Visual PET/CT scoring of mesenteric fdg uptake to differentiate between tuberculous peritonitis and peritoneal carcinomatosis

PURPOSE

We aimed to differentiate tuberculous peritonitis (TBP) from peritoneal carcinomatosis (PC) using a visual positron-emission tomography/computed tomography (PET/CT) scoring system based on mesenteric fluorodeoxyglucose (FDG) uptake.

METHODS

PET/CT scans from 31 patients with TBP and 92 patients with PC were retrospectively reviewed. A visual PET/CT scoring system for mesenteric FDG uptake was used according to the following characteristics: FDG uptake intensity (low = 0, moderate = 1, high = 2), FDG uptake deposits (uniform = 0, irregular = 1, ascitic = 2), FDG uptake focality (diffuse = 0, segmental = 1, focal = 2), nodularity on the corresponding CT (nonnodular = 0, micronodular = 1, macronodular = 2) and mesenteric lymphadenopathy (absent = 0, lymphadenopathy without FDG uptake = 1, lymphadenopathy with FDG uptake = 2). The FDG uptake intensity, deposits, focality, nodularity and mesenteric lymphadenopathy scores between TBP and PC were compared using chi-square tests. The diagnostic performance of this scoring system for differentiating TBP from PC was analyzed using a receiver operating characteristic (ROC) curve. P < 0.05 was considered statistically significant.

RESULTS

Twenty-four patients with TBP (77.4%) and 56 patients with PC (60.9%) had mesenteric FDG uptake (P = 0.095) and were included for evaluation with the visual PET/CT scoring system. PC lesions scored higher than TBP lesions in FDG uptake deposits (P < 0.001), focality (P < 0.001) and nodularity (P < 0.001). No significant differences were observed between PC and TBP lesions in FDG uptake intensity (P = 0.396) and lymphadenopathy (P = 0.074). The total score that combined deposits, focality and nodularity had significant value for differentiating TBP from PC (area under the curve (AUC) = 0.869, P < 0.001), and a cutoff > 1 had a sensitivity (the accuracy for diagnosis of PC) of 80.4% and a specificity (the accuracy for diagnosis of TBP) of 75.0%.

CONCLUSION

A visual PET/CT scoring system based on mesenteric FDG uptake performed well in differentiating between TBP and PC.

Magnetic glassy state at low spin state of Co3+ in EuBaCo2O5+δ (δ = 0.47) cobaltite

The magnetic glassy state is a fascinating phenomenon, which results from the kinetic arrest of the first order magnetic phase transition. Interesting properties, such as metastable magnetization and nonequilibrium magnetic phases, are naturally developed in the magnetic glassy state. Here, we report magnetic glass property in the low spin state of Co³⁺ in EuBaCo₂O_5+δ (δ  =  0.47) cobaltite at low temperature (T  <  60 K). The measurements of magnetization under the cooling and heating in unequal fields, magnetization relaxation and thermal cycling of magnetization show the kinetic arrest of low magnetization state below 60 K. The kinetically arrested low temperature magnetic phase is further supported through the study of isothermal magnetic entropy, which shows the significant entropy change. The present results will open a new window to search the microscopic relation between the spin state transitions and the kinetic arrest induced magnetic glassy phenomena in complex materials.

[Correlative factors of sigmoid sinus diverticulum formation in individuals without pulsatile tinnitus based on CT angiography]

Objective: To analyze the correlative factors of sigmoid sinus diverticulum(SSD) formation in individuals without pulsatile tinnitus based on computed tomography angiography (CTA). Methods: A hospital-based 1∶2 matched case-control study was performed on 42 cases with unilateral SSD and 84 controls for age, gender, and side-matched in Beijing Friendship Hospital affiliated to the Capital Medical University from January 2018 to December 2018.The signs including sigmoid sinus wall dehiscence, venous outflow dominance, transverse sinus stenosis, high jugular bulb, large emissary veins, degree of mastoid pneumatization (grade Ⅰ-Ⅳ) and empty sella, were detected and analyzed. Results: In SSD group and control group, there were statistically significant differences in the incidence of the sigmoid sinus wall dehiscence (66.7%(28/42) vs 19.0%(16/84)), ipsilateral transverse sinus stenosis on the dominant side of venous outflow (26.2%(11/42) vs 4.8%(4/84)), and empty sellae (19.0%(8/42) vs 7.1%(6/84))(all P<0.05).The degree of mastoid pneumatization was worse in SSD group (P<0.05). After stepwise logistic regression analysis,the sigmoid sinus wall dehiscence (P<0.01,OR=6.794,95%CI 2.530-18.245), ipsilateral transverse sinus stenosis on the dominant side (P=0.001, OR=13.293, 95%CI 2.841-62.194), and degree of mastoid pneumatization (P<0.01, OR=0.289, 95%CI 0.156-0.536) were found independently correlated with SSD. Conclusion: Sigmoid sinus wall dehiscence, ipsilateral transverse sinus stenosis on the dominant side of venous outflow and mastoid pneumatization may be some of the independent correlative factors of SSD.

[Investigation of treatment and analysis of prognostic risk on enterocutaneous fistula in China: a multicenter prospective study]

Objective: To investigate the diagnosis and treatment for enterocutaneous fistula (ECF) in China, and to explore the prognostic factors of ECF. Methods: A multi-center cross-sectional study was conducted based on the Registration System of Chinese Gastrointestinal Fistula and Intra-Abdominal Infections to collect the clinical data of ECF patients from 54 medical centers in 22 provinces/municipalities from January 1, 2018 to December 31, 2018. The clinical data included patient gender, age, length of hospital stay, intensive care unit (ICU) admission, underlying diseases, primary diseases, direct causes of ECF, location and type of ECF, complications, treatment and outcomes. All medical records were carefully filled in by the attending physicians, and then re-examined by more than two specialists. The diagnosis of ECF was based on the clinical manifestations, laboratory/imaging findings and intraoperative exploration. Results: A total of 1521 patients with ECF were enrolled, including 1099 males and 422 females, with a median age of 55 years. The top three primary diseases of ECF were malignant tumors in 626 cases (41.2%, including 540 gastrointestinal tumors, accounting for 86.3% of malignant tumors), gastrointestinal ulcers and perforations in 202 cases (13.3%), and trauma in 157 cases (10.3%). The direct causes of ECF were mainly surgical operation in 1194 cases (78.5%), followed by trauma in 156 (10.3%), spontaneous fistula due to Crohn's disease in 92 (6.0%), radiation intestinal injury in 41 (2.7%), severe pancreatitis in 20 (1.3%), endoscopic treatment in 13 (0.9%) and 5 cases (0.3%) of unknown reasons. All the patients were divided into three groups: 1350 cases (88.7%) with simple ECF, 150 (9.9%) with multiple ECF, and 21 (1.4%) with combined internal fistula. Among the patients with simple ECF, 438 cases (28.8%) were jejuno-ileal fistula, 313 (20.6%) colon fistula, 170 (11.2%) rectal fistula, 111 (7.3%) duodenal fistula, 76 (5.0%) ileocecal fistula, 65 (4.3%) ileocolic anastomotic fistula, 55 (3.6%) duodenal stump fistula, 36 (2.4%) gastrointestinal anastomotic fistula, 36 (2.4%) esophagogastric/esophagojejunal anastomotic fistula, 29 (1.9%) gastric fistula and 21 (1.4%) cholangiopancreatiointestinal. Among all the simple ECF patients, 991 were tubular fistula and 359 were labial fistula. A total of 1146 patients finished the treatment, of whom 1061 (92.6%) were healed (586 by surgery and 475 self-healing) and 85 (7.4%) died. A total of 1043 patients (91.0%) received nutritional support therapy, and 77 (6.7%) received fistuloclysis. Infectious source control procedures were applied to 1042 patients, including 711 (62.0%) with active lavage and drainage and 331 (28.9%) with passive drainage. Among them, 841 patients (73.4%) underwent minimally invasive procedures of infectious source control (replacement of drainage tube through sinus tract, puncture drainage, etc.), 201 (17.5%) underwent laparotomy drainage, while 104 (9.1%) did not undergo any drainage measures. A total of 610 patients (53.2%) received definitive operation, 24 patients died within postoperative 30-day with mortality of 3.9% (24/610), 69 (11.3%) developed surgical site infection (SSI), and 24 (3.9%) had a relapse of fistula. The highest cure rate was achieved in ileocecal fistula (100%), followed by rectal fistula (96.2%, 128/133) and duodenal stump fistula (95.7%,44/46). The highest mortality was found in combined internal fistula (3/12) and no death in ileocecal fistula. Univariate prognostic analysis showed that primary diseases as Crohn's disease (χ(2)=6.570, P=0.010) and appendicitis/appendiceal abscess (P=0.012), intestinal fistula combining with internal fistula (χ(2)=5.460, P=0.019), multiple ECF (χ(2)=7.135, P=0.008), esophagogastric / esophagojejunal anastomotic fistula (χ(2)=9.501, P=0.002), ECF at ileocecal junction (P=0.012), non-drainage/passive drainage before the diagnosis of intestinal fistula (χ(2)=9.688, P=0.008), non-drainage/passive drainage after the diagnosis of intestinal fistula (χ(2)=9.711, P=0.008), complicating with multiple organ dysfunction syndrome (MODS) (χ(2)=179.699, P<0.001), sepsis (χ(2)=211.851, P<0.001), hemorrhage (χ(2)=85.300, P<0.001), pulmonary infection (χ(2)=60.096, P<0.001), catheter-associated infection (χ(2)=10.617, P=0.001) and malnutrition (χ(2)=21.199, P<0.001) were associated with mortality. Multivariate prognostic analysis cofirmed that sepsis (OR=7.103, 95%CI:3.694-13.657, P<0.001), complicating with MODS (OR=5.018, 95%CI:2.170-11.604, P<0.001), and hemorrhage (OR=4.703, 95%CI: 2.300-9.618, P<0.001) were independent risk factors of the death for ECF patients. Meanwhile, active lavage and drainage after the definite ECF diagnosis was the protective factor (OR=0.223, 95%CI: 0.067-0.745, P=0.015). Conclusions: The overall mortality of ECF is still high. Surgical operation is the most common cause of ECF. Complications e.g. sepsis, MODS, hemorrhage, and catheter-associated infection, are the main causes of death. Active lavage and drainage is important to improve the prognosis of ECF.

Cloning, expression and activity of ATP-binding protein in Bacillus thuringiensis toxicity modulation against Aedes aegypti

Background

Bacillus thuringiensis israelensis (Bti) is a widely used mosquitocidal microbial pesticide due to its high toxicity. ATP-binding proteins (ABP) are prevalently detected in insects and are related to reaction against Bti toxins. However, the function of ABP in mosquito biocontrol is little known, especially in Aedes aegypti. Therefore, this study aimed to clarify the function of ABP in Ae. aegypti against Bti toxin.

Results

Aedes aegypti ABP (GenBank: XM_001661856.2) was cloned, expressed and purified in this study. Far-western blotting and ELISA were also carried out to confirm the interaction between ABP and Cry11Aa. A bioassay of Cry11Aa was performed both in the presence and absence of ABP, which showed that the mortality of Ae. aegypti is increased with an increase in ABP.

Conclusions

Our results suggest that ABP in Ae. aegypti can modulate the toxicity of Cry11Aa toxin to mosquitoes by binding to Bti toxin. This could not only enrich the mechanism of Bt toxin, but also provide more data for the biocontrol of this transmission vector.

Metagenomic analysis reveals the effects of long-term antibiotic pressure on sludge anaerobic digestion and antimicrobial resistance risk

Continuous stirred-tank digesters with tetracyclines and sulfonamides were operated to investigate the impacts of antibiotic pressure on sludge anaerobic digestion. The versatile methanogen Methanosarcinales and strictly hydrogenotrophic methanogen Methanobacteriales increased and decreased by 21.1% and 10.9% under antibiotic pressure, respectively. KEGG analysis revealed that hydrogenotrophic and acetoclastic methanogenesis pathways were all affected. The decrease in abundance of function genes involved in lipid metabolism, carbohydrate metabolism, and fatty acid degradation, would lead to a reduction in methane production by 25%. Network analysis indicated positive associations among tetracycline residuals, abundance of resistance genes (ARGs), and specific member of potential hosts. Over 1000 ARG subtypes were widely detected in sludge, including macrolide (28%), tetracycline (24%), fluoroquinolone (20%), and peptide (20%) resistance genes. AD process exposed to long-term antibiotic would increase the diversity and abundance of ARG, enhance the association of ARG with specific microbes, and select bacteria able to perform chemotaxis mechanism.

Effect of virtual reality on balance and gait ability in patients with Parkinson's disease: a systematic review and meta-analysis

OBJECTIVE

The aim of this study was to evaluate the effectiveness of virtual reality interventions for improving balance and gait in people with Parkinson's disease.

DESIGN

This is a systematic review and meta-analysis of randomized controlled trials.

METHODS

Databases of MEDLINE, Cochran Central Register of Controlled Trials, EMBASE, PEDro, Web of Science and China Biology Medicine disc were searched from their inception up to 1 March 2019. Two reviewers individually appraised literatures for inclusion, extracted data and evaluated trial quality.

RESULTS

A total of 12 studies with a median PEDro score of 6.4 and involving 419 participants were included. This review first demonstrated significant improvements in Berg Balance Scale (mean difference = 2.69; 95% confidence interval = 1.37 to 4.02; p < 0.0001), Timed Up and Go Test (mean difference = -2.86; 95% confidence interval = -5.60 to -0.12; p = 0.04) and stride length (mean difference = 9.65; 95% confidence interval = 4.31 to 14.98; p = 0.0004) in Parkinson patients who received virtual reality compared with controls. However, there was no significant difference in gait velocity and walk distance.

CONCLUSION

This systematic review and meta-analysis supports the use of virtual reality to enhance the balance of patients with Parkinson's disease. However, the review does not find any definite effect upon gait by the use of virtual reality.

Sludge anaerobic digestion with high concentrations of tetracyclines and sulfonamides: Dynamics of microbial communities and change of antibiotic resistance genes

This study established two mesophilic anaerobic digesters to ascertain the microbial dynamics and variation characteristics of antibiotic resistance genes (ARGs) during sludge anaerobic digestion (AD) with high concentration of antibiotics. System parameters, microbial community, ARGs (tetA, tetM, tetW, sulI, sulII) and integrase gene of class 1 (intI1) were analyzed. General performance of AD showed methane production was inhibited by 17.1% under the pressure of antibiotics. Microbial 16S rRNA high-throughput sequencing results showed the richness of microbial community decreased, but a higher diversity was found with antibiotics added. Furthermore, microbial community structure at genus level was significantly changed. Real-time quantitative PCR of several target genes demonstrated that the adjunction of high concentration of antibiotics exerted a significant induction influence on ARGs, however, the abundance of intI1 decreased observably. Correlation analysis showed intI1 only played a small role in ARGs' transfer during AD, change of potential hosts was the key factor instead.

[Multicenter investigation of extracorporeal membrane oxygenation application in pediatric intensive care unit in China]

Objective: To survey the conduction and evaluate the effectiveness of extracorporeal membrane oxygenation (ECMO) therapy in pediatric intensive care unit (PICU) in China mainland. Methods: In a questionnaire-based survey, we retrospectively reviewed the application of ECMO in children's hospital and general hospital in China mainland to summarize and analyze the categories of diseases and prognosis of children treated with ECMO therapy. Results: By December 31, 2017, a total of 23 hospitals using ECMO, including 22 tertiary referral hospitals and 1 secondary hospital, among which 16 were children's hospitals and 7 were general hospitals. Thirty-seven ECMO equipment was available. A total of 518 patients treated with ECMO, within whom 323 (62.4%) successfully weaned from ECMO and 262 (50.6%) survived to discharge. Among 375 pediatric patients, 233 (62.1%) were successfully weaned from ECMO and 186 (49.6%) survived to discharge. Among 143 newborn patients, 90 (62.9%) successfully weaned from ECMO, 76 (53.1%) survived to discharge. ECMO was applied in veno-arterial (VA) mode to 501 (96.7%) patients, veno-venous (VV) mode to 14 (2.7%) patients, and VV-VA conversion mode to 3 (0.6%) patients. Sixty-nine patients required extracorporeal cardiopulmonary resuscitation (ECPR), including 20 newborn patients (29.0%) and 38 pediatric patients (71.0%), who were all with cardiovascular disease. Neonatal respiratory distress syndrome (26/61), persistent pulmonary hypertension of the newborn (PPHN) (12/61), and meconium aspiration syndrome (MAS) (11/61) are the most common pulmonary diseases in newborn patients; among whom, infants with PPHN had highest survival rate (10/12), followed by MAS (9/11). Among newborn patients with cardiovascular diseases, those who admitted were after surgery for congenital cardiac disease were the most common (54/82), while those with septic shock had the highest survival rate (2/3). In pediatric pulmonary diseases, acute respiratory distress syndrome was the most common (42/93), while plastic bronchitis was with the highest survival rate (4/4), followed by viral pneumonia (13/16). Among pediatric cardiovascular diseases, congenital cardiac defect was the most common (124/282), while fulminant myocarditis had the highest survival rate (54/77). Conclusion: The application of ECMO as a rescue therapy for children with severe cardiopulmonary failure has dramatically developed in China mainland.

[Comparative study on the display ability of CBCT and MSCT in vestibular aqueduct]

Objective: To compare the ability and visibility of cone-beam CT and MSCT in showing vestibular aqueduct. Methods: An experimental anatomical study which from June 2017 to August 2017 was performed on 76 temporal bones from 38 human cadavers with unknown clinical history. They all underwent CBCT and MSCT and all images were unified and standardized. The standard position was oblique sagital reconstruction.The length of the vestibular aqueduct, the midpoint and the external aperture width were measured on the standard position. The internal aperture, isthmus and proximal portion of the vestibular aqueduct on the images of the two kinds of equipment were evaluated. The measurement results of the two devices and image quality of the vestibular aqueduct were compared. Results: There was no significant statistical difference between the results of the measurement of CBCT and MSCT(P>0.05). In CBCT images, the total display rate of internal aperture was 77.6%(59/76), and the clearly display rate was 81.4%(48/59). The total display rate of the proximal portion of vestibular aqueduct was 57.0%(45/79), and the clearly display rate was 60.0%(27/45). The total display rate of isthmus of vestibular aqueduct was 59.2%(45/76), and the clearly display rate was 60.0%(27/45). In MSCT images, the total display rate of was 46.1%(35/76), and the clearly display rate was 60.0%(21/35). The total display rate of 5 of the proximal portion of vestibular aqueduct was 56.6%(43/76), the clearly display rate was 46.5%(20/43). The total display rate of isthmus of vestibular aqueduct was 68.4%(52/76), and the clear display rate 36.5%(19/52). There was significant statistical difference between the CBCT and the MSCT (P<0.05) in displaying of internal aperture of vestibular aqueduct. Conclusion: Compared with MSCT, the image of vestibular aqueduct obtained by CBCT can meet the diagnostic requirements and CBCT have better visibility in showing some subtle structures of vestibular aqueduct than MSCT.

[The correlation between CT score of lung injury and oxygenation index in patients with acute hydrogen sulphide poisoning]

Objective: To explore correlation between chest CT score and oxygenation index in patients with acute hydrogen sulphide poisoning, whether CT score can be applied to assess acute lung injury after acute hydrogen sulfide poisoning and provide basis and reference. Methods: The clinic and a series of CT datas of 32 acute hydrogen sulphide poisoning cases were retrospectively analysed and compared, According to GBZ31-2002 (the diagnostic standard of occupational H(2)S acute poisoning) , these patients were divided into 2 grouds including moderate groud and severe groud; The CT score were improved, referenceing the scoring criteria of the chest X-ray; The difference of the CT score and the oxygenation index were analyzed between moderate and severe group in the acute phase and the disperse phase; The correlation between CT score and oxygenation index were analyzed. Results: The CT score in moderate poisoning group were lower than severe group (2.26±1.37 vs 10.44±2.55, 1.34±0.65 vs 4.55±2.45, all P<0.05) in the acute phase and the dissipation phase.The oxygen index of the 19 cases in the acute phase were 307.55±28.29, and the oxygen index of the 8 cases in the dissipation phase was 435.75±37.00; The oxygen index of the 9 cases in the acute phase and the dissipation phase were respectively 193.17±36.41, 347.67±44.49. The oxygen partial pressure and oxygenation index in severe group were significantly lower than those in moderate group (all P<0.01) in the acute phase and the dissipation phase. Pearman correlation analysis showed that the CT score were negatively correlated to the oxygen index in the acute phase and the dissipation phase, respectively (r=-0.97、-0.75, all P<0.01) . Conclusions: The CT score of lung injury and oxygenation index is negatively correlated. The CT score can be used to evaluate the degree of lung injury, and can be used in the evaluation of acute lung injury after acute hydrogen sulfide poisoning.

Organic loading rate and hydraulic retention time shape distinct ecological networks of anaerobic digestion related microbiome

Understanding of how anaerobic digestion (AD)-related microbiomes are constructed by operational parameters or their interactions within the biochemical process is limited. Using high-throughput sequencing and molecular ecological network analysis, this study shows the succession of AD-related microbiome hosting diverse members of the phylum Actinobacteria, Bacteroidetes, Euryarchaeota, and Firmicutes, which were affected by organic loading rate (OLR) and hydraulic retention time (HRT). OLR formed finer microbial network modules than HRT (12 vs. 6), suggesting the further subdivision of functional components. Biomarkers were also identified in OLR or HRT groups (e.g. the family Actinomycetaceae, Methanosaetaceae and Aminiphilaceae). The most pair-wise link between Firmicutes and biogas production indicates the keystone members based on network features can be considered as markers in the regulation of AD. A set of 40% species ("core microbiome") were similar across different digesters. Such noteworthy overlap of microbiomes indicates they are generalists in maintaining the ecological stability of digesters.

Clinical significance of fibrotic, haemostatic and endotoxic changes in patients with liver cirrhosis

BACKGROUND AND STUDY AIMS

To investigate the relationship among fibrotic, haemostatic and endotoxic changes in patients with different degrees of liver cirrhosis.

PATIENTS AND METHODS

Liver fibrotic markers, including hyaluronic acid (HA), Ccollagen IV (Col-IV), laminin (LN), and N-terminal pro-peptide of collagen type III (PIIINP), were determined by radioimmunoassay. A series of haemostatic tests, including prothrombin time (PT), international normalized ratio, activated partial thromboplastin time, antithrombin-III, thrombin time, fibrinogen, fibrin(ogen) degradation product and D-dimer were determined using an automatic coagulation analyszer. Plasma levels of endotoxin were detected quantitatively using an endotoxin detection kit. Correlation analysis of the data was performed.

RESULTS

Based on Child-Pugh classification, statistically significant differences in fibrotic markers and haemostatic parameters were found in 249 patients with liver cirrhosis, while no significant differences in endotoxin levels were observed. Based on ascites classification, statistically significant differences in fibrotic markers (such as HA, Col-IV and PIIINP, except for LN) and haemostatic parameters were found. As for endotoxin levels, there were significant differences between the ascites, spontaneous bacterial peritonitis (SBP) and no-ascites groups, while no significant differences were observed between the ascites and SBP groups. Correlation analysis demonstrated some correlation among fibrotic markers, haemostatic parameters and endotoxin.

CONCLUSIONS

A close relationship exists between the severity of cirrhosis and fibrotic changes, as well as haemostatic changes. Endotoxin may be an important contributing factor to the development of ascites in cirrhosis. Some correlation may exist between fibrosis, haemostatic and endotoxin.

Experimental Evidence of Kinetic Effects in Indirect-Drive Inertial Confinement Fusion Hohlraums

We present the first experimental evidence supported by simulations of kinetic effects launched in the interpenetration layer between the laser-driven hohlraum plasma bubbles and the corona plasma of the compressed pellet at the Shenguang-III prototype laser facility. Solid plastic capsules were coated with carbon-deuterium layers; as the implosion neutron yield is quenched, DD fusion yield from the corona plasma provides a direct measure of the kinetic effects inside the hohlraum. An anomalous large energy spread of the DD neutron signal (∼282  keV) and anomalous scaling of the neutron yield with the thickness of the carbon-deuterium layers cannot be explained by the hydrodynamic mechanisms. Instead, these results can be attributed to kinetic shocks that arise in the hohlraum-wall-ablator interpenetration region, which result in efficient acceleration of the deuterons (∼28.8  J, 0.45% of the total input laser energy). These studies provide novel insight into the interactions and dynamics of a vacuum hohlraum and near-vacuum hohlraum.

Continuous femoral nerve block and patient-controlled intravenous postoperative analgesia on Th1/Th2 in patients undergoing total knee arthroplasty

The purpose of this study is to observe and compare the effects of continuous femoral nerve block (cFNB) and patient-controlled intravenous analgesia (PCIA) on postoperative analgesia and Th1/Th2 in patients undergoing total knee arthroplasty (TKA). Forty-six TKA were selected and randomly divided into two groups: the cFNB group and PCIA group. Patients in the two groups all underwent general anesthesia using a laryngeal mask. In the cFNB group, the femoral nerve block and catheterization were performed after induction of general anesthesia: 0.375% ropivacaine hydrochloride with a 20 mL loading dose was provided. After the end of the operation, the electronically controlled analgesia pump was connected. In the PCIA group, fentanyl with a 0.05 mg loading dose was provided and the electronic controlled analgesia pump was connected at the end of the operation. Venous blood was collected before anesthesia (T0), 1 h postoperatively (T1), 24 h postoperatively (T2) and 48 h postoperatively (T3). Th1/Th2 was calculated and analyzed by flow cytometry, and other indexes of these time points were recorded. The results show that there was no significant difference between the two groups regarding changes in blood pressure, heart rate and postoperative sedation Ramsay score. There was no significant difference in Th1 percentages (Th1%), Th2 percentages (Th2%) and ratios of Th1-to-Th2 (Th1/Th2) between the two groups at T0, T1 and T2 (P>0.05), while the Th1%, Th2% and Th1/Th2 of the PCIA group were lower than those of the cFNB group at T3 (P less than 0.05). It was concluded that cFNB represents a better postoperative analgesia for patients than PCIA, and has a lesser effect on Th1/Th2 balance, which can improve the outcome of patients.

Rapid startup of thermophilic anaerobic digester to remove tetracycline and sulfonamides resistance genes from sewage sludge

Spread of antibiotic resistance genes (ARGs) originating from sewage sludge is highlighted as an eminent health threat. This study established a thermophilic anaerobic digester using one-step startup strategy to quickly remove tetracycline and sulfonamides resistance genes from sewage sludge. At least 20days were saved in the startup period from mesophilic to thermophilic condition. Based on the results of 16S rDNA amplicons sequencing and predicted metagenomic method, the successful startup largely relied on the fast colonization of core thermophilic microbial population (e.g. Firmicutes, Proteobacteria, Actinobacteria). Microbial metabolic gene pathways for substrate degradation and methane production was also increased by one-step mode. In addition, real-time quantitative PCR approach revealed that most targeted tetracycline and sulfonamides resistance genes ARGs (sulI, tetA, tetO, tetX) were substantially removed during thermophilic digestion (removal efficiency>80%). Network analysis showed that the elimination of ARGs was attributed to the decline of their horizontal (intI1 item) and vertical (potential hosts) transfer-related elements under high-temperature. This research demonstrated that rapid startup thermophilic anaerobic digestion of wastewater solids would be a suitable technology for reducing quantities of various ARGs.

Intranasal Lactoferrin Enhances α-Secretase-Dependent Amyloid Precursor Protein Processing via the ERK1/2-CREB and HIF-1α Pathways in an Alzheimer's Disease Mouse Model

Growing evidence suggests that lactoferrin (Lf), an iron-binding glycoprotein, is a pleiotropic functional nutrient. In addition, Lf was recently implicated as a neuroprotective agent. These properties make Lf a valuable therapeutic candidate for the treatment of Alzheimer's disease (AD). However, the mechanisms regulating the physiological roles of Lf in the pathologic condition of AD remain unknown. In the present study, an APPswe/PS1DE9 transgenic mouse model of AD was used. We explored whether intranasal human Lf (hLf) administration could reduce β-amyloid (Aβ) deposition and ameliorate cognitive decline in this AD model. We found that hLf promoted the non-amyloidogenic metabolism of amyloid precursor protein (APP) processing through activation of α-secretase a-disintegrin and metalloprotease10 (ADAM10), resulting in enhanced cleavage of the α-COOH-terminal fragment of APP and the corresponding elevation of the NH2-terminal APP product, soluble APP-α (sAPPα), which consequently reduced Aβ generation and improved spatial cognitive learning ability in AD mice. To gain insight into the molecular mechanism by which Lf modulates APP processing, we evaluated the involvement of the critical molecules for APP cleavage and the signaling pathways in N2a cells stably transfected with Swedish mutant human APP (APPsw N2a cells). The results show that the ERK1/2-CREB and HIF-1α signaling pathways were activated by hLf treatment, which is responsible for the expression of induced ADAM10. Additional tests were performed before suggesting the potential use of hLf as an antioxidant and anti-inflammatory. These findings provide new insights into the sources and mechanisms by which hLf inhibits the cognitive decline that occurs in AD via activation of ADAM10 expression in an ERK1/2-CREB and HIF-1α-dependent manner.

Depth-resolved microbial community analyses in the anaerobic co-digester of dewatered sewage sludge with food waste

This study evaluated the impacts of FW addition on co-digestion in terms of microbial community. Anaerobic co-digestion (AcoD) reactors were conducted at gradually increased addition of food waste (FW) from 0 to 4kg-VSm^-3d^-1 for 220days. Although no markable acidification was found at an OLR of 4kg-VSm^-3d^-1, the unhealthy operation was observed in aspect of an inhibited methane yield (185mLg^-1VS_added), which was restricted by 40% when compared with its peak value. Deterioration of digestion process was timely indicated by the dramatic decrease of archaeal population and microbial biodiversity. Furthermore, the cooperation network showed a considerable number of rare species (<1%) were strongly correlated with methane production, which were frequently overlooked due to the limits of detecting resolution or analysis methods before. Advances in the analysis of sensitive microbial community enable us to detect the early disturbances in AcoD reactors.

IncRNA H19 promotes tongue squamous cell carcinoma progression through β-catenin/GSK3β/EMT signaling via association with EZH2

H19 is involved in tumor metastasis and associated with tumor progression. Enhancer of zest homolog 2 (EZH2) is overexpressed in multiple cancer types and correlates with tumor proliferation, epithelial-mesenchymal transition, and poor prognosis. However, the interaction between H19 and EZH2 to promote tongue squamous cell carcinoma (TSCC) progression remains largely uncharacterized. Insitu hybridization and quantitative reverse-transcription PCR (qRT-PCR) were performed to measure H19 expression in primary TSCC and adjacent normal tissues and cell lines. EZH2 expression was determined by immunohistochemistry in matched primary TSCC and adjacent normal tissues. The correlation between H19 and EZH2 expression and clinicopathological characteristics were analyzed. The roles of H19 in cell proliferation, apoptosis, and invasion were analyzed using a H19-targeted lentivirus. Western blot and qRT-PCR were carried out to detect downstream signal pathway changes. Expression levels of downstream signaling proteins in primary TSCC tissues and adjacent normal tissues were analyzed by immunohistochemistry. H19 and EZH2 were upregulated in TSCC tissues compared to matched normal tissues, and significantly correlated with WHO grade, lymph node metastasis, and poor prognosis. H19 silencing attenuated cell proliferation, apoptosis, and invasion in vitro. H19 knockdown inhibited the activation of β-catenin/GSK-3β/cyclin D1/c-myc, upregulated E-cadherin and zonula occludens-1 (ZO-1), and inhibited N-cadherin, vimentin, Snail1, Twist1, and ZEB1. Silencing H19 expression also inhibited tumor progression and lung metastasis in an animal model. Our findings indicate that H19 promotes TSCC progression through association with EZH2, and affects downstream β-Catenin/GSK3β/EMT signaling, suggesting that H19 inhibition might be a potential target for the treatment of TSCC.

Sensitive and rapid detection of Pectobacterium atrosepticum by targeting the gyrB gene using a real-time loop-mediated isothermal amplification assay

This study reports the development of a real-time, loop-mediated isothermal amplification (RealAmp) assay for the detection of Pectobacterium atrosepticum (P. atrosepticum). A phylogenetic tree was constructed based on the gyrB gene of P. atrosepticum and related species. Pectobacterium atrosepticum from different sources can be clustered in the same branch with 100% support rate. The RealAmp primers targeting the gyrB gene of P. atrosepticum worked most efficiently at 61·0°C. Compared with 55 related bacterial strains, the eight P. atrosepticum strains displayed positive reaction in the RealAmp assay. The melting temperature (Tm) of P. atrosepticum amplified products was about 85·0°C. The detection limit of the RealAmp assay for the detection of P. atrosepticum in pure culture was approx. 3 CFU reaction(-1) . The detection limit of the RealAmp assay for the detection of P. atrosepticum in artificially contaminated samples was 22 CFU reaction(-1) . The detection rate of the RealAmp assay for the detection of potato tubers was 28·5-32·0% higher than that of the conventional PCR. In summary, a specific, sensitive and rapid RealAmp assay based on the gyrB gene of P. atrosepticum, which can be easily performed and real-time monitored, was established.

SIGNIFICANCE AND IMPACT OF THE STUDY

Potato blackleg caused by Pectobacterium atrosepticum (P. atrosepticum) which is mainly transmitted through the seed potato leads to the decline in potato production. To reduce yield loss, rapid detection of P. atrosepticum in seed potato remains essential. Based on the gyrB gene of P. atrosepticum, species-specific primers were designed. A real-time, loop-mediated isothermal amplification (RealAmp) assay was established for the detection of P. atrosepticum. The RealAmp assay is a specific, rapid and sensitive method for P. atrosepticum detection. Therefore, it provides an effective diagnosis of potato blackleg in both the growing and stored potato.

Developing an Integrated Modeling Tool for River Water Quality Index Assessment

  The goal of this study was to establish a modeling tool for river water quality with a direct linkage to the water quality index (WQI5) calculation and the river water quality model, the Water Quality Analysis Simulation Program (WASP), for pollutant transport modeling. The integrated WASP and WQI5 tool was field-tested to assess pollutant loadings and their impacts on river environment. Suspended solid (SS) and electric conductivity (EC) correlation equations and the WQI5 calculation tool were included in the water quality model and direct WQI5 calculation. The SS concentration, which was influenced by river flows, had crucial effects on river water quality and WQI5 values. EC value was controlled by dissolution of soil minerals, which was affected by the watershed drainage area and surface runoff. The integrated system could establish a direct correlation for river water quality, river flow, and WQI5.

[Effect of trichostatin A on the osteogenic differentiation potential of periodontal ligament stem cells in inflammatory microenvironment induced by tumor necrosis factor-α stimulation]

OBJECTIVE

To compare the expression of histone deacetylase(HDAC)1-11 of human periodontal ligament stem cells(PDLSC)in normal and inflammatory microenvironments, and to investigate the effect of histone deacetylase inhibitor trichostatin A(TSA)on the osteogenic differentiation potential of PDLSC in inflammatory microenvironment induced by tumor necrosis factor-α(TNF-α)stimulation.

METHODS

PDLSC were isolated from periodontal ligament tissues obtained from the surgically extracted human teeth and cultured by single-colony selection. The expression of HDAC1-11 in cells with or without TNF-α(10 μg/L)stimulation was evaluated by quantitative real time-PCR(RT-PCR). The effect of TSA on cell proliferation was investigated by methyl thiazolyl tetrazolium(MTT)assay. The influence of TSA on osteogenic differentiation of PDLSC in inflammatory microenvironment with TNF-α stimulation was assessed by alizarin red staining, quantitative RT-PCR and Western blotting, respectively.

RESULTS

The expression of HDAC in PDLSC with TNF-α stimulation was significantly higher than that in normal PDLSC(P<0.05)(except HDAC7, P=0.243). TSA had no significant effect on PDLSC proliferation at the concentration of 50 nmol/L(P=0.232). The alizarin red staining showed that PDLSC in TNF-α group generated less mineralized nodule than the control group, while the cell matrix mineralization in TSA group was improved obviously. TNF-α had an inhibitory effect on the expression of osteogenesis related genes, runt-related transcription factor-2(RUNX2)and alkaline phosphatase(ALP), with relative gene expression ratio(experimental/control)decreased to 0.17 ± 0.02 and 0.32 ± 0.03, while TSA could significantly increase the genes' expression to 0.67±0.03 and 0.89±0.02(P<0.01). Western blotting test showed that in TNF-α group the expression of osteogenesis related proteins was obviously reduced, and compared with the TNF-α group, TSA could significantly promote the expression of proteinsin inflammatory microenvironment.

CONCLUSIONS

PDLSC in inflammatory microenvironment by TNF-α stimulation had a higher expression of HDAC than that in normal conditions. TSA, as a histone deacetylase inhibitor, could significantly promote the osteogenic differentiation potential of PDLSC in inflammatory microenvironment by suppressing HDAC.

[Correlation Between LDI-based Land Use Types and Water Quality in Sanshan Island of Taihu Lake National Wetland Park, Suzhou]

Sanshan island of Taihu Lake National Wetland Park in Suzhou was taken as a case study to explore the relationship between land use types and water quality under different spatial and temporal conditions.Firstly,principal component analysis was used to calculate the comprehensive index of water quality for a given sampling site.Secondly,landscape development intensity index (LDI),which can represent combined effects of land use types,was calculated based on GIS spatial analysis technology.Finally,overall correlation between water quality and land use types was obtained by using Pearson correlation analysis.The results showed that the water quality varied with the spatial distribution of the wetland park.Totally,water quality of west region was good and water quality of east region was poor;Built-up land and water quality integrated index exhibited obvious positive correlation.And natural water and water quality index was significantly negatively correlated;By building relationship of water quality index and LDI index within 100,150,200,250,300,350,400,450 and 500 m radius buffer,Pearson's r values between them were 0.641,0.678,0.691,0.685,0.691,0.695,0.680,0.653 and 0.649 respectively (P<0.01).These statistics indicated obvious and stable overall correlation between land use types and water quality.This can reflect a variety of land use types' comprehensive effects on wetland water quality,and partly overcome the weakness of incomplete and difficult explanation for water quality changes with single type of land use.