A two-step procedure for coupling development and usage of a pair of human neck models

Both finite element models and multi-body models of human head-neck complex had been widely used in neck injuries analysis, as the former could be used to generate detailed stress strain information and the later could generate dynamic responses with high efficiency. Sometimes, detailed stress and strain information were hoped to be obtained more efficiently, but current methods were not effective enough when they were used to analyze responses of human head neck complex to long duration undulate accelerations. In this paper, a two-step procedure for 'parallel' development and 'sequential' usage of a pair of human head neck models was discussed. The pair of models contained a finite element model and a multi-body model, which were developed based on the coupling 'parallel' procedure using the same bio-realistic geometry. After being validated using available data, the pair of human neck models were applied to analyze biomechanical responses of pilot's neck during arrested landing operation according to the 'sequential' procedure, because typical sustained undulate accelerations usually appeared during such processes. The results, including both kinematic and detailed biomechanical responses of human head-neck complex, were obtained with preferable efficiency. This research provided an effective way for biomechanical analysis of human head neck responses to sustained undulate accelerations.

[Primary research of early oral feeding after total laryngectomy]

Objective: To explore whether early oral feeding after total laryngectomy is safe and effective by evaluating the incidence of pharyngocutaneous fistula (PCF) and the hospital duration. Methods: A retrospective cohort study was conducted, including 52 patients underwent total laryngectomy, plus partial tongue base resection (n=2), partial pharyngectomy (n=1), or pedicle flap (n=2) between January 2012 and October 2017. Patients who had a history of preoperative radiotherapy, chemotherapy or chemoradiotherapy, previous surgery for larynx or pharynx and who had severe complications were excluded. Early oral feeding started between 48 h and 72 h postoperatively, while delayed oral feeding started within postoperative day 8-10. The incidences of PCF in two groups were compared to evaluate whether PCF and early oral feeding was related. Multi-variables analysis was conducted to evaluate risk factors for PCF. Results: PCF rate was 19.2% among all patients, 11.1% in patients with early oral feeding and 23.5% in patients with delayed oral feeding. No significant statistically difference in PCF rate was found between two groups (χ(2)=0.506, P=0.477). Multi-variables analysis showed that oral feeding time (early or delayed) was not a independent risk factor of PCF (Two classification response variable Logistic regression, P=0.200, OR=0.242, 95%CI[0.028-2.118]). But low preoperative albumin level was observed as an independent risk factor for PCF (P=0.039, OR=0.848, 95% CI [0.726-0.992]). A negative correlation was observed between preoperative albumin level and PCF. And also there was not a significant difference in hospital duration between patients with early oral feeding and delayed oral feeding(U=268, P=0.464). Conclusion: For patients total laryngectomy with no previous history of radiotherapy, chemotherapy, chemoradiotherapy, early oral feeding after surgery is safe and effective.

Global land-water nexus: Agricultural land and freshwater use embodied in worldwide supply chains

As agricultural land and freshwater inextricably interrelate and interact with each other, the conventional water and land policy in "silos" should give way to nexus thinking when formulating the land and water management strategies. This study constructs a systems multi-regional input-output (MRIO) model to expound global land-water nexus by simultaneously tracking agricultural land and freshwater use flows along the global supply chains. Furthermore, land productivity and irrigation water requirements of 160 crops in different regions are investigated to reflect the land-water linkage. Results show that developed economies (e.g., USA and Japan) and major large developing economies (e.g., mainland China and India) are the overriding drivers of agricultural land and freshwater use globally. In general, significant net transfers of these two resources are identified from resource-rich and less-developed economies to resource-poor and more-developed economies. For some crops, blue water productivity is inversely related to land productivity, indicating that irrigation water consumption is sometimes at odds with land use. The results could stimulus international cooperation for sustainable land and freshwater management targeting on original suppliers and final consumers along the global supply chains. Moreover, crop-specific land-water linkage could provide insights for trade-off decisions on minimizing the environmental impacts on local land and water resources.

Corneal confocal microscopy as a non-invasive test to assess diabetic peripheral neuropathy

OBJECTIVE

To evaluate the efficacy of corneal confocal microscopy (CCM) as a non-invasive test to assess diabetic peripheral neuropathy in Chinese patients diagnosed with type 2 diabetes.

RESEARCH DESIGN AND METHODS

Diabetic distal symmetric polyneuropathy (DSPN) and its severity degrees were assessed based on the modified Toronto diagnostic criteria in 128 patients with type 2 diabetes (No DSPN [n = 49], mild DSPN [n = 43], moderate-to-severe DSPN [n = 36]) and 24 age-matched controls. CCM was also examined in all enrolled subjects. Corneal nerve fiber length (CNFL), corneal nerve branch density (CNBD) and corneal nerve fiber density (CNFD) were analyzed by Fiji imaging analysis software. The efficacy of CCM as a non-invasive test to assess diabetic peripheral neuropathy was determined.

RESULTS

CNFL was 17.99 ± 0.66, 15.82 ± 0.64, 14.98 ± 0.63, and 12.49 ± 0.93 in healthy controls, T2DM patients with no, mild, and moderate-to-severe DPN, respectively. CNFL in type 2 diabetes patients with no, mild, and moderate-to-severe DSPN demonstrated a significant reduction than in healthy controls (P = .012, .003 and <.001, respectively). CNFL in patients with moderate-to-severe DSPN was significantly shorter than in patients with no or mild DSPN (P < .001 and .004, respectively). CNBD was 41.48 ± 3.35, 33.02 ± 2.50, 30.91 ± 2.33, and 18.00 ± 2.33 in healthy controls, T2DM patients with no, mild, and moderate-to-severe DPN, respectively. CNBD in healthy control was significantly higher than in type 2 diabetes patients with no, mild, and moderate-to-severe DSPN (P = .036, 0.016 and < .001, respectively). CNBD in patients with moderate-to-severe DSPN was significantly lower than in patients with no or mild DSPN (P < .001 for both). CNFD was 35.32 ± 1.18, 35.68 ± 1.10, 34.54 ± 1.12, and 32.28 ± 1.76 in healthy controls, T2DM patients with no, mild, and moderate-to-severe DPN, respectively. CNFD did not differ among the four groups. In an analysis that divided CNFL, CNFD and CNBD into quartiles, there were no significant differences in electromyography findings and vibration perception threshold among the 4 groups; however, significant differences were seen in the positive distribution of temperature perception measurements following CNFL and CNBD stratification (P = .001 and < .001, respectively).

CONCLUSION

CCM might be a non-invasive method for detecting DSPN and its severity degree in Chinese patients diagnosed with type 2 diabetes.

[Efficacy and safety of endonasal phototherapy in the treatment of adult allergic rhinitis: A Meta-analysis]

Objective:To perform a systematic review of the efficacy and safety of endonasal phototherapy in the treatment of AR, and to provide evidence of evidence-based medicine for clinical application. Method:Databases were from PubMed, Embase, Cochrane Library, Chinese Academic Journal Full-text Database (CNKI) and Wanfang database. A randomized controlled trial (RCT) or clinical study literature on intranasal phototherapy for adult AR is available, and the deadline is March 2017. Based on the literature inclusion and exclusion criteria, the related literatures were selected and the quality was evaluated by using the Cochrane inclusion bias assessment table. Meta-analysis was performed with Revman 5.3 software. For continuous outcomes, the weighted mean difference (WMD) and its 95% confidence intervals (CI) were calculated, forest maps and funnel plots were drew. For uncontinuous outcomes, the odds ratio (OR) and its 95%CI were calculated, and forest maps and funnel plots were drew. The efficacy included total nasal symptom scores (TNSS), rhinoconjunctivitis quality of life questionnaire (RQLQ) and palate itching scores, and the safety was assessed by incidence rate of severe drying and mild drying of nasal mucosa. Result:A total of 12 articles were selected, including 5 RCT and 7 clinical studies, and there were 615 adult AR patients. The Meta-analysis shows that endonasal phototherapy significantly reduced the TNSS, RQLQ and palate itching scores, the incidence rate of mild drying of nasal mucosa was higher in comparison with pretreated values, and the difference was statistically significant (P<0.05). The rate of severe drying of nasal mucosa was higher, but the difference was not statistically significant (P>0.05). It also shows that endonasal phototherapy significantly reduced the TNSS, RQLQ and palate itching scores, and the rate of mild drying of nasal mucosa was higher in comparison with placebo and antihistamines groups, and the difference was statistically significant. The rate of severe drying of nasal mucosa was higher, but the difference was not statistically significant. Conclusion:Endonasal phototherapy can improve the symptoms of TNSS, RQLQ and palate itching score in patients, and the safety is also confirmed.Patients who are not satisfied with symptom relief may choose to use it.

Fungal Denitrification Activity in Vertical Flow Constructed Wetlands as Impacted by Plant Species Richness, Carbon, Nitrogen and pH Amendments

To control potential fungal denitrification rate (PFDR) in vertical flow simulated wetlands (VFSW) microcosms, thirty VFSW microcosms were established and planted with three plant species richness levels (i.e. unplanted, monoculture, and four-species polyculture treatment), and effects of carbon, nitrogen and pH amendments on the PFDR were investigated using a room-incubating method. Among seven carbon compounds, sodium citrate, glycerol, glucose and sodium succinate were more effective in enhancing PFDRs. These enhanced effects were dependant on a given species richness level. Sodium nitrite mostly stimulated PFDRs to a greater extent than the other three nitrogen compound amendments at any richness level. Treatments with pH 5.6 or 8.4 had significantly greater PFDRs than the treatment with pH 2.8 in the three species richness levels. However, no effect of plant species richness on the PFDR was observed among any carbon, nitrogen and pH amendments. Current results suggest carbon, nitrogen and pH factors should be considered when mediating fungal denitrification in VFSW microcosms.

Inclusion levels and modes of whole grain incorporation into wheat-based rations differentially influence the performance of broiler chickens

1. The objective was to compare three whole grain (WG) inclusion levels (7.5, 15 and 30%) offered to broiler chickens by three modes of WG incorporation: (i) pre-pellet WG inclusion, (ii) post-pellet WG inclusion as a blend of WG and pelleted concentrate and (iii) post-pellet WG inclusion where WG and pelleted concentrate were provided in separate feed trays against a ground-grain, wheat-based control diet. 2. Ten dietary treatments were offered to 6 replicate cages (6 birds per cage) of male Ross 308 chickens from 7 to 28 d post-hatch. The effects of treatment on relative gizzard weights, gizzard contents, pancreatic weights and pH of gizzard digesta were monitored. Parameters of growth performance, nutrient utilisation (apparent metabolisable energy [AME], metabolisable to gross energy [ME:GE] ratios, nitrogen [N] retention and N-corrected AME [AMEn]), apparent starch and protein (N) digestibility coefficients and disappearance rates in for small intestinal segments and concentrations of free amino acids in plasma taken from the anterior mesenteric vein were determined. 3. Whole grain feeding (WGF) did not influence weight gain, but 30% post-pellet blended and 15 and 30% post-pellet separated treatments significantly depressed (P < 0.05) feed intakes while the 30% post-pellet separated treatment improved (P < 0.01) feed conversion ratios (FCR). WGF regimes significantly increased relative gizzard weights. 4. Overall, WGF generated profound responses in AME, ME:GE ratios, N retention and AMEn that were highly correlated with relative gizzard weights. In general, WGF improved starch and protein (N) digestibilities and again there were some correlations with these outcomes and relative gizzard weights. 5. Post-pellet WG inclusions where WG and pelleted concentrate were offered separately provided chickens with the opportunity to choice feed. Birds showed a preference for the relatively high-protein pelleted concentrate and at 30% WG, this resulted in an improvement in FCR of 7.69% (1.260 versus 1.365; P < 0.001) relative to the ground-grain control diet.

Ankyloglossia as a risk factor for maxillary hypoplasia and soft palate elongation: A functional - morphological study

OBJECTIVES

To characterize associations between restricted tongue mobility and maxillofacial development.

SETTING AND SAMPLE POPULATION

Cross-sectional cohort study of 302 consecutive subjects from an orthodontic practice.

MATERIAL AND METHODS

Tongue mobility (measured with tongue range of motion ratio [TRMR] and Kotlow free tongue measurement) was correlated with measurements of the maxillofacial skeleton obtained from dental casts and cephalometric radiographs.

RESULTS

Tongue range of motion ratio and Kotlow measures of restricted tongue mobility were associated with (i) ratio of maxillary intercanine width to canine arch length, (ii) ratio of maxillary intermolar width to canine arch length and (iii) soft palate length. Restricted tongue mobility was not associated with hyoid bone position or Angle's skeletal classification.

CONCLUSIONS

Restricted tongue mobility was associated with narrowing of the maxillary arch and elongation of the soft palate in this study. These findings suggest that variations in tongue mobility may affect maxillofacial development.

Bioinformatic analysis of pivotal genes associated with septic shock

We aimed to identify important genes associated with septic shock and then explore the possibly significant mechanisms of this disease. We downloaded GSE26440 expression data of samples from 98 children with septic shock and 32 normal controls from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) in samples from patients with septic shock were analyzed in comparison with those in samples from normal controls using a limma package. Functional enrichment analysis for DEGs was performed using DAVID, and a protein–protein interaction (PPI) network was constructed. Upstream transcription factors for DEGs were predicted using the CHIPBase database, and a transcriptional regulation network was constructed. A total of 383 significantly DEGs, including 141 downregulated and 242 upregulated genes, were obtained in the sepsis shock group compared with the normal group. The top five nodes in the PPI network were lysine (K)-specific demethylase 6B (KDM6B), histone deacetylase 2 (HDAC2), V-Myc avian myelocytomatosis viral oncogene homolog (MYC), heat-shock protein 90 kDa alpha (cytosolic), class B member 1 (HSP90AB1), and poly (A)-binding protein, cytoplasmic 1 (PABPC1). Nuclear factor kappa-light-chain-enhancer of activated B cells (NFkB) was the transcription factor targeted by most genes, and it regulated the expression of KDM6B, HDAC2, MYC, HSP90AB1, and PABPC1. In conclusion, KDM6B, HDAC2, MYC, HSP90AB1, and PABPC1 may play important roles in the development of septic shock. Furthermore, NFκB may be involved in septic shock by regulating the expression of KDM6B, HDAC2, MYC, HSP90AB1, and PABPC1.

[Clinical analysis of secondary cervical lymph node dissection in papillary thyroid carcinoma]

Objective: To investigate the value of secondary cervical lymph node dissection in papillary thyroid carcinoma (PTC). Methods: PTC patients with recurrence re-operated in a previously dissected area at our hospital during 2000-2016 were included in this analysis. Patients were divided according to the operative interval of 6 months. The level and number of lymph node metastasis and the number of lymph node dissection were analyzed to calculate the ratio of lymph node metastasis. Results: A total of 336 PTC patients received 360 side lateral cervical lymph nodes dissection. The ratio of recurrence in unilateral lateral neck is 92.9%(312/336). The ratio of recurrence in multiple levels (more than two regions) were 47.5% (171/360). The recurrence ratio of level Ⅱ, Ⅲ, Ⅳ and Ⅴ were 55.6%(200/360), 44.2%(159/360), 59.7%(215/360) and 10.3%(37/360), respectively. Lymph node metastases were inclined to level Ⅱ (33.6%) and Ⅳ (35.8%). The mean number of lymph node dissection and metastasis in the group of operative interval ≤ 6 months was 26.56 per case and 4.37 per case, respectively. The mean number of lymph node dissection and metastasis in the group of operative interval >6 months was 16.80 per case and 3.20 per case, respectively. The number of lymph node dissection and metastasis between these two groups were significantly different (P=0.001, P<0.001). Conclusions: Lymph node metastasis of PTC patients with secondary cervical lymph node dissection are inclined to level Ⅱ and level Ⅳ. Moreover, multi-level metastasis is not rare. Level Ⅱ and level Ⅳ require more attention in the first operation. Most of the patients undergo reoperation because of residual lymph nodes from the previous treatment. Normalization and completeness of the initial dissection are particularly important to PTC patients.

MeCP2, a target of miR-638, facilitates gastric cancer cell proliferation through activation of the MEK1/2-ERK1/2 signaling pathway by upregulating GIT1

Methyl-CpG binding protein 2 (MeCP2) is involved in the carcinogenesis and progression of multiple types of cancer. However, its precise role in gastric cancer (GC) and the relevant molecular mechanism remain unknown. In the present study, we found that miR-638 levels were lower in GC tissues and GC cell lines than in adjacent normal tissues and normal gastric epithelial cell lines, respectively. Low miR-638 levels were associated with poor tumor differentiation, tumor size and lymph node metastasis. MeCP2 expression levels were higher in GC tissues than in adjacent normal tissues. It was found that miR-638 inhibited GC cell proliferation, colony formation, G1–S transition and tumor growth, and induced cell apoptosis by directly targeting MeCP2. MeCP2 promoted GC cell proliferation, colony formation and G1–S cell-cycle transition, and suppressed apoptosis. Molecular mechanistic investigations were performed using an integrated approach with a combination of microarray analysis, chromatin immunoprecipitation sequencing and a reporter gene assay. The results showed that MeCP2 bound to the methylated CpG islands of G-protein-coupled receptor kinase-interacting protein 1 (GIT1) promoter and upregulated its expression, thereby activating the MEK1/2–ERK1/2 signaling pathway and promoting GC cell proliferation. Taken together, our study demonstrates that MeCP2, a target of miR-638, facilitates GC cell proliferation and induces cell-cycle progression through activation of the MEK1/2–ERK1/2 signaling pathway by upregulating GIT1. The findings suggest that MeCP2 plays a significant role in GC progression, and may serve as a potential target for GC therapy.

[Effect of a nano hydroxyapatite desensitizing paste application on dentin bond strength of three self-etch adhesive systems]

Objective: To evaluate a nano-hydroxyapatite (nano-HA) desensitizing paste application on the bond strength of three self-etch adhesives. Methods: Three dentin specimens of about 1 mm thick were cut from two teeth. Scanning electron microscope (SEM) was used to evaluate the dentin surfaces without treatment, after citric acid treatment and after nano-HA treatment. Thirty-six intact third molars extracted for surgical reasons were cut to remove the occlusal enamel with isomet, and then were etched with 1% citric acid for 20 s to simulate the sensitive dentin and divided into two groups randomly using a table of random numbers (n=18): the control group (no treatment) and the HA treated group (with nano-HA paste treatment). Each group was divided into three subgroups randomly using a table of random numbers (n=6). Subgroup A, B and C was bonded with G-Bond, Clearfil S(3) Bond and FL-Bond Ⅱ according to the manufacture's instruction separately. At 24 h after bonding procedure, and after water storage for 6 months, microtensile bond strength of the specimens was tested and the failure mode was analyzed. Results: SEM obeservation showed that citric acid could open the dentin tubules to set up the sensitive dentin model, and the nano-HA could occlude the dentin tubules effectively. For subgroup A, bonding strength of specimens treated with nano-HA ([41.14±8.91] MPa) was significantly high than that of the control group ([34.27±6.16] MPa) at 24 h after bonding procedure (P<0.05). However, after 6 month water ageing, the bonding strength of the control group and the HA treated group showed no significant difference (P>0.05). For subgroup B, specimens with nano-HA application showed lower bonding strength ([30.87±6.41] MPa) than that of the control group ([36.73±5.82] MPa) at 24 h after bonding procedure (P<0.05), and after 6 month water ageing, the bond strength of nano-HA application ([25.73±6.99] MPa) was also lower than that of the control group ([32.33±5.08] MPa) (P<0.05). For subgroup C, the bond strength of the control group and the HA treated group have no significant difference either before or after 6 month water ageing (P>0.05). Failure mode analysis showed that more than half of the samples in all groups were adhesive failure. Conclusions: Nano-HA treatment decreased the bond strength of subgroup B, while had no adverse effect on subgroup A and subgroup C.

[Association of serum albumin level and clinical outcomes among heart failure patients receiving cardiac resynchronization therapy]

Objective: To assess the relationship between serum albumin level and clinical outcome in heart failure (HF) patients receiving cardiac resynchronization therapy (CRT). Methods: In this retrospective cohort study, 357 consecutive chronic heart failure patients receiving CRT between January 2010 and December 2015 were enrolled and divided into two groups based on pre-CRT serum albumin (albumin≥40 g/L, n=244; albumin<40 g/L, n=113). Clinical outcomes were defined as all-cause mortality (including heart transplantation) and rehospitalization due to worsening HF.Baseline characteristics were compared and all-cause mortality (including heart transplantation) and rehospitalization due to worsening heart failure (HF) were analyzed using Kaplan-Meier curves.Prognostic value of albumin level was evaluated in Cox proportional-hazards regression models. Results: Over a median follow-up time of 21 months, 45 patients (12.6%) died, 4 patients (1.1%) underwent heart transplantation and 100 patients (28.0%) were rehospitalized due to worsening HF. HF patients with pre-CRT albumin<40 g/L were related with worse NYHA function class, lower HDL-C level and ACEI/ARB use compared to HF patients with pre-CRT albumin≥40 g/L. Kaplan-Meier analyses evidenced lower survival rate in HF patients (log-rank test: P=0.000 4, χ(2)=12.60) and higher rehospitalization rate due to worsening HF (log-rank test: P=0.009, χ(2)=6.82) in HF patients with pre-CRT albumin<40 g/L.Multivariate Cox analyses indicated that serum pre-CRT albumin <40 g/L was an independent risk factor for all-cause mortality (HR=2.019, 95%CI 1.125-3.622, P=0.018) and HF rehospitalization (HR=1.517, 95%CI 1.014-2.270, P=0.043). Conclusion: Pre-CRT serum albumin level is associated with the severity of heart failure in CRT recipients.Patients with lower pre-CRT albumin level face increased risk of all-cause mortality and HF rehospitalization in chronic heart failure patients receiving cardiac resynchronization.

Impact of continuous positive airway pressure in patients with obstructive sleep apnea during drug-induced sleep endoscopy

OBJECTIVES

The primary objective of the study was to understand the differential impact of continuous positive airway pressure (CPAP) on the location, degree and pattern of airway collapse in obstructive sleep apnea (OSA) patients utilizing drug-induced sleep endoscopy (DISE).

STUDY DESIGN

Non-randomized trial.

SETTING

University Medical Center.

PARTICIPANTS

Fifteen consecutive OSA patients undergoing DISE.

MAIN OUTCOMES AND MEASURES

The patterns of airway collapse were videorecorded at baseline and under differential application of nasal CPAP (nCPAP) at 5, 10 and 15 cm H₂ O. For each modality, the pattern and degree of airway collapse were analyzed by three independent observers using the velum, oropharynx, tongue base, epiglottis (VOTE) classification system.

RESULTS

The modest nCPAP pressures (10 cm H₂ O) had the greatest impact on the lateral walls of the pharynx, followed by the palatal region. The collapsibility of the tongue base and epiglottis demonstrated significant resistance to nCPAP application, which was overcome by increasing nCPAP to 15 cm H₂ O. Compared to 5 cm H₂ O, nCPAP pressures of 10 and 15 cm H₂ O improved complete collapse at least at one level of the upper airway (P=.016 and .001, respectively). Increased nCPAP pressures also led to changes in the configuration of airway collapse at the level of the velum.

CONCLUSIONS

The differential nCPAP effects observed in this study may help to understand some of the mechanisms responsible for inadequate patient response and poor nCPAP compliance. The use of DISE in combination with CPAP may serve as a first step in optimizing patients that failed to adapt to treatment with CPAP. This approach can help the physician identify patterns of airway collapse that may require varying pressures different from the one the patient is using, as well as anatomical factors that may be corrected to help with compliance.

The impacts of hammer-mill screen size and grain particle size on the performance of broiler chickens offered diets based on two red sorghum varieties

1. The two red grain sorghums were extensively characterised. Kafirin, polyphenolic compounds, free, conjugated and bound phenolic acids, phytate concentrations and starch pasting profiles were determined. 2. The experiment consisted of a 2 × 4 factorial array of dietary treatments comprising two red sorghum varieties (Tiger and Block I) ground through 4 hammer-mill screen sizes (2.0, 3.2, 4.8 6.0 mm) prior to incorporation into nutritionally equivalent diets. Eight steam-pelleted dietary treatments were each offered to 7 replicates (6 male Ross 308 birds per cage) from 7 to 28 d post-hatch. 3. Effects of dietary treatments on growth performance, relative gizzard and pancreas weights, nutrient utilisation, apparent starch and protein (N) digestibility coefficients and disappearance rates from 4 small intestinal segments were determined. 4. The 2.0-mm hammer-mill screen generated an average geometric mean particle size of 794 μm and the 6.0-mm screen a mean particle size of 1405 μm. However, hammer-mill screen size did not influence weight gain or FCR. The 6.0-mm screen size generated significantly higher starch and protein (N) digestibility coefficients in the distal jejunum and distal ileum than the 2.0-mm hammer-mill screen. 5. Tiger sorghum was superior to Block I sorghum, as significant advantages were observed for feed conversion ratios (3.25%), AME (0.37 MJ), ME:GE ratios (4.15%), AMEn (0.53 MJ), distal ileal starch digestibility coefficients (2.46%) and protein (N) digestibility coefficients in the distal jejunum (4.66%), proximal ileum (1.96%) and distal ileum (2.16%). The inferior Block I sorghum contained more kafirin (67.1 versus 51.3 g/kg), phytate (9.79 versus 8.40 g/kg), total phenolic compounds (4.68 versus 4.12 mg GAE/g), flavan-4-ols (7.98 versus 5.04 ABS/ml/g), total phenolic acids (554 versus 402 μg/g) and total ferulic acid (375 versus 281 μg/g) in comparison to Tiger sorghum.

[Gastric pull-up reconstruction after pharyngoesphagectomy for advanced hypopharyngeal or cervical esophageal squamous cell carcinoma]

Objective: To analyze the clinical results of gastric pull-up reconstruction following total pharyngoesophagectomy. Methods: A total of 90 patients with hypopharyngeal or cervical esophageal cancinoma who underwent gatric pull-up reconstruction after pharyngoesophagectomy between June 2006 and June 2015 were reviewed retrospectively. Clinical data were analyzed. Rates of survival, recurrence and complicates were calculated with SPSS software. Results: Of 90 patients, 8 patients had hypopharyngeal cancinoma invading cervical esophagus, 51 patients had cervical esophageal carcinoma, and 31 patients had hypophageal and esophageal multiple parimary carcinomas. Forty patients were treated with surgery alone, 29 patients with planned surgery, and 21 patients with salvage surgery. After follow up of 6-104 months with a median of 22 months, 54 patients died and the total 3-year survival rate was 36.3%. Seventeen patients developed local recurrences and 10 patients cervical or mediastinal lymph node metastasis (LNM). The 3-year survival rates of patients with and without recurrence or LNM were respectively 5.9%, and 45.7% (χ²=11.564, P=0.001). Twenty-three patients developed distant metastasis. The 3-year survival rate of patients with and without distant metastasis were respectively 22.9% and 41.8% (χ²=4.534, P=0.033). Multivariate analysis showed local recurrence and distant metastasis as predictors for poor survival. The rates of perioperative mortality and anastomotic fistula were 3.3% (3/90) and 13.3%(12/90), respectively. Conclusions: Gastric pull-up reconstruction is a relatively safe and effective method for esophageal reconstruction after removal of hypopharyngeal or cervical esophageal carcinoma. Some patients could achieve good survival with low mortality and acceptable morbidity after multidisciplinary treatments.

Detection of Jaagsiekte sheep retrovirus in the peripheral blood during the pre-clinical period of ovine pulmonary adenomatosis

The envelope protein (Env) of the Jaagsiekte sheep retrovirus (JSRV) is known to be a unique oncoprotein responsible for inducing ovine pulmonary adenocarcinoma (OPA). The objective of this study was to prepare a specific monoclonal antibody (mAb) against the JSRV Env protein using bioinformatic analysis. According to the structure and epitope prediction results of JSRV Env, the JSRV-Env_572-615 antigen was prepared via peptide synthesis (amino acid sequence 572-615, denoted as JSRV-Env_572-615). BALB/c mice were immunized to prepare the anti-JSRV-Env_572-615 mAb. Spleen cells were fused with SP2/0 myeloma cells after being screened by indirect ELISA and cloned by limiting dilution. The specificity of mAb was evaluated by western blot analysis and immunohistochemistry assays. Western blot results showed that the JSRV Env protein was able to bind to mAb with high specificity. Immunohistochemistry assays demonstrated that the mAb was able to recognize JSRV Env in adenomatous hyperplasia of the lung. Furthermore, JSRV was detected in peripheral blood leukocytes during the pre-clinical period of OPA in 2 of the 25 sheep using this newly synthesized mAb. Therefore, this mAb may be a useful tool for the detection of JSRV in sheep.

Radiofrequency ablation compared with laparoscopic adrenalectomy for aldosterone-producing adenoma

BACKGROUND

Radiofrequency ablation (RFA) is an emerging treatment for primary aldosteronism owing to aldosterone-producing adenoma. Whether RFA could be an alternative treatment to laparoscopic adrenalectomy is unknown.

METHODS

This was a retrospective comparative study in patients with aldosterone-producing adenoma undergoing either laparoscopic adrenalectomy or CT-guided percutaneous RFA between 2004 and 2012. Short-term outcomes and long-term resolution rates of primary aldosteronism (normalized aldosterone to renin ratio), hypokalaemia and hypertension (BP lower than 140/90 mmHg without antihypertensive medical therapy) were evaluated.

RESULTS

Some 63 patients were included, 27 in the laparoscopic adrenalectomy group and 36 in the RFA group. RFA was associated with shorter duration of operation (median 12 versus 124 min; P < 0·001), shorter hospital stay (2 versus 4 days; P < 0·001), lower analgesic requirements (13 of 36 versus 23 of 27 patients; P < 0·001) and earlier resumption of work (median 4 versus 14 days; P = 0·006). Morbidity rates were similar in the two groups. With median follow-up of 5·7 (range 1·9-10·6) years, resolution of primary aldosteronism was seen in 33 of 36 patients treated with RFA and all 27 patients who had laparoscopic adrenalectomy (P = 0·180). Hypertension was resolved less frequently after treatment with RFA compared with laparoscopic adrenalectomy (13 of 36 versus 19 of 27 patients; P = 0·007). Hypokalaemia was resolved in all patients.

CONCLUSION

For patients with aldosterone-producing adenoma the efficacy of resolution of primary aldosteronism and hypertension was inferior after treatment with RFA compared with laparoscopic adrenalectomy.

[Therapeutic evaluation of the correction of the severe bi-maxillary protrusion cases by Tweed-Merrifield technique]

OBJECTIVE

To evaluate the influence of Tweed-Merrifield technique in correction of severe bimaxillary protrusion adult patients on the measurement of the dental and skeletal changes after orthodontic treatment by Johnston analysis and the regular cephalomatric analysis.

METHODS

Twelve adolescent patients with severe bimaxillary protrusion were included in this self-control retrospective study. Lateral cephalometric radiographs were taken before and after treatments. All the radiographs were traced and analyzed by the method of Johnston analysis. Other measurements were evaluated using a series of 13 linear and angular measurements including SNA, SNB, ANB, U1-SN, U1-NA, U1/NA, L1-NB, U1/NB, L1/MP, U1-L1, (U1+L1)/2-AB, MP/SN and MP/FH from regular cephalomatric analysis. These measurements were also applied to compare the differences between pre- and post-treatments, which clarify the dental and skeletal changes by Johnston analysis. The effect of orthodontic correction was determined using the non-parameters test.

RESULTS

The maxillary moved backforward by 1.3 mm according to the stable skull base, while the mandible moved forward by 2.12 mm. The relative position between the maxillary and mandible (ABCH) changed 3.42 mm. The upper and lower incisors retracted significantly. The upper and lower molars moved slightly forward and the relative positions of upper and lower molars and anterior teeth after treatment were 3.44 mm and 4.23 mm respectively. After treatment, the parameters of ANB, U1-NA, U1/NA, U1-SN, L1-NB, L1/NB and L1-M were reduced by -(1.98±1.55)°(P=0.012), - (5.08±4.6) mm (P=0.002), -(11.79±1.21)°(P=0.004), -(13.55±6.32)°(P=0.047), -(3.17±3.07) mm (P=0.010), -(6.84±2.55)°(P=0.038) and -(4.13±2.24)°(P=0.048) on average, whose changes had the statistically significant effects.

CONCLUSION

Tweed-Merrifield technique (directional force technique) can stabilize anchorage molar, retract anterior teeth and significantly improve the hard and soft tissue profile for patients with bimaxillary protrusion, and make a good vertical control which means this technique is applicable to the patients who need strong anchorage. Even for the severe bimaxillary protrusion adult patients, the Tweed-Merrifield technique can control the anchoragewell and make the profiles improved greatly.

Microarray analysis of microRNA deregulation and angiogenesis-related proteins in endometriosis

We examined the aberrant microRNA (miRNA) expression profile responsible for the changes in angiogenesis observed in endometriotic lesions. This study revealed characteristic miRNA expression profiles associated with endometriosis in endometrial tissue and endometriotic lesions from the same patient, and their correlation with the most important angiogenic and fibrinolytic factors. miRNA expression was quantified using a microRNA array and reverse-transcription microRNA polymerase chain reaction. Levels of vascular endothelial growth factor A (VEGFA), epidermal growth factor receptor 2 (EGFR2), phosphatase and tensin homolog (PTEN), and C-X-C chemokine receptor type 4 (CXCR4) were quantified using enzyme-linked immunosorbent assay. The endometrial tissue showed significantly lower levels of miR-200b, miR-15a-5p, miR-19b-1-5p, miR-146a-5p, and miR-200c, and higher levels of miR-16-5p, miR-106b-5p, and miR-145-5p. VEGFA was significantly upregulated, whereas EGFR2, PTEN, and CXCR4 were markedly downregulated, in the endometriotic tissues compared to that in the normal endometrial tissues. In conclusion, differences in the miRNA levels could modulate the expression of VEGFA, EGFR2, PTEN, and CXCR4, and may play an important role in the pathogenesis of endometriosis. The higher angiogenic and proteolytic activities observed in the eutopic endometrium might facilitate the implantation of endometrial cells at ectopic sites.

[Multi-disciplinary treatment increases the survival rate of late stage pharyngeal, laryngeal or cervical esophageal cancers treated by free jejunal flap reconstruction after cancer resection]

OBJECTIVE

To investigate the survival status of patients with pharyngeal, laryngeal or cervical esophageal cancers, who received free jejunal flap (FJF) to repair the defects following tumor resection, and to analyze the effect of multi-disciplinary treatment on their survival.

METHODS

Fifty-eight patients with pharyngeal, laryngeal or cervical esophageal cancer underwent free jejunal flap (FJF) reconstruction after cancer resection between 2010 and 2013. All their clinical records were reviewed and analyzed.

RESULTS

The success rate of flap transplantation was 91.4% (53/58). The 2-year overall survival rates (OSR) of cervical esophageal cancer and hypopharyngeal cancer patients were 67.5% and 49.3%, respectively, both were significantly better than that of laryngeal cancer. The main causes of death were local recurrence and distant metastases. The group with no short-term complications had a better two-year OSR (59.0%) than the group with short-term complications (46.6%), however, the difference between them was not significant (P=0.103). The 2-year survival rate of the initial treatment group was 65.0%, better than that of the salvage treatment group (49.4%), but the difference was not significant (P=0.051). For the stage III and IV patients, the multi-disciplinary treatment group had a significantly better 2-year OSR (64.7%) than the single or sequential treatment group (37.0%, P=0.016).

CONCLUSIONS

Free jejunal flap reconstruction is an ideal option for repairing the cervical digestive tract circumferential defects caused by tumor resection with a high success rate and a low mortality. Compared with the single or sequential treatment, multi-disciplinary treatment can significantly improve the survival rate of late-stage hypopharyngeal and cervical esophageal cancer patients.

Agrobacterium-mediated transformation of the β-subunit gene in 7S globulin protein in soybean using RNAi technology

The objective of this study was to use RNA interference (RNAi) to improve protein quality and decrease anti-nutritional effects in soybean. Agrobacterium tumefaciens-mediated transformation was conducted using RNAi and an expression vector containing the 7S globulin β-subunit gene. The BAR gene was used as the selective marker and cotyledonary nodes of soybean genotype Jinong 27 were chosen as explant material. Regenerated plants were detected by molecular biology techniques. Transformation of the β-subunit gene in the 7S protein was detected by PCR, Southern blot, and q-PCR. Positive plants (10 T0, and 6 T1, and 13 T2) were tested by PCR. Hybridization bands were detected by Southern blot analysis in two of the T1 transgenic plants. RNAi expression vectors containing the soybean 7S protein β-subunit gene were successfully integrated into the genome of transgenic plants. qRT-PCR analysis in soybean seeds showed a clear decrease in expression of the soybean β-subunit gene. The level of 7S protein β-subunit expression in transgenic plants decreased by 77.5% as compared to that of the wild-type plants. This study has established a basis for the application of RNAi to improve the anti-nutritional effects of soybean.