Protozoa and oral health: a systematic review

Gingivitis and periodontitis (GP) are the main diseases of the oral cavity. The ethiology of GP have never been completely understood, however, loss of balance between the host immune system and the microbial virulence of GP pathogens may be considered the trigger of GP. In fact, the immune system, activated by microbiological agents, attacks the host and not the biofilm bacteria, causing the destruction of periodontal tissue, alveolar bone, and loss of teeth. Parasites may play an important role in the pathology of GP. The first studied and the most common parasite in the oral cavity is Entamoeba gingivalis. A possible link between E. gingivalis and GP has never been demonstrated completely, however E. gingivalis is infrequently found in people without GP. In addition, there is evidence that E. gingivalis could favour the onset and progression of GP. In conclusion, we can assert that E. gingivalis and GP may be correlated. This relationship can open new therapeutical approaches for treating GP, particularly in cases refractory to therapy.

Age-related histological changes in rat tibial

BACKGROUND

At present, studies on osteochondral morphogenesis only focus on a certain period of time or only provide a pattern diagram, but lack of dynamic tracking observation from the initiation of development to maturity. This study was to dynamically observe the changes of skeleton morphology and structure from embryo to adult, to provide research data for enriching the knowledge of bone and cartilage tissue structure.

MATERIALS AND METHODS

In the intrauterine experiment, 5 normal pregnant Wistar rats were sacrificed under anesthesia at gestational day (GD) 14, 17, 20, respectively. One of their offspring was randomly selected, and a total of 5 offspring were obtained at each time point. In the postnatal experiment, on the 7th and 10th day after birth and at postnatal weeks (PW) 2, 3, 6, 12, 28, 5 offspring rats from 5 different pregnant Wistar rats were randomly selected and sacrificed under anesthesia at each time point. After obtaining the above offspring, the soft tissue was removed, and the tibia of hind limbs was retained for paraffin-embedded section. After stained with Safranin-O-fast-green and hematoxylin, the morphological development of the tibia was observed under an optical microscope.

RESULTS

At GD14, there was no obvious joint space, the whole hind limb was cartilage and bone tissue was not visible. At GD17, visible joint space was seen and the chondrocytes in the center region appeared to hypertrophy. At GD20, the primary ossification center was obvious, and a typical epiphysis growth plate structure could be seen. On the 7th day after birth, the chondrocytes in the center of epiphysis cartilage were hypertrophic and differentiated, the cartilage canal grow from the cartilage surface toward the center of the epiphysis cartilage, at postnatal day 14, the secondary ossification center was formed. At this time, the tibia had typical morphological characteristics of the metaphysis, however, there was no obvious layered structure of articular cartilage; the stratified structure of articular cartilage could be seen at PW6, but its mature marker (tidemark) was still not visible; however, at PW12, typical four layers of articular cartilage appeared, and the tidemark was visible. The growth plates were clearly visible at PW2, 6 and 12. At PW28, growth plates could still be observed, but its morphology is abnormal.

CONCLUSIONS

Our results, for the first time, dynamically observed the morphological changes of osteochondral at critical period of development from embryo to adult, especially the process of cartilage canal participating in the formation of secondary ossification center.

Enhancing emulsion functionality using multilayer technology: Coating lipid droplets with saponin-polypeptide-polysaccharide layers by electrostatic deposition

Electrically charged food-grade biopolymers can be used to form multilayer coatings around the lipid droplets in oil-in-water emulsions using a sequential layer-by-layer electrostatic deposition approach. In principle, this approach can be used to improve the stability and enhance the functionality of food emulsions. In this study, multilayer coatings were formed from saponins, polypeptides, and polysaccharides using medium chain triglyceride (MCT) lipid droplets as templates (pH 4.0). First, an emulsion containing negatively charged lipid droplets was created using quillaja saponin (QS) as an anionic emulsifier. Second, these anionic droplets were coated with a cationic polypeptide (poly-L-lysine, PLL) to form positively-charged droplets. Finally, these cationic droplets were coated with a negatively-charged polysaccharide, either pectin (PE) or κ-carrageenan (KC), to form anionic droplets. Overall, the 1-layer emulsions had the best resistance to salt, pH, and heat, indicating that quillaja saponins were effective emulsifiers. The 2-layer emulsions had better pH-stability than the 3-layer emulsions, which tended to strongly aggregate under acidic conditions. Conversely, the 3-layer emulsions had better salt-stability than the 2-layer emulsions, which tended to aggregate strongly even at low salt levels (50-100 mM NaCl). All the emulsions were relatively stable to heating (90 °C, 30 min). Overall, our results provide useful insights into the formulation of stable multilayer emulsions from food-grade emulsifiers and biopolymers. There appears to be little advantage to using the multilayer technology to enhance the physical stability of saponin-coated lipid droplets, but there may be advantages in terms of extending their functional properties, which will be explored in future studies.

Prognostic value of age-adjusted d-dimer cutoff thresholds in patients with myocardial infarction treated by percutaneous coronary intervention

Introduction

The association between D-dimer and outcomes of patients with myocardial infarction (MI) remains controversial. Using age-adjusted D-dimer cutoff thresholds significantly improves the accuracy of diagnosis for thrombotic diseases. This study aimed to investigate the prognostic value of age-adjusted D-dimer in MI patients treated by percutaneous coronary intervention (PCI).

Methods

In this observational study, 3614 consecutive patients with MI treated by PCI were retrospectively recruited. The baseline age-adjusted D-dimer threshold was 500 ng/mL, and was calculated as age × 10 in patients older than 50 years. Cox regression was used for outcome analysis. The primary outcome was all-cause death. Discrimination and reclassification were calculated to assess the additional prognostic value of D-dimer when combined with established clinical risk factors and the Global Registry of Acute Coronary Events (GRACE) risk score.

Results

During a median follow-up of 652 days, a total of 194 deaths occurred. High D-dimer level, as defined by age-adjusted thresholds, was an independent predictor for all-cause death (hazard ratio:1.67, 95% confidence interval: 1.23–2.27, P=0.001). Addition of D-dimer level (high or low) significantly improved risk classification for death when combined with established clinical risk factors (net reclassification index [NRI]: 0.601, P<0.001; integrated discrimination improvement [IDI]: 0.011, P=0.046) and GRACE score (NRI: 0.618, P<0.001; IDI: 0.015, P=0.011).

Conclusions

In patients with MI treated by PCI, D-dimer elevation defined by age-adjusted thresholds was an independent predictor for adverse outcomes, and provided additional prognostic value when combined with clinical risk factors and GRACE score.

Funding Acknowledgement

Type of funding source: Public Institution(s). Main funding source(s): Chinese Academy of Medical Sciences

Association between pre-infarction angina and culprit-lesion morphology in patients with ST-segment elevation myocardial infarction: an optical coherence tomography study

Background

Previous studies reported the cardiac protection effect of pre-infarction angina (PIA) in patients with acute myocardial infarction (AMI). However, the association between PIA and culprit plaques characteristics in AMI patients through optical coherence tomography (OCT)assessment remains unclear.

Purpose

We sought to identify culprit-plaque morphology associated with PIA in patients with ST-segment elevation myocardial infarction (STEMI) using OCT.

Methods

A total of 279 STEMI patients who underwent intravascular OCT of culprit-lesion were included. Baseline clinical data and culprit-plaque characteristics were compared between the PIA group the non-PIA group.

Results

Patients with PIA represented 54.8% of the study population (153 patients). No differences were observed in clinical and angiographic data between two groups, except STEMI onset with exertion was significantly less common in PIA group (24.2% versus 40.5%, P=0.004). Patients with PIA exhibited a significantly lower incidence of plaque rupture (40.5% versus 61.9%, P<0.001) and lipid-rich plaques (48.4% versus 69.0%, P=0.001). The thin-cap fibroatheroma (TCFA) prevalence was lower in PIA group, presenting a thicker fibrous cap thickness, although statistically significant differences were not observed (20.3% versus 30.2%, P=0.070; 129.1±92.0μm versus 111.4±78.1μm, P=0.088; respectively). Multivariate logistic regression analysis indicated that PIA was an independent negative predictor for plaque rupture (odds ratio: 0.44, 95% confidence interval: 0.268–0.725, P=0.001).

Conclusion

STEMI patients with PIA showed a significantly lower prevalence of plaque rupture and lipid-rich plaques in culprit-lesion than non-PIA group, implying different mechanisms of STEMI attack.

Flow chart + Bar graphs of OCT findings

Funding Acknowledgement

Type of funding source: Public Institution(s). Main funding source(s): Association between pre-infarction angina and culprit-lesion morphology in patients with ST-segment elevation myocardial infarction: An optical coherence tomography study

Chitosan reduces vitamin D bioaccessibility in food emulsions by binding to mixed micelles

Consumption of sufficiently high quantities of dietary fibers has been linked to a range of health benefits. Recent research, however, has shown that some dietary fibers interfere with lipid digestion, which may reduce the bioavailability of oil-soluble vitamins and nutraceuticals. For this reason, we examined the impact of a cationic polysaccharide (chitosan) on the bioaccessibility of vitamin D using the standardized INFOGEST in vitro digestion model. The vitamin D was encapsulated within an emulsion-based delivery system that contained whey protein-coated corn oil droplets. Our results showed that chitosan promoted severe droplet flocculation in the small intestine and reduced the amount of free fatty acids detected using a pH-stat method. However, a back-titration of the digested sample showed that the lipids were fully digested at all chitosan levels used (0.1-0.5%), suggesting that chitosan may have bound some of the free fatty acids released during lipid digestion. The presence of the chitosan decreased the bioaccessibility of vitamin D by about 37%, but this effect did not depend strongly on chitosan concentration (0.1-0.5%). It was hypothesized that chitosan bound to the vitamin-loaded mixed micelles and promoted their precipitation. The knowledge gained in this study might provide useful insights in designing emulsion-based delivery systems with high vitamin bioaccessibility.

PLCE1 inhibits apoptosis of non-small cell lung cancer via promoting PTEN methylation

OBJECTIVE

To explore the role of phospholipase C epsilon 1 (PLCE1) in regulating cell apoptosis of non-small cell lung cancer (NSCLC) and its underlying mechanism.

PATIENTS AND METHODS

The mRNA and protein levels of PLCE1 in NSCLC tissues, adjacent normal tissues and NSCLC cell lines (A549 and H1299) were detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) and Western blot, respectively. Methylation status in the promoter region of PTEN in NSCLC cells was accessed using the relative commercial kit. Cell apoptosis after transfection of PLCE1 siRNA in NSCLC cells was detected by flow cytometry. Protein expressions of apoptosis-related genes in NSCLC cells after altering PLCE1 expression were detected by Western blot.

RESULTS

PLCE1 was highly expressed in NSCLC tissues and cell lines than that of controls. PLCE1 knockdown promoted PTEN expression and inhibited methylation in H1299 cells. Transfection of PLCE1 siRNA in NSCLC cells remarkably induced cell apoptosis.

CONCLUSIONS

PLCE1 inhibits cell apoptosis of NSCLC by promoting PTEN methylation.

Computer-aided three-dimensional assessment of periodontal healing distal to the mandibular second molar after coronectomy of the mandibular third molar: a prospective study

Background

The periodontal healing distal to the mandibular second molar (M2M) after coronectomy of the M3M has shown controversial results. We aimed to combine a digital method with cone-beam computed tomography (CBCT) and estimate periodontal healing of M2M after M3M coronectomy. An accurate and stable indicator in three dimensions was also explored tentatively.

Methods

Patients with a M3M in contact with the inferior alveolar canal were included. CBCT was applied immediately after coronectomy (baseline) and 6-months later. Data were investigated with digital software for registration. Previously reported and coronectomy-related factors were included for univariate and multivariate analyses.

Results

A total of 181 patients (213 M3Ms) completed 6-month follow-up. Significant reduction in the distal intra-bony defect (DBD) depth of the M2M was shown (1.28 ± 1.24 mm, P < 0.001). DBD depth of the M2M at baseline was the most influential factor (r = 0.59), followed by preoperative M3M condition, age, rotation and migration of the root complex. Remaining enamel (OR = 6.93) and small retromolar space (0.67) contributed to re-contact of the root complex and M2M. Bone volume regenerated in the distal 2 mm was associated significantly with DBD-depth reduction (r = 0.74, P < 0.001).

Conclusions

Bone volume regenerated in the distal 2 mm of the M2M denoted stability of distal periodontal healing of the M2M. DBD depth at baseline was the most influential factor for healing of a DBD of the M2M after M3M coronectomy. The remaining enamel and a small retromolar space could contribute to re-contact of the root complex and the M2M.

Trial registration

China Clinical Trial Center, ChiCTR1800014862. Registered 10 February 2018,

Impact of pesticide polarity and lipid phase dimensions on the bioaccessibility of pesticides in agricultural produce consumed with model fatty foods

For most people, the pesticide residues found on agriculture products are the main source of pesticide exposure, which may adversely influence consumer health. The potential health hazard of residual pesticides depends on the nature of the foods they are consumed with. Studies with fat-soluble vitamins and nutraceuticals have shown that their bioaccessibility depends on food matrix composition and structure. We used an in vitro method to investigate the influence of the dimensions of the lipid phase in model fatty foods (emulsified or bulk oil) on the bioaccessibility of various pesticides. Three pesticides that differed in their oil-water partition coefficients were selected: bendiocarb (log P = 1.7), parathion (log P = 3.8), and chlorpyrifos (log P = 5.3). These pesticides were mixed with tomato puree to represent pesticide-treated agricultural products. Three model foods with different oil phase dimensions were used to represent different kinds of food product: small emulsions (d32 = 0.14 μm); large emulsions (d32 = 10 μm); and, bulk oil. Our results showed that the oil droplets underwent extensive changes as they passed through the simulated gastrointestinal tract due to changes in environmental conditions, such as pH, ionic strength, bile salts, and enzyme activities. The initial rate and final amount of lipid hydrolysis decreased with increasing lipid phase dimensions. Pesticide bioaccessibility depended on both the hydrophobicity of the pesticide and the dimensions of the co-ingested lipid droplets. The least hydrophobic pesticide (bendiocarb) had a high bioaccessibility (>95%) that did not depend on lipid phase dimensions. The more hydrophobic pesticides (parathion and chlorpyrifos) has a lower bioaccessibility that increased with decreasing lipid phase dimensions. Our results demonstrate the critical role that food structure plays on the potential uptake of pesticides from agricultural products, like fruits and vegetables.

Surgery with and without adjuvant radiotherapy is associated with similar survival in T4 colon cancer

AIM

There is little evidence regarding the role of adjuvant radiotherapy for colon cancer. Despite this, national consensus guidelines recommend consideration of radiation for patients with T4 colon cancer. Large comparative studies may be beneficial in clarifying the potential benefit of postoperative radiation for this cohort.

METHOD

We compared the overall survival between patients treated with surgery with and without adjuvant radiation using the National Cancer Database (NCDB) and the Surveillance, Epidemiology, and End Results Program (SEER), as well as disease-specific survival using SEER. Cox proportional hazards models and propensity score matching were used to adjust for relevant confounders.

RESULTS

There were a total of 18 776 patients in the NCDB cohort and 9926 patients in the SEER cohort. After propensity score matching, there was no statistically significant difference in overall mortality between surgery with and without radiation in the NCDB [hazard ratio (HR) 1.11; 95% CI 0.93-1.31; P = 0.25] or in SEER (HR 1.20; 95% CI 0.84-1.72; P = 0.32). Additionally, using SEER, we found no statistically significant difference in disease-specific mortality between these two groups (HR 1.13; 95% CI 0.76-1.67; P = 0.54).

CONCLUSION

Using the NCDB and SEER, we found no statistically significant difference in overall survival or disease-specific survival between patients treated with and without adjuvant radiation. Further studies should evaluate the impact of adjuvant radiotherapy on local control and prevention of recurrence-related morbidity in patients with T4 colon cancer.

THU0204 A SUBGROUP ANALYSIS OF LOW DISEASE ACTIVITY AND REMISSION FROM PHASE 3 STUDY OF FILGOTINIB IN PATIENTS WITH INADEQUATE RESPONSE TO BIOLOGIC DMARDS

Background:

Despite effective treatments, many patients (pts) with rheumatoid arthritis (RA) have inadequate responses to biologic DMARDs (bDMARD-IR), highlighting an unmet need. It is unclear whether prior bDMARD use affects efficacy of the oral, selective JAK-1 inhibitor filgotinib (FIL).

Objectives:

To explore clinical response to FIL in bDMARD-IR pts stratified by mode of action (MOA) and number of prior bDMARDs.

Methods:

The global, phase 3 FINCH-2 (NCT02873936) study treated 448 bDMARD-IR pts with active RA.1Pts were randomised 1:1:1 to once-daily FIL 200 mg, FIL 100 mg, or placebo (PBO) for 24 weeks. Efficacy was assessed by percent of pts achieving low disease activity (LDA) or remission at week (W)24 as measured by CDAI and DAS28(CRP) stratified by number and MOA of prior bDMARDs. Comparisons were not adjusted for multiplicity. Nonresponder imputation was used.

Results:

In total, 448 bDMARD-IR pts were included, 105 with prior experience with ≥3 bDMARDs (Table). At W24, pts receiving FIL were in LDA at a higher proportion vs PBO, irrespective of number of prior bDMARDs or MOA (Figure 1). For pts receiving FIL 200 vs PBO, DAS28(CRP) ≤3.2 was achieved at W24 by 52% vs 26%, 51% vs 22%, and 38% vs 9% of pts with 1, 2, or ≥3 prior bDMARDs, respectively, and 49% vs 21% and 50% vs 13% of pts exposed to TNF or IL-6 inhibitors; for all subgroups, rates were significantly higher vs PBO (Figure 1). Delta between FIL 200 mg and PBO was maintained irrespective of number or type of prior bDMARDs. At W24, pts receiving FIL achieved remission at numerically higher rates vs PBO (Figure 2). For pts receiving FIL 200 mg vs PBO, DAS28(CRP) <2.6 was achieved at W24 by 36% vs 14%, 30% vs 14%, and 22% vs 6% of pts with 1, 2, and ≥3 prior bDMARDs, respectively, and 31% vs 14% and 29% vs 9% of pts exposed to TNF or IL-6 inhibitors (Figure 2). Delta between FIL 200 mg and PBO was maintained irrespective of number or type of prior bDMARDs. Treatment-emergent adverse events across subgroups were consistent with overall study population.

Table.

Number and MOA of prior bDMARDs

FIL 200 mgn = 147FIL 100 mgn = 153PBOn = 148TotalN = 448Prior bDMARDs 173 (49.7)86 (56.2)77 (52.0)236 (52.7) 237 (25.2)33 (21.6)36 (24.3)106 (23.7) ≥337 (25.2)34 (22.2)34 (23.0)105 (23.4)LOE ≥1 bDMARD125 (85.0)129 (84.3)126 (85.1)380 (84.8)Intolerance ≥1 bDMARD36 (24.5)34 (22.2)32 (21.6)102 (22.8)Prior TNFi121 (82.3)134 (87.6)124 (83.8)379 (84.6) LOE ≥1 TNFi97 (66.0)113 (73.9)103 (69.6)313 (69.9) Intolerance ≥1 TNFi25 (17.0)24 (15.7)24 (16.2)73 (16.3)Prior non-TNFi73 (49.7)62 (40.5)75 (50.7)210 (46.9) LOE ≥1 non-TNFi52 (35.4)43 (28.1)56 (37.8)151 (33.7) Intolerance ≥1 non-TNFi13 (8.8)13 (8.5)11 (7.4)37 (8.3)Prior IL-6i34 (23.1)35 (22.9)32 (21.6)101 (22.5) LOE ≥1 IL-6i25 (17.0)22 (14.4)21 (14.2)68 (15.2) Intolerance ≥1 IL-6i5 (3.4)10 (6.5)5 (3.4)20 (4.5)

Data presented as n (%).

i, inhibitor; LOE, lack of efficacy.

Conclusion:

Treatment with FIL vs PBO led to higher rates of LDA and remission in pts with IR to IL-6 or TNF inhibition, or to 1, 2, or ≥3 prior bDMARDs, with a similar safety profile to the overall study population. A significantly higher proportion of pts overall receiving FIL 200 mg vs PBO were in LDA at W24. Improved efficacy of FIL vs PBO in pts who previously failed multiple bDMARDs indicates distinct benefits of selective JAK-1 inhibition with FIL.

References:

[1]Genovese, et al.JAMA2019;322(4):315–25.

Disclosure of Interests: :

Jacques-Eric Gottenberg Grant/research support from: BMS, Pfizer, Consultant of: BMS, Sanofi-Genzyme, UCB, Speakers bureau: Abbvie, Eli Lilly and Co., Roche, Sanofi-Genzyme, UCB, Maya H Buch Grant/research support from: Pfizer, Roche, and UCB, Consultant of: Pfizer; AbbVie; Eli Lilly; Gilead Sciences, Inc.; Merck-Serono; Sandoz; and Sanofi, Roberto Caporali Consultant of: AbbVie; Gilead Sciences, Inc.; Lilly; Merck Sharp & Dohme; Celgene; Bristol-Myers Squibb; Pfizer; UCB, Speakers bureau: Abbvie; Bristol-Myers Squibb; Celgene; Lilly; Gilead Sciences, Inc; MSD; Pfizer; Roche; UCB, Grace C. Wright Consultant of: AbbVie, Amgen, Bristol-Myers Squibb, Exagen, Eli Lilly, Myriad Autoimmune, Novartis, Pfizer, Regeneron Pharmaceuticals, Inc., Sanofi Genzyme, UCB, Speakers bureau: AbbVie, Amgen, Bristol-Myers Squibb, Exagen, Eli Lilly, Myriad Autoimmune, Novartis, Regeneron Pharmaceuticals, Inc., Sanofi Genzyme, UCB, Tsutomu Takeuchi Grant/research support from: Eisai Co., Ltd, Astellas Pharma Inc., AbbVie GK, Asahi Kasei Pharma Corporation, Nippon Kayaku Co., Ltd, Takeda Pharmaceutical Company Ltd, UCB Pharma, Shionogi & Co., Ltd., Mitsubishi-Tanabe Pharma Corp., Daiichi Sankyo Co., Ltd., Chugai Pharmaceutical Co. Ltd., Consultant of: Chugai Pharmaceutical Co Ltd, Astellas Pharma Inc., Eli Lilly Japan KK, Speakers bureau: AbbVie GK, Eisai Co., Ltd, Mitsubishi-Tanabe Pharma Corporation, Chugai Pharmaceutical Co Ltd, Bristol-Myers Squibb Company, AYUMI Pharmaceutical Corp., Eisai Co., Ltd, Daiichi Sankyo Co., Ltd., Gilead Sciences, Inc., Novartis Pharma K.K., Pfizer Japan Inc., Sanofi K.K., Dainippon Sumitomo Co., Ltd., Kenneth Kalunian Grant/research support from: Pfizer, Lupus Research Alliance, Sanford Consortium, Consultant of: Genentech, Nektar, BMS, Janssen, AstraZeneca, Biogen, Vielabio, Equillium, Eli Lilly, ILTOO, Abbvie, Amgen, Roche, Gilead, Alena Pechonkina Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Ying Guo Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Shangbang Rao Shareholder of: Gilead Sciences Inc., Employee of: Gilead Sciences Inc., YingMeei Tan Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Robin Besuyen Shareholder of: Galapagos, Employee of: Galapagos, Mark C. Genovese Grant/research support from: Abbvie, Eli Lilly and Company, EMD Merck Serono, Galapagos, Genentech/Roche, Gilead Sciences, Inc., GSK, Novartis, Pfizer Inc., RPharm, Sanofi Genzyme, Consultant of: Abbvie, Eli Lilly and Company, EMD Merck Serono, Genentech/Roche, Gilead Sciences, Inc., GSK, Novartis, RPharm, Sanofi Genzyme

Stabilization of soybean oil-in-water emulsions using polypeptide multilayers: Cationic polylysine and anionic polyglutamic acid

Oil-in-water emulsions are used as delivery systems for non-polar functional ingredients in various industries, including foods, cosmetics, personal care products, agrochemicals, and pharmaceuticals. Emulsions, however, tend to breakdown under the conditions found in many commercial products. In this study, the functional performance of the lipid droplets in emulsions was tailored by sequential layer-by-layer electrostatic deposition of oppositely charged polypeptides onto their surfaces. Cationic poly-L-lysine (PLL) and anionic poly-glutamic acid (PGA) were used as a pair of oppositely charged polypeptides (pH 4.0). First, a primary emulsion (10% w/w soybean oil-in-water emulsion) was formed consisting of small lipid droplets (d₃₂ = 500 µm) coated by a natural surfactant (0.05% w/w quillaja saponin). Second, cationic PLL was deposited onto the surfaces of the anionic saponin-coated droplets. Third, anionic PGA was deposited onto the surfaces of the cationic PLL-saponin-coated droplets. We then assessed the ability of the coatings to protect the lipid droplets from aggregation when the pH (2.0-9.0), ionic strength (0-350 mM), or temperature (30-90 °C) were altered. The properties of the primary, secondary, and tertiary emulsions were monitored by measuring the mean particle diameter (d₃₂), electrical characteristics (ζ-potential), and microstructure of the lipid droplets. The electrical characteristics of the droplets could be modulated by controlling the number and type of layers used. The primary emulsion had the best resistance to varying environmental conditions, while the secondary emulsion had the worst, suggesting electrostatic deposition should only be used to obtain specific functionalities. Interestingly, PLL detached from the surfaces of the secondary emulsions at high salt concentrations due to electrostatic screening, which improved their salt stability. This phenomenon may be useful for some food applications, e.g., having cationic droplets during food storage, but anionic ones inside the human body.

[Associations between postprocedural D-dimer, hs-CRP, LDL-C levels and prognosis of acute myocardial infarction patients treated by percutaneous coronary intervention]

Objective: To investigate the association between postprocedural D-dimer, high sensitivity C-reactive protein(hs-CRP) and low-density lipoprotein-cholesterol(LDL-C) and outcomes of acute myocardial infarction (AMI) patients treated by percutaneous coronary intervention(PCI), in order to clarify the impacts of thrombotic, inflammatory and cholesterol risks on long-term prognosis. Methods: Patients with AMI who underwent emergency PCI from January 2010 to June 2017 in Fuwai Hospital with complete baseline data were enrolled. Patients were stratified into four groups according to quartiles of D-dimer, hs-CRP and LCL-C. Cox regression was used to analyze the relationship between these biomarkers and prognosis. Restricted cubic spline (RCS) was used to characterize the continuous association between risk of all-cause death and biomarkers. The primary outcome was all-cause death. Results: A total of 3 614 patients were included in the analysis. The age was (59.2±12.0) years old, and 2 845 (78.7%) were male and 3 161 (87.5%) patients were diagnosed as ST-segment elevation myocardial infarction. The follow-up time was 652 (414, 1 880) days. Survival analysis showed that postprocedural D-dimer and hs-CRP were significantly associated with all-cause mortality (all P<0.05). Cox regression with multiple adjustments showed that patients with D-dimer≥580 μg/L presented higher risk of all-cause death (HR=2.03, 95%CI 1.22-3.38, P=0.006), compared to patients with D-dimer<220 μg/L. RCS analysis showed that risk of all-cause death was stably high when D-dimer reached 500 μg/L. Multivariable Cox regression also showed that patients with hs-CRP<2.74 mg/L (HR=1.86, 95%CI 1.10-3.15, P=0.020)or hs-CRP≥11.99 mg/L (HR=2.14, 95%CI 1.35-3.40, P=0.001) presented higher mortality compared to patients whose hs-CRP was 2.74-7.18 mg/L. RCS analysis indicated a J-shaped relation between hs-CRP and mortality, as greater risk of death was observed when hs-CRP was lower than 2 mg/L or higher than 10 mg/L. LDL-C was not associated with outcomes (all P>0.05). Conclusions: Postprocedural D-dimer is significantly associated with long-term prognosis of AMI patients treated by PCI. Patients with extremely high or low levels of hs-CRP presents worse outcomes. Intensive and tailored antithrombotic or anti-inflammatory therapies should be considered for patients with increased thrombotic risk and those with extremely high or low inflammatory risk.

Impact of fat crystallization on the resistance of W/O/W emulsions to osmotic stress: Potential for temperature-triggered release

Water-in-oil-in-water (W/O/W) emulsions can be designed to encapsulate, protect, and release both hydrophilic and hydrophobic functional compounds. In this study, we examined the impact of crystallizing the fat phase on the resistance of W/O/W emulsions to osmotic stress, with the aim of developing osmotic-responsive systems. Polyglycerol polyricinoleate (PGPR) was used as a hydrophobic surfactant to stabilize the inner water droplets, while Quillaja saponin and whey protein isolate (WPI) were used as hydrophilic surfactants to coat the oil droplets. The impact of fat crystallization was examined by using either a liquid (soybean oil, SO) or semi-solid (hydrogenated soybean oil, HSO) fat as the oil phase. An osmotic stress was generated by establishing a sucrose concentration gradient between the internal and external water phases. Alterations in the droplet size, morphology, and stability of the W/O/W emulsions was measured when the sucrose concentration gradient was changed. The W/O droplets in the SO-emulsions swelled/shrank when the external sucrose concentration was below/above the internal sucrose concentration, which is indicative of water diffusing into/out of the droplets. Conversely, there was no change in the size of the W/O droplets in the HSO-emulsions under the same conditions, which was attributed to the mechanical strength of the fat crystal network resisting swelling or shrinking. HSO-emulsions did exhibit swelling when they were heated above a critical temperature, due to melting of the fat crystals and disruption of the crystal network. Our results demonstrate that crystallization of the oil phase of W/O/W emulsions can prevent water transport due to osmotic stress, which may be useful for developing temperature-triggered delivery systems for application in foods, cosmetics, pharmaceuticals, or personal care products.

Comparison of hepatic epithelioid angiomyolipoma and non-hepatitis B, non-hepatitis C hepatocellular carcinoma on contrast-enhanced ultrasound

PURPOSE

The purpose of this study was to retrospectively compare the imaging features of hepatic epithelioid angiomyolipoma (HEAML) to those of hepatocellular carcinoma negative for hepatitis B surface antigen and hepatitis C antibody (NBNC-HCC) on contrast-enhanced ultrasound (CEUS) with sulphur hexafluoride microbubbles.

MATERIAL AND METHODS

Twenty-two patients (4 men, 18 women) with a mean age of 42.6±10.2 (SD) years (range: 22-63 years) with histopathologically confirmed HEMAL were included in the study. Forty-four patients (30 men, 14 women) with a mean age of 57.3±15.9 years (range: 19-85 years) with histopathologically confirmed NBNC-HCC were randomly selected from our institution's database as a control group. The CEUS characteristics of the two groups were compared.

RESULTS

On conventional ultrasound, significant differences in tumor diameter were found between HEAML (4.0±2.0 [SD] cm; range: 1.3-8.9cm) and NBNC-HCC (8.4±4.4 [SD] cm; range: 1.6-18cm) (P<0.001) as well as in degrees of enhancement during the portal (P=0.001) and late phases (P=0.003), contrast distribution (P<0.001) and absence of pseudocaspule (P<0.001). On CEUS, hyperenhancement during the arterial phase was observed in 21/22 (95.5%) HEAMLs and in 43/44 (97.7%) NBNC-HCCs (P>0.999). Homogeneous enhancement was more frequent in HEAMLs (20/22; 90.9%) than in NBNC-HCCs (13/44; 29.6%) (P<0.001). Pseudocapsule was observed in 0/22 HEAMLs (0.0%) and in 36/44 NBNC-HCCs (81.8%) (P=0.017). A prolonged enhancement was observed in 5/22 HEAMLs (22.7%) and in 0/44 NBNC-HCCs (0.0%) (P<0.001) during the late phase.

CONCLUSION

CEUS with sulphur hexafluoride microbubbles is helpful in discriminating between HEAML and NBNC-HCC. Homogeneous enhancement and lack of pseudocapsule are suggestive features for the diagnosis of HEAML.

The tumor suppressor NOR1 suppresses cell growth, invasiveness, and tumorigenicity in glioma

Oxidored-nitro domain-containing protein 1 (NOR1) is a tumor suppressor downregulated in various human cancers, including nasopharyngeal carcinoma (NPC), lung cancer, and testicular cancer. NOR1 protein is highly expressed in the normal brain; however, its role in brain tumors remains unknown. In this study, we demonstrated that the NOR1 protein level was decreased in glioma tissue samples as compared to its normal counterpart. Exogenously expressed NOR1 protein in glioma U251 cells inhibits tumor cell proliferation, migration, and invasion. Re-expression of NOR1 induced cell cycle S to G2 phase arrest and suppressed its tumorigenicity in nude mice. Overexpression of NOR1 in U251 cells also led to a decrease of Ki67 expression in xenografts. Transcriptomic analysis revealed that NOR1 expression altered the expression of genes favored cell proliferation. Among the differentially expressed genes, FOXR2, a member of the FOX gene family, which promotes glioma progression, was decreased in NOR1 expressing cells. The downregulation of FOXR2 by NOR1 was validated in vitro and in vivo. Our findings suggest for the first time that NOR1 suppresses glioma progression via modulating the FOXR2 expression.

Cosmetic approach selection in parotidectomy for benign parotid gland tumour according to its location

OBJECTIVE

The aim of this study is to evaluate the feasibility and aesthetic results when comparing two cosmetic approaches that were employed in parotidectomy according to the tumour location with the traditional Blair approach.

DESIGN

Retrospective study.

SETTING

Tertiary Referral Centre.

PATIENTS

Seventy-six patients were included in the study.

RESULTS

The degree of satisfaction with the cosmetic incision approach was significantly higher than that with the traditional Blair approach. The incidence of transient facial paralysis and salivary fistula were not statistically significant when compared with those in the traditional incision in 6-month follow-up post-operatively.

DISCUSSION

Conventional parotidectomy using the traditional Blair incision (or its modification) usually leaves a visible scar in this region, which can have major adverse impacts on the social or psychological well-being of an individual. To achieve better aesthetic results, according to the location of the benign parotid tumour, two formal cosmetic approach incisions could be performed in parotidectomy, which was superior to the traditional Blair incision. The authors propose that these two cosmetic approaches for parotidectomy can be both technically feasible and safe.