The Comparison of eTEP and IPOM in Ventral and Incisional Hernia Repair: A Systematic Review and Meta-analysis

BACKGROUND

Open sublay technique and laparoscopic intraperitoneal onlay mesh (IPOM) technique are the most common used procedures in ventral and incisional hernia repair, however, each technique has its own disadvantages. The enhanced view total extraperitoneal technique (eTEP) aims to put the mesh in the retromuscular space by minimal invasive technique. This study is to investigate the efficacy and safety of eTEP and IPOM approach in ventral and incisional hernia repair.

METHODS

The major databases (PubMed, Embase, Springer, and Cochrane Library) were searched, and all studies published through May 1, 2021, using the keywords "enhanced view extraperitoneal," "extended view totally extraperitoneal," "eTEP," "TEP," "laparoscopic retromuscular," "ventral hernia," "incisional hernia," "laparoscopic intraperitoneal onlay mesh," "IPOM." All relevant articles and reference lists in these original studies were also obtained from the above databases.

RESULTS

Five trials containing 433 patients were included in the present study. Compared with the IPOM technique, the eTEP ventral/incisional hernia repair was associated a longer operative time [mean difference=44.79; 95% confidence interval (CI): 26.57, 63; P=0.00001], less acute pain on postoperative day 1 (standardized mean difference=-3.90; 95% CI: -4.42, -3.38; P<0.00001), and day 7 (standardized mean difference=-3.72; 95% CI: -6.09, 1.35; P=0.002), and the eTEP group had a shorter hospital stay compared with the IPOM group (mean difference=-0.56; 95% CI: -0.74, -0.39; P=0.00001). There was no significant difference concerning the incidence of seroma, hematoma, intraoperative complication, and postoperative ileus between eTEP and IPOM groups.

CONCLUSIONS

The eTEP technique in ventral and incisional hernia repair shows significantly lower acute postoperative pain and shorter hospital study but a longer operative time. In addition, there is no significant difference in terms of intraoperative or postoperative complications. Further randomized controlled studies with long-term follow-up are needed to evaluate the eTEP technique.

[Clinical investigation and research on Axis Ⅱ evaluation of patients with temporomandibular disorders]

Objective: To screen the physical, psychological and behavioral factors related to patients with temporomandibular disorders (TMD) by using Axis Ⅱ assessment instruments of diagnostic criteria for TMD(DC/TMD). And to provide a reference to establish personalized diagnosis and treatment plans for TMD patients so as to prevent TMD and reduce predisposing factors. Methods: A total of 141 TMD patients, who were admitted in the Department of Oral and Maxillofacial Surgery in School and Hospital of Stomatology, Wuhan University from October 2018 to February 2021 were selected. There were 121 females and 20 males, with an average age of 30 years. A total of 90 healthy people were included as controls. A full-time psychologist conducted relevant questionnaire surveys. The questionnaires include general clinical survey forms and TMD symptom questionnaire. In addition, Axis Ⅱ assessment instruments include graded chronic pain scale, jaw functional limitation scale, oral behaviors checklist, patient health questionnaire-9 (depression), generalized anxiety disorder scale, patient health questionnaire-15 (physical symptoms), etc. The main observational indicators include: pain level, pain impact rates, overall classification of chronic pain, limited chewing function score, limited motor function score, limited communication function score, total jaw function restricted score, depression score, anxiety score, somatic symptom score and oral behavior score.The survey data were imported into SPSS 22.0 software for statistical analysis. Results: In the TMD group 60.3% (85/141) patients had various degrees of pain, 24.1% (34/141) of those with pain effect grades from 1 to 3 and 61.0% (86/141) showed chronic pain overall grades from Ⅰ to Ⅳ. The chewing function restricted score was 2.67(1.17, 4.25), motor function restricted score was 4.25(1.75, 6.12), communication function restricted score was 1.13(1.00, 2.25) and total jaw function restricted score was 2.56(1.47, 4.15) respectively. Patients with mild depression or above accounted for 59.6%(84/141), patients with mild anxiety or above accounted for 56.7%(80/141), 46.1%(65/141) patients had somatization symptoms. Statistical differences (P<0.05) were determined between TMD group and control group in various scores of jaw function, oral behavior grading, depression, anxiety, and physical symptoms. Physical symptoms had significantly statistical difference between different diagnostic classification(P<0.05). Meanwhile, among the different chronic pain levels in the TMD group, there were statistical differences in the various scales of mandibular dysfunction, depression, anxiety, and somatization. In the TMD group, other significant differences were noticed between males and females in terms of the average score of mouth opening, verbal and facial communication, the total score of mandibular dysfunction as well as physical symptoms (P<0.05). Conclusions: Compared with the healthy people, patients with TMD had more abnormal oral behaviors, different restriction of the mandibular functional activities. At the same time, depression, anxiety, and somatization were more serious. Patients with osteoarthritis and subluxation of temporomandibular joint were more likely to suffer physical symptoms. TMD patients suffering from pain had more severe mandibular dysfunction and symptoms of depression, anxiety, and somatization.

[Retrospective analysis of infliximab in the treatment of Kawasaki disease]

Objective: To investigate the efficacy and safety of infliximab (IFX) therapy for children with Kawasaki disease. Methods: Sixty-eight children with Kawasaki disease who received IFX therapy in Children's Hospital of Fudan University from January 2014 to April 2021 were enrolled. The indications for IFX administration, changes in laboratory parameters before and after IFX administration, response rate, drug adverse events and complications and outcomes of coronary artery aneurysms (CAA) were retrospectively analyzed. Comparisons between groups were performed with unpaired Student t test or Mann-Whitney U test or chi-square test. Results: Among 68 children with Kawasaki disease, 52 (76%) were males and 16 (24%) were females. The age of onset was 2.1 (0.5, 3.8) years. IFX was administered to: (1) 35 children (51%) with persistent fever who did not respond to intravenous immunoglobulin (IVIG) or steroids, 28 of the 35 children (80%) developed CAA before IFX therapy; (2) 32 children (47%) with continuous progression of CAA; (3) 1 child with persistent arthritis. In all cases, IFX was administered as an additional treatment (the time from the onset of illness to IFX therapy was 21 (15, 30) days) which consisted of second line therapy in 20 (29%), third line therapy in 20 (29%), and fourth (or more) line therapy in 28 (41%). C-reactive protein (8 (4, 15) vs. 16 (8, 43) mg/L, Z=-3.38, P=0.001), serum amyloid protein A (17 (10, 42) vs. 88 (11, 327) mg/L, Z=-2.36, P=0.018) and the percentage of neutrophils (0.39±0.20 vs. 0.49±0.21, t=2.63, P=0.010) decreased significantly after IFX administration. Fourteen children (21%) did not respond to IFX and received additional therapies mainly including steroids and cyclophosphamide. There was no significant difference in gender, age at IFX administration, time from the onset of illness to IFX administration, the maximum coronary Z value before IFX administration, and the incidence of systemic aneurysms between IFX-sensitive group and IFX-resistant group (all P>0.05). Infections occurred in 11 cases (16%) after IFX administration, including respiratory tract, digestive tract, urinary tract, skin and oral infections. One case had Calmette-Guérin bacillus-related adverse reactions 2 months after IFX administration. All of these adverse events were cured successfully. One child died of CAA rupture, 6 children were lost to follow up, the remaining 61 children were followed up for 6 (4, 15) months. No CAA occurred in 7 children before and after IFX treatment, while CAA occurred in 54 children before IFX treatment. CAA regressed in 23 (43%) children at the last follow-up, and the diameter of coronary artery recovered to normal in 10 children. Conclusion: IFX is an effective and safe therapeutic choice for children with Kawasaki disease who are refractory to IVIG or steroids therapy or with continuous progression of CAA.

Author Correction: Circular RNA circ-PRKCI promotes cell proliferation and invasion by binding to microRNA-545 in gastric cancer

Correction to: European Review for Medical and Pharmacological Sciences 2019; 23 (21): 9418-9426-DOI: 10.26355/eurrev_201911_19435-PMID: 31773680, published online on 15 November 2019. After publication, the authors applied to change Figure 1E stating that "gastric cancer was observed from patients underlying response at Renmin Hospital of Wuhan University from March 2015 to March 2016. By the time of submission, the survival time of follow-up was only 2 years. From the 2-year follow-up data, we found that high expression of CIRC PRKCI was positively associated with a poor prognosis of GC patients". The authors claim that there is no serious change in the conclusion of the article. There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/19435.

Dapansutrile ameliorated chondrocyte inflammation and osteoarthritis through suppression of MAPK signaling pathway

INTRODUCTION

Osteoarthritis (OA) is one of the most common joint diseases in the elderly population. Proinflammatory cytokines, such as Interleukin-1β (IL-1β), play an important role in the development and progression of OA. Dapansutrile is a specific inhibitor of the NOD-like receptor protein 3 (NLRP3) inflammasome and exhibits anti-inflammatory properties.

METHODS

In this study, we investigated the protective effect and the underlying mechanism of dapansutrile on cartilage degeneration in vitro and in vivo. In the present study, chondrocytes were isolated from rats and then were treated with dapansutrile. After that, the expression of (Cox-2, inducible nitric oxide synthase (iNOS), Mmp-3, Mmp-9, Mmp-13 and IL-10) were evaluated at RNA level, then the expression of (COX-2, MMP-3, MMP-9, MMP-13, SOX-9 and COL2) were evaluated at protein level. Subsequently, the activation of the mitogen-activated protein kinase (MAPK) pathway was tested using western blotting (WB). Additionally, the rat OA model was developed to evaluate the protective effects of dapansutrile in vivo.

RESULTS

The results showed that dapansutrile had no obvious cytotoxicity on rat chondrocytes at 24 h (0, 1, 2, 5 and 10 μM). Dapansutrile significantly decreased IL-1β-induced upregulation of COX2, iNOS, matrix metalloproteinase 3 (MMP3), 9 (MMP9) and 13 (MMP13), and reversed IL-1β-induced the downregulation of IL-10, SOX9 and COL2. Dapansutrile also inhibited IL-1β-induced upregulation of the MAPK signaling pathway by downregulating the expression levels of phospho-ERK, and phospho-P38 in a concentration dependent manner. In addition, dapansutrile exhibited protective effects in rat OA model with lower Mankin's score and Osteoarthritis Research Society International (OARSI) score.

CONCLUSION

Our study suggested that dapansutrile effectively inhibited chondrocyte inflammation by suppressing MAPK signaling pathway in vitro, and ameliorated cartilage degeneration in vivo, indicating an anti-inflammatory effect in OA treatment.

Simulating grazing beef and sheep systems

CONTEXT

Ruminant livestock make an important contribution to global food security by converting feed that is unsuitable for human consumption into high value food protein, demand for which is currently increasing at an unprecedented rate because of increasing global population and income levels. Factors affecting production efficiency, product quality, and consumer acceptability, such as animal fertility, health and welfare, will ultimately define the sustainability of ruminant production systems. These more complex systems can be developed and analysed by using models that can predict system responses to environment and management.

OBJECTIVE

We present a framework that dynamically models, using a process-based and mechanistic approach, animal and grass growth, nutrient cycling and water redistribution in a soil profile taking into account the effects of animal genotype, climate, feed quality and quantity on livestock production, greenhouse gas emissions, water use and quality, and nutrient cycling in a grazing system.

METHODS

A component to estimate ruminant animal growth was developed and integrated with the existing components of the SPACSYS model. Intake of herbage and/or concentrates and partitioning of the energy and protein contained in consumed herbage and/or concentrates were simulated in the component. Simulated animal growth was validated using liveweight data from over 200 finishing beef cattle and 900 lambs collected from the North Wyke Farm Platform (NWFP) in southwest England, UK, between 2011 and 2018. Annual nitrous oxide (N₂O), ammonia, methane and carbon dioxide emissions from individual fields were simulated based on previous validated parameters.

RESULTS AND CONCLUSIONS

A series of statistical indicators demonstrated that the model could simulate liveweight gain of beef cattle and lamb. Simulated nitrogen (N) cycling estimated N input of 190 to 260 kg ha^-1, of which 37-61% was removed from the fields either as silage or animal intake, 15-26% was lost through surface runoff or lateral drainage and 1.14% was emitted to the atmosphere as N₂O. About 13% of the manure N applied to the NWFP and excreta N deposited at grazing was lost via ammonia volatilisation.

SIGNIFICANCE

The extended model has the potential to investigate the responses of the system on and consequences of a range of agronomic management and grazing strategies. However, modelling of multi-species swards needs to be validated including the dynamics of individual species in the swards, preferential selection by grazing animals and the impact on animal growth and nutrient flows.

[Correlation between intrahepatic triglyceride content quantified by proton magnetic resonance spectroscopy and glucose metabolism]

Objective: To investigate the correlation between intrahepatic triglyceride content (IHTC) and glucose metabolism in patients with non-alcoholic fatty liver disease (NAFLD) diagnosed by proton magnetic resonance spectroscopy (¹H-MRS). Methods: A total of 239 subjects without diabetes mellitus were previously enrolled and underwent ¹H-MRS scans. Anthropometric indexes including height, weight, waist and blood pressure, and laboratory findings as plasma glucose (PG), insulin (INS), C-peptide (CP), liver enzymes [alanine aminotransferase (ALT), aspartate transaminase (AST), γ-glutamyl transpeptidase (GGT)] and lipid profiles were collected. According to IHTC levels, participants were divided into three groups: the non-NAFLD group (IHTC<5.56%), the mild NAFLD group (IHTC 5.56%-<33%), and the moderate and severe NAFLD group (IHTC ≥ 33%). The clinical characteristics of each group were analyzed, and the correlation between IHTC and glucose metabolism were assessed. Results: Compared with those in the non-NAFLD group, male proportion, waist, 120 min postprandial PG (PG120), CP, liver enzymes and total cholesterol (TC) levels were greater in the NAFLD group, whereas insulin sensitivity index-Cederholm (ISI-Cederholm) and high density lipoprotein cholesterol (HDL-C) levels were lower in the NAFLD groups. Subjects in the moderate and severe NAFLD group had higher levels of 120 min postprandial INS (INS120) and Stumvoll indexes, and lower ISI-Cederholm than those in the mild NAFLD group [80.37 (57.68, 112.70) mU/L vs.110.50(71.78, 172.80)mU/L, 1453(1178, 1798)vs.1737(1325, 2380), 358(297, 446) vs.441(318, 594), 2.27(2.01, 2.53) vs.2.06(1.81, 2.39), respectively, all P<0.05]. Correlation analyses showed that IHTC was significantly positively correlated with waist hip ratio (WHR), PG120, INS120, HOMA insulin resistance (HOMA-IR), Stumvoll 1st-insulin secretion, Stumvoll 2nd-insulin secretion, ALT, AST, GGT and TC (r=0.197, 0.274, 0.334, 0.162, 0.199, 0.211, 0.406, 0.361, 0.215, and 0.196, respectively, all P<0.05), and negatively correlated with ISI-Cederholm and HDL-C (r=-0.334, and-0.237, respectively, all P<0.05). Furthermore, a multiple linear stepwise regression analysis indicated that ISI-Cederholm (Standardized β =-0.298, P<0.001) and Stumvoll 1st insulin secretion (Standardized β = 0.164, P = 0.024) were independent factors of IHTC. Conclusions: Peripheral insulin resistance occurs in the early stage of NAFLD and becomes worse with the progression of the disease. IHTC was independently associated with insulin sensitivity and first-phase insulin secretion.

[Correlation between nUGT1A1 gene polymorphisms and adverse events of irinotecan plus S-1 for patients with recurrent or metastatic esophageal squamous cell carcinoma: a prospective, open-label, randomized controlled trial (ESWN 01)]

Objective: To investigate the correlation between UGT1A1 polymorphisms and the irinotecan plus S-1 regimen-induced toxicities in Chinese advanced esophageal squamous cell carcinoma (ESCC) patients. Methods: A total of 46 recurrent or metastatic ESCC patients selected from ESWN 01 trial were randomly assigned to irinotecan plus S-1 group [intravenous infusion of irinotecan (160 mg/m(2)) on day 1 and oral S-1 (80-120 mg) on days 1-10, repeated every 14 days]. Peripheral venous blood at baseline was collected and genomic DNA was extracted. The genetic polymorphisms of UGT1A1*6 and UGT1A1*28 were analyzed by polymerase chain reaction (PCR) amplification. Irinotecan plus S-1 regimen-induced toxicities of patients with different UGT1A1 polymorphisms were observed. The correlation between UGT1A1 polymorphisms and the adverse effects was analyzed. Results: Among the 46 patients, the numbers of UGT1A1*6 wild type genotype (GG), mutant heterozygote (GA) and mutant homozygote (AA) were 30, 15 and 1, while those with UGT1A1*28 wild type genotype (TA6/6), mutant heterozygote (TA6/7) and mutant homozygote (TA7/7) were 36, 8 and 2, respectively. Only one patient with UGT1A1*6 AA genotype occurred grade 3 diarrhea, while one of the 2 patients with UGT1A1*28 TA7/7 genotype occurred grade 4 diarrhea. No neutropenia was observed in the patient with UGT1A1*6 AA genotype, however, both of the two patients with UGT1A1*28 TA7/7 genotype occurred grade 3-4 neutropenia. Patients with UGT1A1*28 genetic polymorphism (TA 6/7 or TA7/7) had a higher response rate compared with wild-type TA6/6 carriers. (55.6% versus 26.5%). Conclusions: The homozygous genotype of UGT1A1*6 AA and UGT1A1*28 TA7/7 are rare (<5%) in Chinese ESCC population. Not all homozygous AA and TA7/7 carriers occur severe dose limited toxicities (DLT) when treated with irinotecan (160 mg/m(2)) plus S-1 regimen for 2 weeks. However, it's still necessary torigorously observe the occurrence of severe diarrhea and neutropenia in patients with UGT1A1*6 AA and UGT1A1*28 TA7/7 and adjust the dose timely.

Molecular mechanisms of MCM3AP-AS1 targeted the regulation of miR-708-5p on cell proliferation and apoptosis in gastric cancer cells

The article "Molecular mechanisms of MCM3AP-AS1 targeted the regulation of miR-708-5p on cell proliferation and apoptosis in gastric cancer cells, by H. Wang, T. Xu, L. Wu, H.-L. Xu, R.-M. Liu, published in Eur Rev Med Pharmacol Sci 2020; 24 (5): 2452-2461-DOI: 10.26355/eurrev_202003_20512-PMID: 32196596" has been withdrawn from the authors due to the discovery of new results. The authors decided to improve them further. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/20512.

Male urethral diverticulum squamous cell carcinoma containing a calculus: a rare entity

Male urethral diverticula with calculi have a low incidence. It is extremely rare when the diverticulum accompanied with carcinoma. We report a case of diverticulum of the male urethra containing giant calculi which developed into squamous cell carcinoma. The patient initially presented with lower urinary tract symptoms and a hard, painless perineal mass. We believe that the process of diagnosis and treatment is of great significance in clinical practice.

Extreme ultraviolet-excited time-resolved luminescence spectroscopy using an ultrafast table-top high-harmonic generation source

We present a table-top extreme ultraviolet (XUV) beamline for measuring time- and frequency-resolved XUV-excited optical luminescence (XEOL) with additional femtosecond-resolution XUV transient absorption spectroscopy functionality. XUV pulses are generated via high-harmonic generation using a near-infrared pulse in a noble gas medium and focused to excite luminescence from a solid sample. The luminescence is collimated and guided into a streak camera where its spectral components are temporally resolved with picosecond temporal resolution. We time-resolve XUV-excited luminescence and compare the results to luminescence decays excited at longer wavelengths for three different materials: (i) sodium salicylate, an often used XUV scintillator; (ii) fluorescent labeling molecule 4-carbazole benzoic (CB) acid; and (iii) a zirconium metal oxo-cluster labeled with CB, which is a photoresist candidate for extreme-ultraviolet lithography. Our results establish time-resolved XEOL as a new technique to measure transient XUV-driven phenomena in solid-state samples and identify decay mechanisms of molecules following XUV and soft-x-ray excitation.

Hydrogen solution in high-entropy alloys

High-entropy alloys (HEAs) have been reported to have superior ability in hydrogen (H) storage and strong resistance to H embrittlement. These exceptional properties are directly related to the H solution in the HEAs. However, the diversity of atomic environments in the HEAs complicate the calculation of the H solution energy. With regard to this, we clarified an origin causing the variety of solution energy from the viewpoint of chemical and elastic interactions of H with the host atoms. Combining the semi-empirical atom potential and first-principles calculations regarding H in FeCrCoNi, NbMoTaW, and FeCuCrMnMo, we found that the elastic interaction presents a visibly linear relationship with the volume expansion caused by H insertion. By contrast, the chemical interaction shows a non-linear relationship with the volume of the interstitial polyhedron. A universal model was then established to generalize the solution energy of H. This model can expeditiously assess the H distribution and provide insight into evolution of the microstructure in HEAs.

Comparison of in-hospital outcomes and 30-days readmissions between type 1 and type 2 myocardial infarction patients: a study of the nationwide readmissions database

Introduction

Traditionally Type- 1 myocardial infarction (T1-MI) results from a plaque erosion, rupture, or fissure. In contrast, Type- 2 myocardial infarction (T2-MI) is a consequence of severe supply and demand mismatch. Despite the different mechanisms, both T1-MI and T2-MI can be associated with severe morbidity and mortality. Yet there is sparse data analyzing in-hospital outcomes and readmission rates comparing patients who present with T1-MI and T2-MI.

Purpose

We aimed to compare the outcome data of patients with T1-MI and T2-MI derived from the Nationwide Readmissions Database, a large national database of hospital readmissions.

Method

We utilized the 2018 Nationwide Readmissions Database to identify all index hospital admissions with a primary diagnosis of “acute MI” (AMI) using ICD-10 diagnosis codes. All AMI admissions were further categorized into ST-elevation myocardial infarction (STEMI), no-ST-elevation myocardial infarction (NSTEMI), or T2-MI. Primary outcomes analyzed included 30-days major adverse cardiovascular events (MACE) (defined as re-infarction, repeat revascularization and death within 30 days of admission), short term mortality and readmission rates.

Results

Among 556,816 total admissions for AMI, 28,250 (5.1%) were T2-MI. Table 1 compares baseline variables and short-term outcomes for patients with T1-MI vs T2-MI. Compared to patients with T1-MI patients with T2-MI were older, more likely to be female, and had a higher burden of comorbidities. Additionally, T2-MI patients were less likely to receive coronary revascularization during the index admission. The mean length of stay for T2-MI patients was 4.7±0.6 days, which is longer than the length of stay for STEMI patient (4.1±0.4 days) but slightly shorter than NSTEMI patient (4.9±0.4 days). T2-MI patients had a higher rate of all-cause 30-days readmissions but a lower rate of 30-days MACE. Early mortality rate (within 30 days of index admission) in T2-MI patients was comparable to NSTEMI patients but was lower than STEMI patients. Cox proportional-hazards model adjusting for age, sex, comorbidities and type of hospital setting demonstrated that T2-MI was associated with a lower 30-day MACE risk (T2-MI vs STEMI: [HR 0.33 (95% CI 0.31–0.36)]; T2-MI vs NSTEMI [HR 0.70 (95% CI 0.64–0.75)]) and a lower risk of early mortality (T2-MI vs STEMI: [HR 0.29 (95% CI 0.26–0.32)]; T2-MI vs NSTEMI [HR 0.71 (95% CI 0.65–0.79)]). The adjusted HR for 30-days all-cause readmissions was higher with T2-MI, (T2-MI vs STEMI: [HR 1.16 (95% CI 1.10–1.23)]; T2-MI vs NSTEMI: [HR 1.11 (95% CI 1.06–1.16)]).

Conclusion

T2-MI patients are older and have a higher burden of comorbidities. After adjusting for baseline comorbidities, all-cause readmission risk is higher in T2-MI but short-term MACE and mortality is lower with T2-MI.

Funding Acknowledgement

Type of funding sources: None.

[Analysis of fundus examination results in 8 808 pediatric patients in Northwest China]

Objective: To explore the incidence and age distribution of fundus abnormalities in pediatric patients aged 0-3 years in northwest China. Methods: A retrospective study of the clinical data of 8808 pediatric patients aged 0-3 years who underwent fundus examination with a wide-filed digital retinal imaging system and an indirect ophthalmoscope in our hospital from January 2008 to December 2019 were performed. There were 5092 males and 3716 females, with a median age of 1 month (range, 3 days to 3 years), a mean gestational age of 34.32 (SD 2.92) weeks (range, 24 to 42 weeks) and a mean birth weight of 2006.92 (SD 709.23) g (range, 490 to 5500 g), from Shaanxi Province (7415 cases, 84.18%), Gansu Province (770 cases, 8.74%), Ningxia Hui Autonomous Region (94 cases, 1.07%), Qinghai Province (53 cases, 0.60%), Xinjiang Uygur Autonomous Region (14 cases, 0.16%) and other neighboring areas (462 cases, 5.25%). The fundus condition of the enrolled pediatric patients was documented to calculate the annual detection rate. The joinpoint regression model was drawn to estimate the annual percent change and average annual percent change. The constituent ratios and age distribution of different types of fundus abnormalities were finally analyzed. Results: Fundus abnormalities were detected in 2 531 cases (28.74%). During the 12 years, the number of pediatric patients undergoing fundus examination each year in our center increased rapidly in the first 7 years, and then kept almost stable, while the number of fundus abnormality cases increased year by year. The positive detection rate showed an overall upward trend with an average annual percent change of +7.2%, and it was +30.09% from 2016 to 2019. Among all the pediatric patients with fundus abnormalities, there were 1 678 cases with developmental diseases (66.30%), 232 cases with hereditary diseases (9.16%), 140 cases with ocular tumor (5.53%), 64 cases with ophthalmic manifestations of systemic diseases (2.53%), 31 cases with ocular trauma (1.23%), 12 cases with infectious diseases or inflammation (0.48%) and 438 cases with other ocular abnormalities (17.31%). The top 5 abnormalities were retinopathy of prematurity (ROP; 1477 cases, 58.36%), gray patchy retinopathy (225 cases, 8.89%), retinal hemorrhage (157 cases, 6.20%), retinoblastoma (137 cases, 5.41%) and familial exudative vitreoretinopathy (77 cases, 3.04%). Fundus abnormalities varied with age. ROP, developmental diseases other than ROP, hereditary diseases, ocular trauma and infectious diseases were mostly detected in pediatric patients at 0-6 months old, while tumors were mostly detected after 1 year old. Conclusions: The detection rate of fundus abnormalities in the Department of Ophthalmology of Xijing Hospital of Air Force Medical University, a tertiary referral center in northwest China, increased notably year by year. The abnormalities were mainly developmental and hereditary lesions as well as of certain age distribution. They occurred with the highest frequency between birth and 6 months of age, in which ROP was in the ascendancy. Meanwhile, the detection rate of other developmental, hereditary and neoplastic disorders increased with age. Therefore, a comprehensive and objective understanding of the fundus disease in infants is essential. (Chin J Ophthalmol, 2021, 57: 777-783).

1286 3D Printing of Aortic Valve Scaffolds for Heart Valve Regeneration

Introduction

Valvular heart disease (VHD) has been commonly described as the forgotten epidemic, with an estimated global prevalence of 2.5%. Current heart valve replacement therapies only partially offer a solution to the problem. In recent years, synthetic polymers have been explored due to their diversity allowing tailor-picking of essential traits, such as chemical properties, physical properties, and degradation states. This project investigated the feasibility and mechanical properties of reverse three-dimensional printing of biodegradable scaffolds for heart valve regeneration.

Method

Aortic valve dimensions at an average of 100mmHg were used for the computer aided design of the valves. Aortic valve scaffolds were fabricated using the 3D-TIPs reverse printing technique. Infill densities of 30%, 40% or 50% were used. Printed polymer scaffolds were coated in gelatine solution and compared using static tensile tests. Static strength and elasticity of coated and uncoated valves were compared.

Results

At 25%, 50% and 100% strain, significantly different elastic properties in favour of coated scaffolds between coated and uncoated valves was observed. Coated valves displayed greater strength than uncoated valves (p &gt; 0.05). Computer aided design (CAD) software designed anatomically accurate scaffolds, but poor polymer coagulation was observed on the valve cusps.

Conclusions

The reverse-printing 3D-TIPS procedure successfully produces heart valve scaffolds which present architectural similarities to the naïve mitral valve, however, dimensions of the valves ought to be reassessed. Gelatine-coated valves exhibit greater elastic and tensile properties. A further understanding of cellular interactions on the polymer scaffold, in particular in vivo studies, are required for the continuity of future study.

1258 Computational Modelling Of 3D Printed Scaffolds for Heart Valve Regeneration

Aim

Prosthetic heart valve replacement remains the gold standard treatment for valvular heart disease. However, its durability is limited and there is thus a need to develop an understanding of the feasibility of alternative replacement therapies. 3-dimensional printing of heart valves has been explored due to its patient-specific design and control of desired biomechanical properties. Computational studies of the synthetic valves will contribute to optimisation of designs, as well as improved understanding of the biomechanical behaviour of the complex structures.

Method

Aortic valve dimensions at an average of 100mmHg were used for the computerised design of the valves. Fine Element Analysis modelling generated computational experiments alongside predicted results. Simulated radial pressures tests were conducted at pressures from 0mmHg to 140mmHg and compression tests were conducted at displacement levels between 0-10mm. A Young’s modulus of 0.5 MPa was used. All simulations were conducted in a quasi-static manner.

Results

As the radial pressure on the valves increased, the Mises stresses increased. The maxium Mises stress of the heart valve was 0.09MPa and 0.13MPa under the pressures of 90mmHg and 140mmHg respectively. As valve displacement increased, the Mises stress of the heart valves proportionally rose. In simulated radial pressures tests, the compressive force was 0.19N at 1mm compressive displacment and 1.8N at 10mm compressive displacment.

Conclusions

The simulations demonstrated that 3D-printed heart valve scaffolds can withstand simulated radial pressure and compression tests. A further mechanical tests of the printed scaffold and understanding of its response to hemodynamic dynamic flow is required for the continuity of further study.

Evaluation of at-home methods for N95 filtering facepiece respirator decontamination

N95 filtering facepiece respirators (FFRs) are essential for the protection of healthcare professionals and other high-risk groups against Coronavirus Disease of 2019 (COVID-19). In response to shortages in FFRs during the ongoing COVID-19 pandemic, the Food and Drug Administration issued an Emergency Use Authorization permitting FFR decontamination and reuse. However, although industrial decontamination services are available at some large institutions, FFR decontamination is not widely accessible. To be effective, FFR decontamination must (1) inactivate the virus; (2) preserve FFR integrity, specifically fit and filtering capability; and (3) be non-toxic and safe. Here we identify and test at-home heat-based methods for FFR decontamination that meet these requirements using common household appliances. Our results identify potential protocols for simple and accessible FFR decontamination, while also highlighting unsuitable methods that may jeopardize FFR integrity.

Paclitaxel Inhibits Synoviocyte Migration and Inflammatory Mediator Production in Rheumatoid Arthritis

Activated fibroblast-like synoviocytes (FLSs) play a crucial role in the pathogenesis and progression of rheumatoid arthritis (RA). It is urgent to develop new drugs that can effectively inhibit the abnormal activation of RA-FLS. In our study, the RA-FLS cell line, MH7A, and mice with collagen-induced arthritis (CIA) were used to evaluate the effect of paclitaxel (PTX). Based on the results, PTX inhibited the migration of RA-FLS in a dose-dependent manner and significantly reduced the spontaneous expression of IL-6, IL-8, and RANKL mRNA and TNF-α-induced transcription of the IL-1β, IL-8, MMP-8, and MMP-9 genes. However, PTX had no significant effect on apoptosis in RA-FLS. Mechanistic studies revealed that PTX significantly inhibited the TNF-α-induced phosphorylation of ERK1/2 and JNK in the mitogen-activated protein kinase (MAPK) pathway and suppressed the TNF-α-induced activation of AKT, p70S6K, 4EBP1, and HIF-1α in the AKT/mTOR pathway. Moreover, PTX alleviated synovitis and bone destruction in CIA mice. In conclusion, PTX inhibits the migration and inflammatory mediator production of RA-FLS by targeting the MAPK and AKT/mTOR signaling pathways, which provides an experimental basis for the potential application in the treatment of RA.

[Role of exosomal miRNA in tumor progression and its possible mechanism]

Exosome is a kind of biological nano-vesicle with a diameter of about 30-100 nm and is synthesized, secreted, and released in almost all types of body cells. Recent studies have found that exosomes contain a variety of functional proteins, including mRNA and microRNAs (miRNAs) and so on, which play an important role in the process of material transfer and information exchange in cells. In addition, the related-exosomal microRNAs secreted by tumor cells play an important role in regulating theoccurrence, development, invasion and metastasis of tumors and other biological processes.. Therefore, the study of tumor-related exosomal microRNAs will help us to explore the mechanism of tumor progression from the perspective of tumor gene regulation and new tumor markers, which will contribute to the early diagnosis, treatment, disease monitoring and prognosis evaluation.

Is simple reaction time or choice reaction time an indicator of all-cause mortality or CVD mortality?

OBJECTIVES

Simple reaction time (SRT) and choice reaction time (CRT) have been shown to be good indicators for quantitatively assessing the level of human cognitive impairment, but these parameters have also been linked to the risk of human death. This study aimed to quantitatively assess the independent predictive value of SRT or CRT for all-cause mortality or cardiovascular disease (CVD) mortality by conducting a meta-analysis of prospective studies.

STUDY DESIGN

The study design of this study is a prospective cohort study.

METHODS

We conducted a meta-analysis by combining hazard ratios (HRs) and 95% confidence intervals (95% CIs) of SRT or CRT with all-cause mortality or CVD mortality in healthy community residents aged 18 and over. Heterogeneity was evaluated by using Q statistics and Cochrane's I² statistics.

RESULTS

A total of seven prospective studies that examined all-cause mortality and CVD mortality were included. The pooled HR of all-cause mortality in SRT was 1.099 (1.065-1.134, I² = 11.9%), and an increased risk of CVD mortality was associated with lower SRT (HR = 1.186, 95% CI = 1.137-1.236; I² = 52.4%). Similarly, the pooled HR of all-cause mortality in CRT was 1.140 (95% CI = 1.085-1.197, I² = 33.7%). However, lower CRT was not statistically associated with an increased risk of CVD mortality.

CONCLUSION

SRT may be a predictor of all-cause-mortality and CVD mortality, and CRT is significantly associated with an increased risk of all-cause mortality.

Transabdominal Partial Extraperitoneal Repair of Lateral Hernias of the Abdomen and Flank

Background: Lateral hernia (LH) repair is a challenging and debated topic in abdominal wall surgery because of the anatomical location and mesh placement and fixation. Large LHs should be managed with an open procedure; however, there is no consensus regarding the repair of small- to medium-sized LHs. We report our treatment of this type of LH using the transabdominal partial extraperitoneal (TAPE) technique. Methods: After retrospective review of the prospective hernia database at two hernia centers, patients with small- to medium-sized LHs who underwent the TAPE technique were identified and analyzed. The key components of our technique include wide dissection of peritoneum off the defect and use of that peritoneum to cover the lower and medial part of the mesh as much as possible. The parameters studied included patient demographics, intraoperative data, and postoperative outcome. Results: We studied 19 patients with small- to medium-sized LHs repaired using the TAPE procedure between 2017 and 2020. LH etiologies were primary hernia (n = 3), incisional hernia (n = 15), and traumatic hernia (n = 1). Mean defect size was 5.8 ± 2.1 cm (range 2.5-10 cm), mean operative time 118.1 ± 41.7 minutes (range 65-240 minutes), and mean postoperative stay 6.4 ± 2.0 days (range 6-9 days). There were no perioperative complications. At a mean follow-up of 20 months, no patient had recurrence of LH. Discussion: For small- to medium-sized LHs, the laparoscopic TAPE technique is minimally invasive and safe; the procedure is associated with minimal postoperative complications.

Bottom-Up Nanofabrication with Extreme-Ultraviolet Light: Metal-Organic Frameworks on Patterned Monolayers

The fabrication of integrated circuits with ever smaller (sub-10 nm) features poses fundamental challenges in chemistry and materials science. As smaller nanostructures are fabricated, thinner layers of materials are required, and surfaces and interfaces gain a more important role in the formation of nanopatterns. We present a new bottom-up approach in which we use the high optical resolution offered by extreme ultraviolet (EUV) lithography to print patterns on self-assembled monolayers (SAMs). Upon radiation, low-energy electrons induce chemical changes in the SAM so that the projected image is transferred to the substrate surface. We use the chemical differences between exposed and unexposed regions to promote a selective growth of hybrid structures that can act as an etch-resistant layer for further pattern transfer or can be used as functional nanostructures. The EUV doses required to promote selective growth on exposed areas are close to industrial requirements. Furthermore, this method allows for the independent tuning of different steps in the EUV lithography process (photo-induced chemistry, spatially resolved chemical contrast, and formation of nanopatterns), an advantage over current resists, in which the same material plays all roles.

[mTOR signaling pathway-mediated autophagy involved in inhibition of osteoblast differentiation induced by cadmium in human bone marrow mesenchymal stem cells]

Objective: To investigate the role of autophagy mediated by mTOR signaling pathway in the inhibition of osteogenic differentiation of human bone marrow mesenchymal stem cells (hBMSCs) induced by cadmium. Methods: HBMSCs were divided into 0, 2.5 or 5.0 μmol/L groups according to the exposure dose of cadmium chloride (CdCl₂), and each group was treated for 1 day, 4 days and (or) 7 days. The ALP activity and mRNA and protein expression levels of osteogenesis markers (ALP, RUNX2 and OSTERIX), autophagy-related proteins (LC3 and Beclin-1) and mTOR signaling pathway related proteins (mTOR, p-mTOR and p-p70S6K) expression, alkaline phosphatase staining and alizarin red staining were detected. MHY 1485 was selected as the signaling pathway activator. The control group, CdCl₂ group (5.0 μmol/L), MHY 1485 group and CdCl₂+MHY 1485 combined treatment group were set. After 7 days of treatment, the expression levels of autophagy related proteins and mTOR signaling pathway related proteins of hBMSCs in each group were detected. Results: There was no significant difference in ALP activity between 0, 2.5 and 5.0 μmol/L groups on day 1 and 4 (P>0.05); On day 7, compared with the 0 μmol/L group, the ALP activity, expression of osteogenic markers (ALP, RUNX2, OSTERIX) and mTOR signaling pathway related proteins (mTOR, p-mTOR, p-p70S6K) expression decreased in the 2.5 and 5.0 μmol/L group (P<0.05). Compared with the 0 μmol/L group, the staining of the 2.5 and 5.0 μmol/L groups became lighter, and the formation of ALP and mineralized nodules was reduced. Compared with the CdCl₂ group, the autophagy related protein expression in the CdCl₂+MHY 1485 combined treatment group decreased, and the mTOR signaling pathway related protein expression increased. The difference was statistically significant (P<0.05). Conclusion: The inhibition of osteogenic differentiation of hBMSCs by cadmium may be related to autophagy mediated by mTOR signaling pathway.

Identification and characterization of circRNAs in maize seedlings under deficient nitrogen

Here, deep sequencing results of the maize transcriptome in leaves and roots were compared under high-nitrogen (HN) and low-nitrogen (LN) conditions to identify differentially expressed circRNAs (DECs). Circular RNAs (circRNAs) are covalently closed non-coding RNA with widely regulatory potency that has been identified in animals and plants. However, the understanding of circRNAs involved in responsive nitrogen deficiency remains to be elucidated. A total of 24 and 22 DECs were obtained from the leaves and roots, respectively. Ten circRNAs were validated by divergent and convergent primers, and 6 DECs showed the same expression tendency validated by reverse transcriptase-quantitative PCR. Integrating the identified differentially expressed miRNAs, 34 circRNAs could act as miRNA decoys, which might play important roles in multiple biological processes, including organonitrogen compound biosynthesis and regulation of the metabolic process. A total of 51 circRNA-parent genes located in the genome-wide association study identified loci were assessed between HN and LN conditions and were associated with root growth and development. In summary, our results provide valuable information regarding further study of maize circRNAs under nitrogen deficiency and provide new insights into screening of candidate genes as well as the improvement of maize regarding nitrogen deficiency resistance. CircRNA-miRNA-mRNA co-expression networks were constructed to explore the circRNAs that participated in biological development and nitrogen metabolism.

Identification of a pyroptosis-associated long non-coding RNA signature for predicting the immune status and prognosis in skin cutaneous melanoma

OBJECTIVE

Pyroptosis is correlated with programmed tumor cell death and the tumor microenvironment. However, the prognostic value of pyroptosis-associated long non-coding RNAs (lncRNAs) in skin cutaneous melanoma (SKCM), a malignant tumor with a poor prognosis, has not been established.

PATIENTS AND METHODS

In this study, expression profiles and clinical data of patients with SKCM were downloaded from The Cancer Genome Atlas (TCGA) database to identify differentially expressed pyroptosis-related lncRNAs related to overall survival. A lncRNA risk signature was constructed by Cox regression analyses and its prognostic value was evaluated. Associations between the lncRNA signature and immune status, immune microenvironment, tumor stemness, immune checkpoints, and m6A-related genes were further evaluated.

RESULTS

Twenty-two pyroptosis-related lncRNAs were identified and incorporated into a prognostic risk signature. The signature was significantly correlated with overall survival, tumor growth, and metastasis in SKCM. The signature demonstrated better diagnostic accuracy than conventional clinicopathological characteristics. A gene set enrichment analysis indicated that the risk signature was enriched in several immune-related pathways. Furthermore, the risk signature was significantly correlated with the immune microenvironment, immune cell infiltration, and immune subtypes, as well as tumor stem cells and some m6A-related genes. The lncRNA expression levels were also significantly related to responses to several anti-tumor drugs. Finally, a nomogram based on the risk score was established.

CONCLUSIONS

Overall, a risk signature based on 22 pyroptosis-associated lncRNAs was generated, providing a novel perspective on the determinants of prognosis and survival in SKCM and a basis for the development of individualized treatments.

Direct measurement of the PSF for Coulomb delocalization - a reconsideration

An interpretation of Coulomb delocalization, which limits the spatial resolution of inelastic TEM or STEM images, is given. We conclude that the corresponding point spread function cannot be measured as a broadening of a STEM probe.

The efficacy and safety of dupilumab in Chinese patients with moderate-to-severe atopic dermatitis: a randomized, double-blind, placebo-controlled study

BACKGROUND

Dupilumab is an antibody against interleukin 4 receptor α, used in treating atopic dermatitis (AD).

OBJECTIVES

To evaluate the efficacy and safety of dupilumab in adult Chinese patients with moderate-to-severe AD.

METHODS

In this randomized, double-blind, placebo-controlled, parallel-group, phase III study, conducted between December 2018 and February 2020, patients with AD received dupilumab (300mg) or placebo once every 2 weeks for 16 weeks, and were followed up for 12 weeks. The primary efficacy endpoint was the proportion of patients with both Investigator's Global Assessment (IGA) score of 0-1 and a reduction from baseline of ≥2 points at week 16.

RESULTS

Overall, 165 patients (mean age: 30.6 years; 71.5% male) were randomized: 82 to dupilumab and 83 to placebo. At week 16, 26.8% of patients in the dupilumab group and 4.8% of patients in the placebo group achieved the primary endpoint (difference, 22.0%; 95% confidence interval [CI], 11.37-32.65%; p<0.0001). Compared with placebo, higher proportions of patients in the dupilumab group achieved ≥75% reduction in the Eczema Area and Severity Index score (57.3% vs 14.5%; difference, 42.9%; 95% CI, 29.75-55.97%; p<0.0001) and had ≥3-point (52.4% vs 9.6%; difference, 42.8%; 95% CI, 30.26-55.34%; p<0.0001) and ≥4-point (39.0% vs 4.8%; difference, 34.2%; 95% CI, 22.69-45.72%; p<0.0001) reductions in weekly average daily peak daily pruritus numerical rating scale scores. The incidence of TEAEs during the treatment period was similar in the two groups. The incidence of conjunctivitis, allergic conjunctivitis, and injection site reaction was higher in the dupilumab group than in the placebo group.

CONCLUSIONS

In adult Chinese patients, dupilumab was effective in improving the signs and symptoms of AD and demonstrated a favorable safety profile.

Analysis of neurotransmitters associated with neuropsychiatric status in workers following lead exposure

OBJECTIVE

To explore the correlation between neuropsychiatric status and blood neurotransmitter in lead workers, and to provide theoretical basis for the prevention and treatment of lead workers.

SUBJECTS AND METHODS

The study applied cross-sectional survey, 74 occupational lead exposed workers in a battery factory in a city of Hebei province were selected as the lead exposed group, and 62 workers (non-lead workers) were selected as the control group. The occupational health symptoms questionnaire and health examination and POMS (Profile of Mood State, POMS) emotional test questionnaire were applied to investigate the nearly emotional status of the studied objects, ICP-MS was used to determine the blood lead level of all subjects, HPLC (High performance liquid chromatography, HPLC) was applied to determine the concentration of neurotransmitter in peripheral blood of all studied subjects, and all results were applied the Pearson's correlation analysis.

RESULTS

The blood lead concentration of the lead workers group (163.23±40.77 ug/L) was significantly higher than that in the control group (43.62±14.50 ug/L), and the difference was statistically significant. From the analysis of neuropsychiatric status, the neurological symptoms in the lead workers group were higher than that in the control group, among which the symptoms of sleep disturbance, dizziness, fatigue, numbness of limbs and dampness and coldness of limbs were more obvious. Among the symptoms of digestive system, the incidence of abdominal pain, abdominal distension, constipation and nausea and vomiting were higher. According to the POMS emotion questionnaire, the scores of 5 negative emotions and 1 positive emotion in the lead exposure group were higher than that in the control group, and the difference was statistically significant. Related to the control group, the concentration of neurotransmitters such as DA, 5-HT, GABA, Gly, Trp and Glu were statistically decreased, p<0.001. There was a negative correlation between neurotransmitters in peripheral blood and blood lead levels in lead workers, among which 5-HT had the greatest correlation with lead levels (r=-0.569, p<0.001). 5-HT and Trp were significantly correlated with tension-anxiety (T), depression-depression (D), anger-hostility (A), Vigor-hyperactivity (V), fatigue-inertia (F), and confusion-confusion (C). 5-HT, Trp and GABA were significantly correlated with the survey symptoms, among which, the sleep disorder, constipation and fatigue had most significantly positive correlation with 5-HT or Trp, r-value was respectively 0.373, 0.233 and 0.563.

CONCLUSIONS

Lead exposure not only causes the alteration of neuropsychiatric behavior of lead workers, but also changes gastrointestinal symptoms. Serotonin may be involved as the main neurotransmitter synthesized in intestinal, and the synthesis and metabolism may be regulated by intestinal flora.

Expression levels of plasma miRNA-21 and NT-proBNP in children with Kawasaki disease and their clinical significance

OBJECTIVE

The purpose of this study was to detect the expression levels of plasma microRNA-21 (miRNA-21) and NT-proBNP (N-terminal prohormone of brain natriuretic peptide) in children with Kawasaki disease (KD), as well as their clinical significance.

PATIENTS AND METHODS

Children with KD (n=100) who were treated in our hospital from June 2017 to May 2019 were included. In the same period, non-KD children with febrile diseases were included as controls. Plasma levels of miRNA-21 and NT-proBNP were detected by reverse transcriptase-polymerase chain reaction (RT-PCR) and electrochemiluminescence, respectively. Then, the relationship between miRNA-21 and NT-proBNP in children with KD was analyzed by Pearson's correlation test. Potential factors influencing KD were analyzed by Multivariate logistic regression test. Finally, receiver operating characteristic (ROC) curves were depicted to assess the diagnostic potentials of miRNA-21 and NT-proBNP in KD.

RESULTS

The results showed that miRNA-21 and NT-proBNP levels were higher in children with KD. Plasma level of miRNA-21 was positively correlated with NT-proBNP level in children with KD. Besides, both miRNA-21 and NT-proBNP were risk factors influencing the onset of KD. According to ROC curves, the sensitivity and specificity of miRNA-21 in diagnosing KD was 83% and 89%, respectively (AUC=0.9212, 95% CI: 0.8809-0.9614, cut-off value=1.985). NT-proBNP also displayed diagnostic potential in KD (AUC=0.9788, 95% CI: 0.9630-0.9946, cut-off value=265.6, sensitivity=88%, specificity=95%).

CONCLUSIONS

MiRNA-21 and NT-proBNP are upregulated in plasma of children with KD. They are positively correlated with each other and serve as risk factors for KD. Both of them can be utilized as indicators of auxiliary diagnosis in KD.

Monocytic MDSCs skew Th17 cells toward a pro-osteoclastogenic phenotype and potentiate bone erosion in rheumatoid arthritis

OBJECTIVES

While myeloid-derived suppressor cells (MDSCs) were previously shown to promote a proinflammatory T helper (Th) 17 response in autoimmune conditions, a potential impact of the MDSC-Th17 immune axis on abnormal bone destruction in RA remains largely unknown.

METHODS

We investigated the correlation between the frequency of MDSCs or its subsets and joint destruction in RA patients. The reciprocal actions of patient-derived MDSCs and Th17 cells were studied using osteoclast (OC) differentiation and bone resorption assays in vitro, which were further validated using mouse models of RA. Contribution of MDSCs to osteoclastogenesis and bone erosion in vivo was determined by depletion or transfer of MDSCs.

RESULTS

Human MDSCs, particularly monocytic MDSCs (M-MDSCs), exhibit inherent OC-differentiating capacity and positively correlate with clinical bone erosion in RA patients. Strikingly, patient-derived M-MDSCs can program Th17 cells towards a pro-osteoclastogenic phenotype, which in return potentiates OC differentiation via the receptor activator of nuclear factor κΒ ligand (RANK-L)-RANK signalling. This enhanced osteolysis driven by the reciprocal actions of M-MDSCs and Th17 cells is further confirmed using mouse models of RA. Selective depletion of M-MDSCs significantly ameliorates osteoclastogenesis and disease severity in arthritic mice, whereas transfer of M-MDSCs aggravates bone erosion associated with increased OCs in recipient mice.

CONCLUSION

Our findings highlight the functional plasticity of MDSCs and identify a novel pro-osteoclastogenic pathway governed by interplay between myeloid cells and T lymphocytes in autoimmune RA.

Study of PWR hot leg creep rupture and RCS depressurization strategy during an SBO accident

Preventing the leakage of radioactive materials is important to nuclear safety. During a station blackout accident in pressurized water reactors, the hot leg creep rupture caused by hot leg countercurrent flow occurs before the reactor pressure vessel failure that caused by lower head rupture. The secondary fission products barrier is lost after hot leg creep rupture. An analysis for this phenomenon was done using the Modular Accident Analysis Program version 4.0.4 code. A station blackout accident for CPR1000 is simulated and the occurrence and influence of hot leg creep rupture phenomenon are analyzed in detail. After that, a sensitivity analysis of the opening of different pressurizer pilot-operated relief valves at five minutes after entering severe accident management guideline (before the hot leg creep rupture occurs) is studied. The results show that reactor pressure vessel failure time can be extended by at least 4 h if at least one pilot-operated relief valve is opened and direct containment heating phenomenon can be eliminated if at least two pilot-operated relief valves are opened.