TGF-β signaling in intervertebral disc health and disease

OBJECTIVE

This paper aims to provide a comprehensive review of the changing role of transforming growth factor-β (TGF-β) signaling in intervertebral disc (IVD) health and disease.

METHODS

A comprehensive literature search was performed using PubMed terms 'TGF-β' and 'IVD'.

RESULTS

TGF-β signaling is necessary for the development and growth of IVD, and can play a protective role in the restoration of IVD tissues by stimulating matrix synthesis, inhibiting matrix catabolism, inflammatory response and cell loss. However, excessive activation of TGF-β signaling is detrimental to the IVD, and inhibition of the aberrant TGF-β signaling can delay IVD degeneration.

CONCLUSIONS

Activation of TGF-β signaling has a promising treatment prospect for IVD degeneration, while excessive activation of TGF-β signaling may contribute to the progression of IVD degeneration. Studies aimed at elucidating the changing role of TGF-β signaling in IVD at different pathophysiological stages and its specific molecular mechanisms are needed, and these studies will contribute to safe and effective TGF-β signaling-based treatments for IVD degeneration.

[Impact of Herpud1 in the homocysteine-induced phenotypic switching of vascular smooth muscle cells]

Objective: To investigate the impact of homocysteine inducible endoplasmic reticulum(ER) protein with ubiquitin like domain 1 protein (Herpud1) in the homocysteine (Hcy) -induced phenotypic switching of vascular smooth muscle cells (VSMCs). Methods: VSMCs were derived from thoracic aortic artery of male Sprague Dawley rats and cultured VSMCs (4-7 passage) were treated with various concentrations of Hcy (0, 100, 500 and 1 000 μmol/L) and applied to immunofluorescence to observe the morphological changes of VSMCs via SM-actin staining. Western blot was used to detect the expression of VSMCs phenotypic markers, including Osteopontin, Calponin and smooth muscle myosin heavy chain (SM-MHC) and the expression of endoplasmic reticulum stress (ERS) related proteins, including C/EBP-homologous protein (CHOP), inositol-requiring kinase 1 (IRE-1) and glucose regulating protein 78 (GRP78) in the absence and presence of non-selective inhibitor of ERS, 4-phenylbutyric acid (4-PBA, 2 mg/ml). The Herpud1 mRNA and protein levels were determined in Hcy-stimulated VSMCs treated with 4-PBA or transfected with specific siRNA targeting Herpud1. Results: Compared with the control group, SM-actin staining results showed that the shape of VSMCs treated with different concentrations of Hcy for 24 hours changed from long fusiform into round form, arrangement of myofilament became irregular and the most significant alteration was found in the 500 μmol/L Hcy group. After intervention of 24 hours, various concentration of Hcy increased protein expression of Osteopontin, and reduced Calponin and SM-MHC protein expressions in VSMCs (all P<0.05). In addition, the results showed that Hcy increased the expression of CHOP, IRE-1 and GRP78 in a dose-dependent manner, which could be reversed by 4-PBA treatment (all P<0.05). However, 4-PBA inhibited Hcy induced upregulation of Osteopontin and downregulation of Calponin and SM-MHC, suggesting that ERS was involved in Hcy-induced phenotypic switching of VSMCs. Herpud1 protein was mostly expressed in the cytoplasm and was also expressed in the nucli, both in the control, Hcy and Hcy+4-PBA groups. Moreover, Hcy increased mRNA and protein levels of Herpud1 (P<0.05), whereas treatment with 4-PBA could significantly reduce Hcy-induced upregulation of Herpud1 (P<0.05). Furthermore, knockdown of Herpud1 abrogated the effects of Hcy on VSMCs phenotype markers. Conclusion: Herpud1 plays an important role in Hcy-induced phenotypic switching of VSMCs.

Contextual effects of angry vocal expressions on the encoding and recognition of emotional faces: An event-related potential (ERP) study

It has been shown that stimulus memory (e.g., encoding and recognition) is influenced by emotion. In terms of face memory, event-related potential (ERP) studies have shown that the encoding of emotional faces is influenced by the emotion of concomitant context, when contextual stimuli were input from a visual modality. Behavioral studies also investigated the effect of contextual emotion on subsequent recognition of neutral faces. However, there might be no studies ever investigating the context effect on face encoding and recognition, when contextual stimuli were input from other sensory modalities (e.g., an auditory modality). Additionally, it may be unknown about the neural mechanisms underlying context effects on recognition of emotional faces. Therefore, the present study aimed to use vocal expressions as contexts to investigate whether contextual emotion influences ERP responses during face encoding and recognition. To this end, participants in the present study were asked to memorize angry and neutral faces. The faces were presented concomitant with either angry or neutral vocal expressions. Subsequently, participants were asked to perform an old/new recognition task, in which only faces were presented. In the encoding phase, ERP results showed that compared to neutral vocal expression, angry vocal expressions led to smaller P1 and N170 responses to both angry and neutral faces. For angry faces, however, late positive potential (LPP) responses were increased in the angry voice condition. In the later recognition phase, N170 responses were larger for neutral-encoded faces that had been presented with angry compared to neutral vocal expressions. Preceding angry vocal expression increased FN400 and LPP responses to both neutral-encoded and angry-encoded faces, when the faces showed the encoded expression. Therefore, the present study indicates that contextual emotion with regard to vocal expression influences neural responses during face encoding and subsequent recognition.

[Clinical research progression of molecular-targeted drugs and PD-1 inhibitors for advanced hepatocellular carcinoma]

Since sorafenib has been first-line molecular-targeted drug for advanced hepatocellular carcinoma (HCC), clinical studies in the last 10 years failed to confirm that a new molecular-targeted drug or immune checkpoint inhibitor was superior or non-inferior to sorafenib, or approved second-line treatment for patients with the failure of sorafenib. However, many clinical studies published in 2017 have changed people's previous understanding. REFLECT trial showed that as the first-line treatment of advanced HCC, lenvatinib was non-inferior than sorafenib. In addition, RESORCE trial and CheckMate-040 trial confirmed respectively that regorafenib and PD-1 inhibitor nivolumab were options of second-line treatment for patients with advanced HCC after sorafenib treatment. The development of these drugs will bring a new prospect for advanced HCC patients.

[Sero-prevalence of Babesia infection among voluntary blood donors in Jiangsu Province]

OBJECTIVE

To evaluate the sero-positivity of Babesia infection in voluntary blood donors in Jiangsu region, so as to provide the evidence for transfusion safety.

METHODS

A total of 950 blood samples were collected from voluntary blood donors in Jiangsu Provincial Blood Center from February to May, 2017, and detected by double antigen sandwich ELISA targeting peptides derived from B. microti-secreted antigen 1 (BmSA1). The positive samples were confirmed by microscopy and nested-PCR to determine parasitemia. The prevalence of anti-BmSA1 was analyzed between/among different genders, ages and occupations of the blood donors.

RESULTS

Of the 950 blood screened samples, 5 were positive for anti-BmSA1, and the sero-prevalence of Babesia infection was 0.53%. The 5 samples were all negative by microscopy and nested-PCR. There were no gender- (χ² = 0.01, P =0.92) or age-specific differences (χ² = 0.11, P = 0.95) in the sero-prevalence of Babesia infection; however, there was an occupation-specific difference detected in the sero-prevalence of Babesia infection (χ² = 11.93, P < 0.05).

CONCLUSIONS

Babesia infection is detected in voluntary blood donors in Jiangsu region, which should be paid much attention.

Cosmological Constraints from Multiple Probes in the Dark Energy Survey

The combination of multiple observational probes has long been advocated as a powerful technique to constrain cosmological parameters, in particular dark energy. The Dark Energy Survey has measured 207 spectroscopically confirmed type Ia supernova light curves, the baryon acoustic oscillation feature, weak gravitational lensing, and galaxy clustering. Here we present combined results from these probes, deriving constraints on the equation of state, w, of dark energy and its energy density in the Universe. Independently of other experiments, such as those that measure the cosmic microwave background, the probes from this single photometric survey rule out a Universe with no dark energy, finding w=-0.80_{-0.11}^{+0.09}. The geometry is shown to be consistent with a spatially flat Universe, and we obtain a constraint on the baryon density of Ω_{b}=0.069_{-0.012}^{+0.009} that is independent of early Universe measurements. These results demonstrate the potential power of large multiprobe photometric surveys and pave the way for order of magnitude advances in our constraints on properties of dark energy and cosmology over the next decade.

Anal fistula plug vs rectal advancement flap for the treatment of complex cryptoglandular anal fistulas: a systematic review and meta-analysis of studies with long-term follow-up

AIM

The aim was to compare the effectiveness of the anal fistula plug (AFP) with the rectal advancement flap (RAF) for complex cryptoglandular anal fistulas.

METHODS

We conducted a literature search to identify relevant available articles published without language restriction from Embase and PubMed databases and the Cochrane Library. Studies comparing outcomes with the AFP vs RAF for complex cryptoglandular anal fistulas were eligible for inclusion.

RESULTS

A total of 11 articles with 810 patients were included in this meta-analysis. Four RCTs and one observational clinical study provided long-term follow-up. The pooled analysis of all 11 studies indicated that there was no significant difference between the AFP and RAF in terms of healing rate, recurrence rate and incidence of fistula complications. However, the pooled results of studies with long-term follow-up revealed that the RAF group had a significantly higher healing rate (OR 0.32, 95% CI 0.13, 0.78, P = 0.01) and lower recurrence rate (OR 4.45, 95% CI 1.45, 13.65, P = 0.009) than the AFP group.

CONCLUSIONS

For the treatment of complex cryptoglandular anal fistulas, the RAF was superior to the AFP in terms of healing and recurrence rate after pooling of randomized controlled trials with long-term follow-up, even though a comparison based on the pooling of all studies showed no significant difference.

Emotional arousal elicited by irrelevant stimuli affects event-related potentials (ERPs) during response inhibition

Previous event-related potential (ERP) studies using the Go/Nogo task have indicated that response inhibition is influenced by the arousal elicited by emotional stimuli, when those stimuli are relevant to response selection of Go and Nogo trials. Due to stimulus and task design issues, however, it is uncertain whether response inhibition is affected by emotional valence or arousal, when emotional stimuli are irrelevant to response selection. Therefore, the present study aimed to re-investigate this issue by circumventing limitations of previous research. To address this issue, thirty-one young adults (16 females and 15 males) were required to make motor responses to frequently-presented faces of one sex (Go trials) and to inhibit responses to less-frequently presented faces of the opposite sex (Nogo trials). Crucially, the faces were superimposed onto positive, negative and neutral pictures. The pictures were presented in a randomized order. The arousal values between positive and negative pictures were highly matched. Results showed that Nogo faces elicited smaller N2 but larger P3a amplitudes, when the faces were associated with positive and negative pictures as compared to neutral pictures. These findings suggest that response inhibition is influenced by emotional arousal, when emotional stimuli are irrelevant to response selection. Additionally, for Go faces, results showed smaller N2 but larger P3a amplitudes within negative pictures as compared to neutral and positive pictures, suggesting a role of emotional valence elicited by irrelevant stimuli on response execution.

3.7 kW monolithic narrow linewidth single mode fiber laser through simultaneously suppressing nonlinear effects and mode instability

In this paper, we report a 3.7 kW all fiber narrow linewidth single mode fiber laser. The full width at half-maximum is about 0.30 nm, and the beam quality is Mx2=1.358, My2=1.202 at maximum output power. The laser is achieved by simultaneously suppressing nonlinear effects and mode instability (MI). Different seeds are injected into the main amplifier to study stimulated Raman scattering (SRS) effect. The results show that the phase modulated single frequency seed is benefit to suppress the SRS effect. For the phase modulated single frequency seed, inserting a filter in preamplifier will suppress amplified spontaneous emission (ASE) and decrease the backward power. By optimizing the coiling of active fiber, the MI effect is suppressed.

Botulinum Toxin Type A Attenuates Apoptosis in Human Dermal Microvascular Endothelial Cells Exposed to an In Vitro Model of Ischemia/Reperfusion Injury

BACKGROUND

Botulinum toxin type A (BTXA) has been reported to increase survival of critically ischemic skin flaps; however, the effect of BTXA in human dermal microvascular endothelial cells (HDMECs) remains to be investigated. This study aimed to investigate the protective effect of BTXA in HDMECs exposed to an in vitro model of ischemia/reperfusion injury.

METHODS

HDMECs were isolated from human upper eyelid tissue and were randomly divided into 3 groups: 1.

CONTROL GROUP

culture under normoxic conditions (95% air and 5% CO₂); 2. hypoxia/reoxygenation (H/R) group: culture in a hypoxic incubator (94% N₂ + 5% CO₂ + 5% O₂) for 8 hours, followed by culture in saturated aerobic culture medium for 24 hours; and 3. BTXA group: treatment with BTXA for 12 hours before exposure to hypoxic conditions. Flow cytometry was used to analyze the apoptosis of HDMECs, and western blotting was used to detect the expression of apoptosis-related proteins.

RESULTS

H/R leads to severe injury in HDMECs, as evidenced by an increase in the percentage of apoptosis and an increase in expression of apoptosis-related proteins (Bax, cleaved-caspase-3, and cytochrome C). Moreover, H/R results in a decrease in expression of anti-apoptotic protein (Bcl-2), which can be significantly attenuated with BTXA treatment.

CONCLUSION

BTXA protects against apoptosis in HDMECs exposed to an in vitro model of H/R-induced injury.

Saturation cavity ring-down spectrometry using a dynamical relaxation model

We propose a new simple approximate solution to the two-state rate equation model for analyzing decay signals of saturation cavity ring-down spectrometry in the adiabatic and low-saturation regime. It helps obtain baseline-immune Doppler-free spectra for hyperfine transitions and linear absorption coefficients of a gas in the saturation regime. To demonstrate it, a baseline-immune Lamb dip spectrum of the R1A2 transitions in the 2v₂ + v₃ band of methane was recorded. The line position was determined to be 6 076.108 457 7(11) cm^-1, the relative uncertainty being 1.8 × 10^-10.

[The clinical and pathological features, biomarker characteristics and prognosis analysis of lung adenosquamous carcinoma]

Objective: Adenosquamous carcinoma of lung is an uncommon subtype with more aggressive behavior and poor prognosis than adenocarcinoma and squamous cell carcinoma. This study was aimed to investigate the clinicopathological characteristics and prognostic factors of lung adenosquamous carcinoma. Methods: The pathological features and follow-up data of 133 patients were collected and the prognostic factors of these patients were retrospectively analyzed. Results: Among the 133 patients, 81 cases (60.9%) smoked. Among the 62 patients whose percentage of histological components were identified, 45 cases had >50% adenocarcinoma components, and 17 cases had >50% squamous cell carcinoma components. 55 patients had lymph node metastasis at the first visit. All patients accepted at least one test of tumor driven gene mutation, and the results showed that the mutation rate of EGFR was 50.8% (67/132), the mutation rate of K-ras was 8.6% (11/128), the ALK-positive rate was 4.2% (2/48). The gender, smoking status, and the proportion of pathological components were the main influence factors of EGFR mutation status. The median overall survival was 28 months, the rates of 1-year, 3-year, and 5-year survival were 72.9%, 23.3%, and 9.0%, respectively. EGFR tyrosine kinase inhibitors (TKIs) treatment was an independent risk factor for prognose of these patients (P=0.024). Conclusions: Lung adenosquamous carcinoma is a rare subtype with high malignancy and poor prognosis. Early diagnosis and driven-mutation-based individualized therapy may improve the survival of patients with lung adenosquamous carcinoma.

Discovery of New Lines in the R9 Multiplet of the 2v_{3} Band of ^{12}CH_{4}

We present the first results for resolving methane (CH_{4}) line transition frequencies down to the kilohertz level for overlapping lines using comb-linked cavity ring-down spectroscopy, while most available laboratory measurements, having resolution at the megahertz level, cannot separate merged lines. To demonstrate the technique, Lamb-dip spectra and linear-absorption spectra were used to identify overlapped lines of vibration-rotation spectra in the R9 multiplet of the 2v_{3} band. Three new weak lines were found for the first time. The experimental methods are extensible to other important bands of CH_{4} and many other gas-phase molecules, and should provide a more detailed understanding of molecular structure and line parameters for future high-precision studies.

Heat exposure affects jejunal tight junction remodeling independently of adenosine monophosphate-activated protein kinase in 9-day-old broiler chicks

Dysfunction of the intestinal epithelial barrier under elevated temperatures is assumed to prompt pathological conditions and to eventually impede chickens' growth, resulting in massive economic losses in broiler industries. The aims of this research were to determine the impact of acute heat stress on the intestinal tight junction network of broiler chicks (Gallus domesticus L.) and to elucidate whether adenosine monophosphate-activated protein kinase (AMPK) was involved in the integrated response of the broiler's gastrointestinal tract to heat stress. A total of 80 9-day-old Arbor Acres chicks were subjected to temperature treatment (thermoneutral versus heat stress) and AMPK inhibition treatment (5 mg/kg body weight intraperitoneal injection of compound C vs. sham treatment) for 72 h. In addition to monitoring growth performance, the mRNA and protein levels of key tight junction proteins, target components of the AMPK pathway, and biomarkers of intestinal inflammation and oxidative stress were assessed in the jejunum under both stressors at 24 and 72 h. An increase of the major tight junction proteins, claudin-1 and zonula occludens-1, was implemented in response to an exacerbated expression of the AMP-activated protein kinase. Heat stress did not affect zootechnical performance but was confirmed by an increased gene expression of heat shock proteins 70 and 90 as well as heat shock factor-1. In addition, hyperthermia induced significant effects on tight junction proteins, although it was independent of AMPK.

Praseodymium ion doped K+-Na+ thermal ion-exchangeable waveguide-adaptive aluminum germanate glasses

Intense multi-peak red fluorescence and effective near-infrared (NIR) ultra-broadband emission have been observed in Pr³⁺ doped ion-exchangeable aluminum germanate (NMAG) glasses. The maximum emission cross section for P₀3→F₂3 red emission is up to 100.58×10^-21  cm², and the NIR emission corresponding to D₂1→G₄1 transition possesses a full-width at half-maximum (FWHM) of 210 nm. Although the obvious cross-relaxation (CR) process at high concentration causes a decrease of the quantum efficiency, the CR broadens the spectral FWHM effectively from another perspective. The admirable red fluorescence trace and the NIR single-mode transmission confirm that Pr³⁺ doped NMAG glass planar waveguides can support the generation of visible fluorescence and the amplification of infrared signal. For a waveguide channel ion-exchanged in molten KNO₃ for 2 h, the single-mode field diameters at 1.55 μm are identified to be 10.4 μm in the horizontal direction and 6.5 μm in the vertical direction, implying an acceptable overlap with a standard single-mode fiber. Effective red fluorescence and broad NIR emission demonstrate that Pr³⁺ doped NMAG glasses are a promising substrate in developing irradiative luminescence sources and ultra-broadband waveguide amplifiers, especially operating at the entire S-, C-, and L- bands.

Phylogenetic classification of hemagglutinin gene of H9N2 avian influenza viruses isolated in China during 2012-2016 and evaluation of selected candidate vaccine strains

H9N2 subtype avian influenza virus (AIV) was the highly contagious pathogen which has caused severe losses in the poultry industry throughout China in recent years. Using current epidemic viruses as vaccine was an effective way to prevent infection of H9N2 subtype AIV. In this study, a total of 23 H9N2 subtype AIV strains were isolated in 200 samples from 13 provinces of China during 2012-2016. The sequencing and phylogenetic analysis of the hemagglutinin gene sequence of the isolation strains showed that 22 isolation strains were clustered to h9.4.2.5 lineage, while only 1 belonged to h9.4.2.6. The data of cross-HI, neutralization and cross-immune protection shown that the A/chicken/Hunan/HN/2015 (HN) and A/chicken/Shandong/SD/2014 (SD) strains as vaccine could effectively protect present viruses infection compared with other strains. These results indicated that current epidemic viruses were mainly belong to h9.4.2.5 lineage and HN and SD strains as candidate vaccine strains were potentiality for the protection of present H9N2 subtype AIV infection.

The Fate of In Situ Lens Regeneration is Determined by Capsulorhexis Size

BACKGROUND AND OBJECTIVE

Lens regeneration is an optimal strategy for cataract patients to regain visual acuity with accommodation. We recently designed a novel, minimally invasive capsulorhexis surgical method for cataract removal that achieved functional lens regeneration in human infants. However, small anterior capsulorhexis requires advanced surgical expertise. To examine whether the quality of the regenerated lens can be maintained with enlarged anterior capsulorhexis, we investigated the shape and transparency of the regenerated lenses with different anterior capsulorhexis diameters (ACDs).

METHODS

Thirty-six 4-week-old New Zealand albino rabbits were randomly divided into three groups which underwent lens extraction with different ACDs (Group A: 2.0±0.5 mm, Group B: 4.0±0.5 mm, Group C: 6.0±0.5 mm). The anterior capsule opening area (ACOA) was quantified, and the morphology, weight, and histological characteristics of the regenerated lenses were examined.

RESULTS

Lens regeneration was observed in all three groups. In Group A, the regenerated lenses were relatively complete and transparent. In Groups B and C, the regenerated lenses were doughnut-shaped and opaque. The speed of lens regeneration in Group A was significantly faster than that in Groups B and C. The ACOA in Group A healed quickly and completely approximately 2 weeks after surgery. However, in Groups B and C, ACOA did not heal completely until 12 weeks after surgery. Histological examination showed that in Group A, most of the lens epithelial cells differentiated into well-organized lens fibers. However, in Groups B and C, the regenerated lens fibers were disorganized.

CONCLUSION

Capsulorhexis size is a critical determinant of integrity and transparency in lens regeneration.

[An association of ulcerative colitis with tumor necrosis factor superfamily member 15 gene polymorphisms in Chinese patients]

Objective: To explore the relationship between ulcerative colitis (UC) susceptibility and tumor necrosis factor superfamily member (TNFSF) 15 gene polymorphisms and haplotypes in Han nationality in Zhejiang province of China. Methods: A total of 408 UC patients and 574 healthy controls were recruited in this study. Three single nucleotide polymorphisms of TNFSF15 (rs3810936, rs4263839, rs4979462) were examined by improved multiple ligase detection reaction (iMLDR) technique. Analyses of linkage disequilibrium (LD) and haplotype were performed by Haploview 4.2 software in all study subjects. Results: The variant allele A and genotype (GA+AA) of rs4263839 were less frequent in UC patients than in controls (45.34% vs. 50.17%, P=0.035;68.38% vs. 76.66%, P=0.004). According to the severity and location of disease, UC patients were divided into different subgroups. After multiple comparison correction(α=0.012 5), the frequencies of variant allele A and genotype (GA+AA) of rs4263839 were lower in patients with severe UC than in the controls (37.69% vs. 50.17%, P=0.007; 60.00% vs. 76.66%, P=0.004). Similar findings were also drawn for patients with extensive colitis in contrast with the controls (42.22% vs. 50.17%, P=0.009; 63.33% vs. 76.66%, P<0.001). Furthermore, the haplotype analysis indicated that three SNPs above were in a strong LD. The frequency of haplotype TAC was lower in UC patients than in the controls(40.83% vs. 46.04%, P=0.023). Also it was less prevalent in patients with severe UC and patients with extensive colitis when compared with controls respectively (33.38% vs. 46.04%, P=0.005;37.22% vs. 46.04%, P=0.003). Conclusions: TNFSF15 (rs4263839) variation might not only reduce the risk of UC, but also affect the severity and lesion location of UC. The haplotype TAC formed by rs3810936, rs4263839 and rs4979462 might be related to a lower risk of UC, especially in patients with severe colitis or patients with extensive colitis.

[Clinical application value of combined detection of serum miR-378 and miR-21 in gastric cancer]

Objective: To investigate the clinical value of combined detection of serum miR-378 and miR-21 in gastric cancer (GC). Methods: Eighty-seven patients with GC and 78 patients with colorectal cancer(CRC) from National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences were selected, 83 individuals undergoing healthy physical examination were selected as the healthy controls. The levels of serum miR-378 and miR-21 were detected by quantitative real-time PCR (RT-qPCR) (result data were transformed as log2 for analysis). Results: Relative expression levels of miR-378 in the serum were -1.24, -3.25 and -2.73 in healthy controls, GC and CRC patients, respectively. Compared with the healthy controls, the levels of serum miR-378 were significantly decreased in GC and CRC patients (both P<0.05). Relative expression levels of miR-21 in the serum were 0.11, 2.34 and 2.47 in healthy controls, GC and CRC patients, respectively. Compared with the healthy controls, the levels of serum miR-21 were significantly up-regulated in GC and CRC patients (both P<0.05). Moreover, the serum level of miR-378 in GC patients was inversely associated with tumor clinical stage (P<0.05). However, the level of miR-21 showed no significant differences among patients with different clinical and pathological characteristics (all P>0.05). The area under the receiver operating characteristic curve (AUC), sensitivity and specificity of miRNA-378 to diagnose GC was 0.770, 82.0% and 66.0%, respectively, and were 0.900, 85.0%, and 88.0% of miR-21, respectively. The AUC, sensitivity and specificity of combined detection of serum miR-378 and miR-21 to diagnose GC were 0.930, 92.0% and 87.0%, respectively, while the AUC of combined detection of serum CEA and CA-199 was 0.767, the AUC of combined all of the four factors was 0.946. Conclusion: The combined detection of serum miR-378 and miR-21 have a certain effect on diagnosis of GC.

[Evaluation value of the quick sequential organ failure assessment score on prognosis of intensive care unit adult patients with infection: a 17-year observation study from the real world]

OBJECTIVE

To investigate the predictive value of quick sequential organ failure assessment (qSOFA) score on the prognosis of adult patients with infection in intensive care unit (ICU).

METHODS

A retrospective analysis was conducted on the clinical data of the infected patients in the ICU of the 401st Hospital of the People's Liberation Army from August 1st, 2000 to December 31st, 2017. The clinical data included patients' gender, age, basic diseases, etc.; the worst values of vital signs and laboratory test results within 24 hours of admission were recorded, the scores of the qSOFA, sequential organ failure assessment (SOFA), acute physiology and chronic health evaluation II (APACHE II) were calculated separately; the outcome of ICU was recorded. The predictive values of three scoring systems were evaluated by receiver operating characteristic curve (ROC).

RESULTS

Excluding patients with incomplete clinical data, cancer and immunosuppressive patients, a total number of 1 059 patients were enrolled in this study, with 679 males and 380 females, the average age was 72.57±16.06, the ICU mortality was 35.32% (374/1 059). The ROC curve analysis showed that the areas under ROC curve (AUC) of APACHE II, SOFA, qSOFA scores to predict the prognosis of infected patients were 0.713, 0.744 and 0.662, respectively. Although the AUC of qSOFA in predicting prognosis was significantly lower than that of other two scoring systems (both P < 0.05), but it still had some predictive ability. According to the Youden index, the best cut-off point for qSOFA was 2 to evaluate the prognosis of the infection, and the sensitivity was 71.65%, the specificity was 53.87%, the positive likelihood ratio was 1.55, the negative likelihood ratio was 0.53, the positive predictive value was 0.426, the negative predictive value was 0.799, and the accuracy was 59.62%. The mortality of the infected patients was increased with qSOFA score, and the mortality difference among patients with different qSOFA scores was statistically significant (χ² = 84.605, P = 0.000). The patients were divided into two groups according to the cut-off value of qSOFA, and the mortality in qSOFA score ≥2 group was higher than that in qSOFA score < 2 group [odds ratio (OR) = 2.767, 95% confidence interval (95%CI) = 2.116-3.617, P = 0.000].

CONCLUSIONS

qSOFA, SOFA and APACHE II scores have the capability of predicting the outcome for the infected patients. qSOFA score is expected to be a quick and simple tool to judge the prognosis of ICU infection patients because of its advantages of quick acquisition.

Comparative Analysis of Diffusional Kurtosis Imaging, Diffusion Tensor Imaging, and Diffusion-Weighted Imaging in Grading and Assessing Cellular Proliferation of Meningiomas

BACKGROUND AND PURPOSE

An accurate evaluation of the World Health Organization grade and cellular proliferation is particularly important in meningiomas. Our aim was to prospectively evaluate and compare diffusional kurtosis imaging, DTI, and DWI metrics in determining the grade and cellular proliferation of meningiomas.

MATERIALS AND METHODS

Ninety-six consecutive patients with histopathologically confirmed meningiomas were included in this study. Mean kurtosis, radial kurtosis, axial kurtosis, fractional anisotropy, mean diffusivity, and ADC were semiautomatically obtained in the solid components of tumors. Each normalized diffusion value was compared between high-grade meningiomas and low-grade meningiomas using the Mann-Whitney U test. Receiver operating characteristic, multiple logistic regression, and Pearson correlation analysis were used for statistical evaluations.

RESULTS

Diffusional kurtosis imaging metrics (mean kurtosis, radial kurtosis, and axial kurtosis) were significantly higher in high-grade meningiomas than in low-grade meningiomas (P ≤ .001). Mean diffusivity and ADC were significantly lower in high-grade meningiomas than in low-grade meningiomas (P = .003 and .002). Mean kurtosis had significantly greater area the under curve values than mean diffusivity and fractional anisotropy in differentiating high-grade meningiomas from low-grade meningiomas (P = .038 and .002). Mean kurtosis was the only variable that could be used to independently differentiate high-grade meningiomas and low-grade meningiomas (P < .001). Significant correlations were found between the Ki-67 labeling index and kurtosis metrics (P < .001), as well as for mean diffusivity and ADC (P = .004, and .007).

CONCLUSIONS

Compared with other diffusion metrics, mean kurtosis may serve as an optimal parameter for evaluating and predicting the meningioma grade. Moreover, diffusion metrics may potentially reflect cellular proliferation.

Differential effects of uncertainty on LPP responses to emotional events during explicit and implicit anticipation

Previous studies have investigated whether uncertainty influences neural responses to emotional events. The findings of such studies, particularly with respect to event-related potentials (ERPs), have been controversial due to several factors, such as the stimuli that serve as cues and the emotional content of the events. However, it is still unknown whether the effects of uncertainty on ERP responses to emotional events are influenced by anticipation patterns (e.g., explicit or implicit anticipation). To address this issue, participants in the present study were presented with anticipatory cues and then emotional (negative and neutral) pictures. The cues either did or did not signify the emotional content of the upcoming picture. In the inter-stimulus intervals between cues and pictures, participants were asked to estimate the expected probability of the occurrence of a specific emotional category of the subsequent picture based on a scale in the explicit anticipation condition, while in the implicit condition, participants were asked to indicate, using a number on a scale, which color was different from the others. The results revealed that in the explicit condition, uncertainty increased late positive potential (LPP) responses, particularly for negative pictures, whereas LPP responses were larger for certain negative pictures than for uncertain negative pictures in the implicit condition. The findings in the present study suggest that the anticipation pattern influences the effects of uncertainty when evaluation of negative events.

Temperature-scanning saturation cavity ring-down spectrometry for Doppler-free spectroscopy

Saturation cavity ring-down spectroscopy (SCRDS) is a powerful Doppler-free spectroscopy means for measuring absolute frequencies of transitions at the ultra-low uncertainties. We report in this paper a simple way to implement it by temperature scanning the cavity length, which circumvents the need for a complex optical cavity-length stabilization system based upon a piezoelectric actuator (PZT). To demonstrate this approach, the absolute frequencies of the two transitions, R6F1 of the 2v₃ and Q9A1 of the 2v₂ + v₃ bands, of ¹²CH₄, are determined to be 182 185 269.362(20) MHz and 182 187 617.543(39) MHz. The accuracy of measurements is improved by about 3-4 orders of magnitude when compared to those obtained with conventional spectroscopic methods.

[The efficacy of ultrasound-guided spinal nerve posterior ramus pulsed radiofrequency treatment for aged lower back post-herpetic neuralgia]

Objective: To evaluate the efficacy of ultrasound-guided spinal nerve posterior ramus pulsed radiofrequency treatment of lower back post-herpetic neuralgia. Methods: One hundred and twenty-eight cases of lower back or anterior abdominal wall acute post-herpetic neuralgia patients were enrolled. They were randomly divided into two groups. Group A: oral treatment only with gabapentin+ celecoxib+ amitriptyline. Group B: while taking these drugs, patients were treated with radiofrequency pulses using a portable ultrasound device and the paravertebral puncture technique.In both groups, sudden outbreaks of pain were treated with immediate release 10 mg morphine tablets. Before and one week, two weeks, four weeks, eight weeks after treatment, visual analogue scale (VAS) was used for pain score, Pittsburgh sleep quality index scale (PSQI) was used to evaluate sleep quality, and morphine consumption was recorded. Eight weeks after treatment analgesic efficacy was evaluated. Treatment efficiency and significant efficiency was calculated while the occurrence of complications were documented. Results: In the control group, the VAS of T_1,T_2,T₃ and T₄ were 6.7 ±1.2, 5.2 ± 1.0, 3.3 ±1.1, 3.0±0.9.However, at the same time points, the VAS in the treatment group were 3.1±1.0, 2.2±0.7, 1.4±0.5, 1.2±0.5, respectively.The radio frequency group decreased significantly compared with the control group, the difference was statistically significant (t=17.925, 19.662, 12.580, 13.987, all P<0.05). Four weeks after treatment, the TNF-α in the control group was (11.04±2.36)ng/L, and the TNF-β in the radio frequency group was (8.07±2.13) ng/L. After the treatment, the TNF-α of the radio frequency group was lower than the control group, and the difference was statistically significant (t=-6.267, P<0.05). The IL-1β in the control group was (3.47±1.09) ng/L after treatment.The IL-1β in the radio frequency group was (1.96 ±0.56) ng/L, the IL-1β in the radio frequency group was lower than the control group and the difference was statistically significant (t=-8.266, P<0.05). Pearson correlation analysis showed that before and after the treatment of TNF-α were positively correlated with VAS score (r=0.455, 0.327, all P<0.05). IL-1β before and after treatment were positively correlated with VAS score (r=0.369, 0.357, all P<0.05). At T_1,T_2,T₃ and T₄, PSQI in the control group were 8.5±1.5, 7.3±1.4, 6.2±1.3 and 6.0±0.9 respectively.PSQI in the radio frequency group at the same time points were 6.5±1.4, 5.1±1.2, 4.0±1.1 and 3.9±0.5.Comparison between the two groups after treatment, radio frequency group was lower than the control group significantly, and the difference was statistically significant (t=7.798, 9.545, 10.335, 16.318, all P<0.05). Morphine consumption of the control group at T_1,T_2,T_3,T₄ were (22.5±2.2), (15.5±2.9), (6.8±1.5) and (4.2±0.9)mg.However, morphine consumption of the radio frequency group were (13.2±2.5), (7.2±2.7), (3.2±0.6) and (2.2±0.5)mg.Comparison between the two groups after treatment, morphine consumption of the radio frequency group decreased significantly than the control group, and the difference was statistically significant (t=22.341, 16.758, 17.827, 15.541, all P<0.05). During the operation , no error occurred with needle penetrating the abdominal cavity, chest, offal or blood vessels. Conclusion: Ultrasound-guided spinal nerve posterior ramus pulsed radio frequency treatment of lower back or anterior abdominal wall post-herpetic neuralgia proves effective and can reduce patient morphine usage and lead to fewer adverse reactions.

Abstract P5-07-03: Withdrawn

This abstract was withdrawn by the authors.

[Research progress in CoCr metal-ceramic alloy fabricated by selective laser melting]

Cobalt-chromium alloys have been applied to dental porcelain fused to metal (PFM) restorations over the past decades owing to their excellent corrosion resistance, good biocompatibility and low price. The production of CoCr metal-ceramic restorations has always been based on traditional lost-wax casting techniques. However, in recent years, selective laser melting (SLM) is becoming more and more highly valued by dental laboratories and dental practitioners due to its individuation, precision and efficiency. This paper mainly reviews the recent researches on the production process of copings, microstructure, mechanical property, metal-ceramic bond strength, fit of copings, corrosion resistance and biocompatibility of SLM CoCr metal-ceramic alloy.

Sex differences in associations between blood lipids and cerebral small vessel disease

BACKGROUND AND AIMS

Dyslipidemia predicts higher risk of coronary events and stroke and might be associated with cerebral small vessel disease (SVD). Previous studies linking blood lipids and SVD have yielded inconsistent results, which may be attributable to sex differences in lipids metabolism. The aim of this study was to investigate the relationships between blood lipids and SVD in neurologically healthy men and women.

METHODS AND RESULTS

Consecutive 817 people aged 50 years or more were enrolled and underwent magnetic resonance imaging scans to evaluate the periventricular white matter lesions (PVWMLs), deep white matter lesions (DWMLs) and silent brain infarction (SBI). Fasting total cholesterol, triglyceride, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol, apolipoprotein A-1 (apoA-1) and apolipoprotein B were assessed. Multivariable logistic regression analyses were performed to determine the associations of blood lipids with PVWMLs, DWMLs and SBI. HDL-C (for PVWMLs: OR 0.36, 95% CI 0.19-0.71; for DWMLs: OR 0.35, 95% CI 0.20-0.63) and apoA-1 (for PVWMLs: OR 0.27, 95% CI 0.11-0.66; for DWMLs: OR 0.22, 95% CI 0.10-0.48) were inversely associated with the severity of PVWMLs and DWMLs in women but not in men after adjustment for age, hypertension, diabetes, current smoking, daily drinking, body mass index and uric acid. Additionally, no blood lipids were significantly associated with SBI.

CONCLUSIONS

Our findings demonstrate that sex differences may exist in the associations between lipids and SVD. HDL-C and apoA-1 levels were inversely associated with the severity of PVWMLs and DWMLs in women.

Hospital variation in cost of childbirth and contributing factors: a cross-sectional study

OBJECTIVE

To examine hospital variation in cost of childbirth hospitalisations and identify factors that contribute to the variation.

DESIGN

Cross-sectional analysis of linked birth certificate and hospital discharge data.

SETTING

Two hundred and twenty hospitals in California delivering ≥ 100 births per year.

POPULATION

A total of 405 908 nulliparous term singleton vertex births during 2010-2012.

METHODS

Cost of childbirth hospitalisations was compared across hospitals after accounting for differences in patient clinical risk factors. Relative contributions of patient sociodemographic, obstetric intervention, birth attendant and institutional characteristics to variation in cost were assessed by further adjusting for these factors in hierarchical generalised linear models.

MAIN OUTCOME MEASURES

Cost of childbirth hospitalisation.

RESULTS

Median risk-standardised cost of childbirth was $7149 among the hospitals (10^th -90th percentile range: $4760-$10,644). Maternal sociodemographic characteristics and type of birth attendant did not explain hospital variation in cost. Adjustment for obstetric interventions overall reduced within-hospital variance by 15.8% (P < 0.001), while adjusting for caesarean delivery alone reduced within-hospital variance by 14.4% (P < 0.001). However, obstetric interventions did not explain between-hospital variation in cost. In contrast, adjustment for institutional characteristics reduced between-hospital variance by 30.3% (P = 0.002). Hospital type of ownership, teaching/urban-rural status, neonatal care capacity and geographic region were most impactful. Risk-standardised cost was positively correlated with risk-standardised rate of severe newborn morbidities (correlation coefficient 0.22, P = 0.001), but not associated with risk-standardised rate of severe maternal morbidities.

CONCLUSIONS

Cost of childbirth hospitalisations varied widely among hospitals in California. Institutional characteristics significantly contributed to this variation. Higher-cost hospitals did not have better outcomes, suggesting potential opportunities to enhance value in care.

TWEETABLE ABSTRACT

Hospitals vary in cost of childbirth. Institutional characteristics significantly contribute to the variation.

[The association between aflatoxin exposure and primary hepatocellular carcinoma risks: a case-control study in Chongqing]

Objective: To investigate the association between aflatoxin exposure and primary hepatocellular carcinoma (PHC) development. Methods: From December 2013 to May 2016, we selected 214 patients newly diagnosed with PHC as cases, and 214 patients as controls from three hospitals in Chongqing. Cases were confirmed with PHC diagnosis standard. And cases caused by clear reasons such as drug-induced liver injury, alcoholic liver damage, fatty liver and gallstones etiology, were excluded. Controls were included with no cancer and no digestive system disease, and recruited simultaneously with cases. Cases and controls were frequency-matched (1∶1) by same gender and age (±3 years). Peripheral blood and random urine samples were collected and analyzed for serum HBsAg status by biochemistry analyzer, and serum AFB(1)-ALB adduct and urinary AFB(1)-N(7)-GUA adduct by ELISA. Basic information, living habits and history of disease for patients were obtained by questionnaires. We used wilcoxon rank sum test to compare the median of serum AFB(1)-ALB adduct and urinary AFB(1)-N(7)-GUA adduct in cases and controls. Logistic regression analyses were performed to assess risk factors for PHC, and synergism index (S) of aflatoxin with other factors was estimated by the method of Andersson. Results: There was no significant difference in age between PHC cases (50.74±9.67) years and controls (51.15±9.90) years. Logistic regression showed that the odds ratio of HBV infection for PHC development was 46.3 (95% CI: 23.3-88.0). There was a significant difference in median concentrations of serum AFB(1)-ALB adduct (cases vs controls: 146.23 vs 74.42 ng/g albumin, P<0.001), but no difference in median concentrations of urinary AFB(1)-N(7)-GUA adduct was observed (cases vs controls: 0.17 vs 0.14 ng/mg creatinine, P<0.210). The odd ratios for PHC risk after adjustment were 1.9 (95%CI: 1.1-3.4) for AFB(1)-ALB adduct, and 2.1 (95%CI: 1.0-4.2) for AFB(1)-N(7)-GUA adduct. Moreover, we observed a positive interaction of aflatoxin exposure with HBV, alcohol drinking, and diabetes. The S was 4.7 (95%CI: 2.8-7.9), 3.5 (95%CI: 1.0-12.0), and 12.4 (95%CI: 1.8-84.2), respectively for serum AFB(1)-ALB adduct with each of the three factors mentioned, and was 1.9 (95%CI:1.1-3.1), 2.0 (95%CI: 1.1-3.6), and 2.0 (95%CI: 1.1-3.6), respectively for urinary AFB(1)-N(7)-GUA adduct with each of the three factors mentioned. Conclusion: HBV was still the main risk factor, and AFB(1) exposure was also an independent risk factor for PHC in Chongqing. There was a positive interaction of aflatoxin with HBV, alcohol drinking, and diabetes.