[Activation of GABAergic neurons in the zona incerta accelerates anesthesia induction with sevoflurane and propofol without affecting anesthesia maintenance or awakening in mice]

OBJECTIVE

To explore the regulatory effects of GABAergic neurons in the zona incerta (ZI) on sevoflurane and propofol anesthesia.

METHODS

Forty-eight male C57BL/6J mice divided into 8 groups (n=6) were used in this study. In the study of sevoflurane anesthesia, chemogenetic experiment was performed in 2 groups of mice with injection of either adeno-associated virus carrying hM3Dq (hM3Dq group) or a virus carrying only mCherry (mCherry group). The optogenetic experiment was performed in another two groups of mice injected with an adeno-associated virus carrying ChR2 (ChR2 group) or GFP only (GFP group). The same experiments were also performed in mice for studying propofol anesthesia. Chemogenetics or optogenetics were used to induce the activation of GABAergic neurons in the ZI, and their regulatory effects on anesthesia induction and arousal with sevoflurane and propofol were observed; EEG monitoring was used to observe the changes in sevoflurane anesthesia maintenance after activation of the GABAergic neurons.

RESULTS

In sevoflurane anesthesia, the induction time of anesthesia was significantly shorter in hM3Dq group than in mCherry group (P < 0.05), and also shorter in ChR2 group than in GFP group (P < 0.01), but no significant difference was found in the awakening time between the two groups in either chemogenetic or optogenetic tests. Similar results were observed in chemogenetic and optogenetic experiments with propofol (P < 0.05 or 0.01). Photogenetic activation of the GABAergic neurons in the ZI did not cause significant changes in EEG spectrum during sevoflurane anesthesia maintenance.

CONCLUSION

Activation of the GABAergic neurons in the ZI promotes anesthesia induction of sevoflurane and propofol but does not affect anesthesia maintenance or awakening.

[A region-level contrastive learning-based deep model for glomerular ultrastructure segmentation on electron microscope images]

OBJECTIVE

We propose a novel region- level self-supervised contrastive learning method USRegCon (ultrastructural region contrast) based on the semantic similarity of ultrastructures to improve the performance of the model for glomerular ultrastructure segmentation on electron microscope images.

METHODS

USRegCon used a large amount of unlabeled data for pre- training of the model in 3 steps: (1) The model encoded and decoded the ultrastructural information in the image and adaptively divided the image into multiple regions based on the semantic similarity of the ultrastructures; (2) Based on the divided regions, the first-order grayscale region representations and deep semantic region representations of each region were extracted by region pooling operation; (3) For the first-order grayscale region representations, a grayscale loss function was proposed to minimize the grayscale difference within regions and maximize the difference between regions. For deep semantic region representations, a semantic loss function was introduced to maximize the similarity of positive region pairs and the difference of negative region pairs in the representation space. These two loss functions were jointly used for pre-training of the model.

RESULTS

In the segmentation task for 3 ultrastructures of the glomerular filtration barrier based on the private dataset GlomEM, USRegCon achieved promising segmentation results for basement membrane, endothelial cells, and podocytes, with Dice coefficients of (85.69 ± 0.13)%, (74.59 ± 0.13)%, and (78.57 ± 0.16)%, respectively, demonstrating a good performance of the model superior to many existing image-level, pixel-level, and region-level self-supervised contrastive learning methods and close to the fully- supervised pre-training method based on the large- scale labeled dataset ImageNet.

CONCLUSION

USRegCon facilitates the model to learn beneficial region representations from large amounts of unlabeled data to overcome the scarcity of labeled data and improves the deep model performance for glomerular ultrastructure recognition and boundary segmentation.

Angle Basis: a Generative Model and Decomposition for Functional Connectivity

Functional connectivity (FC) is one of the most common inputs to fMRI-based predictive models, due to a combination of its simplicity and robustness. However, there may be a lack of theoretical models for the generation of FC. In this work, we present a straightforward decomposition of FC into a set of basis states of sine waves with an additional jitter component. We show that the decomposition matches the predictive ability of FC after including 5-10 bases. We also find that both the decomposition and its residual have approximately equal predictive value, and when combined into an ensemble, exceed the AUC of FC-based prediction by up to 5%. Additionally, we find the residual can be used for subject fingerprinting, with 97.3% same-subject, different-scan identifiability, compared to 62.5% for FC. Unlike PCA or Factor Analysis methods, our method does not require knowledge of a population to perform its decomposition; a single subject is enough. Our decomposition of FC into two equally-predictive components may lead to a novel appreciation of group differences in patient populations. Additionally, we generate synthetic patient FC based on user-specified characteristics such as age, sex, and disease diagnosis. By creating synthetic datasets or augmentations we may reduce the high financial burden associated with fMRI data acquisition.

Enhancing effects of immobilized chondroitin sulfate on odontogenic differentiation of dental pulp stem cells and reparative dentin formation

OBJECTIVES

Chondroitin sulfate (CS) is a major proteoglycan involved in the mineralization of the organic matrix of dentin. In this study, the roles of CS immobilized in crosslinked collagen I hydrogels (CS-Col I) on odontogenic differentiation of dental pulp stem cells (DPSCs) and reparative dentin formation were investigated.

METHODS

Different concentrations of CS were incorporated into the genipin- crosslinked Col I hydrogels (CS-0.05, CS-0.1, and CS-0.2 respectively). The influences of CS on proliferation and odontogenic differentiation of DPSCs were investigated. Finally, the effect of the functionalized hydrogel on the formation of reparative dentin was analyzed in a rat pulp capping model in vivo.

RESULTS

CS improved the proliferation of DPSCs seeded on the hydrogels (p<0.05). CS also enhanced the mineralization activities and increased the expression levels of the odontogenic related proteins of DPSCs on day 7 and day 14 (p<0.05). In vivo, CS-0.1 hydrogel induced reparative dentin formation with higher quality compared to mineral trioxide aggregate (MTA).

CONCLUSION

CS immobilized in Col I hydrogels could induce odontogenic differentiation of DPSCs in vitro and promote homogeneous mineralized barrier formation in vivo. CS-Col I hydrogel has the potential for reparative dentin formation of high quality in direct pulp capping.

Dispersion characteristics of bioaerosols during treatment of rural solid waste in northwest China

In rural China, the release of bioaerosols containing pathogens from solid waste dumps poses a potential health risk to the local population. Here, we sampled bioaerosols from rural solid waste-treatment in four provinces of northwest China to investigate their emission and dispersion characteristics in order to provide a scientific basis for control and risk reduction of bioaerosols released from rural sanitation facilities. The airborne bioaerosol concentrations and particle size distributions were calculated using an Anderson six-stage airborne microbial sampler and counting with its internal Petri dish culture. High-throughput sequencing was used to characterize the microbial composition at different sampling sites and to explore possible influencing factors, while the health risk associated with exposure was estimated based on average daily dose-rate. The highest concentration point values of bacteria and fungi in bioaerosols near the solid waste were 63,617 ± 15,007 and 8044 ± 893 CFU/m³, respectively. Furthermore, the highest concentration point values of Enterobacteriaceae was 502 ± 35 CFU/m³. Most bioaerosols were coarse particles larger than 3.3 μm. Potentially pathogenic genera of winter-indicator species detected in the air were primarily Delftia, Rhodococcus and Aspergillus. The composition of solid waste and environmental conditions are important factors in determining the characteristics of bioaerosols. Local residents are exposed to bioaerosols mainly through inhalation. Children are at a particularly high risk of exposure through both inhalation and skin contact. The results of this study show that bioaerosols in the vicinity of rural solid waste dumps pose a health risk to the surrounding population. More suitable risk assessment criteria for rural areas should be established, and corresponding control and protection measures should be taken from three aspects: generation source and transmission pathway, as well as the recipient.

Stretchable and Flexible Micro-Nano Substrates for SERS Detection of Organic Dyes

Surface-enhanced Raman spectroscopy (SERS) is a precise and noninvasive analytical technique to identify vibrational fingerprints of trace analytes with sensitivity down to the single-molecule level. However, substrates can influence this capability, and current SERS techniques lack uniform, reproducible, and stable substrates to control plasma hot spots over a wide spectral range. Herein, we demonstrate a flexible SERS substrate via longitudinal stretching of a polydimethylsiloxane (PDMS) film. This substrate, after stretching and shrinking, exhibits an irregular wrinkled structure with abundant gaps and grooves that function as hot spots, thereby improving the hydrophobic properties of the material. To investigate the enhancement effect of Raman signals, silver nanoparticles (AgNPs) were mixed with Rhodamine 6G (R6G) solution, and the obtained blend was dropped onto the PDMS film to form a coffee ring pattern. According to the results, the hydrophobicity of the substrate increases with the degree of PDMS stretching, achieving the optimal level at 150% stretching. Moreover, the increase in hydrophobicity makes the measured molecules more aggregated, which enhances the Raman signal. The stretching and shrinkage of the PDMS film lead to a much higher density of nanogaps among nanoparticles and nanogrooves, which serve as multiple hot spots. Being highly localized regions of intense local fields, these hot spots make a significant contribution to SERS performance, improving the sensitivity and reproducibility of the method. In particular, the relative standard deviation (RSD) was found to be 2.5544%, and the detection limit was 1 × 10^-7 M. Therefore, SERS using stretchable and flexible micro-nano substrates is a promising way for detecting dyes in wastewater.

WTAP promotes macrophage recruitment and increases VEGF secretion via N6-methyladenosine modification in corneal neovascularization

BACKGROUND

Corneal neovascularization (CNV) can be caused by chemical burns. Macrophages are involved in angiogenesis and lymphangiogenesis during CNV. The aim of this study was to investigate whether Wilms' tumor 1-associated protein (WTAP) is involved in macrophage recruitment and VEGF secretion via N6-methyladenosine (m6A) modification.

METHODS

A CNV mouse model was established by corneal alkali burn. Tumor necrosis factor alpha (TNF-α) was used to stimulate vascular endothelial cells. m6A immunoprecipitation qPCR was used to determine the enrichment of m6A levels in mRNAs. The H3K9me3 enrichment in the promoter region of CC motif chemokine ligand 2 (CCL2) was detected by chromatin immunoprecipitation assay. The WTAP inhibition in vivo was performed using the adeno-associated virus.

RESULTS

In the alkali burn corneal tissues, angiogenesis and lymphangiogenesis were promoted as CD31 and LYVE-1 expressions were elevated, and the number of macrophages as well as WTAP expression were increased. Under the TNF-α stimulation, WTAP promoted the recruitment of endothelial cells to macrophages by promoting CCL2 secretion. Mechanistically, WTAP affected the enrichment of H3K9me3 at the CCL2 promoter by regulating the m6A level of SUV39H1 mRNA. The in vivo experiment showed that VEGFA/C/D secretion of macrophages was reduced after WTAP interference. Mechanistically, WTAP regulated the translational efficiency of HIF-1α via m6A modification.

CONCLUSION

WTAP affected macrophage recruitment to endothelial cells via regulation of H3K9me3-mediated CCL2 transcription. WTAP also affected macrophage secretion of VEGFA/C/D via m6A-mediated translation regulation of HIF-1α. Both pathways were involved in the WTAP regulation of angiogenesis and lymphangiogenesis during CNV.

[Analysis of the pathogenesis and risk factors of gallstone]

Objective: To explore the pathogenesis and risk factors of gallstone formation. Methods: The findings of hepatobiliary ultrasound and related data were collected from healthy subjects who underwent a physical examination at Xuanwu Hospital of Capital Medical University from January 2012 to December 2021. A total of 98 344 healthy subjects were included in the study,including 48 241 males and 50 103 females,with a ratio of 1∶1.03,aged (42.0±15.6)years(range:14 to 97 years). The gender,age,body mass index,waist circumference,systolic pressure,diastolic pressure,ALT,AST,total bilirubin,fasting blood glucose,triglyceride,total cholesterol,low-density lipoprotein,high-density lipoprotein were collected.Healthy subjects were required to sit for at least 10 minutes before blood pressure was measured.Rresults of fasting venous blood were collected after 8 to 12 hours on an empty stomach.According to the presence of gallstones by ultrasound results, healthy subjects were divided into study group and control group. Data were analyzed by rank-sum tests and χ² test, and risk factors for gallstone formation were explored by Logistic regression analysis. Results: The incidence of gallstones in this group was 5.42%(5 333/98 344). Among them,the incidence of gallstones in people aged 60 years and above was significantly higher than that in people under 60 years old(15.31%(2 348/15 334) vs. 3.60%(2 985/83 010), χ²=3 473.46,P<0.05).The healthy subjects were divided by age for every 10 years,and the results showed that the incidence of gallstones increased with age. The incidence of gallstones in females was 5.68%(2 844/50 103),greater than 5.16%(2 489/48 241) in males(χ²=11.81,P<0.05). Among them,1 478 cases underwent gallbladder surgical resection due to gallstones,and the operation rate was 27.71%. The operation rate reached the peak between 60 and <70 years old,and decreased after 70 years old. The results of the multivariate analysis showed that,female(OR=1.38, P<0.01),age(OR=1.58, P<0.01),body mass index≥24 kg/m²(OR=1.31, P<0.01),waist circumference≥85 cm(OR=1.24, P<0.01),fasting blood glucose>6.1 mmol/L(OR=1.18,P<0.01),total cholesterol≥5.18 mmol/L(OR=0.87, P=0.019),low-density lipoprotein≥3.37 mmol/L(OR=1.15,P=0.001) were the risk factors for gallstone formation;high-density lipoprotein≥1.55 mmol/L(OR=0.87, P<0.01) was a protective factor for gallstone formation. Conclusions: The incidence of gallstones increases with age in male and female. Gender,age,body mass index,waist circumferenc,fasting blood glucose,total cholesterol,LDL,and HDL are related factors with gallstone formation.

The m6A reader YTHDF2 promotes bladder cancer progression by suppressing RIG-I-mediated immune response

N6-Methyladenosine (m6A) is the most prevalent internal modification among mammalian mRNAs. Recent studies show that m6A methyltransferases, METTL3 and METTL14, play important roles in bladder carcinoma (BLCA). However, the impact of YTHDF2, a crucial m6A reader, has yet to be investigated. Here, we found that YTHDF2 is frequently up-regulated at both the RNA and protein level in bladder cancers. Functionally, YTHDF2 promotes the proliferation and tumor growth of BLCA cells in vitro and in vivo, respectively. Integrative RNA-sequencing and m6A-sequencing analyses show that RIG-I is a downstream target of YTHDF2. Mechanistically, YTHDF2 binds to the coding sequence of DDX58 mRNA and mediates its degradation in an m6A-dependent manner. Knock-down of RIG-I inhibits apoptosis and promotes the proliferation of BLCA cells. Depleting DDX58 also restores the phenotype abrogated by YTHDF2 deficiency. Moreover, bladder cancer Ythdf2-deficient cells implanted orthotopically activate an innate immune response and promote the recruitment of CD8+ T lymphocytes into the tumor bed and the urothelium. Consequently, targeting YTHDF2 may be beneficial in Bacillus Calmette-Guérin (BCG) immunotherapy. Our study reveals that YTHDF2 acts as an oncogene and RIG-I as a tumor suppressor in BLCA. These findings highlight the functional importance of the m6A modification in BLCA and implicate YTHDF2 as a potential therapeutic target of BLCA treatment.

DTX3L induced NLRP3 ubiquitination inhibit R28 cell pyroptosis in OGD/R injury

Ischemia/reperfusion (I/R) injury is one of the most common etiologies in many diseases. Retinal I/R leads to cytokine storm, resulting in tissue damage and cell death. Pyroptosis, a novel type of regulated cell death, occurs after cellular I/R injury. In this study, we established an oxygen glucose deprivation (OGD/R) cellular model (R28) to simulate retinal I/R injury. We conducted an LDH assay, and EthD-III and PI staining procedures to confirm pyroptosis. Mass spectrometry and bioinformatics analysis were used to identify the possible proteins interacting with NLRP3. Co-IP and various molecular biology techniques were used to investigate the possible modes regulating NLRP3 by DTX3L. EthD-III, PI staining and LDH assays demonstrated pyroptosis induced by OGD/R injury, mediated via NLRP3 pathway. Mass spectrometry and bioinformatics analysis screened out three candidate proteins interacting with NLRP3, and further Co-IP experiment indicated that DTX-3L may interact with NLRP3 to regulate its protein levels after injury. Co-IP experiments and various molecular biology methods demonstrated that DTX3L ubiquitinates NLRP3 resulting in pyroptosis after R28 OGD/R injury. Further, NLRP3 LRR and DTX3L RING domains interact with each other. Our study demonstrated that DTX3L may ubiquitinate NLRP3 to regulate OGD/R-induced pyroptosis globally in R28 cells.

Factors influencing the progression from prehypertension to hypertension among Chinese middle-aged and older adults: a 2-year longitudinal study

BACKGROUND

This study aimed to investigate the proportion of prehypertension cases progressing to hypertension among Chinese middle-aged and elderly populations over a 2-year period and related influencing factors.

METHODS

Data were obtained from the China Health and Retirement Longitudinal Study, and 2,845 individuals who were ≥ 45 years old and prehypertensive at baseline were followed from 2013-2015. Structured questionnaires were administered, and blood pressure (BP) and anthropometric measurements were performed by trained personnel. Multiple logistic regression analysis was done to investigate factors associated with prehypertension progressing to hypertension.

RESULTS

Over the 2-year follow-up, 28.5% experienced progression of prehypertension to hypertension; this occurred more frequently in men than women (29.7% vs. 27.1%). Among men, older age (55-64 years: adjusted odds ratio [aOR] = 1.414, 95% confidence interval [CI]:1.032-1.938; 65-74 years: aOR = 1.633, 95%CI: 1.132-2.355; ≥ 75 years: aOR = 2.974, 95%CI: 1.748-5.060), obesity (aOR = 1.634, 95%CI: 1.022-2.611), and number of chronic diseases (1: aOR = 1.366, 95%CI: 1.004-1.859; ≥ 2: aOR = 1.568, 95%CI: 1.134-2.169) were risk factors for progression to hypertension whereas being married/cohabiting (aOR = 0.642, 95% CI: 0.418-0.985) was a protective factor. Among women, risk factors included older age (55-64 years: aOR = 1.755, 95%CI: 1.256-2.450; 65-74 years: aOR = 2.430, 95%CI: 1.605-3.678; ≥ 75 years: aOR = 2.037, 95% CI: 1.038-3.995), married/cohabiting (aOR = 1.662, 95%CI: 1.052-2.626), obesity (aOR = 1.874, 95%CI: 1.229-2.857), and longer naps (≥ 30 and < 60 min: aOR = 1.682, 95%CI: 1.072-2.637; ≥ 60 min: aOR = 1.387, 95%CI: 1.019-1.889).

CONCLUSIONS

Chinese middle-aged and elderly individuals experienced a risk of prehypertension progressing to hypertension over a 2-year period, although the influencing factors differed by sex; this should be considered in interventions.

Design of an Injectable Magnetic Hydrogel Based on the Tumor Microenvironment for Multimodal Synergistic Cancer Therapy

Conventional tumor chemotherapy is limited by its low therapeutic efficacy and side effects, which severely hold back its further application. Drug delivery systems (DDSs) based on nanomaterials have attracted wide interest in cancer treatment; especially, the system can realize efficient synergistic therapies. Here, we designed a smart hydrogel drug delivery system with multiple responses to enhance the tumor treatment effect. By cross-linking oxidized hydroxypropyl cellulose with carboxymethyl chitosan, an injectable hydrogel was obtained, into which artesunate (ART), ferroferric oxide (Fe₃O₄) nanoparticles, and black phosphorus nanosheets (BPs) were preloaded. This DDS has multiple functions including magnetic targeting, pH sensitivity, chemodynamic therapy, and photothermal response. This nanoparticle-composited hydrogel not only preserved excellent rheological properties but also allowed for an accurate stable drug release at tumor sites and synergistic effects of multiple therapies. The in vitro and in vivo experiments revealed that this DDS could efficiently eliminate the HepG2 tumor with good biocompatibility. Taken together, this study clarifies the possible antitumor mechanism of this ART-loaded nanoparticle-composited hydrogel and provides a new strategy for synergistic photothermal-chemo-chemodynamic therapy.

Uniaxial cyclic stretch enhances osteogenic differentiation of OPLL-derived primary cells via YAP-Wnt/β-catenin axis

The pathogenesis of posterior longitudinal ligament ossification (OPLL) remains inadequately understood. Mechanical stimulation is one of the important pathogenic factors in OPLL. As one of the mechanical stimulation transduction signals, the yes-associated protein (YAP) interacts with the Wnt/β-catenin signalling pathway, which plays an important role in osteogenic differentiation. This study aimed to demonstrate the role of YAP-Wnt/β-catenin axis in cell differentiation induced by mechanical stress. Primary cells extracted from posterior longitudinal ligament tissues from OPLL or non-OPLL patients were subjected to sinusoidal uniaxial cyclic stretch (5 %, 0.5 Hz, 3 d). The expression of runt-related transcription factor 2, collagen I, osterix, osteocalcin and alkaline phosphatase were compared between the static and the experimental groups. In addition, the cytoskeleton was detected using phalloidin staining while YAP phosphorylation states and nuclear location were identified using immunofluorescence. The results showed that mechanical stretching loading increased the expression of osteogenic genes and proteins in the OPLL group, while it had no significant effect on the control group. When OPLL cells were stretched, YAP exhibited an obvious nuclear translocation and the Wnt/β-catenin pathway was activated. Knocking down YAP or β-catenin could weaken the impact upon osteogenic differentiation induced by mechanical stimulation. YAP-mediated mechanical stimulation promoted osteogenic differentiation of OPLL cells through Wnt/β-catenin pathway and this progress was independent of the Hippo pathway.

[Prevalence and molecular characterization of Cryptosporidium in captive-bred Mustela putorius furo in Jiangsu Province]

OBJECTIVE

To investigate the prevalence and molecular features of Cryptosporidium in captive-bred Mustela putorius furo in Jiangsu Province.

METHODS

A total of 290 fresh stool samples were collected from a ferret farm in Jiangsu Province on May 2017, and the small subunit rRNA (SSU rRNA) gene of Cryptosporidium was amplified in stool samples using nested PCR assay. The actin, cowp and gp60 genes were amplified in positive samples and sequenced to characterize Cryptosporidium species/genotypes.

RESULTS

A total of 18 stool samples were tested positive for Cryptosporidium SSU rRNA gene, with a detection rate of 6.2%. Sequence and phylogenetic analyses of SSU rRNA, actin and cowp genes characterized Cryptosporidium isolated from captive-bred ferrets as Cryptosporidium sp. ferret genotype. In addition, gp60 gene was amplified in 10 out of 18 stool samples tested positive for Cryptosporidium.

CONCLUSIONS

Cryptosporidium is widely prevalent in captive-bred ferrets in Jiangsu Province, and Cryptosporidium sp. ferret genotype is the only Cryptosporidium genotype in ferrets.

Multimodal investigation of bladder cancer data based on computed tomography, whole slide imaging, and transcriptomics

Background

Multimodal analysis has shown great potential in the diagnosis and management of cancer. This study aimed to determine the multimodal data associations between radiological, pathologic, and molecular characteristics in bladder cancer.

Methods

A retrospective study of computed tomography (CT), pathologic slice, and RNA sequencing data from 127 consecutive adult patients in China who underwent bladder surgery and were pathologically diagnosed with bladder cancer was conducted. A total of 200 radiological and 1,029 pathologic features were extracted by radiomics and pathomics. Multimodal associations analysis and structural equation modeling were used to measure the cross-modal associations and structural relationships between CT and pathologic slice. A convolutional neural network was constructed for molecular subtyping based on multimodal imaging features. Class activation maps were used to examine the feature contribution in model decision-making. Cox regression and Kaplan-Meier survival analysis were used to explore the relevance of multimodal features to the prognosis of patients with bladder cancer.

Results

A total of 77 densely associated blocks of feature pairs were identified between CT and whole slide images. The largest cross-modal associated block reflected the tumor-grade properties. A significant relation was found between pathological features and molecular subtypes (β=0.396; P<0.001). High-grade bladder cancer showed heterogeneity of significance across different scales and higher disorders at the microscopic level. The fused radiological and pathologic features achieved higher accuracy (area under the curve: 0.89; 95% CI: 0.75-1.0) than the unimodal method. Thirteen prognosis-related features from CT and whole slide images were identified.

Conclusions

Our work demonstrated the associations between CT, pathologic slices, and molecular signatures, and the potential to use multimodal data analysis in related clinical applications. Multimodal data analysis showed the potential of cross-inference of modal data and had higher diagnostic accuracy than the unimodal method.

Teaching Chinese characters to first and second graders during the first covid-19 school closure in China: an observational study

The COVID-19 pandemic disrupted education around the world, resulting in the implementation of different forms of remote instruction. The present study provided a description of one interesting and unique approach to providing such instruction by analyzing 144 language arts lessons designed and implemented by 61 distinguished and experienced teachers in Xiangzhou, China. The lessons were used to teach first and second grade students the pronunciation, meaning, recognition, and writing of simplified Chinese characters. These lessons provide a possible model for teaching Chinese characters in the future. The 144 lessons were delivered synchronously through live video interactions with two to four students, while other students were able to access them simultaneously at home via an internet device or on TV (the lessons were accessed 2.1 million times). Lessons were taught four to seven times a week, and teachers devoted 58% of lesson time to teaching characters: 69% and 46% of lesson time was spent teaching characters in grades one and two, respectively. A large number of recommended behaviors for teaching characters (77 out of 80 behaviors assessed) were applied across the 144 lessons, but a relatively small number of teaching behaviors (14) were used in each lesson. This typically included two behaviors for teaching character recognition and four behaviors each for teaching pronunciation, meaning, and writing of characters. Congruently, 6.32, 5.83, 5.49, and 3.78 min per lessons were used to teach character pronunciation, writing, meaning, and recognition, respectively. Character instruction in these lessons was coherently and logically designed, but all live interactions between teachers and students were teacher directed. Directions for future research are presented and implications for practice discussed.

Public awareness and attitudes toward biobank and sample donation: A regional Chinese survey

Background

The biobank is an extraordinary aid to research and scientific progress. Public involvement in biobanks, necessary for their development, is limited due to inadequate knowledge of biobanking and concerns about sample donation. This study explores the effectiveness of different publicity methods in improving participants' willingness to donate, and assesses public motivations and concerns. It aims to identify an efficient method of improving participants' awareness of biobanking and promoting sample donation.

Methods

A structured 20-item questionnaire was formulated to evaluate participants' knowledge of and attitudes toward biobanks and sample donation. In total, 1,500 questionnaires were disseminated to three groups of 500 participants who received, respectively, picture-based promotional material, text-based promotional material, or who attended a biobank-related lecture. Of these, 945 completed questionnaires were received. All the participants completed the questionnaires twice, before and after the corresponding publicity education.

Results

After each of the three methods of publicity based on text, pictures and a lecture, respondents' willingness to donate samples was significantly increased (P < 0.001), the lecture being more effective than the other two methods (P = 0.001). Participants with a medical background were more willing to donate biospecimens after publicity than those without medical backgrounds (P < 0.005) but had common motivations for donation including altruism and aiding medical research. The main concern hindering respondents' willingness to donate was the security of personal information.

Conclusion

Different types of biobank-related publicity based on text material, pictorial material and a lecture all improved respondents' willingness to donate and reduced concerns regarding sample donation. Medical background was a critical factor affecting attitudes toward sample donation after publicity. The results of this study suggest strategies that may popularize biobanks and enhance sample donation, further promoting the development of biobanks.

[Analysis of risk factors for decompensated cirrhosis complicated with sepsis]

Objective: To investigate the related risk factors in patients with decompensated cirrhosis complicated with sepsis. Methods: 1 098 cases with decompensated cirrhosis were collected from January 2018 to December 2020. A total of 492 cases with complete data meeting the inclusion criteria were included. Among them, the sepsis group (240 cases) was complicated with sepsis and the non-sepsis group (252 cases) was not complicated with sepsis. Albumin, cholinesterase, total bilirubin, prothrombin activity, urea, creatinine, international normalized ratio and other indicators of the two groups of patients were collected. Child-Pugh classification and MELD score were performed on two groups of patients. Mann-Whitney U test was used for non-normally distributed measurement data, and rank sum test for grade data. Logistic regression analysis was performed on sepsis-related factors that may affect patients with decompensated cirrhosis complicated with sepsis. Results: 162 cases of gram negative bacteria, 76 cases of gram positive bacteria and 2 cases of Candida were detected. Child-Pugh grade C was mainly in the sepsis group, and Child- Pugh grade A and B was mainly in the non-sepsis group (z=-13.01, P＜0.05). MELD score was significantly higher in patients with sepsis than that of patients without sepsis (z=-12.30, P＜0.05). Neutrophils percentage, C-reactive protein, procalcitonin, and total bilirubin in patients with decompensated cirrhosis complicated with sepsis were 86.90% (79.00%, 91.05%), 48.48 (17.63, 97.55) mg/l,1.34 (0.40, 4.52) ng/l, and 78.50 (32.75149.80) μmol/L, which were significantly higher than that of patients without sepsis [69.55% (58.58%, 75.90%), 5.34 (5.00, 14.94) mg/l, 0.11(0.06,0.24) ng/l, 22.50(15.10,37.55) respectively] μmol/L, P＜0.05], while the albumin level, prothrombin activity level, and the cholinesterase level in sepsis patients were 27.30 (24.45, 30.60) g/L, 46.00% (33.50%, 59.00%), and 1.87 (1.29, 2.66) kU/L, respectively, which was significantly lower than the non-sepsis group [32.65 (28.95, 37.23) g/l, 73.00(59.75～84.85)%, 3.13(2.23～4.59) kU/L, P＜0.05]. Logistic regression analysis showed that serum total bilirubin, albumin, prothrombin activity level and diabetes mellitus were the independent risk factors for complicated sepsis. Conclusion: Patients with decompensated cirrhosis with poor liver function and higher MELD scores are more likely to be complicated with sepsis. Therefore, during the clinical diagnosis and treatment course, patients with decompensated cirrhosis with poor liver reserve function should be actively and dynamically monitored for infection-related indicators such as neutrophil percentage, procalcitonin, C-reactive protein, in an attempt to detect possible potential infections and sepsis, and improve early treatment and prognosis.

Correlating Cytologic and Histologic Features of Hepatic Epithelioid Hemangioendothelioma

Introduction/Objective

Epithelioid hemangioendothelioma (EHE) is a rare malignant vascular tumor composed of epithelioid and dendritic tumor cells embedded in myxoid or hyalinized stroma. It can occur in various organs and has nonspecific clinical and radiologic presentation. We report a case of EHE in the liver with correlation of cytologic and histological findings.

Methods/Case Report

A 68-year-old female presented for evaluation of a right hepatic lobe lesion that was noted on Imaging. MRI abdomen with contrast showed a well-circumscribed hypointense nodule with no contrast enhancement. CT-guided fine needle aspiration showed scattered atypical epithelioid cells in a background of benign hepatocytes which were positive for vascular markers (CD31 and CD34) as well as keratins and SMA. A diagnosis of atypical vascular neoplasm was rendered. A partial hepatectomy was performed a month later which showed a 3.2 cm mass with solid tan-white cut surface. Histologically, the mass was composed of epithelioid tumor cells with focal intracytoplasmic vacuoles which were partly solid and partly forming vascular-like spaces, embedded in a background of hyalinized stroma. Immunohistochemically, in addition to the vascular markers the tumor was positive for CAMTA1 confirming the presence of WWTR1-CAMTA1 gene fusion which is characteristic for epithelioid hemangioendothelioma. The patient was discharged in good condition.

Results (if a Case Study enter NA)

NA.

Conclusion

Diagnosis of EHE on FNA is challenging. It is characterized by discohesive atypical large polygonal cells with abundant dense cytoplasm in a background of benign hepatocytes. Characteristically, the tumor cells have intracytoplasmic vacuoles containing red blood cells, which resemble signet ring-like structures. Immunohistochemically, positivity for vascular markers and CAMTA1 is diagnostic.

Elastotic Mass-Forming Lesion of the Omentum; A New Pathological Entity

Introduction/Objective

Elastotic lesions are rare benign mass-forming entity. Although, few reports of mucosal and submucosal elastotic lesions have been previously described, localization of these lesions in the omentum is not previously described in the literature.

Methods/Case Report

We report a case of 60-year-old man with medical history of obesity, hypertension, diabetes mellitus, and a remote abdominal surgery in 1980s who presented to the emergency room complaining of abrupt severe constant epigastric pain that started few hours before. The pain was not relieved by antiacid or analgesic medications. CT of the abdomen showed multiple distended fluid-filled loops of small bowel in mid abdomen with infiltrative changes of mesentery. A diagnosis of small bowel obstruction was made, and patient proceed to have an exploratory laparotomy. During the procedure, extensive adhesions between small bowel and omentum and small bowel obstruction due to a phytobezoar were noted for which he underwent lysis of adhesion, excision of thickened omentum, and enterotomy for removal of significant food bezoar. Grossly, the omentum has multiple chalky tan-gray masses ranging between 1.2 and 1.0 cm in greatest dimension surrounded by indurated fatty tissue. Microscopically, multiple hypocellular foci are seen that are composed almost entirely of truncated elastic fibers, with sparse delicate bands of collagen and scattered prominent thick-walled vessels. Elastic stain highlights these elastic fibers while trichrome stains the elastic fibers pale gray in contrast to the bright blue color of the collagen fibers. Mucicarmine, and Congo red are negative. Patient tolerated the procedure well however, postoperatively he had local wound infection leading to prolonged skin dehiscence.

Results (if a Case Study enter NA)

NA.

Conclusion

Elastotic mass-forming lesions in the omentum is a new entity that has not been described before in this location that can clinically manifest with signs and symptoms of bowel obstruction. We suggested the name of elastomatosis omentum.