Design and safety analysis of the helium cooled solid breeder blanket for CFETR

This paper reports the design and safety analysis results of the helium cooled solid breeder blanket of the Chinese Fusion Engineering Test Reactor (CFETR). Materials selection and basic structure of the blanket have been presented. Performance analysis including neutronics analysis and thermo-mechanical analysis has shown good results. And the safety analysis of the blanket under Loss Of Coolant Accident (LOCA) conditions has been described. Results showed the current design can deal well with the selected accident scenarios.

[Age-related differences in the clinical symptoms and triggering factors among Chinese patients with acute myocardial infarction]

OBJECTIVE

To analyze the age-related differences in the clinical symptoms and triggering factors among Chinese patients with acute myocardial infarction.

METHODS

Acute myocardial infarction Patients (n=14 854) registered in the China Acute Myocardial Infarction Registry from January 2013 to March 2014 were included in this study. Patients were divided into 4 groups: <55 years old group (3 950 patients), 55-64 years old group (4 361 patients), 65-74 years old group ( 3 759 patients), and ≥75 years old group (2 784 patients). Demographic features, medical history, clinical presentation and triggering factors were obtained via electronic data capture system.

RESULTS

(1)Persistent chest pain and sweat were the major typical symptoms 66.4%(9 863/14 854) and 63.8%(9 471/14 854)) in the whole cohort. Prevalence of persistent chest pain among four groups were 73.8%(2 915/3 950), 69.2%(3 016/4 361), 63.6%(2 394/3 759) and 55.2%(1 538/2 784), and radiating pain among four groups were 36.2%(1 428/3 950), 34.1%(1 487/4 361), 30.9%(1 160/3 759)and 25.9%(722/2 784), and sweat among four groups were 70.0%(2 765/3 950), 66.5%(2 898/4 361), 61.8%%(2 323/3 759)and 53.3%(1 485/2 784), and there were statistical significance for all above symptoms among groups (all P<0.001). (2)triggering factors before acute myocardial infarction could be found in 19.4%(2 879/14 854) of the patients. Prevalence of existed triggering factors among four groups were 23.8%(941/3 950), 21.0%(914/4 361), 16.6%(625/3 759) and 14.3%(399/2 784, P<0.001). Recent excessive unhealthy lifestyles among four groups were 20.8%(196/3 950), 11.9%(109/4 361), 10.1%(63/3 759) and 9.0%(36/2 784) among the 4 groups (P<0.001).

CONCLUSIONS

Persistent chest pain and sweat are absent in nearly half of Chinese patients in ≥75 years old group. Triggering factors prior to acute myocardial infarction could be evidenced in about twenty percent patients, and which are more often in young patients. Clinical Trail Registry: National Institutes of Health，NCT018746.

[Influencing factors of orthostatism brachial-ankle pulse wave velocity and ankle brachial index in the elderly]

OBJECTIVE

To investigate the distribution and influencing factors of orthostatism brachial-ankle pulse wave velocity(baPWV) and ankle brachial index(ABI) in the elderly.

METHODS

Participants were selected with random sampling from ≥60 years old retired workers, who underwent 2010 to 2011 health check-up in the Tangshan Kailuan Hospital, Kailuan Linxi Hospital, Kailuan Zhaogezhuang Hospital. Multivariate linear regression analysis was used to analyze the influencing factors of orthostatism and supine baPWV and ABI in the elderly.

RESULTS

(1) A total of 2 464 participants were included, and 1 601 participants (1 065 males(66.5%) and (67.5±6.1) years old) with integral data were analyzed. Orthostatism baPWV was (3 885.4±1 503.5)cm/s and Supine baPWV was (1 761.2±371.4)cm/s.Orthostatism ABI was 1.54±0.21 and supine ABI was 1.10±0.12. Orthostatism baPWV increased with increasing age, while orthostatism ABI decreased with aging(trend test, both P<0.01)in <65, 65-69, 70-74, and ≥75 years old participants.(2) Multiple linear regression analysis showed that the age(β=0.19, P<0.01), lower limbs orthostatism systolic blood pressure(β=0.18, P<0.01), lower limbs supine systolic blood pressure (β=0.14, P<0.01), orthostatism heart rate (β=0.30, P<0.01), supine heart rate (β=0.23, P<0.01), body mass index (β=-0.18, P<0.01) were associated with orthostatism baPWV, and female(β=-0.055, P=0.01), upper limb orthostatism systolic blood pressure (β=-0.834, P<0.01), lower limbs orthostatism systolic blood pressure (β=0.708, P<0.01), lower limbs supine systolic blood pressure (β=0.099, P<0.01) and fasting blood glucose(β=-0.085, P<0.01) were associated with orthostatism ABI.

CONCLUSIONS

Orthostatism baPWV and ABI were significantly higher than those of supine's. Age, lower limbs orthostatism and supine systolic blood pressure, orthostatism and supine heart rate, body mass index were associated with orthostatism baPWV. Female, upper limb orthostatism systolic blood pressure, lower limbs orthostatism, supine systolic blood pressure and fasting blood glucose were associated with orthostatism ABI in the elderly.

Statistics of highly heterogeneous flow fields confined to three-dimensional random porous media

We present a strong relationship between the microstructural characteristics of, and the fluid velocity fields confined to, three-dimensional random porous materials. The relationship is revealed through simultaneously extracting correlation functions R_{uu}(r) of the spatial (Eulerian) velocity fields and microstructural two-point correlation functions S_{2}(r) of the random porous heterogeneous materials. This demonstrates that the effective physical transport properties depend on the characteristics of complex pore structure owing to the relationship between R_{uu}(r) and S_{2}(r) revealed in this study. Further, the mean excess plot was used to investigate the right tail of the streamwise velocity component that was found to obey light-tail distributions. Based on the mean excess plot, a generalized Pareto distribution can be used to approximate the positive streamwise velocity distribution.

Chinese military medical teams in the Ebola outbreak of Sierra Leone

The 2014-2015 Ebola virus disease (EVD) epidemic in West Africa was the largest in history. The three most affected countries, Guinea, Liberia and Sierra Leone, have faced enormous challenges in controlling transmission and providing clinical care for patients with EVD. The Chinese government, in response to the requests of the WHO and the governments of the affected countries, responded rapidly by deploying Chinese military medical teams (CMMTs) to the areas struck by the deadly epidemic. A total of three CMMTs, comprising 115 military medical professionals, were rotationally deployed to Freetown, Sierra Leone to assist with infection prevention and control, clinical care and health promotion and training. Between 1 October 2014 and 22 March 2015, the CMMTs in Sierra Leone admitted and treated a total of 773 suspected and 285 confirmed EVD cases. Among the 285 confirmed cases, 146 (51.2%) patients survived after treatment. In addition, the CMMTs maintained the record of zero infections among healthcare workers and zero cross-infections between quarantined patients. In this manuscript, we aim to give an overview of the mission, and share our best practices experience on predeployment preparedness, EVD holding and treatment centre building and EVD case management.

Characterisation of lubricin in synovial fluid from horses with osteoarthritis

REASON FOR PERFORMING STUDY

The glycoprotein lubricin contributes to the boundary lubrication of the articular cartilage surface. The early events of osteoarthritis involve the superficial layer where lubricin is synthesised.

OBJECTIVES

To characterise the glycosylation profile of lubricin in synovial fluid from horses with osteoarthritis and study secretion and degradation of lubricin in an in vitro inflammation cartilage model.

STUDY DESIGN

In vitro study.

METHODS

Synovial fluid samples collected from horses with joints with normal articular cartilage and structural osteoarthritic lesions; with and without osteochondral fragments, were analysed for the lubricin glycosylation profiles. Articular cartilage explants were stimulated with or without interleukin-1β for 25 days. Media samples collected at 3-day intervals were analysed by quantitative proteomics, western blot and enzyme-linked immunosorbent assay.

RESULTS

O-glycosylation profiles in synovial fluid revealed both Core 1 and 2 O-glycans, with Core 1 O-glycans predominating. Synovial fluid from normal joints (49.5 ± 1.9%) contained significantly lower amounts of monosialylated Core 1 O-glycans compared with joints with osteoarthritis (53.8 ± 7.8%, P = 0.03) or joints with osteochondral fragments (57.3 ± 8.8%, P = 0.001). Additionally, synovial fluid from normal joints (26.7 ± 6.7%) showed higher amounts of disialylated Core 1 O-glycan than from joints with osteochondral fragments (21.2 ± 4.9%, P = 0.03). A C-terminal proteolytic cleavage site in lubricin was found in synovial fluid from normal and osteochondral fragment joints and in media from interleukin-1β stimulated and unstimulated articular cartilage explants.

CONCLUSIONS

This is the first demonstration of a change in the glycosylation profile of lubricin in synovial fluid from diseased equine joints compared with that from normal joints. We demonstrate an identical proteolytic cleavage site of lubricin both in vitro and in vivo. The reduced sialation of lubricin in synovial fluid from diseased joints may affect the boundary lubricating ability of the superficial layer of articular cartilage and could be one of the early events in the progression of osteoarthritis.

A comparison of general versus regional anesthesia for hip fracture surgery: a meta-analysis

In this study, we aimed to compare the effect of general versus regional anesthesia on postoperative outcomes in patients undergoing surgical repair of hip fracture. Randomized controlled trials, prospective studies and retrospective observational studies were searched in PubMed, Medline and Embase database published between January 2005 and March 2014. The overall outcome was measured by odds ratios (ORs) and risk ratios (RRs) with their corresponding 95% confidence intervals (CIs). A total of 7 trials, involving 36448 patients received general anesthesia and 33952 patients received regional anesthesia, were included in present meta-analysis. We found that the 30-day mortality rate was lower in general anesthesia cases than that in regional cases (5.3% vs. 6.3%). Overall, our results demonstrated that there was no significant difference in 30-day mortality between two types of anesthesia in patients with hip fracture surgery (RR=0.98, 95% CI=0.92-1.04, P=0.48), indicating that types of anesthesia might not be a risk factor for hip fracture surgery. No statistically significant difference was observed in other outcome measures (P>0.05). In conclusion, our results suggested that the choice of anesthesia (general or regional) should be made by the anesthesiologist on an individual basis and based on the patient's medical conditions. Further research is still needed to evaluate the effect of these two anesthesia methods.

A meta-analysis of erlotinib versus docetaxel for advanced nonsmall-cell lung cancer with poor prognosis

BACKGROUND

The extent of the benefit of erlotinib in the treatment of advanced nonsmall-cell lung cancer (NSCLC) is still controversial when compared with docetaxel. This meta-analysis was performed to compare the efficacy of erlotinib with docetaxel for different patients with advanced NSCLC.

MATERIALS AND METHODS

We searched Cochrane Library, PubMed, CNKI, and identified 23 randomized controlled clinical trials from 2008 to 2015. According to our further full-text screening, 6 clinical trials were included in the final meta-analysis.

RESULTS

Six papers were included in this study. The progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and toxicity were included in our outcomes. The pooled hazard ratio (HR) of PFS was 1.57 (95% confidential index [CI] = 1.47-1.69). The pooled HR of OS was 1.66 (95% CI = 1.43-1.92). The pooled risk ratio of ORR was 0.56 (95% CI = 0.35-0.91). The toxicity analysis showed odds ratio = 1.79 (95% CI = 1.20-2.69).

CONCLUSIONS

In terms of PFS, OS, and toxicity the effect of erlotinib in the treatment of advanced NSCLC patients is superior to docetaxel.

The Skewness of Alpha Beta T Cell Receptors in Peripheral Blood of the Patients with Type 1 Diabetes

AIM

To detect the skewness of TCR Vα and TCR Vβ of patients with type 1 diabetes (T1D).

METHODS

The heparinized venous blood was collected from ten patients with T1D. The peripheral blood lymphocytes (PBL) were isolated and used to extract mRNA. Reverse amplyfication was performed for cDNA synthesis. The skewness of TCR Vα and Vβ was detected with real-time florescence quantitative polymerase chain reaction (RQ-PCR) and analyzed by DNA melting-curve analysis technique, respectively.

RESULTS

Among the TCR Vα genes, the skewness frequency rate (SFR) of Vα22 was 30%; both of Vα5 and Vα24 were 20%; Vα28 was the only restricted-clone gene with the SFR of 10%. In all the Vβ genes, Vβ7 and Vβ17 were the the highest expression genes, and their SFRs were both 60%. Vβ11 was near them with the SFR of 40%; the restricted clonal genes were Vβ18 and Vβ20, their SFRs were 10% and 20%, respectivley.

CONCLUSION

There are skewd genes in TCR Vα and TCR Vβ, which are probably relative to the onset of T1D.

Detection of the long noncoding RNAs nuclear-enriched autosomal transcript 1 (NEAT1) and metastasis associated lung adenocarcinoma transcript 1 in the peripheral blood of HIV-1-infected patients

OBJECTIVES

Long noncoding RNAs (lncRNAs) in HIV-1 infection have not been extensively studied. Here we detected two lncRNAs, nuclear-enriched autosomal transcript 1 (NEAT1) and metastasis associated lung adenocarcinoma transcript 1 (MALAT1), in peripheral blood mononuclear cells (PBMCs) and plasma of HIV-1-infected patients.

METHODS

Fifty-nine HIV-1-infected patients and 21 healthy controls were recruited for the study, of whom 31 patients were highly active antiretroviral therapy (HAART)-naïve and 28 patients had been receiving HAART for more than 1 year with undetectable viral loads. Total RNA was extracted from PBMCs and plasma, and levels of NEAT1 and MALAT1 were determined by quantitative real-time polymerase chain reaction.

RESULTS

We found that the levels of NEAT1 and MALAT1 in PBMCs were up-regulated in HAART-naïve patients and were reduced in patients receiving HAART. NEAT1 was down-regulated in the plasma of infected patients and expression was correlated with CD4 T-cell count.

CONCLUSIONS

Our findings suggest that NEAT1 and MALAT1 may interact with HIV-1 in vivo and that the presence of NEAT1 in plasma is a potential biomarker of HIV-1 infection.

A point mutation of zebrafish c-cbl gene in the ring finger domain produces a phenotype mimicking human myeloproliferative disease

Controlled self-renewal and differentiation of hematopoietic stem/progenitor cells (HSPCs) are critical for vertebrate development and survival. These processes are tightly regulated by the transcription factors, signaling molecules and epigenetic factors. Impaired regulations of their function could result in hematological malignancies. Using a large-scale zebrafish N-ethyl-N-nitrosourea mutagenesis screening, we identified a line named LDD731, which presented significantly increased HSPCs in hematopoietic organs. Further analysis revealed that the cells of erythroid/myeloid lineages in definitive hematopoiesis were increased while the primitive hematopoiesis was not affected. The homozygous mutation was lethal with a median survival time around 14-15 days post fertilization. The causal mutation was located by positional cloning in the c-cbl gene, the human ortholog of which, c-CBL, is found frequently mutated in myeloproliferative neoplasms (MPN) or acute leukemia. Sequence analysis showed the mutation in LDD731 caused a histidine-to-tyrosine substitution of the amino acid codon 382 within the RING finger domain of c-Cbl. Moreover, the myeloproliferative phenotype in zebrafish seemed dependent on the Flt3 (fms-like tyrosine kinase 3) signaling, consistent with that observed in both mice and humans. Our study may shed new light on the pathogenesis of MPN and provide a useful in vivo vertebrate model of this syndrome for screening drugs.

MUC1-C activates the TAK1 inflammatory pathway in colon cancer

The mucin 1 (MUC1) oncoprotein has been linked to the inflammatory response by promoting cytokine-mediated activation of the NF-κB pathway. The TGF-β-activated kinase 1 (TAK1) is an essential effector of proinflammatory NF-κB signaling that also regulates cancer cell survival. The present studies demonstrate that the MUC1-C transmembrane subunit induces TAK1 expression in colon cancer cells. MUC1 also induces TAK1 in a MUC1(+/-)/IL-10(-/-) mouse model of colitis and colon tumorigenesis. We show that MUC1-C promotes NF-κB-mediated activation of TAK1 transcription and, in a positive regulatory loop, MUC1-C contributes to TAK1-induced NF-κB signaling. In this way, MUC1-C binds directly to TAK1 and confers the association of TAK1 with TRAF6, which is necessary for TAK1-mediated activation of NF-κB. Targeting MUC1-C thus suppresses the TAK1NF-κB pathway, downregulates BCL-XL and in turn sensitizes colon cancer cells to MEK inhibition. Analysis of colon cancer databases further indicates that MUC1, TAK1 and TRAF6 are upregulated in tumors associated with decreased survival and that MUC1-C-induced gene expression patterns predict poor outcomes in patients. These results support a model in which MUC1-C-induced TAK1NF-κB signaling contributes to intestinal inflammation and colon cancer progression.

Expression of histamine receptor genes Hrh3 and Hrh4 in rat brain endothelial cells

BACKGROUND AND PURPOSE

Brain vascular endothelial cells express histamine H1 and H2 receptors, which regulate brain capillary permeability. We investigated whether H3 and H4 receptors are also expressed in these cells and may thus play a role in permeability regulation.

EXPERIMENTAL APPROACH

An immortalized rat brain endothelial cell line RBE4 was used to assess the presence of H3 and H4 receptors. Reverse transcription-PCR (RT-PCR) and sequencing were used to identify the receptor mRNAs. The receptors were stimulated with histamine and immepip, and specific inverse agonists/antagonists ciproxifan and JNJ 7777120 were used to block H3 and H4 receptors, respectively.

KEY RESULTS

RT-PCR of mRNA extracted from cultured immortalized RBE4 cells revealed two rat H4 receptor gene (Hrh4) transcripts, one full-length (coding sequence 1173 bp), and one with a 164 bp deletion. Also, two rat H3 receptor gene (Hrh3) isoform mRNAs were expressed in RBE4 cells, and sequencing showed they were the full-length H3 receptor and the 144 bp deletion form. Both histamine and immepip (H3 and H4 receptor agonists) activated the Erk1/2 MAPK pathway in the RBE4 cells and in vivo in brain blood vessels by activating H4 receptors, as the H4 receptor-specific inverse agonists/antagonist JNJ 7777120, but not ciproxifan, H3 receptor antagonist, dose-dependently blocked this effect in RBE4 cells.

CONCLUSIONS AND IMPLICATIONS

Both Hrh3 and Hrh4 receptors are expressed in rat brain endothelial cells, and activation of the histamine H4 receptor activates the Erk1/2 cascade. H3 and H4 receptors in endothelial cells are potentially important for regulation of blood-brain barrier permeability, including trafficking of immunocompetent cells.

High-intensity focused ultrasound ablation: an effective and safe treatment for secondary hypersplenism

OBJECTIVE

Hypersplenism is a common disease. The conventional treatment is splenectomy and partial splenic embolization; however, both of them have high complication rates and technical defects. Therefore, safer and more effective techniques should be considered for the treatment of hypersplenism. High-intensity focused ultrasound (HIFU) may provide an effective and safe way for treatment of hypersplenism. Therefore, we conducted this study to assess the safety and efficacy of HIFU in treatment of secondary hypersplenism.

METHODS

A total of 28 patients who suffered from secondary hypersplenism were treated with HIFU ablation. All patients who underwent HIFU were closely followed-up over a year. MRI scan was performed, and the spleens were observed. Blood counts and liver function tests were also carried out.

RESULTS

In the follow-up process, the levels of white blood cells and platelets in the blood after HIFU were significantly higher than those before HIFU, liver function also improved after HIFU treatment. In addition, the symptoms were ameliorated significantly or even disappeared. The MRI showed that the ablation area had turned into a non-perfused volume, and after 12 months of HIFU ablation, the ablated area shrank evidently; the sunken spleen formed a lobulated shape and the splenic volume decreased.

CONCLUSION

HIFU ablation is a safe, effective and non-invasive approach for secondary hypersplenism.

ADVANCES IN KNOWLEDGE

For the first time we used HIFU ablation to treat secondary hypersplenism. It not only expands indications of HIFU but also provides better choice for the treatment of secondary hypersplenism.

Hepatocyte growth factor upregulates nexilin gene expression in cardiomyocytes via JNK pathway

Hepatocyte growth factor (HGF) is a protective factor in myocardial injury, but its mechanisms of action have not yet been fully elucidated. Nexilin, which locates specifically to the Z-disc, is a novel Z-disc protein that enables the Z-discs to persistently withstand the extreme mechanical forces generated during muscle contraction. Therefore, we investigated the role of HGF in modulating nexilin expression in hypoxia-reoxygenation (H/R)-treated cardiomyocytes. We cultured neonatal cardiomyocytes and treated them with HGF. The mRNA and protein levels of nexilin were determined by RT-PCR and Western blotting. H/R treatment decreased nexilin mRNA expression and nexilin protein levels in cardiomyocytes. Furthermore, treatment with HGF upregulated nexilin expression and the JNK inhibitor SP600125 partly inhibited HGF-induced nexilin upregulation. In conclusion, our results suggest that ischemia-reperfusion injury may downregulate nexilin expression in cardiomyocytes, and HGF may exert its protective role during myocardial ischemic injury through upregulation of nexilin expression in cardiomyocytes.

Abnormalities in whole-brain functional connectivity observed in treatment-naive post-traumatic stress disorder patients following an earthquake

BACKGROUND

Convergent studies have highlighted the dysfunction of the amygdala, prefrontal cortex and hippocampus in post-traumatic stress disorder (PTSD). However, only a few studies have investigated the functional connectivity between brain regions in PTSD patients during the resting state, which may improve our understanding of the neuropathophysiology of PTSD. The aim of this study was to investigate patterns of whole-brain functional connectivity in treatment-naive PTSD patients without co-morbid conditions who experienced the 8.0-magnitude earthquake in the Sichuan province of China.

METHOD

A total of 72 PTSD patients and 86 trauma-exposed non-PTSD controls participated in the resting-state functional magnetic resonance imaging study. All these subjects were recruited from the disaster zone of the 2008 Sichuan earthquake. Functional connectivities between 90 paired brain regions in PTSD patients were compared with those in trauma-exposed non-PTSD controls. Furthermore, Pearson correlation analysis was performed between significantly abnormal connectivities in PTSD patients and their clinician-administered PTSD scale (CAPS) scores.

RESULTS

Compared with non-PTSD controls, PTSD patients showed weaker positive connectivities between the middle prefrontal cortex (mPFC) and the amygdala, hippocampus, parahippocampal gyrus and rectus, as well as between the inferior orbitofrontal cortex and the hippocampus. In addition, PTSD patients showed stronger negative connectivity between the posterior cingulate cortex (PCC) and the insula. The CAPS scores in PTSD patients correlated negatively with the connectivity between the amygdala and the mPFC.

CONCLUSIONS

PTSD patients showed abnormalities in whole-brain functional connectivity, primarily affecting the connectivities between the mPFC and limbic system, and connectivity between the PCC and insula.

An ideal-observer model of human sound localization

In recent years, a great deal of research within the field of sound localization has been aimed at finding the acoustic cues that human listeners use to localize sounds and understanding the mechanisms by which they process these cues. In this paper, we propose a complementary approach by constructing an ideal-observer model, by which we mean a model that performs optimal information processing within a Bayesian context. The model considers all available spatial information contained within the acoustic signals encoded by each ear. Parameters for the optimal Bayesian model are determined based on psychoacoustic discrimination experiments on interaural time difference and sound intensity. Without regard as to how the human auditory system actually processes information, we examine the best possible localization performance that could be achieved based only on analysis of the input information, given the constraints of the normal auditory system. We show that the model performance is generally in good agreement with the actual human localization performance, as assessed in a meta-analysis of many localization experiments (Best et al. in Principles and applications of spatial hearing, pp 14-23. World Scientific Publishing, Singapore, 2011). We believe this approach can shed new light on the optimality (or otherwise) of human sound localization, especially with regard to the level of uncertainty in the input information. Moreover, the proposed model allows one to study the relative importance of various (combinations of) acoustic cues for spatial localization and enables a prediction of which cues are most informative and therefore likely to be used by humans in various circumstances.