Repair of facial scars using free and pedicle-expanded deltopectoral flaps

This study aimed to evaluate the effectiveness and long-term outcomes of free and pedicled, expanded deltopectoral flaps with perforation of the internal thoracic artery to repair facial scars. This retrospective review was of 37 patients who presented between June 2013 and June 2019 with various types of facial scar. Ten patients received a free expanded deltopectoral flap and 27 a pedicled, expanded deltopectoral flap. During the stage-one operation, the expander was implanted into the deltopectoral area and fully expanded by normal saline injection. In stage two, the facial lesions were incised, and the free or pedicled flap transferred to reconstruct the defect. Flap necrosis did not occur in the 10 patients treated with free flaps. Two patients need to have the pedicle trimmed three months after surgery because it had become bloated. Distal necrosis occurred in five of 27 patients who received a pedicled, expanded deltopectoral flap. Healing by conservative treatment was noted in two cases and healing after skin grafting was documented in the other three. All 37 patients achieved satisfactory results. A pedicled, expanded deltopectoral flap appears to be a reliable and safe option for the treatment of facial scars.

Molecular Insights into Small-Molecule Drug Discovery for SARS-CoV-2

The mainstream approach to antiviral drugs against COVID-19 is to focus on key stages of the SARS-CoV-2 life cycle. The vast majority of candidates under investigation are repurposed from agents of other indications. Understanding protein-inhibitor interactions at the molecular scale will provide crucial insights for drug discovery to stop this pandemic. In this article, we summarize and analyze the most recent structural data on several viral targets in the presence of promising inhibitors for COVID-19 in the context of the perspective of modes of action (MOA) to unravel insightful mechanistic features with atomistic resolution. The targets include spike glycoprotein and various host proteases mediating the entry of the virus into the cells, viral chymotrypsin- and papain-like proteases, and RNA-dependent RNA polymerase. The main purpose of this review is to present detailed MOA analysis to inspire fresh ideas for both de novo drug design and optimization of known scaffolds to combat COVID-19.

Differential Regional Responses in Soluble Monomeric Alpha Synuclein Abundance Following Traumatic Brain Injury

Alpha synuclein (α-synuclein) is a neuronal protein found predominately in presynaptic terminals. While the pathological effect of α-synuclein aggregates has been a topic of intense study in several neurodegenerative conditions, less attention has been placed on changes in monomeric α-synuclein and related physiological consequences on neuronal function. A growing body of evidence supports an important physiological role of α-synuclein in neurotransmission. In the context of traumatic brain injury (TBI), we hypothesized that the regional abundance of soluble monomeric α-synuclein is altered over a chronic time period post-injury. To this end, we evaluated α-synuclein in the cortex, hippocampus, and striatum of adult rats at 6 h, 1 day, 1, 2, 4, and 8 weeks after controlled cortical impact (CCI) injury. Western blot analysis demonstrated decreased levels of monomer α-synuclein protein in the ipsilateral hippocampus at 6 h, 1 day, 1, 2, and 8 weeks, as well as in the ipsilateral cortex at 1 and 2 weeks and in the ipsilateral striatum at 6 h after CCI compared with sham animals. Immunohistochemical analysis revealed lower α-synuclein and a modest reduction in synaptophysin staining in the ipsilateral hippocampus at 1 week after CCI compared with sham animals, with no evidence of intracellular or extracellular α-synuclein aggregates. Collectively, these findings demonstrate that monomeric α-synuclein protein abundance in the hippocampus is reduced over an extensive (acute-to-chronic) post-injury interval. This deficit may contribute to the chronically impaired neurotransmission known to occur after TBI.

A study on the preparation of polycation gel polymer electrolyte for supercapacitors

The polycation gel polymer electrolyte (PGPE) is a promising electrolyte material for supercapacitors due to its high ionic conductivity and great flexibility. Herein, we report a novel flexible PGPE film, which is prepared by thermal copolymerization. The superiority of PGPE is attributed to the existence of charged groups in the polymer skeleton. Consequently, the crystallinity of the polymer is effectively reduced, and the migration of the lithium ion is evidently promoted. Moreover, the liquid retention capacity of the film is improved, which enhances its ionic conductivity as well. The reported PGPE exhibits a high ionic conductivity of 57.6 mS cm⁻¹ at 25 °C and a potential window of 0–1.2 V. The symmetrical PGPE supercapacitor (AC/AC) shows 95.21% mass-specific capacitance retention after 5000 cycles at 2 A g⁻¹ with a maximum energy density of 12.8 W h kg⁻¹ and a maximum power density of 5.475 kW kg⁻¹. This study confirms the exciting potential of PGPE for high performance supercapacitors.

The polycation gel polymer electrolyte (PGPE) is a promising electrolyte material for supercapacitors due to its high ionic conductivity and great flexibility.

Isolated-alkene-linked porous organic polymers (BIT-POPs): facile synthesis via ROMP and distinguishing overlapping signals in solid-state 13C NMR

The chemical structures of novel isolated-alkene-linked porous organic polymers (named BIT-POPs) were investigated through spectral editing techniques based on solid-state NMR.

Physiological effects of transport duration on stress biomarkers and meat quality of medium-growing Yellow broiler chickens

Pre-slaughter transport exerts negative effects on broilers' welfare, meat yield, and meat quality, but little is known about the effect of transport on medium-growing broiler chickens. This study aimed at evaluating the effects of different durations of transport (0, 0.5, 1, 2, and 3h) on stress biomarkers and meat quality of medium-growing Yellow-feathered broiler chickens. One hundred and eighty Chinese Yellow-feathered broilers aged 75days (marketing age), of 2.02kg average BW, were allotted into five groups; each group contained six replicates (six birds/replicate (crate)). Each crate with dimensions 74×55×27cm (length × width × height) was loaded with six birds, that is, 30kg live BW/m² crate. The tested transport durations increased BW loss (linear, P<0.01), plasma concentrations of ACTH (linear, P<0.10), cortisol and corticosterone (quadratic, P<0.05), and activity of glutathione peroxidase (linear, P<0.05), whereas plasma glucose was not affected. In breast muscle, contents of glycogen, lactic acid, malondialdehyde, and reduced glutathione were not affected (P>0.05), but total antioxidant capacity decreased (linear, P<0.01). The drip loss of breast muscle increased (linear, P<0.01), whereas shear force, pH at 24h postmortem, and breast meat color lightness (L*), redness (a*), and yellowness (b*) scores were not affected. In conclusion, the tested transport durations (from 0.5 to 3h) increased BW loss and some plasma stress biomarkers in 75-day-old Yellow-feathered broiler chickens, but the effect on meat quality attributes was minor.

Preparation and novel photoluminescence properties of the self-supporting nanoporous InP thin films

Self-supporting nanoporous InP membranes are prepared by electrochemical etching, and are then first transferred to highly reflective (> 96%) mesoporous GaN (MP-GaN) distributed Bragg reflector (DBR) or quartz substrate. By the modulation of bandgap, the nanoporous InP samples show a strong photoluminescence (PL) peak at 541.2 nm due to the quantum size effect of the nanoporous InP structure. Compared to the nanoporous InP membrane with quartz substrate, the nanoporous membrane transferred to DBR shows a twofold enhancement in PL intensity owing to the high light reflection effect of bottom DBR.

Prevalence, potential risk factors and mortality rates of acute respiratory distress syndrome in Chinese patients with sepsis

Objective

To investigate the prevalence, risk factors and mortality rate for acute respiratory distress syndrome (ARDS) in Chinese patients with sepsis.

Methods

This prospective study was based on data from consecutive patients with sepsis who attended Cangzhou Central Hospital between January 2017 and May 2019 and who developed ARDS. Multivariate logistic regression was used to identify risk factors associated independently with ARDS development.

Results

Of the 150 sepsis patients, 41 (27%) developed ARDS. Smoking history, presence of chronic obstructive pulmonary disease (COPD), the C-reactive protein (CRP) levels and the Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were associated with developing ARDS. Moreover, combination of the four factors had an even better predictive value for risk of ARDS than each factor alone. 28-day mortality was higher in sepsis patients with ARDS compared with those without ARDS.

Conclusions

In Chinese patients with sepsis, ARDS is relatively common and is associated with increased mortality. Smoking, COPD, CRP levels and APACHE II scores may be useful in predicting sepsis patients who may be at risk of developing ARDS.

[Analysis of clinical characteristics and drug treatment of inflammatory bowel disease in children: a single center study]

Objective: To analyze the clinical characteristics and efficacy of drug treatment in children with inflammatory bowel disease (IBD) at different ages of onset. Methods: The clinical data of 87 children with IBD admitted to Department of Gastroenterology in Children's Hospital, Capital Institute of Pediatrics from January 2009 to December 2018 were collected. The patients were divided into four groups according to the age of onset: 0 -<2 years old group (36 cases), 2 -<6 years old group (10 cases), 6 -<10 years old group (12 cases) and 10 -<18 years old group (29 cases). The clinical manifestations, laboratory examination, endoscopic findings, pathologic and genetic changes, and treatment were compared among different age groups with chi-square test or Fisher's exact text. Results: (1) A total of 87 patients were diagnosed with IBD, including 50 Crohn's disease (CD) (57%), 25 ulcerative colitis (UC) (29%) and 12 unclassified inflammatory bowel disease (IBD-U) (14%). (2) Patients with fever accounted for 78% (28/36) and 8/10 in the 0 -<2 years old group and 2 -<6 years old group, respectively. Patients with abdominal pain and perianal diseases accounted for 6% (2/36) and 47% (17/36) in the 0 -<2 years old group, and their proportions were significantly different among the four groups (χ(2)=8.369, 40.317 and 13.130, all P<0.05). (3) Leukocytosis, thrombocytosis and anemia were more common in the 0-<2 years old group, seen in 72% (26/36), 31% (11/36) and 81% (29/36), respectively. There were significant differences in the changes of complete blood count among the four groups (χ(2)=21.919, 8.095 and 11.520, all P<0.05). (4) Colonic involvement accounted for 85% (17/20) in the 0 -<2 years old CD patients. While in the CD patients over 6 years old, 61% (14/23) had inflammation of ileum and colon, with a significant difference compared to that in patients under 6 years old (19% (5/27) , χ(2)=9.455, P=0.003). Also, the location of bowel inflammation among the four groups were significantly different (χ(2)=21.120, P<0.01). (5) Noncaseating granulomas were found in 15 (30%) CD patients, and crypt abscess was found in 11 (44%) UC patients. (6) Among the 24 patients whose genes were analyzed by high throughput sequencing, 12 had pathogenic single gene mutation. (7) There were 25 patients treated with total enteral nutrition. Among the 25 patients treated with thalidomide, 20 (80%) had clinical remission or partial remission. Among the 19 CD patients treated with infliximab (IFX), 14 had clinical remission at the 6(th) week of treatment, and the proportion of remission maintenance at the 30(th) week of treatment was 12/14. (8) The rate of clinical remission or partial remission was 64% (23/36) in the 0 -<2 years old group, 8/10 in the 2 -<6 years old group, 11/12 in the 6 -<10 years old group, and 83% (24/29) in the 10 -<18 years old group. Conclusions: The proportion of CD was higher than that of UC in this study. Infant onset inflammatory bowel disease was more likely to present with perianal lesions, and was usually associated with leukocytosis, thrombocytosis and anemia, and has high possibility of single gene mutation. IFX may be effective in treating CD.

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is associated with IRF7, BANK1 and TBX21 polymorphisms in two populations

BACKGROUND AND PURPOSE

Autoantibodies targeting the GluN1(NR1) subunit of the anti-N-methyl-D-aspartate receptor (NMDAR) cause encephalitis. Although it has been shown that anti-NMDAR encephalitis is associated with human leukocyte antigen (HLA) loci, susceptibility genes for the disease outside the HLA loci remain unidentified. In this study, we aimed to explore the association of anti-NMDAR encephalitis with non-HLA genes.

METHODS

Two Chinese anti-NMDAR encephalitis cohorts from Han populations were recruited for this study. The North Chinese case-control set consisted of 98 patients and 460 controls, while the South Chinese case-control set included 78 patients and 541 controls. All participants were genotyped for 28 single nucleotide polymorphisms that are associated with autoimmune disorders or infectious diseases.

RESULTS

In two independent case-control sets, we identified significant associations of anti-NMDAR encephalitis with IRF7 rs1131665 (odds ratio [OR] 3.34, 95% confidence interval [CI] 1.99-5.63; P < 0.000001, P^adjusted  = 0.00004), BANK1 rs4522865 (OR 1.44, 95% CI 1.15-1.82; P = 0.0017, P^adjusted  = 0.0149), and TBX21 rs17244587 (OR 2.03, 95% CI 1.35-3.05; P = 0.00051, P^adjusted  = 0.0066). Furthermore, analysis of the three polymorphisms with clinical features of the disease revealed that the IRF7 rs1131665 was associated with tumor status.

CONCLUSION

The present study has for the first time identified non-HLA susceptibility genes for anti-NMDAR encephalitis. The association of IRF7, BANK1 and TBX21 with anti-NMDAR encephalitis suggests that B-cell activation, Th1 responses, virus infection and the type I interferon signaling pathway are involved in the pathogenesis of the disease.

Association of C1q/TNF-related protein-9 (CTRP9) level with obstructive sleep apnea in patients with coronary artery disease

Background

Obstructive sleep apnea (OSA) is closely related to the incidence and progression of coronary artery disease (CAD), but the mechanisms linking OSA and CAD are unclear. C1q/TNF-related protein-9 (CTRP9) is a novel adipokine that protects the heart against ischemic injury and ameliorates cardiac remodeling.

Purpose

We aimed to ascertain the clinical relevance of CTRP9 with OSA prevalence in patients with CAD.

Methods

From August 2016 to March 2019, consecutive eligible patients with CAD (n=154; angina pectoris, n=88; acute myocardial infarction [AMI], n=66) underwent cardiorespiratory polygraphy during hospitalization. OSA was defined as an apnea-hypopnea index (AHI) ≥15 events h–1. Plasma CTRP9 concentrations were measured by ELISA method.

Results

OSA was present in 89 patients (57.8%). CTRP9 levels were significantly decreased in the OSA group than in the non-OSA group (4.7 [4.1–5.2] ng/mL vs. 4.9 [4.4–6.0] ng/mL, P=0.003). The difference between groups was only observed in patients with AMI (3.0 [2.3–4.9] vs. 4.5 [3.2–7.9], P=0.009), but not in patients with AP (5.0 [4.7–5.3] ng/mL vs. 5.1 [4.7–5.9] ng/mL, P=0.571) (Figure 1). Correlation analysis showed that CTRP9 levels were negatively correlated with AHI (r=−0.238, P=0.003) and oxygen desaturation index (r=−0.234, P=0.004), and positively correlated with left ventricular ejection fraction (r=0.251, P=0.004) in all subjects. Multivariate analysis showed that male gender (OR 3.099, 95% CI 1.029–9.330, P=0.044), body mass index (OR 1.148, 95% CI 1.040–1.268, P=0.006), and CTRP9 levels (OR 0.726, 95% CI 0.592–0.890, P=0.002) were independently associated with the prevalence of OSA.

Conclusions

Plasma CTRP9 levels were independently related to the prevalence of OSA in patients with CAD, suggesting that CTRP9 might play a role in the pathogenesis of CAD exacerbated by OSA.

Figure 1. CTRP9 levels in OSA and non-OAS groups

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Natural Science Foundation of China

Absolute configuration of four chiral isomers of pyrisoxazole and their bioactivity

BACKGROUND

Pyrisoxazole is a fungicide that has two chiral carbon atoms and four isomers: (3S,5R)-, (3R,5S)-, (3S,5S)-, and (3R,5R)-pyrisoxazole.

RESULTS

Pure crystals of four pyrisoxazole isomers were prepared by chiral separation and single-crystal cultivation. Their absolute configurations were established by X-ray single crystal diffraction analysis. Bioassays indicated that compound (3S,5R)-pyrisoxazole showed excellent fungicidal activity with a median effective concentration (EC₅₀ ) value of 0.14 μg mL^-1 and protective activity with an EC₅₀ value of 13.29 μg mL^-1 . These values are superior to the commercial fungicides boscalid and racemic pyrisoxazole.

CONCLUSIONS

The biological activity of racemic pyrisoxazole is due almost exclusively to the isomer (3S,5R)-pyrisoxazole; the other three isomers had very low activity. © 2020 Society of Chemical Industry.

Compositional differences in atherosclerosis between the major epicardial arteries; a secondary analysis from the PARADIGM study

Background

Atherosclerotic plaques in the left circumflex artery (LCx) are associated with a lower risk of future events than plaques in the right coronary artery (RCA) and left anterior descending artery (LAD). High risk plaque subtypes including necrotic core and fibrofatty plaque can be evaluated on computed coronary tomography angiography (CCTA) by Hounsfield Unit (HU) density. To date, little is known regarding differences in high risk plaque composition between major epicardial vessels.

Purpose

The aim of this analysis was to compare plaque extent and composition between the three coronary arteries.

Methods

This is a secondary analysis of baseline scans from the PARADIGM study which enrolled consecutive patients with suspected coronary artery disease undergoing serial CCTA at a scan interval of ≥2 years. Plaque quantification by composition was performed in the three coronary arteries based on fixed HU thresholds: high risk subtypes consisting of necrotic core (&lt;30 HU) and fibrofatty plaque (31–130 HU), and other subtypes including fibrous (131–350 HU) and calcified plaque (≥351 HU). Comparisons between the coronary arteries were made using Generalized Estimating Equations (GEE) models, accounting for within-patient clustering of the coronary arteries and adjusting for ASCVD risk score and diabetes mellitus.

Results

From 1,271 patients (mean age 60.3±9.3 years; 57% men; median ASCVD score 9.3%), 3,813 vessels were analyzed. The prevalence of any plaque was lowest in the LCx, as was the prevalence of high risk plaque (Figure; P&lt;0.001 for both). The share of total plaque volume made up by high risk plaque subtypes was the lowest in the LCx (17.3% versus 22.5% [RCA] versus 24.4% [LAD]; P&lt;0.001). In contrast, calcified plaque made up the largest proportion in the LCx (44.5% versus 35.6% [RCA] versus 34.9% [LAD]; P&lt;0.001).

Conclusion

Prevalence of any plaque as well as high risk plaque subtypes was significantly higher in the LAD and RCA than in the LCx. Also, high risk plaque subtypes made up significantly the lowest proportion in the LCx, whereas calcified plaque made up the largest proportion in the LCx. These data support a different atherogenic milieu contributing to the variable risk patterns between the epicardial coronary arteries.

Figure 1. Prevalence of (high risk) plaque

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): This work was supported by the Leading Foreign Research Institute Recruitment Program through the National Research Foundation (NRF) of Korea funded by the Ministry of Science and ICT (MSIT) (Grant no. 2012027176).

Screen-Printed High-Performance Flexible Electrothermal Films Based on Three-Dimensional Intercalation Graphene Nanosheets/MWCNT/Carbon Black Composite

A liquid-phase stripping method was used to strip the graphite under the action of mechanical shear force to prepare graphene nanosheets (GNSs) on a large scale. Given the multicomponent composite conductive particles formed by GNSs with acid-treated MWCNTs (f-MWCNTs) and carbon black (CB), the three-dimensional (3D) intercalation electrothermal composite of GNSs/MWCNTs/CB with excellent conductivity and mechanical properties was prepared with water-based acrylic resin as a connector. Carbon particles (16.97 wt %) are found in the composite and the sheet resistance (R_s) is only 4 Ω sq^-1 as f-MWCNTs and CB intercalations form a more stable 3D conducting medium between the GNSs. The flexible electrothermal film (2.5 cm × 2.5 cm) printed with the 3D intercalation GNSs/MWCNTs/CB composite had a saturation temperature (T_s) of 175 °C with an input of 3 V and lower power consumption (249.87 cm² W^-1). It only takes 10 s to reach T_s and the electrical performance is still intact under the pressure of 1 × 10⁵ kPa. After being bent 2500 times (bending radius is 5 mm), the electrothermal performance of the flexible electrothermal film remained stable.

Obstructive sleep apnea is associated with adverse maternal outcomes using a United States multistate database cohort, 2007-2014

BACKGROUND

Obstructive sleep apnea affects approximately 11% of women of reproductive age, although it is often undetected and untreated. Previous studies suggest an association between obstructive sleep apnea and adverse maternal outcomes. Herein, we aim to better characterize the relationship between obstructive sleep apnea and maternal outcomes.

METHODS

Using the State Inpatient Databases, we performed a retrospective analysis of parturients ≥18 years old having inpatient deliveries in Florida, New York, California, Maryland, and Kentucky from 2007 to 2014. Outcomes included maternal pre-existing conditions, in-hospital mortality, maternal-fetal conditions and complications, and hospital length of stay >5 days.

RESULTS

Our cohort consisted of 6 911 916 parturients of whom 4326 (0.06%) had obstructive sleep apnea. Women with obstructive sleep apnea were more likely to present with pre-existing conditions, such as obesity and pre-pregnancy diabetes. After adjusting for patient- and hospital-level confounders in our multivariate analysis, obstructive sleep apnea status was associated with an increased odds of maternal-fetal conditions and complications, including pre-eclampsia (aOR 2.05, 95% CI 1.87 to 2.26), pulmonary edema (aOR 4.73, 95% CI 2.84 to 7.89), cesarean delivery (aOR 1.96, 95% CI 1.81 to 2.11), early onset delivery (aOR 1.28, 95% CI 1.17 to 1.40), and length of stay >5 days (aOR 2.42, 95% CI 2.21 to 2.65). Obstructive sleep apnea was not significantly associated with a higher risk of in-hospital mortality.

CONCLUSIONS

Pregnant women with obstructive sleep apnea have a significantly higher adjusted risk of adverse maternal outcomes compared with women without obstructive sleep apnea.

A dicyanoisophorone-based highly sensitive and selective near-infrared fluorescent probe for sensing thiophenol in water samples and living cells

Thiophenol (PhSH) is an important sulfhydryl compound in organic synthesis, but it is also a volatile environmental pollutant with high toxicity to organisms. Herein, we reported a novel near-infrared (NIR) probe (1) for turn-on fluorescence detection of PhSH. The probe was prepared by coupling 2,4-dinitrophenyl (DNP) to a dicyanoisophorone-based fluorophore (2). PhSH can specifically perform a nucleophilic aromatic substitution on probe 1 and result in the release of fluorophore 2, thus achieving a turn-on fluorescence response (λ_em = 693 nm). A dramatic color change from red (λ_abs = 525 nm) to blue (λ_abs = 668 nm) was also observed. This fluorescent assay displayed a large Stokes shift (∼133 nm) and a high sensitivity for PhSH, as well as a low detection limit (34 nM). Moreover, probe 1 was successfully applied to monitor PhSH in real water samples and image PhSH in living cells.

The inhibition of hepatic Pxr-Oatp2 pathway mediating decreased hepatic uptake of rosuvastatin in rats with high-fat diet-induced obesity

PURPOSE

Obesity affecting drug pharmacokinetics results in the risk of the therapeutic failure or toxic side effects of drugs increasing. Unfortunately, the pharmacokinetic data in obese patients still lack for majority of drugs. Therefore, our study principally investigated the effect of obesity induced by high fat-diet (HFD) on the pharmacokinetics of rosuvastatin and explored the underlying mechanism via the hepatic pregnane X receptor (Pxr)- organic anion transporting polypeptide 2 (Oatp2) signaling pathway and multidrug resistance-associated protein 2 (Mrp2) in rats.

MAIN METHODS

Rats with obesity was induced by HFD for 4 weeks, and subsequently, the effect of obesity on the blood concentration, pharmacokinetic parameters and biliary excretion of rosuvastatin administrated intravenously and the hepatic uptake of rosuvastatin in the rat primary hepatocytes were evaluated. Additionally, in order to illuminate the underlying mechanism, the alterations of the mRNA expressions of Oatp2, Mrp2 and Pxr and the concentrations of lithocholic acid (LCA), glycine-LCA (GLCA) and taurine-LCA (TLCA) in liver were determined.

KEY FINDINGS

The blood concentration of rosuvastatin that has great relationship with the muscle toxicity increased in rats with HFD-induced obesity, which could be principally ascribed to the decreased hepatic uptake of rosuvastatin that was mainly resulted from the inhibition of hepatic Pxr-Oatp2 pathway.

SIGNIFICANCE

The decreased hepatic uptake of rosuvastatin causing the increase of the rosuvastatin concentration in blood under the condition of HFD-induced obesity provides a cue for clinicians to reduce the rosuvastatin dose for obese patients to avoid the occurrence risk of the muscle toxicity of rosuvastatin.

Stillbirths in China: a nationwide survey

Objective

To estimate a stillbirth rate at 24 or more gestational weeks in 2015–2016 and to explore potentially preventable causes in China.

Design

A multi‐centre cross‐sectional study.

Setting

Ninety‐six hospitals distributed in 24 (of 34) provinces in China.

Population

A total of 75 132 births at 24 completed weeks of gestation or more.

Methods

COX Proportional Hazard Models were performed to examine risk factors for antepartum and intrapartum stillbirths. Population attributable risk percentage was calculated for major risk factors. Correspondence analysis was used to explore region‐specific risk factors for stillbirths.

Main outcome measures

Stillbirth rate and risk factors for stillbirth.

Results

A total of 75 132 births including 949 stillbirths were used for the final analysis, giving a weighted stillbirth rate of 13.2 per 1000 births (95% CI 7.9–18.5). Small for gestational age (SGA) and pre‐eclampsia/eclampsia increased antepartum stillbirths by 26.2% and 11.7%, respectively. Fetal anomalies increased antepartum and intrapartum stillbirths by 17.9% and 7.4%, respectively. Overall, 31.4% of all stillbirths were potentially preventable. Advanced maternal age, pre‐pregnant obesity, chronic hypertension and diabetes mellitus were important risk factors in East China; low education and SGA were major risk factors in Northwest, Southwest, Northeast and South China; and pre‐eclampsia/eclampsia and intrapartum complications were significant risk factors in Central China.

Conclusions

The prevalence of stillbirth was 13.2 per 1000 births in China in 2015–2016. Nearly one‐third of all stillbirths may be preventable. Strategies based on regional characteristics should be considered to reduce further the burden of stillbirths in China.

Tweetable abstract

The stillbirth rate was 13.2 per 1000 births in China in 2015–2016 and nearly one‐third of all stillbirths may be preventable.

The stillbirth rate was 13.2 per 1000 births in China in 2015–2016 and nearly one‐third of all stillbirths may be preventable.

Back pain from painful osteoporotic vertebral fractures: discrepancy between the actual fracture location and the location suggested by patient-reported pain or physical examination findings

Caution is necessary when using symptom or physical examination findings to localize the osteoporotic vertebral fractures (VFs) attributable to the discrepant colocalized relationship.

INTRODUCTION

Whether the location of symptoms or physical examination findings delineates the appropriate spinal range for imaging has not been thoroughly investigated for VFs. The present study aims to analyze the consistency between the fractural vertebrae location and the location suggested by patient-reported pain or physical examination findings.

METHODS

This observational study, following a prospective design, enrolled 358 patients with VFs. The locations of two symptoms (patient-reported back pain [P-RBP], radiating pain [RP]) and findings from two physical examinations (spinal palpation tenderness [SPT], axial spinal percussion pain [ASPP]) were used to locate the VF segments identified using whole-spine magnetic resonance imaging (MRI). The percentage of agreements and kappa coefficient were calculated.

RESULTS

In 20.7% (74/358), the P-RBP site and VF segments were in the same location (kappa = 0.153); 21.2% (76/358) presented with concomitant RP in 93.4% (71/76) of whom the RP dermatome was colocalized with the VF segments (kappa = 0.924); 55.0% (197/358) and 23.2% (83/358) of patients presented with positive SPT and ASPP, respectively; and in 49.2% (97/197) and 96.4% (80/83) of patients with positive SPT (kappa = 0.435) and ASPP (kappa = 0.963), the positive finding and the VF segments were consistently colocalized.

CONCLUSIONS

The positive finding of RP or ASPP is useful in determining the spinal range for imaging tests, while an MRI scan covering the whole thoracic and lumbar spine is necessary in VF-suspected patients with P-RBP or positive SPT, indicating that caution is necessary when using symptoms or physical examination findings to localize VFs.

The Evaluation and Prediction of Laminoplasty Surgery Outcome in Patients with Degenerative Cervical Myelopathy Using Diffusion Tensor MRI

BACKGROUND AND PURPOSE

DTI has been proved valuable for the diagnosis of degenerative cervical myelopathy, whereas its capacity for predicting the outcome of surgery is still under debate. Here we conduct a prospective cohort study to analyze the capacity of DTI for evaluating and predicting laminoplasty surgery outcome for degenerative cervical myelopathy.

MATERIALS AND METHODS

We recruited 55 patients with degenerative cervical myelopathy who underwent DTI before surgery and at 3- and 6-month follow-up stages, and 20 healthy subjects. For clinical assessment, the modified Japanese Orthopedic Association scale was recorded for each patient at different stages. DTI metrics were compared between patients before surgery and healthy subjects. Spearman correlation and receiver operating characteristic were used to analyze the evaluation and prediction capacity of DTI for the modified Japanese Orthopedic Association scale, respectively. We analyzed different vertebral levels: maximal compression level, average of all compression levels, and C2 level.

RESULTS

DTI metrics were significantly different between patients before surgery and healthy subjects. Before surgery, DTI for the maximal compression level or DTI for the average of all compression levels had no significant correlation with the modified Japanese Orthopedic Association scale. For all stages, DTI at the C2 level was correlated with the modified Japanese Orthopedic Association scale. DTI metrics at the C2 level before surgery were significantly correlated with the postoperative modified Japanese Orthopedic Association scale recovery rate. Receiver operating characteristic analysis demonstrated that fractional anisotropy at C2 was capable of predicting the postoperative modified Japanese Orthopedic Association scale recovery rate (P = .04).

CONCLUSIONS

The DTI metrics before laminoplasty surgery, especially fractional anisotropy at the C2 level, have the potential for evaluating and predicting the degenerative cervical myelopathy surgery outcome.

Efficacy of pre-expanded forehead flap based on the superficial temporal artery in correction of cicatricial ectropion of the lower eyelid

Lower eyelid retraction or ectropion bring suffering to the patients both physically and mentally. Efforts to explore pertinent surgical treatments are still needed. Here we have described our preferred surgical technique for lower eyelid ectropion repair with pre-expanded island forehead flaps or pedicled forehead flaps. Between July 2007 and March 2017, a retrospective review of 12 patients who suffered from cicatricial lower eyelid ectropion as a result of trauma, surgery, or infection was conducted. Forehead skin flap based on the superficial temporal artery was expanded depending on the area of defect of the lower eyelid. Tissue expansion, flap transfer, pedicle delaying and division were involved in this process. There were no major complications, such as expander exposure, infection, haematoma or large skin flap necrosis in all the 12 patients. Venous congestion was reported in two patients. No recurrent ectropion was noted in any patient. During the three-month to two-year follow-up all patients were satisfied with the results in terms of the skin texture, colour, and flexibility after the treatment with an expanded forehead skin flap. This study suggests that expanded forehead skin flaps are effective for correction of cicatricial lower eyelid ectropion.

Comparison of contrast-enhanced ultrasound and contrast-enhanced computed tomography for the diagnosis of cervical lymph node metastasis in squamous cell carcinoma of the oral cavity

Early detection of cervical lymph node metastasis (CLNM) from squamous cell carcinoma (SCC) of the oral cavity remains challenging. This prospective study was performed to evaluate the ability of contrast-enhanced ultrasound (CEUS) to detect CLNM from oral cavity SCC. Additionally, its diagnostic value was compared with that of contrast-enhanced computed tomography (CECT). Forty-eight consecutive patients with SCC of the oral cavity were enrolled. All subjects were examined preoperatively with both CEUS and CECT. Subsequently, neck dissections were performed for these patients, and cervical lymph nodes separated from the surgical specimens were assessed histologically. The diagnostic performance of these two examinations was compared based on the results of histopathology. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and Youden index for CEUS and CECT were 69.39% vs. 44.90%, 94.71% vs. 97.12%, 89.88%% vs. 87.16%, 75.56% vs. 78.57%, 92.92% vs. 88.21%, and 64.10% vs. 42.02%, respectively. A significant difference was observed in terms of sensitivity (P=0.024) and Youden index (rate difference 22.08%, 95% confidence interval 2.72-41.44%). Therefore, CEUS appears to be a promising diagnostic tool that is superior to CECT for detecting CLNM from SCC of the oral cavity, with a higher sensitivity.

A single-domain antibody inhibits SFTSV and mitigates virus-induced pathogenesis in vivo

Severe fever with thrombocytopenia syndrome virus (SFTSV) is a novel tick-borne bunyavirus that recently emerged in East Asian countries. SFTS is characterized by high fever, thrombocytopenia, leukopenia, multiorgan failure, and hemorrhage with case fatality rates of 6.3% to 30%. Neither antivirals nor vaccines are available at present. We previously demonstrated that neutralizing antibodies specific for SFTSV glycoprotein (Gn) played a vital role in the survival of patients with SFTS. Nanobodies from camels present unique properties, such as thermostability, high affinity, and low immunogenicity. In the current study, mammalian expressed SFTSV Gn was used to immunize a camel, and functional nanobodies were isolated from the B cell nanobody library constructed from the immunized animal. Clone SNB02 was selected for in-depth analysis for its inhibition of SFTSV replication both in vitro and in vivo. We showed that SNB02 potently inhibited SFTSV infection and prevented thrombocytopenia in a humanized mouse model and is a potential candidate for therapeutics.

Interleukin-6 and severity of COVID-19 patients in Hefei, China

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Twenty-four out of 75 patients developed into severe condition in the course of the infection.

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The prominent laboratory abnormalities of COVID patients were lymphopenia, elevated C-reactive protein (CRP) and lactate dehydrogenase (LDH).

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Elevated interleukin 6 (IL-6) correlated with decrease of LYM%, CD4⁺ and CD8⁺ T cell counts, and increase of CRP, LDH and Procalcitonin (PCT) levels.

Heavy N+ ion transfer in doubly charged N2Ar van der Waals cluster

Van der Waals clusters are weakly bound atomic/molecular systems and are an important medium for understanding micro-environmental chemical phenomena in bio-systems. The presence of neighboring atoms may open channels otherwise forbidden in isolated atoms/molecules. In hydrogen-bond clusters, proton transfer plays a crucial role, which involves mass and charge migration over large distances within the cluster and results in its fragmentation. Here we report an exotic transfer channel involving a heavy N⁺ ion observed in a doubly charged cluster produced by 1 MeV Ne⁸⁺ ions: (N₂Ar)²⁺→N⁺+NAr⁺. The neighboring Ar atom decreases the \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\mathrm{N}}_2^{2 + }$$\end{document}N22+ barrier height and width, resulting in significant shorter lifetimes of the metastable molecular ion state \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\mathrm{N}}_2^{2 + }$$\end{document}N22+(\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\mathrm{X}}^{1}}{\Sigma _{{\mathrm{g}}}^{+}}$$\end{document}X1Σg+). Consequently, the breakup of the covalent N⁺−N⁺ bond, the tunneling out of the N⁺ ion from the \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\mathrm{N}}_2^{2 + }$$\end{document}N22+ potential well, as well as the formation of an N−Ar⁺ bound system take place almost simultaneously, resulting in a Coulomb explosion of N⁺ and NAr⁺ ion pairs.

There are multiple ways by which energy and charge transfer occur in weakly bound systems. Here the authors reveal a heavy ion N⁺ transfer in a doubly charged Van der Waals cluster produced in collisions of the highly charged Ne⁸⁺ ion with N₂Ar, leading to fragmentation of N⁺ and NAr⁺ via Coulomb explosion.

Sediment record of polycyclic aromatic hydrocarbons in Dianchi lake, southwest China: Influence of energy structure changes and economic development

Sixteen polycyclic aromatic hydrocarbons (PAHs) in a sediment core from Dianchi Lake, southwest China, were analysed. The influence of changes in China's energy structure for 2-6 ringed PAHs was investigated to assess sources and the impact of socioeconomic development on temporal changes in concentrations. The concentration of the ΣPAH₁₆ ranged from 746 to 2293 ng g^-1. Prior to the 1960s relatively low concentrations of the ΣPAH₁₆ and a larger proportion of 2-3-ring PAHs indicated that biomass combustion was the main source of PAHs. A rapid increase in the concentrations of 2-3 ring PAHs between 1975 and 2004 was attributed to population growth and coal consumption. A declining trend since 2004 was interpreted as being due to local changes in household energy usage. Increased concentrations of 4-ring PAH between 1975-2005 and 5-6-ring PAHs between the 1980s to 2004 showed correlations with increased coal consumption and the number of motor vehicles, respectively. These were caused by rapid urbanization and industrialization in the Dianchi watershed following the implementation of the Reform and Open Policy in 1978. A subsequent decline in the concentrations of 4-ring and 5-6-ring PAHs may have been due to decreased coal consumption and improvements in emission standards, respectively. Source apportionment by a PMF model revealed that coal combustion (29.2%), vehicle emissions (24.2%), petrogenic sources (21.8%), and biomass combustion (24.9%) were the sources of PAHs in the lake sediment core, and that coal combustion was the most important regional source of PAHs pollution.

0638 Evaluation of an Oral Drug Pyridostigmine Bromide in Patients with Mild to Moderate Obstructive Sleep Apnea

Introduction

A randomized, double-blind, cross-over, placebo-controlled clinical study with pyridostigmine bromide (PYD) in obstructive sleep apnea (OSA) patients ranging from mild to moderate disease was conducted to evaluate its clinical efficacy and safety.

Methods

Six diagnosed male patients with averages of age 48 yr (38 - 57 yr), BMI 28 (26 - 33), AHI 19.2 (15 - 26.2), minimum oxygen saturation (Min SaO2) 81% (75 - 87%) were enrolled to the study. The study consisted one-night acclimatization period followed immediately by a 2-night double-blind treatment period when subjects received either a single dose of PYD (a cholinesterase inhibitor, 90 mg) or placebo before sleep. Subjects were required to maintain in a supine position, and monitored by a standard polysomnography all the time. Sleep questionnaires (The SMH Sleep Questionnaire and ESS) were taken daily immediately after sleep and at the evening to evaluate the sleep satisfaction and the day-time quality, respectively. Safety of the drug was monitored and evaluated.

Results

Reductions of AHI (28.1%, p &lt; 0.01), apnea index (37.2%, p &lt; 0.05), % of total apnea/hypopnea time (36.4%, p &lt; 0.05) were observed in the treatment group compared with the placebo between 2-7 hours of sleep. Min SaO2 was increased, no change, or decreased by PYD in 3, 2, or 1 subject(s), respectively. PYD was generally well tolerated with minimum minor incidents. Subjects reported to have more satisfied sleep and more clear-headed in the treatment night, and more energy, more concentrated and less sleepy during the daytime following the treatment night.

Conclusion

This study demonstrated the initial effectiveness of the PYD treatment for OSA, indicating that it may provide a new treatment option if the efficacy can be maintained in a large-scale clinical trial.

Support

N/A

Bisoprolol, a β1 antagonist, protects myocardial cells from ischemia-reperfusion injury via PI3K/AKT/GSK3β pathway

The aim of this work was to explore whether bisoprolol plays a protective role in cardiomyocytes against ischemia-reperfusion injury via PI3K/AKT/ GSK3β pathway. We pretreated male Sprague Dawley (SD) rats with bisoprolol by oral administration prior to 0.5 h ischemia/4 h reperfusion. Myocardial infarct size and serum levels of cTnI and CK-MB were measured. In vitro, H9c2 cells were treated with hypoxia and reoxygenation, followed by measurement of cell viability, apoptosis, ROS production, cytometry, activities of AKT, GSK3β, and p-38 in the presence and absence of GSK3β siRNA. We found that bisoprolol reduced infarct size from 44% in I/R group to 31% in treated group (P < 0.05). The levels of cTnI and CK-MB were decreased from 286 ± 7 pg/mL and 32.2 ± 2 ng/mL in I/R group to 196 ± 2 pg/mL and 19.6 ± 0.9 ng/mL in the treated group, respectively (P < 0.05). Bisoprolol also increased cell viability while decreased apoptosis and ROS production in the treatment of hypoxia/ reoxygenation. Furthermore, bisoprolol increased AKT and GSK3β phosphorylation, an effect that was immediately eliminated by LY294002. GSK3β-specific siRNA experiment further confirmed that bisoprolol protected the myocardium against hypoxia/reoxygenation-induced injury via suppressing GSK3β activity. In conclusion, bisoprolol protected myocardium against ischemia-reperfusion injury via the PI3K/AKT/ GSK3β pathway.

Facile Synthesis and Study of Microporous Catalytic Arene-Norbornene Annulation-Tröger's Base Ladder Polymers for Membrane Air Separation

We report the facile synthesis and study of two soluble microporous ladder polymers, CANAL-TBs, by combining catalytic arene-norbornene annulation (CANAL) and Tröger's base (TB) formation. The polymers were synthesized in two steps from commercially available chemicals in high yields. CANAL-TBs easily formed mechanically robust films, were thermally stable up to 440 °C, and exhibited very high Brunauer-Teller-Emmett surface areas of 900-1000 m² g^-1. The gas separation performance of the CANAL-TBs for the O₂/N₂ pair is located between the 2008 and 2015 permeability/selectivity upper bounds. After 300 days of aging, CANAL-TBs still exhibited O₂ permeability of 200-500 barrer with O₂/N₂ selectivity of about 5. The polymer with more methyl substituents exhibited higher permeability and slightly larger intersegmental spacing as revealed by WAXS, presumably due to more frustrated chain packing. The facile synthesis, excellent mechanical properties, and promising air separation performance of the CANAL-TB polymers make them attractive membrane materials for various air separation applications, such as aircraft on-board nitrogen generation and oxygen enrichment for combustion.

Multiple-centre clinical evaluation of an ultrafast single-tube assay for SARS-CoV-2 RNA

OBJECTIVE

To evaluate the performance of an ultrafast single-tube nucleic acid isothermal amplification detection assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA using clinical samples from multiple centres.

METHODS

A reverse transcription recombinase-aided amplification (RT-RAA) assay for SARS-CoV-2 was conducted within 15 minutes at 39°C with portable instruments after addition of extracted RNA. The clinical performance of RT-RAA assay was evaluated using 947 clinical samples from five institutions in four regions of China; approved commercial fluorescence quantitative real-time PCR (qRT-PCR) kits were used for parallel detection. The sensitivity and specificity of RT-RAA were compared and analysed.

RESULTS

The RT-RAA test results of 926 samples were consistent with those of qRT-PCR (330 were positive, 596 negative); 21 results were inconsistent. The sensitivity and specificity of RT-RAA was 97.63% (330/338, 95% confidence interval (CI) 95.21 to 98.90) and 97.87% (596/609, 95% CI 96.28 to 98.81) respectively. The positive and negative predictive values were 96.21% (330/343, 95% CI 93.45 to 97.88) and 98.68% (596/604, 95% CI 97.30 to 99.38) respectively. The total coincidence rate was 97.78% (926/947, 95% CI 96.80 to 98.70), and the kappa was 0.952 (p < 0.05).

CONCLUSIONS

With comparable sensitivity and specificity to the commercial qRT-PCR kits, RT-RAA assay for SARS-CoV-2 exhibited the distinctive advantages of simplicity and rapidity in terms of operation and turnaround time.

[Guidelines for the use of post-traumatic tetanus vaccines and passive immune preparation]

Post-traumatic tetanus is the main type of non-neonatal tetanus. To reduce the incidence and mortality rateof tetanus and guide the primary medical institutions to prevent and control tetanus after trauma, the National Immunization Planning Technical Working Group of the Chinese Center for Disease Control and Prevention has compiled this document in the reference with Position Paper by World Health Organization, and the latest research progress both at home and abroad. The guidelines focus on the basic procedures for the prevention and treatment of post-traumatic tetanus, the application of tetanus vaccines and immune preparation, and pre-exposure immunization in high-risk populations of trauma.

[Knowledge, attitude and practice of echinococcosis prevention and control, and their influencing factors among residents living in Seda County, Sichuan Province]

OBJECTIVE

To understand the status of knowledge, attitude and practice on echinococcosis prevention and control and investigate their influencing factors among residents living in Seda County of Sichuan Province, so as to provide a scientific basis for the further implementation of health education interventions in the county.

METHODS

A multi-stage stratified random sampling method was employed on September 2018. Ten townships were randomly sampled, and 2 to 3 administrative villages were randomly sampled from each township. Then, 20 to 40 households were randomly sampled from each village, and 1 to 2 villagers were investigated in each household. The knowledge, attitude and practice on echinococcosis prevention and control were investigated using a household questionnaire survey, and the factors affecting the qualification of echinococcosis prevention and control knowledge were identified using chi-square test and logistic regression analysis.

RESULTS

A total of 760 questionnaires were assigned, and 748 effective questionnaires were recovered, with a recovery rate of 98.42%. The overall qualification rate of echinococcosis prevention and control knowledge was 56.42% (422/748) in residents living in Seda County, and the awareness of the question "How to get echinococcosis?" was only 48.40%. The proportion of subjects with a positive attitude towards echinococcosis prevention and control was 64.71% to 94.79%, and the rate of corrected echinococcosis prevention and control behaviors was 10.40% to 82.45%. Univariate analysis showed that factors affecting the qualification rate of echinococcosis prevention and control knowledge included gender, occupation, education level, frequency of echinococcosis screening and frequency of health education (all P < 0.05), and binary logistic regression analysis showed that women, herdsmen as the primary occupation, an education level of primary school and below, absence of echinococcosis screening and absence of health education were factors responsible for the unqualified awareness of echinococcosis prevention and control knowledge (all P < 0.05).

CONCLUSIONS

There is a low awareness rate of echinococcosis prevention and control knowledge and a low proportion of corrected echinococcosis prevention and control behaviors in residents living in Seda County, Sichuan Province. Multiple forms of health education activities pertaining to echinococcosis prevention and control are needed with adaptation to local circumstance, and implementation of appropriate behavioral interventions is recommended.

Aqueous extraction from dachengqi formula granules reduces the severity of mouse acute pancreatitis via inhibition of pancreatic pro-inflammatory signalling pathways

ETHNOPHARMACOLOGICAL RELEVANCE

Dachengqi decoction (DCQD) belongs to a family of purgative herbal formulas widely used in China for the treatment of acute pancreatitis (AP). AP is a prevalent digestive disease currently without an effective pharmacological intervention. Formula granules have become the preferred method for delivery of herbal formulation in China given its benefit of potency retention, dosing precision and ease of use. The efficacy of DCQD formula granules (DFGs) in experimental AP models has not been investigated.

AIM OF THE STUDY

To analyse and compare the differences in chemical composition of DFGs, with their aqueous extraction (AE) and chloroform extraction (CE) derivatives. To assess their efficacy on severity and targeted pancreatic pro-inflammatory signalling pathways in freshly isolated acinar cells and two models of experimental AP.

MATERIAL AND METHODS

UPLC-Q-TOF-MS was used to analyse chemical components of DFGs and their extractions. Freshly isolated mouse pancreatic acinar cells were treated with taurolithocholic acid 3-sulphate disodium salt (TLCS, 500 μM) with or without DFGs, AE and CE. Apoptotic and necrotic cell death pathway activation was measured by caspase 3/7 (10 μl/mL) and propidium iodide (PI, 1 μM), respectively, using a fluorescent plate reader. Necrotic acinar cells were also counted by epifluorescence microscopy. Mice received either 7 intraperitoneal injections of caerulein (50 μg/kg) at hourly intervals or retrograde infusion of TLCS (3 mM, 50 μl) to induce AP (CER-AP and TLCS-AP, respectively). In CER-AP, mice received oral gavage of DFGs (2.1, 4.2 and 5.2 g/kg), AE (0.6, 1.2, and 2.4 g/kg) and CE (4, 9 and 17 mg/kg), or matched DFGs (1.8 g/kg) and AE (1 g/kg) for 3 times at 2-hourly intervals, or a single intraperitoneal injection of DCQD-related monomers rhein (20 mg/kg), narigeinine (25 mg/kg), and honokiol (5 mg/kg) begun at the 3rd injection of caerulein. In TLCS-AP, DFGs (4.2 g/kg) were given orally at 1, 3 and 5 h post-surgery. Disease severity and pancreatic pro-inflammatory markers were determined.

RESULTS

The main effective anthraquinones and their glycosides, flavonoids and their glycosides, polyphenols and lignans were found in the DFGs. A higher proportion of polar components including glycosides attached to anthraquinones, phenols and flavonoids was found in AE. Conversely, lower polar components containing methoxy substituted flavonoids and anthraquinones were more abundant in CE. DFGs were given at 4.2 g/kg, a consistent reduction in the pancreatic histopathology score and severity indices was observed in both CER-AP and TLCS-AP. In vitro, AE significantly reduced both apoptotic and necrotic cell death pathway activation, while CE increased TLCS-induced acinar cell necrosis. In vivo, AE at dose of 1.2 g/kg consistently reduced pancreatic histopathological scores and myeloperoxidase in the CER-AP that were associated with suppressed expression of pro-inflammatory meditator mRNAs and proteins. CE increased lung myeloperoxidase and failed to protect against CER-AP in all dosages. AE was demonstrated to be more effective than DFGs in reducing pancreatic histopathological scores and myeloperoxidase.

CONCLUSIONS

AE from DFGs alleviated the severity of mouse AP models via an inhibition of pancreatic pro-inflammatory signalling pathways. Efficacy of AE on experimental AP was more potent than its original DFGs and DCQD monomers.

Effect of GATA4 gene methylation on proliferation and apoptosis of SGC-7901 gastric cancer cells

Gastric cancer (GC) remains a major cause of cancer-related deaths worldwide. GATA4 has been previously reported to exhibit functions in GC. In this study, we aimed to investigate the effect of GATA4 gene methylation on GC progression. Methylation-Sensitive High-Resolution Melting was used to detect the methylation of GATA4 promoter region in GC tissues and adjacent normal tissues, GC cell lines and GES-1 cells. The relationship between GATA4 methylation level and clinical characteristics of GC patients was analyzed. GATA4 levels in GC tissues and adjacent normal tissues, GC cell lines and GES-1 cell lines were detected, and gain-of-function was performed to investigate the role of GATA4 in GC. si-GATA4 was transfected into GES-1 cells to observe the changes of various indicators. RNA-seq detected the differentially expressed genes in SGC-7901 cells overexpressing GATA4, and western blot analysis verified their expression. GATA4 methylation rate was increased in GC tissues, and GATA4 promoter was abnormally methylated in GC cells. GATA4 methylation rate in GC tissues was related to lymph node metastasis, differentiation degree and clinical stage of GC patients. Lower expressed GATA4 was observed in GC tissues and cells. Cell proliferation rate decreased and cell apoptosis rate increased in SGC-7901 cells overexpressing GATA4. Transfecting si-GATA4 into GES-1 cells led to increased proliferation, inhibited apoptosis, and restoration of GATA4 led to decreased APC and GSK3β levels. In conclusion, restoration of GATA4 caused by 5-Aza treatment can inhibit the proliferation and promote apoptosis of GC cells possibly via Wnt/β-catenin signaling pathway. This study may offer new sight for GC treatment.

Combined eight-long noncoding RNA signature: a new risk score predicting prognosis in elderly non-small cell lung cancer patients

The elderly are the majority of patients with non-small cell lung cancer (NSCLC). Compared to the overall population's predictive guidance, an effective predictive guidance for elderly patients can better guide patients' postoperative treatment and improve overall survival (OS) and disease-free survival (DFS). Recently, the long non-coding RNAs (lncRNAs) have been found to play an important role in predicting tumor prognosis. To identify potential lncRNAs to predict survival in elderly patients with NSCLC, in the present study, we chose 456 elderly patients with NSCLC and analyzed differentially expressed lncRNAs from four Gene Expression Omnibus (GEO) datasets (GSE30219, GSE31546, GSE37745 and GSE50081). We then constructed an eight-lncRNA formula to predict elderly patients’ prognosis in NSCLC. Furthermore, we validated the prognostic values of the new risk model in two independent datasets, TCGA (n=670) and GSE31210 (n=130). Our data suggested a significant association between risk model and patients’ prognosis. Finally, stratification analysis further revealed the eight-lncRNA signature was an independent factor to predict OS and DFS in stage I elderly patients from both the discovery and validation groups. Functional prediction revealed that 8 lncRNAs have potential effects on tumor immune processes such as lymphocyte activation and TNF production in NSCLC. In summary, our data provides evidence that the eight-lncRNA signature could serve as an independent biomarker to predict prognosis in elderly patients with NSCLC especially in elderly stage I patients.