Suppression of myocardial HIF-1 by pubertal insulin resistance compromises metabolic adaptation and impairs cardiac function in patients with cyanotic congenital heart disease

Background

Cyanotic congenital heart disease (CCHD) is a complex pathophysiological condition involving systemic chronic hypoxia (CH). A proportion of CCHD patients are unoperated due to various reasons. These patients remain CH all their lives and are at increased risk of heart failure as they age. Hypoxia activates cellular metabolic adaptation to balance energy demands by accumulation of hypoxia-inducible factor 1α (HIF-1α).

Purpose

The aim of this study was to determine the effect of CH on cardiac metabolism and function in CCHD patients and how it relates with age. The mechanistic role of HIF-1α in this process was investigated and potential therapeutic targets were explored.

Methods

CCHD patients (n=20) were evaluated for cardiac metabolism and function by positron-emission tomography/computed tomography and magnetic resonance imaging. Heart tissues collected during surgical intervention were subjected to metabolomic and protein analyses. CH rodent models were generated to enable continuous observation of changes in cardiac metabolism and function. The role of HIF-1α in cardiac metabolic adaptation to CH was investigated using genetically modified animals and isotope-labeled metabolomic-pathway tracing studies.

Results

Prepubertal CCHD patients had glucose-dominant cardiac metabolism and normal cardiac function. By comparison, among patients who had entered puberty, the level of myocardial glucose uptake and glycolytic intermediates were significantly lower, but fatty acids were significantly higher, along with decreased left ventricular ejection fraction. These clinical phenotypes were replicated in CH rodent models. In patients and animals with CH, myocardial HIF-1α was upregulated prior to puberty, but was significantly downregulated during puberty. In cardiomyocyte-specific Hif-1α-knockout mice, CH failed to initiate the switch of myocardial substrates from fatty acids to glucose, leading to inhibition of ATP production and impairment of cardiac function. Increased insulin resistance (IR) suppressed myocardial HIF-1α and was responsible for cardiac metabolic maladaptation under CH during puberty. Pioglitazone significantly reduced myocardial IR, restored glucose metabolism, and improved cardiac function in pubertal animals.

Conclusions

In CCHD patients, maladaptation of cardiac metabolism occurred during puberty, impairing cardiac function. HIF-1α was identified as the key regulator of cardiac metabolic adaptation under CH but its expression was suppressed by pubertal IR. The use of pioglitazone during puberty might help improve cardiac function in these patients.

Metabolic maladaptation in CCHD patients

Funding Acknowledgement

Type of funding source: Foundation. Main funding source(s): National Natural Science Foundation of China (81525002, 31971048) and Shanghai Outstanding Medical Academic Leader

Generalized inverse matrix normalization algorithm to extract high-temperature data from multiwavelength pyrometry

Multiwavelength pyrometry (MWP) is one of the most powerful tools for the precise measurement of high temperatures on the surfaces of non-gray materials. However, the unknown spectral emissivity of target materials is the most difficult obstacle to overcome in processing temperature inversion data using MWP. A direct and fast generalized inverse matrix normalization (GIM-NOR) data processing algorithm based on GIM theory for underdetermined equations is proposed in order to minimize the effects arising from unknown emissivity. The shape of the emissivity distribution is obtained so that the channel with the greatest emissivity can be selected in order to obtain a value close to the real temperature. The final inversion accuracy is then further improved using a NOR compensation method. Six kinds of materials with a distribution of emissivities at 1800 K were used to simulate and verify the proposed algorithm. The results show that the average relative error of temperature inversion was 0.63%, obtained within 8 ms computation time using a standard desktop computer, and the accuracy and efficiency were largely unaffected when 5% random noise was inserted into the simulation data. A set of experimental data for rocket nozzle temperature measurements with MWP were also processed based on the proposed novel algorithm. The results show that the relative error on the temperature was less than 0.50%, for a design temperature of 2490 K, and that the processing efficiency was very high, that is, within 9 ms. Simulation and experiment both proved that the proposed efficient data processing algorithm for MWP based on GIM theory was unaffected by emissivity and achieved good inversion precision and fast data processing. Therefore, the proposed new data processing algorithm for MWP data for measuring transient high temperatures has very broad potential applications, and it also provides a theoretical basis for measuring high-temperature fields using MWP.

Clinicopathologic features and prognosis of synchronous and metachronous multiple primary colorectal cancer

PURPOSE

Multiple primary colorectal cancers (MPCCs) are different from solitary colorectal cancers in many aspects, which are not well studied. The aim of this study was to clarify the clinicopathological features and prognosis of MPCCs.

METHODS

The data of 64 patients with MPCCs out of 2300 patients with colorectal cancers (CRCs) from January 2009 to December 2017 were retrospectively analyzed. Stratified analysis was conducted based on subtypes and microsatellite status.

RESULTS

The overall incidence of MPCC was 2.8% and the median follow-up duration was 51.5 (range 1-120) months. Metachronous CRCs (MCRCs) are more likely to appear in the right colon (p < 0.05). However, no significant differences regarding age, sex, BMI, tumor size, smoking/drinking history, TNM stage, family history of cancer, and 5-year survival rate were observed between synchronous CRC (SCRC) and MCRC. Advanced TNM stage (III) and the presence of polyps were found to be independent poor prognostic factors for MPCCs. The prevalence of mismatch repair deficiency (dMMR) in MPCCs was 28.1%. Deficient MMR is more likely to appear in younger, lighter MPCC patients with polyps (p < 0.05). Of four mismatch repair proteins, MLH-1, MSH-2, MSH-6, and PMS-2 were negative in nine, nine, five, and nine patients, respectively. The 5-year survival rate did not differ significantly between MMR-proficient (pMMR) and dMMR groups (p = 0.752).

CONCLUSIONS

Synchronous CRC (SCRC) and MCRC might represent similar disease entities with different courses. Deficient MMR is more likely to appear in younger, lighter MPCC patients with polyps and it is an essential indicator for screening Lynch syndrome.

Analyzing the super-resolution characteristics of focused-spot illumination approaches

SIGNIFICANCE

It is commonly assumed that using the objective lens to create a tightly focused light spot for illumination provides a twofold resolution improvement over the Rayleigh resolution limit and that resolution improvement is independent of object properties. Nevertheless, such an assumption has not been carefully examined. We examine this assumption by analyzing the performance of two super-resolution methods, known as image scanning microscopy (ISM) and illumination-enhanced sparsity (IES).

AIM

We aim to identify the fundamental differences between the two methods, and to provide examples that help researchers determine which method to utilize for different imaging conditions.

APPROACH

We input the same image datasets into the two methods and analyze their restorations. In numerical simulations, we design objects of distinct brightness and sparsity levels for imaging. We use biological imaging experiments to verify the simulation results.

RESULTS

The resolution of IES often exceeds twice the Rayleigh resolution limit when imaging sparse objects. A decrease in object sparsity negatively affects the resolution improvement in both methods.

CONCLUSIONS

The IES method is superior for imaging sparse objects with its main features being bright and small against a dark, large background. For objects that are largely bright with small dark features, the ISM method is favorable.

Preparation and immunological characterization of an inactivated canine Clostridium perfringens type A vaccine

Clostridium perfringens is the main cause of sudden death in dogs and currently there is no vaccine to prevent it. In this study, a canine C. perfringens type A strain was used to prepare a vaccine. C. perfringens was inactivated by formaldehyde and adjuvants were added. The safety and immunological characteristics of the inactivated C. perfringens vaccine were evaluated in mice and dogs. The results showed that the C. perfringens vaccine was safe and had immunoprotective activity. The serum antibody titre of immunized mice reached up to 6·25 × 10⁴ . Both single immunization of 4 ml and dual immunizations of 2 ml each provided good immune protection, with five of five immunized dogs surviving. This study also studied a detoxified crude α-toxin extract vaccine. The results showed that a single immunization with 0·5 ml of the detoxified crude α-toxin extract vaccine provided immune protection, with five of five immunized dogs surviving. The inactivated C. perfringens type A vaccine can be used to prevent canine C. perfringens infections. SIGNIFICANCE AND IMPACT OF THE STUDY: Clostridium perfringens is the main cause of sudden death in dogs and currently there is no vaccine to prevent it. In this study, an inactivated canine C. perfringens vaccine and a detoxified crude α-toxin vaccine were prepared. The safety and protective effects of these vaccines were evaluated using mouse and dog models. The vaccines were shown to be safe and to provide immune protection effects that can be used to prevent canine C. perfringens infection.

Preparation and characterization of polyphenylene sulfide/graphene nanoplatelets composite fibers with enhanced oxidation resistance

Composite masterbatches of polyphenylene sulfide (PPS) with functionalized graphene nanoplatelets (GNPs) were prepared by melt blending via a twin-screw extruder. The structure and morphology of composite masterbatches were characterized by scanning electron microscopy and X-ray diffraction analysis. The PPS/functionalized GNPs composite fibers were then manufactured by a self-made spinning equipment via melt spinning. The oxidation resistance and other properties of PPS composite fibers were also examined. The results showed that the pure PPS fibers exhibited smooth surface, whereas the surface of PPS/functionalized GNPs composite fibers was rough. The addition of functionalized GNPs could be acted as heterogeneous nucleating agents to improve the crystallization and increase the degree of crystallinity. The retention rate of breaking strength of PPS/functionalized GNPs composite fibers could maintain up to 85% after the oxidation treatment. The improvement in the oxidation resistance of PPS/functionalized GNPs composite fibers is the results of comprehensive effects characterized by the X-ray photoelectron spectroscopy analyses. The addition of functionalized GNPs could limit the damage of the C–S group and retard the generation of sulfuryl groups (–SO–) during the oxidation treatment. The chemical combination of the elements sulfur (S) and oxygen (O) could also be restricted, thus weakening the oxidation activity.

Late diagnosis of hepatitis C virus infection, 2014-2016: continuing missed intervention opportunities

OBJECTIVES

Chronic hepatitis C virus (HCV) infection is typically asymptomatic until severe liver disease occurs and even then can remain undiagnosed for some time; thus, screening and treatment of asymptomatic persons are needed to prevent poor outcomes. In a previous analysis of data from between 2006 and 2011, we found that 17% of newly diagnosed HCV infections in 4 large health systems were among persons with cirrhosis and/or end-stage liver disease, termed "late diagnosis." We sought to determine the proportion with late diagnosis during 2014-2016, after release of CDC baby boomer (1945-1965 birth cohort) testing guidelines in 2012.

STUDY DESIGN

The cohort was based on analysis of electronic health records and administrative data of about 2.7 million patients visiting the same healthcare systems during 2014-2016.

METHODS

Among persons with newly diagnosed chronic HCV infection during 2014-2016, we analyzed data collected up to January 1, 2017.

RESULTS

Among 2695 patients with newly diagnosed HCV infection, 576 (21.4%) had late diagnosis. Most were born between 1945 and 1965 (n = 1613 [59.9%]), and among these, 27.6% had late diagnosis. Patients with versus without late diagnosis had equally lengthy prediagnosis observation in the health systems (mean and median, 9.1 and 9.1 vs 8.3 and 7.8 years, respectively) but were more likely to have a postdiagnosis hospitalization (32.5% vs 12.5%; P <.001) with greater number of hospital days (358.8 vs 78.5 per 100 person-years; P <.001).

CONCLUSIONS

More than one-fifth of patients with newly diagnosed HCV infection during 2014-2016-and more than a quarter of those born between 1945 and 1965-had late diagnosis despite many years of in-system care, an increase of 5 percentage points since 2006-2011, after the interim initiation of age-based screening recommendations. Our data highlight missed opportunities for diagnosis and therapeutic intervention before the onset of severe liver disease, which is associated with high cost and diminished outcomes.

[Baicalein inhibits PI3K/AKT signaling pathway and induces autophagy of MGC-803 cells]

Objective To investigate the effect of baicalein (BAI) on autophagy in gastric cancer cell line MGC-803. Methods MGC-803 cells were treated with 0, 5, 15, 25, 50 μmol/L BAI for 24, 48, 72 hours. The proliferation activity of MGC-803 cells was detected by MTT assay. Acridine orange (AO) staining combined with immunofluorescence cytochemical staining was performed to observe the expression of microtubule-associated protein 1 light chain 3 (LC3) and P62 to determine autophagy in MGC-803 cells. The protein levels of LC3, P62, phosphatidylinositol 3-kinase (PI3K), phosphorylated PI3K (p-PI3K), AKT, and p-AKT were detected by Western blot analysis. Results Compared with the control group, BAI significantly inhibited the proliferation of MGC-803 cells in a time- and dose-dependent manner. BAI-treated MGC-803 cells showed a significant increase in acid lysosomes and increased LC3 expression. BAI treatment significantly decreased phosphorylation of PI3K and AKT proteins, increased the ratio of LC3-II/LC3-I and up-regulated the expression of P62 protein. Conclusion Baicalein could inhibit PI3K/AKT signaling pathway and induce autophagy in MGC-803 cells.

Risk factor analysis of progressive spinal deformity after resection of intramedullary spinal cord tumors in patients who underwent laminoplasty: a report of 105 consecutive cases

OBJECTIVE

Laminoplasty has been used in recent years as an alternative approach to laminectomy for preventing spinal deformity after resection of intramedullary spinal cord tumors (IMSCTs). However, controversies exist with regard to its real role in maintaining postoperative spinal alignment. The purpose of this study was to examine the incidence of progressive spinal deformity in patients who underwent laminoplasty for resection of IMSCT and identify risk factors for progressive spinal deformity.

METHODS

Data from IMSCT patients who had undergone laminoplasty at Beijing Tsinghua Changgung Hospital between January 2014 and December 2016 were retrospectively reviewed. Univariate tests and multivariate logistic regression analysis were used to assess the statistical relationship between postoperative spinal deformity and radiographic, clinical, and surgical variables.

RESULTS

One hundred five patients (mean age 37.0 ± 14.5 years) met the criteria for inclusion in the study. Gross-total resection (> 95%) was obtained in 79 cases (75.2%). Twenty-seven (25.7%) of the 105 patients were found to have spinal deformity preoperatively, and 10 (9.5%) new cases of postoperative progressive deformity were detected. The mean duration of follow-up was 27.6 months (SD 14.5 months, median 26.3 months, range 6.2-40.7 months). At last follow-up, the median functional scores of the patients who did develop progressive spinal deformity were worse than those of the patients who did not (modified McCormick Scale: 3 vs 2, and p = 0.04). In the univariate analysis, age (p = 0.01), preoperative spinal deformity (p < 0.01), extent of tumor involvement (p < 0.01), extent of abnormal tumor signal (p = 0.02), and extent of laminoplasty (p < 0.01) were identified as factors associated with postoperative progressive spinal deformity. However, in subsequent multivariate logistic regression analysis, only age ≤ 25 years and preoperative spinal deformity emerged as independent risk factors (p < 0.05), increasing the odds of postoperative progressive deformity by 4.1- and 12.4-fold, respectively (p < 0.05).

CONCLUSIONS

Progressive spinal deformity was identified in 25.7% patients who had undergone laminoplasty for IMSCT resection and was related to decreased functional status. Younger age (≤ 25 years) and preoperative spinal deformity increased the risk of postoperative progressive spinal deformity. The risk of postoperative deformity warrants serious reconsideration of providing concurrent fusion during IMSCT resection or close follow-up after laminoplasty.

Seed-Guided Topic Model for Document Filtering and Classification

One important necessity is to filter out the irrelevant information and organize the relevant information into meaningful categories. However, developing text classifiers often requires a large number of labeled documents as training examples. Manually labeling documents is costly and time-consuming. More importantly, it becomes unrealistic to know all the categories covered by the documents beforehand. Recently, a few methods have been proposed to label documents by using a small set of relevant keywords for each category, known as dataless text classification . In this article, we propose a seed-guided topic model for the dataless text filtering and classification (named DFC). Given a collection of unlabeled documents, and for each specified category a small set of seed words that are relevant to the semantic meaning of the category, DFC filters out the irrelevant documents and classifies the relevant documents into the corresponding categories through topic influence. DFC models two kinds of topics: category-topics and general-topics . Also, there are two kinds of category-topics: relevant-topics and irrelevant-topics. Each relevant-topic is associated with one specific category, representing its semantic meaning. The irrelevant-topics represent the semantics of the unknown categories covered by the document collection. And the general-topics capture the global semantic information. DFC assumes that each document is associated with a single category-topic and a mixture of general-topics. A novelty of the model is that DFC learns the topics by exploiting the explicit word co-occurrence patterns between the seed words and regular words (i.e., non-seed words) in the document collection. A document is then filtered, or classified, based on its posterior category-topic assignment. Experiments on two widely used datasets show that DFC consistently outperforms the state-of-the-art dataless text classifiers for both classification with filtering and classification without filtering. In many tasks, DFC can also achieve comparable or even better classification accuracy than the state-of-the-art supervised learning solutions. Our experimental results further show that DFC is insensitive to the tuning parameters. Moreover, we conduct a thorough study about the impact of seed words for existing dataless text classification techniques. The results reveal that it is not using more seed words but the document coverage of the seed words for the corresponding category that affects the dataless classification performance.

Recent Progress of the Needleless Electrospinning for High Throughput of Nanofibers

BACKGROUND

In recent decades, nanofiber-based materials have been considered as one of the top interesting fundamental materials for academic studies and practical applications. However, the electrospinning, as the most popular method for manufacturing nanofibers, is plagued by its low productivity. The first patent about electrospinning was emerged in 1934 and the needleless electrospinning is regarded as one of the most promising methods to realize the high throughput of nanofibers.

METHODS

This review compares the recent needleless spinning technologies from limited liquid surfaces to free liquid surfaces for improvement of nanofiber throughput. The aim of this review is to reveal the merits and drawbacks of recent methods in practical employment. The view focuses also on the future concern of the needleless electrospinning.

RESULTS

The current needleless electrospinning is featured with the properties: 1) high throughput; 2) lower voltage supply for the stable spinning process; 3) narrow fiber diameter distribution, followed by the drawbacks of poor long-term spinning process and limitation of a good bonding of low voltage supply.

CONCLUSION

This review provides an update on needleless electrospinning methods for high throughput of nanofibers for industrial applications.

One-Step Quaternization/Hydroxypropylsulfonation to Improve Paste Stability, Adhesion, and Film Properties of Oxidized Starch

To investigate the influences of quaternization/hydroxypropylsulfonation on viscosity stability, adhesion to fibers and film properties of oxidized tapioca starch (OTS) for ameliorating its end-use ability in applications such as warp-sizing and paper-making, a series of quaternized and hydroxypropylsulfonated OTS (QHOTS) samples were synthesized by simultaneous quaternization and hydroxypropylsulfonation of OTS with N-(3-chloro-2-hydroxypropyl) trimethylammonium chloride (CHPTAC) and 3-chloro-2-hydroxy-1-propanesulfonic acid sodium salt (CHPS-Na). The QHOTS granules were characterized by Fourier transform infra-red spectroscopic and scanning electron microscope techniques. Apparent viscosity and viscosity stability were determined, and adhesion was evaluated by measuring the bonding force of starch to the fibers. Film properties were also estimated in terms of tensile strength, breaking elongation, bending endurance, degree of crystallinity, and moisture regain. It was showed that quaternization/hydroxypropylsulfonation was capable of obviously improving viscosity stability of gelatinized OTS paste, enhancing bonding forces of OTS to cotton and polylactic acid (PLA) fibers, increasing breaking elongation, bending endurance and moisture regain of film and decreasing its tensile strength and degree of crystallinity, thereby obviously stabilizing paste viscosity, improving adhesion to fibers and lessening film brittleness. Increasing the level of quaternization/hydroxypropylsulfonation favored improvement in the stability, enhancement in adhesion and decrease in brittleness. The QHOTS showed potential in the applications of cotton and PLA sizing.

Generalized inverse matrix-exterior penalty function (GIM-EPF) algorithm for data processing of multi-wavelength pyrometer (MWP)

The unknown emissivity of materials is a huge obstacle in multi-wavelength pyrometry (MWP). It leads to a set of ill-posed equations that cannot be directly inverted to obtain the true temperature from a set of multi-wavelength measurements. Constraint optimization algorithms such as the gradient projection (GP) and internal penalty function (IPF) algorithms provide solutions without any emissivity model assumptions but require a narrow fixed emissivity range and an appropriate initial emissivity input value, otherwise, accuracy and computational efficiency are greatly affected. Here, we propose a generalized inverse matrix-exterior penalty function (GIM-EPF) algorithm to realize an efficient and accurate inversion without limiting the emissivity range in advance. First, a set of emissivities is obtained by the generalized inverse matrix method; these emissivities are used as initial values in the exterior penalty function iteration algorithm, from which temperature and spectral emissivity are obtained. Simulation results show that the GIM-EPF algorithm provides results superior to IPF, especially in computational efficiency. The proposed GIM-EPF method is 8 times faster than the IPF method with a 0.56% relative error at the 1800 K true temperature. The GIM-EPF method also allows near real-time diagnosis of rocket exhaust flame temperature. Rocket nozzle temperature experiment results show that the temperatures derived by the GIM-EPF algorithm agree well with the theoretical design temperature and the IPF inversion temperature.

Uptake of and Factors Associated With Direct-acting Antiviral Therapy Among Patients in the Chronic Hepatitis Cohort Study, 2014 to 2015

BACKGROUND

Limited information is available describing the uptake of direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV) infection among patients in general US health care settings. We determined the proportion of HCV-infected patients in the Chronic Hepatitis Cohort Study prescribed DAAs in 2014, who initiated treatment and identified characteristics associated with treatment initiation.

METHODS

Uptake was defined as the proportion of HCV-infected patients with at least 1 clinical encounter in 2013 who were prescribed a DAA regimen during 2014 and initiated the regimen by August 2015. Using multivariable analysis, we examined demographic and clinical characteristics associated with receipt of DAAs.

RESULTS

The cohort comprised 9508 patients; 544 (5.7%) started a DAA regimen. Higher annual income [adjusted odds ratios (aOR) 2.3 for income>$50K vs. <$30K], higher Fibrosis-4 score (aORs, 2.1, 2.0, and 1.4 for Fibrosis-4, >5.88, 3.25 to 5.88, 2.0 to 3.25, respectively, vs. <2.0), genotype 2 infection (aOR 2.2 vs. genotype 1), pre-2014 treatment failure (aOR 2.0 vs. treatment-naive), and human immunodeficiency virus (HIV) coinfection (aOR 1.8 vs. HCV monoinfection) were associated with DAA initiation. Black race/ethnicity (aOR 0.7 vs. whites) and Medicaid coverage (aOR 0.5 vs. private insurance) were associated with noninitiation. Sex, age, comorbidity, previous liver transplant, and duration of follow-up were not associated with receipt of DAAs.

CONCLUSIONS

Among patients in these general US health care settings, uptake of DAA therapy was low in 2014, and especially so among minority and Medicaid patients. Systemic efforts to improve access to DAAs for all patients are essential to reduce morbidity and mortality from HCV infection.

Recombinant phosphoglucomutase and CAMP factor as potential subunit vaccine antigens induced high protection against Streptococcus iniae infection in flounder (Paralichthys olivaceus)

AIMS

The aim of this study was to screen vaccine candidates from virulence factors of Streptococcus iniae in flounder model.

METHODS AND RESULTS

The immunogenicity of recombinant phosphoglucomutase (rPGM) and rCAMP factor was confirmed by Western blot. The percentage of surface membrane immunoglobulin-positive (sIg⁺ ) lymphocytes in peripheral blood leucocytes, the specific and total serum IgM and the activity of acid phosphatase (ACP) and peroxidase (POD) in flounder were determined with flow cytometry, ELISA and commercial enzyme activity kits, respectively, after intraperitoneal immunization with rPGM and rCAMP factor. The results showed that rPGM and rCAMP factor could induce significant rise in sIg⁺ lymphocytes, specific serum IgM and activities of ACP and POD. Additionally, the relative percent survival rate of the vaccinated flounder was 64 and 54% in challenge experiment using S. iniae, respectively. These results indicated that rPGM and rCAMP factor could evoke humoural and innate immune response in flounder and provide high-efficiency immunoprotection against S. iniae infection.

CONCLUSIONS

Phosphoglucomutase (PGM) and CAMP factor were promising vaccine candidates against S. iniae in flounder.

SIGNIFICANCE AND IMPACT OF THE STUDY

Phosphoglucomutase and CAMP factor have the potential to be vaccine candidates, which provide important information for us to develop the effective subunit vaccines, especially the multivaccine, against S .iniae in aquaculture.

Long-Term Liver Disease, Treatment, and Mortality Outcomes Among 17,000 Persons Diagnosed with Chronic Hepatitis C Virus Infection: Current Chronic Hepatitis Cohort Study Status and Review of Findings

Chronic Hepatitis Cohort Study (CHeCS) publications using data from "real-world" patients with hepatitis C virus (HCV) have described demographic disparities in access to care; rates of advanced liver disease, morbidity, and mortality (2.5%-3.5% per year during 2006-10, although only 19% of all CHeCS decedents, and just 30% of those with deaths attributed to liver disease, had HCV listed on death certificate); substantial comorbidities, such as diabetes, advanced liver fibrosis (29% prevalence), renal disease, and depression, and partial reversal of all these with successful antiviral therapy; patient risk behaviors; and use of noninvasive markers to assess liver disease.

Multiregion whole-exome sequencing of matched primary and metastatic tumors revealed genomic heterogeneity and suggested polyclonal seeding in colorectal cancer metastasis

Background

Distant metastasis accounts for 90% of deaths from colorectal cancer (CRC). Genomic heterogeneity has been reported in various solid malignancies, but remains largely under-explored in metastatic CRC tumors, especially in primary to metastatic tumor evolution.

Patients and methods

We conducted high-depth whole-exome sequencing in multiple regions of matched primary and metastatic CRC tumors. Using a total of 28 tumor, normal, and lymph node tissues, we analyzed inter- and intra-individual heterogeneity, inferred the tumor subclonal architectures, and depicted the subclonal evolutionary routes from primary to metastatic tumors.

Results

CRC has significant inter-individual but relatively limited intra-individual heterogeneity. Genomic landscapes were more similar within primary, metastatic, or lymph node tumors than across these types. Metastatic tumors exhibited less intratumor heterogeneity than primary tumors, indicating that single-region sequencing may be adequate to identify important metastasis mutations to guide treatment. Remarkably, all metastatic tumors inherited multiple genetically distinct subclones from primary tumors, supporting a possible polyclonal seeding mechanism for metastasis. Analysis of one patient with the trio samples of primary, metastatic, and lymph node tumors supported a mechanism of synchronous parallel dissemination from the primary to metastatic tumors that was not mediated through lymph nodes.

Conclusions

In CRC, metastatic tumors have different but less heterogeneous genomic landscapes than primary tumors. It is possible that CRC metastasis is, at least partly, mediated through a polyclonal seeding mechanism. These findings demonstrated the rationale and feasibility for identifying and targeting primary tumor-derived metastasis-potent subclones for the prediction, prevention, and treatment of CRC metastasis.

Nonisothermal crystallization kinetics, morphology, and tensile properties of polyphenylene sulfide/functionalized graphite nanoplatelets composites

Polyphenylene sulfide (PPS)/graphite nanoplates (GNPs) nanocomposites were manufactured by simple melt compounding. The GNPs were first functionalized using synthesized benzimidazolium salt to improve the compatibility with PPS matrix. The functionalized GNPs showed an exfoliated dispersion in PPS matrix, which also could significantly improve the tensile properties of composites. Differential scanning calorimetry was used to investigate the nonisothermal crystallization kinetics of PPS/functionalized GNPs composites. The results showed that the PPS/functionalized GNPs composites always had a higher crystallization peak temperature ( Tc) than pure PPS resin at different cooling rates due to the addition of GNPs. The GNPs could also play the role of heterogeneous nucleating agents to accelerate the crystallization; however, at high content, they could also limit the mobility of PPS macromolecular chains and hinder the crystallization. The Mo equation could be used to analyze the nonisothermal crystallization kinetics, whereas the Ozawa equation was not suitable for the nonisothermal crystallization process. Consistent with a previous analysis, the results also showed that the addition of GNPs could also decrease the crystallization activation energy ( Ec) of PPS resin at low content while increasing the Ec at high content.

[Comparison of the efficacies of cross priming amplification and RealAmp with XpertMTB/RIF for the diagnosis of pulmonary tuberculosis at peripheral microscopic center]

Objective: To compare the efficacies of cross priming amplification (CPA) and RealAmp with XpertMTB/RIF for the diagnosis of pulmonary tuberculosis(TB) at peripheral microscopic centers. Methods: From December of 2014 to December of 2015, 3 193 patients suspected with TB were enrolled consecutively at 3 county level TB clinical clinics in Zhongmu, Xinmi and Dengzhou of Henan province. Totally 3 193 collected sputum samples were detected by smear microscopy, L-J media culture, CPA, RealAmp and Xpert MTB/RIF. The culture positive samples were tested by MPB64 for strain identification. The sensitivity and specificity of CPA, RealAmp and Xpert MTB/RIF were calculated according to L-J solid culture results and clinical diagnosis results. Results: The sensitivity of CPA, RealAmp and Xpert MTB/RIF were 85.5%(413/483), 85.5%(413/483) and 87.9%(422/480), respectively, compared with L-J solid culture, the difference among the 3 methods being not significant(χ(2)=1.6, P>0.05). The specificity of CPA, RealAmp and Xpert MTB/RIF were 96.8%(2 624/2 170), 93.2%(2 527/2 170) and 95.3%(2 567/2 170) compared with culture; and there was a significantly statistic difference among the 3 methods(χ(2)=37.8, P<0.001). The sensitivity of smear microscopy, culture, CPA, RealAmp and Xpert MTB/RIF was 21.7%(300/1 383), 34.9%(483/1 383), 34.6%(478/1 383), 39.2%(542/1 383) and 38.1%(526/1 381) compared with clinical diagnosis. The sensitivity of CPA, RealAmp and Xpert MTB/RIF was higher than that of smear (χ(2) =31.9, P<0.01), but there was no significantly statistic difference between the 3 molecular methods(χ(2)=2.9, P>0.05). The specificity of smear microscopy, L-J solid culture, CPA, RealAmp and Xpert MTB/RIF was 100%(1 810/1 810), 100%(1 810/1 810), 98.8%(1 789/1 810), 98.8%(1 756/1 810) and 97.0%(1 788/1 810), and there was no significantly statistic difference among the 3 molecular methods(χ(2)=0.16, P>0.05). Conclusion: The capability of CPA and RealAmp for diagnosing pulmonary TB was similar to Xpert MTB/RIF.The former 2 methods were more suitable to apply to the diagnoses of pulmonary TB in peripheral laboratories.