POS0884 THE ENHANCED LIVER FIBROSIS (ELF) SCORE AS A BIOMARKER OF SKIN FIBROSIS IN SYSTEMIC SCLEROSIS

Background:

Serum fibrotic markers for systemic sclerosis (SSc) remain limited. The Enhanced Liver Fibrosis (ELF) score, originally derived and validated in patients with chronic liver disease, is an algorithm combining 3 serum markers, known as procollagen type III amino terminal propeptide (PIIINP), tissue inhibitor of metalloproteinases 1 (TIMP-1), and hyaluronic acid (HA). The combined score was proved to be superior to the single components in reflecting the severity of liver fibrosis. However, the performance of ELF score and its components has not been fully validated in SSc.

Objectives:

To investigate PIIINP, TIMP-1, HA, and the combined algorithm ELF score as fibrotic markers for SSc skin involvement.

Methods:

Eighty SSc patients (44 dcSSc and 36 lcSSc), fulfilling the 2013 ACR/EULAR criteria with the absence of chronic liver diseases, were enrolled. Eighty age- and sex- matched healthy controls were also included. Serum PIIINP and HA levels were quantified by chemiluminescence immunoassay. Serum TIMP-1 levels were determined by enzyme-linked immunosorbent assay. The ELF score was calculated using the formula ELF score= 2.494 + 0.846*ln(HA) + 0.735*ln(PIIINP) + 0.391*ln(TIMP-1). Results were correlated with clinical profiles including modified Rodnan skin score (mRSS) and interstitial lung disease (ILD).

Results:

Compared with healthy controls, patients with SSc showed significantly elevated serum PIIINP (11.2±4.8 vs. 5.73±1.4μg/L, p<0.001), TIMP-I (123.7±78.6 vs. 67.8±26.5 ng/ml, p<0.001), and ELF score (10.5±0.9 vs. 9.7±0.4, P<0.001). Even higher levels of PIIINP, TIMP-1, and ELF score were observed in dcSSc patients, compared with lcSSc patients (p<0.001, p=0.024, p=0.003, respectively). No significant difference was found in the levels of serum HA between patients and controls. Strong correlations were observed between mRSS and ELF score (r=0.54, p<0.001), and between mRSS and PIIINP(r=0.62, p<0.001), whereas only weak correlations could be observed between mRSS and TIMP-1 (r=0.28, p=0.02), and between mRSS and HA (r=0.26, p=0.03). When stratified by ELF score, using cutoffs proposed for liver fibrosis and cirrhosis, SSc patients with ELF<9.8 showed the lowest mRSS on average, while patients with ELF>11.3 showed the highest (p<0.001). When stratified by serum PIIINP levels, using the 25th and 75th percentiles, SSc patients with serum PIIIINP levels<7.8μg/L showed the lowest mRSS on average, while patients with PIIINP>14.0μg/L showed the highest (p<0.001). Neither the ELF score nor its components showed significant difference between patients with and without ILD.

Conclusion:

The ELF score could be used for reflecting the severity of overall skin involvement in SSc, and serum PIIINP also increased in parallel with the increase of mRSS. Longitudinal prospective studies exploring ELF score or serum PIIINP as fibrotic markers and outcome measures of SSc are warranted.

References:

[1]Lichtinghagen R, Pietsch D, Bantel H, et al. The Enhanced Liver Fibrosis (ELF) score: Normal values, influence factors and proposed cut-off values. Journal of Hepatology. 2013; 59: 236-42.

[2]Abignano G, Blagojevic J, Bissell LA, et al. European multicentre study validates enhanced liver fibrosis test as biomarker of fibrosis in systemic sclerosis. Rheumatology. 2019; 58: 254-59.

Figure 1.

Correlations of mRSS with ELF score (A) and serum PIIINP (B) and distribution of mRSS among different ELF (C) and PIIINP (D) ranges.

Acknowledgements:

The authors have no acknowledgements to declare.

Disclosure of Interests:

None declared

POS0869 PREDICTIVE VALUE OF ANTI-INTERFERON-INDUCIBLE PROTEIN 16 ANTIBODIES FOR DIGITAL ULCERS OF SYSTEMIC SCLEROSIS

Background:

Interferon-inducible protein 16 (IFI-16) is constitutively expressed in vascular endothelial cells and can inhibit the proliferation of human endothelial cells and the formation of capillary-like structures in vitro. Anti-IFI-16 antibodies were reported in 21%-29% of patients with systemic sclerosis (SSc) and were associated with digital vascular events in a few retrospective studies.

Objectives:

To evaluate the presence and the clinical implication of anti-IFI-16 antibodies in Chinese SSc cohort, focusing on the associations with vasculopathy indexes, and to investigate the predictive value of anti-IFI-16 antibodies for the development of digital ulcers (DUs) in SSc prospectively.

Methods:

Patients with SSc presenting to our center between July 2018 and September 2018 were prospectively enrolled. Serum from 42 SSc patients and 42 age- and sex-matched healthy controls were analyzed for anti-IFI-16 antibodies by enzyme-linked immunosorbent assay (ELISA), and was considered positive if the optical density (OD) value was above the mean OD of controls plus two standard deviations. Tissue immunofluorescence was used to evaluate the expression of IFI16 in skin biopsy samples obtained from SSc patients and normal controls. At baseline, nailfold video-capillaroscopy was performed to assess nailfold capillary density of SSc patients. Power Doppler ultrasound was used to grade finger pulp blood flow (0-no observed flow; 1-decreased flow; 2-normal flow), and to measure ulnar and radial artery blood flow and resistive index (RI). All patients were followed up for 6 months to see whether they experienced new onset or recurrent DUs. The association of anti-IFI-16 antibodies with DUs was analyzed using logistic regression.

Results:

Of the 42 SSc patients, 8 (19.0%) were positive for anti-IFI-16 antibodies. Immunofluorescence of skin biopsy samples from SSc patients exhibited enhanced staining of IFI-16 in the dermis, and colocalization with endothelial marker CD31. SSc patients who were positive for anti-IFI-16 antibodies showed higher ulnar artery RI at baseline (0.95±0.09 vs. 0.86±0.09, p=0.015), while no significant differences were found for other vascular parameters, nor for clinical or demographic profiles. Within 6-month follow-up, 14 (33.3%) patients experienced new-onset or recurrent DUs. Univariate logistic regression revealed the presence of DUs at enrollment (p=0.009), anti-IFI-16 antibody (p=0.012), finger pulp blood flow (p=0.027), and ulnar artery RI (p=0.008) could be the predictors for the development of DUs. Multivariate analysis further identified DUs at enrollment (odds ratio [OR]: 10.85; 95% confidence interval [CI]: 1.61-73.18; p=0.014) and anti-IFI-16 antibody (OR: 15.00; 95% CI: 1.13-199.18; p=0.040) as independent risk factors. Among patients without DUs at enrollment, new-onset ulcers occurred in 80% (4/5) and 4.5% (1/22) of those with and without anti-IFI-16 antibody, respectively (p=0.001).

Conclusion:

Anti-IFI-16 antibody is associated with vasculopathy in SSc and could be used as a novel biomarker for indicating the development of DUs.

References:

[1]McMahan ZH, Shah AA, Vaidya D, et al. Anti-interferon-inducible protein 16 antibodies associate with digital gangrene in patients with Scleroderma. Arthritis Rheumatol. 2016; 68(5): 1262-71.

[2]McMahan ZH, Cottrell TR, Wigley FM, et al. Autoantigens targeted in scleroderma patients with vascular disease are enriched in endothelial lineage cells. Arthritis Rheumatol. 2016; 68(10): 2540–49.

Figure 1.

Multivariate logistic analysis for new or recurrent digital ulcers.

Acknowledgements:

The authors would like to thank Doctor Yi Cheng for performing Power Doppler ultrasound assessment.

Disclosure of Interests:

None declared

A combined recall and rank framework with online negative sampling for chinese procedure terminology normalization

MOTIVATION

Medical terminology normalization aims to map the clinical mention to terminologies coming from a knowledge base, which plays an important role in analyzing Electronic Health Record (EHR) and many downstream tasks. In this paper, we focus on Chinese procedure terminology normalization. The expressions of terminology are various and one medical mention may be linked to multiple terminologies. Existing studies based on Learning To Rank (LTR) does not fully consider the quality of negative samples during model training and the importance of keywords in this domain-specific task.

RESULTS

We propose a combined recall and rank framework to solve these problems. A pair-wise Bert model with deep metric learning is used to recall candidates. Previous methods either train Bert in a point-wise way or based on a multi-class classification problem, which may lead serious efficiency problems or not be effective enough. During model training, we design a novel online negative sampling algorithm to activate the pair-wise method. To deal with multi-implication scenarios, we train the task of implication number prediction together with the recall task in a multi-task learning setting, since these two tasks are highly complementary. In rank step, we propose a keywords attentive mechanism to focus on domain-specific information such as procedure sites and procedure types. Finally, a fusion block merges the results of the recall and the rank model. Detailed experimental analysis shows our proposed framework has a remarkable improvement on both performance and efficiency.

AVAILABILITY

The source code will be available at https://github.com/sxthunder/CMTN upon publication.

Perchlorate occurrence in foodstuffs and water: Analytical methods and techniques for removal from water - A review

Perchlorate (ClO₄^-), a type of contaminant with high diffusivity and durability, has been widely detected in water and foodstuffs, arousing a global concern. It can interfere with normal function of the human thyroid gland, affecting human health. Therefore, determination of perchlorate in water and foodstuffs, and removal from water are important. This review focuses on the occurrence of perchlorate, mainly in water and foodstuffs, and provides an overview of analytical methods for determination of perchlorate over the last two decades. In addition, merits and drawbacks of the various methods have been considered. This review also highlights the most commonly used approaches for removal of perchlorate from water. Finally, current trends and future perspectives in determination of perchlorate and removal from water are proposed. This review provided a comprehensive understanding of perchlorate occurrence and its removal from water, and had practical significance in reducing the harm of perchlorate to human.

Analysis of Risk Factors for Thromboembolic Events in 88 Patients with COVID-19 Pneumonia in Wuhan, China: A Retrospective Descriptive Report

BACKGROUND Since the outbreak of COVID-19 in December 2019, there have been 96 623 laboratory-confirmed cases and 4784 deaths by December 29 in China. We aimed to analyze the risk factors and the incidence of thrombosis from patients with confirmed COVID-19 pneumonia. MATERIAL AND METHODS Eighty-eight inpatients with confirmed COVID-19 pneumonia were reported (31 critical cases, 33 severe cases, and 24 common cases). The thrombosis risk factor assessment, laboratory results, ultrasonographic findings, and prognoses of these patients were analyzed, and compared among groups with different severity. RESULTS Nineteen of the 88 cases developed DVT (12 critical cases, 7 severe cases, and no common cases). In addition, among the 18 patients who died, 5 were diagnosed with DVT. Positive correlations were observed between the increase in D-dimer level (≥5 µg/mL) and the severity of COVID-19 pneumonia (r=0.679, P<0.01), and between the high Padua score (≥4) and the severity (r=0.799, P<0.01). In addition, the CRP and LDH levels on admission had positive correlations with the severity of illness (CRP: r=0.522, P<0.01; LDH: r=0.600, P<0.01). A negative correlation was observed between the lymphocyte count on admission and the severity of illness (r=-0.523, P<0.01). There was also a negative correlation between the lymphocyte count on admission and mortality in critical patients (r=-0.499, P<0.01). Univariable logistic regression analysis showed that the occurrence of DVT was positively correlated with disease severity (crude odds ratio: 3.643, 95% CI: 1.218-10.896, P<0.05). CONCLUSIONS Our report illustrates that critically or severely ill patients have an associated high D-dimer value and high Padua score, and illustrates that a low threshold to screen for DVT may help improve detection of thromboembolism in these groups of patients, especially in asymptomatic patients. Our results suggest that early administration of prophylactic anticoagulant would benefit the prognosis of critical patients with COVID-19 pneumonia and would likely reduce thromboembolic rates.

Specification of complex-PAHs in coal fire sponges (CFS) by high-resolution mass spectrometry with electrospray ionization

Underground coal fires are considered an ecological disaster. While underground coal fires are prevalent in coal-producing areas throughout the world, they are most problematic in northern China. Previous studies have shown that underground coal fires stimulate the formation of cracks or gas outlets on the surface, as well as coal fire sponges (CFS) on the soil layer surface, which collect coal-fired pollutants. Herein, ultra-high-performance liquid chromatography (UHPLC) was used in conjunction with electrospray ionization (ESI) high-resolution mass spectrometry to analyze CFS samples collected from the No. 8 fire zone, located in Wuda coalfield, Inner Mongolia, China. The results show that CFS contain 233 oxy-substituted polycyclic aromatic hydrocarbons (O-PAHs), e.g., naphthaldehyde; 40 oxapolycyclic aromatic hydrocarbons (OPAHs), e.g., dibenzofuran; 40 alkyl-substituted polycyclic aromatic hydrocarbons (R-PAHs); and 11 parent polycyclic aromatic hydrocarbons (PPAHs). Thus, CFS are primarily composed of O-PAHs, which are 25 times and 5 times more prevalent than PPAHs and R-PAHs, respectively. As such, a high relative abundance of varied O-PAHs are discharged from underground coal fires, which is significantly different from what is released during industrial coal burning. Owing to their water solubility and condensability, the new facts disclosed in this paper may provide a new perspective for understanding complex organic pollutants from underground coal fires and their environmental impacts.

The change of cardiac axis deviation in catheter ablation of verapamil-sensitive idiopathic left ventricular tachycardia

BACKGROUND

The underlying mechanism of verapamil-sensitive idiopathic left ventricular tachycardia (ILVT) has been postulated to be reentrant activation in the Purkinje fiber network of the left posterior fascicle or the left anterior fascicle (LAF). However, changing of cardiac axis deviation in sinus rhythm (SR) or during ILVT after radiofrequency catheter ablation (RFCA) has been rarely analyzed.

METHODS

Of the 232 patients with sustained ILVT induced and surface electrocardiogram (ECG) in SR recorded before and after RFCA, the changes of ECG morphology in SR and during ILVT were analyzed.

RESULTS

The surface ECG in SR changed in 114 (49.1%) patients after RFCA. ILVT could still be induced in 27 (23.7%) patients. In comparison with the original ILVT, three forms of ECG morphology were observed. In eight patients, the ILVT morphology was unchanged. In the 13 patients with ILVT axis deviation conversion after ablation, the successful target was more proximal. In the six patients with ILVT morphology change but without axis deviation conversion after ablation, the successful ablation site was more distal. Among 15 patients with recurrent ILVT during follow-up, seven patients had previous axis deviation changes in SR after RFCA, the changes maintained in four patients and recovered in three patients.

CONCLUSIONS

The morphology changes on surface ECG in SR after RFCA would not be a necessary prerequisite or a good endpoint for ILVT ablation. To analyze ILVT morphology changes after ablation would help to further clarify an appropriate approach for catheter ablation of ILVT.

Heterostructure Engineering of Core-Shelled Sb@Sb2 O3 Encapsulated in 3D N-Doped Carbon Hollow-Spheres for Superior Sodium/Potassium Storage

In this work, the core-shelled Sb@Sb₂ O₃ heterostructure encapsulated in 3D N-doped carbon hollow-spheres is fabricated by spray-drying combined with heat treatment. The novel core-shelled heterostructures of Sb@Sb₂ O₃ possess a mass of heterointerfaces, which formed spontaneously at the core-shell contact via annealing oxidation and can promote the rapid Na⁺ /K⁺ transfer. The density functional theory calculations revealed the mechanism and significance of Na/K-storage for the core-shelled Sb@Sb₂ O₃ heterostructure, which validated that the coupling between the high-conductivity of Sb and the stability of Sb₂ O₃ can relieve the shortcomings of the individual building blocks, thereby enhancing the Na/K-storage capacity. Furthermore, the core-shell structure embedded in the 3D carbon framework with robust structure can further increase the electrode mechanical strength and thus buffer the severe volume changes upon cycling. As a result, such composite architecture exhibited a high specific capacity of ≈573 mA h g^-1 for sodium-ion battery (SIB) anode and ≈474 mA h g^-1 for potassium-ion battery (PIB) anode at 100 mA g^-1 , and superior rate performance (302 mA h g^-1 at 30 A g^-1 for SIB anode, while 239 mA h g^-1 at 5 A g^-1 for PIB anode).

Plasma 25-Hydroxyvitamin D3 Concentrations and Risk of New-Onset Proteinuria in Patients With Hypertension

OBJECTIVE

We aimed to evaluate the relationship of plasma 25-hydroxyvitamin D3 (25[OH]D3) with the risk of new-onset proteinuria and examine the possible effect modifiers in patients with hypertension and without chronic kidney disease at baseline.

METHODS

This is a post hoc analysis of the renal substudy of the China Stroke Primary Prevention Trial. A total of 1655 patients with hypertension, who had plasma 25(OH)D3 measurements, as well as without proteinuria and with an estimated glomerular filtration rate of ≥60 mL/min/1.73 m² at baseline, were included in the present study. The main outcome was new-onset proteinuria, defined as a urine dipstick reading of ≥1+ at the exit visit.

RESULTS

The mean (standard deviation) 25(OH)D3 level at baseline was 18.6 (7.5) ng/mL. The median follow-up duration was 4.4 years. Overall, there was a significant inverse association between plasma 25(OH)D3 and the risk of new-onset proteinuria (per standard deviation increment; [odds ratio] OR: 0.70; 95% confidence interval [CI]: 0.50, 0.97). Accordingly, when 25(OH)D3 was assessed as quartiles, a significantly lower risk of new-onset proteinuria was found in participants in quartiles 3-4 (≥17.8 ng/mL; OR: 0.45; 95% CI: 0.23, 0.87), compared with those in quartile 1 (<13.1 ng/mL). Furthermore, a stronger inverse relationship of plasma 25(OH)D3 and new-onset proteinuria was observed in nondiabetic participants (per standard deviation increment; OR: 0.57; 95% CI: 0.39, 0.83; vs. diabetics: OR: 1.48; 95% CI: 0.67, 3.28; P for interaction = 0.028).

CONCLUSION

There was a significant inverse association between plasma 25(OH)D3 and the risk of proteinuria in patients with hypertension, especially in those without diabetes.

Longitudinal health utilities, symptoms and toxicities in patients with ALK-rearranged lung cancer treated with tyrosine kinase inhibitors: a prospective real-world assessment

Background

Tyrosine kinase inhibitors (tkis) have dramatically improved the survival of patients with ALK-rearranged (ALK+) non-small-cell lung cancer (nsclc). Clinical trial data can generally compare drugs in a pair-wise fashion. Real-world collection of health utility data, symptoms, and toxicities allows for the direct comparison between multiple tki therapies in the population with ALK+ nsclc.

Methods

In a prospective cohort study, outpatients with ALK+ recruited between 2014 and 2018, treated with a variety of tkis, were assessed every 3 months for clinico-demographic, patient-reported symptom and toxicity data and EQ-5D-derived health utility scores (hus).

Results

In 499 longitudinal encounters of 76 patients with ALK+ nsclc, each tki had stable longitudinal hus when disease was controlled, even after months to years: the mean overall hus for each tki ranged from 0.805 to 0.858, and longitudinally from 0.774 to 0.912, with higher values associated with second- or third-generation tkis of alectinib, brigatinib, and lorlatinib. Disease progression was associated with a mean hus decrease of 0.065 (95% confidence interval: 0.02 to 0.11). Health utility scores were inversely correlated to multiple symptoms or toxicities: rho values ranged from -0.094 to -0.557. Fewer symptoms and toxicities were associated with the second- and third-generation tkis compared with crizotinib. In multivariable analysis, only stable disease state and baseline Eastern Cooperative Oncology Group performance status were associated with improved hus.

Conclusions

There was no significant decrease in hus when patients with ALK+ disease were treated longitudinally with each tki, as long as patients were clinically stable. Alectinib, brigatinib, and lorlatinib had the best toxicity profiles and exhibited high mean hus longitudinally in the real-world setting.

Enhanced mineralization of bisphenol A by eco-friendly BiFeO3-MnO2 composite: Performance, mechanism and toxicity assessment

An eco-friendly BiFeO₃-MnO₂ composite with dual functionalities of adsorption and catalysis was successfully constructed by using a simple one-step hydrothermal method for the removal of bisphenol A (BPA) pollution from water. Several characterization methods, including X-ray diffraction (XRD), scanning electron microscopy (SEM), and X-ray photoelectron spectroscopy (XPS), were applied to verify the combination of BiFeO₃ and MnO₂. BiFeO₃-MnO₂ (BFO-MO) exhibited excellent adsorption and catalytic activity compared with those of pure BiFeO₃. The adsorption process followed a pseudo-second-order kinetic model and matched the Langmuir isotherm model. Effects of the catalyst and peroxymonosulfate (PMS) concentrations, pH and real water matrix were also analyzed, and BFO-MO displayed perfect adsorption and degradation performance under different conditions. Meanwhile, mineralization performance was tested, and the total organic carbon removal rate was nearly 85%. Moreover, BFO-MO exhibited good stability and reusability after five cycles. Based on radical quenching experiments, SO₄^- and OH were the primary reactive species responsible for BPA oxidation, and the possible reaction mechanism of BFO-MO/PMS was proposed. Finally, the degradation intermediates were identified, and the toxicity of intermediates was assessed. The novel BFO-MO composite is a promising catalyst for synchronous adsorption and degradation to purify wastewater.

Decreased Jagged1 expression in vascular smooth muscle cells delays endothelial regeneration in arteriovenous graft

AIMS

It is well-established that endothelial dysfunction promotes activation of vascular smooth muscle cell (VSMC). Whether decreased accumulation of VSMCs affects endothelial regeneration and functions in arteriovenous graft (AVG) remodelling has not been studied. We sought to identify mechanisms by which the Notch ligand, Jagged1, in VSMCs regulates endothelial cell (EC) functions in AVGs.

METHODS AND RESULTS

AVGs were created in transgenic mice bearing VSMC-specific knockout (KO) or overexpression of Jagged1. VSMC migration, EC regeneration, and its barrier functions as well as AVG remodelling were evaluated. Jagged1 expression was induced in VSMCs of neointima in the AVGs. Jagged1 KO in VSMCs inhibited the accumulation of extracellular matrix as well as VSMC migration. Fewer α-SMA-positive VSMCs were found in AVGs created in VSMC-specific Jagged1 KO mice (VSMCJagged1 KO mice) vs. in WT mice. Decreased VSMCs in AVGs were associated with deterioration of EC functions. In AVGs created in transgenic mice bearing Jagged1 KO in VSMCs exhibited delayed EC regeneration and impaired EC barrier function. Barrier dysfunction of ECs increased inflammatory cell infiltration and dysregulation of AVG remodelling and arterialization. The increased expression of IL-1β in macrophages was associated with expression of adhesion markers in ECs in AVGs created in VSMCJagged1 KO mice. In contrast, AVGs created in mice with overexpression of Jagged1 in VSMCs exhibited improved EC regeneration plus decreased macrophage infiltration. This led to AVG remodelling and arterialization. In co-cultures of ECs and VSMCs, Jagged1 deficiency in VSMCs suppressed N-cadherin and integrin β3 expression in ECs. Inhibition of integrin β3 activation delayed EC spreading and migration. Notably, Jagged1 overexpression in VSMCs or treatment with recombinant Jagged1 stimulated the expression of N-cadherin and integrin β3 in ECs. Jagged1-induced responses were blocked by inhibition of Notch signalling.

CONCLUSIONS

Jagged1 expression in VSMCs maintains EC barrier functions and blocks infiltration of macrophages. These responses promote remodelling and arterialization of AVGs.

The intestinal microbial metabolite desaminotyrosine is an anti-inflammatory molecule that modulates local and systemic immune homeostasis

It is considered that intestinal barrier dysfunction and systemic endotoxemia drive obesity and its related complications. However, what causes barrier dysfunction remains to be elucidated. Here, we showed that the gut microbiota from high-fat diet (HFD)-fed mice had impaired ability to degrade dietary flavonoids, and in correspondence, the microbial-derived flavonoid metabolite desaminotyrosine (DAT) was reduced. Supplementation of DAT in the drinking water was able to counter the HFD-induced body fat mass accumulation and body weight increment. This is correlated with the role of DAT in maintaining mucosal immune homeostasis to protect barrier integrity. DAT could attenuate dextran sodium sulfate (DSS)-induced mucosal inflammation in a type I interferon signal-dependent manner. Furthermore, intraperitoneal injection of DAT-protected mice from bacterial endotoxin-induced septic shock. Together, we identified DAT as a gut microbiota-derived anti-inflammatory metabolite that functions to modulate local and systemic immune homeostasis. Our data support the notion of dysbiosis being an important driving force of mucosal barrier dysfunction and systemic metabolic complications.

[Design and application of static progressive ankle foot orthosis]

The scar contracture of Achilles tendon in burn patients after operation is easy to cause " foot drop" , which leads to ankle dorsiflexion dysfunction. To solve this problem, the authors designed and made a static progressive ankle foot orthosis. The foot support part and the crus support part of the orthotic device are connected by rivets, and the distal end of the foot support part and the proximal end of the crus support part are pulled by the traction belt on both sides, gradually improving the ankle dorsiflexion function. This static progressive ankle foot orthosis is simple, practical, cost-effective, and worthy of clinical promotion.

Investigating the Rheological Properties of Carbon Nanotubes/Polymer Composites Modified Asphalt

The utilization of nanomaterials in the field of binder materials for road paving has attracted researchers’ attention in recent years. This study presented the performance properties of a binder modified with carbon nanotubes (CNT) and polyethylene (PE). The rheological properties, adhesion behavior, morphology, and storage stability of the modified asphalt were investigated. Experimental analysis indicated a positive effect of CNT/PE composites on the performance of the binder. The results indicate that the combined use of CNT and PE shows a significant enhancement on complex modulus, viscosity, and creep recovery of the binder at high temperatures and a great decrease in compliance, indicating great resistance to permanent deformation. Meanwhile, only using CNT to improve the high temperature performance of the binder is limited due to high shear mixing. CNT/PE modifiers enhance the cracking resistance at low temperatures and moisture damage resistance. The CNT/PE melt mixing composites endow asphalt with stronger cracking resistance, better resistance to moisture damage and workability. Asphalt with CNT/PE composites formed an even dispersion system. Notably, CNT bridges on the interface between PE phase and asphalt for the two modified asphalts, which reinforces the cohesion of interface. Asphalt with CNT/PE composites showed improved storage stability in comparison with PE modified asphalt.

[Keyhole Approach Endoscopic Surgery versus Stereotactic Aspiration plus Urokinase in Treating Basal Ganglia Hypertensive Intracerebral Hemorrhage]

Objective To compare the short-and long-term effect of two minimal invasive surgical therapies including keyhole approach endoscopic surgery(KAES)and stereotactic aspiration plus urokinase(SAU)in treating basal ganglia hypertensive intracerebral hemorrhage(hICH). Methods The clinical data of 117 hICH patients(63 received KAES and 54 received SAU)were retrospectively analyzed.The operation time,blood loss during surgery,and drainage time were compared between two groups.The residual hematoma volume,hematoma clearance rate(HCR),Glasgow coma scale(GCS)score,and National Institute of Health Stroke Scale(NIHSS)score were recorded at baseline and in the ultra-early stage,early stage,and sub-early stage after surgery.The 30-day mortality and serious adverse events were assessed and the 6-month modified Rankin scale(mRS)score was rated.Results Baseline data showed no significant difference between these two groups.Compared with the SAU group,the KAES group had significantly longer operation time,more intraoperative blood loss,and shorter drainage time(all P<0.001).In the ultra-early stage after surgery,HCR was significantly higher in the KAES group(P<0.001),whereas in the early and sub-early stage,HCR showed no significant differences(all P>0.05).In the ultra-early and early stage,the GCS and NIHSS scores showed no significant differences between two groups(all P>0.05),whereas in the sub-early stage,the NIHSS score was better in the SAU group(P=0.034).The 30-day mortality and incidences of serious adverse events showed no significant difference(all P>0.05).The good recovery(mRS≤3)at 6-months follow-up showed no significant difference between the two groups(P=0.413).Conclusions Both KAES and SAU are safe and effective in treating basal ganglia hICH.In the ultra-early stage after surgery,KAES achieves better residual hematoma volume and HCR,and patients undergoing SAU quickly catch up.The short-and long-term effectiveness of SAU is comparable or even superior to KAES.

Deep Learning-Based Radiomics of B-Mode Ultrasonography and Shear-Wave Elastography: Improved Performance in Breast Mass Classification

Objective

Shear-wave elastography (SWE) can improve the diagnostic specificity of the B-model ultrasonography (US) in breast cancer. However, whether deep learning-based radiomics signatures based on the B-mode US (B-US-RS) or SWE (SWE-RS) could further improve the diagnostic performance remains to be investigated. We aimed to develop the B-US-RS and SWE-RS and determine their performances in classifying breast masses.

Materials and Methods

This retrospective study included 291 women (mean age ± standard deviation, 40.9 ± 12.3 years) from two centers who had US-visible solid breast masses and underwent biopsy and/or surgical resection between June 2015 and July 2017. B-mode US and SWE images of the 198 masses in 198 patients (training cohort) from center 1 were segmented, respectively, to construct B-US-RS and SWE-RS using the least absolute shrinkage and selection operator regression and tested in an independent validation cohort of 65 masses in 65 patients from center 1 and in an external validation cohort of 28 masses in 28 patients from center 2. The performances of B-US-RS and SWE-RS were assessed using receiver operating characteristic (ROC) analysis and compared with that of radiologist assessment [Breast Imaging Reporting and Data System (BI-RADS)] and quantitative SWE parameters [maximum elasticity (E _max), mean elasticity (E _mean), elasticity ratio (E _ratio), and elastic modulus standard deviation (E _SD)] by using the McNemar test.

Results

The single best-performing quantitative SWE parameter, E _max, had a higher specificity than BI-RADS assessment in the training and independent validation cohorts (P < 0.001 for both). The areas under the ROC curves (AUCs) of B-US-RS and SWE-RS both were 0.99 (95% CI = 0.99-1.00) in the training cohort, 1.00 (95% CI = 1.00-1.00) in the independent validation cohort, and 1.00 (95% CI = 1.00-1.00) in the external validation cohort. The specificities of B-US-RS and SWE-RS were higher than that of E _max in the training (P < 0.001 for both) and independent validation cohorts (P = 0.02 for both).

Conclusion

The B-US-RS and SWE-RS outperformed the quantitative SWE parameters and BI-RADS assessment for classifying breast masses. The integration of the deep learning-based radiomics approach would help improve the classification ability of B-mode US and SWE for breast masses.

Effects of supplementing geese with green sweet sorghum stalks on microbiota in segments of the gastrointestinal tract

To explore the effects of supplementing a basal diet with green sweet sorghum stalks on the gut microbiota in geese, one hundred and twenty 28 day old geese were divided into two groups. Group 1 was fed a basal diet and group 2 was fed 92% of the same basal diet with green sweet sorghum stalks ad libitum for 42 days. Three male geese from each group were killed at 70 days old, four gastrointestinal tract segments (duodenum, jejunum, ileum, and caecum) were collected, and the hypervariable V4 region of the bacterial 16S rRNA gene was sequenced. There were obvious changes of microbiome in the caecum compared with the other three intestinal segments after green sweet sorghum stalks were added to the diet. Group 2 had significantly higher alpha diversity in the caecum compared with group 1 (P <0.05). The phyla of bacterial communities in the caecum differed. Group 2 had more abundant Bacteroidetes and Firmicutes, but Proteobacteria were more abundant in group 1. At genus level, Bacteroides was more prevalent in group 2, as were Prevotella and YRC22 (P <0.05). Functional analysis revealed that the carbohydrate metabolism, membrane transport, endocrine system and digestive system metabolic pathways were overrepresented in group 2. In conclusion, caecal microbes might play an important role in digesting green sweet sorghum stalks in geese.Keywords: caecum, goose, microbiome, microbial diversity

High throughput analysis of 21 perfluorinated compounds in drinking water, tap water, river water and plant effluent from southern China by supramolecular solvents-based microextraction coupled with HPLC-Orbitrap HRMS

The present work reported a high-throughput strategy for the analysis of 21 perfluorinated compounds (PFCs) in drinking water, tap water, river water and plant effluent from southern China by supramolecular solvent (SUPARS) vortex-mixed microextraction combined with high performance liquid chromatography-Orbitrap high resolution mass spectrometry (HPLC-Orbitrap HRMS). The SUPRAS without heating assistance is less solvent-consumption, meeting the requirements for green environmental protection and sustainable development. Parameters in the microextraction such as volume of dodecanol and tetrahydrofuran (THF), vortexing extraction and centrifugation time, salt concentration were investigated. The optimal extraction conditions were 250 μL of undecanol, 1.0 mL of THF and 20.0% (w/v, 4 g) NaCl. Under the optimum conditions, method limit of detection and method limit of quantitation in the ranges of 0.01-0.08 μg/L and 0.03-0.25 μg/L, good recoveries (72.5-117.8%) and intra-day precision (1.1-11.2%, n = 6), high enrichment factors (48-78) were obtained. The developed method was successfully applied for analysis of PFCs in 13 drinking water, tap water, river water and plant effluent samples collected from southern China. Perfluorobutane sulfonic acid was detected in one river water with concentration of 0.48 μg/L and 1H,1H,2H,2H-Perfluorooctane sulfonic acid was detected in one river water and two plant effluent samples with concentrations in the range of 0.14-0.67 μg/L.

Fe and Cu co-doped graphitic carbon nitride as an eco-friendly photo-assisted catalyst for aniline degradation

A novel bimetallic coordinated g-C₃N₄ with Fe₂O₃ composite catalyst (FeCu-g-C₃N₄) was synthesized by simple calcination of Fe³⁺/Cu²⁺/melamine precursor. Its catalytic performance was analyzed via photodegrading aniline. The X-ray diffraction (XRD), field emission scanning electronic microscopy (FESEM), Fourier transform infrared (FT-IR), and X-ray photoelectron spectroscopy (XPS) were employed to characterize the composition and structure of the catalysts. Results indicated that Fe mainly distributed in the Fe(III)-N coordination form and partly in Fe₂O₃ lattice, and Cu inserted at the interstitial positions of g-C₃N₄ in the Cu(I)-N form. The great optical property was also proved by ultraviolet-visible diffuse reflectance spectroscopy (UV-Vis DRS), photoluminescence (PL) spectroscopy, and photocurrent responses. The heterogeneous photo-assisted catalyst exhibited excellent performance in activation of H₂O₂, resulting in 80% decomposition of aniline with low metal leaching in 6 h. The incorporation of Cu elevated the performance of degradation compared to that only iron doped. A synergistic catalytic effect between solid Cu(I) and Fe(III) accelerated the reduction of Fe(III). The ·OH and ¹O₂ were confirmed as major reactive oxygen species (ROS) identified by scavenging experiments and ESR, and e^- was the most essential since it not only led to the generation of ROS but also participated in the circulation of Fe³⁺/Fe²⁺, Cu²⁺/Cu⁺, and Fe³⁺/Cu⁺. Furthermore, the possible catalytic mechanism was proposed based on the analysis.

Chemosensitization by 4-hydroxyphenyl retinamide-induced NF-κB inhibition in acute myeloid leukemia cells

PURPOSE

Inherent and/or acquired multi-drug resistance might be the instigator of treatment failure for acute myeloid leukemia (AML). In the current study, we aimed to explored the chemosensitizing effect of 4-HPR on AML therapy.

METHODS

Luciferase reporter assays were used to test the effect of 4-HPR on transcriptional signaling pathways. The quantitative real-time polymerase chain reaction and immunoblots were used to confirm the role of 4-HPR in NF-κB inhibition, apoptosis, and drug resistance. MTT and flow cytometry assays were applied to test the drug response and chemosensitizing effect of 4-HPR with AML cell lines and primary AML samples.

RESULTS

4-HPR suppressed tumor necrosis factor-α- and daunorubin-induced NF-κB activation in AML cell lines. The expression of anti-apoptotic gene, BCL2, was downregulated, while expressions of pro-apoptotic genes, cIAP, XIAP, and BID, were increased after 4-HPR treatment. Immunoblots showed decreased p65-NF-κB, IκBα, and MDR1, but increased cleaved poly (ADP-ribose) polymerase and BIM. A low concentration of 4-HPR chemosensitized AML cells to daunorubin treatment in vitro.

CONCLUSION

4-HPR-induced NF-κB inhibition was the main driver of the chemosensitizing effect observed in AML cell lines and primary AML samples. These results highlight that 4-HPR might be a promising chemosensitizing agent in AML therapy.

MiR-492 exerts tumor-promoting function in prostate cancer through repressing SOCS2 expression

OBJECTIVE

MiRNAs have been verified to play a role in the development and progression of prostate cancer (PCa). However, the role of miR-492 in PCa has not been mentioned. We aim to detect the expression of miR-492 in PCa and explore its underlying mechanism.

PATIENTS AND METHODS

The relative expression of miR-492 in PCa tissue samples to normal prostate tissues was detected using quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The level of miR-492 in PCa-derived cell lines compared with the normal prostate cell line was also measured. Cell counting kit-8 (CCK-8) and colony formation assays were employed to investigate the cell proliferation ability. Transwell assay and wound-healing assays were utilized to explore the cell invasion and migration abilities. Luciferase assay and Western blot were utilized to explore the underlying mechanism of miR-492 in PCa cells.

RESULTS

MiR-492 expressed significantly higher in PCa tissues than that in the normal tissues. Its expression level was also over-expressed in PCa cells compared with that in the normal cells. The up-regulation of miR-492 promoted the growth, invasion, and migration of the cells, while down-regulation had the opposite effects. SOCS2 was identified as a potential target for miR-492 in PCa. Silencing of SOCS2 could neutralize the inhibitory function of miR-492 inhibitor in PCa cells.

CONCLUSIONS

This study demonstrated that miR-492 was over-expressed in PCa and exerted tumor-promoting function in PCa cells via repressing SOCS2 expression. This might provide a new sight for future accurate therapy for PCa.

Fluorine and nitrogen functionalized magnetic graphene as a novel adsorbent for extraction of perfluoroalkyl and polyfluoroalkyl substances from water and functional beverages followed by HPLC-Orbitrap HRMS determination

Most of the reported magnetic adsorbents are difficult to absorb multi-class of per- and polyfluoroalkyl substances (PFASs), especially the short-chain PFASs. In this work, a novel fluorine and nitrogen functionalized magnetic graphene (G-NH-FBC/Fe₂O₃) was first synthesized and characterized by scanning electron microscope (SEM), Fourier Transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD) and vibrating sample magnetometer (VSM). The as-prepared G-NH-FBC/Fe₂O₃ was utilized as adsorbents for the magnetic solid-phase extraction (MSPE) of 19 PFASs from water and functional beverages and showed excellent adsorption capacity probably due to the hydrophobic interaction. Under the optimal pretreatment and instrumental conditions, a selective and sensitive high performance liquid chromatography Orbitrap high resolution mass spectrometry (HPLC-Orbitrap HRMS) method was developed for the determination of PFASs. Results indicated that the proposed method had favorable linearity (R² ≥ 0.994) within a wide range of concentrations. Limit of detection (LOD) and limit of quantification (LOQ) for the developed method ranged from 3 ng/L to 15 ng/L and 10 ng/L to 49 ng/L, respectively. Finally, the method was successfully applied to determine PFASs in drinking water, river water, tap water, factory drainage and functional beverages with recoveries ranging from 71.9% to 117.6% and relative standard deviation of <10%. The prepared G-NH-FBC/Fe₂O₃ was easy to recycle and could be reused for five times without significant decrease in extraction recoveries of PFASs. These results demonstrated that this novel magnetic G-NH-FBC/Fe₂O₃ could efficiently enrich PFASs and the proposed method is reliable and robust for the determination of PFASs in water and beverage samples.

Perceived dietary salt intake and the risk of primary liver cancer: a population-based prospective study

BACKGROUND

Although a high-salt diet is associated with high risk of chronic diseases such as hypertension, stroke and cardiovascular disease, little is known about the relationship between a high-salt diet and the risk of primary liver cancer (PLC). Consequently, we prospectively assessed the association of high perceived salt intake with the risk of PLC in the Kailuan Study.

METHODS

In total, 97 006 participants who were healthy adults or free living adults at the baseline (2006) were included in the present study. The data of perceived salt intake were collected via questionnaire and classified into three categories: <6 g day^-1 for low salt intake, 6-10 g day^-1 for intermediate salt intake, >10 g day^-1 for high-salt intake. PLC including hepatocellular carcinoma and intrahepatic cholangiocarcinoma (excluding liver metastasis), and was confirmed by review of medical records. We used a Cox proportional hazards model to analyse the association between high perceived salt diet and the risk of PLC after adjusting for possible confounders, including age, gender, body mass index, high sensitivity-C-reactive protein, low-density lipoprotein-cholesterol, total cholesterol, triglycerides, alanine aminotransferase, HbsAg positive, cirrhosis, fatty liver, hypertension, diabetes, drinking status, smoking status and physical exercise.

RESULTS

During the follow-up period of 1 113 816 person-years, 397 PLC events were diagnosed. After adjusting for most potential confounders, subjects in intermediate salt intake and high salt intake had a multivariable hazard ratio and 95% confidence interval of 1.49 (0.97-2.29) and 1.98 (1.22-3.22) (P for trend = 0.0042), respectively, compared to low salt intake.

CONCLUSIONS

A higher perceived salt intake was associated with a higher risk of PLC.