Deciphering the underlying core microorganisms and the marker compounds of Liupao tea during the pile-fermentation process

BACKGROUND

Pile fermentation is one of the key steps in developing the Liupao tea (LBT) quality and unique characteristics. The complex biochemical profile of LBT results from microorganisms present during the pile-fermentation process. However, the critical underlying microorganisms and the marker compounds still need to be determined.

RESULTS

Staphylococcus, Brevibacterium, Kocuria, Aspergillus, and Blastobotrys were the common dominant microorganisms at the end of the pile fermentation of LBT. Staphylococcus, Aspergillus, Blastobotrys, and nine other genera carried by raw tea are the core microorganisms in the LBT during pile fermentation. A total of 29 critical compounds contributed to the metabolic changes caused by the processing of LBT. Of these, gallic acid, adenine, hypoxanthine, uridine, betaine, 3,4-dihydroxybenzaldehyde, and α-linolenic acid could be characterized as potential marker compounds. Correlation analysis showed that the core microorganisms, including Sphingomonas, Staphylococcus, Kocuria, Aureobasidium, Blastobotrys, Debaryomyce, and Trichomonascus, were closely related to major chemical components and differential compounds. Moreover, the mutually promoting Staphylococcus, Kocuria, Blastobotrys, and Trichomonascus were correlated with the enrichment of marker compounds. Integrated molecular networking and metabolic pathways revealed relevant compounds and enzymes that possibly affect the enrichment of marker compounds.

CONCLUSION

This study analyzed the LBT fermentation samples by omics analysis to reveal the stable microbial community structure, critical microorganisms, and markers compounds affecting the quality of LBT, which contributes to a better understanding of pile fermentation of LBT and the fermentation theory of dark tea. © 2023 Society of Chemical Industry.

Degradation of Cell Wall Polysaccharides during Traditional and Tank Fermentation of Chinese Liupao Tea

The increase of polysaccharides in the dark tea pile process is thought to be connected to the cell wall polysaccharides' breakdown. However, the relationship between tea polysaccharides (TPSs) and tea cell wall polysaccharides has not been further explored. In this study, the structural changes in the cell wall polysaccharides [e.g., cellulose, hemicellulose (HC), and pectin] in Liupao tea were characterized before and after traditional fermentation and tank fermentation. Additionally, the degradation mechanism of tea cell wall polysaccharides during fermentation was assessed. The results showed that cellulose crystallinity decreased by 11.9-49.6% after fermentation. The molar ratio of monosaccharides, such as arabinose, rhamnose, and glucose in HC, was significantly reduced, and the molecular weight decreased. The esterification degree and linearity of water-soluble pectin (WSP) were reduced. TPS content increases during pile fermentation, which may be due to HC degradation and the increase in WSP caused by cell wall structure damage. Microorganisms were shown to be closely associated with the degradation of cell wall polysaccharides during fermentation according to correlation analyses. Traditional fermentation had a greater effect on the cellulose structure, while tank fermentation had a more noticeable impact on HC and WSP.

Active learning prediction and experimental confirmation of atomic structure and thermophysical properties for liquid Hf_{76}W_{24} refractory alloy

The determination of liquid atomic structure and thermophysical properties is essential for investigating the physical characteristics and phase transitions of refractory alloys. However, due to the stringent experimental requirements and underdeveloped interatomic potentials, acquiring such information through experimentation or simulation remains challenging. Here, an active learning method incorporating a deep neural network was established to generate the interatomic potential of the Hf_{76}W_{24} refractory alloy. Then the achieved potential was applied to investigate the liquid atomic structure and thermophysical properties of this alloy over a wide temperature range. The simulation results revealed the distinctive bonding preferences among atoms, that is, Hf atoms exhibited a strong tendency for conspecific bonding, while W atoms preferred to form an interspecific bonding. The analysis of short-range order (SRO) in the liquid alloy revealed a significant proportion of icosahedral (ICO) and distorted ICO structures, which even exceeded 30% in the undercooled state. As temperature decreased, SRO structures demonstrated an increase in larger coordination number (CN) clusters and a decrease in smaller CNs. The alterations of the atomic structure indicated that the liquid alloy becomes more ordered, densely packed, and energetically favorable with decreasing temperature, consistent with the obtained fact: Both density and surface tension increase linearly. The simulated thermophysical properties were close to experimental values with minor deviations of 2.8% for density and 3.4% for surface tension. The consistency of the thermophysical properties further attested to the accuracy and reliability of active learning simulation.

Impacts of pregnancy and menopause on COVID-19 severity: a systematic review and meta-analysis of 4.6 million women

BACKGROUND

Corona Virus Disease 2019 (COVID-19) pandemic is still a public health emergency of international concern. However, whether pregnancy and menopause impact the severity of COVID-19 remain unclear.

AIM

This study is performed to investigate the truth.

DESIGN

Study appraisal and synthesis follows PRISMA guideline. Meta-analysis is performed in random-effects model.

METHODS

PubMed, Embase, Cochrane database, Central, CINAHL, ClinicalTrials.gov, WHO COVID-19 database and WHO-ICTRP are searched until 28 March 2023.

RESULTS

In total, 57 studies (4 640 275 COVID-19 women) were analyzed. Pregnant women were at a lower risk of severe COVID-19, intensive care unit (ICU) admission and disease mortality compared to those nonpregnant women with comparable comorbidities. In contrast, pregnant women with more prepregnancy comorbidities were at a higher risk of severe COVID-19, ICU admission and invasive mechanical ventilation (IMV). In addition, pregnant women with pregnancy complications had a significantly increased risk of severe COVID-19 and ICU admission. Menopause increased COVID-19 severity, IMV requirement and disease mortality. Hormone replacement therapy inhibited COVID-19 severity in postmenopausal women. Premenopausal and postmenopausal women had a lower chance of severe illness than age-matched men. The impact of pregnancy on COVID-19 severity was significant in Americans and Caucasians, whereas the effect of menopause on COVID-19 severity was only significant in Chinese.

CONCLUSIONS

Pregnancy and menopause are protective and risk factors for severe COVID-19, respectively. The protective role of pregnancy on COVID-19 is minimal and could be counteracted or masked by prepregnancy or pregnancy comorbidities. The administration of estrogen and progesterone may prevent severe COVID-19.

Isolation, identification, and community diversity of microorganisms during tank fermentation of Liupao tea

Tank fermentation is a novel approach to fermenting teas; however, the species of microorganisms present remain unclear. The microbial community composition of Liupao tea at various stages of tank fermentation was analyzed using high-throughput sequencing. Sphingomonas, Aquabacterium, Pelomonas, Acinetobacter, Blastobotrys, Aspergillus, Debaryomyces, and Aureobasidium were the predominant genera, which is different from pile fermentation. Fifteen genera (including Lactobacillus, Debaryomyces, Candida, Allobaculum, Flavobacterium, Caulobacter, Blastobotrys, Aspergillus, and Rasamsonia) were identified as biomarkers. PICRUSt analysis predicted that the most abundant functional genes were related to metabolism of carbohydrates, amino acids, cofactors, vitamins, and other secondary metabolites. Using the pure culture method, 283 strains were isolated at various stages of fermentation, representing 20 genera and 29 species of bacteria, and 11 genera and 18 species of fungi. Most of the dominant Sphingomonas, Staphylococcus, Aspergillus, and Blastobotrys identified by sequencing were also isolated. Of these, Sphingomonas olei, Aspergillus luchuensis, Aspergillus niger, Aspergillus aculeatus, Aspergillus amstelodami, Blastobotrys adeninivorans, Candida metapsilosis, and Candida blankii were beneficial strains that might be used to ferment Liupao tea. This study provides a basis for the development of processing technologies and utilization of microbial strains in the production of dark teas. PRACTICAL APPLICATION: Microbial diversity in tank-fermented Liupao tea was reported for the first time. 8 microorganisms were the predominant genera. The species, functions and potential risks of microorganisms was revealed. We clarified the differences between tank and pile fermentation.

Mass spectrometry-based metabolic profiling for identification of biomarkers related to footpad dermatitis in ducks

1. A new assessment method for duck footpad dermatitis (FPD) evaluation was developed, combining visual and histological characters using the images and sections of 400 ducks' feet at 340 d of age. All ducks were graded as G0 (healthy), G1 (mild), G2 (moderate) and G3 (severe) according to the degree of FPD.2. To reveal the potential biomarkers in serum related to duck FPD, non-targeted metabolomics and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were used to explore differential metabolites in each group.3. There were 57, 91 and 210 annotated differential metabolites in groups G1, G2 and G3 compared with G0, which meant that the severity of FPD increased in line with the number of metabolites. Four metabolites, L-phenylalanine, L-arginine, L-leucine and L-lysine, were considered potential biomarkers related to FPD.4. KEGG enrichment analysis showed that the FPD was mainly involved in glycolysis, the tricarboxylic acid (TCA) cycle, the pentose phosphate pathway and amino acid metabolism. These are related to production metabolism and can affect the physiological activities of ducks, which might explain the decrease in production performance.

Screening strategy for predominant phenolic components of digestive enzyme inhibitors in passion fruit peel extracts on simulated gastrointestinal digestion

BACKGROUND

The targeted biological activity of a natural product is often the result of the combined action of multiple functional components. Screening for predominant contributing components of targeting activity is crucial for quality evaluation.

RESULTS

Thirteen and nine phenolic compounds inhibiting α-glucosidase and α-amylase, respectively, were identified in the ethanol extracts of passion fruit peel through liquid chromatography-tandem mass spectrometry and multivariate analysis. Considering the different concentrations of components and their interactions, the role of the semi-inhibitory concentration (IC₅₀ ) in the dose-effect relationship is limited. We proposed the active contribution rate (ACR), which is the ratio of a single component concentration to its IC₅₀ in the whole, to assess the relative activity of each compound. Luteolin, quercetin, and vitexin exhibited a minimum IC₅₀ . Before the simulation of gastrointestinal digestion, quercetin, salicylic acid, and luteolin were identified as the dominant contributors to α-glucosidase inhibition according to ACR, while salicylic acid, 2,3-dihydroxybenzoic acid, and quercetin were identified as dominant contributors to α-amylase inhibition. After simulated digestion, the contents of all polyphenolic compounds decreased by various degrees. Salicylic acid, gentisic acid, and vitexin became the dominant inhibitors of α-glucosidase based on ACR (cumulative 57.96%), while salicylic acid and 2,3-dihydroxybenzoic acid became the dominant inhibitors of α-amylase (cumulative 84.50%).

CONCLUSION

Therefore, the ACR evaluation strategy can provide a quantitative reference for screening the predominant contributor components of a specific activity in complex systems. © 2022 Society of Chemical Industry.

Structural Characterization and In Vitro Antioxidant, Hypoglycemic and Hypolipemic Activities of a Natural Polysaccharide from Liupao Tea

This study extracted and purified a natural polysaccharide (TPS-5) that has a molecular weight of 48.289 kDa from Liupao tea, a typical dark tea with many benefits to human health. TPS-5 was characterized as a pectin-type acidic polysaccharide. It has a backbone composed of → 2,4)- α- L-Rhap-(1) → 4)- α- D-GalAp-(1) →, with a branch composed of → 5)- α- L-Ara-(1 → 5,3)- α- L-Ara-(1 → 3)- β- D-Gal-(1 → 3,6)- β- D-Galp-(1) →. The in vitro biological activity evaluation illustrated that TPS-5 has free radical scavenging, ferric-ion-reducing, digestive enzyme inhibitory, and bile-salt-binding abilities. These results suggest that TPS-5 from Liupao tea has potential applications in functional foods or medicinal products.

[Association of greenness exposure with waist circumference and central obesity in Chinese adults aged 65 years and over]

Objective: To examine the association of greenness exposure with waist circumference (WC) and central obesity in older adults in China. Methods: Based on the cross-sectional data from the Chinese Longitudinal Healthy Longevity Survey in 2017-2018, 14 056 participants aged 65 years and over were included. Demographic characteristics, lifestyle, WC, and other information were collected through a questionnaire and physical examination. Based on the satellite monitoring data of moderate-resolution imaging spectroradiometer (MODIS) provided by NASA, the annual mean of normalized difference vegetation index (NDVI) within a radius of 1 000 meters was obtained as the measurement value of greenness exposure. Multivariate linear regression model, multivariate logistic regression model, and restricted cubic splines (RCS) model were used to analyze the association and dose-response relationship between greenness exposure and WC and central obesity in older adults in China. Results: A total of 14 056 participants were enrolled with a median age of 84.0 years [IQR: 75.0-94.0 years]. About 45.0% (6 330) of them were male and 48.6% (5 853) were illiterate. There were 10 964 (78.0%) participants from rural. The mean of WC was (84.4±10.8) cm. Central obesity accounted for 60.2% (8 465), and the NDVI range was (-0.06, 0.78). After adjusting for confounding factors, the multivariate linear regression model showed that the change value of WC in the urban group [β (95%CI):-0.49 (-0.93, -0.06)] was smaller than that in the rural [-0.78 (-0.98, -0.58)] for every 0.1 unit increase in NDVI (Pinteraction=0.022). Compared with the Q1 group in NDVI, WC of Q2 and Q3 groups in rural decreased, and the β (95%CI) values were-1.74 (-2.5, -0.98) and-2.78 (-3.55, -2.00), respectively. The multivariate logistic regression model showed that after adjusting for confounding factors, the risk of central obesity decreased for urban and rural older adults with an increase of 0.1 unit in NDVI, and the OR (95%CI) values were 0.87 (0.80, 0.95) and 0.86 (0.82, 0.89), respectively (Pinteraction=0.284). Compared with the Q1 group in NDVI, the risk of central obesity in the Q2 and Q3 groups in rural was lower, and the OR (95%CI) values were 0.68 (0.58, 0.80) and 0.57 (0.49, 0.68), respectively. The results of the multivariate regression model with RCS showed that there was a non-linear association of NDVI with WC (Pnonlinear=0.006) and central obesity (Pnonlinear=0.025). Conclusion: Greenness exposure is negatively associated with WC and central obesity in older adults in China.

[Current status and future prospects of robotic surgical system in radical gastrectomy for gastric cancer]

Robotic gastrectomy (RG) has always been a hot topic in the field of minimally invasive surgery for gastric cancer. More and more studies have confirmed that short- and long-term outcomes of RG are similar to those of laparoscopic gastrectomy. Robotic surgical systems have more advantages in specific regional lymph node dissection. More delicate operation can reduce intraoperative blood loss and the incidence of postoperative complications. Robotic surgical systems are also more ergonomically designed. However, there are also some problems such as high surgical cost, lack of tactile feedback and prolonged total operation time. In the future, robotic surgical system may be further developed in the direction of miniaturization, intelligence and modularity. At the same time, the robotic surgical system deeply integrated with artificial intelligence technology may realize the automation of some operation steps to some extent.

Two Polysaccharides from Liupao Tea Exert Beneficial Effects in Simulated Digestion and Fermentation Model In Vitro

Liupao tea is an important dark tea, but few studies on purified Liupao tea polysaccharide (TPS) are reported in the literature. In this study, two TPSs, named TPS2 and TPS5, with molecular weights of 70.5 and 133.9 kDa, respectively, were purified from Liupao tea. TPS2 contained total sugar content (53.73% ± 1.55%) and uronic acid content (35.18% ± 0.96%), while TPS5 was made up of total sugar (51.71% ± 1.1%), uronic acid (40.95% ± 3.12%), polyphenols (0.43% ± 0.03%), and proteins (0.11% ± 0.07%). TPS2 and TPS5 were composed of Man, Rha, GlcA, Glc, Gal, and Ara in the molar ratios of 0.12:0.69:0.20:0.088:1.60:0.37 and 0.090:0.36:0.42:0.07:1.10:0.16, respectively. The effects of TPS2 and TPS5 on digestion and regulation of gut microbiota in hyperlipidemic rats were compared. In simulated digestion, TPS5 was degraded and had good antioxidant effect, whereas TPS2 was not affected. The bile acids binding capacities of TPS2 and TPS5 were 42.79% ± 1.56% and 33.78% ± 0.45%, respectively. During in vitro fermentation, TPS2 could more effectively reduce pH, promote the production of acetic acid and propionic acid, and reduce the ratio of Firmicutes to Bacteroidetes. TPS5 could more effectively promote the production of butyric acid and increase the abundance of genus Bacteroides. Results indicate that polysaccharides without polyphenols and proteins have better antidigestibility and bile acid binding. Meanwhile, polysaccharides with polyphenols and proteins have a better antioxidant property. Both have different effects on the gut microbiota.

Antihyperlipidemic effect and increased antioxidant enzyme levels of aqueous extracts from Liupao tea and green tea in vivo

Liupao tea (fermented dark tea) may improve the active function of hyperlipidemia. Utilizing a hyperlipidemia Sprague-Dawley model and UPLC-MS/MS metabolomics, we examined how the effect of Liupao and green tea extracts on hyperlipidemia and antoxidant enzyme levels and compared their constituents. The results showed that the two types of tea could reduce the levels of total cholesterol (TC), total triglyceride, and low-density lipoprotein cholesterol (LDL-C); increase the contents of bile acids and cholesterol in feces; and improve catalase and glutathione peroxidase (GSH-Px) activities. Compared with the model control group, Liupao tea effectively reduced TC and LDL-C levels by 39.53% and 58.55% and increased GSH-Px activity in the liver by 67.07%, which was better than the effect of green tea. A total of 93 compounds were identified from two samples; the amounts of alkaloids and fatty acids increased compared with green tea, and ellagic acid, hypoxanthine, and theophylline with relatively high contents in Liupao tea had a significantly positive correlation with antihyperlipidemic and antioxidant effects. Therefore, Liupao tea had better antihyperlipidemic and antioxidant activities in vivo than green tea, which might be related to the relatively high content of some active substances.

A narrative review of tissue-resident memory T cells and their role in immune surveillance and COVID-19

Most effector T cells will undergo programmed apoptosis after an immune response and some of them may become memory T cells. According to the distribution and functional status, the memory T cells can be divided into effector central memory T cells (TCM), effector memory T cells (TEM) and tissue-resident memory T cells (TRM) cells. TRM cells, including CD4+ TRM and CD8+ TRM cells, colonize various barrier surfaces and are no longer involved in lymphocyte recycling, closely monitored for local perturbations in homeostasis throughout the body as a critical component of the first defense line. When pathogenic microorganisms invade the body, TRM cells can quickly produce a defense response to initiate innate immunity and adaptive immunity by producing cytokines or killer molecules to resist viral and bacterial infections. In addition, TRM cells are also involved in cancer surveillance and play an essential role in maintaining cancer-immune equilibrium. The high frequency of TRM cells in tumor tissues often means favorable survival for patients. The latest research proves that TRM cells also play an important role in vaccine development and pathological features of COVID-19. This article will summarize the biological functions of TRM cells and aims at providing references for further research on their mechanism and for targeting the best treatment of clinical disease.

Acoustic manipulation dynamics of levitated particle with screw-shaped reflecting surface

Existing single-axis acoustic levitation devices with an axisymmetric reflector can manipulate particles in a variety of ways. However, the mechanism by which particles are suspended in a single-axis acoustic levitator with a non-axisymmetric reflector remains poorly understood. This work addresses this issue by proposing a novel single-axis ultrasonic levitator design that includes a flat plane emitter and a screw-plane reflector. The node positions of the standing wave formed in this levitator were predicted by calculating the Gor'kov potential according to a numerical model. The analysis results demonstrate that the nodes were distributed off-axis and their positions varied in a spiral manner when changing the distance between the emitter and reflector. Corresponding experiments based on the proposed design were also conducted, and the results indicated that the distance changes between the emitter and reflector could induce some spiral trajectories of a polyethylene-foam particle placed in the ultrasonic field. Moreover, the trajectory of the suspended particle was found to distribute along a conical surface centered on the central axis of this device. This work provides a new approach for ultrasonic particle manipulation by changing the geometry of the reflector.

[A nomogram for predicting lymph node metastasis in early gastric cancer]

Objective: To explore the independent risk factors of lymph node metastasis (LNM) in early gastric cancer, and to use nomogram to construct a prediction model for above LNM. Methods: A retrospective cohort study was conducted. Inclusion criteria: (1) primary early gastric cancer as stage pT1 confirmed by postoperative pathology; (2) complete clinicopathological data. Exclusion criteria: (1) patients with advanced gastric cancer, stump gastric cancer or history of gastrectomy; (2) early gastric cancer patients confirmed by pathology after neoadjuvant chemotherapy; (3) other types of gastric tumors, such as lymphoma, neuroendocrine tumor, stromal tumor, etc.; (4) primary tumors of other organs with gastric metastasis. According to the above criteria, 1633 patients with early gastric cancer who underwent radical gastrectomy at the Department of General Surgery of the Chinese PLA General Hospital First Medical Center from December 2005 to December 2020 were enrolled as training set, meanwhile 239 patients with early gastric cancer who underwent gastrectomy at the Department of General Surgery of the Chinese PLA General Hospital Fourth Medical Center from December 2015 to December 2020 were enrolled as external validation set. Risk factors of LNM in early gastric cancer were identified by using univariate and multivariate logistic regression analyses. A nomogram prediction model was established with significant factors screened by multivariate analysis. Area under the receiver operating characteristic curve (AUC) was used for assessing the predictive value of the model. Calibration curve was drawn for external validation. Results: Among 1633 patients in training set, the mean number of retrieved lymph nodes was 20 (13-28), and 209 patients (12.8%) had lymph node metastasis. Univariate analysis showed that gender, resection range, tumor location, tumor morphology, lymph node clearance, vascular invasion, lymphatic cancer thrombus, tumor length, tumor differentiation, microscopic presence of signet ring cells and depth of tumor invasion were associated with LNM (all P<0.05). Multivariate analysis revealed that females, tumor morphology as ulcer type, vascular invasion, lymphatic cancer thrombus, tumor length≥3 cm, deeper invasion of mucosa, and poor differentiation were independent risk factors for LNM in early gastric cancers (all P<0.05). Receiver operating characteristic curve indicated that AUC of training set was 0.818 (95%CI: 0.790-0.847) and AUC of external validation set was 0.765 (95%CI: 0.688-0.843). The calibration curve showed that the LNM probability predicted by nomogram was consistent with the actual situation (C-index: 0.818 in training set and 0.765 in external validation set). Conclusions: Females, tumor morphology as ulcer type, vascular invasion, lymphatic cancer thrombus, tumor length≥3 cm, deeper invasion of mucosa and poor differentiation are independent risk factors for LNM of early gastric cancer. The establishment of a nomogram prediction model for LNM in early gastric cancer has great diagnostic value and can provide reference for treatment selection.

[Analysis of influence factors for short-term recurrence of retroperitoneal liposarcoma after complete resection]

Objective: To examine the influence factors of short-term recurrence after complete surgical resection of retroperitoneal liposarcoma. Methods: The clinicopathological data of retroperitoneal liposarcoma at Department of General Surgery, the First Medical Center, People's Liberation Army General Hospital from January 1, 2000 to January 31, 2020 were retrospectively analyzed. There were 60 males and 31 females, aged (52.1±9.9) years (range: 30 to 84 years). Tumor recurrence within 12 months after complete resection was defined as short-term recurrence, and tumor recurrence more than 12 months was defined as non-short-term recurrence. The t test, rank-sum test, χ² test and Fisher exact test were conducted for inter-group comparison. Logistic regression analysis was used to analyze the independent influence factors for the short-term recurrence of retroperitoneal liposarcoma after complete resection. The Kaplan-Meier curve was used to calculate the recurrence-free survival, and the Log-rank test was adopted for the comparison between the groups. Results: The univariate analysis results showed that irregular tumor morphology, multiple pathological subtypes, pathological scores>3, and multiple primary tumors are influence factors for short-term recurrence after complete resection of retroperitoneal liposarcoma (χ²: 4.422 to 7.773, all P<0.05). Regression analysis of the above risk factors showed that multiple primary tumors was the independent risk factor (OR=2.918, 95%CI: 1.127 to 7.556, P=0.027). In the short-term recurrence group, Kaplan-Meier curve analysis showed that patients with multiple primary tumors had a shorter median recurrence time than patients with unifocal tumor (6 months vs. 9 months, P=0.028). Conclusions: Multiple primary tumor is an independent risk factor for short-term recurrence after complete resection of retroperitoneal liposarcoma. It suggests that the frequency of follow-up after surgery should be increased for such patients.

[Analysis of seven cases of multiple myeloma with initial manifestation of bleeding]

A retrospective analysis of 7 patients of multiple myeloma (MM) with initial manifestation of bleeding and coagulation abnormalities were performed. Clinical manifestations, laboratory and imaging examinations were collected. The activity of coagulation factors was measured before the treatment. Single factor X deficiency was seen in one patient. Two cases had factor Ⅶ deficiency, while four other patients had multiple factor deficiency. The time from onset of symptoms to diagnosis ranged from 2 to 10 months. After anti-MM treatment started and plasma or coagulation factors were transfused, the prolonged coagulation time returned to normal from 28-84 days. Most of these patients presented large, deep and multiple sites of hematoma, which caused concerns of bone marrow puncture and may direct to other differential diagnoses. This is helpful to improve physicians' understanding of the special clinical characteristics in MM patients.

[Evaluation of basic laparoscopic training under 5A teaching mode]

Objective: To evaluate the rationality and effectiveness of basic laparoscopic training under 5A teaching mode. Methods: A prospective randomized controlled study was conducted. The teaching records of 70 trainees who received basic laparoscopic traning at the Laparoscopic Surgical Training Base in Chinese PLA General Hospital from July to December 2019 were analyzed. All the trainees participating in the laparoscopy training had obtained the national practicing physician certificates, including 12 junior physicians of our center, 9 intermediate physicians of our center, 19 advanced physicians, 13 postgraduate students, 8 doctoral students, and 9 surgical standardized training physicians. A random number table method was used to divide all the trainees into two groups: the traditional teaching group or the 5A teaching group (35 people in each group). In the traditional teaching group, the training of 4 modules of " precise beans, quincuncial piles, ring positioning and knot-tying suture" modules according to a fixed sequence and schedule was carried out. Each module had a learning time of 8 hours. In the 5A teaching group, the training started from five dimensions of analysis, aim, accomplishment, appraise and advance. Before conducting each stage of training, the actual operation ability of the trainees was tested, each class hour was designed individually, accurate teaching was conducted to the trainees, the ability of the trainees was evaluated dynamically, and the previous steps were cycled periodically based on class hours. The operating time and pass rate of trainees of two groups in the basic operation module of laparoscopy were statistically analyzed, and a hierarchical analysis of related influencing factors was conducted. Results: The time of above modules before training in the 5A teaching group and the traditional teaching group was similar (all P>0.05). After definitive training, the time required for trainees in 5A teaching group and traditional teaching group to complete the 4 modules was shortened to varying degrees. Compared to traditional teaching group, 5A teaching group spent less time in completing each project [precise beans: (63.2±10.1) seconds vs. (83.6±18.7) seconds, quincuncial piles: (56.2±7.3) seconds vs. (101.4±31.7) seconds, ring positioning: (84.2±13.7) seconds vs. (127.3±28.5) seconds, knot-tying suture: (263.2±41.8) seconds vs.(428.8±95.2) seconds, all P<0.05], and had higher pass rates [precise beans: 97.1% (34/35) vs. 80.0% (28/35), quincuncial piles: 91.4% (32/35) vs.71.4% (25/35), ring positioning: 100.0% (35/35) vs. 82.9% (29/35), knot-tying suture: 77.1% (27/35) vs. 60.0% (21/35), all P<0.05]. Among the junior trainees (junior physicians of our center, postgraduate students, doctoral students, and standardized surgical training physicians) and intermediate trainees (intermediate physicians of our center and advanced physicians), the 5A teaching group completed 3 modules (quincuncial piles, ring positioning and knot-tying suture) faster than the traditional teaching group [junior trainees: quincuncial piles (76.4±12.4) seconds vs. (139.8±41.6) seconds, ring positioning (92.2±20.5) seconds vs. (131.3±28.4) seconds, knot-tying suture (293.8±66.7) seconds vs. (444.3±103.3) seconds; intermediate trainees: quincuncial piles (51.4±5.9) seconds vs. (94.7±8.6) seconds, ring positioning (63.9±13.5) seconds vs. (87.5±18.6) seconds, knot-tying suture (210.1±35.6) seconds vs. (367.5±54.9) seconds, all P<0.05]. Conclusion: 5A teaching mode can acheive better training results compared with the traditional teaching mode in basic laparoscopic training, and is worthy of further popularization and application.

[Effect of stable overexpression of XAF1 gene on biological characteristics of ovarian cancer A2780 cells]

OBJECTIVE

To construct an ovarian cancer cell line stably overexpressing XAF1 gene and observe the effects of XAF1 gene overexpression on proliferation, apoptosis, cell cycle and sensitivity to paclitaxel of the cells.

OBJECTIVE

Ovarian cancer A2780 cells were transfected with the plasmids pcDNA3.1(+) or pcDNA3.1(+)-XAF1, and the cells stably Over expressing XAF1 (A2780/XAF1 cells) were screened using G418. Cell clone formation assay and CCK8 assay were used to evaluate the changes in proliferation and paclitaxel sensitivity of the transfected cells, and cell cycle and apoptosis of the cells were analyzed using flow cytometry.

OBJECTIVE

We successfully obtained A2780/XAF1 cells stably overexpressing XAF1, which exhibited no significant changes in cell morphology. Compared with the negative control cells (A2780/NC), A2780/XAF1 cells had lowered clone formation ability (P=0.0016) and attenuated proliferative activity on the first (P=0.009) and third (P=0.0035) days after cell adherence with also a significantly increased percentage of cells in G2-M phase (P < 0.001). A2780/XAF1 cells showed significantly higher apoptosis rates than A2780/NC cells in the absence of apoptotic stimulation, in serum-free culture or following paclitaxel induction (P < 0.001). The proliferative activity of A2780/XAF1 cells was significantly lower than that of A2780/NC cells after exposure to different paclitaxel concentrations (P < 0.001). The half inhibitory concentration of paclitaxel was significantly lower in A2780/XAF1 than in A2780/NC cells.

OBJECTIVE

Overexpression of XAF1 significantly inhibits the proliferation, induces cell cycle arrest, promotes apoptosis, and increases paclitaxel sensitivity in ovarian cancer cells.

Fatty acid composition of the methylotrophic yeast Komagataella phaffii grown under low- and high-methanol conditions

In this study, we analysed the intracellular fatty acid profiles of Komagataella phaffii during methylotrophic growth. K. phaffii grown on methanol had significantly lower total fatty acid contents in the cells compared with glucose-grown cells. C18 and C16 fatty acids were the predominant fatty acids in K. phaffii, although the contents of odd-chain fatty acids such as C17 fatty acids were also relatively high. Moreover, the intracellular fatty acid composition of K. phaffii changed in response to not only carbon sources but also methanol concentrations: C17 fatty acids and C18:2 content increased significantly as methanol concentration increased, whereas C18:1 and C18:3 contents were significantly lower in methanol-grown cells. The intracellular content of unidentified compounds (C_n H_2n O₄ ), on the other hand, was significantly greater in cells grown on methanol. As the intracellular contents of these C_n H_2n O₄ compounds were significantly higher in a gene-disrupted strain for glutathione peroxidase (gpx1Δ) than in the wild-type strain, we presume that the C_n H_2n O₄ compounds are fatty acid peroxides. These results indicate that K. phaffii can coordinate intracellular fatty acid composition during methylotrophic growth in order to adapt to high-methanol conditions and that certain fatty acid species such as C17:0, C17:1, C17:2 and C18:2 may be related to the physiological functions by which K. phaffii adapts to high-methanol conditions.

AB0280 THE INFLUENCE OF TARGET THERAPY AS WELL AS GLUCOCORTICOIDS TAPERING ON DISEASE FLARE IN SYSTEMIC LUPUS ERYTHEMATOSUS: RESULTS FROM A PROSPECTIVE CHINESE COHORT

Background:

Treat-to-target in systemic lupus erythematosus (SLE) has been proposed for 7 years and several recommendations were developed [1]. In these recommendations, prevention of flares should be a realistic target. Meanwhile, ‘remission’ or ‘low disease activity’ was recommended as the treatment target and minimizing glucocorticoids (GC) dose or withdrawal if possible was suggested in the maintenance treatment. However, would target therapy and GC tapering/withdrawal influence disease flare?

Objectives:

To investigate the frequency and determinants of disease flare, especially the influence of target therapy as well as GC tapering on flare in Chinese lupus patients.

Methods:

The baseline and follow-up data of all consecutive patients in a prospective longitudinal lupus cohort from January 2017 to June 2020 were collected. The lupus low disease activity state (LLDAS) was defined as in Golder et al., 2019[2]. The criteria for remission were from DORIS definitions [3]. Flare was assessed using the SELENA-SLEDAI flare index [4].

Results:

We enrolled 185 patients with disease duration at recruitment of 2.3 (0.8–7.7) years. During the 26.2 (12.5-34.5) months of follow-up, 73 (39.5%) patients experienced 95 flares, including 70 mild/moderate and 25 severe flares. The incidence of flare per patient-year was 0.27. Kaplan-Meier analyses showed that compared with those who never achieved LLDAS or DORIS, the patients who achieved the target at least once had a higher flare free survival rate; meanwhile, the patients with prednisone withdrawn had significantly lower flare free rate compared with those with small dose of GC maintained (≤7.5mg/d) (Figure 1A), but among the patients with different prednisone maintain doses (7.5~5mg, 5~2.5mg, and ≤2.5mg) there was not significant difference (Figure 1B). Cox regression analysis showed that younger age at disease onset and lower Complement 3 (C3) level at recruitment were independent risk factors for flare and achieving LLDAS or DORIS ≥50% of visits was independent protective factor (Table 1).

Conclusion:

In this Chinese prospective SLE cohort, age at disease onset, C3 level at recruitment and therapeutic target achieving influenced disease flare independently and significantly. GC tapering in appropriate patients and with appropriate pace did not increase the flare rate, but prednisone withdrawal may induce more disease exacerbation, which needs to be confirmed by large prospective studies.

References:

[1]Van Vollenhoven R F, et al. Treat-to-target in systemic lupus erythematosus: recommendations from an international task force. Ann Rheum Dis, 2014. 73(6): 958-967

[2]Golder, V., et al. Lupus low disease activity state as a treatment endpoint for systemic lupus erythematosus: a prospective validation study. The Lancet Rheumatology, 2019. 1(2): p. e95-e102.

[3]van Vollenhoven R, et al. A framework for remission in SLE: consensus findings from a large international task force on definitions of remission in SLE (DORIS). Ann Rheum Dis. 2017. 76(3): 554–561.

[4]Petri M, et al. Classification and definition of major flares in SLE clinical trials. Lupus. 1999. 8(8): 685-691.

Table 1.

Determinants of disease flare by multivariate Cox regression analyses

Model 1(LLDAS) ΔModel 2(RONT) ΔModel 3(Complete RONT) ΔHR95%CIP valueHR95%CIP valueHR95%CIP valueAge at disease onset (years)†0.970.95-0.990.0040.970.95-0.990.0030.970.95-0.990.003Anti-dsDNA positive at recruitment1.340.82-2.180.2171.120.68-1.850.6491.190.73-1.960.486C3 (mg/L) at recruitment0.9980.997-0.9990.0040.9980.997-0.9990.0070.9980.997-1.0000.010Minimum prednisone dose during follow- up (mg/d)0.980.90-1.080.7161.010.94-1.080.7471.040.97-1.110.243Therapeutic target achieved≥50% of observationsΔ0.600.39-0.940.0010.540.34-0.870.0110.680.51-0.920.011

Δ In the three hazard models, the different target achievement status were included respectively.

RONT: Clinical remission on treatment; Complete RONT: Complete remission on treatment.

Disclosure of Interests:

None declared

[A novel classification and strategy choice of digestive tract reconstruction procedures after function-preserving gastrectomy for early gastric caner]

Function-preserving gastrectomy (FPG) can be regarded as a concrete embodiment of precise treatment for early gastric cancer. Digestive tract reconstruction plays an important role in FPG. The aims of reconstruction mainly include the preservation of normal digestive tract and digestive function, the reconstruction of pivotal anatomical structure, and the consequent improvement of postoperative quality of life. We establish a new classification of digestive tract reconstruction based on the different role of digestive tract reconstructions in FPG for early gastric cancer, meanwhile we briefly summarize current progress and elucidate surgical indications. We hope that it can provide theoretical reference for surgeons to choose the appropriate procedure of digestive tract reconstruction after FPG.

Effect of pile fermentation on the cells of Chinese Liupao tea: The first record of cell wall of Liupao tea on transmission electron microscope

Fermentation often degrades the cell wall of dark tea, changes the carbohydrate components in the cell wall of tea, and thus affects the quality of tea. However, the lack of ultrastructural details limits our knowledge on the effect of fermentation on tea cell walls. Morphological studies of cell structures are important; thus, the cell wall of Liupao tea was analyzed under transmission electron microscopy for the first time, and the effects of different raw materials and fermentation methods on the cell wall and main carbohydrates of tea were compared. Overall, fermentation degrades the cell wall of Liupao tea under the action of microorganisms. Interestingly, the middle lamella degrades obviously, whereas the primary wall is complete. The decrease in hemicellulose and increase in water-soluble pectin (WSP) were remarkable, whereas the changes in cellulose and WSP were considerably correlated with the increase in tea polysaccharide (TPS). The results suggest that cell wall degradation might be related to the increase in TPS.

Phenolic compounds, bioactivity, and bioaccessibility of ethanol extracts from passion fruit peel based on simulated gastrointestinal digestion

Passion fruit peel, a potential source of bioactive compounds, has been used as food stabilizing agent. However, the phenolic composition and bioactivity of passion fruit peel have rarely been reported. The effects of simulated gastrointestinal digestion on the bioactive components, bioactivity and bioaccessibility of passion fruit peel ethanol extracts (PFPE) were investigated using high performance liquid chromatography-tandem mass spectrometry analysis (quasi-targeted metabolomics). Phenols (178) were identified, of which 25 inhibited alpha-glucosidase activity. The stabilities of PFPE phenols were significantly affected by pH changes and digestive enzymes during simulated digestion. The 1,1-diphenyl-2-picrylhydrazyl free radical scavenging capacity and ferric ion reducing antioxidant power were decreased by 32% and 30%, respectively, while 2,2'-azinobis-(3-ethylbenzthiazoline-6-sulphonate) free radical scavenging capacity increased by 17%. Alpha-glucosidase inhibition decreased with decreased PFPE phenolic content. Therefore, passion fruit peel could be considered a source of natural antioxidants and alpha-glucosidase inhibitors.

Purification, characterization, and bioactivity of Liupao tea polysaccharides before and after fermentation

The raw tea polysaccharides (RLTPS) and the aged tea polysaccharides (ALTPS) from raw and aged Liupao tea were extracted and purified to afford five refined fractions. Component analysis revealed that the crude polysaccharide content from raw Liupao tea increased from 1.83 ± 0.09 g / 100 g to 3.44 ± 0.28 g / 100 g and the molecular weight decreased after fermentation. Structural analysis indicated that the molar ratio of rhamnose, galactose, and galacturonic acid increased in refined ALTPS. All the refined polysaccharides were glycoprotein complexes contained pyranose ring structure. The thermal stability and asymmetry of refined ALTPS were stronger than refined RLTPS. For activities in vitro, ALTPS had better anticoagulant activity and bile acid binding capacity than RLTPS. Although the activities of the refined ALTPS fractions were lower than ALTPS, they were still higher than the refined RLTPS. Fermentation plays an important role in improving the quality and biological activity of dark tea.

[Risk factors of postoperative complication after total gastrectomy in advanced gastric cancer patients receiving neoadjuvant chemotherapy]

Objective: At present, there are few studies focusing on the factors short-term complications after total gastrectomy in patients with advanced gastric cancer receiving neoadjuvant chemotherapy (NACT). The purpose of this study is to provide a reference for clinical prevention of complications in these patients. Methods: A retrospective case-control study was conducted. Case inclusion criteria: (1) clinical stage II-III gastric cancer diagnosed by preoperative gastroscopy, pathology, abdominal CT, EUS or PET-CT; (2) evaluated suitable for NACT by MDT discussion; (3) no previous history of other malignant tumors and no concurrent tumor; (4) undergoing total gastrectomy+ D2 lymphadenectomy after NACT. Exclusion criteria: (1) age <18 or >80 years old; (2) severe concurrent diseases, and ASA classification>grade III; (3) stump gastric cancer or history of gastric surgery; (4) incomplete clinicopathological data. According to the above criteria, clinicopathological data of 140 advanced gastric cancer patients who underwent total gastrectomy after NACT in Chinese PLA General Hospital between June 2012 and June 2019 were collected, including 109 males and 31 females with mean age of (56.9±11.4) years and body mass indey (BMI) of (23.3±3.1) kg/m(2). Logistic analysis was used to analyze the relationship between postoperative complication and clinicopathological data. Factors in univariate analysis with P<0.05 were included in the multivariate analysis. Results: Postoperative complications (Clavien-Dindo classification ≥ II) occurred in 35 cases (25.0%) and severe complications (Clavien-Dindo classification ≥ IIIa) occurred in 4 cases (2.9%), including 1 case of esophago-jejunal anastomotic leakage, 1 case of vena cava thrombosis, 1 case of pleural effusion, 1 case of septic shock during perioperative days resulting in death. Univariate analysis showed that BMI (P=0.011), cycle of NACT (P=0.027), tumor diameter (P=0.021), and vascular invasion (P=0.033) were associated with postoperative complication within 30 days, while open/laparoscopic total gastrectomy were not associated with postoperative complication (P=0.926). Multivariate analysis revealed that BMI ≥ 25 kg/m(2) (OR=3.294, 95% CI: 1.343-8.079, P=0.009) and < 4 cycles of NACT (OR=2.922, 95% CI: 1.217-7.016, P=0.016) were independent risk factors for postoperative complication. The 3-year overall survival rates of patients with or without complication were 54.4% and 64.0%, respectively (P=0.395), and 3-year disease-free survival rates were 47.4% and 52.9%, respectively (P=0.587). Conclusions: Higher BMI and fewer cycles of NACT are independent risk factors of postoperative complication in advanced gastric cancer patients undergoing total gastrectomy after NACT. No obvious association is found between postoperative complication and surgical approaches.

[Analysis of clinicopathologic characteristics of gastric cancer patients undergoing gastrectomy based on a single-center gastric cancer database with above 10 000 cases]

Objective: The storage of medical data has been digitized in China, but a unified and structured model has not yet been established. The standardized collection, analysis and sorting of tumor clinical data is the foundation of improving the standard of tumor diagnosis and treatment. Therefore, establishing a database platform of gastric cancer (GC) is an urgent need to integrate data resources and improve the level of diagnosis and treatment. The population economics indexes of GC patients in the last 20 years are analyzed in a single-center GC database. The medical records were structured by natural language processing technology. Authors aim to investigate the clinical pathological characteristics, staging and survival of the GC patients with gastrectomy. Method: A retrospective cohort study was carried out. Clinicopatological data of patients receiving surgical treatment from 2000 to 2019 were retrospectively collected. According to the gastric cancer TNM staging guidelines from the Union for International Cancer Control and the American Joint Committee on Cancer (UICC/AJCC) 8th edition, the structured gastric cancer clinicopathological data were re-evaluated and interpreted. The Kaplan-Meier method and the log-rank test were used to compare survival rate among different groups of patients with complete follow-up data of 2010-2016. Results: Clinicopathological data of 13 492 GC patients were enrolled. The ratio of men to women in the whole group was 3.25:1.00, including 10 320 men with average onset age of 59.68 years, which was basically stable in recent 20 years, and 3172 women with average onset age of 55.93 years, which presented a trend of average increasement of 0.17 year per year. The average hospitalization duration for GC patients showed a decreasing trend year by year, which was 13.87 days in 2019. Average hospitalization cost for GC patients was increasing year by year, with a peak of 83 600 CNY in 2017 and 75 400 CNY in 2019. By natural language identification and exclusion criteria screening, a total of 7218 GC patients obtained structured clinicopathological information. Analysis on clinicopathological characteristics of 3626 GC patients in the last 5 years showed that the average diameter of tumor was (4.44±2.61) cm; the average number of harvested lymph node was 24.30±13.29; the proportion of surgical methods were as following: open surgery in 1398 cases (38.55%), laparoscopic surgery in 1856 cases (51.19%) and robotic surgery in 372 cases (10.26%). The postoperative pathological stage was as following: IA in 658 cases (18.15%), IB in 318 cases (8.77%), IIA in 559 cases (15.42%), IIB in 543 (14.98%), III A in 632 (17.43%), III B in 612 cases (16.88%), III C in 276 cases (7.61%), and IV in 28 cases (0.77%). Complete follow-up data of 3431 patients from 2010 to 2016 were presented. The 1-, 3- and 5-year survival rates were 82%, 69% and 60%, respectively for the whole group. The 1-, 3- and 5-year survival rates for patients undergoing laparoscopic surgery were 83%, 70% and 64%, respectively, and for those undergoing open surgery were 81%, 67% and 56%, respectively, and the difference between the two groups was not statistically significant (P=0.109). The 5-year survival rate of GC patients with different AJCC stages was as following: 88% in IA, 77% in IB, 70% in II A, 62% in II B, 44% in III A, 32% in III B, 22% in III C, and 17% in IV. Conclusion: This study provides basic data for the establishment of comprehensive diagnosis and treatment model of multicenter, shedding light on the improvement of comprehensive treatment of GC in China.

Caspofungin combined with TMP/SMZ as a first-line therapy for moderate-to-severe PCP in patients with human immunodeficiency virus infection

OBJECTIVES

The effectiveness of trimethoprim/sulfamethoxazole (TMP/SMZ) for pneumocystis pneumonia (PCP) is limited with adverse events. Caspofungin, by inhibiting the cyst form of Pneumocystis jirovecii, may be an alternative therapy for PCP. However, the availability of clinical data about caspofungin combined with TMP/SMZ in the treatment of PCP in HIV-infected patients is limited. Thus, we aimed to examine the clinical effectiveness and safety of caspofungin combined with TMP/SMZ as a first-line therapy for moderate-to-severe PCP in HIV-infected patients.

METHODS

From January 2017 to December 2019, data of HIV-infected patients with moderate-to-severe PCP who received either TMP/SMZ alone or caspofungin combined with TMP/SMZ as first-line therapy were retrospectively reviewed to assess the effectiveness and safety of each regimen. The Kaplan-Meier curve and log-rank test were used for survival analysis.

RESULTS

A total of 278 patients met the criteria. The overall positive response rate of PCP treatment was 48.92%, and the overall all-cause in-hospital mortality rate was 33.09%. Patients who received combination therapy consisting of caspofungin and TMP/SMZ had a better positive response rate (59.44% vs. 37.78%, P < 0.001) and lower all-cause in-hospital mortality rate (24.48% vs. 42.22%, P = 0.003). Also, patients who received combination therapy had higher survival rate during a hospital stay (75.52% vs. 57.78%, P = 0.004), and those who received longer combination therapy were more likely to have higher survival rate (P = 0.042). We found that age (P = 0.019), CD4 cell count (P = 0.001) and therapeutic regimen (P = 0.002) were significant risk factors for all-cause in-hospital mortality rate in univariate analysis. In multivariate analysis, only CD4 cell count and therapeutic regimen were statistically significant factors associated with all-cause in-hospital mortality rate. Patients with a CD4 count of > 30 cells/µL and patients who received combination therapy consisting of caspofungin and TMP/SMZ were more likely to survive from PCP (P = 0.011 and P = 0.002, respectively). There were no additional severe adverse events caused by adding caspofungin.

CONCLUSIONS

For HIV-infected patients with moderate-to-severe PCP, combination therapy with caspofungin and TMP/SMZ is an effective and promising first-line therapy with no greater number of adverse events compared with TMP/SMZ monotherapy. Patients who received caspofungin had better positive response rates and lower all-cause in-hospital mortality rates. Also, we recommend early initiation of caspofungin.

Defining heart disease risk for death in COVID-19 infection

BACKGROUND

Cardiovascular disease (CVD) was in common in coronavirus disease 2019 (COVID-19) patients and associated with unfavorable outcomes. We aimed to compare the clinical observations and outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients with or without CVD.

METHODS

Patients with laboratory-confirmed SARS-CoV-2 infection were clinically evaluated at Wuhan Seventh People's Hospital, Wuhan, China, from 23 January to 14 March 2020. Demographic data, laboratory findings, comorbidities, treatments and outcomes were collected and analyzed in COVID-19 patients with and without CVD.

RESULTS

Among 596 patients with COVID-19, 215 (36.1%) of them with CVD. Compared with patients without CVD, these patients were significantly older (66 vs. 52 years) and had higher proportion of men (52.5% vs. 43.8%). Complications in the course of disease were more common in patients with CVD, included acute respiratory distress syndrome (22.8% vs. 8.1%), malignant arrhythmias (3.7% vs. 1.0%) including ventricular tachycardia/ventricular fibrillation, acute coagulopathy(7.9% vs. 1.8%) and acute kidney injury (11.6% vs. 3.4%). The rate of glucocorticoid therapy (36.7% vs. 25.5%), Vitamin C (23.3% vs. 11.8%), mechanical ventilation (21.9% vs. 7.6%), intensive care unit admission (12.6% vs. 3.7%) and mortality (16.7% vs. 4.7%) were higher in patients with CVD (both P < 0.05). The multivariable Cox regression models showed that older age (≥65 years old) (HR 3.165, 95% CI 1.722-5.817) and patients with CVD (HR 2.166, 95% CI 1.189-3.948) were independent risk factors for death.

CONCLUSIONS

CVD are independent risk factors for COVID-19 patients. COVID-19 patients with CVD were more severe and had higher mortality rate, early intervention and vigilance should be taken.

Evaluation of Mycoflora and Citrinin Occurrence in Chinese Liupao Tea

Citrinin (CIT), a known nephrotoxic mycotoxin, is mainly produced by Penicillium, Aspergillus, and Monascus species. It is a natural contaminant in cereal grains, foods, and feedstuff. Liupao tea (or Liubao tea) is a typical Chinese dark tea obtained via indigenous tea fermentation facilitated by microorganisms. Certain fungi present in Liupao tea that may produce CIT are a potential threat to consumer health. In the present study, various potential toxigenic mycoflora and the natural occurrence of CIT in Liupao tea were surveyed via the culture-dependent method, high performance liquid chromatography-fluorescence detection (HPLC-FLD), and ultrahigh performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). Total mold counts ranged from 3.5 × 10² CFU/g to 2.1 × 10⁶ CFU/g tea in 28 tea samples. A total of 218 fungal isolates belonging to five genera and 23 species were identified. Some of these strains, such as Aspergillus ochraceus, Aspergillus oryzae, Penicillium citrinum, and Penicillium chrysogenum, may potentially be a CIT-producing species. In addition, 32.7% of 113 Liupao tea samples were contaminated with CIT at concentrations ranging from 7.8 to 206.1 μg/kg. These CIT concentrations in Liupao tea are chiefly attributed to climatic conditions and water activity during storage that favor fungal proliferation and mycotoxin production. However, CIT could not be detected in Liupao tea stored for over 10 years. These results provide the first information about the potential toxigenic mycoflora and natural occurrence of CIT in Liupao tea. Therefore, storage conditions and fungal community must be monitored to ensure the quality of Liupao tea.

[Surgical selection and metastatic warning of splenic lymph node dissection in advanced gastric cancer radical surgery: a prospective, single-center, randomized controlled trial]

Objective: To investigate the surgical options for splenic lymph node dissection in patients with advanced gastric cancer undergoing radical total gastrectomy, and to evaluate the sentinel effect of No. 4s lymph node on splenic lymph node metastasis. Methods: A prospective, single-center, randomized and controlled study was carried out (Trial registration, No.NCT02980861). Enrollment criteria: (1) >18 years old and <65 years old; (2) gastric adenocarcinoma locating in the proximal or corpus; (3) preoperative clinical staging as cT2-4aN0-3M0; (4) D2 radical total gastrectomy feasible judged before operation; (5) physical ability score 0 to 1; (6) I to III of ASA classification. Pregnant or lactating women, patients with severe mental illness or previous history of upper abdominal surgery, those suffered from other malignant tumors in the past 5 years, or heart and lung system diseases judged to affect surgery before operation, those receiving preoperative chemotherapy, radiotherapy or targeted therapies, and distant metastases being found during surgery were excluded. According to above criteria, 222 patients at The First Medical Center of Chinese PLA General Hospital from December 2016 to December 2017 were enrolled prospectively and were randomly divided into the laparoscopic splenic hilar lymph node dissection group (laparoscopic group, n=114) and the open splenic hilar lymph node dissection group (open group, n=108). The result of rapid frozen immunohistochemistry of harvested No.4s lymph nodes was used to evaluate the sensitivity and specificity of sentinel effect on splenic hilar lymph node metastasis. The surgical parameters, postoperative recovery parameters, and complication rates were compared between the two groups. Results: There were 80 males and 34 females in the lapascopic group with a mean age of (56.1±10.2) years, and 69 males and 39 females in the open group with a mean age of (58.4±10.9) years. There were no significant differences in baseline data between the two groups (all P>0.05). Total blood loss was less in the laparoscopic group [(96.3±82.4) ml vs. (116.6±101.9) ml, t=1.124, P<0.001], and the amount of bleeding from the splenic hilar lymph nodes dissected was also less than that in the open group [(25.3±17.8) ml vs. (59.5±36.4) ml, t=1.172, P<0.001]. However, the operation time, the time of splenic hilar lymph node, the number of lymph node dissected and number of splenic hilar lymph node dissected were not significantly different between the two groups (all P>0.05). As compared to the open group, the laparoscopic group had shorter time to the first flatus [(1.3±1.2) days vs. (1.6±1.5) days, t=1.665, P=0.021], shorter time to fluid diet [(4.6±1.4) days vs. (4.9 ± 1.6) days, t=1.436, P=0.007], shorter time to remove nasogastric tube [(3.9±2.6) days vs. (4.3±2.4) days, t=0.687, P<0.001] and shorter hospital stay [(10.3±6.6) days vs. (12.1±7.2) days, t=0.697, P<0.001]. Complication rate was 14.0% (16/114) and (12.0%) ((1)3/108) in the laparoscopic group and the open group, respectively, without significant difference (χ(2)=6.723, P=0.331). The sensitivity of the No. 4s lymph node for the prediction of splenic hilar lymph node metastasis reached 89.5%, and the specificity reached 99.6%. Conclusions: Laparoscopic technique is safe and feasible in the treatment of splenic hilar lymph node dissection in advanced gastric cancer. The No.4s lymph node examination has good sentinel effect on predicting the metastasis of splenic hilar lymph nodes.

Using chemical fractionation and speciation to describe uptake of technetium, iodine and selenium by Agrostis capillaris and Lolium perenne

To understand the dynamic mechanisms governing soil-to-plant transfer of selenium (Se), technetium-99 (⁹⁹Tc) and iodine (I), a pot experiment was undertaken using 30 contrasting soils after spiking with ⁷⁷Se, ⁹⁹Tc and ¹²⁹I, and incubating for 2.5 years. Two grass species (Agrostis capillaris and Lolium perenne) were grown under controlled conditions for 4 months with 3 cuts at approximately monthly intervals. Native (soil-derived) ⁷⁸Se and¹²⁷I, as well as spiked ⁷⁷Se, ⁹⁹Tc and ¹²⁹I, were assayed in soil and plants by ICP-MS. The grasses exhibited similar behaviour with respect to uptake of all three elements. The greatest uptake observed was for ⁹⁹Tc, followed by ⁷⁷Se, with least uptake of ¹²⁹I, reflecting the transformations and interactions with soil of the three isotopes. Unlike soil-derived Se and I, the available pools of ⁷⁷Se, ⁹⁹Tc and ¹²⁹I were substantially depleted by plant uptake across the three cuts with lower concentrations observed in plant tissues in each subsequent cut. Comparison between total plant offtake and various soil species suggested that ⁷⁷SeO₄^2-, ⁹⁹TcO₄^- and ¹²⁹IO₃^-, in soluble and adsorbed fractions were the most likely plant-available species. A greater ratio of ¹²⁷I/¹²⁹I in the soil solid phase compared to the solution phase confirmed incomplete mixing of spiked ¹²⁹I with native ¹²⁷I in the soil, despite the extended incubation period, leading to poor buffering of the spiked available pools. Compared to traditional expressions of soil-plant transfer factor (TF_total), a transfer factor (TF_available) expressed using volumetric concentrations of speciated 'available' fractions of each element showed little variation with soil properties.

LncRNA SNHG7 promotes the proliferation of esophageal cancer cells and inhibits its apoptosis

OBJECTIVE

Our research studied the expression of long noncoding RNA (lncRNA) SNHG7 in esophageal cancer cells and tissues. The effect of lncRNA SNHG7 on proliferation and apoptosis of esophageal cancer cells has been discussed.

PATIENTS AND METHODS

Si-SNHG7 was transfected into esophageal cancer cells, and qRT-PCR was performed to detect the expression of lncRNA SNHG7 in esophageal cancer cells and tissues. The effect of SNHG7 on the proliferation of esophageal cancer cells was measured by CCK8 assay and plate cloning assay, respectively. Flow cytometry was used to detect the effect of SNHG7 on the cell cycle and apoptosis rate of esophageal cancer cells. Changes in expression of downstream protein p15 and p16 after si-SNHG7 intervention were analyzed by qRT-PCR and Western blot.

RESULTS

QRT-PCR showed that the expression of SNHG7 in esophageal cancer tissues and cells was significantly up-regulated. After the si-SNHG7 intervention, the proliferation of esophageal cancer cells was inhibited, the apoptosis rate increased, and the cell cycle was blocked in G1-G0 phase. QRT-PCR and Western blot showed that, after the si-SNHG7 intervention, the expression of p15 and p16 increased significantly.

CONCLUSIONS

The expression of SNHG7 in the tissues and cells of esophageal cancer is significantly up-regulated. SNHG7 can partly promote the development of esophageal cancer by regulating the expression of p15 and p16.

Long non-coding RNA DUXAP8 regulates proliferation and invasion of esophageal squamous cell cancer

OBJECTIVE

The purpose of this research was to detect the expression of long non-coding RNA DUXAP8 in esophageal cancer, and to explore its underlying mechanism in the development of esophageal squamous cell carcinoma (ESCC).

PATIENTS AND METHODS

We collected 78 pairs of esophageal cancer tissues and normal adjacent tissues. The mRNA level of DUXAP8 in these esophageal cancer tissues and corresponding adjacent tissues was detected by quantitative Real-time polymerase chain reaction (qRT-PCR). The relationship between DUXAP8 expression and the prognosis of esophageal cancer was analyzed. Small interfering RNA (siRNA) was applied to reduce the expression of DUXAP8 in ESCC cell lines (TE-1 and KYSE520). Meanwhile, the specific effect of DUXAP8 on the biological functions of ESCC cells was analyzed by CCK-8 assay (cell counting kit-8), colony formation assay and transwell assay, respectively. Furthermore, the regulatory effect of DUXAP8 on Wnt/β-catenin pathway was detected by Western blot.

RESULTS

DUXAP8 was overexpressed in ESCC tissues than that of normal adjacent tissues. DUXAP8 expression was positively correlated to tumor stage and lymph node metastasis, whereas negatively correlated to the survival rate of ESCC patients. Cell proliferation, colony formation and invasion abilities were significantly decreased after knockdown of DUXAP8 in ESCC cells. Western blot results showed that DUXAP8 could regulate the occurrence of ESCC via Wnt/β-catenin pathway.

CONCLUSIONS

DUXAP8 expression was significantly correlated with tumor stage, lymph node metastasis and poor prognosis of ESCC patients. DUXAP8 may promote the occurrence of ESCC via Wnt/β-catenin pathway.

Nitrogen-aeration tuned ultrasonic synthesis of SiO2@PNIPAm nanoparticles and preparation of temperature responsive Pickering emulsion

Ultrasonic synthesis has shown great potential applications in preparing varieties of nanostructured materials. However, fabrication of nanomaterials with tunable structures and desirable properties is still challenging because of the instability and nonuniform distribution of cavitation effect in liquid phase. In this study, a novel aeration tuned ultrasonic synthesis approach is proposed for optimizing the cavitation effect in both time and space scales and fabricating SiO₂@PNIPAm NPs. By alternation of ultrasonication and N₂ aeration, more and more gas bubbles are formed in the reaction liquid, and the collapse of those bubbles is further enhanced by the reactants of solid SiO₂ and intermediate functionalized SiO₂ NPs. As a result, SiO₂@PNIPAm NPs with various grafting ratios are successfully synthesized simply by changing the number of ultrasonic synthesis cycle. The SiO₂@PNIPAm NPs are subsequently used as stabilizer to form Pickering emulsions with different temperature response. This work provides a potential facile sonochemical synthesis method with high efficiency in obtaining inorganic/organic NPs of well determined structures.

Ultrasonic modulation of phase separation and corrosion resistance for ternary Cu-Sn-Bi immiscible alloy

The effect of power ultrasound on the liquid phase separation of ternary Cu-32%Sn-20%Bi immiscible alloy is experimentally investigated, which shows that as compared with the layered structure formed under static condition, the macrosegregation resulted from liquid phase separation is remarkably reduced with the increase of ultrasonic amplitude. A homogenous microstructure characterized by refined (Bi) particles dispersing uniformly on the (Cu₃Sn) matrix is obtained when the ultrasonic amplitude reaches the highest value of 24 μm. This is mainly ascribed to the ultrasonically induced cavitation and acoustic streaming, which promotes the nucleation, the fragmentation, and the dispersion of (Bi) droplets. The finally solidified immiscible alloy exhibits obvious improvements in electrochemical corrosion resistance, microhardness and wear-resisting if compared with those in static solidification. These results prove that applying power ultrasound is an effective way to modulate the liquid phase separation and enhance the applied performance for immiscible alloys.

Proton migration in hydrocarbons induced by slow highly charged ion impact

Different from most of the previous studies using light or photons, we use highly charged ions as projectiles to activate proton migration in the smallest saturated and unsaturated hydrocarbon molecules, i.e., CH₄ and C₂H₂. The H₃ ⁺ formation channel (H₃ ⁺ + CH⁺) and isomerization channel (C⁺ + CH₂ ⁺), serving as indicators of proton migration, are observed in the fragmentation of CH₄ and C₂H₂ dications. Corresponding kinematical information, i.e., kinetic energy release, is for the first time obtained in the collisions with highly charged ions. In particular, for the C⁺ + CH₂ ⁺ channel, a new pathway is identified, which is tentatively attributed to the isomerization on high-lying states of acetylene dication. The kinetic energy release spectra for other two-body breakup channels are also determined and precursor dication states could thus be identified.