[Recommendations of diagnosis and treatment of primary Sjögren's syndrome in China]

Sjögren's syndrome is a chronic systemic autoimmune disease characterized by lymphocyte proliferation and progressive exocrine gland damage. In China, standardized diagnosis and treatment for Sjögren's syndrome lags behind other common rheumatic diseases, such as rheumatoid arthritis and systemic lupus erythematosus. Based on the evidence and guidelines from China and other countries, Chinese Sjögren's Syndrome Collaborative Research Group together with stomatologist and ophthalmologist developed Standardization of diagnosis and treatment of primary Sjögren's syndrome. The purposes are: (1) to standardize the detection and interpretation of key indicators for the diagnosis of Sjögren's syndrome, including serum anti SSA antibody and labial gland pathology; (2) to suggest using widely accepted disease activity index in evaluation of the disease; (3) to standardize rational management for Sjögren's syndrome patients with topical and systemic diseases.

GPR39 Overexpression in OSCC Promotes YAP-Sustained Malignant Progression

The clinical outcome of oral squamous cell carcinoma (OSCC) has not improved in recent years, mainly due to the limited effective targeted therapy that has been applied. Recently, a transcriptional coactivator, YAP, has been shown to have a key regulatory role in malignant progression in multiple cancers, including OSCC. But pharmacologically targeting YAP or the Hippo pathway, which is the main signaling pathway regulating YAP, has been proven to be challenging. Therefore, uncovering YAP upstream regulators in cancer would identify novel therapeutic targets for treatment of YAP-sustained cancers. Here, we showed that YAP was overactivated in OSCC and that high YAP activity in patients with OSCC was associated with malignant progression and poor survival. We uncovered that GPR39 (a G protein-coupled receptor) was overexpressed in OSCC, that the expression level of GPR39 was correlated with the activity level of YAP, and that the high GPR39 expression was associated with malignant progression and poor survival in patients with OSCC. Moreover, we found that GPR39 regulated YAP through a Gαq/11-RhoA-dependent signaling pathway. Importantly, inhibition of GPR39 resulted in YAP-sustained OSCC growth inhibition. Our findings suggest that GPR39 is a potential therapeutic target for OSCC treatment with itself as a biomarker.

Mesenchymal stem cells induced regulatory dendritic cells from hemopoietic progenitor cells through Notch pathway and TGF-β synergistically

Mesenchymal stem cells (MSCs) are one of the attractive candidates in regenerative medicine of many clinical applications because of their low immunogenicity and immunomodulatory property. Our previous studies provided that mouse bone marrow-derived Sca-1⁺MSCs could drive the differentiation of regulatory DC (regDCs) (Scal-1⁺ BM-MSC-driven DC [sBM-DCs]) from hemopoietic progenitor cells (HPCs) and the Notch pathway played a critical role in maintaining the immunomodulatory property. However, the detailed mechanisms of their immunoregulatory capacity are not fully defined. In the present study, we show that BM-MSCs expressed high levels of Jagged 1 while sBM-DCs expressed high levels of Notch1. Jagged1 expressed on the surface of BM-MSCs initiated Notch signaling to maintain the immunomodulatory property of the sBM-DCs. The level of TGF-β is high in MSCs, either alone or coculture with HPCs medium. TGF-β plays a vital role in the proliferation and differentiation of sBM-DCs and inhibition of TGF-β reduce the number and increase the percentage of CD34, CD117, CD135 of generation cells. Thus, MSCs induced the regDCs from HPCs via the Notch signaling pathway and TGF-β synergistically. This study further broadens our understanding of the immunomodulatory mechanism and the potential therapeutic efficacy of MSCs.

[Survival analysis of laboratory - bred smooth - shelled Oncomelania snails in Yunnan Province]

OBJECTIVE

To investigate the survival period of Yunnan Province-derived smooth-shelled Oncomelania snails bred in laboratory.

METHODS

Oncomelania snails were sampled from Heqing and Yongsheng counties where schistosomiasis is endemic, and uninfected adult snails were collected and bred in laboratory. The survival period of snails sampled from these two counties was compared.

RESULTS

The 1-, 2-, 3- and 4-year survival rates of laboratory-bred smooth-shelled snails sampled from Yunnan Province were 72.36%, 29.11%, 13.08% and 0.21%, respectively, and were 74.66%, 38.91%, 19.46% and 0.45% for snails derived from Heqing County, and 70.36%, 20.55%, 7.51% and 0 for snails sampled from Yongsheng County, respectively. The mean and median survival period of Yunnan Province-derived adult snails was 20.90 and 20.67 months, and there were significant differences between the snails sampled from Heqing and Yongsheng counties in terms of the mean (22.94 vs. 19.13 months, P < 0.05) and median survival period (21.63 vs. 19.81 months, P < 0.05).

CONCLUSIONS

The mean survival period of Yunnan Province-derived smooth-shelled adult snails is approximately 20 months in laboratory, and the survival varies in geographical areas.

[Effect of different support angles on the fitness of removable partial denture framework fabricated using selective laser melting technique]

Objective: To evaluate the fitness of bilateral free-end dentition defect removable partial denture framework fabricated by selective laser melting (SLM) technique with different support angles. Methods: After the control group has been set to eliminate the system error, and according to the standard model of bilateral mandibular posterior teeth loss, eighteen titanium alloy removable partial denture frameworks fabricated by SLM technology were divided into 3 groups with support angles of 0° (horizontal group), 45°(45° group) and 90° (vertical group). Plaster cast with duplicated structure of tissue surface of the removable partial denture (RPD) framework was obtained. A three-dimensional scanner was used to scan original and duplicated plaster casts. The gaps between framework and the model in different parts were analyzed using Geomagic Qualify software to evaluate the fitness of the framework with visual method. Results: The framework fits on the plaster model completely, and its tissue surface fitted on the plaster model well. The deviation between frameworks and plaster casts was calculated as follow: the total deviations of the horizontal, 45°, and vertical group were (0.146±0.017), (0.182±0.015) and (0.185±0.022) mm respectively. The mean deviation of the horizontal group was significantly less than those of the 45° group and the vertical group (P<0.05). Moreover, there was no significant difference in the total deviation between the 45° group and the vertical group. The total deviation of occlusal rest of the horizontal group was significantly less than that of the 45° group (P<0.05). However, no significant difference was detected in the deviation of occlusal rest among the vertical group, the horizontal group, and the 45° group (P>0.05). There was no significant difference in the deviation of occlusal rest among the vertical group, the horizontal group, and the 45° group. The deviation of clasp of the horizontal group was significantly smaller than those of the 45° group and the vertical group (P<0.05). Whereas, there was no significant difference in the deviation of clasp between the 45° group and the 90° group (P>0.05). No significant difference was found in the deviation of lingual bar among the three groups (P>0.05). Conclusions: Among the three kinds of bilateral free-end dentition defect RPD framework fabricated by SLM in different support angles, horizontal printing was proved to reach the minimal deviation, even though the fitness of all three kinds of frameworks can fullfil clinical requirements according to previous studies.

Risk assessment of mycotoxins in stored maize: case study of Shandong, China

Risk characterisation of dietary exposure of aflatoxins (AFs), fumonisins (FBs), deoxynivalenol (DON), zearalenone (ZEA) in maize from Shandong Province was conducted in this study. A total of 520 maize samples were collected after harvesting in 2014 and 2015 from 26 selected villages in Shandong Province, China. A deterministic approach was used in the current study. The dietary intake data of maize was obtained from ‘Shandong Statistical Yearbook 2018’. The risk characterisation of FBs, DON, and ZEA was evaluated in 4 population groups (2 to 6-year-old children, standard adults, city adults and village adults) based on probable intake. 2 to 6-year-old children and adults were exposed to FBs (0.42 and 0.20 μg/kg body weight (bw)/day), DON (0.04 and 0.019 μg/kg bw/day), and ZEA (0.0024 and 0.0011 μg/kg bw/day) through mean maize consumption in diets, which was lower than the provisional maximum tolerable daily intake of each mycotoxin established by JECFA. Risk assessments showed a low risk for liver cancer due to consumption of aflatoxin B1 (0.027-0.21 cases per 100,000 persons per year) contaminated maize compared with China’s current liver cancer incidence of 24.6 cases per 100,000 persons per year.

Maternal exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin suppresses male reproductive functions in their adulthood

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is a ubiquitous environmental contaminant in the environment. The developmental period is more sensitive to TCDD and there is a possibility that maternal exposure to TCDD may affect in adulthood. Adult female Wistar rats were exposed to 0.5, 1.0, and 2.0 µg/kg TCDD during the critical stage of organogenesis, that is, on GD15. The results revealed a significant decrease in indices of reproductive organ weight in adult male rats exposed to prenatal TCDD, and dose-dependent reduction in epididymal sperm reserves, percent motile, and viable sperm with an increase in percent morphological abnormal sperm. Polymerase chain reaction analysis revealed downregulated expression levels of steroidogenic markers such as steroidogenic acute regulatory, cholesterol side-chain cleavage, and 3β- and 17β-hydroxysteroid dehydrogenase (HSDs) in experimental rats. Immunofluorescence sections portrayed reduced distribution of 3β- and 17β-HSD proteins in testes of experimental rats. Furthermore, spermatogenic markers (acid phosphatase, alkaline phosphatase, lactate dehydrogenase, and sorbitol dehydrogenase) were significantly altered in the testes. Serum levels of testosterone, follicle stimulating hormones, and luteinizing hormone were significantly decreased. Testicular levels of hydrogen peroxide and lipid peroxidation were significantly elevated with a decline in superoxide dismutase, catalase, glutathione peroxidase activities, and total thiol levels. Moreover, histological and morphometric examination of testicular cross-sections depicted degenerative changes. Male fertility assessment in adult rats revealed a significant decrease in mating index, fertility index, and mean number of pre- and postimplantations with an increase in pre- and postimplantation losses in rats cohabited with in utero TCDD-exposed adult males. In conclusion, the findings of this study provided clear evidence that maternal exposure to TCDD during the critical stage of development results in suppressed reproductive health in adulthood.

Tailoring spontaneous infrared emission of HgTe quantum dots with laser-printed plasmonic arrays

Chemically synthesized near-infrared to mid-infrared (IR) colloidal quantum dots (QDs) offer a promising platform for the realization of devices including emitters, detectors, security, and sensor systems. However, at longer wavelengths, the quantum yield of such QDs decreases as the radiative emission rate drops following Fermi's golden rule, while non-radiative recombination channels compete with light emission. Control over the radiative and non-radiative channels of the IR-emitting QDs is crucially important to improve the performance of IR-range devices. Here, we demonstrate strong enhancement of the spontaneous emission rate of near- to mid-IR HgTe QDs coupled to periodically arranged plasmonic nanoantennas, in the form of nanobumps, produced on the surface of glass-supported Au films via ablation-free direct femtosecond laser printing. The enhancement is achieved by simultaneous radiative coupling of the emission that spectrally matches the first-order lattice resonance of the arrays, as well as more efficient photoluminescence excitation provided by coupling of the pump radiation to the local surface plasmon resonances of the isolated nanoantennas. Moreover, coupling of the HgTe QDs to the lattice plasmons reduces the influence of non-radiative decay losses mediated by the formation of polarons formed between QD surface-trapped carriers and the IR absorption bands of dodecanethiol used as a ligand on the QDs, allowing us to improve the shape of the emission spectrum through a reduction in the spectral dip related to this ligand coupling. Considering the ease of the chemical synthesis and processing of the HgTe QDs combined with the scalability of the direct laser fabrication of nanoantennas with tailored plasmonic responses, our results provide an important step towards the design of IR-range devices for various applications.

Postoperative intravenous parecoxib sodium followed by oral celecoxib post total knee arthroplasty in osteoarthritis patients (PIPFORCE): a multicentre, double-blind, randomised, placebo-controlled trial

OBJECTIVES

To evaluate the morphine-sparing effects of the sequential treatment versus placebo in subjects undergoing total knee arthroplasty (TKA), the effects on pain relief, inflammation control and functional rehabilitation after TKA and safety.

DESIGN

Double-blind, pragmatic, randomised, placebo-controlled trial.

SETTING

Four tertiary hospitals in China.

PARTICIPANTS

246 consecutive patients who underwent elective unilateral TKA because of osteoarthritis (OA).

INTERVENTIONS

Patients were randomised 1:1 to the parecoxib/celecoxib group or the control group. The patients in the parecoxib/celecoxib group were supplied sequential treatment with intravenous parecoxib 40 mg (every 12 hours) for the first 3 days after surgery, followed by oral celecoxib 200 mg (every 12 hours) for up to 6 weeks. The patients in the control group were supplied with the corresponding placebo under the same instructions.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary endpoint was the cumulative opioid consumption at 2 weeks post operation (intention-to-treat analysis). Secondary endpoints included the Knee Society Score, patient-reported outcomes and the cumulative opioid consumption.

RESULTS

The cumulative opioid consumption at 2 weeks was significantly smaller in the parecoxib/celecoxib group than in the control group (median difference, 57.31 (95% CI 34.66 to 110.33)). The parecoxib/celecoxib group achieving superior Knee Society Scores and EQ-5D scores and greater Visual Analogue Scale score reduction during 6 weeks. Interleukin 6, erythrocyte sedation rate and C-reactive protein levels were reduced at 72 hours, 2 weeks and 4 weeks and prostaglandin E2 levels were reduced at 48 hours and 72 hours in the parecoxib/celecoxib group compared with the placebo group. The occurrence of adverse events (AEs) was significantly lower in the parecoxib/celecoxib group.

CONCLUSIONS

The sequential intravenous parecoxib followed by oral celecoxib regimen reduces morphine consumption, achieves better pain control and functional recovery and leads to less AEs than placebo after TKA for OA.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov (ID: NCT02198924).

A study of dynamic contrast-enhanced MR imaging features and influence factors of pelvic bone marrow in adult females

Perfusion of the pelvic bone marrow is reduced in the postmenopausal group and with age. Quantitative dynamic contrast-enhanced MRI could reflect the blood supply characteristics and hemodynamic changes of the pelvic bone marrow. These results contribute to the description of osteoporosis in the postmenopausal females and the elderly.

INTRODUCTION

To investigate the effect of menstrual status and age on the perfusion of pelvic bone marrow in adult females using quantitative dynamic contrast-enhanced MRI (DCE-MRI).

METHODS

In total, 96 adult females who underwent DCE-MRI between September 2017 and December 2017 were included. All the subjects' quantitative DCE-MRI parameters of pelvic bone marrow were measured and retrospectively analyzed, including K^trans (volume transfer constant), K_ep (efflux rate constant), and V_e (interstitial volume). According to their menstrual status, the subjects were divided into a premenopausal group (n = 39) and a postmenopausal group (n = 57), and the two groups were then divided into four subgroups according to age. The intraobserver reliability was assessed by the intraclass correlation coefficient (ICC). The parameters were compared between different menstrual status groups and age subgroups by Mann-Whitney test, and Spearman correlation analysis was used to evaluate the correlation between the age and the quantitative parameters.

RESULTS

The ICCs of the K^trans, K_ep, and V_e values were 0.989, 0.974, and 0.920, respectively. K^trans, K_ep, and V_e of the premenopausal group were significantly higher than those of the postmenopausal group (P < 0.05). The overall age was negatively correlated with K^trans, K_ep, and V_e (r = - 0.590, - 0.357, and - 0.381, respectively, P < 0.05). In the premenopausal group, K^trans and V_e were significantly higher in subgroup 1 (≤ 40 years) compared with subgroup 2 (> 40 years) (P < 0.05), and age showed a negative correlation with K^trans and V_e (r = - 0.344 and - 0.334, respectively, P < 0.05). In the postmenopausal group, K^trans and K_ep were significantly higher in subgroup 3 (≤ 60 years) compared with subgroup 4 (> 60 years) (P < 0.05), and age showed a negative correlation with K^trans and K_ep (r = - 0.460 and - 0.303, respectively, P < 0.05).

CONCLUSION

Menstrual status and age have significant effects on the perfusion of the pelvic bone marrow microenvironment in adult females and that the microenvironment of the pelvic bone marrow displays different changes at different age stages. Quantitative DCE-MRI has contributed to the interpretation of the pelvic bone marrow perfusion status.

NR4A1 promotes TNF‑α‑induced chondrocyte death and migration injury via activating the AMPK/Drp1/mitochondrial fission pathway

Nuclear receptor subfamily 4 group A member 1 (NR4A1)-induced chondrocyte death plays a critical role in the development of osteoarthritis through poorly defined mechanisms. The present study aimed to investigate the role of NR4A1 in regulating chondrocyte death in response to tumor necrosis factor-α (TNF-α) and cycloheximide (CHX) treatment, with a focus on mitochondrial fission and the AMP-activated protein kinase (AMPK) signaling pathway. The results demonstrated that NR4A1 was significantly upregulated in TNF-α and CHX exposed chondrocytes. Increased NR4A1 triggered mitochondrial fission via the AMPK/dynamin-related protein 1 (Drp1) pathway, resulting in mitochondrial dysfunction, and mitochondrial permeability transition pore (mPTP) opening-related cell death. Furthermore, excessive mitochondrial fission impaired chondrocyte migration through imbalance of F-actin homeo-stasis. Inhibiting NR4A1 attenuated TNF-α and CHX-induced mitochondrial fission and, thus, reduced mitochondrial dysfunction in chondrocytes, mPTP opening-related cell death and migration injury. Altogether, the present data confirmed that mitochondrial fission was involved in NR4A1-mediated chondrocyte injury via regulation of mitochondrial dysfunction, mPTP opening-induced cell death and F-actin-related migratory inhibition.

Protective effect of tauroursodeoxycholic acid on the autophagy of nerve cells in rats with acute spinal cord injury

OBJECTIVE

To investigate the impact and protective effect of tauroursodeoxycholic acid (TUDCA) on the autophagy of nerve cells in rats with acute spinal cord injury.

MATERIALS AND METHODS

Seventy-two 6-8-week-old male Sprague-Dawley (SD) rats were selected and were randomly divided into a sham operation group, a saline control group and a TUDCA treatment group (high and low dose groups). The experimental animals were sacrificed at 24 hours, 5 days and 10 days after spinal cord injury. The Basso, Beattie, Bresnahan locomotor scale was used to assess the hind limb locomotor function after the rats were injured but before sudden death. Electron microscopy, hematoxylin and eosin (HE) staining, TUNEL assays and immunohistochemistry techniques were used to observe the autophagy of the cells. Western blotting was used to analyze the expression of the autophagy-related factor Beclin-1 and the apoptosis-related factor caspase-3, and reverse transcription polymerase chain reaction (RT-PCR) was used to analyze the mRNA expression levels of the above proteins.

RESULTS

The locomotor scores of the rats in the saline group were significantly reduced, their Beclin-1 expression levels in neurons were decreased, and caspase-3 expression was increased. The hind limb locomotor scores of rats in the TUDCA groups were decreased, with no difference between the high- and low-dose groups. Beclin-1 expression in their neurons was increased, and caspase-3 expression was decreased; there was a significant difference when compared with the control group, while there was no significant difference between the high- and low-dose groups.

CONCLUSIONS

TUDCA significantly activates the neuronal autophagic expression in rats with acute spinal cord injury to inhibit the apoptosis of nerve cells; therefore, it has a protective effect on neurons.

Long noncoding RNA Lnc01614 promotes the occurrence and development of gastric cancer by activating EMT pathway

OBJECTIVE

To investigate the expression characteristics of long noncoding ribonucleic acid (lncRNA) lnc01614 in gastric cancer, so as to further investigate its roles in the occurrence and development of gastric cancer and its potential regulatory mechanism.

PATIENTS AND METHODS

Quantitative Real-time polymerase chain reaction (qRT-PCR) was used to detect the expression levels of lnc01614 in 79 pairs of gastric cancer tissues and normal adjacent tissues. The correlations of lnc01614 expression with pathological parameters of gastric cancer and prognoses of patients were also analyzed. QRT-PCR was employed to further verify the expression of lnc01614 in gastric cancer cells. Lnc01614 knockdown expression models were established using small interfering RNA (siRNA) in gastric cancer cell strains (SGC-7901 and AGS). The effect of lnc01614 on the biological function of gastric cancer cells was analyzed by Cell Counting Kit-8 (CCK-8) and transwell invasion and migration assay. Lastly, Western blotting was performed to explore its potential mechanism.

RESULTS

The results of qRT-PCR showed that the expression of lnc01614 in gastric cancer tissues was significantly higher than that in normal tissues. Compared with patients with low expression of lnc01614, patients with high expression of lnc01614 had higher tumor staging, greater lymph node metastasis and distant metastasis rates, and lower overall survival rate. In comparison with the negative control si-NC group, cell proliferation, invasion and migration abilities in lnc01614 knockdown expression group (si-lnc01614) were significantly decreased. Western blotting results indicated that si-lnc01614 group exhibited increased E-cadherin expression, and significantly reduced vimentin and snail expression.

CONCLUSIONS

Lnc01614 was upregulated in gastric cancer and significantly correlated with gastric cancer staging, lymph node metastasis, distant metastasis and poor prognosis. Lnc01614 may promote the proliferation, invasion and migration capabilities of gastric cancer through the regulation of epithelial-mesenchymal transition (EMT) pathway.

Secondary radiation measurements for particle therapy applications: Charged secondaries produced by 16O ion beams in a PMMA target at large angles

Particle therapy is a therapy technique that exploits protons or light ions to irradiate tumor targets with high accuracy. Protons and ¹²C ions are already used for irradiation in clinical routine, while new ions like ⁴He and ¹⁶O are currently being considered. Despite the indisputable physical and biological advantages of such ion beams, the planning of charged particle therapy treatments is challenged by range uncertainties, i.e. the uncertainty on the position of the maximal dose release (Bragg Peak - BP), during the treatment. To ensure correct 'in-treatment' dose deposition, range monitoring techniques, currently missing in light ion treatment techniques, are eagerly needed. The results presented in this manuscript indicate that charged secondary particles, mainly protons, produced by an ¹⁶O beam during target irradiation can be considered as candidates for ¹⁶O beam range monitoring. Hereafter, we report on the first yield measurements of protons, deuterons and tritons produced in the interaction of an ¹⁶O beam impinging on a PMMA target, as a function of detected energy and particle production position. Charged particles were detected at 90° and 60° with respect to incoming beam direction, and homogeneous and heterogeneous PMMA targets were used to probe the sensitivity of the technique to target inhomogeneities. The reported secondary particle yields provide essential information needed to assess the accuracy and resolution achievable in clinical conditions by range monitoring techniques based on secondary charged radiation.

Review and performance of the Dose Profiler, a particle therapy treatments online monitor

Particle therapy (PT) can exploit heavy ions (such as He, C or O) to enhance the treatment efficacy, profiting from the increased Relative Biological Effectiveness and Oxygen Enhancement Ratio of these projectiles with respect to proton beams. To maximise the gain in tumor control probability a precise online monitoring of the dose release is needed, avoiding unnecessary large safety margins surroundings the tumor volume accounting for possible patient mispositioning or morphological changes with respect to the initial CT scan. The Dose Profiler (DP) detector, presented in this manuscript, is a scintillating fibres tracker of charged secondary particles (mainly protons) that will be operating during the treatment, allowing for an online range monitoring. Such monitoring technique is particularly promising in the context of heavy ions PT, in which the precision achievable by other techniques based on secondary photons detection is limited by the environmental background during the beam delivery. Developed and built at the SBAI department of "La Sapienza", within the INSIDE collaboration and as part of a Centro Fermi flagship project, the DP is a tracker detector specifically designed and planned for clinical applications inside a PT treatment room. The DP operation in clinical like conditions has been tested with the proton and carbon ions beams of Trento proton-therapy center and of the CNAO facility. In this contribution the detector performances are presented, in the context of the carbon ions monitoring clinical trial that is about to start at the CNAO centre.