microchannel (MC) is associated with plaque progression and vulnerability. Optical coherence tomography (OCT) could provide a chance to directly visualize plaque neovascularization in vivo.

Methods

1268 STEMI patients who underwent OCT examination of culprit lesion were included and divided into MC group (the culprit plaque with MC, n=560) and no-MC group (the culprit plaque without MC, n=708). MC was defined as a no-signal tubuloluminal structure on the cross-sectional optical coherence tomographic image. Clinical, angiography and other plaque morphological characteristics were compared between the two groups. Logistic regression analysis was used to identify independent predictors of MC in overall. In addition, the difference of predictors on MC was found in plaque rupture (PR) and plaque erosion (PE).

Results

Significant differences between MC group and no-MC group were found in the frequency of thin-cap fibroatheroma (74.6% vs 64.4%, p&lt;0.001), lipid plaque (91.8% vs 82.9%, p&lt;0.001), lipid core length (13.7±6.5mm vs 12.6±6.3mm, p=0.006) and the minimal lumen area (MLA, 1.95±0.98mm2 vs 2.10±1.58mm2, p=0.046). In MC group, the other vulnerable plaque morphological characteristics, such as macrophage (88.8% vs 75.1%, p&lt;0.001), cholesterol crystal (39.6% vs 32.9%, p=0.013), spotty calcification (38.6% vs 29.5%, p&lt;0.001) were more frequent. And compared with MLA the more locations of the culprit lesion in MC group was proximal (proximal, 47.3% vs 38.1%, at MLA, 38.2% vs 44.2%, distal, 14.5% vs 17.7%, p=0.004).The difference of Hemoglobin (Hb, 147.5±16.9g/L vs 144.1±18.2g/L, p&lt;0.001), lipidemia (TC, 188.7±43.6mmol/L vs 180.8±40.0mmol/L, p&lt;0.001, LDL-C, 121.5±37.4mmol/L vs 115.7±36.8mmol/L, p=0.005, and TC/HDL, 4.0±1.6 vs 3.8±1.0, p&lt;0.001), and hypertension (50.7% vs 44.2%, p=0.021) between 2 groups was statistically significant. Multivariable logistic regression models showed 7 independent parameters associated with MC in culprit plaque of overall: hypertension, Hb, TC, MLA, lesion location (compared with MLA), lipid core length, macrophage, spotty calcification. In addition, Hb, TC and MLA were common predictors of MC in PR and PE, however, the predictive effect of MLA on MC was opposite in PR [OR (95% CI)=1.266 (1.095–1.463), p=0.001] and PE [OR (95% CI)=0.742 (0.597–0.922), p=0.007].

Conclusions

MC in culprit plaque is associated with more lipid (especially cholesterol), higher Hb, hypertension, lesion location (compared with MLA) and the other vulnerable plaque morphological characteristics. The predictors of MC were different in plaque rupture and plaque erosion.

Flow chart

Funding Acknowledgement

Type of funding source: Foundation. Main funding source(s): National Natural Science Foundation of China (81827806, 81801861); National Key R&D Program of China (2016YFC1301100)

Impact of macrophage infiltration in patients with st-segment elevation myocardial infarction caused by plaque erosion: an in vivo optical coherence tomography study

Background

Chronic inflammatory infiltration is a common process for atherosclerosis development. However, autopsy studies reveal that incidence rate of inflammatory infiltrates are less abundant in plaque erosion compared with plaque rupture.

Purpose

Studies performed by optical coherence tomography (OCT) have allowed to establish the severity of plaque inflammation by assessing macrophage infiltration (MØI). In this study, we aimed at assessing the impaction of MØI in plaque erosion among patients with STEMI by using OCT.

Methods

A total of 1561 patients with ST-segment elevation myocardial infarctions (STEMI) who underwent OCT imaging were enrolled in this study. According to the exclusion criteria, 312 patients with STEMI exhibiting plaque erosion were classified as MØI or no MØI.

Results

163 (52.2%) patients had MØI at the site of plaque erosion, whereas 149 (47.8%) patients had no evidence of MØI and patients of MØI group were significantly older (P=0.015). The result of angiography showed the prevalence of multi-vessel disease appeared more frequency (P=0.021) and diameter stenosis% were higher (P=0.031) in MØI group. OCT results showed the minimum fibrous-cap thickness was thinner (P&lt;0.001) and the maximum lipid arc was larger (P=0.005) in MØI group. Some patients underwent imaging follow-up at 1 year. There was no significant difference in the culprit plaque morphology progress among two groups (Figure 1A-1D).

Conclusions

This study demonstrated that plaque inflammation can increase culprit lesion severity and plaque vulnerability in patients with STEMI caused by plaque erosion.

Figure 1

Funding Acknowledgement

Type of funding source: None

Correlation between endothelial cell apoptosis and SIRT3 gene expression in atherosclerosis rats

OBJECTIVE

To investigate the correlation between the endothelial cell apoptosis and sirtuin-3 (SIRT3) gene expression in atherosclerosis (AS) rats.

MATERIALS AND METHODS

The AS model in rats was established through the high-fat diet. A total of 12 rats fed normally were enrolled as the control group, while 12 rats fed with high-fat diet were enrolled as the experimental group. After the experiment, the aortic tissues of rats were collected, and the relative area of the arterial plaque (total area of plaque/total area of the vessel) was measured via oil red O staining. The serum was collected to detect the levels of blood lipid, including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). Moreover, the expression levels of SIRT3 and apoptotic genes were determined via Reverse Transcription-Polymerase Chain Reaction (RT-PCR), Western blotting and immunohistochemistry (IHC), respectively. The apoptosis was detected via terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining.

RESULTS

The area of aortic plaque in the experimental group [(36.15±9.52)%] was significantly larger than that in the control group [(11.62±3.25)%] (p<0.01). Compared with those in the control group, the serum TC, TG and LDL-C levels were significantly increased in the experimental group, while the HDL-C level was significantly decreased (p<0.05). Compared with those in the control group, the mRNA and protein expression levels of SIRT3 in the aorta of rats markedly declined in the experimental group (p<0.05), while Caspase-3 and Caspase-9 expressions were significantly increased (p<0.05), respectively. The results of TUNEL staining revealed that the apoptosis in the aorta of rats in the experimental group was remarkably higher than that in the control group (p<0.05).

CONCLUSIONS

The expression of SIRT3 is deleted in the aorta of AS rats and closely related to the apoptosis. SIRT3 may serve as a potential target for the treatment of AS.

[Effect of risperidone on prepulse inhibition of the startle reflex and P50 deficit in patients with first-episode and chronic schizophrenia]

Objective: To investigate the effect of antipsychotic medicine risperidone on prepulse inhibition of the startle reflex (PPI) and P50 deficit in patients with first-episode and chronic. Methods: Thirty-eight patients with first-episode schizophrenia and 36 patients with chronic schizophrenia, both in acute stage, were enrolled in the study. All patients were treated with risperidone of different doses (2 to 6mg/d). All patients fulfilled the evaluation of PPI and P50 before treatment and 8 weeks after treatment. The psychotic symptoms were assessed with Positive and Negative Syndrome Scale (PANSS), and the therapeutic effects were evaluated with PANSS reduction rate. Results: (1) There was no significant difference in PPI and P50 parameters between the two groups before treatment (PPI ratio: first group 43%±29%, chronic group 42%±27%, P>0.05; P50 S2/S1 ratio: first group 83%±33%, chronic group 82%±24%, P>0.05). (2) There was no significant correlation between PPI and P50 inhibition parameters and disease course, psychotic episodes and psychiatric symptoms (PANSS total score, positive symptoms score, negative symptoms score and general psychopathology symptoms score) of schizophrenia (P>0.05). (3) Except the group main effect for S2 amplitude (F=5.75, P=0.019), there was no significant change for main effect and interaction of the other P50 and PPI inhibition ratio parameters after treatment (P50 S2/S1 ratio: first group before treatment 83%±33%, after treatment 85%±49%, P>0.05; chronic group before treatment 82%±44%, after treatment 84%±35%, P>0.05. PPI ratio: first group before treatment 43%±29%, after treatment 42%±27%; chronic group before treatment 42%±27%, after treatment 41%±28%,P>0.05). The effect of risperidone on P50 and PPI parameters was not related to the therapeutic effect. Conclusion: Deficit in sensory gating inhibition exists in both first-episode schizophrenia and chronic schizophrenia, and risperidone is not effective in treating the deficit in sensory gating (PPI and P50) inhibition of schizophrenia.

Monitoring of lung malignant epithelial cells by gene methylation analysis in the conditionally reprogrammed cell cultures

Conditionally reprogrammed cell (CRC) technology is an effective method for culturing primary malignant cells and non-malignant epithelial cells in vitro. This can be useful for precision medicine applications, such as drug sensitivity assays. However, this approach is commonly hindered by the non-specific growth of non-malignant epithelial cells in CRC cultures and the lack of effective biomarkers/assays to distinguish them from primary tumor cells. In this study, we developed a DNA methylation-based, real-time PCR assay to investigate SHOX2 and PTGER4 gene promoters as sensitive markers for human lung cancer. We first found that in formalin-fixed, paraffin-embedded (FFPE) malignant lung samples, 90% (28/31) had increased SHOX2 and/or PTGER4 promoter methylation as compared with their adjacent non-malignant samples. We then applied this assay to fresh surgical tumors and found increased SHOX2 and/or PTGER4 promoter methylation in 80% (20/25) of tumor samples as compared with their corresponding adjacent non-malignant tissues. Increased methylation of SHOX2 or PTGER4 promoter regions was also detected in 52% (13/25) of CRC cultures. The presence of malignant cells was confirmed by growth in soft agar cultures, a hallmark of malignant transformation, as well by EGFR mutation analysis. These results demonstrate that SHOX2 and PTGER4 promoter methylation levels can be used to detect malignant lung epithelial cells in CRC cultures.

[Treatment strategies for colorectal cancer patients in tumor hospitals under the background of corona virus disease 2019]

In December 2019, a new outbreak of corona virus disease 2019 began to occur. Its pathogen is 2019-nCoV, which has the characteristics of strong infectivity and general susceptibility. The current situation of prevention and control of new coronavirus pneumonia is severe. In this context, as front-line medical workers bearing important responsibilities and pressure, while through strict management strategy, we can minimize the risk of infection exposure. By summarizing the research progress and guidelines in recent years in the fields of colorectal cancer disease screening, treatment strategies (including early colorectal cancer, locally advanced colorectal cancer, obstructive colorectal cancer, metastatic colorectal cancer and the treatment of patients after neoadjuvant therapy), the choice of medication and time limit for adjuvant therapy, the protective measures for patients undergoing emergency surgery, the re-examination of postoperative patients and the protection of medical staff, etc., authors improve treatment strategies in order to provide more choices for patients to obtain the best treatment under the severe epidemic situation of new coronavirus pneumonia. Meanwhile we hope that it can also provide more timely treatment modeling schemes for colleagues.

[Thinking of treatment strategies for colorectal cancer patients in tumor hospitals under the background of coronavirus pneumonia]

In December 2019, a new outbreak of coronavirus pneumonia began to occur. Its pathogen is 2019-nCoV, which has the characteristics of strong infectivity and general susceptibility. The current situation of prevention and control of new coronavirus pneumonia is severe. In this context, as front-line medical workers bearing important responsibilities and pressure, while through strict management strategy, we can minimize the risk of infection exposure. By summarizing the research progress and guidelines in recent years in the fields of colorectal cancer disease screening, treatment strategies(including early colorectal cancer, locally advanced colorectal cancer, obstructive colorectal cancer, metastatic colorectal cancer and the treatment of patients after neoadjuvant therapy), the choice of medication and time limit for adjuvant therapy, the protective measures for patients undergoing emergency surgery, the re-examination of postoperative patients and the protection of medical staff, etc., authors improve treatment strategies in order to provide more choices for patients to obtain the best treatment under the severe epidemic situation of new coronavirus pneumonia. Meanwhile we hope that it can also provide more timely treatment modeling schemes for colleagues.

[Molecular epidemiology of Listeria monocytogenes isolated from ready-to-eat food in 2017 in China]

Objective: To analyze the molecular characteristics of Listeria monocytogenes strains from ready-to eat food in China. Methods: A total of 239 Listeria monocytogenes strains isolated from ready-to-eat food in 2017, all strains underwent whole-genome sequencing (WGS) , and comparisons uncovered population structure derived from lineages, clonal complex, serogroups, antimicrobial susceptibility and virulence, which were inferred in silico from the WGS data. Core genome multilocus sequence typing was used to subtype isolates. Results: All strains were categorized into three different lineages, lineage Ⅱ was the predominant types in food, and IIa was the main serogroups. CC8, CC101 and CC87 were the first three prevalent CCs among 23 detected CCs, accounting for 49.4%. Only 4.6% (11 isolates) of tested strains harbored antibiotic resistance genes, which were mostly trimethoprim genes (7 isolates, 2.9%). All strains were positive for LIPI-1, and only a part of strains harbored LIPI-3 and LIPI-4, accounting for 13.8% (33 isolates) and 14.2% (34 isolates), respectively. ST619 carried both LIPI-3 and LIPI-4. 51.5% (123 isolates) of strains carried SSI-1, and all CC121 strains harbored SSI-2. Different lineages, serogroups and CCs can be separated obviously through cgMLST analysis, and 24 sublineages were highly concordant with CCs. Conclusion: Ⅱa was the main serogroups in ready-to-eat food isolates in China; CC8, CC101 and CC87 were the prevalent CCs, and CC87 isolates was hypervirulent isolates, cgMLST method can be adopted for prospective foodborne disease surveillance and outbreaks detection.

Comparison of hand-sewn versus modified coupled arterial anastomoses in head and neck reconstruction: a single operator's experience

Microvascular coupler devices have gained wide acceptance as an alternative to the traditional hand-sewn technique in reconstructive surgery. However, no study has directly compared the efficacy of the coupler and hand-sewn techniques in arterial anastomosis during head and neck reconstruction surgery. A total of 123 patients who underwent surgery performed by a single surgeon between 2016 and 2018 were included in this retrospective study. The patients were divided into the coupler group and the hand-sewn group according to the technique of arterial anastomosis used. Patients in the coupler group underwent a special procedure including arterial bifurcation to enlarge the recipient artery diameter. Of the 123 free flap surgeries performed, 56 were done using a coupler and 67 with the standard suture technique. One flap in the coupler group failed due to simultaneous arterial and venous thromboses. One flap in the hand-sewn group was lost due to venous compromise. The overall flap survival rate was 98.4% (n=121). There was a significant decrease in anastomotic time when a coupler was used (P<0.001). The complication and flap loss rates were similar in the coupler and hand-sewn groups. The application of the coupler helped to decrease the anastomotic time and achieved satisfactory vessel patency.

P98 Distal myopathy induced the onset of arrhythmogenic right ventricular cardiomyopathy in a pedigree carrying novel DSG2 null variant

Background

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare cardiac disease predominantly caused by variants in desmosome genes. Variants in human Desmoglein-2 (DSG2) gene can cause ARVC with incomplete penetrance. However, it remains unknown whether ARVC would penetrate by distal myopathy.

Methods

We performed targeted next-generation sequencing using a cardiomyopathy/ion channelopathy panel in a Chinese ARVC pedigree. Plasmids of DSG2 were constructed, and pathogenicity of the DSG2 variant was investigated by real-time PCR, western blots, Immunofluorescence, and electron microscope.

Results

We identified a novel nonsense variant in DSG2 (c.710T &gt; A, p.Leu237Ter) and a reported pathogenic missense variant of distal myopathy in MYH7 (c. 1322C &gt; T, p.Thr441Met) in the proband of an ARVC pedigree. The functional analyses suggested that the nonsense variant could affect the expression and cell location of DSG2, and the number and shape of desmosomes were affected as well, indicating that the variant was implicated in the pathogenesis of ARVC. We found only patients carrying the distal myopathy pathogenic variant would manifested early-onset severe ARVC phenotype, which suggested that MYH7-p.Thr441Met variant could induced the onset of ARVC in the DSG2-p.Leu237Ter variant carriers.

Conclusions

Our study identified a novel null variant in DSG2 gene (c.710T &gt; A, p.Leu237Ter) in an ARVC pedigree with incomplete penetrance. Only patients who carried a distal myopathy associated variant in MYH7 (c. 1322C &gt; T, p.Thr441Met) would induce the onset of ARVC with early-onset and severe symptoms.

MicroRNA-19b alleviates lipopolysaccharide-induced inflammatory injury in human intestinal cells by up-regulation of Runx3

OBJECTIVE

Ulcerative colitis (UC) is an unexplained inflammatory disease in bowel. Some studies reported that microRNA-19b (miR-19b) was closely related to cell inflammatory response. We aimed to explore the molecular mechanism of miR-19b on lipopolysaccharide (LPS)-induced human intestinal cell inflammatory injury.

MATERIALS AND METHODS

Caco2 cells were treated with 10 ng/ml LPS to induce inflammatory injury. The expression of miR-19b and runt-related transcription factor 3 (Runx3) was changed in Caco2 cells by cell transfection. Then, the viability, apoptosis and pro-inflammatory factors expressions of transfected cells were assessed using trypan blue exclusion assay, flow cytometry, qRT-PCR, Western blotting and enzyme-linked immunosorbent assay (ELISA), respectively, after LPS treatment. At last, the expressions of key factors involved in nuclear factor kappa B (NF-κB) and phosphatidylinositol 3-kinase/protein kinase 3 (PI3K/AKT) pathways were evaluated using Western blotting.

RESULTS

LPS significantly induced Caco2 cell inflammatory injury, down-regulated miR-19b expression and activated NF-κB and PI3K/AKT pathways. Suppression of miR-19b enhanced the LPS-induced Caco2 cell inflammatory injury, as well as NF-κB and PI3K/AKT pathways activation. Overexpression of miR-19b had opposite effects. In addition, miR-19b regulated the expression of Runx3 in Caco2 cells. Overexpression of Runx3 reversed the miR-19b knockdown-induced Caco2 cell viability inhibition, apoptosis enhancement, inflammatory factors expressions and NF-κB and PI3K/AKT signaling pathways activation.

CONCLUSIONS

Our study demonstrated that miR-19b alleviated LPS-induced Caco2 cell inflammatory injury via up-regulation of Runx3 and deactivation of NF-κB and PI3K/AKT signaling pathways.

P3390Relationship of thrombus healing to underlying plaque characteristics in ST-segment elevation myocardial infarction: an optical coherence tomography study

Background

Acute ST-segment elevation myocardial infarction (STEMI) is typically characterized by an occlusive coronary thrombus propagation on a disrupted or eroded atherosclerotic plaque. A variable period of plaque instability and thrombus formation occur days or weeks old in approximately 50% of patients with STEMI. Presence of late stage (older) thrombi in aspirated coronary material is an independent predictor of 1-year and long-term mortality in STEMI patients. However, the relationship between coronary thrombus healing to underlying plaque morphology and characteristics in vivo still remains largely unknown.

Purpose

Our objective was to assess differences in thrombus healing between ruptured and eroded plaques in vivo and evaluate the impact of underlying plaque characteristics on thrombus healing using optical coherence tomography (OCT).

Methods

Analyzable coronary material was obtained during primary percutaneous coronary intervention (PCI) from 135 patients with STEMI within 12h of symptom onset. Thrombi were morphologically classified as either early or late stage (lytic changes or organization). Of the 135 patients, 110 were eligible for culprit lesion evaluation using OCT. Quantitative and qualitative underlying plaque characteristics were assessed by OCT.

Results

Late-stage thrombi were found in 49 of 110 (44.5%) culprit plaques. Patients with eroded plaques more frequently had late-stage thrombi compared with ruptured plaques (59.0% vs. 36.6%, p<0.001). Subgroup analysis was performed between plaque rupture, identified in 71 patients (64.5%) and plaque erosion in 39 patients (35.5%). In plaque ruptures, patients with late-stage thrombi had larger lipid core length (12.4±3.3 vs. 14.5±3.8, p=0.020), larger rupture cavity length [1.5 (1.0, 2.0) vs. 1.9 (1.5, 2.8), p=0.034] and increased residual thrombus length [7.8 (6.3, 11.2) vs. 10.3 (7.8, 13.8), p=0.021] assessed by OCT compared with early thrombus group. However, in plaque erosions, late stage thrombi were associated with decreased residual thrombus burden compared with patients with early thrombus group [16.8 (12.8, 20.4) vs. 13.4 (10.7, 14.8), p=0.012]. No significant difference was found between thrombus healing with peak creatine kinase concentration or maximum NT-pro BNP in subgroup analysis.

Conclusions

Coronary thrombi in STEMI patients exhibited diverse phases of healing, depending on the etiology of the underlying culprit plaque in vivo. These observations indicate entirely distinct mechanisms of thrombus propagation, maturation and healing between plaque rupture and erosion, illustrating an opportunity for more tailored treatment in patients with different plaque type.

Process–Structure–Property Relationships in Selective Laser Melting of Porosity Graded Gyroids

Selective laser melting (SLM) can be used to tailor both the geometry and mechanical properties of lattice structures to match bone properties. In this work, a process–structure–property (PSP) relationship for Ti6AL4V porosity graded gyroids (PGGs) structures was developed. A design of experiment approach was used to test the significance and contribution of different process parameters on microstructure, morphology, and mechanical properties. Process maps to predict the morphology errors at specific laser power and scan speed were developed. Moreover, the mechanical properties of radially PGGs with a relative density of 25% are evaluated using different SLM process parameters. The results showed that PGGs with different radial gradation designs have mechanical properties that are compatible with bone implants: apparent compressive modulus of 1.4–5.3 GPa and compressive strength 40–154 MPa.

Wearable, Flexible, Disposable Plasma-Reduced Graphene Oxide Stress Sensors for Monitoring Activities in Austere Environments

In austere environments, for example, in outer space, on surfaces of extra-terrestrial bodies (Moon, Mars, etc.), or under water, technologies that can enable continuous, reliable, and authentic monitoring of movement of human operators and devices can be critical. We report here the production and human body test of wearable, flexible graphene oxide stress sensors suitable for real-time monitoring of body parameters, state and position of humans, and automatic equipment. These sensors have excellent sensitivity and signal strength across a wide strain range, alleviating the need for additional instrumentation for signal processing and amplification. Their low cost makes them virtually disposable, which may benefit such applications as smart clothing. The sensors were fabricated by a concomitant reduction and N-doping of graphene oxide on polydimethylsiloxane in N₂-H₂ plasma. The direct bias and other plasma parameters have a significant effect on the reduction and properties of graphene oxide sensors, as shown by optical emission, Raman and X-ray photoelectron spectroscopies, and X-ray diffraction. Optical emission showed different excitation and ionization processes involving atomic and molecular species in the N₂-H₂ discharge. The photoelectron spectroscopy has confirmed the graphene reduction and introduction of nitrogen doping into the reduced graphene oxide. The bias efficiently controls plasma-induced electric fields, and plasma-related effects determine the N-doping levels. The reduced graphene oxides demonstrate excellent tensile properties, which make them suitable for efficient but cheap stress sensors. This eco-friendly, fast, room-temperature method shows a great potential for fabrication of efficient, flexible sensors.

[Analysis of occupational poisoning in Jiangsu Province, from 2006-2015]

Objective: Analysis of occupational poisoning character and laws in Jiangsu Province from 2006-2015, so as to provide scientific basis for the formulation of effective intervention measures and prevention strategies. Methods: According to the data of Jiangsu province occupational poisoning cases reports of year 2006 to 2015, by EXCEL arranged, using SPSS software to do epidemiological data statistical analysis. Results: In the past ten years, the number of occupational poisoning cases reported in Jiangsu province increased first and then declined. 547 cases of acute occupational poisoning reported in Jiangsu province from 2006-2015 years (35.82% of the total poisoning cases, the same below) , 980 cases of chronic occupational poisoning (64.18%) . The ratio of male and female in acute poisoning was 2.48, while 1.55 of chronic poisoning. The cases of poisoning reported were young and middle-aged, and working years was mainly in 5 years. The cases reported in the south of Jiangsu (mainly is chronic poisoning) is higher than that in the northern part of Jiangsu (mainly is acute poisoning) , which is more economically underdeveloped.. The reported highest mortality rate of occupational poisoning is asphyxia gas poisoning (5.43%) , followed by irritating gas poisoning (2.99%) and organic solvent poisoning (0.47%) . Many more occupational poisoning cases reported from large, joint-stock enterprises, especially chronic poisoning. Meanwhile more cases of acute poisoning reported from small, micro private enterprises. Conclusion: Although a decline in occupational poisoning cases in Jiangsu, the prevention and treatment measures are still not lax. According to the species of toxic, regional economic differences, the scale of the enterprises and the type of economy, the characteristic key classification and prevention should be carried out. Expand the coverage of hospitals in the diagnosis and reporting of occupational poisoning diseases, and strive to improve the quality of occupational disease reports.

[Analysis on the relationship between Occupational Stress Factors and Psychological Stress Reaction among Petrochemical Workers]

Objective: Analyze the detection rates of occupational contraindication and suspected occupational disease from the employee exposure to noise and describe the distribution characteristics. Methods: According to the Technical Specifications for Occupational Health Surveillance (GBZ 188-2014) 、Diagnosis of Occupational Noise-induced Deafness (GBZ 49-2014) and Guideline of Identification of Contraindication to Job Placement (GBZ/T 260-2014) , calculate and analyze the occupational contraindication and suspected occupational disease detection rates of 149 271 workers from January 1st to December 31st in 2015 who were exposed to noise. Analyze the detection rates distribution characteristics between different gender, age, seniority, industry and enterprise scale. Results: The detection rates of occupational contraindication is 2.08%. The suspected occupational disease detection rates of absences workers (2.13%) is higher than during (2.03%) . The occupational contraindication detection rates of< age 20 (2.64%) , 41~50 years old (2.48%) and<1 working years (5.35%) , are higher than others. The detection rates of suspected occupational disease increases with the growth of ages and working years. The occupational contraindication detection rates of scientific research and technology services industry (10.46%) is the highest. The suspected occupational disease detection rates of transportation warehousing and postal services (5.88%) is the highest. The occupational contraindication detection rates of medium-sized enterprise (2.27%) is the highest, meanwhile, the microenterprise's (1.60%) is the lowest. The suspected occupational disease detection rates of large-scale enterprise (3.21%) is the highest, meanwhile, the microenterprise's (1.33%) is the lowest. Conclusion: Enterprise should insist on regular occupational health examination, strengthen screening of occupational contraindication in new workers, especially pre-job workers and detect the occupational disease patients early. Focus on non-traditional noise industries above mentioned, improve intensity of noise hazards prevention and control. The detection rates of occupational contraindication and suspected occupational disease can be used as a reference standard for the quality control of occupational examination and report of medical institutions.

Gastric infusion of short-chain fatty acids can improve intestinal barrier function in weaned piglets

Background

The present study was conducted to investigate the effects of gastric infusion of short-chain fatty acids (SCFA) on gut barrier function in a pig model. In this study, 21 DLY barrows with an average initial body weight of (8.31 ± 0.72) kg were randomly allotted into three treatments: (1) control, (2) infusing low SCFA, S1, (3) infusing high SCFA, S2. The experimental period lasted for 7 days.

Results

Gastric infusion of SCFA increased the concentrations of SCFA in serum and digesta, and enhanced the mRNA and protein abundances of SCFA receptors in pig intestine (P < 0.05). Moreover, gastric infusion of SCFA led to alteration of intestinal morphology, elevation of intestinal development-related gene abundances, and decrease of apoptotic cell percentage, as well as reduction of pro-apoptosis gene and protein abundances (P < 0.05). Besides, the jejunal SLC₇A₁ and ileal DMT1 mRNA abundances in the SCFA infusion groups were higher than those in the control group (P < 0.05). Additionally, gastric infusion of SCFA increased the mRNA abundances of Occludin and Claudin-1 in the duodenum and ileum, enhanced Lactobacillus spp counts in the ileal digesta, decreased the mRNA and protein abundances of IL-1β in the colon, and reduced Escherichia coli count in the ileal digesta (P < 0.05).

Conclusions

These data indicated that gastric infusion of SCFA, especially high SCFA concentration, may be beneficial to gut development of piglets via improving gut morphology, decreasing apoptotic cell percentage, and maintaining intestinal barrier function.

Electronic supplementary material

The online version of this article (10.1186/s12263-019-0626-x) contains supplementary material, which is available to authorized users.

[Association between hyponatremia and hemodynamic and prognosis in patients with intermediate-risk acute pulmonary embolism]

Objective: To investigate the association between hyponatremia and hemodynamic and prognosis in patients with intermediate-risk acute pulmonary embolism. Methods: We retrospectively recruited 110 intermediate-risk acute pulmonary embolism patients (right ventricular dysfunction was confirmed by echocardiography and CT scan with or without the elevated levels of cardiac injury biomarkers) in the first and the second affiliated hospital of Harbin medical university from January 1,2011 to December 31, 2014. The patients were aged (58.4±14.9) years old.There were 49 males and 61 females.Patients were divided into 2 groups as non-hyponatremia group (plasma sodium>135 mmol/L, 93 cases) and hyponatremia group (plasma sodium≤135 mmol/L, 17 cases). Baseline clinical and hemodynamic parameters were obtained from these patients. All enrolled patients were followed up after discharge. Results: Heart rate ((106.7±21.9) beats per minute vs. (93.4±19.4) beats per minute, P=0.043),N-terminal pro B type natriuretic peptide (NT-proBNP, (5 561±1 593) ng/L vs. (1 738±589) ng/L, P=0.005), mean pulmonary arterial pressure((42.6±12.6)mmHg(1 mmHg=0.133 kPa) vs. (33.9±13.3)mmHg, P=0.046), mean right atria pressure ((20.6±8.1)mmHg vs. (10.2±5.4)mmHg, P=0.014), systolic right atria pressure ((27.3±9.0)mmHg vs. (15.6±6.1)mmHg,P=0.013) and diastolic right atria pressure(6.5(4.3,15.5)mmHg vs. 5.0(2.0,8.0)mmHg,P=0.016) were significantly higher in hyponatremia group than in non-hyponatremia group,and systolic blood pressure was significantly lower in hyponatremia group than in non-hyponatremia group ((113.5±21.9)mmHg vs.(129.5±28.9)mmHg, P=0.048). Pearson correlation analysis showed that hyponatremia was negatively correlated with heart rate (r=-0.262, P=0.043), NT-proBNP (r=-0.227, P=0.048), mean pulmonary arterial hypertension (r=-0.259, P=0.046), mean right ventricular pressure (r=-0.296, P=0.047), mean right atria pressure (r=-0.550, P=0.001), systolic right atria pressure (r=-0.552, P=0.001), and diastolic right atria pressure (r=-0.542, P=0.001). Kaplan-Meier survival analysis showed that the 1-year, 2-year and 3-year cumulative survival rates were 76.5%,70.6%,and 64.7% in the hyponatremia group, and 90.3%,86.0%,and 83.9% in the non-hyponatremia group(log-rank test, P=0.036).Multivariate Cox regression analysis showed that hyponatremia was an independent risk factor of death of intermediate-risk pulmonary embolism patient(HR=4.126, 95%CI 1.982-11.343, P=0.036). Conclusion: Hyponatremia is associated with adverse hemodynamic and reduced survival in patients with intermediate-risk pulmonary embolism.