Anode-Driven Controlled Release of Cathodic Fuel via pH Response for Smart Enzymatic Biofuel Cell

Enzymatic biofuel cells (EBFCs) with or without a membrane to separate the anodic and cathodic compartments generally suffered from high internal resistance or interactive interference, both of which restricted the improvement of their performance. Herein, a smart membrane-less EBFC was engineered based on anode-driven controlled release of cathodic acceptor via pH-responsive metal-organic framework ([Fe(CN)6]3-@ZIF-8) nanocarriers. The glucose anodic oxidation would produce gluconic acid accompanied by the change in pH value from neutral to the acidic case, which could drive the degradation of [Fe(CN)6]3-@ZIF-8 nanocarriers and further realize the controlled release of cathodic acceptor [Fe(CN)6]3-. More importantly, compared with controlled EBFC with or without membrane, the power output of the as-proposed EBFC enhanced at least 700 times due to the seamless electronic communication. Therefore, the ingenious strategy not only realized the successful engineering of the membrane-less EBFC but also provided an appealing idea for constructing smart devices.

FRI0196 INVOLVEMENT OF THE PULMONARY ARTERIES IN PATIENTS WITH TAKAYASU ARTERITIS

Background:

Takayasu arteritis (TA) is a chronic, granulomatous large-vessel vasculitis. It involves the aorta and its main branches predominantly, and leads to vascular thickness, stenosis and occlusion [1]. Besides the aorta and its branches, pulmonary arteries (PAs) are involved in TA. PAs have been reported to be involved in 6.9% to 80% of TA patients from different populations [2-3].

Objectives:

We investigated the clinical characteristics, pulmonary parenchymal features and cardiac functions in TA patients with PA involvement by combining multiple imaging modalities (MRA, CTA, PET-CT, lung VQ scan, echocardiography and high-resolution computed tomography (HRCT)). Our aim was to elicit better understanding of TA patients with PA involvement to aid rational treatment for these patients and improve their prognosis.

Methods:

We enrolled 216 patients with TA from a large prospective cohort. PAI was assessed in each patient based on data from magnetic resonance angiography/computed tomography angiography. Pulmonary hypertension, cardiac function, and pulmonary parenchymal abnormalities were evaluated further in patients with PAI based on echocardiography, New York Heart Association Functional Classification and pulmonary computed tomography, respectively. These abnormalities related to PAI were followed up to evaluate treatment effects.

Results:

PAI was detected in 56/216 (25.93%) patients, which involved the pulmonary trunk, main PAs and small vessels in the lungs. Among patients with PAI, 28 (50%) patients were accompanied by pulmonary hypertension, which was graded as ‘severe’ in 9 (16.07%), ‘moderate’ in 10 (17.86%) and mild in 9 (16.07%). Forty (71.43%) patients had cardiac insufficiency (IV: 6, 10.71%; III: 20, 35.71%; II: 14, 25.00%). Furthermore, 21 (37.50%) patients presented with abnormal parenchymal features in the area corresponding to PAI (e.g., the mosaic sign, infarction, bronchiectasis). During follow-up, two patients died due to abrupt pulmonary thrombosis. In the remaining patients, the abnormalities mentioned above improved partially after routine treatment.

Conclusion:

PA involvement is very common in TA patients. Physicians should be alerted to PA involvement even if obvious pulmonary symptoms are absent because they can cause PH, cardiac insufficiency as well as pulmonary parenchymal lesions, which will worsen the prognosis.

References:

[1]M.L.F. Zaldivar Villon, J.A.L. de la Rocha, L.R. Espinoza. Takayasu Arteritis: Recent Developments. Curr Rheumatol Rep 2019; 21: 45.

[2]N. Matsunaga, K. Hayashi, I. Sakamoto, et al. Takayasu arteritis: protean radiologic manifestations and diagnosis. Radiographics 1997; 17: 579-594.

[3]M. Bicakcigil, K. Aksu, S. Kamali, et al. Takayasu’s arteritis in Turkey - clinical and angiographic features of 248 patients. Clin Exp Rheumatol 2009; 27: S59-64.

Figure 1.

Imaging of PA lesions in TA patientsA:Dilationof the pulmonary trunk; B: thickness of the pulmonary trunk; C: stenosis of the right main PA; D: embolism of lower PAs on both sides; E: inflammation of the pulmonary-trunk root upon PET–CT; F: absence of left PAs and stenosis of the right main PA; G–I: pulmonary MRA (G), CTA (H) and VQ scan (I) of a patient with TA. MRA shows a fine right main PA and low perfusion in the right lung (G); CTA demonstrates a fine right main PA and fewer PA branches in the right lung (H); lung VQ scan shows multiple arterial emboli in the right lung and obvious less blood supply to the right lung.

Figure 2.

Pulmonary lesions on HRCT.A: Themosaicsign in the left lung; B: Pulmonary infarction of the right middle lobe; C: Mild pleural effusion on the left side; D: Bronchiectasis in the right lung; E–F: Ground-glass opacity (E) in the right upper lobe of a TA patient with an embolism of the right upper pulmonary branches (F); G–I: Cavitation (G) and mass-like consolidation (H) in the patient with severe stenosis of right main pulmonary artery (I).

Acknowledgments:

None

Disclosure of Interests:

None declared

FRI0224 IDENTIFICATION OF RISK AND PROGNOSTIC FACTORS FOR POLYARTERITIS NODOSA PATIENTS WITH DIGITAL GANGRENE

Background:

Polyarteritis nodosa (PAN) is a segmental, necrotizing vascular disease that primarily impacts medium-sized muscle arteries. The estimated annual incidence of PAN is still lacking in China. Digital gangrene is an ischemic manifestation of the limb. However, the causes and the treatment methods vary from case to case, and the outcome is unpredictable. These features emphasize the need to identify measurable variables that accelerate digital gangrene development in PAN patients. However, little effort has been made to identify the clinical and laboratory factors that affect PAN patients with digital gangrene to anticipate their natural history and response to therapy.

Objectives:

Many patients with polyarteritis nodosa (PAN) complicated with digital gangrene have poor outcomes and related research information is limited. This study was carried out to identify the associated risk and prognostic factors.

Methods:

We conducted a retrospective study of 148 PAN patients admitted to Peking Union Medical College Hospital (PUMCH) from September 1986 to December 2018. The characteristics, therapeutic regimens, and outcome data for patients with and without gangrene were compared. The Kaplan–Meier method and Cox hazard regression model were used to evaluate the prognostic factors.

Results:

Forty-seven (31.8%) PAN patients had digital gangrene complications. The average age was 40.4±17.9 years and the average disease duration was 11 (4-27) months. The presence of digital gangrene was correlated with smoking history [odds ratio (OR), 4.27; 95% confidence interval (95% CI), 1.56-11.66] and eosinophil elevation (28.12; 10.30-76.8). Thirty-two (68.1%) gangrene patients received methylprednisolone pulse therapy and all of these patients were treated with cyclophosphamide. Nine patients suffered irreversible organ injury and two died. Disease duration ≥ 24 months and elevated serum C-reactive protein (CRP) were identified as hazardous factors for poor prognosis in patients with gangrene (P=0.003, HR=8.668, 95% CI 2.11, 35.55 andP=0.042, HR=27.062, 95% CI 1.13, 648.57, respectively).

Conclusion:

Smoking history and eosinophil elevation in PAN patients were more prone to digital gangrene and high serum CRP level predicted poor outcomes. PAN patients with smoking history and elevated eosinophils need to be seriously evaluated by clinicians. Furthermore, the CRP level should be efficiently controlled for good prognosis.

References:

[1]De Virgilio A, Greco A, Magliulo G, Gallo A, Ruoppolo G, Conte M, et al. Polyarteritis nodosa: A contemporary overview. Autoimmun Rev. 2016;15:564-70.

[2]Pagnoux C, Seror R, Henegar C, Mahr A, Cohen P, Le Guern V, et al. Clinical features and outcomes in 348 patients with polyarteritis nodosa: a systematic retrospective study of patients diagnosed between 1963 and 2005 and entered into the French Vasculitis Study Group Database. Arthritis Rheum. 2010;62:616-26.

[3]Xu D, You X, Wang Z, Zeng Q, Xu J, Jiang L, et al. Chinese Systemic Lupus Erythematosus Treatment and Research Group Registry VI: Effect of Cigarette Smoking on the Clinical Phenotype of Chinese Patients with Systemic Lupus Erythematosus. PLoS One. 2015;10:e0134451.

Acknowledgments:

No

Disclosure of Interests:

Dong Xu: None declared, Xinping Tian: None declared, Xiaofeng Zeng Consultant of: MSD Pharmaceuticals, Fengchun Zhang: None declared, Lin Zhao: None declared, Shangzhu Zhang: None declared, Jiaxin Zhou: None declared, Jiu-liang Zhao: None declared, Xiaodan Kong: None declared

Proteolytic activity of Vibrio harveyi YeaZ is related with resuscitation on the viable but non-culturable state

The YeaZ protein of Vibrio harveyi was expressed in Escherichia coli and purified. The purified recombinant protein YeaZ exhibited the protease activity. The proteolytic activities with azocasein as substrate were 39 130 U mg^-1 . The mutation of the amino acid in active sites such as Asp⁸⁸ , Ser¹⁸⁵ and Trp¹⁶⁹ was performed. The enzyme activities of the purified mutant proteins with Asp⁸⁸ -Ala, Ser¹⁸⁵ -Leu and Trp¹⁶⁹ -Glu were decreased to 24·28, 35·27 and 41·66%, respectively. The mutant protein with two amino acid residues (Asp⁸⁸ -Ala/Ser¹⁸⁵ -Leu) lost the protease activity completely. Addition of the purified recombinant YeaZ increased resuscitation of the viable but non-culturable state (VBNC) cells to culturable state, and the culturable cell count increased from 1·35 × 10² to 3·10 × 10⁶  CFU per ml. While addition of the mutant YeaZ without protease activities did not show obvious promoting effect on resuscitation of VBNC cells. Moreover, the purified YeaZ also showed lower muralytic activity, and the activities of proteins with single amino acids mutation (Thr⁷¹ and Asp¹¹² ) were reduced from 7·05 to 4·75 and 2·50 U mg^-1 , the resuscitation-promoting effect on VBNC cells was not affected by these mutant proteins. These results implied that resuscitation-promoting effect of YeaZ on VBNC cell was partly related to its protease activities, but not with the muralytic activity. SIGNIFICANCE AND IMPACT OF THE STUDY: Vibrio harveyi is a major pathogen of marine animals. The bacterium could enter into a viable but non-culturable state (VBNC) state when exposed to harsh conditions, and retains its pathogenicity after resuscitation. In this work, we analysed the enzyme activities of a resuscitation-promoting factor YeaZ and the relationship of protease activities with its promoting effect on the resuscitation of VBNC cells. The results partly revealed the promoting mechanism of the YeaZ on the bacterial resuscitation from VBNC state. The protein could be used as a new drug target and vaccine candidate.

[Radiation dose and image quality of noncontrast chest CT in domestic and imported main stream manufacturers]

Objective: To compare the radiation dose and image quality of noncontrast chest CT and detection of ground-glass opacity pulmonary nodules (GGN) in domestic 128-slice spiral CT with the other CT scanners from three main stream manufacturers. Methods: From May 8, 2018 to October 31, 2018, noncontrast chest CT images from Neusoft 128-slice CT (75 males, 25 females, (42±16) years), dual-source 64-slice CT (53 males, 47 females, (50±16) years) and dual-source 128-slice CT scanners(69 males, 31 females, (62±17) years), Toshiba 128-slice CT (51 males, 49 females, (58±13) years) and GE 128-slice CT scanner (55 males, 45 females, (60±10) years) were collected in Eastern Theater Command and Tianjin People's Hospital. Radiation dose and image quality were evaluated.GGN detected both in Neusoft CT and dual-source CT scanners were used to analyze the displaying ability of lesions. Results: The noise in lung window of Neusoft CT ((37.8±4.9) HU) was higher than that of other mainstream CT scanners, and the noise in mediastinal window ((8.4±1.9) HU) was lower than that of GE 128-slice CT ((9.8±3.2) HU), but higher than that of dual-source CT and Toshiba 128-slice CT ((6.9±3.5)HU) (P<0.05). The absolute value of lung SNR in Neusoft CT was lower than that of other mainstream CT scanners, and the SNR in aorta (4.6±1.3) was lower than those of dual-source CT and Toshiba 128-slice CT(6.8±2.2) (P<0.05), but was not statistically significant compared with GE 128-slice CT (5.0±1.7). The mean CT value of upper lung ((-863±31) HU) at Neusoft CT was higher than 128-row dual-source CT ((-869±35) HU), and the mean CT value of aorta ((37±7) HU) was lower than that of Toshiba 128-slice CT((42±7) HU) and GE 128-slice CT ((45±9) HU) (P<0.05), while the mean CT values of the remaining lung and aorta were not statistically significant (P>0.05). The two readers had good to excellent consistency for image quality in five scanners (the highest kappa value=0.984). The delineation ability of Neusoft CT for GGN boundary was lower than that of dual-source CT (P<0.05), but had similar abilities to display the solid components, lobulation, burring, vacuoles, vascular bundle sign and pleural depression sign of GGN (all P>0.05). Radiation dose of Neusoft CT was lower than Toshiba 128-slice CT, but higher than dual-source 64-sliceCT and GE 128-slice CT scanners (P<0.05). Conclusions: With lower radiation dose than Toshiba 128-slice CT, Neusoft CT chest examination can meet the requirements of clinical diagnosis, but higher radiation dose and the lower image quality than dual-source CT and GE 128-slice CT shown in this study indicate further improvement is needed in terms of software and hardware.

Multifunctional nanocomposites MGO/FU-MI inhibit the proliferation of tumor cells and enhance the effect of chemoradiotherapy in vivo and in vitro

PURPOSE

The limitation of surgery, radiotherapy and chemotherapy in the treatment of cancer and the rise of the application of nanomaterials in the field of biomedicine have promoted the application of various nanomaterials in the combination of radiotherapy and chemotherapy in the treatment of cancer. To improve the efficiency of cancer treatment, the multifunctional nanocomposites MGO/FU-MI (MGO/FU-MI NCs) were used for combination chemotherapy and radiotherapy to verify its effectiveness in treating tumors.

METHODS

The proliferation activity of MGO/FU-MI NCs on MC-38 and B16 cells was detected by CCK-8, and the level of apoptosis and reactive oxygen species were detected by flow cytometry. To verify its efficacy in the combination of chemoradiotherapy, different treatment regimens were developed for several groups of tumor-bearing mice.

RESULTS

The MGO/FU-MI NCs can induce apoptosis, stimulate ROS production, and inhibit cell proliferation. In vivo experiments, when MGO/FU-MI NCs are used alone for chemotherapy, have a certain therapeutic effect on mouse tumors. When MGO/FU-MI NCs are combined with radiation, the tumor volume can be significantly reduced and the survival time of mice is significantly prolonged.

CONCLUSION

The MGO/FU-MI NCs are very effective in the treatment of tumors when combined with radiotherapy and chemotherapy, and have the potential to be a combination of radiotherapy and chemotherapy.

Photo-driven self-powered biosensor for ultrasensitive microRNA detection via DNA conformation-controlled co-sensitization behavior

We developed a photoelectrochemical enzymatic fuel cell-based self-powered biosensing platform for microRNA detection via DNA conformation change-controlled co-sensitization behavior.

Grafting induces flowering time and tuber formation changes in Brassica species involving FT signalling

Brassica species are widely cultivated and important biennial and annual crops. The transition from vegetative to reproductive development in Brassica species is critical in agriculture and horticulture. Grafting is a useful tool for improving agricultural production and investigating the movement of long-range signals. Here we established a hypocotyl micrografting system in B. rapa crops and successfully grafted the rootstock of turnip onto many different scion genotypes. Grafting with turnip rootstock prolonged vegetative growth, delayed flowering and improved seed yield in rapeseed. The late-flowering turnip rootstock could delay flowering of the scion of the early-flowering turnip accession. The BrrFLC1 (FLOWERING LOCUS C1 in B. rapa) transcript levels and H3K4me3 levels at the BrrFLC1 locus were up-regulated and subsequently suppressed the downstream FT (FLOWERING LOCUS T) signals in leaves of the scion to delay flowering. Vernalization treatment can efficiently promote flowering time in turnip. The non-vernalised turnip flowered early after grafting onto the rootstock of the vernalised turnip, which was accompanied by high levels of FT homologue expression in leaves of the scion. Hypocotyl excision experiments revealed that the process of tuber formation was suppressed by removing the hypocotyl tissue, which in turn repressed the expression of tuberization-related genes. Our findings suggest that the rootstock generates mobile signals that are transported from the rootstock to the scion to fine-tune FT signalling and modulate flowering time.

Isolation, identification and attenuation of a pathogenic duck hepatitis virus type 1 in China, and complete genomic sequence comparison between the embryo-passaged, attenuated derivatives and their parent

Duck viral hepatitis (DVH) is an acute and fatal disease of young ducklings characterized by rapid transmission and damages. The most important agent of DVH is duck hepatitis virus 1 (DHV-1). The effective control of DVH was achieved by active immunization of 1-day-old duck- lings with an attenuated DHV-1 virus vaccine. However, the attenuated virus might reverse to virulence. In this study, a DHV-1 strain, Du/CH/LBJ/090809, was identified and its genomic se- quences were determined. The genome of Du/CH/LBJ/090809 is composed of 7,692 nt excluding poly A and the virus was clustered into genotype A by comparing with other referenced DHV-1 strains. Du/CH/LBJ/090809 could lead to 30% mortality of 10-day-old specific pathogen free (SPF) ducklings. The virus was passaged serially in SPF chicken embryonated eggs and three vi- ruses, passage 16 (P16), P29 and P40, were selected for genomic analysis. P29 and P40 were used to evaluate the attenuation in duckling by inoculating the virus to 10-day-old SPF ducklings. Re- sults of vaccination-challenge assay showed that the inactivated virus P40 could evoke protection against the pathogenic parent virus. Nucleotide and amino acid sequences of the genomes of Du/ CH/LBJ/090809, P16, P29 and P40 were compared. Changes both in nucleotides and amino acids, which might be contributed to the decreasing in virulence by chicken embryo-passaging of DHV- 1, were observed. We speculated that these changes might be important in the adaption and at- tenuation of the virulent virus. Additionally, strains obtained in this study will provide potential candidate in the development of vaccines against DHV-1.

Gut microbiota of newborn piglets with intrauterine growth restriction have lower diversity and different taxonomic abundances

Aim

Intrauterine growth retardation (IUGR) is a prevalent problem in mammals. The present study was conducted to unveil the alterations in intestinal microbiota in IUGR piglets.

Methods and Results

We identified the alterations of small intestinal microbiota in IUGR piglets on 7, 21 and 28 days of age using 16S rRNA sequencing. The results showed that IUGR piglets had a decreased alpha diversity of jejunum microbiota at 7 and 21 days of age; had lower abundances of Bacteroidetes and Bacteroides in the jejunum at 7, 21 and 28 days of age, Oscillibacter in the jejunum at 21 days of age, and Firmicutes in the ileum at 21 days of age; whereas they had higher abundances of Proteobacteria and Pasteurella in the ileum at 21 days of age and Escherichia–Shigella in the jejunum at 28 days of age. Correlation analysis showed that Bacteroides, Oscillibacter and Ruminococcaceae_UCG‐002 compositions were positively associated with the body weight (BW) of IUGR piglets, nevertheless Proteobacteria and Escherichia–Shigella relative abundances were negatively correlated with the BW of IUGR piglets. Gene function prediction analysis indicated that microbiota‐associated carbohydrate metabolism, lipid metabolism, glycan biosynthesis and metabolism, amino acid metabolism, and xenobiotics biodegradation and metabolism were downregulated in the IUGR piglets compared to control piglets.

Conclusions

The present study profiled the intestinal microbiota of newborn piglets with IUGR and the newborn IUGR piglets have lower diversity and different taxonomic abundances. Alterations in the abundances of Bacteroidetes, Bacteroides, Proteobacteria Escherichia–Shigella and Pasteurella may be involved in nutrient digestion and absorption, as well as the potential mechanisms connecting to the growth and development of IUGR in mammals.

Significance and Impact of the Study

The small intestinal microbiota were highly shaped in the IUGR piglets, which might further mediate the growth and development of IUGR piglets; and the gut microbiota could serve as a potential target for IUGR treatment.

Identification of the membrane-spanning domain of glycoprotein 45 in bovine immunodeficiency virus

The membrane-spanning domain (MSD) of the transmembrane subunit (TM) anchors the envelope glycoprotein (Env) on the lipid bilayer of the host cell membrane and virions. Its functions include membrane fusion efficiency and intracellular trafficking of the lentivirus envelope protein. Our study aimed to determine the MSD of bovine immunodeficiency virus (BIV) glycoprotein 45 (gp45) and reveal structural characteristics of the BIV Env protein. We have predicted the region of the BIV MSD and obtained the sequence using bioinformatics software. Various kinds of assays, including analogy analysis, fluorescence microscopy, and dye-transfer-based assays, were carried out to validate the prediction. The results, for the first time, show that the BIV MSD is located at the D170 to M191 amino acids of gp45, and the identified MSD divides gp45 into the extracellular domain (ED), MSD and cytoplasmic domain (CT). We further found that the BIV MSD had a similar structure and function as the HIV MSD using amino acid sequence alignment and fluorescence microscopy. Additionally, the dye-transfer-based assay demonstrates that deletion of the BIV MSD efficiently decreases cell-cell fusion. Based on the identification of the MSD, a "snorkeling" model, in which the flanking charged amino acid residues are buried in the lipid bilayer while their side chains interact with polar head groups, was proposed for the BIV MSD. Ultimately, we further improved the primary structure of the BIV envelope glycoprotein.

miR-15a-5p regulates expression of multiple proteins in the megakaryocyte GPVI signaling pathway

Essentials The action of microRNAs (miRs) in human megakaryocyte signaling is largely unknown. Cord blood-derived human megakaryocytes (MKs) were used to test the function of candidate miRs. miR-15a-5p negatively regulated MK GPVI-mediated αIIbβ3 activation and α-granule release. miR-15a-5p acts as a potential "master-miR" regulating genes in the MK GPVI signaling pathway. SUMMARY: Background Megakaryocytes (MKs) invest their progeny platelets with proteins and RNAs. MicroRNAs (miRs), which inhibit mRNA translation into protein, are abundantly expressed in MKs and platelets. Although platelet miRs have been associated with platelet reactivity and disease, there is a paucity of information on the function of miRs in human MKs. Objective To identify MK miRs that regulate the GPVI signaling pathway in the MK-platelet lineage. Methods Candidate miRs associated with GPVI-mediated platelet aggregation were tested for functionality in cultured MKs derived from cord blood. Results An unbiased, transcriptome-wide screen in 154 healthy donors identified platelet miR-15a-5p as significantly negatively associated with CRP-induced platelet aggregation. Platelet agonist dose-response curves demonstrated activation of αIIbβ3 in suspensions of cord blood-derived cultured MKs. Overexpression and knockdown of miR-15a-5p in these MKs reduced and enhanced, respectively, CRP-induced αIIbβ3 activation but did not alter thrombin or ADP stimulation. FYN, SRGN, FCER1G, MYLK. and PRKCQ, genes involved in GPVI signaling, were identified as miR-15a-5p targets and were inhibited or de-repressed in MKs with miR-15a-5p overexpression or inhibition, respectively. Lentiviral overexpression of miR-15a-5p also inhibited GPVI-FcRγ-mediated phosphorylation of Syk and PLCγ2, GPVI downstream signaling molecules, but effects of miR-15a-5p on αIIbβ3 activation did not extend to other ITAM-signaling receptors (FcγRIIa and CLEC-2). Conclusion Cord blood-derived MKs are a useful human system for studying the functional effects of candidate platelet genes. miR-15a-5p is a potential "master-miR" for specifically regulating GPVI-mediated MK-platelet signaling. Targeting miR-15a-5p may have therapeutic potential in hemostasis and thrombosis.

Extended International Normalized Ratio testing intervals for warfarin-treated patients

Essentials Warfarin typically requires International Normalized Ratio (INR) testing at least every 4 weeks. We implemented extended INR testing for stable warfarin patients in six anticoagulation clinics. Use of extended INR testing increased from 41.8% to 69.3% over the 3 year study. Use of extended INR testing appeared safe and effective.

SUMMARY

Background A previous single-center randomized trial suggested that patients with stable International Normalized Ratio (INR) values could safely receive INR testing as infrequently as every 12 weeks. Objective To test the success of implementation of an extended INR testing interval for stable warfarin patients in a practice-based, multicenter collaborative of anticoagulation clinics. Methods At six anticoagulation clinics, patients were identified as being eligible for extended INR testing on the basis of prior INR value stability and minimal warfarin dose changes between 2014 and 2016. We assessed the frequency with which anticoagulation clinic providers recommended an extended INR testing interval (> 5 weeks) to eligible patients. We also explored safety outcomes for eligible patients, including next INR values, bleeding events, and emergency department visits. Results At least one eligible period for extended INR testing was identified in 890 of 3362 (26.5%) warfarin-treated patients. Overall, the use of extended INR testing in eligible patients increased from 41.8% in the first quarter of 2014 to 69.3% in the fourth quarter of 2016. The number of subsequent out-of-range next INR values were similar between eligible patients who did and did not have an extended INR testing interval (27.3% versus 28.4%, respectively). The numbers of major bleeding events were not different between the two groups, but rates of clinically relevant non-major bleeding (0.02 per 100 patient-years versus 0.09 per 100 patient-years) and emergency department visits (0.07 per 100 patient-years versus 0.19 per 100 patient-years) were lower for eligible patients with extended INR testing intervals than for those with non-extended INR testing intervals. Conclusions Extended INR testing for stable warfarin patients can be successfully and safely implemented in diverse, practice-based anticoagulation clinic settings.

Nosocomial outbreak of Candida parapsilosis sensu stricto fungaemia in a neonatal intensive care unit in China

BACKGROUND

Candida parapsilosis is a common agent of fungaemia, but few outbreaks of Candida parapsilosis infection have been reported in China.

AIM

To elaborate an outbreak of nosocomial Candida parapsilosis sensu stricto fungaemia in a neonatal intensive care unit (NICU) of a comprehensive hospital in China from July to October 2017.

METHODS

Epidemics and characteristics of fungaemia cases were investigated. Surveillance samples were collected. Vitek 2 Compact System, internal transcribed spacer sequencing, and random amplified polymorphic DNA (RAPD) typing were conducted to identify the isolates. Antifungal susceptibility test was performed for all bloodstream isolates.

FINDINGS

Sixteen neonates were diagnosed as Candida parapsilosis sensu stricto fungaemia during this period. Presenting symptoms included leucopenia, thrombocytopenia, and respiratory crackles. Fifteen cases were cured whereas one case who suffered from severe concomitant diseases died. The isolates were susceptible to fluconazole, amphotericin B, itraconazole, voriconazole, and 5-fluorocytosine. A total of 313 surveillance samples were collected, and Candida parapsilosis sensu stricto was identified from 16 environmental samples and one sample from an ultrasonographer's hand. The colonized locations included wiping cloths, faucets, sinks, operating table, puddles in the bathroom, a ventilator, and an ultrasonic probe. The RAPD patterns of all the Candida parapsilosis sensu stricto isolates from bloodstream and surveillance samples were identical. The outbreak was controlled after a series of infection control measures.

CONCLUSION

Contaminated environment was associated with this outbreak. Close attention to immunocompromised patients, thorough environmental disinfection and hand hygiene should be strengthened in NICU.

Injury Detection for Central Nervous System via EEG with Higher Order Crossing-based Methods

Higher order crossing (HOC) is a powerful tool for time series analysis. Two HOC-based EEG analysis methods are developed for brain injury detection and quantification. The first method explores EEG spectrum characteristics via an estimate of the dominant frequency of a pre-processed EEG signal. The second method is based on the norm of the AHOC, an HOC obtained from the -filter prefiltered EEG signal. Both methods are shown to be effective in detecting hypoxic/asphyxic injuries as well as assessing the severity of the injury.

SLC14A1: a novel target for human urothelial cancer

Urinary bladder cancer is the second commonly diagnosed genitourinary malignancy. Previously, bio-molecular alterations have been observed within certain locations such as chromosome 9, retinoblastoma gene and fibroblast growth factor receptor-3. Solute carrier family 14 member 1 (SLC14A1) gene encodes the type-B urea transporter (UT-B) which facilitates the passive movement of urea across cell membrane, and has recently been related with human malignancies, especially for bladder cancer. Herein, we discussed the SLC14A1 gene and UT-B protein properties, aiming to elucidate the expression behavior of SLC14A1 in human bladder cancer. Furthermore, by reviewing some well-established theories regarding the carcinogenesis of bladder cancer, including several genome wide association researches, we have bridged the mechanisms of cancer development with the aberrant expression of SLC14A1. In conclusion, the altered expression of SLC14A1 gene in human urothelial cancer may implicate its significance as a novel target for research.

Altered gut microbiota in RA: implications for treatment

Rheumatoid arthritis (RA) is an autoimmune disease with progressive joint disorder. The complex interplay of genetic and environmental influences is important for the development of the disease. A growing body of evidence has shed light on the association of dysbiosis of gut microbiota with RA. Certain gut microbial strains have been shown to inhibit or attenuate immune responses in RA experimental models, suggesting that specific species among intestinal commensal bacteria may play either a pathogenic or a protective role in the development of RA. Oral intake of probiotics/prebiotics can therefore represent a therapeutic approach for RA treatment. However, the relevant scientific work has only just begun, and the available data in this field remain limited. Fortunately, utilization of new sequencing technologies allows expanded research on the association of intestinal bacterial flora and human diseases to be attempted. In this review, we summarize the role of gut microbiota in RA progression and address how specific bacterial strains regulate the immune response in disease process. Probiotics/prebiotics in the treatment of RA is also discussed.

Transplantation of Adipose-Derived Mesenchymal Stem Cells Efficiently Rescues Thioacetamide-Induced Acute Liver Failure in Mice

BACKGROUND

We aimed to investigate the efficacy of adipose-derived mesenchymal stem cell (ADMSC) transplantation in acute liver failure caused by thioacetamide in mice as well as its underlying mechanism by comparing transplantation routes.

METHODS

ADMSCs were isolated from inguinal fat pads of enhanced green fluorescent protein (EGFP) transgenic mice and analyzed regarding their surface markers and differentiation potential. Acute liver failure models were established by infusion of thioacetamide, and then we injected EGFP-ADMSCs or phosphate-buffered saline solution by intrasplenic or intravenous route. The restoration of biologic functions of the livers receiving transplantation was assessed by means of a variety of approaches, such as survival rates, live function parameters, histology, localization of EGFP-ADMSCs, and immunofluorescence analysis.

RESULTS

ADMSCs were positive for CD90 and CD44 and negative for CD34 and had adipogenic and osteogenic differentiation potential. And they prevented the release of liver injury biomarkers. Transplantation via tail vein provided a significant survival benefit, but no significant differences were observed in the intrasplenic pathway and between the 2 pathways in our animal experiments. Furthermore, the transplanted cells were well integrated into injured livers and produced albumin and cytokeratin-8.

CONCLUSIONS

Direct transplantation of ADMSCs is an effective treatment for acute liver failure rather than intrasplenic transplantation. The transplanted ADMSCs exhibit the potential to differentiate into hepatocyte-like cells in the injured livers. Thus, ADCMSCs would be a potential option for treatment of acute liver failure.

Mucin expression profile of benign and malignant cervical tissues and correlation with clinical-pathologic parameters

PURPOSE

To detect the expression of mucins in diverse benign and malignant cervical tissues of cervical disease.

MATERIALS AND METHODS

158 cases of cervical tissues were collected. Sections were stained with monoclonal antibodies against MUC1, MUC2, MIUC4, MUC5AC, and MUC20 by immunohistochemistry.

RESULTS

Normal cervical epithelium showed high expr ession of MUC1I, MUC4, and MUC5AC, partial expression of MUC20, and no MUC2. With the development from chronic cervicitis, cervical intraepithelial neoplasia (CI7N) to cervical squamous cell carcinoma (SCC), the expression of MUC1, NMUC4, and MUC20 was statistically significant. The expression of MUCl was related with the depth of invasion and clinical stage of SCC. The positive rates of MUC4 and MUC20 were associated with the degree of differentiation and clinical stage of SCC. There was a correlation between the expression of MUC4, MUC 1, and MUC20 in cervical squamous lesions.

CONCLUSION

Mucins may be involved in the development of cervical cancer.

Association of a type 2 diabetes genetic risk score with insulin secretion modulated by insulin sensitivity among Chinese Hans

Type 2 diabetes (T2D) is characterized by insulin resistance and impaired insulin secretion. The present study aimed to identify the influence of insulin sensitivity on the genetic risk of impaired insulin secretion among a Chinese Han population. For 3229 controls and 1994 treatment-naïve T2D, single nucleotide polymorphisms (SNPs) from 24 T2D-related genomic loci were genotyped and a genetic risk score (GRS) was constructed. Results showed that GRS was associated with insulin secretion and disposition indices in both controls and treatment-naïve T2Ds. Upon stratifying the participants into tertiles by the Matsuda index, we observed an inhibitory relationship between the GRS and insulin secretion in low insulin sensitive but not in high insulin sensitive controls and treatment-naïve T2Ds. Moreover, low insulin sensitive individuals exhibited more severe impairment in insulin secretion and beta cell response to insulin sensitivity with an increase in risk alleles. Our findings identified that the association of GRS with insulin secretion was strongly modulated by insulin sensitivity in both controls and T2Ds of Chinese Han. It indicates that insulin sensitization should be emphasized in prevention and treatment of T2D for beta cell protection.