[Pilot study of the relationship between clinical classification of gallbladder cancer and prognosis: a retrospective multicenter clinical study]

Objectives: To propose a novel clinical classification system of gallbladder cancer, and to investigate the differences of clinicopathological characteristics and prognosis based on patients who underwent radical resection with different types of gallbladder cancer. Methods: The clinical data of 1 059 patients with gallbladder cancer underwent radical resection in 12 institutions in China from January 2013 to December 2017 were retrospectively collected and analyzed.There were 389 males and 670 females, aged (62.0±10.5)years(range:22-88 years).According to the location of tumor and the mode of invasion,the tumors were divided into peritoneal type, hepatic type, hepatic hilum type and mixed type, the surgical procedures were divided into regional radical resection and extended radical resection.The correlation between different types and T stage, N stage, vascular invasion, neural invasion, median survival time and surgical procedures were analyzed.Rates were compared by χ(2) test, survival analysis was carried by Kaplan-Meier and Log-rank test. Results: Regional radical resection was performed in 940 cases,including 81 cases in T1 stage,859 cases in T2-T4 stage,119 cases underwent extended radical resection;R0 resection was achieved in 990 cases(93.5%).The overall median survival time was 28 months.There were 81 patients in Tis-T1 stage and 978 patients in T2-T4 stage.The classification of gallbladder cancer in patients with T2-T4 stage: 345 cases(35.3%)of peritoneal type, 331 cases(33.8%) of hepatic type, 122 cases(12.5%) of hepatic hilum type and 180 cases(18.4%) of mixed type.T stage(χ(2)=288.60,P<0.01),N stage(χ(2)=68.10, P<0.01), vascular invasion(χ(2)=128.70, P<0.01)and neural invasion(χ(2)=54.30, P<0.01)were significantly correlated with the classification.The median survival time of peritoneal type,hepatic type,hepatic hilum type and mixed type was 48 months,21 months,16 months and 11 months,respectively(χ(2)=80.60,P<0.01).There was no significant difference in median survival time between regional radical resection and extended radical resection in the peritoneal type,hepatic type,hepatic hilum type and mixed type(all P>0.05). Conclusion: With application of new clinical classification, different types of gallbladder cancer are proved to be correlated with TNM stage, malignant biological behavior and prognosis, which will facilitate us in preoperative evaluation,surgical planning and prognosis evaluation.

The effect of primer cap material on ballistic toolmark evidence

There has recently been an increase in the research and implementation of advanced measurement techniques to ballistic toolmark identification. This has led to a shift from greyscale imaging to the acquisition of dense areal datasets. With the addition of mathematical correlation algorithms, these advanced techniques will be advantageous in criminal investigation. However, with the use of areal topography comes the addition of height point data which may differ in primer caps of varying material composition. This study discusses the differences in the overall topography of firing pin impressions in different primer cap materials, and the effect it has on the successful correlation of ballistic toolmark evidence.

Increased intrinsic connectivity for structural atrophy and functional maintenance after acute ischaemic stroke

BACKGROUND AND PURPOSE

Significant clinical recovery has commonly been observed in ischaemic stroke patients with irreversible brain structural damage. However, brain mechanisms that help to maintain clinical function remain unclear.

METHODS

Sixty-two patients with acute ischaemic stroke underwent longitudinal clinical assessments and magnetic resonance scanning. The clinical recovery trajectory was evaluated using a hierarchical linear model and intrinsic connectivity was analysed with a seed-based approach to examine its changing pattern based on the regional volume changes calculated using voxel-wise analysis.

RESULTS

It was observed that clinical outcome measures improved mainly in the short-term period (baseline versus 3 weeks) and then remained stable. Grey matter volume was reduced significantly in the bilateral caudate over the entire 3-year long-term period. Significant intrinsic connectivity increases were observed in the caudate-middle cingulum over the short-term period and in the caudate-precuneus and caudate-calcarine over the long-term period. Finally, it was found that increased caudate-calcarine connectivity was associated with reduced right caudate volume, and a positive correlation was found between increased caudate-middle cingulum connectivity and the amount of modified Rankin score changes.

CONCLUSIONS

The increased intrinsic connectivity found in this study tends to be a compensatory mechanism for post-stroke structural damage, associated with clinical recovery. The study helps in understanding the significance of enhanced intrinsic connectivity in post-stroke long-term assessment and rehabilitation.

[Primary small cell neuroendocrine carcinoma of the tonsil: a case report]

Neuroendocrine carcinoma(NEC) of the tonsil is extremely rare that exhibits highly malignant and poorly prognosis. Only a few of case reports and the optial treatment is still uncertain. Here, the current study presents a case of 60-year-old male with neck mass rapidly growing for four months. It was diagnosed a primary tonsil neuroendocrine carcinoma. And he was treated by one cycle of cisplatin and etoposide. It had no effect and the tumor was rapidly progressed. With review of the literatures, the nomenclature, clinicopathological characteristics and treatment modalities of this rare tumor are discussed.

[Screening for hotspot mutations associated with genetic hearing impairment in pregnant women and subsequent prenatal diagnosis in high risk pregnancies]

Objective: To screen for hotspot gene mutations associated with genetic deafness in Chinese pregnant women, and to perform risk assessment and prenatal diagnosis in high-risk families. Methods: Between November 2012 and October 2017, 26 117 pregnant women were screened by molecular hybridization microarray for 9 hot-spot mutations in 4 hereditary deafness related genes (GJB2 c. 35 del G, c. 176_191 del 16 bp, c. 235 del G, c. 299_300 del AT, GJB3 c. 538 C>T, SLC26A4 c. 2168 A>G, IVS 7-2 A>G, mitochondrial DNA 12S rRNA m. 1494 C>T, m. 1555 A>G). Genotype analysis was carried out in husbands of women carrying mutations, and prenatal diagnosis was carried out in the fetuses with high risk of deafness. Results: Among all women tested, 1 208(4.63%) were carriers of genetic deafness mutations, 7 with hearing impairment were affected by homozygous or compound heterozygous mutations, 51 were mitochondrial gene mutation carriers, 103 were carriers of GJB3 c. 538 C>T heterozygous mutation, 1 026 were carriers of GJB2 or SLC26A4 heterozygous mutations, and 21 carried heterozygous mutations in two genes simultaneously. In 394 families, the husbands accepted gene sequence testing, and 27 in which were determined as carriers of mutations in identical genes as their wives. Among which, 18 families received prenatal diagnosis, and 5 fetuses were diagnosed as hereditary deafness. In 9 families who did not receive prenatal diagnosis, 1 neonate was diagnosed as compound heterozygote after delivery. Conclusion: In order to prevent birth defects with congenital hearing problems, it is effective to provide screening for hotspot mutations in pregnant women and to perform prenatal diagnosis on high risk pregnancies.

Clinical analysis of Hashimoto thyroiditis coexistent with papillary thyroid cancer in 1392 patients

Papillary thyroid carcinoma (PTC) is the most common malignant tumour of the thyroid. The effect of the concurrent presence of Hashimoto's thyroiditis (HT) and PTC is still under debate. The aim of this study is to investigate the influence of coexistent HT on prognostic outcomes and the association of coexistent HT with clinicopathological features. The demographic and clinicopathological data of 1,392 patients who underwent surgery in our hospital from 2007 to 2016 was collected and analysed. Among 1,392 PTC patients, the rate of HT was 25.6%. There were significant differences in the mean levels of thyroid stimulating hormone (3.27 vs. 2.41 μIU/L, p < 0.01), thyroperoxidase antibodies (110.31 vs. 131.2 U/ml, p < 0.01) and thyroglobulin antibodies (131.90 vs. 113.53 ng/ml, p < 0.01) between the two groups. PTC patients with HT had the following characteristics compared to patients without HT: smaller tumour size (p < 0.01), female predominance (p < 0.01) and higher rate of multifocality (p = 0.024). In addition, patients with HT had a significantly lower rate of lymph node metastasis (LNM) and advanced TNM stage than patients without HT (all p < 0.01). Multivariate analysis found that both age and multifocality were significantly associated with central LNM in HT patients (p < 0.01, p = 0.019, respectively). Extrathyroidal invasion and TSH level were also significant independent factors for lateral LNM in HT patients (p < 0.008, p = 0.04, respectively). HT is associated with a significantly higher risk of PTC. The coexistence of HT in PTC patients is associated with favourable clinical outcomes compared to PTC without HT. Total thyroidectomy and prophylactic central compartment lymphadenectomy should be a choice for PTC patients with HT.

Improvements of interfacial friction and heat transfer models for rectangular narrow channel reflood simulation based on RELAP5

Plate fuel assembly is widely used in reactor cores due to benefits of the narrow rectangular channels. Compared with rod assembly, the heat transfer area and power density can be increased in narrow rectangular channel, where little researches on post-CHF thermal-hydraulic characteristics have been done. Once the loss of coolant accident happens, post-CHF thermal-hydraulic characteristics are important for accident mitigation. This paper mainly evaluates the corresponding reflood models in RELAP5/MOD3 code. Combined with the post-CHF thermal-hydraulic characteristics in the narrow channel, interfacial friction model and post-CHF heat transfer models are modified. According to the comparison results with Saxena reflood experiments, conclusions can be obtained that the original RELAP5/MOD3 code overestimates quench front velocity and heat transfer in the film boiling region. The results from the code with new models agree better with the experimental data.

Racial disparities in vaccination for seasonal influenza in early childhood

OBJECTIVES

Influenza vaccination is the best protection against infection and severe complications of disease, such as hospitalization and death. Therefore, it is important to accurately estimate vaccination coverage and to evaluate the role of race/ethnicity. This study examines racial disparities in influenza vaccination among children using a nationally representative sample.

STUDY DESIGN

This study used cross-sectional data from the 2009-2014 National Immunization Survey for children aged 19-35 months (n = 98,186) in the United States.

METHODS

The outcome variable was receipt of influenza vaccination (yes/no) and exposure variable was race/ethnicity. Weighted multivariate logistic regression was used to estimate the odds ratio and 95% confidence intervals (CIs) for the effect of race/ethnicity on receipt of the influenza vaccine.

RESULTS

The overall vaccination rates were 81.6% for non-Hispanic whites, 79.2% for Hispanics, 80.5% for non-Hispanic blacks, and 80.7% for non-Hispanic mixed/other. In the adjusted model, compared with non-Hispanic white children, Hispanic children were 13% less likely to receive influenza vaccination within the last 12 months (adjusted odds ratio [aOR] = 0.87; 95% CI: 0.80-0.94). In addition, children aged 24-29 months (aOR = 0.48; 95% CI: 0.44-0.52) and 30-35 months (aOR = 0.33; 95% CI: 0.30-0.36) were significantly less likely to receive influenza vaccination within the last 12 months compared with those who were 19-23 months old.

CONCLUSIONS

There were differences in influenza vaccination rates among different racial groups. Hispanic children had the lowest vaccination rates. Findings from our study have significant implications for targeted interventions to increase the overall vaccination rate for children in the United States.

Establishment and characterization of a new cell line from koi brain (Cyprinus carpio L.)

A novel permanently growing brain cell line from koi (Cyprinus carpio L.) (KB cell line) was established, and its suitability for detection of koi herpesvirus (KHV) was demonstrated in this study. The KB cell line was optimally maintained at 27°C in Leibovitz's L-15 medium supplemented with 10% foetal bovine serum (FBS). It was subcultured more than 100 times, and chromosome analysis revealed that 51.54% of KB cells at passage 80 maintained the abnormal diploid chromosome number 2n = 96 while the modal chromosome number was 2n = 100. The cell line was cryopreserved in liquid nitrogen at -196°C and was recovered from storage after 1 year with good cell viability and vitality. The results of virus isolation demonstrated that KB cells were susceptible to KHV, which was shown by the presence of an obvious cytopathic effect and abundant virus particles. The viral titres of KHV in KB reached 10^5.73 TCID₅₀ /0.1 ml within 7 days. Immunofluorescence and Western blot assays confirmed that KB replicated KHV. The newly established KB cell line will serve as a useful tool to elucidate KHV disease (KHVD) pathogenesis.

Electric field tuned MoS2/metal interface for hydrogen evolution catalyst from first-principles investigations

Understanding the interfacial properties of catalyst/substrate is crucial for the design of high-performance catalyst for important chemical reactions. Recent years have witnessed a surge of research in utilizing MoS₂ as a promising electro-catalyst for hydrogen production, and field effect has been employed to enhance the activity (Wang et al 2017 Adv. Mater. 29, 1604464; Yan et al 2017 Nano Lett. 17, 4109-15). However, the underlying atomic mechanism remains unclear. In this paper, by using the prototype MoS₂/Au system as a probe, we investigate effects of external electric field on the interfacial electronic structures via density functional theory (DFT) based first-principles calculations. Our results reveal that although there is no covalent interaction between MoS₂ overlayer and Au substrate, an applied electric field efficiently adjusts the charge transfer between MoS₂ and Au, leading to tunable Schottky barrier type (n-type to p-type) and decrease of barrier height to facilitate charge injection. Furthermore, we predict that the adsorption energy of atomic hydrogen on MoS₂/Au to be readily controlled by electric field to a broad range within a modest magnitude of field, which may benefit the performance enhancement of hydrogen evolution reaction. Our DFT results provide valuable insight into the experimental observations and pave the way for future understanding and control of catalysts in practice, such as those with vacancies, defects, edge states or synthesized nanostructures.

High performance composites of spinel LiMn2O4/3DG for lithium ion batteries

A highly crystalline nanosized spinel LiMn₂O₄/3DG composite cathode material for high rate lithium ion batteries was successfully prepared by mixing spinel LiMn₂O₄ particles with reduced graphene oxide (3DG). Spinel LiMn₂O₄ and reduced three-dimensional graphene oxide were synthesized using a hydrothermal method and freeze-drying technology, respectively. The structure, morphology and electrochemical performance of the synthesized materials were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS) and galvanostatic charge–discharge techniques. The results showed that the LiMn₂O₄/3DG composites exhibited excellent rate capability and stable cycling performance. The discharge capacity was 131 mA h g⁻¹ and the capacity remains at 89.3% after 100 cycles at a 0.5 C rate, while the discharge capacity was 90 mA h g⁻¹ at 10 C. Compared with spinel LiMn₂O₄ materials, the LiMn₂O₄/3DG composites showed obvious improvement in electrochemical performance.

3DG/LiMn₂O₄ composites exhibit a high specific capacity and excellent rate performance.

Validation of a KHV antibody enzyme-linked immunosorbent assay (ELISA)

Koi herpesvirus (KHV) causes KHV disease (KHVD). The virus is highly contagious in carp or koi and can induce a high mortality. Latency and, in some cases, a lack of signs presents a challenge for virus detection. Appropriate immunological detection methods for anti-KHV antibodies have not yet been fully validated for KHV. Therefore, it was developed and validated an enzyme-linked immunosorbent assay (ELISA) to detect KHV antibodies. The assay was optimized with respect to plates, buffers, antigens and assay conditions. It demonstrated high diagnostic and analytical sensitivity and specificity and was particularly useful at the pond or farm levels. Considering the scale of the carp and koi industry worldwide, this assay represents an important practical tool for the indirect detection of KHV, also in the absence of clinical signs.

Comparison of Kaposi Sarcoma Risk in Human Immunodeficiency Virus-Positive Adults Across 5 Continents: A Multiregional Multicohort Study

BACKGROUND

We compared Kaposi sarcoma (KS) risk in adults who started antiretroviral therapy (ART) across the Asia-Pacific, South Africa, Europe, Latin, and North America.

METHODS

We included cohort data of human immunodeficiency virus (HIV)-positive adults who started ART after 1995 within the framework of 2 large collaborations of observational HIV cohorts. We present incidence rates and adjusted hazard ratios (aHRs).

RESULTS

We included 208140 patients from 57 countries. Over a period of 1066572 person-years, 2046 KS cases were diagnosed. KS incidence rates per 100000 person-years were 52 in the Asia-Pacific and ranged between 180 and 280 in the other regions. KS risk was 5 times higher in South African women (aHR, 4.56; 95% confidence intervals [CI], 2.73-7.62) than in their European counterparts, and 2 times higher in South African men (2.21; 1.34-3.63). In Europe, Latin, and North America KS risk was 6 times higher in men who have sex with men (aHR, 5.95; 95% CI, 5.09-6.96) than in women. Comparing patients with current CD4 cell counts ≥700 cells/µL with those whose counts were <50 cells/µL, the KS risk was halved in South Africa (aHR, 0.53; 95% CI, .17-1.63) but reduced by ≥95% in other regions.

CONCLUSIONS

Despite important ART-related declines in KS incidence, men and women in South Africa and men who have sex with men remain at increased KS risk, likely due to high human herpesvirus 8 coinfection rates. Early ART initiation and maintenance of high CD4 cell counts are essential to further reducing KS incidence worldwide, but additional measures might be needed, especially in Southern Africa.

Xenografting of isolated equine (Equus caballus) testis cells results in de novo morphogenesis of seminiferous tubules but not spermatogenesis

The study of spermatogenesis in the horse is challenging because of the absence of an in vitro system that is capable of reproducing efficient spermatogenesis and because of the difficulties and costs associated with performing well-controlled studies in vivo. In an attempt to develop novel methods for the study of equine spermatogenesis, we tested whether cells from enzymatically digested pre-pubertal equine testicular tissue were capable of de novo tissue formation and spermatogenesis following xenografting under the back skin of immunocompromised mice. Testes were obtained from normal pre-pubertal colts and dissociated into cell suspensions using trypsin/collagenase digestion. Resulting cell pellets, consisting of both somatic and germ cells, were injected into fascial pockets under the back skin of immunocompromised, castrated mice and maintained for between 1 and 14 months. Mice were killed and grafts were recovered and analyzed. As has been reported for testis cell suspensions from pigs, mice, cattle, and sheep, de novo formation of equine testicular tissue was observed, as evidenced by the presence of seminiferous tubules and an interstitial compartment. There was an increased likelihood of de novo testicular formation as grafting period increased. Using indirect immunofluorescence, we confirmed the presence of spermatogonia in de novo formed seminiferous tubules. However, we found no evidence of meiotic or haploid cells. These results indicate that dissociated pre-pubertal equine testis cells are capable of reorganizing into the highly specialized endocrine and spermatogenic compartments of the testis following ectopic xenografting. However, in spite of the presence of spermatogonia within the seminiferous tubules, spermatogenesis does not occur. Although this technique does allow access to the cells within the seminiferous tubule and interstitial compartments of the equine testis prior to reaggregation, the absence of spermatogenesis will limit its use as a method for the study of testicular function in the horse.

Nutritional effects on the mycelial growth and enzymatic activity of Isaria farinosa, and Hepialus larvae growth

AIMS

To investigate the nutritional requirements of the mycelial growth and pathogenesis-related enzymatic activity on Isaria farinosa and the nutritional effect of fungus on its host Hepialus larvae.

METHODS AND RESULTS

Sixteen carbon sources, 16 nitrogen sources and 9 vitamin combinations were tested. The nutritional conditions that significantly prevented I. farinosa pathogenesis were selected as feed additives for rearing Hepialus larvae. Citric acid significantly inhibited the growth of I. farinosa and the activity of three enzymes. l-histidine and l-aspartic acid significantly reduced the dry weights of mycelia and their protease and lipase activities. Vitamin combination that lacked VB 1 significantly increased the growth of I. farinosa and enhanced its chitinase and lipase activities. l-aspartic acid, VB 1 or a combination of them were beneficial for maintaining the larvae survival rate and decreasing the disease rate. The result provides new insight to develop a nutrition-based strategy to control fungal epidemics during insect rearing.

CONCLUSIONS

The ability of some specific nutrients to inhibit mycelial growth and enzymatic activity can prevent epidemics of fungal disease.

SIGNIFICANCE AND IMPACT OF THE STUDY

These results will aid in the development of nutrition-based strategies to control entomopathogenic fungal epidemics during the large-scale rearing of insects.

Toll-Like Receptor 11 (TLR11) Interacts with Flagellin and Profilin through Disparate Mechanisms

Toll-like receptors (TLRs) are innate immune receptors that sense a variety of pathogen-associated molecular patterns (PAMPs) by interacting with them and subsequently initiating signal transduction cascades that elicit immune responses. TLR11 has been shown to interact with two known protein PAMPs: Salmonella and E. coli flagellin FliC and Toxoplasma gondii profilin-like protein. Given the highly divergent biology of these pathogens recognized by TLR11, it is unclear whether common mechanisms are used to recognize these distinct protein PAMPs. Here we show that TLR11 interacts with these two PAMPs using different receptor domains. Furthermore, TLR11 binding to flagellin and profilin exhibits differential dependency on pH and receptor ectodomain cleavage.

Clinicopathological features and outcomes in patients undergoing radical resection for early gastric cancer with signet ring cell histology

BACKGROUND

The signet ring cell histology is regarded as an independent predictor of poor prognosis in advanced gastric adenocarcinomas, but its biologic behavior in early gastric cancer remains highly controversial.

OBJECTIVE

Our objective was to compare the clinicopathological features and outcomes in patients undergoing curative resection between SRCs and non-SRCs histologic types of early gastric cancer.

METHODS

Clinicopathologic features and the overall survival rates of 334 patients with early gastric cancer undergoing D2 curative resection from January 1994 to December 2008 were retrospectively reviewed and compared according to the histologic type.

RESULTS

Clinicopathologic features were comparable between two groups, except age, ulcer findings and the presence of lymph node metastasis. The incidence of recurrence for SRCs group was significantly lower than that for non-SRCs group (10.4% vs. 19.6%; P<0.05). The overall 5-year survival rate was 88.6% in all cases. The overall survival rate of patients in SRCs group was significantly better than that of patients in non-SRCs group (5-year survival, 93.9% vs. 85.8%; P=0.027). Multivariable analysis revealed that SRCs subtype, lymphovascular invasion, and lymph node metastasis were independent prognostic factors.

CONCLUSION

Our analysis revealed that the biological behavior of SRCs was different from other undifferentiated cancer histologic subtypes in early stage. Early gastric cancer with signet ring cell histology had low incidence of lymph node metastasis and a relatively favorable prognosis.