SARS-CoV-2 receptor binding domain-specific antibodies activate platelets with features resembling the pathogenic antibodies in heparin-induced thrombocytopenia

Severe COVID-19 is associated with unprecedented thromboembolic complications. We found that hospitalized COVID-19 patients develop immunoglobulin Gs (IgGs) that recognize a complex consisting of platelet factor 4 and heparin similar to those developed in heparin-induced thrombocytopenia and thrombosis (HIT), however, independent of heparin exposure. These antibodies activate platelets in the presence of TLR9 stimuli, stimuli that are prominent in COVID-19. Strikingly, 4 out of 42 antibodies cloned from IgG1+ RBD-binding B cells could activate platelets. These antibodies possessed, in the heavy-chain complementarity-determining region 3, an RKH or Y5 motif that we recently described among platelet-activating antibodies cloned from HIT patients. RKH and Y5 motifs were prevalent among published RBD-specific antibodies, and 3 out of 6 such antibodies tested could activate platelets. Features of platelet activation by these antibodies resemble those by pathogenic HIT antibodies. B cells with an RKH or Y5 motif were robustly expanded in COVID-19 patients. Our study demonstrates that SARS-CoV-2 infection drives the development of a subset of RBD-specific antibodies that can activate platelets and have activation properties and structural features similar to those of the pathogenic HIT antibodies.

Clinical and genetic spectrum of a Chinese cohort with SCN4A gene mutations

Skeletal muscle sodium channelopathies due to SCN4A gene mutations have a broad clinical spectrum. However, each phenotype has been reported in few cases of Chinese origin. We present detailed phenotype and genotype data from a cohort of 40 cases with SCN4A gene mutations seen in neuromuscular diagnostic service in Huashan hospital, Fudan University. Cases were referred from 6 independent provinces from 2010 to 2018. A questionnaire covering demographics, precipitating factors, episodes of paralysis and myotonia was designed to collect the clinical information. Electrodiagnostic studies and muscle MRI were retrospectively analyzed. The clinical spectrum of patients included: 6 Hyperkalemic periodic paralysis (15%), 18 Hypokalemic periodic paralysis (45%), 7 sodium channel myotonia (17.5%), 4 paramyotonia congenita (10%) and 5 heterozygous asymptomatic mutation carriers (12.5%). Review of clinical information highlights a significant delay to diagnosis (median 15 years), reports of pain and myalgia in the majority of patients, male predominance, circadian rhythm and common precipitating factors. Electrodiagnostic studies revealed subclinical myotonic discharges and a positive long exercise test in asymptomatic carriers. Muscle MRI identified edema and fatty infiltration in gastrocnemius and soleus. A total of 13 reported and 2 novel SCN4A mutations were identified with most variants distributed in the transmembrane helix S4 to S6, with a hotspot mutation p.Arg675Gln accounting for 32.5% (13/40) of the cohort. Our study revealed a higher proportion of periodic paralysis in SCN4A-mutated patients compared with cohorts from England and the Netherlands. It also highlights the importance of electrodiagnostic studies in diagnosis and segregation studies.

Prediction of Target-Drug Therapy by Identifying Gene Mutations in Lung Cancer With Histopathological Stained Image and Deep Learning Techniques

Lung cancer is a kind of cancer with high morbidity and mortality which is associated with various gene mutations. Individualized targeted-drug therapy has become the optimized treatment of lung cancer, especially benefit for patients who are not qualified for lung lobectomy. It is crucial to accurately identify mutant genes within tumor region from stained pathological slice. Therefore, we mainly focus on identifying mutant gene of lung cancer by analyzing the pathological images. In this study, we have proposed a method by identifying gene mutations in lung cancer with histopathological stained image and deep learning to predict target-drug therapy, referred to as DeepIMLH. The DeepIMLH algorithm first downloaded 180 hematoxylin-eosin staining (H&E) images of lung cancer from the Cancer Gene Atlas (TCGA). Then deep convolution Gaussian mixture model (DCGMM) was used to perform color normalization. Convolutional neural network (CNN) and residual network (Res-Net) were used to identifying mutated gene from H&E stained imaging and achieved good accuracy. It demonstrated that our method can be used to choose targeted-drug therapy which might be applied to clinical practice. More studies should be conducted though.

Two new cationic α-helical peptides identified from the venom gland of Liocheles australasiae possess antimicrobial activity against methicillin-resistant staphylococci

Methicillin-resistant staphylococci have become growing threats to human health, and novel antimicrobials are urgently needed. Natural antimicrobial peptides (AMPs) are promising alternatives to traditional antibiotics. Here, two novel cationic α-helical antimicrobial peptides, Lausporin-1 and Lausporin-2, were identified from the venom gland of the scorpion L. australasiae through a cDNA library screening strategy. Biochemical analyses demonstrated that Lausporin-1 and Lausporin-2 are cationic α-helical amphipathic molecules. Antimicrobial assays demonstrated that the two peptides possess antibacterial activities against several species of antibiotic-resistant staphylococci. Importantly, they are active against methicillin-resistant Staphylococcus aureus, Staphylococcus epidermidis and Staphylococcus capitis, with the minimum inhibitory concentrations ranging from 2.5 to 10 μg/ml. Moreover, both peptides can induce dose-dependent plasma membrane disruptions of the bacteria. In short, our work expands the knowledge of the scorpion L. australasiae venom-derived AMPs and sheds light on the potential of Lausporin-1 and Lausporin-2 in the development of novel drugs against methicillin-resistant staphylococci.

MiR-142-5p reverses the resistance to gefitinib through targeting HOXD8 in lung cancer cells

OBJECTIVE

To investigate the role and potential mechanism of micro ribonucleic acid (miR)-142-5p in the acquired resistance to gefitinib in lung cancer cells.

MATERIALS AND METHODS

The drug resistance of PC9/G cells was detected via methyl thiazolyl tetrazolium (MTT) assay. Expression levels of miR-142-5p and HOXD8 in PC9 and PC9/G cells were detected via quantitative Reverse Transcription-Polymerase Chain Reaction (qRT-PCR) and Western blotting. PC9/G cells were transfected with miR-142-5p mimic, while PC9 cells were transfected with miR-142-5p inhibitor. Subsequently, expression changes of HOXD8 were determined using qRT-PCR and Western blotting, cell sensitivity to gefitinib was detected through MTT assay, and the apoptosis was detected via flow cytometry. Moreover, Dual-Luciferase reporter assay was conducted to determine the relationship between HOXD8 and miR-142-5p. Finally, potential involvement of HOXD8 in miR-142-5p-regulated gefitinib sensitivity was confirmed via rescue tests.

RESULTS

PC9/G cells were more significantly resistant to gefitinib compared with its parental PC9 cells. MiR-142-5p was down-regulated in PC9/G cells, while that of HOXD8 was up-regulated in PC9/G cells. Transfection of miR-142-5p mimic could inhibit the expression level of HOXD8 in PC9/G cells and reverse its resistance to gefitinib. Conversely, transfection of miR-142-5p inhibitor could upregulate HOXD8 in PC9 cells and promote its resistance to gefitinib. According to the Dual-Luciferase reporter assay, miR-142-5p could suppress the expression of HOXD8 through the targeted binding to the HOXD8 3'UTR. Moreover, miR-142-5p could regulate mitochondrial apoptosis pathway by targeting HOXD8. Finally, rescue tests confirmed that miR-142-5p regulated the sensitivity of PC9 cells to gefitinib by acting on the target gene HOXD8.

CONCLUSIONS

Down-regulation of miR-142-5p induces the resistance of lung cancer PC9 cells to gefitinib by upregulating HOXD8.

LINC01857 promotes the development of gastric cancer by regulating microRNA-200b

OBJECTIVE

The aim of this study was to investigate the expression characteristics of LINC01857 in gastric cancer (GCa), and to further study whether it could promote GCa development by modulating microRNA-200b.

PATIENTS AND METHODS

Quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) was used to examine LINC01857 expression in 60 pairs of GCa tissues and adjacent tissues. The interplay between LINC01857 level and clinical indexes and the prognosis of GCa patients was analyzed. Meanwhile, qRT-PCR was used to verify the expression level of LINC01857 in GCa cell lines. LINC01857 knockdown model was constructed by lentivirus transfection in GCa cell lines. Subsequently, the effect of LINC01857 on the biological function of GCa cells was analyzed by Cell Counting Kit 8 (CCK8), wound healing, and transwell assays. Furthermore, the in-depth relationship between LINC01857 and microRNA-200b was explored.

RESULTS

QRT-PCR results showed that LINC01857 level in GCa tissues was remarkably higher than that of adjacent tissues, and the difference was statistically significant (p<0.05). Compared with patients with a low level of LINC01857, the rate of lymph node and distant metastasis in patients with a high level of LINC01857 was remarkably higher, while the overall survival rate was lower (p<0.05). In vitro experiments showed that LINC01857 knockdown remarkably decreased the invasion, migration, and crawling ability of GCa cells (p<0.05). Subsequent qRT-PCR results demonstrated that the level of microRNA-200b was remarkably upregulated after the silence of LINC01857. In addition, the silence of microRNA-200b could reverse the biological function of GCa cells induced by the knockout of LINC01857.

CONCLUSIONS

LINC01857 was highly expressed in GCa, and was associated with lymph node metastasis, distant metastasis, and poor prognosis of patients with GCa. In addition, LINC01857 enhanced the metastatic ability of GCa cells by regulating microRNA-200b.

Augmented Reality Navigation for Stereoscopic Laparoscopic Anatomical Hepatectomy of Primary Liver Cancer: Preliminary Experience

Background

Accurate determination of intrahepatic anatomy remains challenging for laparoscopic anatomical hepatectomy (LAH). Laparoscopic augmented reality navigation (LARN) is expected to facilitate LAH of primary liver cancer (PLC) by identifying the exact location of tumors and vessels. The study was to evaluate the safety and effectiveness of our independently developed LARN system in LAH of PLC.

Methods

From May 2018 to July 2020, the study included 85 PLC patients who underwent three-dimensional (3D) LAH. According to whether LARN was performed during the operation, the patients were divided into the intraoperative navigation (IN) group and the non-intraoperative navigation (NIN) group. We compared the preoperative data, perioperative results and postoperative complications between the two groups, and introduced our preliminary experience of this novel technology in LAH.

Results

There were 44 and 41 PLC patients in the IN group and the NIN group, respectively. No significant differences were found in preoperative characteristics and any of the resection-related complications between the two groups (All P > 0.05). Compared with the NIN group, the IN group had significantly less operative bleeding (P = 0.002), lower delta Hb% (P = 0.039), lower blood transfusion rate (P < 0.001), and reduced postoperative hospital stay (P = 0.003). For the IN group, the successful fusion of simulated surgical planning and operative scene helped to determine the extent of resection.

Conclusions

The LARN contributed to the identification of important anatomical structures during LAH of PLC. It reduced vascular injury and accelerated postoperative recovery, showing a potential application prospects in liver surgery.

Importance of Microvascular Invasion Risk and Tumor Size on Recurrence and Survival of Hepatocellular Carcinoma After Anatomical Resection and Non-anatomical Resection

Purpose: To establish a valid prediction model to prognose the occurrence of microvascular invasion (MVI), and to compare the efficacy of anatomic resection (AR) or non-anatomic resection (NAR) for hepatocellular carcinoma (HCC).

Methods: Two hundred twenty-eight patients with HCC who underwent surgical treatment were enrolled. Their hematological indicators, MRI imaging features, and outcome data were acquired.

Result: In the multivariable analysis, alpha-fetoprotein >15 ng/mL, neutrophil to lymphocyte ratio >3.8, corona enhancement, and peritumoral hypointensity on hepatobiliary phase were associated with MVI. According on these factors, the AUROC of the predictive model in the primary and validation cohorts was 0.884 (95% CI: 0.829, 0.938) and 0.899 (95% CI: 0.821, 0.967), respectively. Patients with high risk of MVI or those with low risk of MVI but tumor size >5 cm in the AR group were associated with a lower rate of recurrence and death than patients in the NAR group; however, when patients are in the state of low-risk MVI with tumor size >5 cm, there is no difference in the rate of recurrence and death between AR and NAR.

Conclusion: Our predictive model for HCC with MVI is convenient and accurate. Patients with high-risk of MVI or low-risk of MVI but tumor size >5 cm executing AR is of great necessity.

Immune Profiling Reveals Molecular Classification and Characteristic in Urothelial Bladder Cancer

Urothelial bladder cancer (UBC) is the most common malignant tumor of the urinary system. Most patients do not benefit from treatment with immune checkpoint inhibitors, which are closely associated with immune profiling in the context of UBC. Therefore, we aimed to characterize the immune profile of UBC to identify different immune subtypes that may influence therapy choice. We identified four subtypes of UBC based on immune profiling including immune ignorant, cold tumor, immune inactive, and hot tumor. After excluding the cold tumor subtype because of its unique pathology distinct from the other types, a high correlation between patient survival and immune characteristics was observed. Most immune cell types had highly infiltrated the hot tumor subtype compared to other subtypes. Interestingly, although immune cells infiltrated the tumor microenvironment, they exhibited an exhaustion phenotype. CCL4 may be the key molecule functioning in immune cell infiltration in the hot tumor subtype. Moreover, neutrophils may function as an important suppressor in the tumor microenvironment of the immune ignorant and immune inactive subtypes. Furthermore, different tumor-intrinsic signaling pathways were involved in immune cell infiltration and exclusion in these four different subtypes. Immune profiling could serve as a prognostic biomarker for UBC, and has potential to guide treatment decisions in UBC. Targeting tumor-intrinsic signaling pathways may be a promising strategy to treat UBC.

Temperature dependent onset of shear thinning in supercooled glass-forming network liquids

The onset of shear thinning and the transition from Newtonian to non-Newtonian behavior in the viscous flow of select chalcogenide and oxide network glass-forming liquids in the deeply supercooled regime and its temperature dependence are studied using parallel plate rheometry. In all cases, the onset occurs at a shear rate γ̇_c that is several orders of magnitude lower than the shear relaxation rate τ₀ ^-1 and the former increases with increasing temperature. These results are in good qualitative agreement with the predictions of the existing models of shear relaxation and shear thinning based on the nonlinear Langevin equation theory, random first order transition theory, and the free volume model. However, in contrast to the theoretical predictions, the reduced shear rate W₀ (=τ₀γ̇_c) at the onset is found to range between 10^-3 and 10^-5 and decrease with increasing temperature. This temperature dependence becomes stronger with increasing fragility of the liquid. These results likely indicate that the shear thinning mechanism in network liquids could be fundamentally different from those in molecular, metallic, or polymeric glass-formers.

Interleukin-4 improves white matter integrity and functional recovery after murine traumatic brain injury via oligodendroglial PPARγ

Long-term neurological recovery after severe traumatic brain injury (TBI) is strongly linked to the repair and functional restoration of injured white matter. Emerging evidence suggests that the anti-inflammatory cytokine interleukin-4 (IL-4) plays an important role in promoting white matter integrity after cerebral ischemic injury. Here, we report that delayed intranasal delivery of nanoparticle-packed IL-4 boosted sensorimotor neurological recovery in a murine model of controlled cortical impact, as assessed by a battery of neurobehavioral tests for up to five weeks. Post-injury IL-4 treatment failed to reduce macroscopic brain lesions after TBI, but preserved the structural and functional integrity of white matter, at least in part through oligodendrogenesis. IL-4 directly facilitated the differentiation of oligodendrocyte progenitor cells (OPCs) into mature myelin-producing oligodendrocytes in primary cultures, an effect that was attenuated by selective PPARγ inhibition. IL-4 treatment after TBI in vivo also failed to stimulate oligodendrogenesis or improve white matter integrity in OPC-specific PPARγ conditional knockout (cKO) mice. Accordingly, IL-4-afforded improvements in sensorimotor neurological recovery after TBI were markedly impaired in the PPARγ cKO mice compared to wildtype controls. These results support IL-4 as a potential novel neurorestorative therapy to improve white matter functionality and mitigate the long-term neurological consequences of TBI.

Positive effect of Astragaloside IV on neurite outgrowth via talin-dependent integrin signaling and microfilament force

Integrin plays a prominent role in neurite outgrowth by transmitting both mechanical and chemical signals. Integrin expression is closely associated with Astragaloside IV (AS-IV), the main component extracted from Astragali radix, which has a positive effect on neural-protection. However, the relationship between AS-IV and neurite outgrowth has not been studied exhaustively to date. The present study investigated the underlying mechanism of AS-IV on neurite outgrowth. Longer neurites have been observed in SH-SY5Y cells or cortical neurons after AS-IV treatment. Furthermore, AS-IV not only increased the expression of integrin β but also activated it. The AS-IV-induced increased integrin activity was attributed to the integrin-activating protein talin. Application of the actin force probe showed that AS-IV led to an increase in intracellular microfilament force during neurite growth. Furthermore, in response to AS-IV, the microfilament force was regulated by talin and integrin activity during neurite growth. These results suggest that AS-IV has the ability to increase intracellular structural force and facilitate neurite elongation by integrin signaling, which highlights its therapeutic potential for neurite outgrowth.

Manifestations and impact of the COVID-19 pandemic in neuroinflammatory diseases

Objective

To report initial results of a planned multicenter year‐long prospective study examining the risk and impact of COVID‐19 among persons with neuroinflammatory disorders (NID), particularly multiple sclerosis (MS).

Methods

In April 2020, we deployed online questionnaires to individuals in their home environment to assess the prevalence and potential risk factors of suspected COVID‐19 in persons with NID (PwNID) and change in their neurological care.

Results

Our cohort included 1115 participants (630 NID, 98% MS; 485 reference) as of 30 April 2020. 202 (18%) participants, residing in areas with high COVID‐19 case prevalence, met the April 2020 CDC symptom criteria for suspected COVID‐19, but only 4% of all participants received testing given testing shortages. Among all participants, those with suspected COVID‐19 were younger, more racially diverse, and reported more depression and liver disease. PwNID had the same rate of suspected COVID‐19 as the reference group. Early changes in disease management included telemedicine visits in 21% and treatment changes in 9% of PwNID. After adjusting for potential confounders, increasing neurological disability was associated with a greater likelihood of suspected COVID‐19 (OR_adj = 1.45, 1.17–1.84).

Interpretations

Our study of real‐time, patient‐reported experience during the COVID‐19 pandemic complements physician‐reported MS case registries which capture an excess of severe cases. Overall, PwNID seem to have a risk of suspected COVID‐19 similar to the reference population.

Identification and Validation of Efficacy of Immunological Therapy for Lung Cancer From Histopathological Images Based on Deep Learning

Cancer immunotherapy, as a novel treatment against cancer metastasis and recurrence, has brought a significantly promising and effective therapy for cancer treatments. At present, programmed death 1 (PD-1) and programmed cell death-Ligand 1 (PD-L1) treatment for lung cancer is primarily recognized as an immune checkpoint inhibitor (ICI) to play an anti-tumor effect; however, it remains uncertain regarding of its efficacy though. Thereafter, tumor mutation burden (TMB) was recognized as a high-potential to be a predictive marker for the immune therapy, but it is invasive and costly. Therefore, discovering more immune-related biomarkers that have a guiding role in immunotherapy is a crucial step in the development of immunotherapy. In our study, we proposed a deep convolutional neural network (CNN)-based framework, DeepLRHE, which can efficiently analyze immunological stained pathological images of lung cancer tissues, as well as to identify and explore pathogenesis which can be used for immunological treatment in clinical field. In this study, we used 180 whole slice images (WSIs) of lung cancer downloaded from TCGA which was model training and validation. After two cross-validation used for this model, we compared with the area under the curve (AUC) of multiple mutant genes, TP53 had highest AUC, which reached 0.87, and EGFR, DNMT3A, PBRM1, STK11 also reached ranged from 0.71 to 0.84. The study results showed that the deep learning can used to assist health professionals for target-therapy as well as immunotherapies, therefore to improve the disease prognosis.

Development of a primary reference material of natural C-reactive protein: verification of its natural pentameric structure and certification by two isotope dilution mass spectrometry

C-reactive protein (CRP) is one of the most commonly used biomarkers for inflammation. The standardisation of a procedure for the detection of CRP has attracted significant attention globally, and primary reference materials of CRP based on the recombinant expression of E. coli that exist in the form of monomers have been developed. However, a primary reference material of natural CRP is still required to achieve the exact matching of CRP measurements in secondary reference materials (e.g. CRP in frozen human serum). Herein, the development process for a certified reference material of natural CRP is reported, namely GBW09228. The raw material employed in this study was CRP extracted and purified from human body fluid, and exhibits a natural and verified pentameric structure. Through the use of amino acid analysis isotope dilution mass spectrometry (AAA-IDMS) and signature peptide-IDMS, this reference material was certified, and its certification results can be traced to SI units. The developed method was evaluated for its accuracy using the international comparison tests of the National Metrology Institute of Japan (NMIJ) and the Korea Research Institute of Standards and Science (KRISS). Overall, a CRP primary certified reference material (CRM) of well-characterised purity was determined that could be used to calibrate an IDMS-based reference method, that could then be used to assign target values to secondary CRMs. These secondary CRMs could in turn be used to calibrate and verify the accuracy of immunoassays, thereby giving a good foundation for establishing a complete traceability chain for CRP.

Medium optimization for high yield production of human serum albumin in Pichia pastoris and its efficient purification

OBJECTIVE

To improve the yield of recombinant human serum albumin (HSA) in Pichia pastoris by medium optimization and establish the related purification scheme.

RESULTS

A simplified version of the generally used buffered glycerol complex medium (BMGY), which contained yeast extract, glycerol and potassium salts, was found to be applicable. By decreasing the salt concentration of basal salt medium (BSM) to half of the original formula further, we achieved a high yield of 17.47 g/L HSA in the supernatant within a 192 h induction, which is the highest rHSA yield ever reported as far as we know. Accompanied with a three-step purification procedure which recovered two thirds of the desired protein at high purity, our work lays a solid foundation for large-scale industrial production of HSA.

CONCLUSION

Medium optimization plays a significant role in improving the yield of desired protein, lowering the production cost and helping to explore the producing strain's character.

Vitamin D status was associated with sepsis in critically ill children: A PRISMA compliant systematic review and meta-analysis

BACKGROUND

Sepsis leads to the high mortality in critically ill infants and children. It is still controversial whether vitamin D deficiency was associated with the incidence of sepsis. Thus we designed the systematic review and meta-analysis.

METHODS

The Ovid Medline, Embase, PubMed, and Cochrane library were systematically searched until April 5, 2020. The 25 hydroxyvitamin D (25-OHD) level was recorded and set 20 ng/mL as cut-off in cohort study to divide the lower and higher 25-OHD group. The odds ratio (OR) and 95% confidence intervals (CIs) were calculated for comparing the impact of vitamin D deficiency on the incidence of sepsis in critically ill children.

RESULTS

A total of 27 studies were included with 17 case-control studies and 10 cohort studies. In those case-control studies, the maternal 25-OHD level and neonatal 25-OHD level in sepsis group was significant lower than non-sepsis group (P < .001). The percentage of severe vitamin D deficiency was significant higher in sepsis group comparing to non-sepsis group (odds ratio [OR] = 2.66, 95% CI = 1.13-6.25, P < .001). In those cohort studies, the incidence of sepsis in lower 25-OHD group was 30.4% comparing with 18.2% in higher 25-OHD level group. However, no statistical significant difference in terms of mechanical ventilation rate and 30-day mortality.

CONCLUSION

We demonstrated that critically ill infants and children with sepsis could have a lower 25-OHD level and severe vitamin D deficiency comparing to those without sepsis. Future studies should focus on the association of vitamin D supplement and the occurrence of sepsis in critically ill children.

[The clinical observation of sirolimus combined with calcineurin inhibitors for steroid-resistant/steroid-dependent extensive cGVHD]

Objective: To observe the efficacy and safety of sirolimus combined with calcineurin inhibitor (CNI) in the treatment of glucocorticoid resistant/dependent extensive chronic graft-versus-host disease (cGVHD) . Methods: A total of 27 patients with steroid-resistant/steroid-dependent extensive cGVHD from November 2015 to January 2019 were enrolled and given sirolimus capsules combined with cyclosporine or tacrolimus to observe the clinical efficacy and adverse events. Results: The median duration of medication was 14.2 months and the mean duration was 16.7 months. The median follow-up time was 20.1 months (12.9-46.1 months) . Following the 6-month follow-up, 3 cases achieved complete response (CR) and 12 cases partial response (PR) . The overall response rate (ORR) was 55.6% ; for progression-free survival (PFS) , PFS-6 reached 88.9% (24/27) , and for overall survival (OS) , OS-6 was 100% . At the 1-year follow-up, there were 5 cases of CR and 11 cases of PR, ORR was 59.3% , PFS-12 reached 62.9% (17/27) , and OS-12 was 100% . The subgroup analysis found that the program was more effective for cGVHD in male donors and the target organ analysis had an advantage in the treatment of oral cavity, skin, and liver rejection. Adverse events were observed: hyperlipidemia 11.1% , oral ulcer 7.4% , fungal infection 11.1% , liver injury 3.7% , renal insufficiency 0, and no new CMV and EB viremia. Conclusion: Sirolimus combined with calcineurin inhibitors is effective in treating steroid-resistant/steroid-dependent extensive cGVHD, especially because adverse reactions (renal toxicity, CMV, EBV infection) are low in number, which is suitable for long-term treatment of cGVHD.

Pillar-beam structures prevent layered cathode materials from destructive phase transitions

Energy storage with high energy density and low cost has been the subject of a decades-long pursuit. Sodium-ion batteries are well expected because they utilize abundant resources. However, the lack of competent cathodes with both large capacities and long cycle lives prevents the commercialization of sodium-ion batteries. Conventional cathodes with hexagonal-P2-type structures suffer from structural degradations when the sodium content falls below 33%, or when the integral anions participate in gas evolution reactions. Here, we show a "pillar-beam" structure for sodium-ion battery cathodes where a few inert potassium ions uphold the layer-structured framework, while the working sodium ions could diffuse freely. The thus-created unorthodox orthogonal-P2 K0.4[Ni0.2Mn0.8]O2 cathode delivers a capacity of 194 mAh/g at 0.1 C, a rate capacity of 84% at 1 C, and an 86% capacity retention after 500 cycles at 1 C. The addition of the potassium ions boosts simultaneously the energy density and the cycle life.

[Intraocular pressure with miniscleral contact lenses]

According to literature data, some experts do not exclude the possibility that scleral lens wear could influence intraocular pressure.

PURPOSE

To evaluate the influence of rigid gas permeable miniscleral contact lenses on intraocular pressure (IOP), keratometry readings and corneal thickness, and to study the correlation between scleral (IOPs) and corneal (IOPc) intraocular pressure using the Icare ic100 tonometer (model TAO11, Icare Finland Oy).

MATERIAL AND METHODS

The study included 99 volunteers without history of ocular diseases. The first group consisted of 66 participants (122 eyes) aged 22.3±2.2 years - IOPc and IOPs were measured by the Icare ic100 tonometer in order to determine the correlation. The second group (33 participants, aged 22.7±1.7 years) - day 1, diurnal IOPc and IOPs fluctuations were measured; on day 2, a miniscleral lens (diameter 14.9 mm) was placed on the study eye and was worn for 6 hours, the paired eye served as control. IOP was measured before, after lens placement, after 2 hours of lens wear, and before and after lens removal. Corneal topography was evaluated before and after lens removal.

RESULTS

In the first group, there was a weak but significant correlation between IOPc and IOPs (Spearman correlation coefficient 0.285, p=0.001). In the second group, IOPc in the study eye before lens placement (14.8±3.8 mm Hg) and IOPc after its removal (13.6±3.9 mm Hg) were not different from those in the control eye. There were also no statistically significant changes in IOPs before, during lens wear, and after lens removal. The central corneal thickness increased by 2.9% (p<0.001) after 6 hours of lens wear.

CONCLUSION

In young individuals without history of ocular diseases, wearing the miniscleral lens for 6 hours does not have significant influence on IOP and does not cause clinically significant corneal edema.

Ethanol steam reforming on Rh: microkinetic analyses on the complex reaction network

Reaction networks were generated for ethanol steam reforming to CO and CO2. After the pruning of the networks, the preferred reaction pathways of the CO and CO2 production on Rh(111) were identified and detailed kinetic information was analyzed.

Role of glucocorticoid receptor phosphorylation-mediated synaptic plasticity in anxiogenic and depressive behaviors induced by monosodium glutamate

Psychiatric diseases and metabolic disorders frequently cooccur, yet the mechanisms underlying this interaction remain unknown. The aim of this study was to determine the role of glucocorticoid receptor (GR) phosphorylation in the comorbidity of metabolic and psychiatric disorders. Neonatal Sprague-Dawley rats were subcutaneously injected with monosodium glutamate (MSG) every 2 days for 10 days after birth. Metabolic and behavioral tests were performed 12 weeks later. Golgi staining and transmission electron microscopy (TEM) were performed to evaluate synaptic structural plasticity. Changes in GR phosphorylation and the BDNF/TrkB pathway were evaluated by western blotting and immunofluorescence. We found that MSG-treated rats displayed significant metabolic abnormalities accompanied by anxiogenic and depressive behaviors, an altered synaptic ultrastructure and the loss of dendritic spines. The expression of phosphorylated GR was reduced in the brain. Furthermore, a specific agonist of BDNF/TrkB significantly reversed the reduction in GR phosphorylation, as well as the metabolic and behavioral outcomes. These findings indicate that a decrease in BDNF/TrkB pathway-dependent GR phosphorylation is a long-term effect of MSG treatment that may contribute to metabolic and behavioral disturbances.

A Machine Learning Approach for Tracing Tumor Original Sites With Gene Expression Profiles

Some carcinomas show that one or more metastatic sites appear with unknown origins. The identification of primary or metastatic tumor tissues is crucial for physicians to develop precise treatment plans for patients. With unknown primary origin sites, it is challenging to design specific plans for patients. Usually, those patients receive broad-spectrum chemotherapy, while still having poor prognosis though. Machine learning has been widely used and already achieved significant advantages in clinical practices. In this study, we classify and predict a large number of tumor samples with uncertain origins by applying the random forest and Naive Bayesian algorithms. We use the precision, recall, and other measurements to evaluate the performance of our approach. The results have showed that the prediction accuracy of this method was 90.4 for 7,713 samples. The accuracy was 80% for 20 metastatic tumors samples. In addition, the 10-fold cross-validation is used to evaluate the accuracy of classification, which reaches 91%.

Biogenesis of the peptide-derived redox cofactor pyrroloquinoline quinone

Pyrroloquinoline quinone (PQQ) is a peptide-derived redox cofactor produced by prokaryotes that also plays beneficial roles in organisms from other kingdoms. We review recent developments on the pathway of PQQ biogenesis, focusing on the mechanisms of PqqE, PqqF/G, and PqqB. These advances may shed light on other, uncharacterized biosynthetic pathways.

Unconventional Hall response in the quantum limit of HfTe5

Interacting electrons confined to their lowest Landau level in a high magnetic field can form a variety of correlated states, some of which manifest themselves in a Hall effect. Although such states have been predicted to occur in three-dimensional semimetals, a corresponding Hall response has not yet been experimentally observed. Here, we report the observation of an unconventional Hall response in the quantum limit of the bulk semimetal HfTe5, adjacent to the three-dimensional quantum Hall effect of a single electron band at low magnetic fields. The additional plateau-like feature in the Hall conductivity of the lowest Landau level is accompanied by a Shubnikov-de Haas minimum in the longitudinal electrical resistivity and its magnitude relates as 3/5 to the height of the last plateau of the three-dimensional quantum Hall effect. Our findings are consistent with strong electron-electron interactions, stabilizing an unconventional variant of the Hall effect in a three-dimensional material in the quantum limit.

[Research on consistency of different measurement methods for saliva 1,5-anhydroglucitol]

Objective: To evaluate the consistency of different measurement methods of saliva 1,5-anhydroglucitol (1,5-AG) in different glucose metabolism populations. Methods: From January 2018 to June 2019, 175 healthy volunteers (21-65 years, 58 males and 117 females) with normal glucose tolerance (NGT) and 80 diabetic patients (18-70 years, 44 males and 36 females) were enrolled in Shanghai Jiao Tong University Affiliated Sixth People's Hospital. Saliva was collected by saliva collection tube, and 1,5-AG was measured using both enzymatic and mass spectrometry methods. Serum 1,5-AG was determined by enzymatic method. Results: In NGT subjects, both serum and saliva 1,5-AG levels detected by enzymatic method were positively correlated with the saliva 1,5-AG levels detected by liquid chromatography-mass spectrometry (r=0.247 and 0.523, respectively, both P<0.05). However, there was no significant correlation between saliva and serum 1,5-AG levels detected by enzymatic method (r=-0.074, P=0.333). In diabetic patients, both serum and saliva 1,5-AG levels detected by enzymatic method were positively correlated with the saliva 1,5-AG levels detected by gas chromatography-mass spectrometry (r=0.284 and 0.423, respectively, both P<0.05). However, there was no significant correlation between saliva and serum 1,5-AG levels detected by enzymatic method (r=-0.079, P=0.487). Conclusions: Both serum and saliva 1,5-AG levels detected by enzymatic method have a good consistency with saliva 1,5-AG levels detected by mass spectrometry method. The saliva and serum 1,5-AG levels detected by enzymatic method are not well correlated, and thus the enzymatic detection of saliva 1,5-AG needs further improvement in clinical practice.

Using a Self-Assembled Two-Dimensional MXene-Based Catalyst (2D-Ni@Ti3C2) to Enhance Hydrogen Storage Properties of MgH2

In this work, we report the remarkable catalytic effects of a novel Ti₃C₂ MXene-based catalyst (Ni@Ti-MX), which was prepared via self-assembling of Ni nanoparticles onto the surface of exfoliated Ti₃C₂ nanosheets. The resultant Ni@Ti-MX catalyst, characterized by ultradispersed Ni nanoparticles being anchored on the monolayer Ti₃C₂ flakes, was introduced into MgH₂ through ball milling. In situ transmission electron microscopy (TEM) analysis revealed that a synergetic catalytic effect of multiphase components (Mg₂Ni, TiO₂, metallic Ti, etc.) derived in the MgH₂ + Ni@Ti-MX composite exhibits remarkable improvements in the hydrogen sorption kinetics of MgH₂. In particular, the MgH₂ + Ni@Ti-MX composite can absorb 5.4 wt % H₂ in 25 s at 125 °C and release 5.2 wt % H₂ in 15 min at 250 °C. Interestingly, it can uptake 4 wt % H₂ in 5 h even at room temperature. Furthermore, the dehydrogenation peak temperature of the MgH₂ + Ni@Ti-MX composite is about 221 °C, which is 50 and 122 °C lower than that of MgH₂ + Ti-MX and MgH₂, respectively. The excellent hydrogen sorption properties of the MgH₂ + Ni@Ti-MX composite are primarily attributed to the peculiar core-shell nanostructured MgH₂@Mg₂NiH₄ hybrid materials and the interfacial coupling effects from different catalyst-matrix interfaces. The results obtained in this study demonstrate that using self-assembling of transition-metal elements on two-dimensional (2D) materials as a catalyst is a promising approach to enhance the hydrogen storage properties of MgH₂.

Kras-Deficient T Cells Attenuate Graft-versus-Host Disease but Retain Graft-versus-Leukemia Activity

Acute graft-versus-host disease (aGVHD) is one major serious complication that is induced by alloreactive donor T cells recognizing host Ags and limits the success of allogeneic hematopoietic stem cell transplantation. In the current studies, we identified a critical role of Kras in regulating alloreactive T cell function during aGVHD. Kras deletion in donor T cells dramatically reduced aGVHD mortality and severity in an MHC-mismatched allogeneic hematopoietic stem cell transplantation mouse model but largely maintained the antitumor capacity. Kras-deficient CD4 and CD8 T cells exhibited impaired TCR-induced activation of the ERK pathway. Kras deficiency altered TCR-induced gene expression profiles, including the reduced expression of various inflammatory cytokines and chemokines. Moreover, Kras deficiency inhibited IL-6-mediated Th17 cell differentiation and impaired IL-6-induced ERK activation and gene expression in CD4 T cells. These findings support Kras as a novel and effective therapeutic target for aGVHD.

Extensible artificial intelligence model predicts post-ablation AF recurrence using coronary sinus electrogram

Background

Atrial fibrillation (AF) is a major public health problem with significant adverse outcomes and catheter ablation is a widely adopted treatment. The CABANA trial showed that catheter ablation reduced AF recurrence to a greater extent than medications. However, some of patients who underwent this procedure still experience relapse. Here, we present an innovative way to identify this subgroup using an artificial intelligence (AI) -assisted coronary sinus electrogram.

Hypothesis

Our hypothesis is that credible features in the electrogram can be extracted by AI for prediction, therefore rigorous drug administration, close follow-up or potential second procedure can be applied to these patients.

Methods

67 patients from two independent hospitals (SPH & ZSH) with non-valvular persistent AF undergoing circumferential pulmonary vein isolation were enrolled in this study, 23 of which experienced recurrence 6 months after the procedure. We collected standard 2.5-second fragments of coronary sinus electrogram from ENSITE NAVX (SPH) and Carto (ZSH)system before the ablation started. A total of 1429 fragments were obtained and a transfer learning-based ResNet model was employed in our study. Fragments from ZSH were used for training and SPH for validation of deep convolutional neural networks (DCNN). The AI model performance was evaluated by accuracy, recall, precision, F-Measure and AUC.

Results

The prediction accuracy of the DCNN in single center reached 96%, while that in different ablation systems reached 74.3%. Also, the algorithm yielded values for the AUC, recall, precision and F-Measure of 0.76, 86.1%, 95.9% and 0.78, respectively, which shows satisfactory classification results and extensibility in different cardiology centers and brands of electroanatomic mapping instruments.

Conclusions

Our work has revealed the potential intrinsic correlation between coronary sinus electrical activity and AF recurrence using DCNN-based model. Moreover, the DCNN model we developed shows great prospects in the relapse prediction for personalized post-procedural management.

Funding Acknowledgement

Type of funding source: Foundation. Main funding source(s): The National Natural Science Foundation of China

CMF-Impute: an accurate imputation tool for single-cell RNA-seq data

MOTIVATION

Single-cell RNA-sequencing (scRNA-seq) technology provides a powerful tool for investigating cell heterogeneity and cell subpopulations by allowing the quantification of gene expression at single-cell level. However, scRNA-seq data analysis remains challenging because of various technical noises such as dropout events (i.e. excessive zero counts in the expression matrix).

RESULTS

By taking consideration of the association among cells and genes, we propose a novel collaborative matrix factorization-based method called CMF-Impute to impute the dropout entries of a given scRNA-seq expression matrix. We test CMF-Impute and compare it with the other five state-of-the-art methods on six popular real scRNA-seq datasets of various sizes and three simulated datasets. For simulated datasets, CMF-Impute outperforms other methods in imputing the closest dropouts to the original expression values as evaluated by both the sum of squared error and Pearson correlation coefficient. For real datasets, CMF-Impute achieves the most accurate cell classification results in spite of the choice of different clustering methods like SC3 or T-SNE followed by K-means as evaluated by both adjusted rand index and normalized mutual information. Finally, we demonstrate that CMF-Impute is powerful in reconstructing cell-to-cell and gene-to-gene correlation, and in inferring cell lineage trajectories.

AVAILABILITY AND IMPLEMENTATION

CMF-Impute is written as a Matlab package which is available at https://github.com/xujunlin123/CMFImpute.git.

SUPPLEMENTARY INFORMATION

Supplementary data are available at Bioinformatics online.

[The appropriate cut-off point of time in range (TIR) for evaluating glucose control in type 2 diabetes mellitus]

Objective: To investigate the appropriate cut-off point of time in range (TIR) for evaluating glucose control in type 2 diabetes mellitus (T2DM) patients, and analyze the prevalence of abnormal carotid intima-media thickness (CIMT) and diabetic retinopathy (DR) in different TIR categories. Methods: A total of 2 161 subjects with T2DM (1 183 males) were enrolled from hospitalized patients at the Department of Endocrinology and Metabolism of the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University from January 2005 to February 2012. The age of the enrolled participants was (60.4±11.9) years. Each patient underwent continuous glucose monitoring (CGM) for three consecutive days, then TIR (3.9-10.0 mmol/L), time above range (TAR) and time below range (TBR) were calculated. Fundus photography and carotid artery Doppler ultrasound were performed to diagnose DR and abnormal CIMT (defined as CIMT≥1.0 mm), respectively. Multivariate logistic regression models were used to examine the independent association of different TIR groups with CIMT and DR. Results: All subjects were divided into 4 groups according to TIR:≤40%, 41%-70%, 71%-85% and>85%. Significant linear trends in age, diabetes duration, body mass index (BMI), total cholesterol, glycated hemoglobin A1c (HbA1c), TAR and mean glucose (MG) existed among the 4 groups (all P(trend)<0.05). However, there was only a weak correlation between TIR and TBR (<3.9 mmol/L) (r=0.087, P<0.001), and no significant association was observed between TBR (<3 mmol/L) and the TIR categories (P(trend)=0.378). The overall prevalence of abnormal CIMT and DR was 12.1% and 23.8%, respectively. The prevalence of abnormal CIMT in the 4 groups with ascending levels of TIR was 16.9% (59/349), 12.9% (96/746), 11.2% (57/510) and 9.0% (50/556) (P(trend)<0.001), respectively. And the prevalence of DR was 30.7% (107/349), 29.4% (219/746), 20.8% (106/510) and 14.9% (83/556), respectively (P(trend)<0.001). In the binary logistic regression model by adjusting confounding factors, compared with TIR≤ 40%, the risk of abnormal CIMT was reduced by 33.8% (OR=0.662, 95%CI: 0.456-0.963, P=0.031), 40.8% (OR=0.592, 95%CI: 0.390-0.899, P=0.014), and 45.0% (OR=0.550, 95%CI: 0.358-0.846, P=0.006) in the other three groups, respectively. And the risk of DR was reduced by 2.9% (OR=0.971, 95%CI: 0.725-1.301, P=0.844), 33.4%(OR=0.666, 95%CI: 0.479-0.924, P=0.015) and 53.3% (OR=0.467, 95%CI: 0.331-0.657, P<0.001), respectively. Conclusion: Using 40%, 70% and 85% as cut-off point of TIR helps stratify the risk of diabetic complications, and assess the glucose control (Poor: TIR≤40%; Unsatisfactory: TIR≤70%; Satisfactory: TIR>70%; Optimal: TIR>85%) in patients with T2DM.

Rheological behavior of molecular vs network chalcogenide supercooled liquids

The viscoelastic behavior of supercooled glass-forming liquids along the binary join As₄S₃-GeS₂ with As₄S₃ contents varying from 81.25 to 9 mol. % and correspondingly with structures varying from predominantly molecular to a three-dimensional tetrahedral network is studied by small-amplitude oscillatory shear parallel plate rheometry. The storage shear modulus G' shows a scaling behavior of G'(ω) ∼ ωⁿ in the terminal (low-frequency) regime, where n varies between 1 and 2 and shows an increasingly anomalous departure from the expected value of 2 (Maxwell scaling) with increasing molecule content. A concomitant departure from the Maxwell scaling is also observed for the loss modulus G″ at frequencies above the G'-G″ crossover. On the other hand, the variation in the phase angle δ with the complex modulus indicates that the molecular liquid does not display a purely viscous response even at the lowest frequencies. These results, combined with an analysis of the relaxation spectra of these liquids, suggest that the anomalous behavior of molecular liquids may be linked to their rather broad relaxation spectrum and the presence of slow relaxation processes associated with molecular clusters. Additionally, these liquids are also characterized by a wide high-frequency plateau in the relaxation spectral density that can be linked to the rotational dynamics of the constituent molecules. Such fundamental differences between the rheological behavior of molecular and network liquids may explain the significantly higher fragility of the former.

Expression profiles of long non-coding RNAs during fetal lung development

With advances in neonatology, a greater percentage of premature infants now survive and consequently, diseases of lung development, including bronchopulmonary dysplasia and neonatal respiratory distress syndrome, have become more common. However, few studies have addressed the association between fetal lung development and long non-coding RNA (lncRNA). In the present study, right lung tissue samples of fetuses at different gestational ages were collected within 2 h of the induction of labor in order to observe morphological discrepancies. An Affymetrix Human GeneChip was used to identify differentially expressed lncRNAs. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses were performed. A total of 687 lncRNAs were identified to be differentially expressed among three groups of fetal lung tissue samples corresponding to the three embryonic periods. A total of 34 significantly upregulated and 12 significantly downregulated lncRNAs (fold-change, ≥1.5; P<0.05) were detected at different time points (embryonic weeks 7-16, 16-25 and 25-28) of fetal lung development and compared with healthy tissues Expression changes in lncRNAs n340848, n387037, n336823 and ENST00000445168 were validated by reverse transcription-quantitative PCR and the results were consistent with the GeneChip results. These novel identified lncRNAs may have roles in fetal lung development and the results of the present study may lay the foundation for subsequent in-depth studies into lncRNAs in fetal lung development and subsequent clarification of the pathogenesis of neonatal pulmonary diseases.

Topological Interface between Pfaffian and Anti-Pfaffian Order in ν=5/2 Quantum Hall Effect

A recent thermal Hall experiment triggered renewed interest in the problem of ν=5/2 quantum Hall effect, which motivated novel interpretations based on the formation of mesoscopic puddles made of Pfaffian and anti-Pfaffian topological orders. Here, we study an interface between the Pfaffian and anti-Pfaffian states, which may play crucial roles in thermal transport, by means of state-of-the-art, density-matrix renormalization group simulations. We demonstrate that an intrinsic electric dipole moment emerges at the interface, similar to the "p-n" junction sandwiched between N-type and P-type semiconductor. Importantly, we elucidate the topological origin of this dipole moment, whose formation is to counterbalance the mismatch of guiding-center Hall viscosity of bulk Pfaffian and anti-Pfaffian states. In addition, these results imply that the formation of a dipole moment could be helpful to stabilize the puddles made of Pfaffian and anti-Pfaffian states in experimental conditions.

Nobiletin alleviates ischemia/reperfusion injury in the kidney by activating PI3K/AKT pathway

Recent studies have demonstrated that nobiletin (NOB) displays anti-oxidative and anti-apoptotic efficacies against multiple pathological insults. However, the potential effects of NOB on the injury caused by ischemia and reperfusion (I/R) in the kidney remain undetermined. In the present study, I/R injury was elicited by right kidney removal and left renal pedicel clamping for 45 min, followed by reperfusion for 24 h. NOB was added at the start of reperfusion. Histological examination, detection of biomarkers in plasma, and measurement of apoptosis induced by endoplasmic reticulum stress (ERS) were used to evaluate renal injury. Additionally, the PI3K/AKT inhibitor LY294002 was also used in mechanistic experiments. NOB pre-treatment significantly reduced renal damage caused by I/R injury, as indicated by decreased serum levels of creatine, blood urea nitrogen and tubular injury scores. Furthermore, NOB inhibited elevated ERS-associated apoptosis, as evidenced by reduced apoptotic rates and ERS-related signaling molecules (such as, C/EBP homologous protein, caspase-12 and glucose-regulated protein of 78 kDa). NOB increased phosphorylation of proteins in the PI3K/AKT pathway. The inhibition of PI3K/AKT signaling with pharmacological inhibitors could reverse the beneficial effects of NOB during renal I/R insult. In conclusion, NOB pre-treatment may alleviate I/R injury in the kidney by inhibiting reactive oxygen species production and ERS-induced apoptosis, partly through the PI3K/AKT signaling pathway.

Aged fragrance formed during the post-fermentation process of dark tea at an industrial scale

Although aged fragrance is the most outstanding quality characteristic of dark tea, its formation still is not much clear. Thus, the volatiles of Qingzhuan tea (QZT) during the whole post-fermentation process were investigated at an industrial scale. The results showed that most of volatiles increased during pile-fermentation of QZT and weakened during aging storage, but some new volatiles were produced through aging storage. Hexanal, (E)-2-hexenal, (E)-2-decenal, 2,6,6-trimethyl-1-cyclohexene-1-carboxaldehyde, heptanal, (E)-2-octenal, (R)-5,6,7,7a-tetrahydro-4,4,7a-trimethyl-2(4H)-benzofuranone, ionone, 2-heptanone, 3-ethyl-4-methyl-1H-pyrrole-2,5-dione, (R,S)-5-ethyl-6-methyl-3-hepten-2-one, cis-5-ethenyltetrahydro-5-trimethyl-2-furanmethanol, and linalool generated by pile-fermentation should be the basic volatiles of aged fragrance in QZT, and 4-(2,4,4-trimethyl-cyclohexa-1,5-dienyl)-but-3-en-2-one, 6-methyl-5-heptene-2-one, safranal, guaiene, trans-2-(2-propynyloxy)-cyclohexanol, nonanal, and 4-(2,6,6-trimethyl-1-cyclohexen-1-yl)-2-butanone formed during aging storage should be the transformed volatiles of aged fragrance in QZT, which together constitute the characteristic components of aged fragrance. Notably, 4-(2,6,6-trimethyl-1-cyclohexen-1-yl)-2-butanone, 6-methyl-5-heptene-2-one, and safranal were selected as the key volatiles of QZT. These results contribute to understand better the formation of agedfragrance in dark tea.

Segmenting the Semi-Conductive Shielding Layer of Cable Slice Images Using the Convolutional Neural Network

Being an important part of aerial insulated cable, the semiconductive shielding layer is made of a typical polymer material and can improve the cable transmission effects; the structural parameters will affect the cable quality directly. Then, the image processing of the semiconductive layer plays an essential role in the structural parameter measurements. However, the semiconductive layer images are often disturbed by the cutting marks, which affect the measurements seriously. In this paper, a novel method based on the convolutional neural network is proposed for image segmentation. In our proposed strategy, a deep fully convolutional network with a skip connection algorithm is defined as the main framework. The inception structure and residual connection are employed to fuse features extracted from the receptive fields with different sizes. Finally, an improved weighted loss function and refined algorithm are utilized for pixel classification. Experimental results show that our proposed algorithm achieves better performance than the current algorithms.

A novel method of fluorescent imaging can guide hepatectomy for intrahepatic cholangiocarcinoma with intrahepatic biliary obstruction

OBJECTIVE

The aim of this study was to present a novel bile-duct obstructed area imaging (BOAI) and to investigate the feasibility and accuracy of this method in guiding hepatectomy for intrahepatic cholangiocarcinoma (ICC) with intrahepatic biliary obstruction.

METHODS

From May 2017 to October 2019, eligible patients who underwent hepatectomy guided by BOAI were enrolled. Perioperative outcomes and operative data were analyzed. To assess the feasibility of BOAI and Glissonean pedicle approach, demarcations based on them were compared. To verify the accuracy of BOAI staining of the target territory, simple linear regression analysis, and intraclass correlation coefficient were used to examine the relationship between predicted resected liver volume (PRLV) and actual resected liver volume (ARLV).

RESULTS

BOAI staining achieved valid demarcation in 15 (93.8%) of 16 patients, whereas the ischemic line achieved valid demarcation in only nine patients (57.3%; p = .017). ARLV and PRLV had a strong positive correlation (PRLV = 60.06 + 0.925 × ARLV; R = .945; p = .000). Meanwhile, ARLV (intraclass correlation coefficient = .971) achieved an excellent agreement with PRLV (p < .001).

CONCLUSIONS

The novel BOAI staining method can provide valid, feasible, and accurate demarcation line and may be an effective method in the surgical treatment of intrahepatic biliary obstruction.

Placenta-Derived Osteoprotegerin Is Required for Glucose Homeostasis in Gestational Diabetes Mellitus

Osteoprotegerin (OPG) is involved in various biological processes, including bone remodeling, vascular calcification and pancreatic β-cell function. Although some clinical studies have shown an increase in serum OPG level during pregnancy, the role of OPG in gestational diabetes mellitus (GDM) is largely unknown. Therefore, we explored the effect of OPG in metabolic homeostasis during pregnancy. We initially evaluated serum OPG levels using ELISA and western blotting techniques on samples from GDM patients. We also assessed OPG expression levels in maternal mice. We then used blastocysts transduced with lentiviruses capable of trophoblast-specific transgene expression to establish placenta-specific OPG knockdown or overexpression mouse models for functional and mechanistic investigation after embryo transplantation. We found that OPG expression was positively associated with GDM in clinical samples, and OPG levels were significantly increased in GDM patient sera and term placenta. Serum OPG was significantly increased in maternal compared to non-pregnant mice, and expression levels of OPG were the highest in placenta compared with other organs, including bone, liver and pancreas. OPG was also significantly increased in pregnant mice fed a high-fat diet (HFD). Placenta-specific OPG knockdown induced glucose intolerance, decreased β-cell proliferation and decreased serum insulin levels, whereas placenta-specific OPG overexpression promoted glucose tolerance and enhanced β-cell proliferation, which increased serum insulin production and decreased fetal weight in HFD-feeding pregnant mice. Placenta-derived OPG (pl-OPG) regulated glucose homeostasis during pregnancy via enhancement of β-cell proliferation, which suggests a potential therapeutic application of OPG for GDM.

[Application of 3D visualization and 3D printing in individualized precision surgery for Bismuth-Corlette type Ⅲ and Ⅳ hilar cholangiocarcinoma]

OBJECTIVE

To explore the application of 3D visualization and 3D printing in individualized precision surgical treatment of Bismuth-Corlette type Ⅲ and Ⅳ hilar cholangiocarcinoma.

METHODS

We retrospectively analyzed the data of 10 patients with hilar cholangiocarcinoma undergoing surgeries under the guidance of 3D visualization and 3D printing in the Department of Hepatobiliary Surgery, Zhujiang Hospital from May 2016 to March 2019. Thin-section CT data of the patients were collected for 3D reconstruction and 3D printing, and the 3D printed models were used for observing the 3D relationship of tumor with the intrahepatic bile duct, hepatic artery, portal vein and hepatic vein system and for performing preoperative simulated surgery and surgical planning. The 3D printed models were subsequently used for real-time intraoperative navigation to guide surgeries in the operating room.

RESULTS

3D visualization models were successfully reconstructed for all the 10 patients and printed into 3D models. The 3D visualization types in Bismuth-Corlette classification included type Ⅲa (4 cases), type Ⅲb (4 cases), and type Ⅳ (2 cases); 4 patients showed portal vein variation, 3 had hepatic artery variation, and 2 had both portal vein and hepatic artery variations. Two patients were found to have trifurcation type of portal vein variation, one had "I-shaped" variation, and one showed the absence of the right anterior branch of the portal vein; 3 patients had hepatic artery variations with the left hepatic artery originating from the left gastric artery (1 case) and the right hepatic artery originating from the superior mesenteric artery (2 cases). Four patients with type Ⅲb underwent left hepatectomy; 4 with type Ⅲa received right hepatectomy; 1 patient with of type Ⅳ received peripheral hepatic resection and another underwent left hepatectomy. The results of preoperative 3D reconstruction, 3D printed model and preoperative planning were consistent with the intraoperative findings. The operative time was 452±75.12 min with a mean intraoperative blood loss of 356±62.35 mL and a mean hospital stay of 15 ± 4.61 days in these cases. One patient had bile leakage and 3 patients had pleural effusion postoperatively, and they were discharged after drainage and medications. No liver failure or death occurred in these cases perioperatively.

CONCLUSIONS

3D visualization and 3D printing can facilitate accurate preoperative assessment, surgical planning and surgical procedure optimization for Bismuth-Corlette type Ⅲ and Ⅳ hilar cholangiocarcinoma to improve surgical safety and reduce surgical risks especially in cases of intrahepatic vascular variations.

Improving the Treatment of Acute Lymphoblastic Leukemia

l-Asparaginase (EC 3.5.1.1) was first used as a component of combination drug therapies to treat acute lymphoblastic leukemia (ALL), a cancer of the blood and bone marrow, almost 50 years ago. Administering this enzyme to reduce asparagine levels in the blood is a cornerstone of modern clinical protocols for ALL; indeed, this remains the only successful example of a therapy targeted against a specific metabolic weakness in any form of cancer. Three problems, however, constrain the clinical use of l-asparaginase. First, a type II bacterial variant of l-asparaginase is administered to patients, the majority of whom are children, which produces an immune response thereby limiting the time over which the enzyme can be tolerated. Second, l-asparaginase is subject to proteolytic degradation in the blood. Third, toxic side effects are observed, which may be correlated with the l-glutaminase activity of the enzyme. This Perspective will outline how asparagine depletion negatively impacts the growth of leukemic blasts, discuss the structure and mechanism of l-asparaginase, and briefly describe the clinical use of chemically modified forms of clinically useful l-asparaginases, such as Asparlas, which was recently given FDA approval for use in children (babies to young adults) as part of multidrug treatments for ALL. Finally, we review ongoing efforts to engineer l-asparaginase variants with improved therapeutic properties and briefly detail emerging, alternate strategies for the treatment of forms of ALL that are resistant to asparagine depletion.