Molecular Cloning and Sexually Dimorphic Expression Analysis of nanos2 in the Sea Urchin, Mesocentrotus nudus

Sea urchin (Mesocentrotus nudus) is an economically important mariculture species in China and the gonads are the solely edible parts to human. The molecular mechanisms of gonad development have attracted increasing attention in recent years. Although the nanos2 gene has been identified as a germ cell marker in several invertebrates, little is known about nanos2 in adult sea urchins. Hereinto, we report the characterization of Mnnano2, an M. nudus nanos2 homology gene. Mnnanos2 is a maternal factor and can be detected continuously during embryogenesis and early ontogeny. Real-time quantitative PCR (RT-qPCR) and section in situ hybridization (ISH) analysis revealed a dynamic and sexually dimorphic expression pattern of Mnnano2 in the gonads. Its expression reached the maximal level at Stage 2 along with the gonad development in both ovary and testis. In the ovary, Mnnanos2 is specifically expressed in germ cells. In contrast, Mnnanos2 is expressed in both nutritive phagocytes (NP) cells and male germ cells in testis. Moreover, knocking down of Mnnanos2 by means of RNA interference (RNAi) reduced nanos2 and boule expression but conversely increased the expression of foxl2. Therefore, our data suggest that Mnnanos2 may serve as a female germ cell marker during gametogenesis and provide chances to uncover its function in adult sea urchin.

[The effect of air test and methylene blue perfusion test on detecting the quality of anastomosis during laparoscopic rectal cancer excision (Dixon)]

Objective: To investigate the feasibility and safety of air test (AT) and methylene blue perfusion test (MBPT) to detect the quality of the anastomosis in laparoscopic rectal cancer excision (Dixon), and compare the two approaches. Methods: AT is performed by filling the pelvis with saline solution and insufflating the rectum with air through a size 22 G balloon catheter (Foley). MBPT is carried out by surrounding clean sponges around anastomosis and injecting methylene blue solution into the rectum as like as AT. The balloon catheter connected manometer,ensuring the pressure in rectum can reach 40 cmH(2)O during AT and MBPT. The presence of air bubbles and overt blue-stained spillage indicated anastomotic leaks which are were resolved during surgery. All 28 patients undergoing laparoscopic rectal excision received both AT and MBPT intraoperatively in a randomized fashion. The integrity of the anastomosis, postoperative vital signs, blood examination, drainage and postoperative imaging were analyzed. Results: All 28 patients received both tests successfully with no adverse event. MBPT Level 1 was detected in 15 cases, level 2 in 8 cases, level 3 in 5 cases. No MBPT level 4 was observed. AT level 1 was detected in 22 cases, level 2 in 5 cases, level 3 in 1 cases. No AT level 4 was founded. Three cases were diagnosed with postoperative anastomotic leakage (3/28, 10.71%), of which 2 cases were Grade B [definition and grading proposed by the international study group of rectal cancer (ISREC) in 2010]. One case was Grade C. The positive rate of MBPT was superior to AT (the McNemar testing, P<0.01). Conclusions: The two intraoperative tests are both technically feasible and safe. Compared to AT, MBPT has the advantage of localizing the leak site with a higher positive accuracy, and represents a promising standardized approach for intraoperative test of the anastomosis quality. Intraoperative repair is absolutely helpful for the level 3 and 4 intraoperative tests.

[Adrenal androgen measurement for assessing the selectivity of adrenal venous sampling in primary aldosteronism]

Objective: To investigate the usefulness of adrenal androgens for assessing the selectivity of adrenal venous sampling (AVS). Methods: Between January 2010 and December 2016, 37 consecutive patients [with an average age of (47±14) years, 16 males and 21 females] with primary aldosteronism (PA) who underwent AVS were enrolled. AVS procedures were performed with the bilateral simultaneous technique without cosyntropin stimulation. Cortisol, androstenedione, dehydroepiandrosterone (DHEA), and DHEA sulfate (DHEAS) concentrations were measured in adrenal venous (AV) and peripheral venous (PV) samples, respectively. Results: The selectivity index (SI) based on androstenedione and DHEA was higher than that of cortisol (SI-left: 13.9, 13.1 vs 6.05, P=0.006, 0.035; SI-right: 30.4, 18.5 vs 11.6, P=0.028, 0.051). However, the SI based on DHEAS was lower than that of cortisol (SI-left: 1.3 vs 6.0, P=0.002; SI-right: 1.5 vs 11.6, P=0.038). Plasma androstenedione and DHEA concentrations were positively correlated with cortisol and aldosterone in AV samples (all P<0.001). Compared to cortisol, the variation ratio of AV androstenedione and DHEA was lower from t(-15) to t(0) (0.23, 0.43 vs 0.52, both P<0.05). Using the receiver operating characteristic curve, a SI ≥ 3.0 for androstenedione or DHEA provided optimal sensitivity(97.7%, 91.9%) and specificity (93.8%, 93.8%) in AVS. Conclusion: Given the greater AV/PV ratios and reduced variability compared to cortisol, the adrenal androgens androstenedione and DHEA are useful for assessing the selectivity of AVS without cosyntropin stimulation and may be superior analytes in conditions with marked variability of cortisol levels or with adrenocortical tumors co-secreting cortisol and aldosterone.

Forensic Analysis of 52 Corpses Found in Wells

OBJECTIVES

To explore the forensic pathological characteristics of corpses in wells, and to summarize the differences in corpses between homicide and suicide, so as to provide references for forensic analysis of such cases.

METHODS

Data of 52 corpses found in wells （51 cases） in Xuchang, Henan Province from 2004 to 2016 were retrospectively collected, and descriptive statistics were performed on the dead individuals, time of death, wells, autopsies, and diatom testings.

RESULTS

The proportion of males and females in the 52 corpses was 1∶2.5, and 42 people were at the age of >20-50 years （80.8%）. The accuracy of the death time inference were 75.0% and 54.2% within 8 d and 8 d or more after the actual death time, respectively. Most of the wells （84.3%） were small ones with big wellhead diameters of 60-100 cm. The death causes in homicide cases were mainly mechanical injury and suffocation （90.3%） with heads downwards （58.1%）, but that in suicide cases was mostly drow-ning （85.0%） with heads upwards （65.0%） and body surface abrasions （95.0%）.

CONCLUSIONS

Cases of corpses in wells should be comprehensively analyzed according to scene inspections, autopsies, and auxi-liary tests combined with inspection results.

[A study on alterations in mitochondrial biological characteristics during cellular senescence of human embryonic lung fibroblasts]

Objective: To study the alterations of mitochondrial biological characteristics during both cellular replicative and premature senescence induced by hydrogen peroxide in human embryonic lung fibroblasts (HEFs). Methods: The premature senescence was induced by 400 μmol/L H(2)O(2) once a day at the same time and with 2 hours each time, after four consecutive days the premature senescence models were classified into premature senescence initiation group (PSi) and premature senescence persistence group (PSp). Based on the life span of HEFs, the cell replicative senescence was divided into five groups included young-age (22 PDL), middle-age (35 PDL), replicative senescence (49 PDL), PSi and PSp. The mitochondrial distribution, relative content, adenosine triphosphate (ATP) contents, 8-hydroxydeoxyguanosine (8-OHdG) levels, the relative mitochondrial transcription factor A (TFAM) as well as mitochondrial DNA methyltransferase 1 (mtDNMT1) mRNA levels, mtDNA copy number, the relative TFAM protein level and the total enzyme activity of mitochondrial DNA methyltransferases (mtDNMTs) were detected in five senescence groups. Results: The mtDNA copy number, 8-OHdG contents, level of mtDNMT1 mRNA and mtDNMTs activity in 49 PDL group were higher than those in 22 PDL group (all P values <0.05); The level of 8-OHdG in PSi was higher than that in 22 PDL group (P<0.05); The ATP contents, mtDNA copy number, the mRNA and protein expression levels of TFAM and mtDNMTs activity of PSp were higher than those in 22 PDL group (all P values<0.05). Conclusion: During the cellular senescence of HEFs, the higher mtDNA copy number and mtDNMTs activity were common features regardless of replicative or premature senescence, with possibility that oxidative stress was involved in modifying the occurrence of premature senescence.

[Clinical Analysis of Treating EBV Infection Accompanied with GVHD after Allon-HSCT by EBV-Specific Cytotoxic T Lymphocytes]

OBJECTIVE

To investigate the efficiency and safety of treating Epstein-Barr virus (EBV) infection of acute graft versus host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) by EBV specific cytotoxic T lymphocytes (EBV-CTL).

METHODS

The Clinical characteristics, therapeutic efficacy and safety of 12 patients with EBV infection treated by EBV-CTL infusion after allo-HSCT in Department of Hemahlogy of Aero Space Center Hospital between Jan 2015 and May 2017 were analyzed retrospectioely.

RESULTS

Our of 12 cases received EBV-CTL infusion after transplantation, 9 did not received Rituximab therapy due to the active infection, 4 cases including 3 received Ritaximab progressed into posttransplantation lymphoroliferetive disease (PTLD). The median time of EBV infection was 47 (22-71) days, median time of antivirus therapy before tramplantation was 10 (8-33) days, median time of first CTL infusion was 59(34-86) days after transplatation. The 43 cases-time CTL infusion was performed smoothly, no related harmful evnts occoured, no progression of GVHD was observed. After the first course of infusion, complete remission (CR), Partial remssion (PR) and no remssion (NR) were obtained in 9, 1 and 2 patients respectively, the relapse was observed in 4 patients who then received the socond course of infusion and all reached CR, the patient in PR did not reathed CR finally and died of GVGD at 5 months after transpplantation . Only 1 out of 2 cases of NR obtained CR, another 1 still was in NR, and died of transplantation related infection at 5 months after transplantation. 4 cases of PTLD were all cared.

CONCLUSION

Preliminary results of this study suggest that EBV-CTL infusion is safe for the EBV infection combined with acute GVHD after all-HSCT. However, a further larger scale clinical studies are needed to prove the efficiency.

[Effects of CD34(+) selected stem cells for the treatment of poor graft function after allogeneic stem cell transplantation]

目的

观察输注纯化供者CD34⁺细胞治疗单倍型造血干细胞移植后移植物功能不良的疗效和安全性。

方法

对2014年1月至2018年3月期间接受供者纯化CD34⁺细胞治疗的12例单倍型造血干细胞移植后移植物功能不良患者进行回顾性分析。

结果

12例患者中男9例、女3例，中位年龄26（14~54）岁；急性淋巴细胞白血病4例，急性髓系白血病5例，慢性髓性白血病2例，慢性粒-单核细胞白血病1例。分选产物CD34⁺细胞纯度为92.0%（44.0%~97.0%），回收率为55.0%（45.0%~96.7%），回输CD34⁺细胞的中位数为1.9（0.9~4.4）×10⁶/kg，CD3⁺细胞中位数为0.6（0.3~2.0）×10⁴/kg。中性粒细胞恢复中位时间为18（14~39）d，血小板恢复中位时间为29（16~153）d，红细胞恢复中位时间为60（9~124）d。12例患者输注过程中未发生严重不良反应，10例获得完全缓解，1例患者获得部分缓解，1例患者无效，未发生重症感染和重度GVHD。

结论

回输供者纯化CD34⁺细胞是单倍型造血干细胞移植后植入功能不良的一种安全、有效治疗方法。

Intratumoral IL17-producing cells infiltration correlate with antitumor immune contexture and improved response to adjuvant chemotherapy in gastric cancer

BACKGROUND

Tumor IL17-producing (IL17A+) cells infiltration has different prognostic values among various cancers. The objective of this study was to assess the effect of IL17A+ cells in gastric cancer.

PATIENTS AND METHODS

The study included two patient cohorts, the Cancer Genome Atlas cohort (TCGA, n = 351) and the Zhongshan Hospital cohort (ZSHC, n = 458). The TCGA and ZSHC were used for mRNA-related and cells infiltration-related analyses, respectively. The roles of IL17A mRNA and IL17A+ cells in overall survival (OS), response to adjuvant chemotherapy (ACT), and immune contexture were evaluated. Another independent cohort was included to identify the correlation between mRNA of IL17A and IL17A+ cells infiltration (the preliminary Zhongshan Hospital cohort, PZSHC, n = 21).

RESULTS

The infiltration of IL17A+ cells was positively correlated with the expression of IL17A mRNA (Spearman's ρ = 0.811; P < 0.001). High IL17A mRNA expression and intratumoral IL17A+ cells were correlated with improved OS and remained to be significant after adjusted for confounders. Patients with TNM II/III disease whose tumor present higher intratumoral IL17A+ cells or lower peritumoral IL17A+ cells can benefit more from ACT. Elevated IL17A mRNA expression and increased intratumoral IL17A+ cells infiltration was associated with more antitumor mast cells and nature killer cells infiltration and less pro-tumor M2 macrophages infiltration. High IL17A mRNA expression represented a Th17 cells signature and immune response process and was correlated with increased cytotoxic GZMA, GZMB, IFNG, PRF1, and TNFSF11 expression.

CONCLUSIONS

IL17A mRNA expression and intratumoral IL17A+ cells infiltration were correlated with antitumor immune contexture. IL17A+ cells infiltration could be used as an independent prognostic biomarker for OS and predictive biomarker for superior response to ACT, and further prospective validation needs to be conducted.

[Influence of apatinib and VEGFR2-906T>C polymorphism on clinical outcomes of advanced non-small cell lung cancer patients]

Objective: To investigate the clinical outcomes of advanced non-small cell lung cancer (NSCLC) treated by apatinib regimens and the influence of VEGFR2-906T>C polymorphism. Methods: A total of 109 patients with advanced NSCLC who were treated by apatinib after three and more lines from March 2015 to December 2017 in the Department of Oncology of the First Affiliated Hospital of Zhengzhou University were included in this study. Overall response rates were evaluated after 2 cycles, then progression free survival (PFS) and overall survival (OS) were investigated, and safety data were recorded. Additionally, peripheral blood and the biopsy tissue specimens of some NSCLC patients were collected for the genotyping of genetic variation and VEGFR2 gene mRNA expression, respectively. The association between genotype and other characteristics and VEGFR2 gene mRNA expression were analyzed. The univariate analysis of genotypes and prognosis was carried out by Kaplan-Meier survival analysis, and multivariate analysis were adjusted by Cox regression analysis. Results: The treatment effect could be evaluated in all the 109 patients, among them, complete remission (CR) 0 case, partial remission (PR) 19 case, stable disease (SD) 58 case, progression disease (PD) 32 case. Overall response rate (ORR) was 17.43%, disease control rate (DCR) was 70.64%, median PFS was 4.35 months, median OS was 8.35 months. Of the polymorphisms analyzed, only -906T>C was of clinical significance. The prevalence of -906T>C in VEGFR2 among the study population were as follows: TT genotype 64 cases (58.72%), TC genotype 37 cases (33.94%), CC genotype 8 cases (7.34%), minor allele frequency of -906T>C was 0.24. The distribution of three genotypes was in accordance with Hardy-Weinberg Equilibrium (P=0.418). CC and TC genotype patients were merged in the comparison of clinical outcomes. The analysis of patients with different genotypes found that the ORR of CC/TC genotypes and TT genotypes were 13.33% and 20.31% (P=0.377), respectively. And the median PFS of patients with CC/TC genotype and TT genotype were 3.25 and 5.35 months, respectively, which was statistically significant (P=0.007). In terms of OS, the median OS of the two genotypes were 7.35 and 9.15 (P=0.014), respectively. Adjusted in multivariate Cox regression analysis of PFS, TC/CC genotypes were an independent factor for PFS (OR=1.83, P=0.015). The correlation between -906T>C and adverse reactions was not found in the safety analysis. Additionally, of the 69 biopsy tissue specimens, gene expression analysis was conducted. And the results show that the mRNA expression of VEGFR2 in cancer tissues of the patients with CC/TC genotypes were significantly higher than those of the TT genotype patients (P<0.001). Conclusions: Apatinib is safe and effective for patients with advanced non-small cell in multiline therapy. VEGFR2 -906T>C CC/TC genotype has a worse effect on apatinib multiline treatment in patients with advanced NSCLC.

[Pollution Characteristic of Ni in Sediments in the Three Gorges Reservoir]

The Three Gorges Reservoir (TGR) has achieved the target of water storage of 175 m for eight consecutive years until October 2017. To study the temporal and spatial variation of nickel (Ni) in different water periods under 175 m operating conditions in the TGR area, probe the impact of a large-scale water conservancy project on the Ni enrichment, and establish the pollution evaluation system of Ni in the TGR area, we collected 173 surface sediment samples from the TGR area during four consecutive water periods from December 2015 to June 2017 and measured the Ni concentration by using inductively coupled plasma mass spectrometry (ICP-MS). The mean values of Ni in the four water periods are higher than the background value of Yangtze sediment and soil. At the spatial scale, the Ni content in the mainstream exhibits a clear upward trend from upstream to downstream and is lower than that of the tributary. The tributaries of the lower reaches shows a notably higher Ni content than the tributaries of the upper and middle reaches. At the temporal scale, the water period exerts an insignificant effect on the Ni content. The Ni content is relatively stable and shows a downward tendency at a 175 m water level. The regional geochemical baseline (RGB) value of Ni was obtained through building a geochemical baseline model in the area. The RGB values of Ni in sediments during four consecutive water periods are 47.0, 44.2, 42.9, and 41.9 mg·kg^-1, respectively. The Ni contents in the middle and lower reaches of the mainstream and tributary are significantly affected by human activities. Moreover, the pollution evaluations based on global Ni background values, local background values, and geochemical baseline values as reference values were compared and the geoaccumulation index and potential ecological risk of Ni were determined to comprehensively assess its pollution risk. The assessment data indicate that Ni in the aquatic environment of the TGR area is almost uncontaminated and poses a low ecological risk, except for samples in regions around Fengdu County and Guizhou Town in the Zigui County along the mainstream, which were uncontaminated to moderately contaminated. Relative to global and regional background values, the pollution assessment results obtained using the RGB as a reference value are more scientific and better match the temporal and spatial variation of the study area.

Cancer-Associated Fibroblasts Correlate with Tumor-Associated Macrophages Infiltration and Lymphatic Metastasis in Triple Negative Breast Cancer Patients

Background: Cancer-associated fibroblasts (CAFs) have been shown to be among the most prominent cells in tumor microenvironment and play a significant role in accelerating tumor metastasis by interacting with other type of cells. Tumor-associated macrophages (TAMs), the predominant tumor-infiltrating immune cells, also play important roles in cancer progression. Here, we aimed to evaluate the effects of CAFs on infiltration of TAMs and lymphatic metastasis in triple-negative breast cancer (TNBC).

Material and methods: The study included 278 patients with histologically confirmed TNBC. Immunohistochemical staining of α-smooth muscle actin and fibroblast activation protein were used to identify CAFs. Polarized functional status of infiltrated TAMs was detected by expression of CD163. The clinicopathological features were assessed from all the patients' medical records.

Results: The CAFs-related markers were found to be expressed more frequently in TNBC patents with aggressive behaviors, including recurrence and poor histological differentiation. High activation of CAFs was positively correlated with elevated infiltration of polarized CD163-positive TAMs and lymph node metastasis in TNBC patients. Multivariate Cox analysis revealed that the activation of CAFs, TAMs infiltration, and lymph node metastasis were independent prognostic factors for disease-free survival in TNBC patients.

Conclusion: Cancer-associated fibroblasts were associated with infiltration of CD163-positive macrophages and lymphatic metastasis, and may be potential prognostic predictors of TNBC.

[Four Cases of Wernicke's Encephalopathy Following Hematopoietic Stem Cell Transplantation]

OBJECTIVE

To make through introduction of Wernicke's encephalopathy (WE) following hematopoietic stem cell transplantation (HSCT) in terms of clinical characteristics, diagnostic process and treatment.

METHODS

The clinical charactaristics, diagnostic and therapeutic process and prognostic follow-up in 4 patients diagnosed of WE following HSCT between January 2016 to January 2017 at Department of Hematology, Chinese Aerospace Center Hospital were retrospectively analyzed.

RESULTS

Four patients included 2 ALL and 2 AML, and 3 males and 1 female, their age ranged from 8 to 20 years old. 4 patients accouted for about 3% of all petients who received HSCT at that time. Typical triad syndrome consisting of ocular motility disorders, ataxia, global confusion was seen in only 1 patient. However, confusion and heterophthongia as onset of this complication were seen in all patients. Cerebral computed tomograph scan was universally unremarkable and useless. Cerebral MRI scan disclosed that typical involvement including thalamus, fourth ventricle, third ventricle, middle cerebral aqueduct was seen in 3, while untypical site including mamillary body was in the remaining 1 patient. All received vitamin B₁ supplement therapy by intramuscular injection at a dose of 100 mg each day. Initial response was observed at 2, unknown, 3, 4 days after treatment and all obtained complete remission within 2 weeks without any event of relapse after median follow-up period of 8 (7-12) months.

CONCLUSION

Any recipient of HSCT with clinical signs or symptoms of central nervous system should receive vitamin B₁ supplementary therapy immediately to decrease risk of mortality of WE even if the diagnosis of WE is uncertain.

[Endoscopicretrograde cholangio-pancreatography management of long-term complications after pancreaticoduodenectomy]

Objective: To investigate the feasibility and effectiveness of endoscopicretrograde cholangio-pancreatography(ERCP)in the management of long-term complications after pancreaticoduodenectomy. Methods: From January 2009 to July 2018, the clinical data of 62 patients with biliary or pancreatic long-term complications after pancreatoduodenectomy were reviewed at Department of General Surgery, and the corresponding ERCP were carried out in the multi-disciplinary cooperation.There were 39 males and 24 females.The age was 56.5 years(aging from 13 to 76 years). The time of treatment was 3 months to 20 years after pancreatoduodenectomy.The long-term biliopancreatic complications after pancreatoduodenectomy included 51 cases of biliary calculi, 42 cases of bilioenteric anastomotic stenosis with proximal bile duct dilatation, and 11 cases of pancreaticointestinal anastomosis stenosis with distal pancreatic duct dilatation.All patients received conventional duodenoscopy or single-balloon enteroscopy assisted ERCP under general anesthesia. Results: A total of 95 ERCP were performed in 62 patients, averaging 1.5 times per case.The long-term complications of cholangiopancreatic after pancreatoduodenectomy(ERCP indications) included 56 times of bile duct stones(58.9%), 45 times of bilioenteric anastomatic stricture(47.4%), 11 times of recurrent pancreatitis(11.6%), 6 cases(6.3%) of bilioenteric anastomatic foreign body, 3 times of intrahepatic bile duct stenosis(3.2%). Among the 95 times, 82 times(86.3%) achieved endoscopic endoscopy, 76 times(80.0%) were diagnosed successfully, and 72 times(75.8%) were successfully treated with ERCP.Small intestinal perforation occurred in 1 patient undergoing duodenoscopy, and then healed by surgical repair. Conclusion: Multi-disciplinary collaboration of ERCP is safe and effective in the treatment of long-term complications after pancreaticoduodenectomy, but the long-term effect still needs further clinical follow-up.

PM2.5 stimulated the release of cytokines from BEAS-2B cells through activation of IKK/NF-κB pathway

Previous studies indicated that exposure to fine particulate matter (PM_2.5) was related to pulmonary inflammatory diseases through activation of nuclear factor kappa B (NF-κB) signaling pathway to trigger cytokine secretions in human lung carcinoma cells. To investigate the potential mechanisms underlying expression of cytokines via activated NF-κB by PM_2.5, human bronchial epithelial cells (BEAS-2B cells) were treated with PM_2.5 extracts at different concentrations (6, 13, 25, 50, 100, 200, and 400 µg mL^-1) for 6 and 24 h. We found that 100 µg mL^-1 PM_2.5 increased interleukin 6 (IL-6) and IL-8 expression at 24 h (p < 0.05 or p < 0.01). Moreover, 100 µg mL^-1 PM_2.5 upregulated phosphorylated IκB kinase (IKK), p65, and IκBα at 6 h, which could be reversed by the IKK inhibitor Bay11-7082 (p < 0.05 or p < 0.01). The p65 subunit of NF-κB was translocated into the nucleus of the cells treated with 100 µg mL^-1 PM_2.5 at 6 and 24 h. Bay11-7082 partly inhibited PM_2.5-induced increases of IL-6 and IL-8 secretion. The results indicated that PM_2.5 extract increased IL-6 and IL-8 levels in BEAS-2B cells through activation of IKK/NF-κB pathway. Our study will contribute to better understanding of the mechanism of PM_2.5-induced pulmonary inflammatory diseases.

Updated Genetic Testing of Primary Hyperoxaluria Type 1 in a Chinese Population: Results from a Single Center Study and a Systematic Review

Primary hyperoxaluria type 1 (PH1) is a rare but devastating autosomal recessive inherited disease caused by mutations in gene AGXT. Pathogenic mutations of AGXT were mostly reported in Caucasian but infrequently in Asian, especially in Chinese. To update the genotypes of PH1 in the Chinese population, we collected and identified 7 Chinese probands with PH1 from 2013 to 2017 in our center, five of whom had delayed diagnosis and failed in kidney transplantation. Samples of peripheral blood DNA from the 7 patients and their family members were collected and sequencing analysis was performed to test the mutations of gene AGXT. Western blotting and enzyme activity analysis were conducted to evaluate the function of the mutations. Furthermore, a systematic review from 1998 to 2017 was performed to observe the genetic characteristics between Chinese and Caucasian. The results showed that a total of 12 mutations were identified in the 7 pedigrees. To the best of our knowledge, 2 novel variants of AGXT, p.Gly41Trp and p.Leu33Met, were first reported. Bioinformatics and functional analysis showed that only 7 mutations led to a reduced expression of alanine-glyoxylate amino transferase (AGT) at a protein level. The systematic review revealed significant population heterogeneity in PH1. In conclusion, new genetic subtypes and genetic characteristics of PH1 are updated in the Chinese population. Furthermore, a genotype-phenotype correlation is found in PH1.

[Impact of aortic root morphology on the implantation depth of aortic valve prosthesis during trans-catheter aortic valve replacement in patients with native bicuspid aortic valve stenosis]

Objective: To investigate the impact of aortic root morphology on the implantation depth of aortic valve prosthesis during trans-catheter aortic valve replacement (TAVR) in bicuspid aortic valve patients. Methods: Clinical data of 40 patients with native bicuspid aortic valve stenosis who underwent TAVR using the self-expandable prosthesis (the Venus A-valve) from 2014 to 2017 in Fuwai Hospital was retrospectively analyzed. The patients were divided into non-deep implantation group (implant depth ≤10 mm by instant angiogram after implantation,29 cases) and deep implantation group (implant depth> 10 mm by instant angiogram after implantation,11 cases).Pre-procedural aortic root characteristics (e.g. calcification, angle and dimensions) were assessed by CT. The impact of aortic root morphology on the implantation depth and clinical outcomes were also evaluated. Results: The age was (75.1±5.9) years with equal representation from the raphe-type and non-raphe type (52.5%(21/40) and 47.5%(19/40)).The bigger aorta angle ((56.5±4.5)° vs. (47.4±9.4)°, P=0.004),more frequent mild-calcification (HU850, <200 mm(3)) or severe-calcification(HU850, >1 000 mm(3)) of aortic leaflets (7/11 vs. 4/29, P=0.006), as well as higher ratio of left ventricular outflow tract perimeter to annulus perimeter ((109.2±7.5)% vs. (101.5±6.5)%, P=0.004) were found in the deep implantation group compared to the non-deep implantation group. The new in-hospital onset of bundle-branchheart-block or atrioventricular block conduction disturbance rate was higher in the deep implantation group than in the non-deep implantation group (6/11 vs. 2/29, P=0.030).Left ventricular ejection fraction was similar between deep implantation group and non-deep implantation group at baseline((49.9±8.9)% vs. (55.8±10.4)%, P=0.117), and was significantly lower in the deep implantation group than in the non-deep implantation group at 30 days after implantation ((51.6±12.8)% vs. (60.9±8.1)%, P=0.020). Conclusion: Aortic root morphology of bicuspid aortic valve patients is associated with implantation depth of the prosthesis during TAVR, which affects the conduction system and left ventricular function during and post TAVR.

High-efficient catalytic reduction of 4-nitrophenol based on reusable Ag nanoparticles/graphene-loading loofah sponge hybrid

Noble metal nanoparticles (NPs) such as Au and Ag have shown many applications in the field of catalysis, sensing etc. due to their excellent photoelectric properties. But agglomeration and a low recovery rate are big problems for their applications. In this research, a novel Ag NPs/graphene (reduced graphene oxide)-loading loofah sponge (Ag NPs/RGO-LS) was synthesized through a one-step reduction method. Where the RGO is used as a nano-support with the high specific surface area and the high conductivity to prevent the agglomeration of Ag NPs and provide a conductive layer. The natural, green, low-cost and high-yield LS is designed as a macro-support to reduce the loss of Ag NPs during recycling. The as-prepared Ag NPs/RGO-LS is stable, uniform, and exhibits high efficiency and reusability in the catalytic reduction of 4-nitrophenol (4-NP) with a high rate constant of 1.893 min^-1 as well as an average conversion of 98% in 6 min during five cycles. The results have not only paved the way for the wide application of Ag NPs but also provide a new road for the application of other metal NPs.

HOXA11-AS promotes the growth and invasion of renal cancer by sponging miR-146b-5p to upregulate MMP16 expression

Recently, increasing studies showed that long noncoding RNAs (lncRNAs) play critical roles in tumor progression. However, the function and underlying mechanism of HOMEOBOX A11 antisense RNA (HOXA11-AS) on renal cancer remain unclear. In the current study, our data showed that the expression of HOXA11-AS was significantly upregulated in clear cell renal cell carcinoma (ccRCC) tissues and cell lines. High HOXA11-AS expression was associated with the advanced clinical stage, tumor stage, and lymph node metastasis. Function assays showed that HOXA11-AS inhibition significantly suppressed renal cancer cells growth, invasion, and ETM phenotype. In addition, underlying mechanism revealed that HOXA11-AS could act as a competing endogenous RNA (ceRNA) that repressed miR-146b-5p expression, which regulated its downstream target MMP16 in renal cancer. Taken together, our findings suggested that HOXA11-AS could promote renal cancer cells growth and invasion by modulating miR-146b-5p-MMP16 axis. Thus, our findings suggested that HOXA11-AS could serve as potential therapeutic target for the treatment of renal cancer.

[Association between speed and endurance performance with sleep duration in children and adolescents]

OBJECTIVE

To analyze the association between sleep duration and athletic performance, and provide scientific basis to improve the 50 m and endurance performance in children and adolescents.

METHODS

All the 119 462 subjects aged 9-15 years in both genders were sampled from 2014 National Physical Fitness and Health Surveillance by using stratified random cluster sampling method, to measure the height, weight, 50 meters and endurance performance and investigate sleep duration with questionnaire. Their body mass indexes (BMI) were calculated and the students' 50 m, endurance run scores and sleep durations were assessed. Binary Logistic regression was used to analyze the difference between the different sleep groups, and multifactor Logistic regression was used to analyze the relationship between the sleep condition and athletic performance.

RESULTS

The prevalence of insufficient sleep was 94.67% in the total subjects, the prevalence was higher among the girls (95.26%)than the boys (94.09%, χ²=80.99, P<0.001), and higher among the urban (95.41%) than the rural students(93.93%, χ²=128.48, P<0.001).The children with sufficient sleep had better performance in 50 m and endurance run scores( χ²_{50 m}=10.10, P_{50 m}＜0.01; χ²_{endurance run}=21.76, P<0.001). Logistic regression analysis after controlling the gender, area, grade and BMI showed that children with adequate sleep showed better results(OR_{50 m}=1.14, 95%CI_{50 m}=1.05-1.23, P_{50 m}<0.01; OR_{endurance run}=1.21, 95%CI_{endurance run}=1.11-1.31, P_{endurance run}<0.001). As for gender, the excellent rates of 50 m and endurance run scores in the boys with adequate sleep were higher (P<0.001), but there were no significant difference in 50 m and endurance run excellent rates in the girls of different sleep conditions. The excellent rates of 50 m and endurance run in the urban children and the endurance rate in the rural children and adolescents with adequate sleep were higher than those with insufficient sleep (P<0.01) while there were no significant difference in the 50 m excellent rates between the different sleep groups in rural areas. The 50 m and endurance run excellent rates of the children and adolescents with adequate sleep in each grade were higher than those of the children in the same grade with insufficient sleep (P_{primary students' endurance performance}<0.001, and the rest P<0.05). Children and adolescents with normal BMI and overweight who slept well had better performance in 50 m (P<0.05). The endurance run excellent rate of children and adolescents with adequate sleep in each BMI group was higher than that in children and adolescents with insufficient sleep in the same BMI group (P_malnutrition<0.01, P_normal<0.01, P_overweight<0.05, P_obesity<0.05). The children and adolescents were divided into different groups according to the sleep duration,the one who slept less than 7 hours had lower 50 m excellent rate than the other groups with longer sleeping duration (P<0.01) and the rate in the ones who slept more than 9 hours was the highest (P<0.001).The endurance excellent rate in the children and adolescents who slept more than 9 hours was significantly higher than that in the other groups (P<0.001).There was no significant dose-response relationship in excellent rates and sleep durations.

CONCLUSION

The prevalence of insufficient sleep has increased, and the sleep condition in children and adolescents is severe. Children and adolescents with sufficient sleep have better athletic performance, so we should strengthen the prevention and control of the lack of sleep in children and adolescents.

[The role of preoperative (18)F-FDG PET-CT in lymphatic metastasis diagnosis of cutaneous malignant melanoma on extremities and trunk]

Objective: To evaluate the clinical value of preoperative (18)F-Fludeoxyglucose ((18)F-FDG PET-CT) in lymphatic metastasis diagnosis of cutaneous melanoma on extremities and trunk. Methods: 112 patients with cutaneous melanoma pathologically of extremities and trunk from January 2006 to December 2016, who received (18)F-FDG PET-CT examination preoperatively, were retrospectively reviewed. The correlations between the maximal diameters of lymph nodes, the maximal standard uptake value (SUV) and the diagnostic impression grades of PET-CT examination, and the final pathological diagnosis were analyzed. The correlations between Breslow thickness of primary lesions and the diagnostic impression of PET-CT examination were also analyzed. All the above were analyzed with Receiver Operating Characteristic (ROC) curve to get the cut-off value. Based on the final results of pathological diagnosis of lymph nodes as the golden standard, the statistically significant indicators of ROC curve analysis were used to evaluate the diagnostic effect, as well as to calculate the sensitivity, specificity and accuracy. With gender, age, maximal diameter of lymph nodes, maximal SUV, diagnosis impressions, and Breslow thickness as the independent variables and pathological diagnosis results of lymph nodes as the dependent variable, two-class stepwise Logistic regression analysis was used to determine the independence of diagnostic indicators. ROC curve analysis and log rank test were used to analyze the relationship between Breslow thickness and patient survival. Results: To evaluate melanoma patients' lymph node status, the results of ROC curve analysis showed that the area under the curve of lymph node maximal diameter, maximal SUV, diagnosis impression of PET-CT examinations were 0.789, 0.786 and 0.816, respectively (all P<0.05). The cut-off values were 0.85 cm, 1.45 and 2.5, respectively. The sensitivity of the cut-off values to determine the status of lymph nodes in melanoma patients were 71.4%, 64.9% and 72.1% respectively, and the specificities were 85.2%, 88.7% and 87.0% respectively. Multivariate Logistic regression analysis showed that PET-CT diagnosis impressions had independent diagnostic significance for the lymph node status of melanoma patients (OR=11.296, 95%CI: 2.550~50.033). The area under the curve of Breslow thickness evaluating PET-CT diagnostic impression is 0.664 (P=0.042) and the cut-off value was 4.25 mm. The survival rate of the patients with Breslow thickness ≥ 4.25 mm was lower than that in the group <4.25 mm (P=0.006). Conclusions: (18)F-FDG PET-CT can help to evaluate metastases and make treatment decisions for cutaneous melanoma of extremities and trunk, especially for patients whose primary lesion's Breslow thickness has reached more than 4.25 mm. For the patients whose maximal SUV of regional lymph node is higher than 1.45 and short diameter of the largest lymph node is larger than 0.85cm, the possibility of metastases should be considered.

Cisplatin as a Radiosensitizer in Clinical Practice: A Pilot Study

Fifty-four patients with Inoperable cancers were treated with a combination of cisplatin and radiotherapy from May 1984 to February 1989. Cisplatin was administered at a dose of 40 mg/week, for a total dose of 160-320 mg, during radiation therapy. In 4 cases with brain metastases, the cisplatin dose was 40 mg/m2. Cisplatin concentration in blood was measured using the flameless atomic absorption spectrophotometric method. Radiation therapy was delivered by a 6 MV X-ray or a cobalt-60 unit up to a total dose of 50-70 Gy. Among the 54 patients, 89% (48) responded to the treatment regimen; complete responses (CR) and partial responses (PR) were 56% and 33%, respectively. Six patients were stable in their disease. Among the 30 patients who had CR's, the 1-year survival rate was 88% (21/24). Two patients (7%) had local relapse. However, among PRs, the 1-year survival rate was 33% (4/12) and local failure (61%) (11/18). Objective tumor response was observed in 4 cases with brain metastasis, 2 of the 4 patients were alive for more than 6 months. Toxic effects were moderate and consisted of emesis and myelosuppression. Grade III bone marrow suppression amounted to 11%, and the interval of recovery was relatively long compared with that reported in the literature. Further prospective controlled studies are recommended.

Curcumin enhances the effects of irinotecan on colorectal cancer cells through the generation of reactive oxygen species and activation of the endoplasmic reticulum stress pathway

Although initially effective against metastatic colorectal cancer (CRC), irinotecan-based chemotherapy leads to resistance and adverse toxicity. Curcumin is well known for its anti-cancer effects in many cancers, including CRC. Here, we describe reactive oxygen species (ROS) generation and endoplasmic reticulum (ER) stress as important mechanisms by which curcumin enhances irinotecan's effects on CRC cells. CRC cell lines were treated with curcumin and/or irinotecan for 24 h, and then evaluated using cell proliferation assays, cell apoptosis assays, cell cycle analysis, intracellular Ca²⁺ measurements, ROS measurements and immunoblotting for key ER stress-related proteins. We found that cell viability was inhibited and apoptosis was increased, accompanied by ROS generation and ER stress activation in CRC cells treated with curcumin alone or in combination with irinotecan. Blocking ROS production attenuated the expression of two markers of ER stress: binding of immunoglobulin protein (BIP) and CCAAT/enhancer-binding protein homologous protein (CHOP). Blocking CHOP expression using RNA interference also inhibited ROS generation. These results demonstrated that curcumin could enhance the effects of irinotecan on CRC cells by inhibiting cell viability and inducing cell cycle arrest and apoptosis, and that these effects may be mediated, in part, by ROS generation and activation of the ER stress pathway.

[Molecular epidemiology and transmission of HIV-1 infection in Zhejiang province, 2015]

Objective: To understand the distribution of HIV-1 subtype diversity and its transmission characteristics in Zhejiang province. Methods: A total of 302 newly diagnosed HIV-1 positive patients were selected through stratified random sampling in Zhejiang in 2015. HIV-1 pol genes were sequenced successfully with reverse transcription PCR/nested PCR and phylogenetic analysis was conducted for 276 patients. Then a molecular epidemiologic study was performed combined with field epidemiological investigation. Results: Of 276 sequence samples analyzed, 122 CRF07_BC strains (44.2%), 103 CRF01_AE strains (37.3%), 17 CRF08_BC strains (6.1%), 9 B strains (3.2%), 6 CRF55_01B strains (2.2%), 5 C strains (1.8%), 1 CRF59_01B strain (0.4%), 1 CRF67_01B strain (0.4%), 1 A1 strain (0.4%), and 11 URFs strains (4.0%) were identified. Phylogenetic analysis revealed 16 clusters with only 15.1% (34/225) sequences involved among CRF07_BC and CRF01_AE strains. The clustered cases in MSM were higher than that in populations with other transmission routes. And clusters existed between the populations with different transmission routes. Conclusion: The major strains of HIV-1 in Zhejiang are CRF07_BC and CRF01_AE. The HIV subtypes showed more complexity in Zhejiang. It is necessary to strengthen the surveillance for HIV subtypes, carry out classified management and conduct effective prevention and control in the population at high risk.

LncRNA-TUSC7/miR-224 affected chemotherapy resistance of esophageal squamous cell carcinoma by competitively regulating DESC1

BACKGROUND

This study aims to clarify the underlying mechanism for the tumor suppressive function of lnc TUSC7 in chemotherapy resistance of esophageal squamous cell carcinoma (ESCC).

METHODS

TUSC7, miR-224 and DESC1 expressions in ESCC tissues and cells were detected by qRT-PCR. Protein level of DESC1, EGFR and p-AKT were observed by Western blot. Overall survival was calculated using the Kaplan-Meier method. Dual-luciferase reporter gene assay and RIP assay were used to comfirm TUSC7 binding to miR-224, and miR-224 binding to DESC1. Cell proliferation, apoptosis, and colony formation was detected by MTT, Flow Cytometry and Colony formation assays.

RESULTS

TUSC7 was downregulated in ESCC tissues and cells, and low TUSC7 indicated worse overall survival. The analysis of bioinformatics softwares showed that TUSC7 specifically bound to miR-224, and we proved miR-224 was upregulated in ESCC and negatively correlated with TUSC7 expression. Overexpression of TUSC7/inhibition of miR-224 suppressed cell proliferation, colony formation and chemotherapy resistance of ESCC cells, and promoted cell apoptosis. In addition, we confirmed that miR-224 specifically bound to DESC1, and negatively correlated with DESC1. TUSC7 suppressed the proliferation and chemotherapy resistance of ESCC cells by increasing DESC1 expression via inhibiting miR-224. We also confirmed DESC1 inhibited chemotherapy resistance of ESCC cells via EGFR/AKT. Finally, in vivo experiments demonstrated that overexpression of TUSC7 decreased tumor growth and chemotherapy resistance.

CONCLUSION

These findings suggested TUSC7 suppressed chemotherapy resistance of ESCC by downregulating miR-224 to modulate DESC1/EGFR/AKT pathway.

Tyrosinase-doped bioink for 3D bioprinting of living skin constructs

Three-dimensional bioprinting is an emerging technology for fabricating living 3D constructs, and it has shown great promise in tissue engineering. Bioinks are scaffold materials mixed with cells used by 3D bioprinting to form a required cell-laden structure. In this paper, a novel bioink made of gelatin methacrylamide (GelMA) and collagen (Col) doped with tyrosinase (Ty) is presented for the 3D bioprinting of living skin tissues. Ty has the dual function of being an essential bioactive compound in the skin regeneration process and also as an enzyme to facilitate the crosslink of Col and GelMA. Further, enzyme crosslinking together with photocrosslinking can enhance the mechanical strength of the bioink. The experimental results show that the bioink is able to form stable 3D living constructs using the 3D bioprinting process. The cell culture shows that three major cell lines: human melanocytes (HEM), human keratinocytes (HaCat) and human dermal fibroblasts (HDF) exhibit high cell viabilities. The viability of these three cell lines is above 90%. The proliferation and scratching test show that Ty can enhance the proliferation of HEM, inhibit the growth and migration of HDF and not affect HaCat significantly. Animal tests show that the doped bioinks for 3D bioprinting can help form an epidermis and dermis, and thus have high potential as a skin bioink.

Expression and functional regulation of stemness gene Lgr5 in esophageal squamous cell carcinoma

Cancer stem cells (CSCs) are defined as a rare subpopulation of undifferentiated cells with biological characteristics that include the capacity for self-renewal, differentiation into various lineages, and tumor initiation. To explore the mechanism of CSCs in esophageal squamous cell carcinoma (ESCC), we focused on Leucine-rich repeat containing G protein-coupled receptor 5 (Lgr5), a target gene of the Wnt signaling pathway, which has been identified as a marker of intestinal stem cells and shown to be overexpressed in several human malignancies. Lgr5 expression was significantly correlated with lymph node metastasis, increased depth of invasion, increased tumor size, advanced differentiation, higher AJCC stage and poorer survival. Silencing of Lgr5 expression in the ESCC cell line KYSE450 by small interfering RNA (siRNA) strongly inhibited cell proliferation, migration and invasion ability, the expression of CSCs-related genes and Wnt/β-catenin signaling. In addition, Lgr5 was highly expressed in ESCC spheroid body cells, which were identified by high expression of CSCs-related genes, and high tumorigenicity in vivo. Taken together, these results demonstrate that Lgr5 activation of Wnt/β-catenin signaling is a potential mechanism to promote the progression of ESCC and ESCC stem cell renewal, and Lgr5 may be used as a molecular target for the development of treatments for ESCC.

Downregulation of Egr-1 Expression Level via GluN2B Underlies the Antidepressant Effects of Ketamine in a Chronic Unpredictable Stress Animal Model of Depression

Ketamine is a non-competitive antagonist of N-methyl-D-aspartate receptors (NMDARs). Growing evidence suggests that a single dose of ketamine produces a series of rapid and remarkable antidepressant properties. However, the mechanisms remain unclear. In our study, the antidepressant properties of a single dose of ketamine (10 mg/kg, i.p.) in mice exposed to chronic unpredictable stress (CUS) were assessed using the open-field test (OFT) and the forced swimming test (FST). Early growth response 1 (Egr-1) and postsynaptic density protein 95 (PSD-95) mRNA and protein expression levels were examined using qRT-PCR and western blot, respectively. Dendritic spine density in the CA1 region of the hippocampus was detected by Golgi staining. AMPAR currents in hippocampal slices were measured by electrophysiology. Our study showed that CUS induced a significant depression-like behavior accompanied by an upregulation of Egr-1 and downregulations of PSD-95, spine density, and AMPAR currents in the hippocampus, and a single dose of ketamine rapidly restored these changes. Interestingly, a single dose of Ro-25-6981 (an GluN2B antagonist, 10 mg/kg, i.p.) or Egr-1 siRNA, but not NVP AAM077 (an GluN2A antagonist, 10 mg/kg, i.p.), could produce the same antidepressant effects as ketamine. These data demonstrate that ketamine may produce its rapid antidepressant effects by downregulating the expression of Egr-1 via blocking GluN2B in the hippocampus.

Licochalcone A inhibits PI3K/Akt/mTOR signaling pathway activation and promotes autophagy in breast cancer cells

Previous studies have demonstrated that Licochalcone A possesses anti-inflammatory, anticancer, anti-bacterial, anti-malarial and anti-parasitic activities. In the present study the potential anticancer effects of Licochalcone A on MCF-7 cells were investigated. Licochalcone A significantly decreased cell viability and promoted autophagy and apoptosis, as demonstrated by an MTT assay, acridine orange staining and Annexin V-fluorescein isothiocyanate staining, respectively. Western blot analyses demonstrated that Licochalcone A treatment activated the LC3-II signaling pathway while suppressing the phosphoinositide 3-kinase (PI3K)/RAC-α serine-threonine-protein kinase (Akt)/mammalian target of rapamycin (mTOR) signaling pathway. In addition, Licochalcone A significantly increased caspase-3 activity and significantly decreased B-cell lymphoma-2 expression. The results from the present study indicate that Licochalcone A inhibits PI3K/Akt/mTOR activation, and promotes autophagy and apoptosis in MCF-7 cells.

Tumor-associated macrophages correlate with phenomenon of epithelial-mesenchymal transition and contribute to poor prognosis in triple-negative breast cancer patients

BACKGROUND

Tumor-associated macrophages (TAMs) are associated with poor outcomes in multiple solid cancers and play important roles in cancer progression. Epithelial-mesenchymal transition (EMT) may account for metastasis and recurrence. However, the association between TAMs and EMT is not clarified in triple-negative breast cancer (TNBC). The aim of this study was to investigate the effects of TAMs on EMT in TNBC.

MATERIAL AND METHODS

We studied specimens from 278 patients with TNBC. TAMs marker cluster of differentiation 163 and EMT-related marker E-cadherin were detected by immunohistochemistry in TNBC tissues, and their clinical significance was evaluated from the patients' medical records.

RESULTS

TNBC patients with polarized cluster of differentiation 163⁺ TAMs infiltration and low level of E-cadherin had a significantly higher risk of aggressive features, including recurrence, histologic differentiation, and lymph node metastasis. Infiltration of TAMs was also negatively correlated with E-cadherin in TNBC tissues. Multivariate analysis indicated that infiltration of TAMs and low expression of E-cadherin were independent prognostic factors of overall survival and disease-free survival in TNBC patients.

CONCLUSIONS

High infiltration of TAMs was associated with low expression of E-cadherin and could be used as an unfavorable prognostic factor for patients with TNBC.

[The understanding of Epstein-Barr virus associated lymphoproliferative disorder]

In recent years, there are increasing articles concerning Epstein-Barr virus associated lymphoproliferative disorder (EBV+ LPD), and the name of EBV+ LPD is used widely. However, the meaning of EBV+ LPD used is not the same, which triggered confusion of the understanding and obstacles of the communication. In order to solve this problem. Literature was reviewed with combination of our cases to clarify the concept of EBV+ LPD and to expound our understanding about it. In general, it is currently accepted that EBV+ LPD refers to a spectrum of lymphoid tissue diseases with EBV infection, including hyperplasia, borderline lesions, and neoplastic diseases. According to this concept, EBV+ LPD should not include infectious mononucleosis (IM) and severe acute EBV infection (EBV+ hemophagocytic lymphohistiocytosis, fatal IM, fulminant IM, fulminant T-cell LPD), and should not include the explicitly named EBV+ lymphomas (such as extranodal NK/T cell lymphoma, aggressive NK cell leukemia, Burkitt lymphoma, and Hodgkin lymphoma, etc.) either. EBV+ LPD should currently include: (1) EBV+ B cell-LPD: lymphomatoid granulomatosis, EBV + immunodeficiency related LPD, chronic active EBV infection-B cell type, senile EBV+ LPD, etc. (2) EBV+ T/NK cell-LPD: CAEBV-T/NK cell type, hydroa vacciniforme, hypersensitivity of mosquito bite, etc. In addition, EBV+ LPD is classified, based on the disease process, pathological and molecular data, as 3 grades: grade1, hyperplasia (polymorphic lesions with polyclonal cells); grade 2, borderline (polymorphic lesions with clonality); grade 3, neoplasm (monomorphic lesions with clonality). There are overlaps between EBV+ LPD and typical hyperplasia, as well as EBV+ LPD and typical lymphomas. However, the most important tasks are clinical vigilance, early identification of potential severe complications, and treating the patients in a timely manner to avoid serious complications, as well as the active treatment to save lives when the complications happened.

Hypoxia-inducible factor-1 alpha Correlates with Tumor-Associated Macrophages Infiltration, Influences Survival of Gastric Cancer Patients

Background: Hypoxia was a common feature for accelerating tumor metastasis by both inducting epithelial-mesenchymal transition (EMT) of tumor cells and polarization of tumor-associated macrophages (TAMs). The association and roles between hypoxia, EMT and TAMs in the biological behavior of gastric cancer (GC) for the time being recurrence is unclear. Material and methods: hypoixa by expression of hypoxia-inducible factor-1 alpha (HIF-1α), polarized functional status of infiltrated TAMs by immunohistochemical staining of CD68 and CD163, and the expression of E-cadherin as EMT property had been evaluated in 236 patients consecutive with histologically confirmed GC. Clinical significance was assessed for all these patients. Results: High expression of HIF-1α was found in patients with aggressive features, especially for recurrent patients. High infiltration of TAMs and abnormal expression of EMT-marker were also related to aggressive characteristics and predicted poor prognosis in GC. Meanwwhile, there existed a significant correlation among expression of HIF-1α, infiltration of TAMs and EMT marker in GC tissues. Multivariate Cox analysis revealed that high expression of HIF-1α combined TAMs infiltration were independent prognostic factors for disease-specific survival rate. Conclusion: HIF-1α is an unfavorable indicator for prognosis, may promote tumor progression through the induction of EMT and establishment of a pro-tumor immunosuppressive microenvironment. Further investigation into the therapeutic effects of blocking hypoxia is possible a potential strategy for GC treatment.

[Expression and clinical significance of Nrf2 and ERK pathway in papillary thyroid carcinoma]

Objective:To explore the expression and clinical significance of nuclear factor erythroid-2 related factor 2 (Nrf2) and ERK sinal in papillary thyroid carcinoma (PTC). Method:PTC microassy were detected by immunohistochemical method (IHC). The expression of Nrf2, ERK₂ and p-ERK½ in PTC, para-carcimoma and normal thyroid tissue were detected by Western blot. The transcriptional level of Nrf2 mRNA in PTC, para-carcimoma and normal thyroid tissue were detected by real-time quantitative PCR (qPCR) method. Result:Nrf2, ERK₂, p-ERK½ protein were high expression in group of lymph node metastasis PTC and negative or weak positive expression in para-carcinoma tissue (P<0.01). And the proteins of clinical stage Ⅲ-Ⅳ of PTC groups express higher than without lymph node metastasis group and clinical stage Ⅰ-Ⅱ of PTC group (P<0.05). The expression of Nrf2 protein was positively correlated with ERK₂ and p-ERK½ protein in PTC (r=0.723 2,r=0.668 6,P<0.05). The Western blot results of Nrf2, ERK₂, p-ERK½ had a higher level in PTC than those of paracarcinoma and normal thyroid tissue (P<0.01). The level of Nrf2 mRNA were higher than those of paracarcinoma and normal thyroid tissue (P<0.01). Conclusion:High expresion of Nrf2 may be associated with the progression of papillary thyroid carcinoma, and may relate to the high expression and activity of ERK pathway.

Severe and uncontrolled asthma in China: a cross-sectional survey from the Australasian Severe Asthma Network

BACKGROUND

Severe asthma is largely unexplored in the Chinese population. Patients with asthma underwent systematic evaluation, by investigating the characteristics of uncontrolled asthma and of asthma treated with three different controller therapies.

METHODS

This multi-centre, real-world study was conducted from March 2014 to September 2015. Adults with stable asthma underwent assessment of medication use, asthma control, quality of life, psychological symptoms, work productivity and activity impairment, bronchodilator response and sputum induction.

RESULTS

Participants (n=379) had a mean (SD) age of 47.4 (14.0) years, and 57.0% were female. There were 14.8% (n=56) of patients receiving treatment with Step 4/5 as severe asthma, but only 13 (3.4%) met ERS/ATS severe refractory asthma criteria. The patients with severe asthma usually used triple controller therapy: ICS/LABA, additional leukotriene modifier or theophylline, and reported better asthma control. Two fifths of patients (n=147) had uncontrolled asthma, with worse symptoms, psychological symptoms (both P<0.001), health-related work productivity and activity impairment, increased eosinophilic inflammation in sputum [1.68% (0.0, 17.1%) vs. 0.2% (0.0, 1.3%), P<0.0001] and more exacerbations (P<0.05). Multiple regression analysis indicated that triple controller therapy significantly reduced the risk of uncontrolled asthma [OR =0.32, 95% CI =(0.14, 0.75)].

CONCLUSIONS

Although there is a relatively low proportion of severe refractory asthma based on ERS/ATS criteria, two of five patients with asthma in China are uncontrolled, displaying more psychological symptoms and reduced work productivity. Substantial gain in asthma control is obtained by triple controller therapy and this may be a promising therapeutic option for persistent asthma.

Association between metformin and the risk of gastric cancer in patients with type 2 diabetes mellitus: a meta-analysis of cohort studies

Objectives

The objective of this study was to evaluate the association between metformin therapy and the incidence of gastric cancer (GC) in patients with type 2 diabetes mellitus (T2DM).

Methods

We systemically searched the following databases for studies published between the databases’ dates of inception and Nov. 2016: PubMed, Embase, the Cochrane Library, the Web of Science, and the China National Knowledge Infrastructure (CNKI). Hazard ratios (HR)and corresponding 95% confidence intervals (CIs) for the association between metformin therapy and the incidence of GC in patients with T2DM were the outcome measures assessed in this study. STATA 12.0 (Stata Corporation, College Station, Texas, USA) was used to conduct the statistical analysis.

Results

A total of seven cohort studies including 591,077 patients met all the criteria for inclusion in the analysis. Our data showed that metformin therapy was associated with a significantly lower incidence of GC in patients with T2DM than other types of therapy (HR=0.763, 95% CI: 0.642˜0.905). Subgroup analysis showed that patients living in Taiwan benefitted more from metformin therapy than patients living in any other region, as metformin significantly decreased the risk of GC in patients living in Taiwan but did not significantly decrease the risk of GC in patients living in other regions (HR=0.514, 95% CI: 0.384-0.688). The results of the present analysis support the idea that metformin facilitates reductions in the risk of T2DM-related GC.

Conclusions

The risk of GC among patients with T2DM is lower in patients receiving metformin therapy than in patients not receiving metformin therapy.

[Prognostic analysis of patients with myasthenia gravis after extended thymectomy]

Objective: To identify the long-term outcome of patients with myasthenia gravis (MG) after extended thymectomy, and to analyze the prognostic factors. Methods: The medical data and follow-up results in 72 patients with MG who underwent extended thymectomy in Department of Thoracic Surgery, Anhui Provincial Hospital Affiliated with Anhui Medical University from January 2006 to October 2015 were retrospectively reviewed and analyzed. There were 32 male and 40 female patients, aging from 10 to 70 years with a mean age of 39.5 years. The outcome-related factors including gender, age while being operated on, duration of preoperative period, whether taking steroid before operation, modified Osserman classification, pathology type of thymus were analyzed by χ(2) test and multivariate regression analysis. Results: All patients were followed up from 6 to 75 months (median 37 months). Among them, 21 patients (29.2%) achieved complete stable remission, 18 patients (25.0%) experienced pharmacological remission, 20 patients (27.8%) improved, 9 patients (12.5%) reminded stable and 4 patients (5.6%) deteriorated. Both univariate and multicariate analysis revealed that duration of preoperative period (OR=22.871, 95% CI: 2.813 to 185.917, P=0.003) and Osserman classification (OR=0.103, 95% CI: 0.014 to 0.774, P=0.027) showed significantly associated with the surgical curative effect. Conclusions: Extended thymectomy is an efective measure for MG. The duration of preoperative period and Osserman classification are prognostic factors for thymectomized MG. Those patients with generalized MG or whose duration of preperative period is less than 6 months are likely to have better prognosis.

High Infiltration of Polarized CD163+ Tumor-Associated Macrophages Correlates with Aberrant Expressions of CSCs Markers, and Predicts Prognosis in Patients with Recurrent Gastric Cancer

Background: As the most predominant tumor-infiltrating immune cells, tumor-associated macrophages (TAMs) are associated with poor outcome in multiple solid cancers and play important roles in cancer progression. Cancer stem cells (CSCs) may account for metastasis and recurrence after cancer therapy. However, the association between TAMs and CSCs is not clarified in gastric cancer (GC). The aim of the present study was to evaluate the effects of TAMs on CSCs in GC and find out the risk factors to predict recurrence and prognosis.

Material and methods: This study included consecutive 236 patients with histologically confirmed primary GC. TAMs marker CD163 and CSCs-related proteins were detected by immunohistochemistry (IHC) in GC tissues and their prognostic values were all investigated.

Results: High expression of CD163⁺ TAMs was found in patents with aggressive characteristics, especially for patents with recurrence. There existed a significant correlation between high expression of CD163 and CSCs-related markers in GC tissues. In patients with recurrence, high-expression of CD163 TAMs was an independent worse prognostic factor.

Conclusion: High infiltration of TAMs was related to aggressive behavior, associated with aberrant expression of CSC markers, and an independent worse prognostic factor in GC. Targeting TAMs may be a potential treatment strategy for GC, including patients with recurrence.

[Outcome comparison of different therapy procedures in surgical high-risk elderly patients with severe aortic stenosis]

Objective: To compare the outcome of surgical high-risk elderly patients with severe aortic stenosis(SAS) treated by different therapy procedures, including transcatheter aortic valve implantation(TAVI), surgical aortic valve replacement(SAVR), and drug therapy. Methods: We retrospectively analyzed the clinical data of 242 surgical high-risk elderly (age ≥65 years old) SAS patients hospitalized in Fuwai Hospital between September 2012 and June 2015. According to the treatment method, patients were divided into TAVI group (81 cases), SAVR group (59 cases) and drug therapy group (102 cases). The primary end point was all-cause mortality at 1 year post procedure, and secondary end point included cardiac function class(NYHA), vascular complication, valvular function, non-fatal myocardial infarction, new atrial fibrillation, stroke, bleeding, pacemaker implantation, acute renal failure, and readmission. We used the Kaplan-Meier method to estimate survival function based on follow up data and survival was compared between groups with the use of the log-rank test. Results: (1) In the baseline data, there were statistically significant difference among 3 groups for the age, left ventricular ejection fraction, cardiac function class Ⅲ and Ⅳ, rates of combined diabetes, chronic renal failure, mild and moderate mitral regurgitation (P<0.01 or 0.05). The risk score of the Society of Thoracic Surgeons(STS) was 7.28±4.98 in the TAVI group, and 5.67±3.49 in the SAVR group(P=0.036). (2) The perioperative rates of pacemaker implantation(11.3%(9/81) vs. 0, P=0.025) and mild paravalvular regurgitation(29.6%(24/81) vs.1.7%(1/59), P<0.001) were significantly higher in TAVI group than in SAVR group.(3)The rate of rehospitalization was significantly lower in TAVI group than in SAVR group(3.0%(2/67) vs. 22.7%(10/44) P=0.005) and the rate of pacemaker implantation was significantly higher in TAVI group than in SAVR group(17.5 (12/67) vs. 0, P=0.008) after 1 year. The rates of death from any cause in the TAVI (5.8%(4/67)) and SAVR group (11.4%(5/44)) were significantly lower than that in the drug therapy group (54.9%(50/91), both P<0.05) after 1 year and was similar between TAVI group and SAVR group(P=0.622). (4) The rates of cardiac function classⅠandⅡ increased and Ⅲ and Ⅳ decreased in TAVI and SAVR group after 1 year when compared with base line(P<0.001). The rates of cardiac function class Ⅱ, and Ⅲ increased , class Ⅰ and Ⅳ decreased in drug therapy group after 1 year compared with base line (P=0.020). (5)The survival rates after 1 year were significantly higher in the TAVI group and SAVR group than in the drug therapy group(log-rank test, P<0.001), and the difference was similar between TAVI group and SAVR group (log-rank test, P=0.062). Conclusion: In surgical high-risk elderly patients with SAS, the prognosis of drug therapy was poor, and TAVI and SAVR were associated with similarly improved rates of survival after 1 year, although there were significant differences in periprocedural complications between TAVI and SAVR groups.

Expression of prion protein in the cerebrospinal fluid of patients with Parkinson's disease complicated with rapid eye movement sleep behavior disorder

Parkinson's disease (PD) is one of the most common neurodegenerative diseases and mainly manifests with decreasing numbers of dopaminergic neurons. Rapid eye movement (REM) sleep behavior disorder (RBD) has an incidence of 15-47% in all PD patients. Prion proteins (PrPs), which are expressed in both neurons and glial cells of the brain, are believed to be correlated with abnormal neurological functions, although their role in PD-related sleeping disorders remains unclear. We therefore investigated the expressional profiles of PrP in PD patients with RBD. Quantitative real-time polymerase chain reaction and western blotting were used to detect the mRNA and protein levels of PrP, respectively, in the cerebrospinal fluid (CSF) of PD patients with RBD, PD patients without sleeping disorder, and healthy people (N = 23 each). We investigated the correlation between the CSF PrP level and sleeping behavior in PD patients. Patients with PD complicated with RBD had significantly elevated CSF PrP expression levels (both mRNA and protein) compared with either PD patients without sleeping disorder or healthy individuals (P < 0.05 in both cases). There is elevated expression of PrP in the CSF of PD patients with RBD. This may benefit the diagnosis of PD-related RBD.

[Changes of the expression for genes related with senescence and the telomerase activity during cellular replicative and premature senescence in human embryonic lung fibroblasts]

Objective: To detect the alterations of telomerase activity and the expression for oxidative stress responsive genes related with senescence during cellular replicative senescence and hydrogen peroxide-induced premature senescence in human embryonic lung fibroblasts (HELFs) in vitro. Methods: The HELFs were divided into young cells (22 population doubling levels, 22PDL) , mid-aged cells (35PDL) and replicative senes-cent cells (49PDL) and premature senescent cells induced by H(2)O(2)(premature senescence, PS). The telomerase activity was detected by ELISA assay during cellular replicative and premature senescence. The mRNA level of oxidative stress responsive genes related with senescence for Foxo1, Foxo3, Pdx1, apoA-I and MMP1 was per-formed by RT-Q-PCR separately. Results: The mRNA level for Foxo1, Foxo3, apoA-I and Pdx1 was decreased separately during cellular replicative senescence compared to that in the young-stage cells with statistical signifi-cance (P<0.05). The expression of MMP1 was up-regulated 5.1-fold obviously (P<0.05). In premature senes-cence, the mRNA level was only decreased for Foxo1, Foxo3 and apoA-I, but up-regulated 2.3-fold and 6.2-fold for Pdx1 and MMP1 respcetively vs 22PDL significantly (P<0.05). The telomerase activity in young cells was not detected, and it increased in mid-aged cells and replicative senescence stages during cellular replicative se-nescence as compared to 22PDL with statistical significance (P<0.05). The telomerase activity in premature se-nescence was highly active. Conclusion: The expression for genes related with senescence has differences be-tween replicative and premature senescence and hydrogen peroxide modifies their expression levels. The telomer-ase activity has been going up with increased PDLs.

[Expression and significance of serum E-cadherin in patients with papillary thyroid carcinoma]

Objective:Experiments testing the concentration of serum E-cadherin were conducted through the patients with papillary thyroid carcinoma (PTC), nodular goiter and normal people. Combining the detection of E-cadherin protein in the tissues including papillary thyroid carcinoma,nodular goiter and normal thyroid tissues around adenoma,we analyze the effect and siginificance of E-cadherin in the papillary thyroid carcinoma.Method:The concentrations of E-cadherin in the serum of 86 cases of PTC patients, 16 cases of NG patients and 10 normal adults were detected by enzyme linked immunosorbent assay (ELISA) method, and the relationships between the serum level and clinical pathology characteristics of thyroid papillary carcinoma were explored. Western blot were used to detect the content of E-cadherin protein in tissues including PTC, nodular goiter tissues and normal thyroid tissues around adenoma.Result:The results showed that content of serum E-cadherin in PTC were significantly higher than those in nodular goiter tissues and normal thyroid issues (P< 0.05). There were no obviously differences between nodular goiter tissues and normal thyroid issues in the content of E-cadherin (P> 0.05). The content of E-cadherin protein in the tissues of PTC was evidently lower than those in nodular goiter tissues and normal thyroid tissues around adenoma (P< 0.05). There were no obviously differences between nodular goiter tissues and normal thyroid tissues around adenoma in the content of E-cadherin (P> 0.05). The abnormal expression of serum E-cadherin was correlated with the lymph node metastasis and pathological stage of PTC (P< 0.05). On the other hand,it is irrelevant to the gender､age and the tumor size of the patients (P> 0.05).Conclusion:The up-regulation of serum E-cadherin is correlated with the lymph node metastasis and pathological stage of PTC. The detection of the serum E-cadherin content plays a vital role in the aspects of early diagnosis and prognosis evaluation.

[Analysis on antiretroviral therapy efficacy for HIV/AIDS in Zhejiang province, 2009-2014]

OBJECTIVE

To analyze the efficacy of highly active antiretroviral therapy(HAART)for HIV/AIDS in Zhejiang province from 2009 to 2014.

METHODS

A retrospective cohort study was conducted among patients with access to HAART aged <15 years from 2009 to 2014 through descriptive epidemiological analysis on the patients' demographic characteristics, HAART efficacy. The immune recovery Kaplan-Meier curves were drawn by using baseline CD(4) T lymphocytes cell(CD(4))data. The influencing factors for virus suppression were analyzed by using logistic regression model.

RESULTS

There were 9 594 patients with access to HAART in Zhejiang from 2009 to 2014. The' average age of the patients was 38.7 years old, the male to female ratio was 4.11∶1. Heterosexual(55.9%)and homosexual(40.0%)contacts were the main transmission routes. Baseline CD(4) count 200-349 cells/μl was found in 45.4% of the patients, the median of the CD(4) count was 221(IQR: 123-298). The median of time for CD(4) recovery in patients with baseline CD(4) count <200 cells/μl was 3.48 and 11.58 times higher than the patients with baseline CD(4) count 200-349 cells/μl and baseline CD(4) count ≥350 cells/μl. Univariate and multivariate logistic regression analyses showed that marital status, HAART regimen, treatment miss in last week and CD(4) recovery were major influencing factors for HAART efficacy.

CONCLUSIONS

HAART had good treatment effecacy in HIV/AIDS patients in Zhejiang. The baseline CD(4) count and adherence to HAART were the most important influencing factors. It is recommended to take measures to expand HIV screening and HAART coverage, conduct HAART adherence education, and strengthen the special care for high-risk groups to improve the HAART efficacy in Zhejiang province.

Cognitive fatigue effect on rehabilitation task performance in a haptic virtual environment system

INTRODUCTION

This paper presents a study on an affordable rehabilitation approach to post-stroke patients. In this approach, a patient performs a task on a haptic virtual environment system and a physician examines the patient's task remotely based on the performing data.

OBJECTIVES

The objective of this study is to test a hypothesis that an elevated cognitive fatigue state may significantly affect the patient's task performance so as to disturb judgment by physicians.

METHODS

The study included the development of a test-bed for the experiment and an experimental study for the hypothesis. The study took the wrist coordination function of the upper limb as an example.

RESULT

The study showed that the cognitive fatigue state has a significant influence on the patient's task performance; in other words, there is a noise (75% discrepancy from the true performance information) in the performance data.

CONCLUSION

The study provides great potential for accurate assessment of the functional state from true patient task performance. The future work needs to focus on the removal of the noise. The limitation of this study is that the experiment was carried out on healthy subjects, although post-stroke patients are more susceptible to an elevated cognitive fatigue state from a common sense.

[Study on the influence of laryngeal lesions on the prognosis of pneumomediastinum in dermatomyositis]

Objective:To investigate the influence of laryngeal lesions on the prognosis of pneumomediastinum in patients with dermotomyositis(DM). Method:The clinical data of patients with DM were retrospectively analyzed. Hoarseness, laryngeal lesions and pneumomediastinum in patients with DM were analyzed to evaluate the influence of laryngeal lesions and hoarseness on the prognoses and diagnosis of pneumomediastinum in patients with DM. Result:Forty-two patients with a diagnosis of DM were included in the study.Twenty of all the patients were diagnosed of interstitial lung disease(ILD) with the incidence of 47.6%. Four of the patients displayed hoarseness with the incidence of 9.5%. Three cases were complicated by pneumomediastinum with the incidence of 7.1%. All patients have normal vocal cord movement. One of the 4 patients with hoarseness showed congestion of her vocal folds, and the other 3 patients showed white change on both of the vocal folds. All the 3 patients with white change on both vocal folds complicated by pneumomediastinum and died on respiratory failure. There were statistical differences(P<0.01) on the prognosis and occurrence of pneumomediastinum between patients with or without hoarseness and laryngeal lesions. Conclusion:Hoarseness and laryngeal lesions may associate with poor prognosis and occurrence of pneumomediastinum in DM.

[Construction of ear tissue engineered epithelial patch]

Objective: To construct tissue engineered-epithelial patches with human adipose-derived mesenchymal stem cells (hADSC) and extracellular matrix scaffold (ECM), and to observe their morphological characteristics and biological behaviors. Methods: The cultured and purified hADSC were co-cultured with the ECM. The adhesion of hADSC formed sheet on the ECM were observed by the scanning electron microscopy. The activity and apoptosis of hADSC cultured on the ECM were observed by laser scanning confocal microscope. The autocrine function of hADSC were determined by qPCR(hepatoeyte growth factor, transforming growth factor-β, epidermal growth factor). Results: hADSC proliferated actively when cultured on the ECM. The scanning electron microscopy demonstrated that the bottom of the ECM possessed smooth, with uneven thickness, widely interconnected collagen bundles. Meanwhile, it showed that hADSC had good adhesion with ECM surface and grew overlapped. The immunofluorescence revealed that hADSC proliferated stably, did not appear a large number of apoptosis when cultured on the ECM. qPCR results indicated that the autocrine function of hADSC cultured on the ECM were significantly higher than those in non-scaffold group(P<0.05). Conclusion: hADSC has good biocompatibility with ECM scaffold. hADSC grows well in the environment of ECM and has active secretion function.

[Echocardiographic features of sinus of Valsalva aneurysm extending into left ventricle]

OBJECTIVE

To observe image features of sinus of Valsalva aneurysm (SVA) extending into left ventricle by echocardiography.

METHODS

Echocardiographic features of 5 cases of SVA extending into left ventricle and underwent surgery at Union Hospital from July 1995 to September 2015 were reviewed retrospectively and image and surgical findings were compared. A total of 4 patients were diagnosed by conventional and 3D echocardiography before surgery, and 1 patient was diagnosed by conventional echocardiography.

RESULTS

The origin, extending position, rupture status, complications of the SVA and associated cardiovascular lesions determined by echocardiography were entirely consistent with surgical findings in all cases, with the exception of one failed diagnosis of hypoplasty of an adjacent aortic cusp. Besides the common features of SVA, echocardiographic features of SVA extending into left ventricle included a thin-walled saccular lesion arising from the aortic root in continuation with the aortic annulus, with significant morphological changes and movement. Moreover, following features were observed: very low origin of the saccular lesion arising between the sinus base and the aortic annulus; the aneurysm going back and forth between the aortic root and the left ventricular outflow tract in 4 cases with an intact interventricular septum, and between the left ventricle and the right ventricle through the septal defect in another case complicated by a huge ventricular septal defect; diastolic shunt into the left ventricle when ruptured; displacement of the adjacent aortic annulus due to compression of aneurismal origin and prolapse of both aortic valve and annulus observed in all cases, resulting in a severe aortic regurgitation; obstructions of the left ventricular outflow tract due to the space-occupying effect were also found in 2 cases.

CONCLUSION

The SVA extending into left ventricle has distinguished echocardiographic characteristics, which could be accurately diagnosed either by conventional or real-time 3D echocardiography.

Isolation, identification, and optimal cultivation of a marine bacterium antagonistic to Magnaporthe grisea

In this paper, a plate confrontation method was used to isolate bacteria antagonistic to the rice blast fungus Magnaporthe grisea from samples collected from China's Dalian Bay. The antagonist strain LM-031 was obtained. We studied this strain's morphological, physiological and biochemical characteristics and analyzed its 16S rDNA sequence. We compared the effects of different culture conditions (type of media, carbon and nitrogen source, incubation temperature and time, and initial pH value) on the inhibitory effect against M. grisea. Strain LM-031 was preliminarily identified as Bacillus pumilus and was found to strongly inhibit M. grisea, especially when grown on BPY medium at an initial pH 7 for 72 h at 30°C. The optimum carbon and nitrogen sources for growth were lactose and peptone, respectively. The most suitable carbon and nitrogen sources for production of active substances were glucose and NH4Cl, respectively. Our results show that development and utilization of B. pumilus LM-031 has great potential for biological control of M. grisea.

[Isolation, culture and identification of human adipose-derived mesenchymal stem cells]

Objective: To establish isolation and culture methods of human adipose derived mesenchymal stem cells(hADSCs) in vitro and to investigate the basic biological characteristics of hADSCs as seed cells involved in repair of epithelium during temporal bone surgery.Method:Human adipose tissue was collected after liposuction surgery from the cosmetic and plastic surgery center,and then was digested with 0.3% collagenase Ⅰ. hADSCs were isolated and adherent cultured. Multilineage differentiation potential of hADSCs were determined by differentiating cells into adipocytes and osteoblast. Phenotypes of cells were detected by flow cytometer, and cell growth curve was observed by MTT. Result:Obtained hADSCs were similar size, spindle-shaped fibroblasts-liked cells and had differentiation potential to adipocytes and osteoblast. Flow cytometry showed that cells were highly positive for CD105, CD90, CD29 and weakly positive for CD34 and CD45. MTT exhibited that hADSCs had a exponential growth phase. Conclusion:Isolated stem cells from human adipose tissue show the typical characterization of hADSCs, and can be used as seed cells involved in repair of epithelium during temporal bone surgery.

[Correlation analysis between 18F-FDG uptake features and the prognosis in patients with pathologic stage Ⅰ lung adenocarcinoma]

OBJECTIVE

To analyze the (18)F-FDG uptake features and the correlation between (18)F-FDG uptake and the prognosis in patients with pathologic stageⅠlung adenocarcinoma.

METHODS

One hundred and seventeen patients with stageⅠlung adenocarcinoma proved by surgery, who underwent a preoperative (18)F-FDG PET-CT, were studied retrospectively. The tumors' SUVmax in different groups of clinicopathologic factors were compared. The correlations between the SUVmax and clinicopathologic factors were analyzed using Spearman rank correlation. The ROC was plotted to estimate the most discriminative cut-off point for SUVmax in predicting the recurrence or progression of tumor. The progression-free survival (PFS) in different clinicopathologic groups were estimated using the Kaplan-Meier method and Log-rank test.

RESULTS

The SUVmax of pathologic stageⅠlung adenocarcinomas were significantly different in different groups of gender, tumor size, density, tumor differentiation grade and T staging, respectively (P<0.05 for all). Patients with a larger tumor size, a higher proportion of solid component, poorer grade of tumor differentiation had a higher SUVmax. The T1b group had a higher SUVmax than T1a and T2a groups. The male group had a higher SUVmax than the female group. The SUVmax was positively correlated with the size of the adenocarcinomas (P<0.01), and was negatively correlated with both the density and tumor differentiation grade (P<0.01). But there was no correlation between SUVmax and the T stage (P>0.05). The patients with an SUVmax of <3.0 had a much better PFS (75.1±3.0 month)than those with an SUVmax of ≥3.0 (52.7±5.9 month)(P<0.01). The tumor with a poorer differentiation grade was associated with reduced PFS (45.7±5.4 months) compared with those with well differentiated tumor (76.7±4.2 month)(P<0.05). The PFS showed no statistically significant differences in different gender, age, smoking history, tumor size, density and T staging groups (P>0.05).

CONCLUSIONS

(18)F-FDG uptake is correlated with the tumor size, density, and differentiation grade, and has a prognostic value for predicting the PFS in the patients with pathologic stageⅠ lung-adenocarcinoma. Patients with an SUVmax of <3.0 have a much better PFS than those with an SUVmax of ≥3.0.