[Middle and long-term follow-up of 101 children with giant coronary artery aneurysm of Kawasaki disease]

Objective: To summarize the clinical features, middle-and long-term prognosis of Kawasaki disease (KD) with giant coronary artery aneurysm (GCAA). Methods: In this retrospective cohort study, a cross-sectional analysis was conducted on 101 KD children with GCAA in the KD with GCAA database established by Beijing Children's Hospital, Capital Medical University in 2004. GCAA was diagnosed as coronary artery absolute lumen diameter ≥8.0 mm. All patients were followed up regularly. The endpoint was the time of last follow-up or the death time. T test or χ² test was used for comparison between groups. Results: A total of 101 KD children with GCAA were enrolled, including 82 males (81.2%) and 19 females (18.8%). The age of disease onset was 2.5 (1.0, 4.5) years. The follow-up duration was 4.5 (2.7, 7.5) years, with a longest of 19 years. All children received routine treatment with aspirin and warfarin, and clopidogrel was added in severe cases. At the end of follow-up, 13 cases (12.9%) had cardiac enlargement, 11 cases (10.9%) developed heart failure, 13 cases (12.9%) experienced myocardial infarction, 2 cases (2.0%) underwent coronary artery bypass graft and 6 cases (5.9%) died. A total of 170 coronary arteries were involved, including 24 (14.1%) GCAAs on the main trunk of left coronary artery, 10 (5.9%) GCAAs on left circumflex, 57 (33.5%) GCAAs on left anterior descending, 78 (45.9%) GCAAs on the middle segments of right coronary artery, and 1 (0.6%) GCAA in the distal segments of right coronary artery. Eleven cases (10.9%) recovered with the coronary artery absolute lumen diameter of all GCAAs below 4.0 mm. Among 170 branches with GCAAs, 28 (16.5%) regressed below 4.0 mm. No significant difference was found in the regression rates between right and left GCAA (18.7% (17/91) vs. 13.9% (11/79), χ²=2.473, P=0.116). There was no statistically significant difference in retraction between unilateral GCAA and bilateral GCAA (16.1% (9/56) vs. 4.4% (2/45), χ²=2.381, P=0.123). Conclusions: GCAA of KD occurred more common in the middle segments of right and left anterior descending coronary arteries. The incidence of adverse cardiac events and the mortality rate in children with GCAA complicated with KD was high. Their long-term prognosis was poor.

[Systematic review of the qualitative researches on care experience of caregivers of burn children]

Objective: To systematically review the care experience of caregivers of burn children, so as to provide references for guiding the continuing care in hospitals, communities, and homes. Methods: Databases including Cochrane Library, PubMed, ScienceDirect, ProQuest, Web of Science, and CINAHL were retrieved with the search terms of " burn" , " care/caregivers/nursing/father/mother/relatives" , " needs/perceptions/exceptions/attitudes/feelings/demands/experiences" , " qualitative research" , and the Chinese Journals Full-text Database, China Biology Medicine disc, VIP Database, and Wanfang Data were retrieved with the search terms in Chinese version of "//" , "//////" , "/////" , "" to search the qualitative researches on care experience of caregivers of burn children published from the establishment of the databases to November 2019. After screening and extracting the data, the quality evaluation criteria for qualitative research of the Australian Joanna Briggs Institute Evidence-Based Health Care Center and its integrative/aggregative synthesis method were used to assess the quality of the included literature and meta-integrate the research results respectively. Results: A total of 16 studies and 269 caregivers were enrolled. The quality of one included literature was grade A, and the quality of 15 included literature was grade B. A total of 65 research results were extracted with totally 6 categories formed after summarization, and 2 integrated results obtained as follows: (1) The caregivers experienced heavy psychological pressure and burden in the care process, which had a significant impact on family, social relations, and daily life. (2) With the care time lapsing, through the support of all sectors of society and self-adjustment, the caregivers gradually accepted the reality and actively took various countermeasures, but they still faced many challenges in disease care. Conclusions: The caregivers of burn children have many physical and mental health problems and face many care challenges. The government, medical and health institutions, and society should give a great attention to these issues, improve the social support system and security system, reduce the family-related pressure of burn children's families, and improve the quality of family life.

MiR-21 promotes fracture healing by activating the PI3K/Akt signaling pathway

OBJECTIVE

This study aims to elucidate the potential mechanism of micro ribonucleic acid (miR)-21 in promoting fracture healing.

MATERIALS AND METHODS

30 male Sprague-Dawley rats were randomly divided into group A (phosphate-buffered saline, PBS, n=10), group B (AntagomiR-21, n=10) and group C (AntagomiR-NC, n=10) according to the different treatments. The femoral fracture operation was performed in every rat, which was pathologically diagnosed via X-ray. After the successful modeling, 50 μL (2 nmoL) PBS, 50 μL AntagomiR-21 or 50 μL AntagomiR-NC was intraperitoneally injected into rats in group A, B or C, respectively. The above agents were injected once a week for 6 weeks. At 6 weeks, 3 rats were executed in each group, and the tissue at the fracture end was observed via hematoxylin-eosin (HE) staining. The fracture healing of rats was evaluated via imaging at 1 and 7 weeks. At the same time, the expression of miR-21 in the three groups was detected via Reverse Transcription-Polymerase Chain Reaction (RT-PCR), and the expression of phosphatidylinositol 3-hydroxy kinase (PI3K) and phosphorylated-serine/threonine-protein kinase B (p-Akt) in the three groups was detected via Western blotting.

RESULTS

According to the histological staining, the bone repair at the fracture end of rats in group B was not significant with fracture and poor continuity compared with those in group A and group C. The imaging evaluation revealed that in group B, the callus tissues were significantly reduced, the fracture line had undesirable healing. There were no displacement and loosening of internal fixation compared with group A and group C. Besides, RT-PCR showed that the miR-21 expression declined markedly in group B compared with that in group A and group C, and the differences were statistically significant (p<0.05). Western blotting manifested that the protein levels of PI3K and p-Akt also declined in group B compared with those in group A and group C, and there were statistically significant differences (p<0.05).

CONCLUSIONS

MiR-21 promotes the fracture healing in fractured rats by activating the PI3K/Akt signaling pathway.

Air temperature, carbon dioxide, and ammonia assessment inside a commercial cage layer barn with manure-drying tunnels

Understanding the air temperature distribution, ammonia (NH₃) and carbon dioxide (CO₂) levels in poultry housing systems are crucial to poultry health, welfare, and productivity. In this study, 4 Intelligent Portable Monitoring Units and 7 temperature sensors were installed inside and between the cages and above 2 minimum ventilation fans of a commercial stacked-deck cage laying hen house in the Midwest United States (425,000 laying hens) to continuously monitor the interior environment over a 6-month period. During cold conditions (March 12th–May 22nd), there was a variation noted, with barn center temperatures consistently being highest in the longitudinal and lateral direction (P < 0.001) and the top floor deck warmer than the bottom floor (P < 0.05). During hotter conditions (May 23rd–July 26th), the interior thermal environment was more uniform than during the winter, resulting in a difference only in the longitudinal direction. The daily CO₂ and NH₃ concentrations were 400 to 4,981 ppm and 0 to 42.3 ppm among the 4 sampling locations, respectively. Both CO₂ and NH₃ decreased linearly with increasing outside temperatures. The mean NH₃ and CO₂ concentrations varied with sampling locations and with the outside temperatures (P < 0.001). For CO₂, the minimum ventilation sidewall had lower values than those measured in the barn’s center (P < 0.05) during cold weather, while the barn center and the manure room sidewall consistently measured the highest concentrations during warmer weather (P < 0.05). For NH₃, the tunnel ventilation inlet end consistently had the lowest daily concentrations, whereas the in-cage and manure drying tunnel sidewall locations measured the highest concentrations (P < 0.001). Higher NH₃ and CO₂ concentrations were recorded within the cage than in the cage aisle (P < 0.05). The highest NH₃ concentration of 42 ppm was recorded above the minimum exhaust fan adjacent to the manure drying tunnel, which indicated that higher pressure (back pressure) in the manure drying tunnel allowed air leakage back into the production area through nonoperating sidewall fan shutters.

MFN2 contributes to metabolic disorders and inflammation in the aging of rat chondrocytes and osteoarthritis

OBJECTIVE

Metabolic disorders and inflammation of chondrocytes are major pathological changes in aging cells and osteoarthritis (OA). Recent studies demonstrated age-related mitochondrial dysfunction may be a key contributing factor in the development of OA. Mitofusin 2 (MFN2) is a key regulator of mitochondrial fusion, cell metabolism, autophagy and apoptosis. This study was performed to ascertain whether MFN2 was involved in the aging of chondrocytes and OA.

METHODS

Metabolic measurements were taken in rat chondrocytes between different ages (3-week, 5-month, 12-month). MFN2 activity was detected in both human and rat chondrocytes during aging and OA. Then, knockdown of MFN2 with small interfering RNA (siRNA) was performed to confirm whether MFN2 contributes to metabolic changes. Lentiviruses were used to establish MFN2-overexpression/knockdown OA models both in vivo and in vitro to confirm whether MFN2 contributes to OA progress. Further, regulatory mechanism of MFN2 was assessed and interaction between MFN2 and PARKIN was performed.

RESULTS

A metabolic shift to mitochondrial respiration was confirmed in rat chondrocytes during aging. MFN2 expression was elevated in both human and rat chondrocytes during aging and OA. Knockdown of MFN2 with siRNA reversed the age-related metabolic changes in rat chondrocytes. Overexpression of MFN2 exacerbated inflammation and OA progress, while knockdown of MFN2 ameliorated inflammation and OA progress. Further, MFN2 could be ubiquitinated by PARKIN, declined PARKIN expression during aging and OA might result in elevated MFN2 expression.

CONCLUSIONS

Elevated MFN2 contributes to metabolic changes and inflammation during aging of rat chondrocytes and osteoarthritis.

[Clinicopathological features of lung salivary gland-type tumors]

Objective: To study the clinicopathological characteristics of lung salivary gland-type tumors (SGT), and to compare with the corresponding primary SGT in salivary glands. Methods: Twenty-three cases of lung SGT were retrieved from the files of Peking University First Hospital from January 2004 to September 2018. The morphology, immunophenotype, genotype and outcome of these cases were analyzed. Results: The 23 patients included 13 males and 10 females, with age range of 13-79 years (median 54 years). There were 11 cases of adenoid cystic carcinoma, 10 cases of mucoepidermoid carcinoma (MEC), one case each of clear cell carcinoma and myoepithelioma. The morphology and immunophenotype of lung SGT were very similar to their counterparts in salivary gland. MYB rearrangement was detected in one of 11 adenoid cystic carcinomas. MAML2 rearrangement was detected in all the MECs. EWSR1 rearrangement was detected in the one case of clear cell carcinoma. Of patients with adenoid cystic carcinoma, the survival time was more than 60 months (three cases), 52 months (one case), and 12-36 months (three cases). There was no recurrence and death in seven cases of MEC with follow-up results. One case of clear cell carcinoma recurred after 52 months of follow-up. Conclusions: Although the SGT of lung and their counterparts in salivary gland are very similar in their morphology, immunophenotype, genotype and prognosis, there are also some differences between each other. MYB rearrangement can be detected in most adenoid cystic carcinomas of salivary gland, but rarely in lung adenoid cystic carcinoma. The prognosis of patients with lung MEC is better than that of patients with salivary gland MEC, while the prognosis of patients with lung adenoid cystic carcinoma is worse than that of patients with salivary gland adenoid cystic carcinoma.

Effects of acute heat stress on intestinal microbiota in grow-finishing pigs, and associations with feed intake and serum profile

AIMS

This study was conducted to assess the effects of acute heat stress (HS) on intestinal microbiota, and the associations with the changes in feed intake (FI) and serum profile.

METHODS AND RESULTS

Twenty four individually housed pigs (Duroc × Large White × Landrace, 30 ± 1 kg body weight) were randomly assigned to receive one of three treatments (8 pigs/treatment): (i) thermal neutral (TN) conditions (25 ± 1°C), (ii) HS conditions (35 ± 1°C), (iii) pair-feeding (PF) with HS under TN conditions. After 24-h treatment, pigs were monitored to assess FI, and samples of serum and faeces were collected to investigate serum profile, microbial composition and short chain fatty acids (SCFAs). The results showed that HS decreased (P < 0·05) FI compared with the TN group. Compared with TN group, HS changed the serum profile by affecting biochemical parameters and hormones related with energy metabolism and stress response; immune indicators were also altered in HS group. Most of changes in serum profile were independent of FI reduction. Additionally, HS shifted the diversity and composition of faecal microbial community by increasing (P < 0·05) Proteobacteria and decreasing (P < 0·05) Bacteroidetes. Moreover, HS decreased (P < 0·05) the concentrations of propionate, butyrate, valerate, iso-valerate and total SCFAs in faeces in an FI-independent manner. Furthermore, the Spearman correlation analysis implied that changes of serum profile have potential correlation with alterations of faecal microbiota and their SCFAs metabolites in acute HS-treated grow-finishing pigs.

CONCLUSIONS

Metabolism disorders caused by 24-h acute HS associated with changes of faecal microbiota and their SCFAs metabolites in an FI-independent manner in grow-finishing pigs.

SIGNIFICANCE AND IMPACT OF THE STUDY

These results give us a new insight of the intestinal damage caused by acute HS and the underlying mechanisms.

Petrifilm™ Rapid S. aureus Count Plate Method for Rapid Enumeration of Staphylococcus aureus in Selected Foods: Collaborative Study

A rehydratable dry-film plating method for Staphylococcus aureusin foods, the 3M™ Petrifilm™ Rapid S. aureus Count Plate method, was compared with AOAC® Official MethodSM 975.55 (Staphylococcus aureus in Foods). Nine foods—instant nonfat dried milk, dry seasoned vegetable coating, frozen hash browns, frozen cooked chicken patty, frozen ground raw pork, shredded cheddar cheese, fresh green beans, pasta filled with beef and cheese, and egg custard—were analyzed for S. aureus by 13 collaborating laboratories. For each food tested, the collaborators received 8 blind test samples consisting of a control sample and 3 levels of inoculated test sample, each in duplicate. The mean log counts for the methods were comparable for pasta filled with beef and cheese; frozen hash browns; cooked chicken patty; egg custard; frozen ground raw pork; and instant nonfat dried milk. The repeatability and reproducibility variances of the Petrifilm Rapid S. aureus Count Plate method were similar to those of the standard method.

Effect of cooled perches on the efficacy of an induced molt in White Leghorn laying hens previously exposed to heat stress

This study examined the effect of water-chilled perches on hen production and physiological responses to induced molt during elevated temperatures. A total of 288White Leghorns at 82 wk of age were housed in 36 cages of 6 banks. Each bank was assigned to 1 of 3 treatments: cooled perches, air perches, and no perches. The hens were subjected to 2 heat episodes during their first laying cycle at week 21 to 35 and week 73 to 80, respectively. The hens were subjected to a 28 D nonfasted molting regimen starting at 85 wk of age. Cyclic heat of 32°C (6:00 am to 6:00 pm) was applied daily during the molting period. After molt, hens were returned to a layer diet and housed under thermoneutral condition. Two birds per cage were monitored for BW change during molt. Egg production was recorded daily. Feed utilization was measured during molt at 86 and 88 wk of age. Egg weight and eggshell traits were examined at 84 wk (pre-molt) and post-molt at 92, 96, and 104 wk of age. Rectal temperature and blood samples were collected from 2 birds per cage at the end of molt. Blood samples were used for determining heterophil/lymphocyte ratio, corticosterone, and thyroid hormones. Plumage condition was examined at 22 wk post-molt. Compared to control and air perch hens, cooled perch hens had higher feed usage and greater BW loss, lower heterophil/lymphocyte ratios (P < 0.05) with no difference in thyroid hormones and corticosterone at the end of molt. Cooled perch hens also had higher egg production beginning at 98 wk of age (Ptreatment*age < 0.0001) than control hens and sometimes the air-perch hens. Cooled perch hens had higher rectal temperature than control but not air perch hens at end of molt. Moreover, cooled perch hens had better breast feather scores than air perch hens but worse vent plumage (P ≤ 0.05) than both control and air perch hens. These results indicate that the provision of cooled perches assists hens with better adaptation to stressors, such as induced molt plus heat exposure, resulting in improved post-molt egg production.

Identification of differential abundances of mRNA transcript in cumulus cells and CCND1 associated with yak oocyte developmental competence

The development of an accurate and noninvasive preselection process for competent oocytes is essential to achieve a highly efficient in vitro production (IVP) of embryos. Cumulus cells (CCs) have important functions in oocyte growth, development, maturation, and fertilization. It, therefore, is important to know if the quality of oocytes can be ascertained by assessment of gene expression of the surrounding CCs or not. The aim of this study was to identify differentially expressed genes in yak CCs from oocytes with varying developmental competences as possible biomarkers for distinguishing oocyte competence. The isolated CCs were pooled into immature and mature groups in accordance with the maturation outcome of oocytes. A total of 9516 genes were differentially expressed in the two CC categories (P <  0.05). With a minimum change of 2.5-fold, 45 up-regulated and 79 down-regulated genes were observed in CCs belonging to the mature group compared with those in the immature group (P <  0.01). These genes were primarily enriched for the cell cycle, meiosis, cell signaling, metabolism, and apoptosis. The selected candidate genes (CCND1, BMP15, GDF9, H19, KLF4, GPC1, SYCP3, and CTSB) were validated using quantitative real-time polymerase chain reaction (RT-qPCR) and there were expression patterns similar to those detected with transcriptome analysis. The CCs from fertilized oocytes arrested at the 2-cell (2-cell group), or 8-cell (8-cell group) stages or that developed into blastocysts (the blastocyst group) had a 1.5-, 1.8-, and 2.3-fold increase, respectively, in mRNA relative abundance of CCND1 compared with CCs from unfertilized oocytes (P <  0.05). The results with the RT-qPCR analysis confirmed that the relative abundance of CCND1 mRNA in CCs was associated with oocyte developmental competence. In conclusion, RNA-Seq is useful in extracting transcriptomes and selecting markers associated with oocyte developmental competence. Furthermore, the expression of the CCND1 gene in yak CCs can be used to preselect oocytes for IVP efficiency.

T-cell receptor gene therapy targeting melanoma-associated antigen-A4 by silencing of endogenous TCR inhibits tumor growth in mice and human

Genetically engineered T cells expressing a T-cell receptor (TCR) are powerful tools for cancer treatment and have shown significant clinical effects in sarcoma patients. However, mismatch of the introduced TCR α/β chains with endogenous TCR may impair the expression of transduced TCR, resulting in an insufficient antitumor capacity of modified T cells. Here, we report the development of immunotherapy using human lymphocytes transduced with a codon-optimized melanoma-associated antigen (MAGE)-A4 and HLA-A*2402-restricted TCR, which specifically downregulate endogenous TCR by small interfering RNA (si-TCR). We evaluated the efficacy of this immunotherapy in both NOD-SCID mice and uterine leiomyosarcoma patients. Our results revealed that transduced human lymphocytes exhibited high surface expression of the introduced tumor-specific TCR, enhanced cytotoxic activity against antigen-expressing tumor cells, and increased interferon-γ production by specific MAGE-A4 peptide stimulation. Retarded tumor growth was also observed in NOD-SCID mice inoculated with human tumor cell lines expressing both MAGE-A4 and HLA-A*2402. Furthermore, we report the successful management of a case of uterine leiomyosarcoma treated with MAGE-A4 si-TCR/HLA-A*2402 gene-modified T cells. Our results indicate that the TCR-modified T cell therapy is a promising novel strategy for cancer treatment.

Study of mesh infection management following inguinal hernioplasty with an analysis of risk factors: a 10-year experience

PURPOSE

We present a review of our 10-year experience in managing patients with mesh infection following hernioplasty and analyze the occurrence of known predisposing factors.

METHODS

We analyzed 392 cases of mesh infection treated at our center between 2007 and 2018 after a preoperative work-up. (Thirty-one patients underwent the primary hernia repair procedure at our hospital, whereas the others underwent the primary surgery at other local centers and were referred to our center.) The method of infected mesh removal (open or laparoscopic) was selected depending on the primary surgical approach. Open repair involved the excision of the mesh, infected tissue, and sinus (if present). The laparoscopic approach was used to identify the abscess, excise the mesh, and allow drainage into the preperitoneal space.

RESULTS

The operative course in all patients was uneventful. A second surgery to extract the residual mesh around the pubic bone was performed in 7 patients. Hernia recurred in 29 patients after mesh removal. The discharge culture results were positive in 193 patients. Of these, Staphylococcus spp. was identified as the causative organism in 126 patients. Risk factors for mesh infection, including obesity, smoking, and diabetes, were identified in 182 (46.5%), 154 (39.3%), and 35 (8.9%) patients, respectively.

CONCLUSIONS

It is recommended the approach of mesh removal is tailored as per the primary hernioplasty method. We analyzed the occurrence of risk factors for mesh infection in this study, but further studies are needed to develop a predictive model that is both internally and externally validated to evaluate the probability of mesh infection.

Cryptoanalysis on optical image encryption systems based on the vector decomposition technique in the Fourier domain

In this paper, the security of optical cryptosystems based on the vector decomposition technique in the Fourier domain is analyzed. Compared to the conventional cryptosystem based on the equal modulus decomposition (EMD) technique, an additional EMD structure is introduced in the cascaded EMD-based cryptosystem; hence, the mask including the phase information of the Fourier spectrum is further encoded in the second EMD structure to enhance the security level. However, it is shown that the number of the private keys has not been increased in the cascaded EMD-based cryptosystem, which makes it possible to crack the cascaded EMD-based cryptosystem. Therefore, a chosen-plaintext attack (CPA) and a special attack with an arbitrarily given private key are proposed to retrieve information from encoded images obtained by the cascaded EMD-based cryptosystem. In addition, the security of the cryptosystem based on the random modulus decomposition (RMD) technique is also analyzed. Compared to the EMD-based cryptosystem in which the Fourier spectrum is decomposed into two vectors with equal moduli, the security level of the cryptosystem has been improved by using the RMD technique to decompose the spectrum into vectors with unequal moduli to decrease the number of the amplitude constraints. However, it is found that the arbitrarily given ciphertext provides the attackers enough information to retrieve the precise information of the plaintext without any knowledge of the private keys. A special attack is proposed to crack the RMD-based cryptosystem. This is the first time to report that these two cryptosystems based on the vector decomposition technique are attacked successfully. Numerical simulation is conducted to validate the feasibility and effectiveness of the proposed attacks.

Wnt Production in Dental Epithelium Is Crucial for Tooth Differentiation

The Wnt ligands display varied spatiotemporal expression in the epithelium and mesenchyme in the developing tooth. Thus far, the actions of these differentially expressed Wnt ligands on tooth development are not clear. Shh expression specifies the odontogenic epithelium during initiation and is consistently restricted to the dental epithelium during tooth development. In this study, we inactivate Wntless ( Wls), the key regulator for Wnt trafficking, by Shh-Cre to investigate how the Wnt ligands produced in the dental epithelium lineage act on tooth development. We find that conditional knockout of Wls by Shh-Cre leads to defective ameloblast and odontoblast differentiation. Wls^Shh-Cre teeth display reduced canonical Wnt signaling activity in the inner enamel epithelium and the underlying mesenchyme at the early bell stage, as exhibited by target gene expression and BAT-gal staining. The expression of Wnt5a and Wnt10b is not changed in Wls^Shh-Cre teeth. By contrast, Wnt10a expression is significantly increased in response to epithelial Wls deficiency. In addition, the expression of Hedgehog signaling pathway components Shh, Gli1, and Patched1 was greatly decreased in Wls^Shh-Cre teeth. Epithelial Wls loss of function in Shh lineage also leads to aberrant cell proliferation in dental epithelium and mesenchyme at embryonic day 16.5; however, the cell apoptosis is unaffected. Moreover, we find that Decorin and Col1a1, the key markers for odontoblast differentiation that are downregulated in Wls^Shh-Cre teeth, act as direct downstream targets of the canonical Wnt signaling pathway by chromatin immunoprecipitation analysis. Additionally, Decorin and Col1a1 expression can be increased by lithium chloride (LiCl) treatment in the in vitro tooth explants. Taken together, our results suggest that the spatial expression of Wnt ligands within the dental epithelial lineage regulates the differentiation of tooth structures in later stages.

6-year change in resting heart rate is associated with incident type 2 diabetes mellitus

BACKGROUND AND AIMS

Elevated resting heart rate (RHR) is associated with risk of type 2 diabetes mellitus (T2DM). However, the association of change in RHR (ΔRHR) and incident T2DM is not fully elucidated. We aimed to assess the dose-response association between 6-year ΔRHR and T2DM.

METHODS AND RESULTS

A total of 12155 non-T2DM participants ≥18 years old were enrolled during 2007-2008 and followed up during 2013-2014. ΔRHR was calculated by subtracting the baseline RHR from the RHR value at 6-year follow-up. Age-, sex-, and RHR-specific relative risks (RRs) and 95% confidence intervals (CIs) for the effect of ΔRHR on incident T2DM were calculated by using modified Poisson regression models. As compared with ΔRHR of 0 beats/min, the adjusted risk of T2DM was significantly increased with RHR increment and reduced with RHR reduction. ΔRHR was positively associated with future risk of T2DM [RR per unit increase: 1.03 (1.03-1.04)]. As compared with stable change in RHR group (-5<ΔRHR<5 beats/min), for ΔRHR ≤ -10 beats/min, -10<ΔRHR ≤ -5 beats/min, 5≤ΔRHR<10 beats/min, and ΔRHR ≥10 beats/min groups, the pooled adjusted RR (95% CI) of T2DM was 0.69 (0.55-0.86), 0.90 (0.73-1.11), 1.31 (1.07-1.61), and 1.90 (1.59-2.26), respectively. This significant association still existed on subgroup analyses based on age, sex, and baseline RHR and sensitivity analyses.

CONCLUSIONS

Dynamic RHR change was significantly associated with incident T2DM. Our study suggests that RHR may be a non-invasive clinical indicator for interventions aiming to reduce incident T2DM in the general population.

MicroRNA-10-5p regulates differentiation of bone marrow mesenchymal stem cells into cardiomyocytes by targeting TBX5

OBJECTIVE

The purpose of the study was to investigate the regulatory effect of microRNA-10-5p on TBX5 during myocardial differentiation of bone marrow mesenchymal stem cells (BMSCs) in rats.

MATERIALS AND METHODS

Rat BMSCs were first isolated, cultured and identified by flow cytometry. Expression levels of BNP (Brain Natriuretic Peptide), α-actinin, and Islet-1 in BMSCs co-cultured with rat cardiomyocytes were detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Dual-luciferase reporter gene assay was conducted to verify the binding condition between microRNA-10-5p and TBX5. Subsequently, we detected TBX5 expression after overexpression or knockdown of microRNA-10-5p in BMSCs. Rescue experiments were conducted by overexpression of both microRNA-10-5p and TBX5 in BMSCs, and then, the expression levels of BNP, α-actinin, and Islet-1 were detected by qRT-PCR and Western blot.

RESULTS

Flow cytometry results showed positive-CD73 (99.3%), positive-CD90 (95.4%), and negative-CD34 (4.2%), which were consistent with immunophenotypic characteristics of BMSCs. TBX5 overexpression or microRNA-10-5p knockdown increased mRNA levels of BNP, α-actinin, and Islet-1 in BMSCs co-cultured with rat cardiomyocytes. Dual-luciferase reporter gene assay confirmed that microRNA-10-5p could bind to TBX5. Both mRNA and protein expressions of TBX5 were negatively regulated by microRNA-10-5p. The inhibited expression levels of BNP, α-actinin, and Islet-1 by microRNA-10-5p overexpression in BMSCs were partially reversed by TBX5 overexpression.

CONCLUSIONS

MicroRNA-10-5p regulates BMSCs differentiation into cardiomyocytes by binding to TBX5.

Security analysis and enhancement of a cryptosystem based on phase truncation and a designed amplitude modulator

In this paper, the security of a cryptosystem based on phase truncation and a designed amplitude modulator (AM) is evaluated. In the cryptosystem, an undercover AM used as an additional key is added to modulate the amplitude information of the spectrum in the Fourier plane. Compared to the conventional phase-truncated Fourier transform (PTFT)-based cryptosystem, the security of the cryptosystem is improved by increasing the number of unknown keys. However, it is found that the designed AM is irrelative to the plaintext, and one of the parameters in the designed AM contributes less to the security enhancement of the cryptosystem due to low key sensitivity. Based on the analysis, a special attack containing two iterative processes is proposed to crack the cryptosystem, in which the known-plaintext-attack-based iterative process I with a specific normalization operator is used to retrieve the designed AM and the amplitude-phase-retrieval-technique-based iterative process II is used to retrieve the corresponding plaintext from the arbitrarily given ciphertext with the help of the retrieved AM. In addition, an inherent drawback widely existing in PTFT-based cryptosystems is reported for the first time: most information of the original image could be retrieved using two correct phase keys (or only the first phase key) generated in the encryption process, even without the corresponding ciphertext in PTFT-based cryptosystems. To address this issue, a security-enhanced cryptosystem is proposed in this paper. Numerical simulation is carried out to demonstrate the effectiveness and feasibility of the proposed attack and cryptosystem.

Vascular and Biliary Complications Following Deceased Donor Liver Transplantation: A Meta-analysis

OBJECTIVE

To assess biliary and vascular complications after liver transplantations (LTs) sourced from deceased donors.

METHODS

This study reviewed potentially relevant English-language articles gathered from PubMed and Medline published from 2012 to 2017. One additional study was carried out using our institution's database for articles published from 2013 to 2017. Biliary and vascular complications from adult patients receiving their first deceased-donor LT were included. This meta-analysis was performed using Review Manager version 5.2 (Cochrane Collaboration, Copenhagen, Denmark) and the study quality was evaluated using the Newcastle-Ottawa Scale.

RESULTS

Ten studies met our inclusion criteria. Heterogeneity in donation after cardiac death (DCD) and donation after brain death (DBD) recipients was observed and minimized after pooling a subgroup analysis. This latter analysis focused on biliary stricture, biliary leaks and stones, and vascular thrombosis and stenosis. Meta-analyses showed that patients receiving DCD organs have a greatly increased risk of biliary complications compared to those receiving DBD organs, particularly the following: biliary leaks and stones (odds ratio [OR] = 1.69, 95% confidence interval [CI] 1.22-2.34); and biliary stricture (OR = 1.58, 95% CI 1.21-2.06). DCD grafts tended to be but were not significantly associated with DBD regarding vascular thrombosis (OR = 1.62, 95% CI 1.05-2.50), and the risk of vascular stenosis in DCD grafts was not statistically significant (OR = 1.25, 95% CI, .70-2.25).

CONCLUSION

DCD was associated with an increased risk of biliary complications after LT, tended to indicate an increased risk of vascular thrombosis versus, and was not associated with an increased risk of vascular stenosis compared to DBD. There was no significant difference between the grafts.

[Exogenous CRX gene induces Müller cell-derived progenitors to differentiate into photoreceptors]

Objective: To investigate whether exogenous CRX gene would be able to induce Müller cells-derived progenitors to differentiate into photoreceptors. Methods: Experimental study. Müller cells-derived progenitors resulted from primary Müller cells isolated from KunMing mice(5-7 days old) and cultured in free-serum media. Markers of Müller cells(glutamine synthetase, GS and Vimentin) and stem cells (Nestin and Sox2) were analysed by immnocytochemical assays. The secondary passage progenitors were divided into three groups: (1)the control group; (2)the empty vector group was transfected with lentivirus GFP; (3)the treated group was transfected with lentivirus GFP-CRX. After differentiation for 7 days, 7 days after differentiation, the expression of markers of photoreceptors were analyzed by q-PCR and Western blot assay. Results: There were 96.03%±1.21% of Müllerz cells cultured in vitro were immunoreactive to both GS and Vimentin. The dedifferentiation cells expressed Nestin and Sox2. After 7 days of induction, Exogenous CRX induced Müller cell-derived progenitors to differentiate into rod-like cells showed appearance like neuron morphology. q-PCR demonstrated that mRNAs of CRX and Rhodopsin were upregulated greatly. CRX mRNA were 9 times (P<0.05) and Rhodopsin mRNA were 20 times (P<0.05). The difference between the control group and the empty vector group was not statistically significant. Western blot showed that the expression of CRX was upregulated significantly, and was 2.7 times(P<0.05). But expression of Rhodopsin was weak and was nearly not detected in the control group and empty vector group. The expression of S-opsin was not detected. Conclusion: CRX gene could induce the differentiation of Müller cell-derived progenitor into rod photoreceptors, indicating a new avenue to study müller cells as endogenous seed cells for retinal photoreceptor. (Chin J Ophthalmol, 2018, 54: 923-928).

Identification of SUV39H2 as a potential oncogene in lung adenocarcinoma

BACKGROUND

SUV39H2 (suppressor of variegation 3-9 homolog 2), which introduces H3K9me3 to induce transcriptional repression, has been reported to play critical roles in heterochromatin maintenance, DNA repair, and recently, carcinogenesis. Dysregulation of SUV39H2 expression has been observed in several types of cancers. However, neither the genomic landscape nor the clinical significance of SUV39H2 in lung adenocarcinoma has been probed comprehensively.

METHODS

In this research, we conducted bioinformatics analysis to primarily sort out potential genes with dysregulated expressions. After we identified SUV39H2, RNA-seq was performed for a high-throughput evaluation of altered gene expression and dysregulated pathways, followed by a series of validations via RT-qPCR and bioinformatics analyses. Finally, to assess the potential oncogenic role of SUV39H2, we employed the invasion assay and clone formation assay in vitro and tumorigenesis assays in mouse models in vivo.

RESULTS

Through bioinformatics analyses, we found that SUV39H2 underwent a severe upregulation in the tumor tissue, which was also confirmed in the surgically removed tissues. Overexpression of SUV39H2 was mainly associated with its amplification and with shorter patient overall survival. Then, the RNA-seq demonstrated that TPM4, STOM, and OPTN might be affected by the loss of function of SUV39H2. Finally, in vitro and in vivo experiments with SUV39H2 knockdown all suggested a potential role of SUV39H2 in both carcinogenesis and metastasis.

CONCLUSIONS

SUV39H2 expression was elevated in lung adenocarcinoma. TPM4, OPTN, and STOM were potentially regulated by SUV39H2. SUV39H2 might be a potential oncogene in lung adenocarcinoma, mediating tumorigenesis and metastasis.

Effects of carbon dioxide on turkey poult performance and behavior

Appropriate ventilation of poultry facilities is critical for achieving optimum performance. Ventilation promotes good air exchange to remove harmful gases, excessive heat, moisture, and particulate matter. In a turkey brooder barn, carbon dioxide (CO2) may be present at higher levels during the winter due to reduced ventilation rates to maintain high temperatures. This higher CO2 may negatively affect turkey poult performance. Therefore, the objective of this study was to evaluate the effects of subjecting tom turkey poults (commercial Large White Hybrid Converters) to different constant levels of atmospheric CO2 on their growth performance and behavior. In three consecutive replicate trials, a total of 552 poults were weighed post-hatch and randomly placed in 3 environmental control chambers, with 60 (Trial 1) and 62 (Trials 2 and 3) poults housed per chamber. They were reared with standard temperature and humidity levels for 3 wks. The poults were exposed to 3 different fixed CO2 concentrations of 2,000, 4,000, and 6,000 ppm throughout each trial. Following each trial (replicate), the CO2 treatments were switched and assigned to a different chamber in order to expose each treatment to each chamber. At the end of each trial, all poults were sent to a local turkey producer to finish growout. For each trial, individual body weight and group feed intake were measured, and mortality and behavioral movement were recorded. Wk 3 and cumulative body weight gain of poults housed at 2,000 ppm CO2 was greater (P < 0.05) than those exposed to 4,000 and 6,000 ppm CO2. Feed intake and feed conversion were unaffected by the different CO2 concentrations. No significant difference in poult mortality was found between treatments. In addition, no effect of CO2 treatments was evident in the incidence of spontaneous turkey cardiomyopathy for turkeys processed at 19 wk of age. Poults housed at the lower CO2 level (2,000 ppm) demonstrated reduced movement compared with those exposed to the 2 higher CO2 concentrations.

IL-37 inhibits IL-4/IL-13-induced CCL11 production and lung eosinophilia in murine allergic asthma

BACKGROUND

IL-37 is emerging as an anti-inflammatory cytokine, particularly in innate inflammation. However, the role of IL-37 in Th2-mediated allergic lung inflammation remains uncertain. We sought to determine the role and the underlying mechanisms of IL-37 in the development of house dust mites (HDM)-induced murine asthma model.

METHODS

We examined the effect of IL-37 administration during the sensitization or challenge phase on Th2-mediated allergic asthma induced by inhaled HDM. Cellular source of CCL11 and distribution of IL-37 receptors, IL-18Rα and IL-1R8, were determined in HDM-exposed lungs. Finally, we examined the effect of IL-37 on CCL11 production and STAT6 activation in different primary lung structural cell types upon IL-4/IL-13 stimulation.

RESULTS

IL-37 had no effect on HDM sensitization, but when administrated during the challenge phase, significantly attenuated pulmonary eosinophilia, CCL11 production, and airway hyper-reactivity (AHR). Interestingly, IL-37 treatment had no significant effects on lung infiltrating T cells and Th2 cytokine production. Intranasal co-administration of CCL11 reversed the inhibiting effect of IL-37 on HDM-induced pulmonary eosinophilia and AHR. Furthermore, we demonstrated that CCL11 was primarily expressed by fibroblasts and airway smooth muscle cells (AMSC), while IL-37 receptors by tracheobronchial epithelial cells (TEC). In vitro study showed that IL-37 inhibited IL-4/IL-13-induced STAT6 activation and CCL11 production by fibroblasts and AMSC, which was dependent on its direct action on TEC. Moreover, cell contact was required for the inhibitory effect of IL-37-treated TEC.

CONCLUSIONS

IL-37 attenuates HDM-induced asthma, possibly by inhibiting IL-4/IL-13-induced CCL11 production by fibroblasts and AMSC via its direct act on TEC.

Hybrid attack on an optical cryptosystem based on phase-truncated Fourier transforms and a random amplitude mask

In this paper, the security of a cryptosystem based on phase-truncated Fourier transforms (PTFTs) and a random amplitude mask (RAM) is evaluated. In the cryptosystem, fake keys used as encryption keys in the second PTFT-based structure are generated by the first PTFT-based structure in which the RAM is encoded by random phase masks (RPMs) used as public keys. Compared to the classical PTFT-based encryption scheme, the security level of the cryptosystem is improved by using cascaded PTFTs to encode the encryption keys and the plaintext simultaneously. However, it is found that a known plaintext-ciphertext pair can provide enough constraints in the iterative process to retrieve the fake keys, which then can be used to retrieve unknown arbitrary plaintext from the corresponding ciphertext. Based on the analysis, we propose a specific attack based on hybrid iterative processes to break the cryptosystem. Two iterative processes with different constraints are involved in the proposed attack. The first known-plaintext-attack (KPA)-based iterative process is used to retrieve two fake keys with the help of two public keys and a known plaintext-ciphertext pair, while the second amplitude-phase retrieval algorithm-based iterative process with a median filter is employed to retrieve the plaintext from the corresponding ciphertext using two retrieval fake keys. To the best of our knowledge, it is the first time that the cryptosystem is attacked by the KPA-based iterative algorithm successfully. Numerical simulation results validate the feasibility and effectiveness of the proposed attack.

Clinical effects and safety evaluation of dexmedetomidine hydrochloride combined with etomidate fat emulsion in patients undergoing interventional treatment of stroke during anesthesia

OBJECTIVE

Stroke patients are often elderly and afflicted with comorbidities that can make them more susceptible to surgical complications during anesthesia, such as respiratory depression. This study examined the clinical effects of dexmedetomidine hydrochloride combined with etomidate fat emulsion in patients undergoing interventional treatment of stroke during anesthesia.

PATIENTS AND METHODS

90 patients with stroke admitted at the Second Hospital of Dalian Medical University between February 2015 and March 2016 were selected for interventional treatment in the study. The patients were randomly divided into three different treatment groups, with 30 patients in each group. Group A patients were treated with dexmedetomidine hydrochloride, group B patients were treated with etomidate fat emulsion, and group C patients were treated with dexmedetomidine hydrochloride combined with etomidate fat emulsion. Mean arterial blood pressure (MAP), heart rate (HR), wake-up time, and extubation time were compared and analyzed for the patients of each group at different time points.

RESULTS

MAP and HR of patients in group C were notably decreased after anesthesia, and were significantly lower than patients in groups A and B (p<0.05). MAP and HR of the patients in groups A and B did not significantly change over the different time points. The three groups also did not show dramatic changes when patients were extubated after 3 min (p>0.05). Further data on wake-up time, extubation, and spontaneous breathing recovery time among the patients did not show any significant differences in the three groups (p>0.05). However, the prevalence of complications in group C was lower than in groups A and B (p<0.05).

CONCLUSIONS

Dexmedetomidine hydrochloride combined with etomidate fat emulsion in patients undergoing interventional treatment of stroke during anesthesia has potential value in clinical applications, through the maintenance of ideal hemodynamics and a reduction in complications.

[Clinicpathological features and survival of patients with AIDS related non-Hodgkin's lymphoma]

目的

分析艾滋病相关非霍奇金淋巴瘤（ARL）患者的临床特征及生存状态。

方法

回顾性分析53例ARL患者的临床资料，按1∶2随机配对对照研究方法，以106例普通非霍奇金淋巴瘤（NHL）患者为对照，比较两组患者的生存率。

结果

53例ARL患者的平均年龄为43（11~67）岁，诊断NHL时CD4⁺T细胞中位数为（146±20）个/µl。53例患者中B细胞来源者47例（88.7%），T细胞来源者6例（11.3%）。Ann Arbor分期Ⅲ~Ⅳ期者占52.8%（28/53）；IPI评分中高危组和高危组患者比例分别为45.3%（24/53）和18.9%（10/53）。ARL诊断后放弃治疗者占37.7%（20/53），抗HIV治疗联合放化疗者占62.3%（33/53）。抗NHL治疗采用CHOP（环磷酰胺、长春新碱、表阿霉素、泼尼松）方案。ARL组患者的总生存（OS）时间显著短于对照组[（6.0±1.3）对（48.0±10.0）个月，P<0.05]。接受抗NHL治疗的患者中，ARL组（33例）和对照组（100例）患者的OS时间差异无统计学意义[（48.0±10.9）对（77.0±11.1）个月，P=0.816]；ARL组患者1年OS率低于对照组（60.6%对83.0%，P<0.05），但两组患者的2年（53.5%对60.5%）、3年（48.1%对45.9%）和5年（39.1%对27.5%）OS率差异均无统计学意义（P值均>0.05）。

结论

ARL多见于青壮年，1年内病死率高，抗HIV治疗联合CHOP方案抗NHL治疗能显著改善ARL患者预后。

Silk fibroin preserves beta cell function under inflammatory stress while stimulating islet cell surface GLUT2 expression

Silk fibroin is a novel biomaterial for enhancing transplanted islet cell function and survival. This study investigated whether silk fibroin may have unique properties that improve islet function in the face of inflammatory-mediated stress during transplantation. Murine islet function was tested in vitro with either silk fibroin or alginate and challenged with inflammatory cytokines. The glucose-stimulated insulin secretion index for all conditions decreased with inflammatory cytokines, but was better preserved for islets exposed to silk compared to those exposed to alginate or medium. GLUT2 transporter expression on the cell surface of islets exposed to silk was increased compared to alginate or medium alone. Upon cytokine stress, a greater percentage of islet cells exposed to silk expressed GLUT2 on their surface. We conclude that preconditioning islets with silk fibroin stimulates islet cell surface GLUT2 expression, an increase, which persists under inflammatory stress, and may improve islet engraftment and function after transplantation.

Higher Incidence of Renal Allograft Glomerulonephritis in Living-Related Donor Kidney Transplantation

Glomerulonephritis recurrence has emerged as one of the leading causes of allograft loss. We aimed to investigate the effect of living-related and deceased donation on the incidence of renal allograft glomerulonephritis and its effect on renal allograft survival.

METHODS

Adult renal allograft recipients with primary glomerulonephritis were enrolled. Transplantation date was from Feb 2004 to Dec 2015. Exclusion criteria included combined organ transplantation, structural abnormality, diabetic nephropathy, hypertension nephropathy, obstructive nephropathy, and primary uric acid nephropathy. The incidence of biopsy-proven allograft glomerulonephritis was compared between the living-related donor group and the deceased donor group. Graft survival was assessed with Kaplan-Meier method, and Cox proportional hazard model was used to evaluate the effect of posttransplant glomerulonephritis on graft outcome.

RESULTS

There were 525 living-related donor kidney transplant recipients (LRKTx) and 456 deceased donor kidney transplant recipients (DDKTx) enrolled. The incidence of IgA nephropathy was 8.8% in the LRKTx group and 1.3% in the DDKTx group (P < .001); the incidence of focal segmental glomerulosclerosis (FSGS) was 3.8% in the LRKTx group and 1.5% in the DDKTx group (P = .03). FSGS increased the risk of graft failure compared with non-FSGS (hazard ratio [HR], 3.703 [1.459-9.397]; P = .006). IgA nephropathy increased the risk of graft failure by over 5 times 5 years after kidney transplantation compared with non-IgA nephropathy, but it did not affect early allograft survival (HR for ≥5 years, 6.139; 95% CI, 1.766-21.345; P = .004; HR for <5 years, 0.385 [0.053-2.814]; P = .35).

CONCLUSIONS

Higher incidence of IgA nephropathy and FSGS in renal allograft was observed in living-related donor kidney transplantation compared with deceased donor kidney transplantation. De novo or recurrent IgA nephropathy and FSGS impaired long-term renal allograft survival.

Security analysis of a double-image encryption technique based on an asymmetric algorithm

In this paper, we evaluate the security of a double-image encryption technique based on an asymmetric algorithm. Compared with traditional cryptosystems based on a phase-truncated Fourier transform, the technique is able to improve the security of the encryption by combining a joint transform correlator; consequently, the encryption scheme is immune to some common attacks. We propose a special attack based on a phase retrieval algorithm with median filtering and normalization operation to break the cryptosystem. Low key sensitivity of a position parameter set has been found and an additional constraint is utilized to improve the attack to simplify the process and further decrease the computational time. Numerical simulation results show that the cryptosystem is vulnerable to the proposed special attack.