Effect of Spin-Draw Rate and Stretching Ratio on Polypropylene Hollow Fiber Membrane Made by Melt-Spinning and Stretching Method

A series of polypropylene hollow fiber membranes was fabricated by melt-spinning and stretching. The crystalline behavior and hard elasticity of precursor hollow fibers were studied by differential scanning calorimetry (DSC), elastic recovery and strain-stress curves. The structure and properties of membranes were investigated in detail by scanning electron microscopy (SEM), optical microscopy, pure water flux, and so on. The results showed that membranes with excellent structure and properties can be obtained at a spin-draw rate of 350 m/min and a stretching ratio of 200 %. The evolution of crystal structure was explored during the annealing and stretching processes by two-dimensional small-angle X-ray scattering (2D-SAXS). Shish-kebab structure was obtained during annealing for hollow fibers at a spin-draw rate of 350 m/min. The crystalline lamellae were destroyed and micropores were formed during the fabrication of membranes by stretching.

Characteristics, management, and outcome of primary hyperparathyroidism at a single clinical center from 2005 to 2016

This study presents the clinical and biochemical profiles of patients with PHPT between 2005 and 2016 at our center. Most PHPT patients in China show symptomatic features. The number of symptomatic and asymptomatic patients increased during that time, and the number of individuals with parathyroid carcinoma is now increasing.

INTRODUCTION

Over the last decade, the prevalence of primary hyperparathyroidism (PHPT) has increased sharply, and the number of individuals with parathyroid cancer is still trending upward. Little is known about the clinical outlook of the disease over the last decade in China. The aim of this study was to describe the clinical characteristics of PHPT patients at our center from January 2005 to December 2016.

METHODS

Two hundred sixty patients with PHPT visiting Shanghai Jiao Tong University Affiliated Sixth People's Hospital were enrolled retrospectively. The clinical manifestations and biochemical abnormalities of these patients were analyzed.

RESULTS

Among all patients, 73.1% had symptomatic PHPT, while the number of symptomatic and asymptomatic patients increased 1 to 2.5 times and 1.5 to 3 times, respectively, from 2005 to 2016. Bone pain and single adenoma were the most frequent signs and pathological results. The patients with parathyroid carcinoma over the last 5 years accounted for 90% (9/10) of all parathyroid carcinoma patients from 2005 to 2016, and parathyroid carcinoma patients had higher levels of serum calcium, parathyroid hormone (PTH), and serum creatinine (P < 0.05) than parathyroid hyperplasia and parathyroid adenoma patients.

CONCLUSIONS

Most patients with PHPT in China still exhibit classic clinical and biochemical features. Both symptomatic and asymptomatic patients have increased over the last 12 years. Although the proportion of parathyroid carcinoma was small, a noticeable upward tendency was observed at our center.

[Clinical analysis of 138 multiple primary cancers diagnosed of digestive system malignant tumor initially]

Objective: To study the clinical characteristics, strategy of treatment and prognosis of multiple primary cancers(MPC) diagnosed of digestive system malignant tumor firstly. Methods: From January, 2000 to December, 2015, the clinical, follow-up and prognostic data of 138 MPC patients diagnosed of digestive system malignant tumor firstly were retrospectively analyzed. Results: 138 cases were found in 10 580 cases with malignant tumors, and the incidence was 1.30%. There were 129 cases of duplex primary cancers, 8 cases of triple primary cancers and 1 case of quintuple primary cancers. The repetitive primary cancer was occurred in digestive system (61cases, 44.2%) most frequently, with the next in respiratory system (46 cases, 33.3%). 52.2% (72 cases) suffered second primary cancer in 2 years after first primary cancer diagnosed, and 75.4% (104 cases) in 5 years. The median overall survival in patients with all cancer lesions radically treated was 168 months, better than any other treatment (68 months, P<0.05). Conclusions: The second primary cancers of MPC cases initially diagnosed of digestive system malignant tumor most frequently occurred in the digestive system and respiratory system. More concern should be attracted in follow-up, especially in the first 5 years. The key to improve patient' prognosis was radical treatment to every primary cancer.

DNA hydroxymethylation rate in the AChE and HoxC4 promoter associated with human sperm quality

The relationship of altered DNA 5'-hydroxymethylation in human spermatozoa with seminal parameters remains unclear. The aim of the study was to investigate the association between the 5'-hydroxymethylcytosine (5hmC) rate in the promoters of acetylcholinesterase (AChE) and homeobox C4 (HoxC4) genes and human sperm concentration/motility. The study population consisted of three groups: asthenozoospermia (AZ), oligoasthenozoospermia (OAZ) and normozoospermia (NZ). The 5hmC rate in the promoter was measured by CCGG loci-dependent MspI/HpaII restriction mapping of glycosylation-modified sperm DNA combined with a hydroxymethylation-specific real-time polymerase chain reaction assay. The 5hmC rate in the AChE promoter in group AZ and OAZ was higher than that in group NZ (p < .05). A weak inverse correlation between 5hmC rate of AChE and sperm motility was observed in all subjects (r = -.172, p < .05). The 5hmC rate in the HoxC4 promoter in group OAZ was lower than that in group NZ (p < .05). These results indicated that altered 5hmC rates of AChE and HoxC4 promoters are associated with low sperm motility and sperm concentration respectively.

Effect of methionine deficiency on duodenal and jejunal IgA+ B cell count and immunoglobulin level of broilers

Dietary methionine (met) is reported to enhance antibody production and boost cell-mediated immunity in chickens. Methionine deficiency has been shown to affect the development of the lymphoid organs and the generation of antibodies in chickens. This study is designed to investigate the effects of met deficiency on IgA⁺ B cells and immunoglobulins (sIgA, IgA, IgG and IgM) for a 6 week period in the duodenum and jejunum of Cobb broiler chicken using immunohistochemistry and enzyme-linked immunosorbent assay (ELISA) techniques. The results of the study showed that the IgA⁺ B cell count reduced significantly in the met deficiency group compared to the control group (P<0.05 or P<0.01). The contents of sIgA, IgA, IgG and IgM in the met deficiency group were significantly decreased (P<0.05 or P<0.01), especially at 28 and 42 days of age. It can be concluded that met deficiency exerts significant effects on the humoral immune system of intestinal mucosa. This study has provided valuable experimental insight which could be useful for future studies on the function of met in the intestine of humans and other animals.

A proteomics analysis reveals that A2M might be regulated by STAT3 in persistent allergic rhinitis

BACKGROUND

Proteomics tools can be used to identify the differentially expressed proteins related to allergic rhinitis (AR). However, the large numbers of proteins related to AR have not yet been explored using an advanced quantitative proteomics approach, known as isobaric tags for relative and absolute quantitation (iTRAQ).

OBJECTIVES

To identify differentially expressed proteins in persistent AR patients and to explore the regulatory signalling pathways involving the identified proteins.

METHODS

Forty-five persistent AR patients and 20 healthy controls were recruited for this study. iTRAQ was used to identify the proteins that were differentially expressed between these two groups, and a bioinformatics analysis was then conducted to identify the signalling pathways associated with the identified proteins. Immunofluorescence labelling was performed to detect alpha-2-macroglobulin (A2M), STAT3, p-STAT3 and IL17 in the nasal mucosa.

RESULTS

A total of 133 differentially expressed proteins were identified. We then determined the top 10 regulatory pathways associated with these proteins and found that the blood coagulation pathway had the most significant association. A2M, a protein involved in the blood coagulation pathway, was found to be differentially expressed in the serum of AR patients. The bioinformatics analysis indicated that STAT3 is an upstream transcription factor that might regulate A2M expression. An immunofluorescence study further confirmed that STAT3 and A2M are co-localized in nasal mucosa cells. Additionally, A2M, STAT3, p-STAT3, and IL17 are elevated in AR patients. The expressional level of A2M is positively related to IL17 and the symptom of the congestion in AR subjects.

CONCLUSIONS

The blood coagulation pathway may be a key regulatory network pathway contributing to the allergic inflammatory response in AR patients. A2M, which is regulated by STAT3, may be an important protein in the pathogenesis of allergic rhinitis in AR patients.

Genome-wide association study identifies the common variants in CYP3A4 and CYP3A5 responsible for variation in tacrolimus trough concentration in Caucasian kidney transplant recipients

The immunosuppressant tacrolimus (TAC) is metabolized by both cytochrome P450 3A4 (CYP3A4) and CYP3A5 enzymes. It is common for European Americans (EA) to carry two CYP3A5 loss-of-function (LoF) variants that profoundly reduces TAC metabolism. Despite having two LoF alleles, there is still considerable variability in TAC troughs and identifying additional variants in genes outside of the CYP3A5 gene could provide insight into this variability. We analyzed TAC trough concentrations in 1345 adult EA recipients with two CYP3A5 LoF alleles in a genome-wide association study. Only CYP3A4*22 was identified and no additional variants were genome-wide significant. Additional high allele frequency genetic variants with strong genetic effects associated with TAC trough variability are unlikely to be associated with TAC variation in the EA population. These data suggest that low allele frequency variants, identified by DNA sequencing, should be evaluated and may identify additional variants that contribute to TAC pharmacokinetic variability.

A Dataset for Three-Dimensional Distribution of 39 Elements Including Plant Nutrients and Other Metals and Metalloids in the Soils of a Forested Headwater Catchment

Quantification and evaluation of elemental distribution in forested ecosystems are key requirements to understand element fluxes and their relationship with hydrological and biogeochemical processes in the system. However, datasets supporting such a study on the catchment scale are still limited. Here we provide a dataset comprising spatially highly resolved distributions of 39 elements in soil profiles of a small forested headwater catchment in western Germany () to gain a holistic picture of the state and fluxes of elements in the catchment. The elements include both plant nutrients and other metals and metalloids that were predominately derived from lithospheric or anthropogenic inputs, thereby allowing us to not only capture the nutrient status of the catchment but to also estimate the functional development of the ecosystem. Soil samples were collected at high lateral resolution (≤60 m), and element concentrations were determined vertically for four soil horizons (L/Of, Oh, A, B). From this, a three-dimensional view of the distribution of these elements could be established with high spatial resolution on the catchment scale in a temperate natural forested ecosystem. The dataset can be combined with other datasets and studies of the TERENO (Terrestrial Environmental Observatories) Data Discovery Portal () to reveal elemental fluxes, establish relations between elements and other soil properties, and/or as input for modeling elemental cycling in temperate forested ecosystems.

[Lung transplantation for connective tissue disease-associated interstitial lung disease recipient]

Objective: To investigate the timing and complications of lung transplantation for the treatment of connective tissue disease-associated interstitial lung disease (CTD-ILD). Method: The clinical data of connective tissue-associated disease lung transplantation recipients from September, 2015 to February, 2017 were collected. Results: 11 patients with CTD-ILD were evaluated by lung transplantation and were treated with lung transplantation. Including 2 cases dermatomyositis/polymyositis and interstitial lung disease (PM/DM-ILD), 4 cases rheumatoid arthritis and interstitial lung disease (RA-ILD), 4 cases of primary Sjgren's syndrome and interstitial lung disease (pSS-ILD), 1 case of systemic sclerosis and interstitial lung disease (SSc-ILD). There are 6 cases are CTD-ILD-PAH patients of all. There were 5 males and 6 females, aged 37-70 years, with an average age of (52.73±9.53) years. 7 patients received single lung transplantation, 4 patients received double lung transplantation. 3 patients died in the early postoperative period, one for pulmonary embolism, one for septic shock and heart failure, one for severe primary graft failure (PGD). The remaining patients were followed up (4-24 months) with good survival, no acute and chronic rejection and other complications were observed. The survival rate was similar to that of other disease sources. Conclusion: There is no recurrence, acute and chronic rejection and other complications were observed in CTD-ILD and/or PAH lung transplant recipients. And the survival rate was comparable to that of other disease sources.Lung transplantation is a safe and effective choice for selected CTD-ILD patients.

MiR-96 expression in prostate cancer and its effect on the target gene regulation

OBJECTIVE

Previous studies showed that miR-96 was associated with a carcinogenic effect. To investigate the expression of miR-96 and related target genes in the regulation of prostatic cancer, we compared the expression of miR-96 in both prostatic cancer and adjacent normal tissues, and explored the role of miR-96 in prostate cancer.

PATIENTS AND METHODS

PC-3 cell line originated from human prostatic cancer tissues was prepared. RNA was extracted for examination of miR-96 expression. The expressional alternation of miR-96 target genes, forkhead box O1 (FOXO1) and forkhead box O3a (FOXO3a), in prostatic cancer, was confirmed by PC-3 cells transfected with miR-96 and anti miR-96.

RESULTS

Compared with control group, levels of FOXO1 and FOXO3a in PC-3 cells treated with anti miR-96 were 1.584 times and 1.637 times higher, respectively. Further, PC-3 cells were transfected with siRNA targeting FOXO1 and FOXO3a, resulting in a significant decrease of FOXO1 and FOXO3a expression, as verified by qPCR and Western blot analyses. Compared with untreated groups, proliferation and cell clonal formation exhibited a marked increase in PC-3 cells under transfection with both siR-FOXO1 and siR-FOXO3a.

CONCLUSIONS

As target genes of miR-96, FOXO1 and FOXO3a confer protection against prostatic cancer, while the inhibition of FOXO1 and FOXO3a enhances cancer proliferation.

[Effects of retroperitoneal laparoscopic ureterolithotomy and flexible-ureteroscopic holmium laser lithotripsy for complex upper ureteral calculi]

Objective: To explore the clinical effects of retroperitoneal laparoscopic ureterolithotomy (RPLU) and flexible-ureteroscopic holmium laser lithotripsy (f-UHLL) for complicated upper ureteral calculi. Methods: A total of 45 cases of complicated upper ureteral calculi between March 2014 and January 2016 in Department of Urology, Affiliated Jiangyin Hospital of Southeast University Medical College were retrospectively analyzed, there were 32 males and 13 females, ranging from 27 to 45 years with an average age of (34.1±9.5) years. Of the 45 patients, 28 had ureteral distortion and 17 had concurrent ureteral stones in the lower or middle ipsilateral ureter. In those patients, 20 cases underwent f-UHLL, and 25 cases received RPLU. The stone size, operation time, hospital stay, stone clearance rates and postoperative fever rates between the two groups were compared with t test and χ(2)test. Results: The operation was successfully performed in all patients, no complications with leakage of urine or ureteral perforation occurred, and no significant difference in renal function between the two methods were founded in postoperative period. There was no significant difference in operation time((78.4±8.5) minuetes vs.(73.3±11.3) minuetes, t=0.61, P=0.67), time of double J tube removed ((33.8±3.4)days vs. (37.6±8.9) d, t=2.37, P=0.08) and ipsilateral renal glomerular filtration rates ((41.3±7.6)ml/minuetes vs.(40.5±7.1) ml/min, t=0.78, P=1.27) between the two groups. However, the hospitalization time ((5.9±1.7)days vs. (4.2±1.6) days, t=1.92, P=0.04), postoperative fever rates (4% vs.30%, χ(2)=5.72, P=0.03) and calculus clearance rates (100% vs. 75%, χ(2)=7.03, P=0.01) in RPLU were significantly higher than f-UHLL. Besides, 5 patients in the f-UHLL group had postoperative stone residue and were treated with extracorpore shock wave lithotripsy. Conclusions: Both RPLU and f-UHLL are safety and validity for complex upper ureteral calculi. RPLU can improve the rate of calculus removal and reduce the rate of postoperative fever.

Long non-coding RNA Loc344887 is a potential prognostic biomarker in non-small cell lung cancer

OBJECTIVE

Long non-coding RNA NmrA-like family domain containing 1 pseudogene (Loc344887) has been shown to be aberrantly expressed in non-small cell lung cancer (NSCLC). However, the biological function of Loc344887 in NSCLC remains unknown. The present study aimed to explore the prognosis value of Loc344887 in NSCLC patients.

PATIENTS AND METHODS

Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was used to detect the expression level of Loc344887 in NSCLC tissues and adjacent non-tumor lung tissues. Correlations between Loc344887 expression and the clinicopathological features of NSCLC patients were then evaluated. Overall survival was examined using Kaplan-Meier curves. Cox regression analyses were performed to judge whether plasma Loc344887 was an independent predictor of survival.

RESULTS

The expression levels of Loc344887 were increased in NSCLC tissues compared with those in normal lung tissues (p < 0.05). High Loc344887 expression level was significantly associated with lymph node metastasis (p = 0.005), advance stage (p = 0.001), and poorer differentiation (p = 0.014). Furthermore, patients with high expression of Loc344887 had a significantly shorter overall survival time compared with those with low Loc344887 expression in NSCLC (p < 0.001). Further analysis by Cox regression showed that high expression of Loc344887 in NSCLC was an independent predictor of poor prognosis.

CONCLUSIONS

These findings, for the first time, suggested the potential roles of Loc344887as a prognostic factor and as a therapeutic target for NSCLC.

[Systematic evaluation on effectiveness and safety of recombinant human growth hormone in treating adult patients with severe burn]

Objective: To systcmatically evaluate the effectiveness and safety of recombinant human growth hormone (rhGH) in treating adults with severe burn. Methods: Databases including PubMed, Cochrane Library, and Embase were searched using key words " burns, thermal, human growth hormone, growth hormone, hGH, and somatropin (human)" , and China Biology Medicine disc, Chinese Journals Full-text Database, VIP Database, and Wanfang Database were searched using key words in Chinese version "," to obtain the randomized controlled trials about rhGH in the treatment of adults with severe burn from the establishment of each database to December 2016. The measurement indexes included hemoglobin (Hb) and plasma total protein, inflammatory factors [including interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α)], incidence rate of sepsis, incidence rate of hyperglycemia, wound healing time, length of stay, and mortality rate. Meta-analysis was conducted by RevMan 5.3 statistical software. Results: A total of 8 trials involving 534 patients were included; 276 patients in rhGH group were treated with rhGH and 258 patients in placebo control group were treated with placebo. One trial had low risk of bias, while the other 7 trials had unclear risk of bias. The levels of Hb and plasma total protein of patients in rhGH group were higher than those in placebo control group, with standardized mean differences (SMDs) respectively 2.00 and 2.23 [with 95% confidence intervals (CIs) respectively 0.19-3.82 and 1.21-3.26, P<0.05 or P<0.01]. The levels of IL-6 and TNF-α of patients in rhGH group were lower than those in placebo control group, with SMDs respectively -1.46 and -1.13 (with 95% CIs respectively -2.40--0.53 and -1.75--0.51, P values below 0.05). Incidence rate of sepsis and mortality rate of patients in rhGH group were lower than those in placebo control group, with relative risks (RRs) respectively 0.60 and 0.35 (with 95% CIs respectively 0.42-0.85 and 0.15-0.83, P values below 0.05). Incidence rate of hyperglycemia of patients in rhGH group was higher than that in placebo control group, with RR of 2.39 (with 95% CI 1.79-3.18, P<0.001). The wound healing time and length of stay of patients in rhGH group were lower than those in control group, with SMDs respectively -1.54 and -2.00 (with 95% CIs respectively -2.22--0.86 and -3.51--0.49, P<0.05 or P<0.01). Hb, plasma total protein, inflammatory factors, incidence rate of sepsis, wound healing time, length of stay, and mortality rate showed no significant publication bias (P values above 0.05), while there may be publication bias in incidence rate of hyperglycemia (P=0.026). Conclusions: rhGH can inhibit the breakdown of Hb and plasma total protein, reduce the level of inflammatory factors and incidence rate of sepsis, thus shorten the wound healing time and length of stay, thereby reduce mortality rate of adult patients with severe burn. However rhGH may cause hyperglycemia.

Focal Low and Global High Permeability Predict the Possibility, Risk, and Location of Hemorrhagic Transformation following Intra-Arterial Thrombolysis Therapy in Acute Stroke

BACKGROUND AND PURPOSE

The contrast volume transfer coefficient (K^trans), which reflects blood-brain barrier permeability, is influenced by circulation and measurement conditions. We hypothesized that focal low BBB permeability values can predict the spatial distribution of hemorrhagic transformation and global high BBB permeability values can predict the likelihood of hemorrhagic transformation.

MATERIALS AND METHODS

We retrospectively enrolled 106 patients with hemispheric stroke who received intra-arterial thrombolytic treatment. K^trans maps were obtained with first-pass perfusion CT data. The K^trans values at the region level, obtained with the Alberta Stroke Program Early CT Score system, were compared to determine the differences between the hemorrhagic transformation and nonhemorrhagic transformation regions. The K^trans values of the whole ischemic region based on baseline perfusion CT were obtained as a variable to hemorrhagic transformation possibility at the global level.

RESULTS

Forty-eight (45.3%) patients had hemorrhagic transformation, and 21 (19.8%) had symptomatic intracranial hemorrhage. At the region level, there were 82 ROIs with hemorrhagic transformation and parenchymal hemorrhage with a mean K^trans, 0.5 ± 0.5/min, which was significantly lower than that in the nonhemorrhagic transformation regions (P < .01). The mean K^trans value of 615 nonhemorrhagic transformation ROIs was 0.7 ± 0.6/min. At the global level, there was a significant difference (P = .01) between the mean K^trans values of patients with symptomatic intracranial hemorrhage (1.3 ± 0.9) and those without symptomatic intracranial hemorrhage (0.8 ± 0.4). Only a high K^trans value at the global level could predict the occurrence of symptomatic intracranial hemorrhage (P < .01; OR = 5.04; 95% CI, 2.01-12.65).

CONCLUSIONS

Global high K^trans values can predict the likelihood of hemorrhagic transformation or symptomatic intracranial hemorrhage at the patient level, whereas focal low K^trans values can predict the spatial distributions of hemorrhagic transformation at the region level.

[Expression of intercellular adhesion molecule-1 and myeloperoxidase in peripheral blood and its significance in elderly patients with OSAHS]

Objective:To investigate the detection and significance of serum intercellular adhesion molecule-1 (ICAM-1) and myeloperoxidase (MPO) in elderly patients with OSAHS in adults.Method:Ninety-three cases of elderly OSAHS patients who confirmed by PSG were observed. According to the range of AHI, they were divided into 3 groups (severe, moderate and mild). 31 cases of healthy person were observed as control group. The serum ICAM-1 and MPO were determined by ELISA method; ICAM-1 and MPO were measured after comprehensive treatment in patients with elderly severe OSAHS, and the correlation between ICAM-1, MPO and PSG were analyzed.Result:①With the severity of snoring increased, the serum levels of ICAM-1 and MPO increased gradually (F=29.937,18.946; P< 0.01); The concentration of ICAM-1 and MPO in each group showed that there was no significant difference between the mild group and the control group (P> 0.05), there were significant differences between the rest each two groups (P< 0.05). ②There was no correlation between serum levels of ICAM-1, MPO, BMI, age in OSAHS patients (P> 0.05). There was a positively relationship between ICAM-1 and MPO . Both of them were negatively correlated with AHI, and positively correlated with LSaO2 (P< 0.01). ③The concentration of ICAM-1, MPO and AHI in 31 elderly patients with severe OSAHS decreased and LSaO₂ increased significantly after 3 months of comprehensive treatment (P< 0.01).Conclusion:The increase of ICAM-1 and MPO concentration in peripheral blood is one of the mechanisms of cardiovascular damage in elderly patients with OSAHS. Determination of peripheral blood ICAM-1, MPO levels in elderly patients with OSAHS to help determine the severity of disease, the evaluation of treatment,which may have a certain reference value for the prediction of cardiovascular disease risk in patients with severe OSAHS.

Mechanisms of vasorelaxation induced by total flavonoids of Euphorbia humifusa in rat aorta

Euphorbia humifusa Willd. (EH), rich in flavonoids, has long been used for the treatment of bacillary dysentery and enteritis in China, and is known to have antioxidant, hypotensive and hypolipidemic properties. However, the vasorelaxant effect of total flavonoids of EH (TFEH) and action mechanisms are not clearly defined yet. The aim of the present study was to investigate the effects of TFEH on the vascular tension and its underlying mechanisms. Experiments were performed in rat thoracic aorta using the organ bath system. TFEH (0.01 - 100 μg/ml) caused a concentration-dependent vasorelaxation, which was dependent on a functional endothelium, and were significantly attenuated by inhibitors of endothelial NO synthase, its upstream signaling pathway, PI3K/Akt, and soluble guanylate cyclase, but not by blockade of K_Ca channel, K_ATP channel, cyclooxygenase, muscarinic and β-adrenergic receptors. Extracellular Ca²⁺ depletion, and pre-treatment with modulators of the store-operated Ca²⁺ entry channels, Gd³⁺ and 2-aminoethyl diphenylborinate, significantly attenuated the TFEH-induced vasorelaxation. Our findings suggest that TFEH elicit vasorelaxation via endothelium-dependent NO-cGMP pathway through activation of PI3K/Akt- and Ca²⁺-eNOS-NO signaling. Further, it is suggested that TFEH-induced activation of the NO-soluble guanylate cyclase-cGMP-protein kinase G signaling relaxes vascular smooth muscle cells through an inhibition of the L-type Ca²⁺ channel activity.

Medical therapy for preventing recurrent endometriosis after conservative surgery: a cost-effectiveness analysis

OBJECTIVE

To assess the cost-effectiveness of different strategies, including gonadotropin-releasing hormone agonist (GnRH-a) and oral contraceptive therapy, for the prevention of endometriosis recurrence after conservative surgery.

DESIGN

Cost-effectiveness analysis from a health care perspective.

SETTING

A health-resource-limited setting in China.

POPULATION

Patients who underwent conservative laparoscopic or laparotomic surgery for endometriosis.

METHODS

A Markov model was developed for the endometriosis disease course. Clinical data were obtained from published studies. Direct medical costs and resource utilization in the Chinese health care setting were taken into account. The health and economic outcomes were evaluated over a period from treatment initiation to menopause onset. Sensitivity analyses were carried out to test the impact of various parameters and assumptions on the model output.

MAIN OUTCOME MEASURES

Quality-adjusted life years (QALYs) gained and costs from a health care perspective.

RESULTS

The incremental cost-effectiveness ratio of 6-month GnRH-a therapy compared with no therapy ranged from $6,185 per QALY in deep endometriosis to $6,425 with peritoneal endometriosis. A one-way sensitivity analysis showed considerable influential factors, such as remission rates and utility values. Probabilistic sensitivity analysis indicated that 6-month GnRH-a therapy is cost-effective in most cases at a threshold of $7,400/QALY, regardless of the type of endometriosis.

CONCLUSION

Six months of therapy with GnRH-a can be a highly cost-effective option for the prevention of endometriosis recurrence.

TWEETABLE ABSTRACT

Gonadotropin-releasing hormone agonist is cost effective for the prevention of endometriosis recurrence.

[Effect of sandblasting on bending strength and subcritical crack growth of the dental zirconia ceramics]

Objective: To evaluate the effect of sandblasting on bending strength and subcritical crack growth (SCG) under cyclic loading of yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramics. Methods: After being polished, sixty bar-shaped specimens of Y-TZP (Wieland zirconia ceramics) were assigned to two groups (n=30) according to the random number table, the sandblasting group (SG) which was treated with sandblasting and the control group (CG) which remained untouched. In each group, half of the specimens (n=15) were subjected to bending strength test, and the results were examined by Weibull statistics and analyzed with ANOVA. The other 15 specimens in each group were subjected to fatigue tests. The results were examined by Weibull statistics and subcritical crack propagation rates were calculated. Results: The bending strengths of SG and CG were (1 291±133) and (1 140±124) MPa (F=10.117, P=0.004), and the Weibull modules of the two groups were 11.06 and 10.64 respectively. The crack growth rate of SCG of SG was lower than that of CG under the same cyclic loading. Conclusions: Proper sandblasting on Y-TZP ceramic can increase its bending strength and resistance to SCG.

Prognostic significance of tumour regression grade after neoadjuvant chemoradiotherapy for a cohort of patients with locally advanced rectal cancer: an 8-year retrospective single-institutional study

AIM

Locally advanced rectal cancer (LARC) is frequently treated with neoadjuvant chemoradiotherapy (NACRT) to reduce the risk of local recurrence and improve survival. Tumour response to NACRT is variable and may influence the prognosis after subsequent surgery. This study compared the prognostic values of tumour regression grade (TRG) and neoadjuvant pathological (ypTNM) downstaging in patients with Stage II and III rectal cancer treated with NACRT followed by curative surgery.

METHOD

This study included 185 patients with LARC treated with long-course radiotherapy (45 Gy in 25 fractions) plus 5-fluorouracil over 5 weeks between 2005 and 2013. We used multivariate analysis to assess the relationship of Dworak's five-tier TRG, ypTNM stage and ypTNM downstaging with clinicopathological factors, 5-year disease-free survival (DFS) and 5-year overall survival (OS).

RESULTS

Total regression (TRG4), good regression (TRG3), moderate regression (TRG2), minor regression (TRG1) and no regression (TRG0) were seen in 38 (20.6%), 65 (35.2%), 43 (23.2%), 28 (15.1%) and 11 (5.9%) patients, respectively. TNM downstaging following NACRT occurred in 109 (58.9%) patients. The 5-year DFS rates after NACRT for TRG0, TRG1, TRG2, TRG3 and TRG4 were 0%, 58.5%, 66.4%, 80.4% and 82.6%, respectively (P < 0.001). The ypTNM stage correlated with 5-year DFS (P = 0.004) but not 5-year OS (P = 0.075). Multivariate analysis demonstrated that TRG was related to both DFS and OS (P < 0.001).

CONCLUSION

TRG measured on a five-tier system was better than ypTNM stage for predicting outcome in patients with LARC treated with NACRT and surgery.

Diagnostic value of epidermal growth factor, cancer antigen 125, and cancer antigen 15-3 in bronchoalveolar lavage fluid of lung cancer

AIM

In the present study, we assessed the diagnostic value of epidermal growth factor (egf) and cancer antigens 125 (ca125) and 15-3 (ca15-3) in bronchoalveolar lavage fluid (balf) of lung cancer from 79 enrolled patients with suspected lung cancer.

METHODS

All patients underwent fibrescopic examination, during which balf samples were collected. Levels of egf, ca125, and ca15-3 were determined in balf using commercially available test kits.

RESULTS

The results showed that levels of egf in balf were significantly higher in patients with lung cancer than in patients with benign diseases (p < 0.01); no significant differences for ca125 (p = 0.67) or ca15-3 (p = 0.43) in balf were observed between the lung cancer patients and the non-cancer control subjects. With a cut-off value of 27.22 pg/mL, egf showed a sensitivity of 63.6% and a specificity of 65.7% in predicting the malignant nature of pulmonary disease.

CONCLUSIONS

The study findings suggest that levels of egf are significantly increased in balf from patients with lung cancer than in balf from patients with benign disease. Detection of the level of egf in balf is proposed as a noninvasive test to identify patients at high risk for lung cancer.

[The comparation of fusion targeting biopsy and systematic biopsy in the clinical diagnosis of prostate cancer: a meta-analysis]

Objective: To systematically compare the differences in the detection rate of prostate cancer with fusion targeting biopsy and systemic biopsy. Methods: A computer-based search of PubMed, Medline, China Biomedical Literature Database and Wanfang database (from the beginning of establishment of library to October 2016) on the detection rate of prostate cancer by fusion targeting biopsy and systemic biopsy was performed manually.The inclusion and exclusion criteria were formulated by 2 reviewers, and the data were extracted and evaluated respectively. RevMan5.3 software was used to analyze the detection rate of prostate cancer by two biopsy methods. Results: A total of 15 related clinical studies were included, 5 337 cases were enrolled in the study, including 2 667 cases of targeted fusion biopsy and 2 670 cases of routine systemic biopsy. The results showed that the overall detection rate of prostate cancer in targeting fusion biopsy was significantly higher than that of conventional systemic biopsy (OR=1.16, 95% CI 1.04-1.30, P=0.007). The detection rates of prostate cancer with different risk grades by two biopsy methods were conducted. We found that targeted fusion biopsy had a significant advantage compared with conventional system biopsy (OR=1.37, 95% CI 1.19-1.58, P<0.05) in middle and high risk prostate cancer with Gleason ≥ 7 points. In low-risk prostate cancer patients with Gleason score <7, the detection rate of prostate cancer by targeted fusion biopsy was lower (OR=0.76, 95% CI 0.65-0.89, P<0.05) than that of conventional systemic biopsy. Conclusions: Targeted fusion biopsy was significantly better than systemic biopsy in the overall detection rate of prostate cancer and the detection rate of the middle and high risk prostate cancer with Gleason ≥7 points. However, systemic biopsy performed better in patients with Gleason<7 points of low-risk prostate cancer.

A Pharmacokinetic and Safety Study of Trebananib, an Fc-Fusion Peptibody, in Patients With Advanced Solid Tumors and Varying Degrees of Renal Dysfunction

Clearance of trebananib (AMG 386), a 64-kD antiangiogenic peptibody, has been associated with estimated glomerular filtration rate (eGFR). We prospectively evaluated trebananib pharmacokinetics and safety/tolerability in advanced solid tumor patients with varying degrees of renal function. Patients were assigned to normal renal function, mild, moderate, or severe renal dysfunction cohorts based on eGFR, received trebananib 15 mg/kg i.v. weekly, and underwent week 1 and week 5 pharmacokinetic and weekly safety assessments. For 28 patients, trebananib clearance decreased from normal renal function (1.52 mL/hr/kg), to mild (1.20 mL/hr/kg), moderate (0.79 mL/hr/kg), and severe (0.53 mL/hr/kg) renal dysfunction (P ≤ 0.001). Treatment-related adverse events showed no association with clearance. Trebananib clearance was proportional to eGFR and unrelated to pretreatment protein excretion. These data confirm a role for renal clearance of a recombinant peptibody with molecular weight <69 kD and support a longer dosing interval for patients with severe renal dysfunction.

A component-by-component characterisation of high-risk atherosclerotic plaques by multiphoton microscopic imaging

AIMS

Atherosclerotic plaques vulnerable to rupture are almost always inflamed, and carry a large lipid core covered by a thin fibrous cap. The other components may include neovascularisation, intraplaque haemorrhage and spotty calcification. In contrast, stable plaques are characterised by a predominance of smooth muscle cells and collagen, and lipid core is usually deep seated or absent. This study is a proof of principle experiment to evaluate the feasibility of multiphoton microscopy (MPM) to identify aforementioned plaque components.

METHODS AND RESULTS

MPM is a nonlinear optical technique that allows imaging based on intrinsic tissue signals including autofluorescence and higher-order scattering. In our study, MPM imaging was performed on morphologically diverse aortic and coronary artery plaques obtained during autopsy. Various histologically verified plaque components including macrophages, cholesterol crystals, haemorrhage, collagen and calcification were recognised by MPM.

CONCLUSIONS

Recognition of the distinct signatures of various plaque components suggests that MPM has the potential to offer next-generation characterisation of atherosclerotic plaques. The higher lateral resolution (comparable to histology) images generated by MPM for identifying plaque components might complement larger field of view and greater imaging depth currently available with optical coherence tomography imaging. As the next step MPM would need to be evaluated for intact vessel imaging ex vivo and in vivo.

[Analyses on relevant factors of the prognosis of elderly patients with acute poisoning]

Objective: To explore the risk factors influencing the prognosis of elderly patients with acute poisoning. Methods: We retrospected 177 elderly patients with Acute Poisoning who were treated in the emergency department of the first affiliated hospital of wenzhou medical university from July 2009 to May 2015. According to the outcome of patients, we distributed the patients to death group (31 cases) and survival group (146 cases) , compared the clinic data and using multivariate analysis with Logistic regression to prognosis factors. Results: There were 177 cases in total, with 146 survivors (82.5%) and 31 deaths (17.5%) . In which 102 cases (57.6%) had chronic underlying diseases. There were 28 cases of pesticide poisoning in the death group, and the fatality rate of pesticide poisoning was 23.5%. The mortality rate was 12.8% in the 60-69 years-old group (11/86) , 20% (13/65) in the 70-79 years-old group, 26.9% (7/26) in the 80-89 years-old group. The most common reason of poisoning was intentional ingestion, with 100 cases (56.5%) . The tract of the poisoning was mainly in digestive system, including 148 cases (83.6%) . The PSS score and APACHE-II score were 2.97±0.18 and 19.8±2.8 in the death group, 2.27±0.81 and 12.8±5.3 in the survival group. Compared with the survival group, poison (pesticides or non) 、poisoning route、cause of poisoning、PSS score、APACHEⅡ score have significant difference in death group (P<0.05) . Poison (pesticides or non) 、PSS score、APACHEⅡ, were the independent risk factors of poor prognosis. Conclusion: Most of the elderly patients with acute poisoning have one or more chronic underlying diseases, the digestive tract ingestion and pesticide poisoning are more common. The fatality rate of the old patients is significantly higher than that of non elderly poisoning. Type of toxications, PSS score and APACHE-II score are the prognostic factors in elderly patients.

Multi-chamber microfluidic platform for high-precision skin permeation testing

The established in vitro tool used for testing the absorption and penetration of chemicals through skin in pharmacology, toxicology and cosmetic science is the static Franz diffusion cell. While widespread, Franz cells are relatively costly, low-throughput and results may suffer from poor reproducibility. Microfluidics has the potential to overcome these drawbacks. In this paper, we present a novel microfluidic skin permeation platform and validate it rigorously against the Franz cell by comparing the transport of 3 model chemicals of varying lipophilicity: caffeine, salicylic acid and testosterone. Permeation experiments through silicone membranes show that the chip yields higher sensitivity in permeant cumulative amounts and comparable or lower coefficients of variation. Using a skin organotypic culture, we show that the chip decreases the effect of unstirred water layers that can occur in static Franz cells. The validation reported herein sets the stage for efficient skin permeation and toxicity screening and further development of microfluidic skin-on-chip devices.

[Study on application of two risk assessment methods in coal dust occupational health risk assessment]

Objective: To evaluate the applicability of quantitative grading method (GBZ/T 229.1-2010) and occupational hazard risk index method in coal dust occupational health risk assessment. Methods: Taking 4 coal mines as the research object of risk assessment and making occupational health field testing and investigation. Based on two risk assessment methods, we analysed the health risk levels of 20 occupations which were exposed to coal dust in workplaces. Results: Coal dust working post had different risk levels in 4 coal mines, the post of higher risk level were mainly concentrated in the underground workplace of coal mine, especially the post of coal mining and tunneling system. The two risk assessment results showed that the risk levels of coal-mining machine drivers and tunneling machine drivers were the highest. The risk levels of coal dust working post used by two risk assessment methods had no significant difference (P>0.05) and were highly correlated (r=0.821, P<0.001) . Evaluation results of two risk assessment methods were supported by the field investigation and literatures. Conclusion: The two risk assessment methods can be used in coal dust occupational health risk assessment.

Pairing mechanism in the ferromagnetic superconductor UCoGe

Superconductivity is a unique manifestation of quantum mechanics on a macroscopic scale, and one of the rare examples of many-body phenomena that can be explained by predictive, quantitative theories. The superconducting ground state is described as a condensate of Cooper pairs, and a major challenge has been to understand which mechanisms could lead to a bound state between two electrons, despite the large Coulomb repulsion. An even bigger challenge is to identify experimentally this pairing mechanism, notably in unconventional superconductors dominated by strong electronic correlations, like in high-Tc cuprates, iron pnictides or heavy-fermion compounds. Here we show that in the ferromagnetic superconductor UCoGe, the field dependence of the pairing strength influences dramatically its macroscopic properties like the superconducting upper critical field, in a way that can be quantitatively understood. This provides a simple demonstration of the dominant role of ferromagnetic spin fluctuations in the pairing mechanism.

Intraepithelial Attack Rather than Intratumorally Infiltration of CD8+T Lymphocytes is a Favorable Prognostic Indicator in Pancreatic Ductal Adenocarcinoma

BACKGROUND

Tumor-infiltrating lymphocytes (TILs) are one of the major participants in the tumor microenvironment of pancreatic ductal adenocarcinoma (PDAC). However, the mechanism of interaction between TILs and tumors is complex and remains unclear.

OBJECTIVE

To evaluate the state of immunoreactions in PDAC tissues, and explore the prognostic value of these markers in a large sample, to provide a new theoretical basis for PDAC immunotherapy.

METHOD

Immunohistochemical staining of CD4+ and CD8+T cells was performed in a tissue microarray (TMA) of 143 cases of PDAC. Two major variables for the spatial distributions of CD4+T and CD8+T cells in PDAC tissues, intraepithelial attack and intratumoral infiltration, were used to evaluate the state of immunoreactions, and the interrelationships with the clinicopathological variables were analyzed.

RESULTS

Our data showed that both the intraepithelial CD4+T and CD8+T attack were less frequent than the intratumoral infiltration. CD8+T intraepithelial attack and intratumoral infiltration were more intense than CD4+T. CD8+T intraepithelial attack was an independent favorable prognostic factor for overall survival, correlating negatively with vascular invasion and positively with CD4+T and CD8+T high intratumoral infiltration. CD8+T high intratumoral infiltration without CD8+T intraepithelial attack was a poor prognostic factor. CD8+T high intratumoral infiltration was accompanied by T stage progression. Conclusively, in PDAC progression, imbalances of T cells occurred in CD4+ and CD8+ immunoreactions. The CD8+T intraepithelial attack was an independent favorable prognostic indicator, however the intraepithelial attack of CD4+T and the both intratumoral infiltration of CD8+T and CD4+T played an ambiguous role.

CONCLUSION

Our data suggested that it is a potential approach to increasing the number of intraepithelial attacking CD8+T cells for tumor immunotherapy, and exploring a new mechanism for immunosuppression in a tumor microenvironment with high T cell infiltration without attack.

Direct observation of atomic-scale origins of local dissolution in Al-Cu-Mg alloys

Atomistic chemical inhomogeneities are anticipated to induce dissimilarities in surface potentials, which control corrosion initiation of alloys at the atomic scale. Precise understanding of corrosion is therefore hampered by lack of definite information describing how atomistic heterogeneities regulate the process. Here, using high-angle annular dark-field (HAADF) scanning transmission electron microscope (STEM) and electron energy loss spectroscopy (EELS) techniques, we systematically analyzed the Al₂₀Cu₂Mn₃ second phase of 2024Al and successfully observed that atomic-scale segregation of Cu at defect sites induced preferential dissolution of the adjacent zones. We define an “atomic-scale galvanic cell”, composed of zones rich in Cu and its surrounding matrix. Our findings provide vital information linking atomic-scale microstructure and pitting mechanism, particularly for Al-Cu-Mg alloys. The resolution achieved also enables understanding of dealloying mechanisms and further streamlines our comprehension of the concept of general corrosion.