Case Report: Surgical Therapy for Left Innominate Vein Aneurysm Under Thoracoscopy

Left innominate vein aneurysm is extremely rare, with a limited number of case reports present in the literature. Herein, we report a case of a 50-year-old female patient presenting with an incidental finding of an anterior mediastinal mass on chest radiography during a routine health examination. Contrast-enhanced computerized tomography (CT) of the chest showed a 4.8 × 4.6 cm anterior mediastinal mass with significant homogenous enhancement after injection of the contrast medium, suggesting a diagnosis of Castleman's disease, but not excluding thymoma. The patient underwent surgical resection of the anterior mediastinal mass under a thoracoscopic approach. Postoperative pathology confirmed the diagnosis of a left innominate vein aneurysm. This is the first case reporting a left innominate vein aneurysm resected under thoracoscopy. Despite this successful treatment experience, we need to emphasize that open thoracotomy or median sternotomy should be chosen as the first choice for surgeons who lack experience in thoracoscopic surgery, with the aim of avoiding intraoperative accidents.

Equine chorionic gonadotropin pretreatment 15 days before fixed-time artificial insemination improves the reproductive performance of replacement gilts

Fixed-time artificial insemination (FTAI) technology uses exogenous reproductive hormones to regulate the sexual cycle and ovulation of sows without oestrus identification, which improves the sow breeding utilisation rate, reduces the number of non-productive days, and elevates the efficiency of pig farm management. In this study, we aimed to optimise FTAI procedures. Healthy 190-day-old and about 90 kg Large White × Landrace crossing breed replacement gilts (n = 166) which were of unknown reproductive status were randomly selected and divided into three groups: a control group (n = 62), an eCG-15D group in which the gilts were pretreated with equine chorionic gonadotropin (eCG) injection 15 days before starting FTAI (n = 50), and an eCG-20D group pretreated with eCG injection 20 days before starting FTAI (n = 54). All three groups were then subjected to the same conventional FTAI procedure. Pigs were orally administered Altrenogest (ALT, 20 mg per pig per day) for 18 days and then 42 h after ALT feeding was stopped, they were injected with 1 000 IU eCG followed by 100 μg GnRH 80 h later. The gilts were inseminated for the first time 24 h after gonadotropin-releasing hormone (GnRH) injection and then again 16 h later. After 42 h of ALT feeding, gilts in the eCG-15D group displayed a higher follicular diameter until artificial insemination (AI) than those from the other groups (P < 0.05). In addition, the ovulation times were the most synchronised in the eCG-15D group, with 100% of the gilts ovulating before the second AI on day 25 of FTAI. Furthermore, the gilts in the eCG-15D group achieved the highest pregnancy rate (92%), farrowing rate (90%), total pigs born (11.59), and pigs born alive (11.18). Together, the findings of this study demonstrate that reproductive performance can be optimised by pretreating gilts with eCG 15 days before conventional FTAI.

A modified approach of portaccess lymphadectomy for locally advanced nonsmall cell lung cancer: A single center experience

OBJECTIVES

Systematic nodal dissection (SND) is an important component of locally advanced non-small cell lung cancer (NSCLC), but modification of this procedure is rarely reported. In this paper, we reported a modified technique of systematic mediastinal lymph node dissection (MLND) of operable lung cancer by video-assisted thoracic surgery (VATS). Parallel upward dissection (the PUD technique) was named due to this modification and the efficacy of the PUD technique was evaluated as well.

METHODS

We summarized the tips of the PUD technique and its version was updated in surgical aspect. The design and procedure sequence of the PUD technique were introduced in detail as well as its pros and cons. A retrospective study was performed on 998 cases of locally advanced NSCLC which accepted the PUD procedure in Department of Thoracic Surgery, Second Xiangya Hospital, Central South University, from 2012 to 2020. The perioperative mortality and the incidence of general and serious complications (such as recurrent laryngeal nerve injury, bronchopleural fistula) were analyzed.

RESULTS

All the 998 cases were operated successfully with the PUD technique and few post-operation complications were found. There was no perioperative mortality and severe complication such as recurrent laryngeal nerve injury and bronchopleural fistula.

CONCLUSIONS

The PUD technique is safe and convenient and it can be a good supplement to the existing surgical techniques for locally advanced lung cancer.

Decreased IL-6 and NK Cells in Early-Stage Lung Adenocarcinoma Presenting as Ground-Glass Opacity

Background

Lung ground-glass opacities (GGOs) are an early manifestation of lung adenocarcinoma. It is of great value to study the changes in the immune microenvironment of GGO to elucidate the occurrence and evolution of early lung adenocarcinoma. Although the changes of IL-6 and NK cells in lung adenocarcinoma have caught global attention, we have little appreciation for how IL-6 and NK cells in the lung GGO affect the progression of early lung adenocarcinoma.

Methods

We analyzed the RNA sequencing data of surgical specimens from 21 patients with GGO-featured primary lung adenocarcinoma and verified the changes in the expression of IL-6 and other important immune molecules in the TCGA and GEO databases. Next, we used flow cytometry to detect the protein expression levels of important Th1/Th2 cytokines in GGO and normal lung tissues and the changes in the composition ratio of tumor infiltrating lymphocytes (TILs). Then, we analyzed the effect of IL-6 on NK cells through organoid culture and immunofluorescence. Finally, we explored the changes of related molecules and pathway might be involved.

Results

IL-6 may play an important role in the tumor microenvironment of early lung adenocarcinoma. Further research confirmed that the decrease of IL-6 in GGO tissue is consistent with the changes in NK cells, and there seems to be a correlation between these two phenomena.

Conclusion

The IL-6 expression status and NK cell levels of early lung adenocarcinoma as GGO are significantly reduced, and the stimulation of IL-6 can up-regulate or activate NK cells in GGO, providing new insights into the diagnosis and pathogenesis of early lung cancer.

Immune Microenvironment Signatures as Biomarkers to Predict Early Recurrence of Stage Ia-b Lung Cancer

Introduction

Approximately 30% of patients diagnosed with stage Ia-b NSCLC die of recurrent disease after surgery. This study aimed to identify immune-related biomarkers that might predict tumor recurrence in stage Ia-b NSCLC within 40 months after curative resection.

Methods

Gene expression data of stage Ia-b NSCLC samples was retrieved from the TCGA database, the GEO databases, and the Second Xiangya hospital (XXEYY) database. 22 types of tumors infiltrating immune cells and the expression of immune-associated genes were investigated using CIBERSORT, immunohistochemical staining, and GSEA analyses in a total of 450 patients (80 in the training cohort and 370 in the validation cohorts). Recurrence-related immune features were selected based on the LASSO Cox regression model.

Results

High density of Tregs, Macrophages M0 and M1 cell could be observed in recurrence group while the memory B cell was more frequently enriched in controls, yet Tregs alone was significantly associated with tumor early recurrence in TCGA cohort, XYEYY cohort and GSE37745 dataset. A handful of immune-related genes were identified in the recurrence group. Based on Lasso regression analysis, the expressions of five immune-related genes, RLTPR, SLFN13, MIR4500HG, HYDIN and TPRG1 were closely correlated with tumor early recurrence. In the training cohort (TCGA), the combination of these five genes has sensitivity and specificity of 85% and 85%, with AUC of 0.91 (95% CI 0.84-0.98) for lung cancer early recurrence prediction, whereas in validation cohorts, the sensitivity and specificity using this panel was 61-89% and 54-82%, with AUC of 0.62-0.84.

Conclusion

Our study demonstrated that the immune microenvironment signatures were closely related to tumor early recurrence. Compared to tumor-infiltrating lymphocytes, the expression of five immune-related genes could be robust biomarkers to predict early recurrence of stage Ia-b NSCLC after curative resection.

Metabolomics Changes of Serum and Tissues in Mice Died of Acute Tetracaine Poisoning

Abstract

Objective To study the changes of metabolites in serum and tissues （kidney, liver and heart） of mice died of acute tetracaine poisoning by metabolomics, to search for potential biomarkers and related metabolic pathways, and to provide new ideas for the identification of cause of death and research on toxicological mechanism of acute tetracaine poisoning. Methods Forty ICR mice were randomly divided into control group and acute tetracaine poisoning death group. The model of death from acute poisoning was established by intraperitoneal injection of tetracaine, and the metabolic profile of serum and tissues of mice was obtained by ultra-high performance liquid chromatography-electrostatic field orbitrap high resolution mass spectrometry （UPLC-Orbitrap HRMS）. Multivariate statistical principal component analysis （PCA） and orthogonal partial least square-discriminant analysis （OPLS-DA） were used, combined with t-test and fold change to identify the differential metabolites associated with death from acute tetracaine poisoning. Results Compared with the control group, the metabolic profiles of serum and tissues in the mice from acute tetracaine poisoning death group were significantly different. Eleven differential metabolites were identified in serum, including xanthine, spermine, 3-hydroxybutylamine, etc.; twenty-five differential metabolites were identified in liver, including adenylate, adenosine, citric acid, etc.; twelve differential metabolites were identified in heart, including hypoxanthine, guanine, guanosine, etc; four differential metabolites were identified in kidney, including taurochenodeoxycholic acid, 11, 12-epoxyeicosatrienoic acid, dimethylethanolamine and indole. Acute tetracaine poisoning mainly affected purine metabolism, tricarboxylic acid cycle, as well as metabolism of alanine, aspartic acid and glutamic acid. Conclusion The differential metabolites in serum and tissues of mice died of acute tetracaine poisoning are expected to be candidate biomarkers for this cause of death. The results can provide research basis for the mechanism and identification of acute tetracaine poisoning.

Lung microbiome alterations in NSCLC patients

Lung is colonized by a diverse array of microbes and the lung microbiota is profoundly involved in the development of respiratory diseases. There is little knowledge about the role of lung microbiota dysbiosis in lung cancer. In this study, we performed metagenomic sequencing on bronchoalveolar lavage (BAL) from two different sampling methods in non-small cell lung cancer (NSCLC) patients and non-cancer controls. We found the obvious variation between bronchoscopy samples and lobectomy samples. Oral taxa can be found in both bronchoscopy and lobectomy samples and higher abundance of oral taxa can be found in bronchoscopy samples. Although the NSCLC patients had similar microbial communities with non-cancer controls, rare species such as Lactobacillus rossiae, Bacteroides pyogenes, Paenibacillus odorifer, Pseudomonas entomophila, Magnetospirillum gryphiswaldense, fungus Chaetomium globosum et al. showed obvious difference between NSCLC patients and non-cancer controls. Age-, gender-, and smoking-specific species and EGFR expression-related species in NSCLC patients were detected. There results implicated that different lung segments have differential lung microbiome composition. The oral taxa are found in the lobectomy samples suggesting that oral microbiota are the true members of lung microbiota, rather than contamination during bronchoscopy. Lung cancer does not obviously alter the global microbial composition, while rare species are altered more than common species. Certain microbes may be associated with lung cancer progression.

Synthesis, structure, and properties of carbon/carbon composites artificial rib for chest wall reconstruction

In this work, braided carbon fiber reinforced carbon matrix composites (3D-C/C composites) are prepared by chemical vapor infiltration process. Their composite structure, mechanical properties, biocompatibility, and in vivo experiments are investigated and compared with those of traditional 2.5D-C/C composites and titanium alloys TC4. The results show that 3D-C/C composites are composed of reinforced braided carbon fiber bundles and pyrolytic carbon matrix and provide 51% open pores with a size larger than 100 μm for tissue adhesion and growth. The Young's modulus of 3D-C/C composites is about 5 GPa, much smaller than those of 2.5D-C/C composites and TC4, while close to the autogenous bone. 3D-C/C composites have a higher tensile strength (167 MPa) and larger elongation (5.0%) than 2.5D-C/C composites (81 MPa and 0.7%), and do not show obvious degradation after 1 × 106 cyclic tensile loading. The 3D-C/C composites display good biocompatibility and have almost no artifacts on CT imaging. The in vivo experiment reveals that 3D-C/C composites artificial ribs implanted in dogs do not show displacement or fracture in 1 year, and there are no obvious proliferation and inflammation in the soft tissues around 3D-C/C composites implant. Our findings demonstrate that 3D-C/C composites are suitable for chest wall reconstruction and present great potentials in artificial bones.

Spatial analysis of the T-cell repertoire in non-small cell lung cancer reveals a clonality gradient from the tumor to the distal lung

e20544

Background: The immunomodulatory effects of the tumor microenvironment (TME) significantly impact the T cell repertoire resulting in different anti-tumor immune responses. Previous work by our group and others has highlighted intratumor heterogeneity in T cell clonality, spatial distribution, and diversity, as well as infiltration of bystander T cells in early-stage non-small cell lung cancer (NSCLC). However, little is known about how the TME impacts the T cell repertoire in distant or surrounding adjacent uninvolved lung tissue. Methods: We investigated the interplay between tumor and surrounding lung tissues by investigating the T cell repertoire at the tumor site, tumor margin, and 1cm, 2cm, 5cm, and 10cm away from the tumor as well as in peripheral blood in 21 NSCLC patients with a total of 123 samples undergoing T cell receptor (TCR) CDR3b sequencing using the Geneplus technology. Differences in regional T cell repertoires were analyzed based on clonality, diversity, and Morisita Overlap Index (MOI). GLIPH was utilized to identify motifs associated with pathogen specificity in each region. Results: Clonality was lowest within the tumor and progressively increases from tumor margin to tumor adjacent lung toward distant lung with “hot spot” regions of T cell expansion located in adjacent lung tissue proximal to the tumor, namely 2cm away (p = 0.0025). Dominant T cell populations were better conserved between the tumor margins and “hot regions” of high clonality compared to the tumors (p = 0.0009) highlighting the differences between these environments and possible T cell exclusion in immunosuppressive TME. GLIPH analysis revealed an inverse correlation between clonality and the proportion of pathogen-associated TCR motifs (r = -0.83, p = 0.0195). Interestingly, tumor tissue contained the highest proportion of predicted pathogen TCRs whereas regions of high clonality contained the lowest (p < 0.0001), suggesting the antigen-independent nature of T cell trafficking. Conclusions: Combined, these results highlight isolated pockets of T cell expansion in the lungs outside the tumor and potential immune evasion mechanisms in NSCLC.

Comprehensive characterization of genomic and radiologic features reveals distinct driver patterns of RTK/RAS pathway in pulmonary nodules presenting as ground-glass opacity

e20516

Background: GGO-associated pulmonary nodule has been known as radiological appearances of early stage and exhibit more indolent biological behavior. The correlation of different driver gene and radiological features remain poorly understood. Methods: We performed high-depth sequencing of 334 resected pulmonary nodules presenting as GGO from 262 Chinese patients with a custom 1021-gene panel. 130 were multiple pulmonary nodules from 58 patients (2-4 samples per patient). Clinical-pathologic and radiologic parameters of these pulmonary nodules were collected. Immunohistochemistry and multiplex immunofluorescent staining were applied to analyze proliferation and immune cell markers of GGO-associated pulmonary nodules. Results: Mixed GGO enriched in the pathology of invasive LUAD comparing to pure GGO (182/216 vs 73/118, p < 0.001). 88.0% (294/334) of GGO-associated nodules carried at least one gene mutation in EGFR/ERBB2/BRAF/KRAS/MAP2K1 of the RTK/RAS signaling pathway and these driver genes were mutual exclusive to each other. T790M mutation was detected in one patient who had a nodule with CTR > 0.5 and was pathologically defined as MIA. 96.4% (54/56) multiple pulmonary nodules from the same patients showed distinct oncogenic alterations, but 72.4% (42/58) patients carried at least one mutant gene in RTK/RAS pathway across each pulmonary nodule. Nodules with ERBB2/ BRAF/ MAP2K1 mutations tended to be more indolent than those with EGFR and KRAS mutations, showing fewer mutations in radiology status of mGGO or pathology of invasive LUAD. KRAS-mutant subgroup possessed the highest expression of Ki-67 and PD-L1, more infiltration of CD4+ T cell and CD8+T cell. The second highest Ki67-expression was in EGFR-mutant subgroup, together with more CD8+T cell. For EGFR-mutant nodules, co-mutations with TP53 or RBM10 enriched in nodules with CTR > 0.5 and showing higher values of mean CT attenuation and TMB, which may relate to GGO evolution or invasiveness progression. Conclusions: This study elucidated a comprehensive genomic landscape of Chinese radiologically detected GGO-associated pulmonary nodules and highlighted different driver patterns of RTK/RAS pathway corresponding to radiologic features. Our findings provided valuable insight for further research on driver event of RTK/RAS pathway and cancer interception of GGO-associated pulmonary nodules.

Identification of recurrence-associated gene signature and tumor immune microenvironment features in resected stage I NSCLC

9080

Background: Surgery is the primary treatment for stage I NSCLC, but postoperative recurrence leads to poor prognosis. Alterations of tumor genes and immune microenvironment may be crucial factors for tumor recurrence; however, the detailed mechanisms remain unclear. Methods: A total of 130 resected stage I NSCLC patients were enrolled, 69 developed recurrence within three years and 61 without recurrence over five years. Whole exome sequencing (WES) was performed to evaluate genomic alterations. Immunohistochemistry was carried out to assess the expression of PD-L1, CD3 and CD8. We calculated density of CD3+ and CD8+ T cells in the center of tumors (CT) and invasive margins (IM), defined six immunoscore types based on the location and density of both cells, and performed ROC analysis to evaluate prognostic value of them. We further verified our results using stage I NSCLC cohorts from the Cancer Genome Atlas (TCGA) and Tumor immune estimation resource (TIMER) database. Results: In univariate analysis, lung adenocarcinoma (LUAD) patients showed significantly higher risk of recurrence (p = 0.008). There was no statistically significant correlation between recurrence and other clinical factors, including TNM stage. Although driver gene mutations, such as those of EGFR, had no correlation with recurrence, MUC4 mutation and high tumor mutation burden (TMB) were significantly associated with higher risk of recurrence (p = 0.001 and 0.0032, respectively). Enrichment analysis of KEGG pathways showed that Ras pathway mutations were significantly enriched in MUC4 mutant group and recurrence group (p = 0.02 and 0.05, respectively). 9.6% patients had PD-L1 positive expression (TPS≥1%), but showed no association with recurrence. Recurrence group had much lower density of CD8CT, CD8IM and CD3CT +T cells(p = 0.0026, 0.0022 and 0.0308, respectively). Immunoscore type V, based on the average of CD8CT, CD8IM and CD3CT + T cells, had the highest prognostic value (AUC = 0.764) and was used as the final immunoscore in our study. In multivariate analysis, we found MUC4 mutation and low immunoscore were independent predictors of higher risk of recurrence. Smoking history was also an independent prognostic factor in LUAD. While in LUSC, only immunoscore correlated with recurrence. In TCGA cohort, MUC4 mutation rate was significantly lower (3.6% vs. 24.3%, p < 0.001) and had no correlation with risk of recurrence (p = 0.765). Besides, the tumor infiltrating CD8+ T cells also had no correlation with risk of recurrence (p = 0.469). Conclusions: In this study, we established a refined immunoscore with high prognostic value for tumor recurrence in stage I NSCLC. In addition, we showed for the first time a strong association between MUC4 mutation and recurrence, which might be mediated by the Ras pathway. Finally, the recurrence mechanisms might vary among different histological subtypes.

Accurate diagnosis of pulmonary nodules using a noninvasive DNA methylation test

BACKGROUNDCurrent clinical management of patients with pulmonary nodules involves either repeated low-dose CT (LDCT)/CT scans or invasive procedures, yet causes significant patient misclassification. An accurate noninvasive test is needed to identify malignant nodules and reduce unnecessary invasive tests.METHODWe developed a diagnostic model based on targeted DNA methylation sequencing of 389 pulmonary nodule patients' plasma samples and then validation in 140 plasma samples independently. We tested the model in different stages and subtypes of pulmonary nodules.RESULTSA 100-feature model was developed and validated for pulmonary nodule diagnosis; the model achieved a receiver operating characteristic curve-AUC (ROC-AUC) of 0.843 on 140 independent validation samples, with an accuracy of 0.800. The performance was well maintained in (a) a 6 to 20 mm size subgroup (n = 100), with a sensitivity of 1.000 and adjusted negative predictive value (NPV) of 1.000 at 10% prevalence; (b) stage I malignancy (n = 90), with a sensitivity of 0.971; (c) different nodule types: solid nodules (n = 78) with a sensitivity of 1.000 and adjusted NPV of 1.000, part-solid nodules (n = 75) with a sensitivity of 0.947 and adjusted NPV of 0.983, and ground-glass nodules (n = 67) with a sensitivity of 0.964 and adjusted NPV of 0.989 at 10% prevalence. This methylation test, called PulmoSeek, outperformed PET-CT and 2 clinical prediction models (Mayo Clinic and Veterans Affairs) in discriminating malignant pulmonary nodules from benign ones.CONCLUSIONThis study suggests that the blood-based DNA methylation model may provide a better test for classifying pulmonary nodules, which could help facilitate the accurate diagnosis of early stage lung cancer from pulmonary nodule patients and guide clinical decisions.FUNDINGThe National Key Research and Development Program of China; Science and Technology Planning Project of Guangdong Province; The National Natural Science Foundation of China National.

Effect modification of the association between diurnal temperature range and hospitalisations for ischaemic stroke by temperature in Hefei, China

OBJECTIVES

Diurnal temperature range (DTR) is an important indicator of global climate change. Many epidemiological studies have reported the associations between high DTR and human health. This study investigated the association between DTR and hospitalisations for ischaemic stroke in Hefei, China.

STUDY DESIGN

This is an ecological study.

METHODS

Data of daily hospital admissions for ischaemic stroke and meteorological variables from 1 January 2009 to 31 December 2017 were collected in Hefei, China. A generalised additive model combined with distributed lag non-linear model was used to quantify the effects of DTR on ischaemic stroke. The interactive effect between DTR and temperature was explored with a non-parametric bivariate response surface model.

RESULTS

High DTR was associated with hospitalisations for ischaemic stroke. The adverse effect of extremely high DTR (99th percentile [17.1 °C]) occurred after 8 days (relative risk [RR] = 1.021, 95% confidence interval [CI] = 1.002, 1.041) and the maximum effect appeared after 12 days (RR = 1.029, 95% CI = 1.011, 1.046). The overall trend of the effect of DTR on ischaemic stroke was decreasing. In addition, there was a significant interactive effect of high DTR and low temperature on ischaemic stroke.

CONCLUSIONS

This study suggests that the impact of high DTR should be considered when formulating targeted measures to prevent ischaemic stroke, especially for those days with high DTR and low mean temperature.

Heterotrimeric G protein signalling in plant biotic and abiotic stress response

Heterotrimeric G proteins act as molecular switches to participate in transmitting various stimuli signals from outside of cells. G proteins have three subunits, Gα, Gβ and Gγ, which function mutually to modulate many biological processes in plants, including plant growth and development, as well as biotic and abiotic stress responses. In plants, the number of Gγ subunits is larger than that of the α and β subunits. Based on recent breakthroughs in studies of plant G protein signal perception, transduction and downstream effectors, this review summarizes and analyses the connections between different subunits and the interactions of G proteins with other signalling pathways, especially in plant biotic and abiotic stress responses. Based on current progress and unresolved questions in the field, we also suggest future research directions on G proteins in plants.

[HIV infection and related factors among men who have sex with men aged 50 and above]

Objectives: To explore the HIV prevalence and related factors among MSM aged 50 and above and provide evidence on the prevention and control of HIV/AIDS. Methods: Based on an MSM social application software Blued 7.1.6, we recruited participants through online convenience sampling to collect demographic variables, behavioral and self-reported HIV infection status, etc. Univariate χ2 test and multivariate logistic regression were used to analyze the related factors of self-reported HIV infection. Results: Self-reported HIV infection rate was 17.6%(126/714) among the participants. In multivariable analysis, participants who got divorced or widowed had a 2.07(95%CI: 1.34-3.21) times greater risk of self-reported HIV-positive than those who were married. Participants unaware of HIV-related knowledge showed a 1.92(95%CI:1.21-3.04) times greater risk of self-reported HIV-positive than those with better HIV-related knowledge. Participants who have ever been diagnosed with sexually transmitted disease (STD) showed a 3.17(95%CI:2.09-4.83) times greater risk of self-reported HIV-positive than those without STD infection history. Conclusion: Our findings indicated that the self-reported HIV infection rate was high among MSM aged 50 and above. Being divorced or widowed, being unaware of HIV-related knowledge and STD infection history was proved related with self-reported HIV infection.

[Exploration on contamination and transmission of SARS-CoV-2 in imported cold chain aquatic products]

Contaminations of SARS-CoV-2 have been found for many times in imported cold chain aquatic products and their packaging materials in China. The purpose of this paper is to analyze the contamination status, sources and transmission risks of SARS-CoV-2 in imported cold chain aquatic products, and try to put forward relevant suggestions and strategies in order to provide evidence for the prevention and control of SARS-CoV-2 infection.

Sevoflurane inhibits neuronal apoptosis and expressions of HIF-1 and HSP70 in brain tissues of rats with cerebral ischemia/reperfusion injury

OBJECTIVE

To observe the influences of sevoflurane on neuronal apoptosis and expressions of hypoxia-inducible factor 1 (HIF-1), and heat-shock protein 70 (HSP70) in brain tissues of rats with cerebral ischemia/reperfusion (I/R) injury.

MATERIALS AND METHODS

A total of 60 Sprague-Dawley rats were selected and divided into sham-operation group (Sham group, n=20), cerebral I/R model group (Model group, n=20), and 3% sevoflurane treatment group (Sevoflurane group, n=20). The rats in each group received neurological scoring, and the blood and brain tissues were collected to detect the concentrations of serum K+, Na+ and glucose (Glu). Enzyme-linked immunosorbent assay (ELISA) was adopted to measure the levels of inflammatory factors [tumor necrosis factor-β (TNF-β) and interleukin-6 (IL-6)] and oxidative stress [catalase (CAT), malondialdehyde (MDA) and superoxide dismutase (SOD)]. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay was performed to determine the nerve cell apoptosis in the brain tissues. The gene and protein expressions of Caspase-3, HIF-1, and HSP70 in the brain tissues were measured via quantitative Reverse Transcription-Polymerase Chain Reaction (qRT-PCR) and Western blotting.

RESULTS

In Sevoflurane group, the content of serum Glu and Na+ was decreased markedly, that of K+ was increased notably, and the levels of TNF-β, IL-1 and IL-6 were lowered remarkably compared with those in Model group (p<0.05). Moreover, the neurological score was reduced evidently (p<0.05). Model group had significantly strengthened the activity of MDA and CAT and decreased SOD content, while Sevoflurane group exhibited the opposite results. TUNEL staining showed that there were distinctly more apoptotic cells that were dominated by glial cells in Model group and fewer apoptotic cells in Sevoflurane group. It was indicated in gene assay that the messenger ribonucleic acid (mRNA) expression levels of HIF-1, HSP70, and Caspase-3 in Model group were remarkably higher than those in Sham group and Sevoflurane group (p<0.05). According to the results of Western blotting, the protein expressions of HIF-1 and HSP70 in Sevoflurane group were markedly lower than those in Model group.

CONCLUSIONS

Sevoflurane can reduce the content of inflammatory factors, inhibit apoptosis, and reduce the expressions of HIF-1 and HSP70 in the case of cerebral I/R injury, thus exerting protective effects on rats with cerebral I/R injury.

A novel dentin bonding scheme based on extrafibrillar demineralization combined with covalent adhesion using a dry-bonding technique

Dentin bonding is a dynamic process that involves the penetration of adhesive resin monomers into the extrafibrillar and intrafibrillar demineralized collagen matrix using a wet-bonding technique. However, adhesive resin monomers lack the capacity to infiltrate the intrafibrillar space, and the excess water that is introduced by the wet-bonding technique remains at the bonding interface. This imperfectly bonded interface is inclined to hydrolytic degradation, severely jeopardizing the longevity of bonded clinical restorations. The present study introduces a dentin bonding scheme based on a dry-bonding technique, combined with the use of extrafibrillar demineralization and a collagen-reactive monomer (CRM)-based adhesive (CBA). Selective extrafibrillar demineralization was achieved using 1-wt% high-molecular weight (MW) carboxymethyl chitosan (CMCS) within a clinically acceptable timeframe to create a less aggressive bonding substance for dentin bonding due to its selectively extrafibrillar demineralization capacity. CMCS demineralization decreased the activation of in situ collagenase, improved the shrinking resistance of demineralized collagen, and thus provided stronger and more durable bonding than traditional phosphoric acid etching. The new dentin bonding scheme that contained CMCS and CBA and used a dry-bonding technique achieved an encouraging dentin bonding strength and durability with low technical sensitivity. This bonding scheme can be used to improve the stability of the resin-dentin interface and foster the longevity of bonded clinical restorations.

The antibacterial effect and physical performance of pit and fissure sealants based on an antibacterial core-shell nanocomposite

The application of pit and fissure sealants is a well-established method to prevent and treat early childhood caries. Resin-based sealants with antibacterial properties provide additional benefits for caries prevention in a cariogenic oral environment. The objective of this study was to evaluate the effect of an antibacterial core-shell AgBr/cationic polymer nanocomposite (AgBr/BHPVP) on the properties of a resin-based pit and fissure sealant. A commercialized pit and fissure sealant without fluoride, Concise (3M, ESPE, USA), was used as the parent material and negative control. Experimental antibacterial sealants were formulated by the addition of AgBr/BHPVP nanoparticles at mass fractions of 0.5, 1.0, and 1.5 wt% to the parent material. A fluoride-releasing sealant, Clinpro (3M, ESPE), was used as the positive control. Bacterial colony-forming unit (CFU) counts, metabolic activity tests, field emission-scanning electron microscopy (FE-SEM), and confocal laser scanning microscopy (CLSM) observations were used to evaluate the antibacterial properties of AgBr/BHPVP-modified sealants against Streptococcus mutans before and after five months of aging. The Vickers microhardness, degree of conversion, and microleakage level of the sealants were also investigated. According to the results of CFU counts and metabolic tests, sealants containing AgBr/BHPVP showed better contact-killing bactericidal activity against S. mutans than the two commercial sealants, irrespective of aging conditions (both P < 0.05). The AgBr/BHPVP-modified sealants also showed a significant inhibitory effect on the planktonic S. mutans around the cured sealant surfaces. In addition, the Vickers microhardness, degree of conversion, and microleakage level of the parent material were not damaged by modification with AgBr/BHPVP (P > 0.05). AgBr/BHPVP-modified pit and fissure sealant with a dual bactericidal mechanism is a promising option for the prevention of pit and fissure caries.

A novel technique for preoperative localization of pulmonary nodules using a mixture of tissue adhesive and iohexol under computed tomography guidance: A 140 patient single-center study

Background

The increase in the incidence of pulmonary nodules has made computed tomography (CT) screening a requirement for diagnosis and treatment. Small pulmonary nodule detection during video‐assisted thoracoscopic surgery (VATS) or thoracotomy is frequently challenging; however, accurate and efficient localization of nodules is critical for precise resection. Herein, we introduce and evaluate the feasibility and safety of a novel technique for preoperative pulmonary nodule localization.

Methods

From March 2018 to December 2019, 140 patients with 153 pulmonary nodules measuring <2 cm in diameter were enrolled in this study. Preoperative, CT‐guided localization was performed on each nodule with an injected mixture of tissue adhesive and iohexol. Patient and nodule characteristics, localization data, complications, surgical data, and pathological results were analyzed.

Results

All 153 nodules in 140 patients were successfully marked preoperatively and detected during surgery (n = 153/153). Mean nodule size was 8.7 ± 2.6 mm, and mean distance from nodule to pleura was 7.9 ± 8.2 mm. The mean procedural time was 8.7 ± 1.0 min. Nine patients (6.4%) underwent two simultaneous nodule localizations and two patients (1.4%) underwent three simultaneous nodule localizations. Pneumothorax (17/140, 12.1%), pain (6/140, 4.3%), and pungent odor (5/140, 3.6%) were the major complications. No patient required further treatment, and no allergic reactions or embolisms were observed.

Conclusions

Preoperative CT‐guided nodule localization using a mixture of tissue adhesive and iohexol is an efficient technique for localizing small and impalpable pulmonary lesions, including multiple pulmonary nodules. Our study demonstrates that this novel method is safe and straightforward to implement.

N6-Methyladenosine RNA Methylation Regulator-Related Alternative Splicing (AS) Gene Signature Predicts Non-Small Cell Lung Cancer Prognosis

Aberrant N6-methyladenosine (m6A) RNA methylation regulatory genes and related gene alternative splicing (AS) could be used to predict the prognosis of non-small cell lung carcinoma. This study focused on 13 m6A regulatory genes (METTL3, METTL14, WTAP, KIAA1429, RBM15, ZC3H13, YTHDC1, YTHDC2, YTHDF1, YTHDF2, HNRNPC, FTO, and ALKBH5) and expression profiles in TCGA-LUAD (n = 504) and TCGA-LUSC (n = 479) datasets from the Cancer Genome Atlas database. The data were downloaded and bioinformatically and statistically analyzed, including the gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses. There were 43,948 mRNA splicing events in lung adenocarcinoma (LUAD) and 46,020 in lung squamous cell carcinoma (LUSC), and the data suggested that m6A regulators could regulate mRNA splicing. Differential HNRNPC and RBM15 expression was associated with overall survival (OS) of LUAD and HNRNPC and METTL3 expression with the OS of LUSC patients. Furthermore, the non-small cell lung cancer prognosis-related AS events signature was constructed and divided patients into high- vs. low-risk groups using seven and 14 AS genes in LUAD and LUSC, respectively. The LUAD risk signature was associated with gender and T, N, and TNM stages, but the LUSC risk signature was not associated with any clinical features. In addition, the risk signature and TNM stage were independent prognostic predictors in LUAD and the risk signature and T stage were independent prognostic predictors in LUSC after the multivariate Cox regression and receiver operating characteristic analyses. In conclusion, this study revealed the AS prognostic signature in the prediction of LUAD and LUSC prognosis.