Targeting regulated cell death in tumor nanomedicines

Nanomedicines hold great potential in anticancer therapy by modulating the biodistribution of nanomaterials and initiating targeted oxidative stress damage, but they are also limited by the inherent self-protection mechanism and the evolutionary treatment resistance of cancer cells. New emerging explorations of regulated cell death (RCD), including processes related to autophagy, ferroptosis, pyroptosis, and necroptosis, substantially contribute to the augmented therapeutic efficiency of tumors by increasing the sensitivity of cancer cells to apoptosis. Herein, paradigmatic studies of RCD-mediated synergistic tumor nanotherapeutics are introduced, such as regulating autophagy-enhanced photodynamic therapy (PDT), targeting ferroptosis-sensitized sonodynamic therapy (SDT), inducing necroptosis-augmented photothermal therapy (PTT), and initiating pyroptosis-collaborative chemodynamic therapy (CDT), and the coordination mechanisms are discussed in detail. Multiangle analyses addressing the present challenges and upcoming prospects of RCD-based nanomedicines have also been highlighted and prospected for their further strengthening and the broadening of their application scope. It is believed that up-and-coming coadjutant therapeutic methodologies based on RCDs will considerably impact precision nanomedicine for cancer.

An Overview of Chemical Additives on (Micro)Plastic Fibers: Occurrence, Release, and Health Risks

Plastic fibers are ubiquitous in daily life with additives incorporated to improve their performance. Only a few restrictions exist for a paucity of common additives, while most of the additives used in textile industry have not been clearly regulated with threshold limits. The production of synthetic fibers, which can shed fibrous microplastics easily (< 5 mm) through mechanical abrasion and weathering, is increasing annually. These fibrous microplastics have become the main composition of microplastics in the environment. This review focuses on additives on synthetic fibers; we summarized the detection methods of additives, compared concentrations of different additive types (plasticizers, flame retardants, antioxidants, and surfactants) on (micro)plastic fibers, and analyzed their release and exposure pathways to environment and human beings. Our prediction shows that the amounts of predominant additives (phthalates, organophosphate esters, bisphenols, per- and polyfluoroalkyl substances, and nonylphenol ethoxylates) released from clothing microplastic fibers (MFs) are estimated to reach 35, 10, 553, 0.4, and 568 ton/year to water worldwide, respectively; and 119, 35, 1911, 1.4, and 1965 ton/year to air, respectively. Human exposure to MF additives via inhalation is estimated to be up to 4.5–6440 µg/person annually for the above five additives, and via ingestion 0.1–204 µg/person. Notably, the release of additives from face masks is nonnegligible that annual human exposure to phthalates, organophosphate esters, per- and polyfluoroalkyl substances from masks via inhalation is approximately 491–1820 µg/person. This review helps understand the environmental fate and potential risks of released additives from (micro)plastic fibers, with a view to providing a basis for future research and policy designation of textile additives.

Genera of phytopathogenic fungi: GOPHY 4

This paper is the fourth contribution in the Genera of Phytopathogenic Fungi (GOPHY) series. The series provides morphological descriptions and information about the pathology, distribution, hosts and disease symptoms, as well as DNA barcodes for the taxa covered. Moreover, 12 whole-genome sequences for the type or new species in the treated genera are provided. The fourth paper in the GOPHY series covers 19 genera of phytopathogenic fungi and their relatives, including Ascochyta, Cadophora, Celoporthe, Cercospora, Coleophoma, Cytospora, Dendrostoma, Didymella, Endothia, Heterophaeomoniella, Leptosphaerulina, Melampsora, Nigrospora, Pezicula, Phaeomoniella, Pseudocercospora, Pteridopassalora, Zymoseptoria, and one genus of oomycetes, Phytophthora. This study includes two new genera, 30 new species, five new combinations, and 43 typifications of older names.

Taxonomic novelties: New genera:Heterophaeomoniella L. Mostert, C.F.J. Spies, Halleen & Gramaje, Pteridopassalora C. Nakash. & Crous; New species:Ascochyta flava Qian Chen & L. Cai, Cadophora domestica L. Mostert, R. van der Merwe, Halleen & Gramaje, Cadophora rotunda L. Mostert, R. van der Merwe, Halleen & Gramaje, Cadophora vinacea J.R. Úrbez-Torres, D.T. O’Gorman & Gramaje, Cadophora vivarii L. Mostert, Havenga, Halleen & Gramaje, Celoporthe foliorum H. Suzuki, Marinc. & M.J. Wingf., Cercospora alyssopsidis M. Bakhshi, Zare & Crous, Dendrostoma elaeocarpi C.M. Tian & Q. Yang, Didymella chlamydospora Qian Chen & L. Cai, Didymella gei Qian Chen & L. Cai, Didymella ligulariae Qian Chen & L. Cai, Didymella qilianensis Qian Chen & L. Cai, Didymella uniseptata Qian Chen & L. Cai, Endothia cerciana W. Wang. & S.F. Chen, Leptosphaerulina miscanthi Qian Chen & L. Cai, Nigrospora covidalis M. Raza, Qian Chen & L. Cai, Nigrospora globospora M. Raza, Qian Chen & L. Cai, Nigrospora philosophiae-doctoris M. Raza, Qian Chen & L. Cai, Phytophthora transitoria I. Milenković, T. Májek & T. Jung, Phytophthora panamensis T. Jung, Y. Balci, K. Broders & I. Milenković, Phytophthora variabilis T. Jung, M. Horta Jung & I. Milenković, Pseudocercospora delonicicola C. Nakash., L. Suhaizan & I. Nurul Faziha, Pseudocercospora farfugii C. Nakash., I. Araki, & Ai Ito, Pseudocercospora hardenbergiae Crous & C. Nakash., Pseudocercospora kenyirana C. Nakash., L. Suhaizan & I. Nurul Faziha, Pseudocercospora perrottetiae Crous, C. Nakash. & C.Y. Chen, Pseudocercospora platyceriicola C. Nakash., Y. Hatt, L. Suhaizan & I. Nurul Faziha, Pseudocercospora stemonicola C. Nakash., Y. Hatt., L. Suhaizan & I. Nurul Faziha, Pseudocercospora terengganuensis C. Nakash., Y. Hatt., L. Suhaizan & I. Nurul Faziha, Pseudocercospora xenopunicae Crous & C. Nakash.; New combinations:Heterophaeomoniella pinifoliorum (Hyang B. Lee et al.) L. Mostert, C.F.J. Spies, Halleen & Gramaje, Pseudocercospora pruni-grayanae (Sawada) C. Nakash. & Motohashi., Pseudocercospora togashiana (K. Ito & Tak. Kobay.) C. Nakash. & Tak. Kobay., Pteridopassalora nephrolepidicola (Crous & R.G. Shivas) C. Nakash. & Crous, Pteridopassalora lygodii (Goh & W.H. Hsieh) C. Nakash. & Crous; Typification: Epitypification:Botrytis infestans Mont., Cercospora abeliae Katsuki, Cercospora ceratoniae Pat. & Trab., Cercospora cladrastidis Jacz., Cercospora cryptomeriicola Sawada, Cercospora dalbergiae S.H. Sun, Cercospora ebulicola W. Yamam., Cercospora formosana W. Yamam., Cercospora fukuii W. Yamam., Cercospora glochidionis Sawada, Cercospora ixorana J.M. Yen & Lim, Cercospora liquidambaricola J.M. Yen, Cercospora pancratii Ellis & Everh., Cercospora pini-densiflorae Hori & Nambu, Cercospora profusa Syd. & P. Syd., Cercospora pyracanthae Katsuki, Cercospora horiana Togashi & Katsuki, Cercospora tabernaemontanae Syd. & P. Syd., Cercospora trinidadensis F. Stevens & Solheim, Melampsora laricis-urbanianae Tak. Matsumoto, Melampsora salicis-cupularis Wang, Phaeoisariopsis pruni-grayanae Sawada, Pseudocercospora angiopteridis Goh & W.H. Hsieh, Pseudocercospora basitruncata Crous, Pseudocercospora boehmeriigena U. Braun, Pseudocercospora coprosmae U. Braun & C.F. Hill, Pseudocercospora cratevicola C. Nakash. & U. Braun, Pseudocercospora cymbidiicola U. Braun & C.F. Hill, Pseudocercospora dodonaeae Boesew., Pseudocercospora euphorbiacearum U. Braun, Pseudocercospora lygodii Goh & W.H. Hsieh, Pseudocercospora metrosideri U. Braun, Pseudocercospora paraexosporioides C. Nakash. & U. Braun, Pseudocercospora symploci Katsuki & Tak. Kobay. ex U. Braun & Crous, Septogloeum punctatum Wakef.; Neotypification:Cercospora aleuritis I. Miyake; Lectotypification: Cercospora dalbergiae S.H. Sun, Cercospora formosana W. Yamam., Cercospora fukuii W. Yamam., Cercospora glochidionis Sawada, Cercospora profusa Syd. & P. Syd., Melampsora laricis-urbanianae Tak. Matsumoto, Phaeoisariopsis pruni-grayanae Sawada, Pseudocercospora symploci Katsuki & Tak. Kobay. ex U. Braun & Crous.

Citation: Chen Q, Bakhshi M, Balci Y, Broders KD, Cheewangkoon R, Chen SF, Fan XL, Gramaje D, Halleen F, Horta Jung M, Jiang N, Jung T, Májek T, Marincowitz S, Milenković T, Mostert L, Nakashima C, Nurul Faziha I, Pan M, Raza M, Scanu B, Spies CFJ, Suhaizan L, Suzuki H, Tian CM, Tomšovský M, Úrbez-Torres JR, Wang W, Wingfield BD, Wingfield MJ, Yang Q, Yang X, Zare R, Zhao P, Groenewald JZ, Cai L, Crous PW (2022). Genera of phytopathogenic fungi: GOPHY 4. Studies in Mycology101: 417–564. doi: 10.3114/sim.2022.101.06.

Up-regulation of MiR-146b-5p Inhibits Fibrotic Lung Pericytes via Inactivation of the Notch1/PDGFRβ/ROCK1 Pathway

Lung fibrosis is a serious human pathology. MiR-146b-5p is down-regulated in idiopathic pulmonary fibrosis, and the Notch1/PDGFRβ/ROCK1 pathway is activated. However, the relation between miR-146b-5p and the Notch1/PDGFRβ/ROCK1 pathway in lung fibrosis remains unclear. To investigate the function of miR-146b-5p in lung fibrosis, an in vivo model of lung fibrosis was established in mice by bleomycin. The fibrosis in lung tissues of mice was observed by HE, Masson and Sirius Red staining. Lung pericytes were isolated and identified by fluorescence microscopy. Immunofluorescence staining and Western blot were used to investigate the expression of desmin, NG2, collagen I and α-SMA. CCK8 assay was used to assess the cell viability, and flow cytometry was performed to evaluate the cell cycle in pericytes. Furthermore, the correlation between miR-146b-5p and Notch1 was analysed by Spearman analysis. The mechanism by which miR-146b-5p affects pericytes and lung fibrosis via the Notch1/ PDGFRβ/ROCK1 pathway was explored by RT-qPCR, Western blot, immunofluorescence staining and dual luciferase reporter gene assay. In bleomycin-treated mice, miR-146b-5p was down-regulated, while Notch1 was up-regulated. Up-regulation of miR-146b-5p significantly inhibited the viability and induced G1 phase arrest of lung pericytes. MiR-146b-5p mimics up-regulated miR-146b-5p, desmin, and NG2 and down-regulated α-SMA and collagen I in the lung pericytes. Additionally, miR-146b-5p was negatively correlated with Notch1, and miR-146b-5p interacted with Notch1. Over-expression of miR-146b-5p inactivated the Notch1/PDGFRβ/ROCK1 pathway. Our results indicate that up-regulation of miR-146b-5p inhibits fibrosis in lung pericytes via modulation of the Notch1/PDGFRβ/ROCK1 pathway. Thus, our study might provide a novel target against lung fibrosis.

[Family genetic analysis of paternal Dystrophin gene mutations in a case of female Duchenne muscular dystrophy]

A pedigree genetic analysis of a female Duchenne muscular dystrophy (DMD) inherited from paternal chimerism was conducted to explore the genetic diagnosis strategy. No large deletions/duplications was found in the DMD gene of the proband. Next-generation sequencing (NGS) results showed that the proband had a heterozygous mutation in the DMD gene c.4707C>A (p.C1569X). This locus has not been reported in the literature and is considered as a pathogenic mutation. Sanger sequencing revealed that the father of the proband carried the same mutation, and the mosaic ratio was about 17.7%. The specific enzyme digestion test showed that the proband had maternal skewed X-inactivation. DMD a recessive inherited disease of the X chromosome, exists in female patients, and very few of them are inherited from paternal origin. Female patients need to pay close attention to skewed X-inactivation and suspected new mutations. Mosaic is not excluded, especially the inheritance of paternal mosaicism with normal phenotype. Prenatal gene screening is necessary for reproduction.

The upregulation of proteins light chain 3 and autophagy-related 5 and the occurence of intestinal-type gastric cancer

This study aims to investigate the expression levels and values of autophagy genes light chain 3 (LC3) and autophagy-related 5 (ATG5) in intestinal-type gastric cancer. Ninety samples of normal gastric mucosa, intraepithelial neoplasia, and gastric cancer tissue were used in this study. The messenger ribonucleic acid (mRNA) and protein expression levels of autophagy genes LC3 and ATG5 were detected using quantitative reverse transcription polymerase chain reaction, Western blot, and the immunohistochemistry method. The correlations of the autophagy genes and certain clinical pathological parameters were analyzed. The results showed that LC3 mRNA expression was 43.76 ± 20.31 in the normal group, 111.29 ± 18.65 in the intraepithelial neoplasia group, and 131.78 ± 26.29 in the gastric cancer group, while ATG5 mRNA expression was 4.52 ± 2.37 in the normal group, 7.09 ± 1.88 in the intraepithelial neoplasia group, and 10.25 ± 2.81 in the gastric cancer group. The differences between the groups were statistically significant (P < 0.05). The protein expression of LC3 in the normal group was 1.05 ± 0.41, 1.53 ± 0.36 in the intraepithelial neoplasia group, and 1.99 ± 0.14 in the gastric cancer group. The protein expression of ATG5 was 0.78 ± 0.24 in the normal group, 1.37 ± 0.39 in the intraepithelial neoplasia group, and 2.04 ± 0.63 in the gastric cancer group. The differences between the groups were statistically significant (P < 0.05). The positive rate of LC3 protein expression was 33.3% in the normal group and 60% in the intraepithelial neoplasia group, and the difference was statistically significant (χ² = 4.89; P = 0.04). In the gastric cancer group, the positive rate of LC3 protein expression was 83.3%, making it significantly higher than the intraepithelial neoplasia group, with a statistically significant difference (χ² = 4.02, P = 0.045). The positive rate of ATG5 protein expression was 23.3% in the normal group, 50.0% in the intraepithelial neoplasia group, and 76.7% in the gastric cancer group. The expression in the intraepithelial neoplasia group was much higher than in the normal group, with a statistically significant difference (χ² = 4.59, P = 0.03), and that of the gastric cancer group was much higher than that of the intraepithelial neoplasia group, with a statistically significant difference (χ² = 4.59, P = 0.03). LC3 protein expression was significantly correlated with depth of infiltration, and lymph node status. ATG5 protein expression was significantly correlated with age, depth of infiltration, and lymph node status. There was also a correlation between the LC3 and ATG5 proteins (correlation coefficient r = 0.72, P = 0.001). The enhanced autophagy activity of LC3 and ATG5 may participate in the occurrence and development of intestinal gastric cancer, and they may play a synergistic role in promoting the occurrence and development of intestinal gastric cancer. These findings provide clinical value for the diagnosis of intestinal gastric cancer.

[Clinical and prognostic study of anti-N-methyl-D-aspartate receptor encephalitis children with paroxysmal sympathetic hyperactivity syndrome]

The data of clinical characteristics, medical cost and prognosis of 22 anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis children from the Department of Neurology, Capital Institute of Pediatrics between May 2018 and January 2021 were analyzed, and 6 of them occurred paroxysmal sympathetic hyperactivity syndrome (PSH). It was found that the anti-NMDAR encephalitis children with PSH had severer consciousness disorder [median Glasgow Coma Scale (GCS) score at admission: 7.5], longer duration of consciousness disorder (median time: 53 days), higher hospitalization cost (median cost: 230 000 RMB), severer neurological injury at onset [median modified Rankin Scale (mRS) score at admission: 4], and longer recovery time of neurological function (median time of mRS score recovered to 0-2: 7 months), compared with those without PSH (all P<0.05). Therefore, more attention should be paid to sympathetic excited symptoms of anti NMDAR encephalitis, and thus identify and intervene early on PSH to reduce the neurological damage and economic burden.

[Advances in the role of extracellular histones in the inflammatory process of liver injury]

Histones are important structural proteins of chromatin in the nucleus, which can regulate gene transcription, and can be released from the nucleus to the outside of the cell under injury and inflammatory stimulations, thereby causing cytotoxicity and immune stimulation, and aggravating tissue damage. Extracellular histones are involved in the occurrence and development of many diseases, including sepsis, autoimmune diseases, liver injury, and acute lung injury. Therefore, its application not only can be used as a body's biomarker of inflammation, but also it is expected to become a molecular target for the treatment of diseases. This article reviews the role of extracellular histones in the inflammatory process of liver injury.

First-in-human phase 1 study of the anti-TIGIT antibody vibostolimab as monotherapy or with pembrolizumab for advanced solid tumors, including non-small cell lung cancer

BACKGROUND

In this first-in-human phase 1 study, we investigated the safety and efficacy of the anti-TIGIT antibody vibostolimab as monotherapy or in combination with pembrolizumab.

METHODS

Part A enrolled patients with advanced solid tumors and part B enrolled patients with non-small cell lung cancer (NSCLC). Patients received vibostolimab 2.1-700 mg alone or with pembrolizumab 200 mg in part A and vibostolimab 200 mg alone or with pembrolizumab 200 mg in part B. Primary end points were safety and tolerability. Secondary end points included pharmacokinetics and objective response rate (ORR) per RECIST v1.1.

RESULTS

Part A enrolled 76 patients (monotherapy, 34; combination therapy, 42). No dose-limiting toxicities were reported. Across doses, 56% of patients receiving monotherapy and 62% receiving combination therapy had treatment-related adverse events (TRAEs); grade 3-4 TRAEs occurred in 9% and 17% of patients, respectively. The most common TRAEs were fatigue (15%) and pruritus (15%) with monotherapy and pruritus (17%) and rash (14%) with combination therapy. Confirmed ORR was 0% with monotherapy and 7% with combination therapy. In part B, 39 patients had anti-PD-1/PD-L1-naïve NSCLC (all received combination therapy) and 67 had anti-PD-1/PD-L1-refractory NSCLC (monotherapy, 34; combination therapy, 33). In patients with anti-PD-1/PD-L1-naive NSCLC: 85% had TRAEs-the most common were pruritus (38%) and hypoalbuminemia (31%); confirmed ORR was 26%, with responses occurring in both PD-L1-positive and PD-L1-negative tumors. In patients with anti-PD-1/PD-L1‒refractory NSCLC: 56% receiving monotherapy and 70% receiving combination therapy had TRAEs-the most common were rash and fatigue (21% each) with monotherapy and pruritus (36%) and fatigue (24%) with combination therapy; confirmed ORR was 3% with monotherapy and 3% with combination therapy.

CONCLUSION

Vibostolimab plus pembrolizumab was well tolerated and demonstrated antitumor activity in patients with advanced solid tumors, including patients with advanced NSCLC.

Microplastics habituated with biofilm change decabrominated diphenyl ether degradation products and thyroid endocrine toxicity

Microplastics (MPs) are rapidly colonized by microbial biofilms in a natural aquatic environment, and the nature of the microbial community and type of MP can result in different degradation products of organic pollutants. Here, we quantified the degradation products of a ubiquitously detected pollutant, decabrominated diphenyl ether (BDE-209), under both light-only and biota conditions and in the absence or presence of three kinds of MPs, styrofoam polystyrene, hard polyamide, and polypropylene film. The results showed that the BDE-209 concentration increased by 0.7-2.8 fold in the presence of MPs, probably due to the "sustained release" desorption effect. Under light-only conditions, the penta- and hexa-BDE concentrations in the presence of styrofoam or hard MPs were significantly reduced, which can be deemed a beneficial effect. However, when biota were present, the debromination products increased with the addition of MPs, particularly in the presence of styrofoam MPs. These products caused a 1.7-fold upregulation in triiodothyronine content and a 5.9-fold upregulation of thyroid stimulating hormone β expression in zebrafish larvae. The increase in debromination products could be attributed to the distinct high abundance of the bacteria Chloroflexi, Proteobacteria, and Basidiomycotina on styrofoam MPs that can participate in pollutant degradation. Collectively, our results indicate that MPs can alter the degradation pathways of BDE-209 and increase the toxicity to the endocrine system and the thyroid in aquatic organisms.

PLGA+Fe₃O₄+PFP Nanoparticles Drug-Delivery Demonstrates Potential Anti-Tumor Effects on Tumor Cells

Background

Nanoparticles are proven as a potential tool for treating various disorders. However, efficient nanoparticle delivery of anti-tumor drugs is urgently needed for tumor treatment. This study aimed to generate a drug-delivery nanoparticle with higher efficacy and safety.

Material/Methods

We developed a poly-(lactide-co-glycolide) (PLGA) nanoparticle (FLGA-Fe₃O₄+PFP) embedded with super-paramagnetic iron oxide (Fe₃O₄) and perfluoropentane (PFP). Characteristics of FLGA-Fe₃O₄+PFP nanoparticles were observed using optical microscopy, scanning electron microscopy, and transmission electron microscopy. HNE1 and HepG2 cells were cultured and used for experiments. MTT was used to evaluate cytotoxic effects of FLGA-Fe₃O₄+PFP nanoparticles on HNE1 and HepG2 cells. Cell engulfment capacity was examined and a cell targeting experiment was conducted to evaluate invasive capability and binding efficiency of PLGA+Fe₃O₄+PFP nanoparticles, respectively. Biological toxicity of PLGA+Fe₃O₄+PFP nanoparticles in rats was evaluated by determining CK, LDH, creatinine, and UA levels, and ALT and AST activities.

Results

PLGA+Fe₃O₄+PFP nanoparticles demonstrated well-defined spherical and dispersed morphology with smooth surfaces. There were scattered black spots on shells of PLGA+Fe₃O₄+PFP nanoparticles. PLGA+Fe₃O₄+PFP nanoparticles did not trigger obvious effects on cell viability of HNE1 and HepG2 cells. HNE1 and HepG2 cells demonstrated higher engulfment capacity for PLGA+ Fe₃O₄+PFP nanoparticles. PLGA+Fe₃O₄+PFP nanoparticles demonstrated higher targeting CDDP delivery efficacy and promoted binding efficiency of targeting CDDP with cells. PLGA+Fe₃O₄+PFP nanoparticles demonstrated no obvious toxic effects on heart, kidney, liver (without effects on CK, LDH, creatinine, UA levels, and ALT and AST activities).

Conclusions

PLGA+Fe₃O₄+PFP nanoparticles were safe, with higher invasive ability and binding efficiency of targeting CDDP with tumor cells. Therefore, PLGA+Fe₃O₄+PFP nanoparticles demonstrated potential anti-tumor effects after transplantation.

Endoscopic sinus surgery improves Eustachian tube function in patients with chronic rhinosinusitis: a multicenter prospective study

BACKGROUND

Patients with chronic rhinosinusitis (CRS) often have Eustachian tube dysfunction (ETD) symptoms. This study aimed to prospectively investigate the effect of endoscopic sinus surgery (ESS) on improvement of Eustachian tube function in CRS patients with ETD from a Chinese population and determine factors associated with improvement.

METHODS

A prospective study was performed in CRS patients with ETD who underwent ESS from 3 tertiary medical centers in south China. The Eustachian tube Dysfunction Questionnaire 7 (ETDQ-7), Sinonasal Outcome Test 22 (SNOT-22), tympanograms, endoscopic findings and Valsalva maneuver were recorded and analyzed preoperatively and postoperatively at 8-12 weeks.

RESULTS

A total of 70 CRS patients with ETD were included in this study. The ETDQ-7 score and the ability of positive Valsalva maneuver in CRS patients were significantly improved postoperatively at 8-12 weeks. The number of patients with type A tympanogram was increased postoperatively. Reduced Eustachian tube mucosal inflammation was also observed postoperatively. In addition, ESS appeared to reverse slight tympanic membrane atelectasis after 8-12 weeks. Moreover, improvement in tympanogram was presented in more than half of CRS patients with concomitant otitis media with effusion postoperatively at 8-12 weeks. Univariate and multivariate analysis revealed failure of normalization of ETDQ-7 postoperatively was associated with concomitant allergic rhinitis and higher preoperative SNOT-22 score.

CONCLUSIONS

This study confirms Eustachian tube function is often improved after ESS in CRS patients with ETD. Concomitant allergic rhinitis and higher preoperative SNOT-22 score are associated with failure of normalization of ETD symptoms.

Corrosion comparison of free and roller surfaces of Fe70Si8B12Nb10 amorphous ribbon

The corrosion resistance of the free surface (FS) and roller surface (RS) of Fe₇₀Si₈B₁₂Nb₁₀ amorphous ribbon was systematically compared in simulated seawater (0.6 M NaCl). The electrochemical method and scanning electron microscopy showed that the FS corrosion resistance was higher than that of the RS. XPS etching and Mott–Schottky tests indicated that the passivation films on the FS and RS were divided into outer and inner layers. In the spinning process, the elements with a higher atomic mass tend to segregate toward the FS, while the elements with a lower atomic mass segregate toward the RS. These results provide data that can be used to improve the quality of melt spinning ribbons and to optimize the manufacturing of involved electric devices.

The two surfaces of the Fe₇₀Si₈B₁₂Nb₁₀ amorphous ribbon have very different corrosion resistances due to different structures.

Biodegradable plastics in the air and soil environment: Low degradation rate and high microplastics formation

In recent years, the promotion and use of biodegradable plastics (BPs) are growing into a general trend. Here the degradation performance of different types of BPs was investigated in the natural environment. Their degradation levels followed the order of pure BPs> BP blends> claimed "BP"≈ non-biodegradable plastic after 6-month incubation. Photo- and biodegradation were the main degradation mechanisms of these plastics in the air and soil, respectively. Poly(p-dioxanone) (PPDO) exhibited the highest weight loss potentials in both air (54.7 ± 9.1%) and soil (56.8 ± 4.8%), due to its special ether bond and the rich and diverse microorganisms on its biofilms. The microbiota on PPDO was distinct and enriched with Chloroflexi and Firmicutes that responsible for carbon cycle and organic degradation. The weight loss was only 1.1-8.0% for poly(lactic acid), and 0.8-6.8% for poly(butylene adipate-co-terephthalate), and other plastics are basically non-degradable. Of note, numerous microplastics were formed after PPDO degradation, with 441 ± 326 and 2103 ± 131 item/g plastic in the air and soil, respectively. Taken together, the monitoring of BP biodegradation in the natural environment is of vital importance, and it is risky to promote large-scale application of BPs if the knowledge gap of their environmental behavior has not been well addressed.

Flupentixol/melitracen for chronic refractory cough after treatment failure with other neuromodulators

BACKGROUND: Gabapentin and baclofen are recommended for the treatment of chronic refractory cough (CRC). We investigated the efficacy of flupentixol/melitracen in patients unresponsive to these neuromodulators.METHODS: A total of 101 patients with CRC who failed to respond to gabapentin and baclofen were recruited, and treated with flupentixol/melitracen. The prevalence of cough resolution and changes in the Cough Symptom Score (CSS), cough thresholds to capsaicin, Hull Airway Reflux Questionnaire (HARQ), Leicester Cough Questionnaire (LCQ), Generalized Anxiety Disorder-7, Hamilton Anxiety Rating Scale, Patient Health Questionnaire-9, and Hamilton Depression Rating Scale-24 were evaluated after treatment.RESULTS: Ninety-eight patients (97.0%) completed the study. The overall successful cough resolution rate was 62.4% (63/101). Cough resolution was accompanied by an obvious decrease in the CSS and HARQ score and a remarkable increase in cough thresholds to capsaicin challenge and LCQ score, whereas anxiety and depression scores did not change significantly. The prevalence of adverse effects (e.g., insomnia and dizziness) was 21.8%. The prevalence of cough recurrence within 2 weeks after treatment cessation was 17.8%.CONCLUSION: Flupentixol/melitracen may be an efficacious option for CRC unresponsive to other neuromodulators.

Fish Ingest Microplastics Unintentionally

Microplastics (size of plastic debris <5 mm) occur in various environments worldwide these days and cause detrimental effects on biota. However, the behavioral responses of fish to microplastics in feeding processes are not well understood. In the present study, juveniles from four fish species and two common shapes of microplastics were used to explore fish feeding responses. We found swallowing-feeding fish ingested more pellets than filtering- and sucking-feeding fish. With high-definition and high-speed observational experiments, we found that all species did not actively capture microfibers; instead, they passively sucked in microfibers while breathing. Surprisingly, fish showed a rejective behavior, which was spontaneously coughing up microfibers mixed with mucus. Nevertheless, some of the microfibers were still found in the gastrointestinal tracts and gills of fish, while abundances of ingested microfibers were increased in the presence of food. Our findings reveal a common phenomenon that fish ingest microplastics inadvertently rather than intentionally. We also provide insights into the pathways via which microplastics enter fish and potential strategies to assess future ecological risk and food safety related to microplastics.

[A historical review of dental education and practice qualification in modern China]

A series of regulations and policies for Dental Practitioner Qualification were issued during modern times (1906-1949) in China from local to national levels, in which the certification for qualification had been largely based on dental education and training experiences. The present article reviews the evolution and progression of dental practitioner qualification management, as well as its relationship to dental education before 1949, which may hopefully provide a historical background for the development of modern dentistry and enhance the understanding of the current management process for dental practitioner qualifications in China.

[Prediction of the vaulting after posterior chamber intraocular lens implantation]

Objective: To investigate the influencing factors on the vaulting one month after implantable collamer lens (ICL) implantation, and to develop and verify a prediction formula. Methods: The first half of this study was retrospective case series study, and the second half was cross-sectional stydy. A total of 83 eyes of 83 patients who underwent ICL implantation in the Lixiang Eye Hospital of Soochow University were included in the first half of the study, with an average age of (27±5) years, from August 1, 2019 to December 30, 2019. All patients underwent a complete preoperative examination, including axis length, anterior chamber depth, comprehensive optometry, intraocular pressure, central corneal thickness, white-to-white diameter, horizontal and vertical sulcus-to-sulcus diameter (STS), crystalline lens thickness (LT), corneal curvature, and bright and dark pupil diameter. Multiple linear regression (stepwise) was used to develop a prediction formula. In the validation part, a total of 65 people (65 eyes) were included, with an average age of (26±5) years, from March 1, 2020 to June 1, 2020. The accuracy and reliability of the formula were verified by the intergroup correlation coefficient and Bland-Altman consistency test. Results: At 1 month after surgery, ICL size had the greatest impact on the vaulting (β=0.942, P<0.001), followed by horizontal STS (β=-0.517, P<0.001), LT (β=-0.376, P<0.001), and vertical STS (β=-0.257, P=0.017). The influence of other factors was not statistically significant (all P>0.05). The regression equation was as follows: the vaulting (μm)=-1 369.05+657.12×ICL size-287.41×horizontal STS-432.50×LT-137.33×vertical STS (the fitting degree R=0.813, R²=0.660, and corrected R²=0.643). In the verification part, the predicted average vaulting was (497.31±102.75) μm, while the actual vaulting was (514.62±152.99) μm. About 96.92% (63/65) of the patients were fitted in the moderate vault, and 3.08% (2/65) were in the high vault. The intergroup correlation coefficient was 0.581. According to the Bland-Altman test, the actual vaulting was 17.31 μm, higher than the predicted value, and the 95% confidence interval of the difference was -260.28 to 294.90 μm. Conclusion: The ICL size, horizontal and vertical STS and LT are the factors that affect and predict the vaulting one month after ICL implantation, and our prediction formula has good accuracy and reliability. (Chin J Ophthalmol, 2021, 57: 519-525).

Application of Maxillary Sinus Effusion Detection in Diagnosis of Drowning

Abstract

Objective To study the imaging characteristics of maxillary sinus effusion in drowned bodies, to explore its morphological characteristics and value in the diagnosis of the cause of death, and to provide objective evidence to support the study of virtual anatomy of drowning. Methods The 154 postmortem CT examination cases （31 cases of drowning, 123 cases of non-drowning） of Beijing Public Security Bureau Forensic Center in 2019 were collected. The bodies of all cases were scanned by multi-layer spiral CT before double-blind reading by clinical imaging experts. Maxillary sinus of corpses with maxillary sinus effusion in imaging findings was punctured. The detection rate of maxillary sinus effusion was calculated. The CT value and volume of maxillary sinus effusion were measured on 3D DICOM workstation. Results The detection rate of maxillary sinus effusion in the drowning was 100%, the shape was horizontal liquid level, the volume was 1.2-11.2 mL, the CT value was 6.08-19.02 Hu, with an average value of 12.85 Hu. The detection rate of maxillary sinus effusion in non-drowning was 19.51% （24/123）, the shape was wavy or irregular, and there were bubbles inside, the volume was 0.4-13.4 mL, the CT value was 23.68-77.75 Hu, with an average value of 42.08 Hu. The differences in CT value between the two groups had statistical significance. Conclusion The postmortem CT examination method can be used to observe the shape and measure the CT value of the maxillary sinus effusion in the bodies in water, which can be an auxiliary examination method for identification of drowning.

[Effect of fatty acid synthase gene silencing on lipid metabolism and biological behaviors of human hepatoblastoma HepG2 cells]

OBJECTIVE

To investigate the effect of fatty acid synthase (FASN) gene silencing on lipid metabolism and biological behaviors of human hepatoblastoma HepG2 cells.

OBJECTIVE

Small interfering RNA (siRNA) targeting FASN gene or a negative control siRNA sequence (NC-siRNA) was transfected into HepG2 cells, and the gene silencing efficiency was evaluated with qRT-PCR and Western blotting. Triglyceride level in the cells was detected using enzyme-linked immunosorbent assay, and Oil red O staining was performed to examine intracellular lipid droplets. The proliferation ability of the transfected cells was tested by CCK-8 assay, and cell apoptosis was evaluated using annexin V-FITC/PI apoptosis detection kit. Wound healing assay and Transwell assay were performed to assess the migration ability of the transfected cells.

OBJECTIVE

Transfection of the cells with FASN-siRNA, but not NC-siRNA, significantly lowered FASN expression at both the mRNA and protein level (P < 0.001) and decreased the number of lipid droplets (P < 0.001) and triglyceride level (P < 0.01) in the cells. FASN gene silencing significantly inhibited proliferation, increased apoptosis rate and suppressed migration of HepG2 cells (P < 0.001).

OBJECTIVE

FASN gene silencing inhibits proliferation and migration and promotes apoptosis of HepG2 cells possibly by suppressing lipid synthesis in the cells.

[Study on the demand of social organizations working for female sex workers regarding project management and capacity building of HIV prevention and treatment]

Objective: To understand the capacity building needs on social organizations providing HIV prevention and treatment services for female sex workers (FSW). Methods: Questionnaires and interview were conducted with the heads of social organizations participating in China AIDS Fund for Non-Governmental Organizations (CAFNGO) project 2017-2018. Data from the CAFNGO's information system were compiled and analyzed using Excel 2016 and SPSS 25.0 software. The distribution of social organizations, availability of funds, and social organizations' needs for capacity building were analyzed. Results: Nationwide, 184 social organizations were involved in project '2017-2018 CAFNGO's FSW field work'. Out of which, 156 answers were valid. Social organizations that participated in the implementation of fund projects were mainly concentrated in the western region, accounting for 44.0% (81/184), with Sichuan, Guangxi, and Yunnan being the majority. However, the eastern part received the most financial support. Social organizations expressed the highest demand for project data collection and analysis, accounting for 68.6% (107/156). Items on risk analysis, response, and quality control project ranked the second, accounting for 64.1% (100/156). Results showed that statistically significant differences were seen on capacity building needs among social organization leaders with different levels of training on management of planning and finance of the project (χ²=5.78,P=0.016;χ²=8.99,P=0.003). Conclusions: Currently, the number of social organizations and the related fund provision concerning HIV prevention and control among FSWs were not consistent in China. Thus, it is necessary to encourage, guide, and support the development of social organizations and satisfy social organizations' needs on capacity-building and planning.

[Study of sequential surgical guide assisting full arch immediate implant placement and provisionalization in patients with severe periodontitis]

To explore the technical process and the therapeutic effect of using sequential surgical guide with independent intellectual property rights assisting immediate implantation and restoration of the full arch, with the support from the periodontal splint for mobile supporting teeth, patients with severe periodontitis who planned to undergo immediate full arch implantation were recruited from August 2019 to December 2020 at the Department of Prosthodontics, Department of Periodontology, Department of Implantology and First Clinical Division, Peking University School and Hospital of Stomatology. Through the procedure of collecting preoperative maxillofacial data, making systematic diagnostic design, making periodontal splints fixation, producing surgical guide, and carrying out guided surgery for full arch immediate implantation, eight cases were included. By registering the postoperative cone-beam CT (CBCT) with the preoperative data, the difference between the actual three-dimensional position of the implants and the virtual design was observed, and the accuracy of the implant placement position guided by the sequential guide was statistically analyzed using SPSS 25.0 software. Analysis indicators include coronal and apical global displacement, coronal horizontal and vertical displacement, apical horizontal and vertical displacement, and angular deviation. Results revealed that the 8 patients [2 males and 6 females, aged (49.0±9.3) years (38-65 years)] of recruited cases included 7 cases of maxilla and 1 cases of mandible. A total of 48 implants, of which 44 implants were placed upright and 4 were placed tilted, 16 implants in the anterior region and 32 implants in the posterior region. No guide plate fracture or damage to important anatomical structures were reported. The overall displacement at the coronal point [(0.83±0.48) mm] and the global displacement at the apical point [(1.36±0.57) mm] were within the clinically acceptable safety range, and the horizontal displacement and vertical displacement at the coronal point, horizontal displacement and vertical displacement at the apical point, and the angle deviation of implants axial have no statistic significant difference in the anterior and posterior region (P>0.05). Periodontal splints combined with sequential surgical guides to assist patients with severe periodontitis for immediate full arch implantation and immediate restoration can expand the indications of guide assisted implant surgery. It meets the safety requirements in clinical applications.

[Visual fixation patterns during basic facial emotion recognition and its correlation with social impairment among children with high-functioning autism spectrum disorder]

Objective: To explore the visual fixation patterns during facial emotion recognition and the association between fixation duration percentage (FDP) of eye region with social impairment among high-functioning autism spectrum disorders (HFASD). Methods: Children were recruited from the Child and Adolescent Behavior Research Center of Sun Yat-sen University, Guangzhou, between July and December 2019 for case control study. A total of 42 children with HFASD and 23 age-and gender-matched typical development (TD) children were enrolled. Based on their performance during the facial emotion recognition task, HFASD children were further divided into ASD-1 group (correctly recognized both happy and fear emotions) and ASD-2 group (recognized happy emotions only). During the free viewing task, an infrared eye tracker was used to record the gazing data of children in the three groups. The social responsiveness scales (SRS) was utilized to evaluate HFASD children's social impairment, with the cutoff score of 75 to differentiate those from mild and severe social impairment. The differences of FDP among the three groups were analyzed by the Analysis of Variance (ANOVA) model. Mixed linear regression model was conducted to evaluate the associations between social impairment and FDP of eye region among HFASD children. Results: The final sample consists of 25 ASD-1 (20 males, aged (7.9±1.0) years), 17 ASD-2(14 males, aged (7.2±1.2) years), and 23 TD (12 males, aged (7.7±1.3) years) children. There were no significant differences in age and gender among three groups (F=2.05, χ²=10.08, P=0.14 and 0.07, respectively). For the happy emotion, there are significant differences in eye FDP among the three groups (TD: 0.37±0.20, ASD-1: 0.35±0.20, ASD-2: 0.47±0.24, F=3.97, P=0.02). Mixed linear regression model revealed that, adjusting for emotion, gender, age and intelligence quotient, ASD children's eye FDP negatively associates with social impairment (OR=0.15, 95%CI: 0.06-0.35, P<0.01). Conclusions: Longer FDP is associated with milder social impairment among HFASD children. HFASD children with facial emotion recognition difficulties require longer fixation to recognize happy emotions.

Does Maintenance of Pulmonary Blood Flow Pulsatility at the Time of the Fontan Operation Improve Hemodynamic Outcome in Functionally Univentricular Hearts?

It is unclear whether residual anterograde pulmonary blood flow (APBF) at the time of Fontan is beneficial. Pulsatile pulmonary flow may be important in maintaining a compliant and healthy vascular circuit. We, therefore, wished to ascertain whether there was hemodynamic evidence that residual pulsatile flow at time of Fontan promotes clinical benefit. 106 consecutive children with Fontan completion (1999-2018) were included. Pulmonary artery pulsatility index (PI, (systolic pressure-diastolic pressure)/mean pressure)) was calculated from preoperative cardiac catheterization. Spectral analysis charted PI as a continuum against clinical outcome. The population was subsequently divided into three pulsatility subgroups to facilitate further comparison. Median PI prior to Fontan was 0.236 (range 0-1). 39 had APBF, in whom PI was significantly greater (median: 0.364 vs. 0.177, Mann-Whitney p < 0.0001). There were four early hospital deaths (3.77%), and PI in these patients ranged from 0.214 to 0.423. There was no correlation between PI and standard cardiac surgical outcomes or systemic oxygen saturation at discharge. Median follow-up time was 4.33 years (range 0.0273-19.6), with no late deaths. Increased pulsatility was associated with higher oxygen saturations in the long term, but there was no difference in reported exercise tolerance (Ross), ventricular function, or atrioventricular valve regurgitation at follow-up. PI in those with Fontan-associated complications or the requiring pulmonary vasodilators aligned with the overall population median. Maintenance of pulmonary flow pulsatility did not alter short-term outcomes or long-term prognosis following Fontan although it tended to increase postoperative oxygen saturations, which may be beneficial in later life.

11-year follow-up outcomes of catheter ablation of para-hisian accessory pathways

Funding Acknowledgements

Type of funding sources: None.

Background

Ablation of para-hisian accessory pathways (APs) remains challenging due to anatomic characteristics and few studies have focused on the causes for recurrence of radiofrequency ablation of para-hisian APs.

Objective

This retrospective single center study was aimed to explore the risk factors for recurrence of para-hisian APs.

Methods

113 patients who had a para-hisian AP with an acute success were enrolled in the study. In the 11-year follow-up, 15 cases had a recurrent para-hisian AP. Therefore 98 patients were classified into success group while 15 patients were classified into recurrence group. Demographic and ablation characteristics were analyzed.

Results

Gender difference was similar in two groups. The median age was 36.2 years old and was younger in recurrence group. Maximum ablation power was significantly higher in success group (29 ± 7.5 vs 22.9 ± 7.8, p &lt; 0.01). Ablation time of final target sites was found to be markedly higher in success group (123.4 ± 53.1 vs 86.7 ± 58.3, p &lt; 0.05). Ablation time less than 60 seconds was detected in 12 (12.2%) cases in success group and 7 (46.7%) cases in recurrence group (p &lt; 0.01). Occurrence of junctional rhythm was significantly higher in recurrence group (25.5% vs 53.3%, p &lt; 0.05). No severe conduction block, no pacemaker implantation and no stroke were reported. Junctional rhythm during ablation (OR = 3.833, 95%CI 1.083-13.572, p = 0.037) and ablation time &lt;60s (OR = 5.487, 95%CI 1.411-21.340, p = 0.014) were independent risk factors for the recurrence of para-hisian AP.

Conclusions

Considering the long-term safety of ablation of para-hisian AP, proper extension of ablation time and increase of ablation power could be applied during operation.

Three-dimensional bioprinting of artificial ovaries by an extrusion-based method using gelatin-methacryloyl bioink

PURPOSE

The aim of this study was to design and fabricate a three-dimensional (3D) printed artificial ovary.

METHODS

We first compared the printability of gelatin-methacryloyl (GelMA), alginate and GelMA-alginate bioinks, of which GelMA was selected for further investigation. The swelling properties, degradation kinetics and shape fidelity of GelMA scaffolds were characterized by equilibrium swelling/lyophilization, collagenase processing and micro-computed tomography evaluation. Commercial ovarian tumor cell lines (COV434, KGN, ID8) and primary culture ovarian somatic cells were utilized to perform cell-laden 3D printing, and the results were evaluated by live/dead assays and TUNEL detection. Murine ovarian follicles were seeded in the ovarian scaffold and their diameters were recorded every day. Finally, in vitro maturation was performed, and the ovulated oocytes were collected and observed.

RESULTS

Our results indicated that GelMA was suitable for 3D printing fabrication. Its scaffolds performed well in terms of hygroscopicity, degradation kinetics and shape fidelity. The viability of ovarian somatic cells was lower than that of commercial cell lines, suggesting that extrusion-based 3D culture fabrication is not suitable for primary ovarian cells. Nevertheless, the GelMA-based 3D printing system provided an appropriate microenvironment for ovarian follicles, which successfully grew and ovulated in the scaffolds. Metaphase II oocytes were also observed after in vitro maturation.

CONCLUSIONS

The GelMA-based 3D printing culture system is a viable alternative option for follicular growth, development and transfer. Accordingly, it shows promise for clinical application in the treatment of female endocrine and reproductive conditions.

[Methylene blue play a role in preventing septic liver injury by inducing macrophage polarization]

Thirty mice were used to establish a sepsis model with cecal ligation and puncture. 15 mg/kg methylene blue or isotonic saline were injected intraperitoneally to observe liver tissue pathological changes. Changes in macrophage frequency and expressional condition of M1 and M2-type hepatic inflammatory factors were detected. After LPS stimulation, the expression level of macrophage inflammatory factor were detected. The results showed that the pathological liver injury was significantly reduced in the MB mice group (P < 0.05), and the frequency of liver macrophage was not statistically significantly different (P > 0.05). MB elevation had promoted the expression of M2-type hepatic inflammatory factor (P < 0.05) and macrophage inflammatory factor (P < 0.05). MB can play a role in preventing septic liver injury by inducing macrophages polarization to M2-type.

Arecoline hydrobromide enhances jejunum smooth muscle contractility via voltage-dependent potassium channels in W/Wv mice

Gastrointestinal motility was disturbed in W/Wv, which were lacking of interstitial cells of Cajal (ICC). In this study, we have investigated the role of arecoline hydrobromide (AH) on smooth muscle motility in the jejunum of W/Wv and wild-type (WT) mice. The jejunum tension was recorded by an isometric force transducer. Intracellular recording was used to identify whether AH affects slow wave and resting membrane potential (RMP) in vitro. The whole-cell patch clamp technique was used to explore the effects of AH on voltage-dependent potassium channels for jejunum smooth muscle cells. AH enhanced W/Wv and WT jejunum contractility in a dose-dependent manner. Atropine and nicardipine completely blocked the excitatory effect of AH in both W/Wv and WT. TEA did not reduce the effect of AH in WT, but was sufficient to block the excitatory effect of AH in W/Wv. AH significantly depolarized the RMP of jejunum cells in W/Wv and WT. After pretreatment with TEA, the RMP of jejunum cells indicated depolarization in W/Wv and WT, but subsequently perfused AH had no additional effect on RMP. AH inhibited the voltage-dependent K+ currents of acutely isolated mouse jejunum smooth muscle cells. Our study demonstrate that AH enhances the contraction activity of jejunum smooth muscle, an effect which is mediated by voltage-dependent potassium channels that acts to enhance the excitability of jejunum smooth muscle cells in mice.

PAEs and PBDEs in plastic fragments and wetland sediments in Yangtze estuary

Phthalates (PAEs) and polybrominated diphenyl ethers (PBDEs) are widely used as additives in various plastic products. Because of their ubiquity and potential hazards to the environment, they have attracted widespread attention. This research supports the addition critical data of the concentration and distribution of PAEs and PBDEs in the plastic fragments and wetland sediments in Yangtze Estuary. The concentrations of Σ₇PAEs and Σ₉PBDEs in the plastic samples in Yangtze Estuary wetlands were 26.8-4241.8 μg/g and n.d. (no detectable) to 250.1 μg/g, respectively. The sixteen PAEs and eight PBDEs varied from 35.9 to 36225.2 ng/g and 3.9-253.0 ng/g in sediment samples. The dominant types of these chemicals in plastic and sediment samples were diisobutyl phthalate (DIBP), dibutyl phthalate (DBP), dioctyl phthalate (DEHP) and BDE-209. According to correlation analysis and principal component analysis, the major sources of additives in sediment were associated with the leak from plastic fragment and microplastic. Based on the equilibrium partitioning theory and Sediment Quality Guidelines (SeQGs), the ecological risk of PAEs (high risk) and PBDEs (moderate risk) were evaluated. Overall, the investigated area has been moderately polluted by additives and microplastics; therefore, it is necessary to strengthen the control of environmental input of plastic waste.

[Clinicopathological features of adenocarcinoma of the rete testis]

Objective: To investigate the clinicopathological features, immunophenotype, and differential diagnosis of adenocarcinoma of the rete testis. Methods: Four adenocarcinoma cases of the rete testis diagnosed at West China Hospital, Chengdu, China (3 cases, including 2 consultation cases) and the First Affiliated Hospital of Fujian Medical University, Fuzhou, China (1 case) between January 2009 and December 2017 were included. Their clinical, morphologic and immunohistochemical features were analyzed using histological analysis and immunohistochemical staining. Related literature was reviewed to reveal the characteristics of this tumor. Results: The 4 patients' age range was 26-64 years. The maximum diameters of the tumors were 3.0 and 4.5 cm in 2 cases, respectively. On gross examination, adenocarcinomas of the rete testis appeared as a solid, white to gray or tan to yellow mass that raised at the hilum of the testis. Microscopically, all tumors showed multiple histologic patterns, including corded/trabecular (4/4), glandular, nested, sarcomatoid (3/4), solid (2/4), papillary, cribriform, and slit-like (1/4). Three types of adenocarcinoma cells included cuboidal to columnar (4/4), polygonal (4/4) and spindle-shaped (2/4) with pale eosinophilic and clear cytoplasm. The tumor cell nuclei appeared moderately to markedly atypical and pleomorphic, with a various number of mitoses. Transition from benign to malignant rete epithelium was seen in all cases. Eosinophilic hyaloid globules were found in 1 case. On immunohistochemical study, the tumor cells were diffusely, strongly positive for CKpan (4/4), EMA (4/4), Ber-EP4 (3/3) and CAⅨ(2/2), and focally positive for CK7 (4/4), vimentin (4/4), CD10 (4/4), PAX8 (3/3), PAX2 (3/3). The Ki-67 proliferative index was all>50% (4/4). The prognosis was poor. Two of the 3 patients died within 1 year after the surgical resection. Conclusions: Adenocarcinoma of the rete testis is a rare malignant tumor with several histologic patterns. Transition from benign to malignant rete epithelium is an important diagnostic clue. Detailed clinical history, tumor growth site and immunohistochemistry are helpful for its diagnosis and differential diagnosis.

Stage-dependent and regioselective toxicity of 2- and 6-hydroxychrysene during Japanese medaka embryogenesis

Exposure to oxygenated polycyclic aromatic hydrocarbons (oxy-PAHs) at critical developmental time-points in fish models impairs red blood cell concentrations in a regioselective manner, with 2-hydroxychrysene being more potent than 6-hydroxychrysene. To better characterize this phenomenon, embryos of Japanese medaka (Oryzias latipes) were exposed to 2- or 6-hydroxychrysene (0.5, 2, or 5 μM) from 4 h-post-fertilization (hpf) to 7 d-post-fertilization. Following exposure, hemoglobin concentrations were quantified by staining fixed embryos with o-dianisidine (a hemoglobin-specific dye) and stained embryos were imaged using brightfield microscopy. Exposure to 2-hydroxychrysene resulted in a concentration-dependent decrease in hemoglobin relative to vehicle-exposed embryos, while only the highest concentration of 6-hydroxychrysene resulted in a significant decrease in hemoglobin. All tested concentrations of 2-hydroxychrysene also caused significant mortality (12.2 % ± 2.94, 38.9 % ± 14.4, 85.6 % ± 11.3), whereas mortality was not observed following exposure to 6-hydroxychrysene. Therefore, treatment of embryos with 2-hydroxychrysene at various developmental stages and durations was subsequently conducted to identify key developmental landmarks that may be targeted by 2-hydroxychrysene. A sensitive window of developmental toxicity to 2-hydroxychrysene was found between 52-100 hpf, with a 24 h exposure to 10 μM 2-hydroxychrysene resulting in significant anemia and mortality. Since exposure to 2-hydroxychrysene from 52 to 100 hpf, a window that includes liver morphogenesis in medaka, resulted in the highest magnitude of toxicity, liver development and function may have a role in 2-hydroxychrysene developmental toxicity.

Recent developments in sustainably sourced protein-based biomaterials

Research into the development of sustainable biomaterials is increasing in both interest and global importance due to the increasing demand for materials with decreased environmental impact. This research field utilises natural, renewable resources to develop innovative biomaterials. The development of sustainable biomaterials encompasses the entire material life cycle, from desirable traits, and environmental impact from production through to recycling or disposal. The main objective of this review is to provide a comprehensive definition of sustainable biomaterials and to give an overview of the use of natural proteins in biomaterial development. Proteins such as collagen, gelatin, keratin, and silk, are biocompatible, biodegradable, and may form materials with varying properties. Proteins, therefore, provide an intriguing source of biomaterials for numerous applications, including additive manufacturing, nanotechnology, and tissue engineering. We give an insight into current research and future directions in each of these areas, to expand knowledge on the capabilities of sustainably sourced proteins as advanced biomaterials.

Can perihaematomal radiomics features predict haematoma expansion?

AIM

To evaluate the association between perihaematomal radiomics features and haematoma expansion (HE).

MATERIALS AND METHODS

Clinical and radiological data were collected retrospectively. The 1:1 propensity score matching (PSM) method was used to balance the difference of baseline characteristics between patients with and without HE. Radiomics features were extracted from the intra- and perihaematomal regions. Top HE-associated features were selected using the minimum redundancy, maximum relevancy algorithm. Support vector machine models were used to predict HE. Predictive performance of radiomics features from different regions was evaluated by receiver operating characteristic curve and confusion matrix-derived metrics.

RESULTS

A total of 1,062 patients were enrolled. After PSM analysis, the propensity score-matched cohort (PSM cohort) included 314 patients (HE: n=157; non-HE: n=157). The PSM cohort was distributed into the training (n=218) and the validation cohorts (n=96). The predictive performance of intra- and perihaematomal features were comparable in the training (area under the receiver operating characteristic curve [AUC], 0.751 versus 0.757; p=0.867) and the validation cohorts (AUC, 0.724 versus 0.671; p=0.454). By incorporating intra- and perihaematomal features, the combined model outperformed the single intrahaematomal model in the training cohort (AUC, 0.872 versus 0.751; p<0.001). Decision curve analysis (DCA) further confirmed the clinical usefulness of the combined model.

CONCLUSION

Perihaematomal radiomics features can predict HE. The integration of intra- and perihaematomal signatures may provide additional benefit to the prediction of HE.

[Auxiliary pathological diagnosis algorithm based on color moments for frozen-section of thyroid cancer]

Objective: To develop a color-moment based model for frozen-section diagnosis of thyroid lesions, and to evaluate the model's value in the frozen-section diagnosis of thyroid cancer. Methods: In this study, 550 frozen thyroid pathological slides, including malignant and non-malignant cases, were collected from Taizhou Central Hospital (Taizhou University Hospital), China, between June 2018 and January 2020. The 550 digitalized frozen-section slides of thyroid were divided into training set (190 slides), validation set (48 slides), test set A (60 slides) and test set B (252 slides). The tumor regions on the slides of malignant cases in the training and validation sets were labeled by pathologists. The labeling information was then used to train the thyroid frozen-section diagnosis models based on the voting method and those based on the color moment. Finally, the performance of two pathological slide diagnosis models was evaluated using the test set A and test set B, respectively. Result: The classification accuracy of the thyroid frozen-section diagnosis model based on the voting method was 90.0% and 83.7%, using test sets A and B, respectively, while that based on color moments was 91.6% and 90.9%, respectively. For actual frozen-section diagnosis of thyroid cancer, the model developed in this study had higher accuracy and stability. Conclusion: This study proposes a color-moment based frozen-section diagnosis model, which is more accurate than other classification models for frozen-section diagnoses of thyroid cancer.