Transurethral enucleation of the prostate combined with laparoscopic bladder diverticulectomy

Objective: We present a one-session procedure for treating bladder diverticula combined with benign prostatic hyperplasia (BPH).Material and methods: Between January 2015 and April 2019, transurethral plasmakinetic enucleation of the prostate (TUEP) followed by laparoscopic bladder diverticulectomy (LD) were performed in 12 patients at our institution, in four of them combined with bladder stone(s) and in one patient combined with diverticular tumor. Clinical data were retrospectively collected.Results: The mean size of the prostate was 137.3 ± 96.3 (65.5-403.3) ml. The mean maximal diameter of the diverticulum was 8.0 ± 2.7 (3.2-12.0) cm. The mean total operation time was 214.2 ± 69.0 (120-300) min, and the mean enucleation time was 23.2 ± 6.4 (12-35) min. The mean intraoperative blood loss was 52.1 ± 14.9 (30-80) ml. The average pre- and post-operative maximum flow rate was 5.1 ± 1.4 (2.4-8.5) ml/s and 12.8 ± 2.3 (9.6-17.1) ml/s. Except for urinary infection in one patient, no other severe peri- or postoperative complications were observed.Conclusions: TUEP accompanied by LD in one session provides an effective and minimally invasive surgical treatment for bladder diverticula combined with BPH, with or without bladder stones, and permits reasonable operation time and rapid discharge.

Selective targeting of the oncogenic KRAS G12S mutant allele by CRISPR/Cas9 induces efficient tumor regression

Rationale: KRAS is one of the most frequently mutated oncogenes in cancers. The protein's picomolar affinity for GTP/GDP and smooth protein structure resulting in the absence of known allosteric regulatory sites makes its genomic-level activating mutations a difficult but attractive target.

Methods: Two CRISPR systems, genome-editing CRISPR/SpCas9 and transcription-regulating dCas9-KRAB, were developed to deplete the KRAS G12S mutant allele or repress its transcription, respectively, with the goal of treating KRAS-driven cancers.

Results: SpCas9 and dCas9-KRAB systems with a sgRNA targeting the mutant allele blocked the expression of the mutant KRAS gene, leading to an inhibition of cancer cell proliferation. Local adenoviral injections using SpCas9 and dCas9-KRAB systems suppressed tumor growth in vivo. The gene-depletion system (SpCas9) performed more effectively than the transcription-suppressing system (dCas9-KRAB) on tumor inhibition. Application of both Cas9 systems to wild-type KRAS tumors did not affect cell proliferation. Furthermore, through bioinformatic analysis of 31555 SNP mutations of the top 20 cancer driver genes, the data showed that our mutant-specific editing strategy could be extended to a reference list of oncogenic mutations with high editing potentials. This pipeline could be applied to analyze the distribution of PAM sequences and survey the best alternative targets for gene editing.

Conclusion: We successfully developed both gene-depletion and transcription-suppressing systems to specifically target an oncogenic KRAS mutant allele that led to significant tumor regression. These findings show the potential of CRISPR-based strategies for the treatment of tumors with driver gene mutations.

The bioeffects of degradable products derived from a biodegradable Mg-based alloy in macrophages via heterophagy

Biodegradable magnesium alloys are promising candidates for use in biomedical applications. However, degradable particles (DPs) derived from Mg-based alloys have been observed in tissue in proximity to sites of implantation, which might result in unexpected effects. Although previous in vitro studies have found that macrophages can take up DPs, little is known about the potential phagocytic pathway and the mechanism that processes DPs in cells. Additionally, it is necessary to estimate the potential bioeffects of DPs on macrophages. Thus, in this study, DPs were generated from a Mg-2.1Nd-0.2Zn-0.5Zr alloy (JDBM) by an electrochemical method, and then macrophages were incubated with the DPs to reveal the potential impact. The results showed that the cell viability of macrophages decreased in a concentration-dependent manner in the presence of DPs due to effects of an apoptotic pathway. However, the DPs were phagocytosed into the cytoplasm of macrophages and further degraded in phagolysosomes, which comprised lysosomes and phagosomes, by heterophagy instead of autophagy. Furthermore, several pro-inflammatory cytokines in macrophages were upregulated by DPs through the induction of reactive oxygen species (ROS) production. To the best of our knowledge, this is the first study to show that DPs derived from a Mg-based alloy are consistently degraded in phagolysosomes after phagocytosis by macrophages via heterophagy, which results in an inflammatory response owing to ROS overproduction. Thus, our research has increased the knowledge of the metabolism of biodegradable Mg metal, which will contribute to an understanding of the health effects of biodegradable magnesium metal implants used for tissue repair. STATEMENT OF SIGNIFICANCE: Biomedical degradable Mg-based alloys have great promise in applied medicine. Although previous studies have found that macrophages can uptake degradable particles (DPs) in vitro and observed in the sites of implantation in vivoin vivo, few studies have been carried out on the potential bioeffects relationship between DPs and macrophages. In this study, we analyzed the bioeffects of DPs derived from a Mg-based alloy on the macrophages. We illustrated that the DPs were size-dependently engulfed by macrophages via heterophagy and further degraded in the phagolysosome rather than autophagosome. Furthermore, DPs were able to induce a slight inflammatory response in macrophages by inducing ROS production. Thus, our research enhances the knowledge of the interaction between DPs of Mg-based alloy and cells, and offers a new perspective regarding the use of biodegradable alloys.

Association Between the Use of Benzodiazepines and the Occurrence of Acute Angle-closure Glaucoma in the Elderly: A Population-based Study

Introduction

Acute angle-closure glaucoma (AACG) is an ophthalmic emergency, accompanied with severe eye pain, headache, and visual changes because of acute intraocular pressure elevation. Among psychotropic drugs, several antidepressants, typical antipsychotics with strong anticholinergic effects, and topiramate have been known to increase a possibility of AACG. Benzodiazepines have been used widely in the treatment of mental and physical illnesses regardless of age or indication. Since benzodiazepines have some anticholinergic properties and affect pupillae muscles, their use could be theoretically a risk factor for AACG. However, it is unclear whether benzodiazepines actually increase the risk of AACG. To our knowledge, there was no population-based study on the risk of benzodiazepines to the occurrence of AACG.

Objectives/aims

To know whether benzodiazepines increase the risk of AACG in a geriatric population.

Methods

We will perform a case-control study using a geriatric cohort from the National Health Insurance database. Case subjects will be defined as cases diagnosed with AACG confirmed by the claim data of laser iridotomy, which is the definitive treatment of AACG. The controls, which were not diagnosed with AACG, will be matched with case subjects according to similar age, sex, and the scores of the Charlson comorbidity index.

Results

The data handling and statistical analyses will be executed in autumn and winter 2016.

Conclusions

Any preliminary findings of this study will be presented at the EPA 2017. We will discuss the importance of a pharmaco-epidemiological study in the geriatric research.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Spaser Nanoparticles for Ultranarrow Bandwidth STED Super-Resolution Imaging

Super-resolution microscopy, as a powerful tool of seeing abundant spatial details, typically can only distinguish a few distinct targets at a time due to the spectral crosstalk between fluorophores. Spaser (i.e., surface plasmon laser) nanoprobes, which confine lasing emission into nanoscale, offer an opportunity to eliminate such obstacle. Here, realized is narrow band stimulated emission depletion (STED) nanoscopy on spaser nanoparticles by collecting the coherent spasing signals. Demonstrated are the physics concept and feasibility of erasing spaser emission by using a depletion beam to suppress the population inversion, which lays the foundation of spaser-based STED super-resolution. Thanks to the small size (47 nm) and narrow spectral linewidth (3.8 nm) of the spaser nanoparticles, a 74 nm spatial resolution in STED imaging within an acquisition bandwidth of 10 nm is finally obtained. These spaser nanoparticles, if multiplexing with different wavelengths, in principle, allow for spectral-multiplexed imaging, sensing, cytometry, and light operation of a large number of targets all at once.

A blood-based 22-gene expression signature for hepatocellular carcinoma identification

Background

Hepatocellular carcinoma (HCC) is one of the most common and lethal malignancies. Early detection of HCC could largely reduce mortalities. Ultrasonography (US) and serum Alpha Fetoprotein (AFP) test are the screening methods that are most frequently applied to high-risk populations. Due to the poor performance of AFP testing, and the highly operator-dependent nature of US, a biomarker for HCC early diagnosis is highly sought after. We developed a method for HCC screening using a 22-gene expression signature.

Methods

Peripheral whole blood of 98 patients were processed through microarrays for the first round of feature selection via two strategies, Minimal Redundancy Maximal Relevance and Least Absolute Shrinkage and Selection Operator combined with Support Vector Machine (SVM). Candidate genes were combined for further validation through qPCR in an enlarged population with 316 samples with 104 chronic hepatitis, 112 liver cirrhosis (LC), and 100 HCC.

Results

A 22-gene signature was established in classifying HCC and non-cancer samples with good performance. The area under curve reached 0.94 in all of the samples and 0.93 in the AFP -negative samples.

Conclusions

We have established a blood mRNA signature with high performance for HCC screening. Our results show transcriptome of peripheral blood could be valuable source for biomarkers.

Plasma extracellular vesicle long RNA profiling identifies a diagnostic signature for the detection of pancreatic ductal adenocarcinoma

OBJECTIVE

Pancreatic ductal adenocarcinoma (PDAC) is difficult to diagnose at resectable stage. Recent studies have suggested that extracellular vesicles (EVs) contain long RNAs. The aim of this study was to develop a diagnostic (d-)signature for the detection of PDAC based on EV long RNA (exLR) profiling.

DESIGN

We conducted a case-control study with 501 participants, including 284 patients with PDAC, 100 patients with chronic pancreatitis (CP) and 117 healthy subjects. The exLR profile of plasma samples was analysed by exLR sequencing. The d-signature was identified using a support vector machine algorithm and a training cohort (n=188) and was validated using an internal validation cohort (n=135) and an external validation cohort (n=178).

RESULTS

We developed a d-signature that comprised eight exLRs, including FGA, KRT19, HIST1H2BK, ITIH2, MARCH2, CLDN1, MAL2 and TIMP1, for PDAC detection. The d-signature showed high accuracy, with an area under the receiver operating characteristic curve (AUC) of 0.960, 0.950 and 0.936 in the training, internal validation and external validation cohort, respectively. The d-signature was able to identify resectable stage I/II cancer with an AUC of 0.949 in the combined three cohorts. In addition, the d-signature showed superior performance to carbohydrate antigen 19-9 in distinguishing PDAC from CP (AUC 0.931 vs 0.873, p=0.028).

CONCLUSION

This study is the first to characterise the plasma exLR profile in PDAC and to report an exLR signature for the detection of pancreatic cancer. This signature may improve the prognosis of patients who would have otherwise missed the curative treatment window.

The kinetic profile and clinical implication of SCC-Ag in squamous cervical cancer patients undergoing radical hysterectomy using the Simoa assay: a prospective observational study

Background

To study the kinetic profile and clinicopathological implications of squamous cell carcinoma antigen (SCC-Ag) in cervical cancer patients who underwent surgery by a self-developed SCC-Ag single molecule assay (Simoa) prototype immunoassay.

Methods

Participants were prospectively enrolled between 04/2016 and 06/2017. Consecutive serum samples were collected at five points: day 0 (the day before surgery), postoperative day 4, weeks 2–4, months 2–4 and months 5–7. In total, 92 patients and 352 samples were included. The kinetic change in SCC-Ag levels and their associations with clinicopathological characteristics were studied.

Results

Simoa SCC-Ag was validated by comparison with the Architect assay. SCC-Ag levels measured by the Simoa assay were highly correlated with the Architect assay’s levels (Pearson’s correlation coefficient = 0.979, Passing-Bablok regression slope 0.894 (0.847 to 0.949), intercept − 0.009 (− 0.047 to 0.027)). The median values for each time-point detected by the Simoa assay were 2.49, 0.66, 0.61, 0.72, and 0.71 ng/mL, respectively. The SCC-Ag levels decreased dramatically after surgery and then stabilized and fluctuated to some extent within 6 months. Patients with certain risk factors had significantly higher SCC-Ag values than their negative counterparts before surgery and at earlier time points after surgery, while no difference existed at the end of observation. Furthermore, although patients with positive lymph nodes had sustained higher SCC-Ag levels compared to those with negative lymph nodes, similar kinetic patterns of SCC-Ag levels were observed after surgery. Patients who received postoperative treatment had significantly higher SCC-Ag values than those with surgery only at diagnosis, while no difference existed after treatment.

Conclusions

The Simoa SCC-Ag prototype was established for clinical settings. The SCC-Ag levels were higher in patients with risk factors, whereas the kinetic trend of SCC-Ag might be mainly affected by postoperative adjuvant therapy. These data indicate that the SCC-Ag level might be a good predictor for the status of cervical cancer, including disease aggressiveness and treatment response.

Assessment of the ameliorating effect of sedimentary iron inputs on sulfide stress in eelgrass beds

Iron is recognized as an efficient method to alleviate sulfide stress. This study tested the response of Zostera marina plants to different levels of sedimentary sulfides (100.0-818.7 μmol L^-1) and iron inputs (590.0-825.3 μg L^-1) in a field experiment performed over an eighty-day period. We measured plant responses in terms of shoot density and plant morphology and productivity. The relationship between the propagation effort (PE, in %) and sulfide content (S, in μmol L^-1) was expressed as: PE = -14.01 × ln (S) + 86.86 (R² = 0.99, p < .01), which indicates that the toxic limit of the pore-water sulfide concentration for the survival of eelgrass is 493 μmol L^-1. The addition of iron can reduce the toxicity of sulfides to eelgrass beds, resulting in an increase in plant density and productivity, and can even reverse the decline of eelgrass beds exposed to high sulfide concentrations.

New quaternary chalcogenide Ba4HgAs2S10 originating from the combination of linear [HgS2]2− and tetrahedral [AsS4]3− modules

A new quaternary chalcogenide Ba₄HgAs₂S₁₀ is constructed by combining linear HgS₂²⁻ and tetrahedral AsS₄³⁻ modules.

The Positive Role of Shame for Post-exilic Returnees in Ezra/Nehemiah

ABSTRACT While shame is often cast in a negative light as a response accompanied by destructive forces in modern culture, this article examines a different phenomenon and argues that shame plays an important positive role for post-exilic returnees in Ezra/Nehemiah. Shame can be progressive and edifying if it is oriented in the right direction. This article surveys key shame terms in Ezra/Nehemiah by examining בושׁ I in Ezra 8:22, בושׁ I and כלם in Ezra 9:6-7, חרפה in Neh 1:3; 2:17 and בוזה in Neh 3:36 (Eng. 4:4) for their semantics and concludes that shame plays a positive role in social control for the post-exilic returnees. Shame, in each of these cases, motivated the people of God not for bad but for good; it contributed to the rebuilding of the temple of the Lord, the rebuilding of the wall, and the restoration of a holy people to the Lord in the midst of fierce opposition. Keywords: Shame; Positive role; Disgrace; Reproach; Contempt; Exile; Returnees; Holy Seed; Rebuilding; Ezra; Nehemiah

Grayscale-Thermal Tracking via Inverse Sparse Representation based Collaborative Encoding

Grayscale-thermal tracking has attracted a great deal of attention due to its capability of fusing two different yet complementary target observations. Existing methods often consider extracting the discriminative target information and exploring the target correlation among different images as two separate issues, ignoring their interdependence. This may cause tracking drifts in challenging video pairs. This paper presents a collaborative encoding model called joint correlation and discriminant analysis based inver-sparse representation (JCDA-InvSR) to jointly encode the target candidates in the grayscale and thermal video sequences. In particular, we develop a multi-objective programming to integrate the feature selection and the multi-view correlation analysis into a unified optimization problem in JCDA-InvSR, which can simultaneously highlight the special characters of the grayscale and thermal targets through alternately optimizing two aspects: the target discrimination within a given image and the target correlation across different images. For robust grayscale-thermal tracking, we also incorporate the prior knowledge of target candidate codes into the SVM based target classifier to overcome the overfitting caused by limited training labels. Extensive experiments on GTOT and RGBT234 datasets illustrate the promising performance of our tracking framework.

A Biodegradable Mg-Based Alloy Inhibited the Inflammatory Response of THP-1 Cell-Derived Macrophages Through the TRPM7-PI3K-AKT1 Signaling Axis

Mg-based alloys might be ideal biomaterials in clinical applications owing to favorable mechanical properties, biodegradability, biocompatibility, and especially their anti-inflammatory properties. However, the precise signaling mechanism underlying the inhibition of inflammation by Mg-based alloys has not been elucidated. Here, we investigated the effects of a Mg-2.1Nd-0.2Zn-0.5Zr alloy (denoted as JDBM) on lipopolysaccharide (LPS)-induced macrophages. THP-1 cell-derived macrophages were cultured on JDBM, Ti-6Al-4V alloy (Ti), 15% extract of JDBM, and 7.5 mM of MgCl2 for 1 h before the addition of LPS for an indicated time; the experiments included negative and positive controls. Our results showed JDBM, extract, and MgCl2 could decrease LPS-induced tumor necrosis factor (TNF) and interleukin (IL)-6 expression. However, there were no morphologic changes in macrophages on Ti or JDBM. Mechanically, extract and MgCl2 downregulated the expression of toll-like receptor (TLR)-4 and MYD88 compared with the positive control and inhibited LPS-induced nuclear factor-kappa B (NF-κB) and mitogen-activated protein kinase (MAPK) signaling pathways by inactivation of the phosphorylation of IKK-α/β, IKβ-α, P65, P38, and JNK. Additionally, the LPS-induced reactive oxygen species (ROS) expression was also decreased by extract and MgCl2. Interestingly, the expression of LPS-induced TNF and IL-6 could be recovered by knocking down TRPM7 of macrophages, in the presence of extract or MgCl2. Mechanically, the activities of AKT and AKT1 were increased by extract or MgCl2 with LPS and were blocked by a PI3K inhibitor, whereas siRNA TRPM7 inhibited only AKT1. Together, our results demonstrated the degradation products of Mg-based alloy, especially magnesium, and resolved inflammation by activation of the TRPM7-PI3K-AKT1 signaling pathway, which may be a potential advantage or target to promote biodegradable Mg-based alloy applications.

[Functional diversity of fishes in the Minjiang Estuary, Southeast China]

Based on samples collected by bottom trawl in May, August, November and December 2016 in the Minjiang Estuary, species richness and functional diversity of fishes, as well as their spatial-temporal variations, were quantified by a trait-based approach. The functional diversity varied with the changes of species richness. The species richness averaged across all stations were (17.8±5.1) species in spring, (22.4±5.6) in summer, (17.7±6.3) in autumn, and (12.1±2.3) in winter. Functional diversity also showed seasonal variation, with the highest in summer as (33.94±28.70), followed by (9.93±8.83) in winter, (11.30±7.55) in spring and (19.05±19.32) in autumn. The key functional species varied seasonally, as Setipinna taty contributing to 26% of the total functional value in spring, Polydactylus sextarius at 26% in summer, Harpadon nehereus climbing to 69% in autumn, and Collichthys lucidus at 38% in winter. The seasonal variations of fish species function were determined by life history and its interaction with other species.

Loss of methylation of H19-imprinted gene derived from assisted reproductive technologies can be mitigated by cleavage-stage embryo transfer in mice

PURPOSE

Studies on rodents have shown that assisted reproductive technologies (ARTs) are associated with perturbation of genomic imprinting in blastocyst-stage embryos. However, the vulnerable developmental window for ART influence on the genomic imprinting of embryos is still undetermined. The purpose of this study was to establish the specific embryonic development stage at which the loss of methylation of H19 imprinting control regions (ICRs) was caused by ART occurrence. Additionally, we explored protocols to safeguard against possible negative impacts of ART on embryo H19 imprinting.

METHODS

Mouse embryos were generated under four different experimental conditions, divided into four groups: control, in vitro culture (IVC), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI). The methylation levels of H19 ICR of the grouped or individual embryos were analyzed by bisulfite-sequencing PCR.

RESULTS

Our data showed that the loss of methylation of H19 ICR in mouse blastocysts was inflicted to a similar extent by IVC, IVF, and ICSI. Specifically, we observed a significant loss of methylation of H19 ICR between the mouse 8-cell and morula stages. In addition, we revealed that the transfer of mouse embryos generated by ARTs in the uterus at the 8-cell stage induced the occurrence of methylation patterns in the blastocysts closer to the in vivo ones.

CONCLUSIONS

Our findings indicate that the loss of methylation of H19 ICR caused by ARTs occurs between the 8-cell and the morula stages, and the transfer of cleavage embryos to the uterus mitigates the loss methylation of H19 derived by mice ARTs.

Population structure of Aphyocypris normalis: phylogeography and systematics

Aphyocyprisnormalis (Teleostei: Cyprinidae) is an endemic species in South China, but little is known about its genetic structure. This study examined the population structure of A.normalis using sequences of the mitochondrial DNA control region and cytochrome b gene (2,086 bp). In total, 107 specimens were collected from nine populations. All 105 mtDNA haplotypes were identified as belonging to two allopatric phylogroups. The results of a statistical dispersal-vicariance analysis (S-DIVA) suggested that the ancestral populations of A.normalis were distributed widely on Hainan Island and east of the Leizhou Peninsula. A comparison of the fixation indices N_ST (0.532) and G_ST (0.004) revealed that the phylogeny and geography had a significant relationship. Our study found that (1) the Wuzhishan and Yinggeling Mountain Range was an important barrier limiting gene exchange between populations on both sides; (2) cyclic climate changes may have shaped migrations and population differentiations; and (3) different colonization times caused different population diversities between codistributed species. In addition, the inter- and intraspecific diversities of the genus Aphyocypris were estimated.