Construction of Ketoenamine-Based Covalent Organic Frameworks with Electron-Rich Sites for Efficient and Rapid Removal of Iodine from Solution

Porous covalent organic frameworks (COFs) have been widely used for the efficient removal of iodine from solution due to their abundance of electron-rich sites. In this study, two kinds of ketoenamine-based COFs, TpBD-(OMe)2 and TpBD-Me2, are successfully synthesized via Schiff base reaction under solvothermal conditions using 1, 3, 5-triformylphoroglucinol as aldehyde monomer, o-tolidine and o-dianisidine as amino monomers. The ability of TpBD-(OMe)2 and TpBD-Me2 to adsorb iodine in cyclohexane or aqueous solutions has been quantitatively analyzed and interpreted in terms of adsorption sites. TpBD-Me2 possesses two adsorption sites, -NH- and -C=O, and exhibits an adsorption capacity of 681.67 mg/g in cyclohexane, with an initial adsorption rate of 0.6 g/mol/min with respect to COF unit cell. The adsorption capacity of TpBD-(OMe)2 can be as high as 728.77 mg/g, and the initial adsorption rate of TpBD-(OMe)2 can reach 1.2 g/mol/min in the presence of oxygen atoms between the methyl group and the benzene ring. Compared with TpBD-Me2, the higher adsorption capacity and adsorption rate of TpBD-(OMe)2 towards iodine are not only reflected in organic solvents, but also in aqueous solutions. It is proven through X-ray photoelectron spectroscopy and Raman spectroscopy that iodine exists in the form of I2, I3-, and I5- within TpBD-(OMe)2 and TpBD-Me2 after adsorption. This work not only expands the application of COFs in the field of iodine adsorption, but also provides research ideas and important an experimental basis for the optimization of iodine adsorption sites.

[Structural changes of the frontal cortex in depressed mice are associated with decreased expression of brain-derived neurotrophic factor]

OBJECTIVE

To investigate the changes in gray matter volume in depressive-like mice and explore the possible mechanism.

METHODS

Twenty-four 6-week-old C57 mice were randomized equally into control group and model group, and the mice in the model group were subjected to chronic unpredictable mild stimulation (CUMS) for 35 days. Magnetic resonance imaging was performed to examine structural changes of the grey matter volume in depressive-like mice. The expression of brain-derived neurotrophic factor (BDNF) in the grey matter of the mice was detected using Western blotting and immunofluorescence staining.

RESULTS

Compared with the control mice, the mice with CUMS showed significantly decreased central walking distance in the open field test (P < 0.05) and increased immobile time in forced swimming test (P < 0.05). Magnetic resonance imaging showed that the volume of the frontal cortex was significantly decreased in CUMS mice (P < 0.001, when the mass level was greater than or equal to 10 756, the FDRc was corrected with P=0.05). Western blotting showed that the expression of mature BDNF in the frontal cortex was significantly decreased in CUMS mice (P < 0.05), and its expression began to decrease after the exposure to CUMS as shown by immunofluorescence staining. The volume of different clusters obtained by voxel-based morphometry (VBM) analysis was correlated with the expression level of mature BDNF detected by Western blotting (P < 0.05).

CONCLUSION

The decrease of frontal cortex volume after CUMS is related with the reduction of mature BDNF expression in the frontal cortex.

Genotype-degree of hemolysis correlation in hereditary spherocytosis

BACKGROUND

Hereditary spherocytosis (HS) is a common inherited hemolytic anemia, caused by mutations in five genes that encode erythrocyte membrane skeleton proteins. The red blood cell (RBC) lifespan could directly reflect the degree of hemolysis. In the present cohort of 23 patients with HS, we performed next-generation sequencing (NGS) and Levitt's carbon monoxide (CO) breath test to investigate the potential genotype-degree of hemolysis correlation.

RESULTS

In the present cohort, we identified 8 ANK1,9 SPTB,5 SLC4A1 and 1 SPTA1 mutations in 23 patients with HS, and the median RBC lifespan was 14(8-48) days. The median RBC lifespan of patients with ANK1, SPTB and SLC4A1 mutations was 13 (8-23), 13 (8-48) and 14 (12-39) days, respectively, with no statistically significant difference (P = 0.618). The median RBC lifespan of patients with missense, splice and nonsense/insertion/deletion mutations was 16.5 (8-48), 14 (11-40) and 13 (8-20) days, respectively, with no significant difference (P = 0.514). Similarly, we found no significant difference in the RBC lifespan of patients with mutations located in the spectrin-binding domain and the nonspectrin-binding domain [14 (8-18) vs. 12.5 (8-48) days, P = 0.959]. In terms of the composition of mutated genes, 25% of patients with mild hemolysis carried ANK1 or SPTA1 mutations, while 75% of patients with mild hemolysis carried SPTB or SLC4A1 mutations. In contrast, 46.7% of patients with severe hemolysis had ANK1 or SPTA1 mutations and 53.3% of patients with severe hemolysis had SPTB or SLC4A1 mutations. However, there was no statistically significant difference in the distribution of mutated genes between the two groups (P = 0.400).

CONCLUSION

The present study is the first to investigate the potential association between genotype and degree of hemolysis in HS. The present findings indicated that there is no significant correlation between genotype and degree of hemolysis in HS.

Long-term outcomes of aplastic anemia with cytogenetic abnormalities at diagnosis

OBJECTIVES

To elucidate the clinical characteristics of AA patients with cytogenetic abnormalities.

METHODS

We retrospectively screened 30 patients (30/1206, 2.5%) with cytogenetic abnormalities from 1206 patients with severe and very severe AA who received immunosuppressive therapy (IST) during the years 2012-2019.

RESULTS

The most common abnormalities were trisomy 8 (+8, 10/30, 33.3%) and loss of Y (-Y, 8/30, 26.7%). The abnormal clones disappeared 6 months after IST in 14 patients and sustained in 12 patients. Patients with sustained abnormal clones had a lower hematologic response at 6 months after IST than the disappeared (33.3% vs. 64.3%, p = .116). The hematologic response after IST, 5-year overall survival, 5-year event-free survival, myelodysplastic syndrome or acute myeloid leukemia transformation in AA patients with cytogenetic abnormalities were not statistically different from those in normal cytogenetic patients.

CONCLUSION

For AA patients with chromosome abnormalities but ineligible for hematopoietic stem cell transplant, IST is effective and appropriate as first-line treatment.

Deep Generative Mixture Model for Robust Imbalance Classification

Discovering hidden pattern from imbalanced data is a critical issue in various real-world applications. Existing classification methods usually suffer from the limitation of data especially for minority classes, and result in unstable prediction and low performance. In this paper, a deep generative classifier is proposed to mitigate this issue via both model perturbation and data perturbation. Specially, the proposed generative classifier is derived from a deep latent variable model where two variables are involved. One variable is to capture the essential information of the original data, denoted as latent codes, which are represented by a probability distribution rather than a single fixed value. The learnt distribution aims to enforce the uncertainty of model and implement model perturbation, thus, lead to stable predictions. The other variable is a prior to latent codes so that the codes are restricted to lie on components in Gaussian Mixture Model. As a confounder affecting generative processes of data (feature/label), the latent variables are supposed to capture the discriminative latent distribution and implement data perturbation. Extensive experiments have been conducted on widely-used real imbalanced image datasets. Experimental results demonstrate the superiority of our proposed model by comparing with popular imbalanced classification baselines on imbalance classification task.

Hetrombopag plus porcine ATG and cyclosporine for the treatment of aplastic anaemia: early outcomes of a prospective pilot study

Hetrombopag, a small molecular thrombopoietin-receptor agonist, has shown encouraging efficiency in immunosuppressive therapy refractory or relapsed severe aplastic anaemia. To investigate the response rate of hetrombopag combined with IST as first-line treatment, we designed a prospective pilot study including 32 patients with SAA treated with anti-human T lymphocyte porcine immunoglobulin (p-ATG), cyclosporine, and hetrombopag. In addition, 96 patients with SAA treated with p-ATG and cyclosporine alone were matched as controls. In total, 21.9% of patients treated with hetrombopag achieved complete response (CR) at 3 months, while 5.2% of patients achieved CR in the control group (P = 0.005). At 6 months, the CR rates were 34.4% in the hetrombopag group and 14.6% in the control group (P = 0.015). The overall response rates at 6 months were 68.7% and 50.0% in the hetrombopag and control groups, respectively. The median time to haematologic response was 56 days and 77 days, and to CR was 96 days and 214 days in the hetrombopag and control groups, respectively. In conclusion, adding hetrombopag to IST as first-line treatment resulted in faster and better haematologic response in SAA.

Antihuman T lymphocyte porcine immunoglobulin combined with cyclosporine as first-line immunosuppressive therapy for severe aplastic anemia in China: a large single-center, 10-year retrospective study

Background

Antihuman T lymphocyte porcine immunoglobulin (p-ATG) has been the most common ATG preparation in immunosuppressive therapy (IST) in Chinese patients with severe aplastic anemia (SAA) since 2009.

Objectives

This study aimed to evaluate the early hematologic response and long-term outcomes of a large cohort of patients with SAA who received p-ATG plus cyclosporine (CsA) as first-line therapy from 2010 to 2019.

Design

This is a single-center retrospective study of medical records.

Methods

We analyzed the data of 1023 consecutive patients with acquired aplastic anemia (AA) who underwent p-ATG combined with CsA as a first-line IST treatment from 2010 to 2019 at our department.

Results

The median age of the patients was 24 (4-75) years, and the median follow-up time was 57.2 months (3 days-137.5 months). There was an early mortality rate of 2.8% with a median death time of 0.9 months (3 days-2.9 months). The overall response rates were 40.6% and 56.1% at 3 and 6 months, respectively. The 5-year cumulative incidences of relapse and clonal evolution were 9.0% [95% confidence interval (CI) = 4.2-16.0%] and 4.5% (95% CI = 1.4-10.6%), respectively. The 5-year overall survival (OS) and event-free survival rates were 83.7% (95% CI = 81.1-86.0%) and 50.4% (95% CI = 47.1-53.5%), respectively.

Conclusion

p-ATG combined with CsA for the treatment of AA is effective and safe, and p-ATG can be used as an alternative ATG preparation for the standard IST regimen in areas in which h-ATG is not available.

Controlled Iodine Phase Transfer of Covalent Organic Framework Membranes for Instant but Sustained Disinfection

Freestanding membranes of CuCl₂-implanted TpPa covalent organic frameworks (COFs) were mechanochemically produced. The resulting membrane had a high I₂ adsorption capacity (566.78 g·mol^-1) in cyclohexane, which corresponds to 2.2I₂ per unit cell with 1.3I₂ immobilized on 3Cl^- ions (60%) and 0.9 on 3N atoms (40%). Upon being placed in aqueous media, the membrane released 61.1% of its loaded I₂ mainly by its Cl^- ions within 10 min and the remaining 38.9% mainly from its N atoms within about 5 h. Thanks to that, the COF membranes loaded with 1.5 mg of I₂ could be repetitively utilized to kill about 10⁸ CFU/mL E. coli in 0.5-3 min at least five times, after which the membranes could retain their bactericidal activity for 4 h against 10⁸ CFU/mL E. coli. This highlights the promising application of I₂-loaded TpPa-CuCl₂ COF membranes for instant and sustained disinfection.

Development and validation of early death risk score model for emergency status prediction in very severe aplastic anemia

This study developed and validated the Early Death Risk Score Model for early identification of emergency patients with very severe aplastic anemia (VSAA). All 377 patients with VSAA receiving first-line immunosuppressive therapy (IST) were categorized into training (n=252) and validation (n=125) cohorts. In the training cohort, age >24 years, absolute neutrophil count ≤0.015×10⁹/L, serum ferritin >900ng/mL and times of fever before IST >1 time were significantly associated with early death. Covariates were assigned scores and categorized as: low (score 0-4), medium (score 5-7) and high (score ≥8) risk. Early death rate was significantly different between risk groups and the validation cohort results were consistent with those of the training cohort. The area under the receiver operating characteristic curve for the model was 0.835 (0.734,0.936) in the training cohort and 0.862 (0.730,0.994) in the validation cohort. The calibration plots showed high agreement, and decision curve analysis showed good benefit in clinical applications. The VSAA Early Death Risk Score Model can help with early identification of emergency VSAA and optimize treatment strategies. Emergency VSAA with high risk is associated with high early death rate, and alternative donor hematopoietic stem cell transplantation could be a better treatment than IST even without HLA-matching.

Serum circulating free DNA of syncytin-1 as a novel molecular marker for early diagnosis of non-small-cell lung cancer

Background: Liquid biopsy has been receiving attention as an emerging detection technology in the clinical application of non-small-cell lung cancer (NSCLC). Methods: We quantified serum circulating free DNA (cfDNA) of syncytin-1 in 126 patients and 106 controls, analyzed the correlation of level with pathological parameters and explored diagnostic utility. Results: The cfDNA of syncytin-1 levels in NSCLC patients were higher than healthy controls (p < 0.0001). These levels were associated with smoking history (p = 0.0393). The area under the curve of cfDNA of syncytin-1 was 0.802, and combination of cfDNA of syncytin-1/cytokeratin 19 fragment antigen 21-1/carcinoembryonic antigen markers improved diagnostic efficiency. Conclusion: The cfDNA of syncytin-1 was detected in NSCLC patients and can be used as a novel molecular marker for early diagnosis.

Geotechnical Seismic Isolation System Based on Rubber-Sand Mixtures for Rural Residence Buildings: Shaking Table Test

The anti-seismic problem of rural residential buildings is the weak link of seismic retrofitting in China. Recently, geotechnical seismic isolation (GSI) technology based on rubber-sand mixtures (GSI-RSM) using rubber-sand mixtures (RSM) between the structural foundation and the foundation soil has been proven to have the possibility of potential applications in rural residential buildings. Many theoretical studies exist on the effectiveness of seismic isolation of the GSI-RSM system, but few studies on either the seismic response test of model buildings placed on the RSM layer or the large-scale shaking table test exist. Therefore, this study considers a large shaking table test performed on a 1/4 single-story masonry structure model with and without a GSI-RSM system by selecting a standard input ground motion and varying input acceleration amplitudes. The test results show that the GSI-RSM system can reduce the seismic response of superstructures. The isolation effect of the GSI-RSM system is low in small earthquakes and increases with increasing earthquake magnitude. Overall, the RSM layer can filter part of the high-frequency components of the earthquake to transmit to the superstructure and consume more seismic energy by generating friction slip in the interaction with the structural foundation.

Potential cerebrovascular protective functions of lycium barbarum polysaccharide in alleviating hyperglycemia-aggravated cerebral ischemia/reperfusion injury in hyperglycemic rats

OBJECTIVE

Lycium barbarum polysaccharide (LBP) is the efficient primary compound of Lycium barbarum and has been shown to alleviate hyperglycemia-aggravated cerebral ischemia/reperfusion (I/R) injury. However, the cerebrovascular changes related to diabetes mellitus (DM) and the potential cerebrovascular protective effects of LBP are still unknown. This study aimed to explore the cerebrovascular protective functions of LBP on cerebral I/R injury in diabetic rats and its potential mechanisms.

MATERIALS AND METHODS

Sprague Dawley (SD) rats were separated into three groups: the normoglycemic (NG), diabetic hyperglycemic (HG), and HG + LBP (50 mg/kg) treatment groups. A 30 min transient middle cerebral artery occlusion (tMCAO) with 24 h reperfusion was established. The neurological deficits, cerebral water content, infarct volume, and cerebrovascular permeability were assessed to evaluate the extent of cerebral injury. Histopathological alterations were assessed by hematoxylin and eosin, Nissl, immunohistochemical, and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling staining. A transmission electron microscope was used to detect ultrastructural alterations, and a western blot was used to examine protein expression.

RESULTS

The HG rats exhibited a significant increase in neurological deficits, cerebral water content, infarct volume, cerebrovascular permeability, neural cell death, and apoptosis compared with the NG rats, and the LBP treatment alleviated these effects. Cerebrovascular structure analysis showed that the cross-sectional area (CSA) and wall thickness were remarkably altered in the HG rats compared with the NG rats. The LBP treatment protected the cerebrovascular structure and vasoreactivity by decreasing the wall thickness and increasing the CSA, α-smooth muscle actin, and endothelial nitric oxide synthase expression of cerebral vessels.

CONCLUSIONS

The intake of LBP benefits the cerebrovascular structure and vasoreactivity in diabetic rats. Our research provides a possible new strategy for treating stroke in patients with DM.

First-line immunosuppressive therapy with rATG and CsA for severe aplastic anemia: 15 years' experience

Rabbit antithymocyte globulin (rATG) instead of horse ATG has been used for severe aplastic anemia (SAA) patients in China. This study aimed to investigate the hematologic responses and long-term overall survival (OS) outcomes in SAA patients who received rATG and cyclosporine as first-line immunosuppressive therapy. We analyzed data of 542 SAA patients treated with this therapy between 2005 and 2019. The median age was 20 (range, 2-80) years, and the median follow-up time was 45.5 (range, 0.1-191.4) months. The early mortality rate was 3.9%. The overall response rates (ORRs) were 40.2%, 56.1%, and 62.4% at 3, 6, and 12 months, respectively. The 6- and 12-month ORR of patients treated with 3 mg/kg/d of rATG in 2015-2019 seemed higher than that of patients treated with 3.5-3.75 mg/kg/day in 2005-2014 (60.2% vs. 54.9%, P = 0.30 and 69.9% vs. 60.1%, P = 0.049, respectively). The 10-year cumulative incidences of relapse and clonal evolution were 10.6 ± 2.9% and 7.5 ± 1.5%, respectively. The 10-year OS rate and event-free survival rate were 80.1 ± 2.1% and 75.6 ± 3.7%, respectively. Age, disease severity, treatment periods, and the interval from diagnosis to IST were independent predictors of OS. In conclusion, 3 mg/kg/day rATG is effective as first-line treatment for SAA.

Seismic Behavior of Shear Keys Enhanced with Novel Energy Absorption Devices in Immersion Joints Based on Pseudo-Static Tests

Shear keys are usually installed as crucial shear-resistant members of an immersion joint; thus, the mechanical behavior of the shear keys, especially under earthquake loading, deserves more attention. This paper presents a novel arc-shaped energy absorption device developed for shear keys. In order to verify the seismic performance of shear keys strengthened by the arc-shaped energy absorption devices, a series of pseudo-static tests were conducted, in which different axial pressures (300 kN, 400 kN) were also taken into consideration. The testing results indicated that failure mode of the shear key enhanced by the energy absorption devices was a synthesis of the oblique shear failure of the rubber blankets, the buckling of the energy absorption devices, and the concrete fracture of the shear key. In view of load-displacement hysteretic curves of testing specimens, loops of the reinforced shear keys were plumper than those from a traditional shear key. In addition, the load-bearing capacity (cracking load, yield load, peak load, and failing load) differences of the shear keys with and without energy absorption devices reinforcement under the same axial pressure were 33.0%, 36.7%, 26.0%, and 23.6%, respectively. The maximum equivalent viscous coefficient values of the shear keys with and without energy absorption devices reinforcement were 0.37, 0.38, and 0.32, respectively. The arc-shaped energy absorption devices can contribute to the hysteretic behavior of the shear keys. However, the axial pressure had a positive influence on the load bearing capacity, accumulated energy absorption capacity, and initial stiffness of the shear keys. In contrast to that, the axial pressure had negative influence on ductility ratio of the reinforced shear keys (equivalent viscous coefficient values of two enhanced shear keys were roughly equal). A reasonable stiffness scheme of an energy absorption device should be given attention during the anti-seismic design of an immersion joint. The study can provide scientific support for further study on the seismic responses of immersion joints and promote the application of earthquake control technology in immersed tunnels.

Respiratory pandemic and indoor aeraulics of classrooms

Respiratory pandemics, such as COVID19, may be transmitted by several modes. The present work focuses on the transmission through small droplets released by people from their mouth by breathing, speaking, coughing, sneering, and possibly aspirated by other people around through their respiration. An analysis of droplet evolution in simplified situations shows that the droplets reach very quickly a quasi-equilibrium temperature before encompassing an isothermal evaporation process. The removal of droplets from suspension is thus piloted by balance between evaporation and sedimentation. It is shown that ambient relative humidity is a major factor influencing the lifetime of droplets and the distance they may travel. As a consequence, and independently of any other health consideration linked to ambient humidity, it is seen that a dry air is a favourable factor for limiting risk of contamination from COVID19. Further investigation is made using computational fluid dynamics (CFD) in a classroom geometry. Several ventilation strategies are investigated: classical regulatory mechanical ventilation, open window natural ventilation and displacement natural ventilation. Ventilation has several effects which influence contamination risk: by introducing fresh air, it reduces droplet concentration; humidity released by human occupants is also limited. However, these effects are not uniform in space, and depend on ventilation strategy. Application of a dose-effect model calibrated for COVID19 to CFD results allows to estimate contamination risk. It is shown that contamination risk is higher for regulatory mechanical ventilation, and may be reduced, using natural ventilation in the absence of wind, by a factor 2.3 to nearly 3 when the teacher is sick, and by a factor 6 to 500 when a student is sick. In the presence of wind, the reduction factor is as high as 13 when the teacher is sick and 17 when a student is sick.

Efficacy of eltrombopag with immunosuppressive therapy for children with acquired aplastic anemia

BACKGROUND

Eltrombopag (EPAG), an oral thrombopoietin receptor agonist (TPO-RA), has been proven to improve the hematologic response without increasing toxic effects as a first-line therapy combined with standard immunosuppressive treatment (IST) in adults with severe aplastic anemia (SAA). Nevertheless, the clinical evidence on the efficacy of EPAG in children with acquired aplastic anemia is limited and controversial.

METHODS

We performed a single-center, retrospective study to analyze the clinical outcomes of fifteen patients aged ≤18 years with newly diagnosed acquired SAA who received first-line IST and EPAG (EPAG group) compared with those of forty-five patients who received IST alone (IST group) by propensity score matching (PSM).

RESULTS

There was no difference in the overall response (OR) rate between the EPAG group and IST group (53.3% vs. 46.7% at 3 months, P = 0.655; 66.7% vs. 57.8% at 6 months, P = 0.543), but the complete response (CR) rate was statistically significant (20.0% vs. 4.4% at 3 months, P = 0.094; 46.7% vs. 13.3% at 6 months, P = 0.012). The median time to achieve a hematological response in the EPAG and IST groups was 105 days and 184 days, respectively. No difference was observed in the event-free survival (EFS) or overall survival (OS) rates.

CONCLUSION

Adding EPAG to standard IST as the first-line treatment for children with acquired SAA improved the rapidity of hematological response and the CR rate but did not improve the OR or EFS rates.

Effect of Li+/Na+ exchange on mechanical behavior and biological activity of lithium disilicate glass-ceramic

Lithium disilicate (LD) glass-ceramics with a stoichiometric composition were ion-exchanged in pure NaNO₃ or mixed NaNO₃ + KNO₃ molten salt baths below the glass transition temperature (T_g). The microstructures, surface morphologies, mechanical properties and bioactivities of the ion-exchanged glass-ceramics were studied in detail. It was found that the strength and toughness of LD glass-ceramic could be enhanced from 175 MPa to 0.96 MPa m^1/2 before ion-exchange to 546 MPa and 4.31 MPa m^1/2 respectively under a lowered ion-exchange temperature because the less stress relaxation. In addition, a gradient of Na⁺ rich layer in the surface of glass-ceramic was induced by Li⁺/Na⁺ exchange, which could be beneficial to the formation of HA (Hydroxyapatite) with nano-size porous after soaking in SBF (Simulated Body Fluid) solution and exhibited better bioactivity compared with the original LD glass-ceramic. The results might provide a reference for the strengthening and biological activation of LD glass-ceramics in bone restoration applications.

[Pulmonary mucormycosis after lung transplantation:3 cases report with literature review]

Objective: To report the risk factors, clinical characteristics and treatment courses of pulmonary mucormycosis after lung transplantation(LT). Methods: We included 3 cases with pulmonary mucormycosis after LT from March 2017 to July 2020 in the centre for lung transplantation of China-Japan Friendship Hospital. Twelve cases from Chinese and English literature from China National Knowledge Infrastructure (CNKI), China Biomedical Literature Service System and Pubmed Database from March 1980 to July 2020 were added. The risk factors, clinical characteristics and treatment courses of all cases were summarized and analyzed. Results: Pulmonary mucormycosis occurred in 1.06% (3/284) in our centre. A total of 15 cases with 12 cases from literature included 10 males and 5 females with a mean age of(47±20)years. Thirteen cases occurred after LT, and 2 cases occurred after heart-lung transplantation (HLT). Nine probable cases were diagnosed by positive isolation of the pathogen from bronchoalveolar lavage fluid or sputum. Three proven cases were diagnosed by transbronchial lung biopsy. Meanwhile, the other 3 proven cases diagnosed by CT-guided percutaneous lung biopsy, autopsy and surgical operation respectively. Ten cases (66.7%) were diagnosed with pulmonary mucormycosis within 90 days after lung transplantation. The mortality was as high as 46.67% (7/15), but if it occurred within 90 days, the mortality reached 70% (7/10). The average interval between transplantation and positive isolation of the pathogen was 112.3 (5-378) days. Conclusions: The clinical and radiographic features of pulmonary mucormycosis after LT were nonspecific. It had a high mortality, especially in those occurred within 90 days after LT. The combination of antifungal therapy and surgical resection may contribute to a better outcome of the disease.

Comparison of Levitt's CO breath test and the 15 N-glycine labeling technique for measuring the lifespan of human red blood cells

The red blood cell (RBC) lifespan is an important physiological indicator of clear significance in clinical research, used for the differential diagnosis of various diseases such as anemia, compensatory phase hemolysis, and polycythemia. The ¹⁵ N-glycine labeling technique is the gold standard method for determining RBC lifespans. However, the usefulness of this technique in clinical settings is seriously hindered by the several weeks required to complete the analyses. Levitt's CO breath test is another reliable technique for determining RBC lifespans, with a simpler protocol giving much faster results, making it more useful in clinical applications. We compared the CO breath test and ¹⁵ N-glycine labeling technique for measuring the human RBC lifespan. We investigated human RBC lifespans where each subject undertook both the ¹⁵ N-glycine labeling technique and the CO breath test. The correlation between the results from these two methods was analyzed. Eight of the ten subjects successfully completed the study. The RBC lifespan values obtained by Levitt's CO breath test were lower than those obtained by the ¹⁵ N-glycine labeling technique. The RBC lifespan values determined from the ¹⁵ N-glycine labeling technique and the CO breath test were significantly correlated, with a Pearson correlation coefficient of R = 0.98 (p < 0.05), while the R² of the linear regression equation was 0.96. The CO breath test exhibits as good performance as the ¹⁵ N-glycine labelling technique in distinguishing healthy subjects from subjects with hemolysis. The result suggests that the CO breath test is a reliable method for quickly determining human RBC lifespans in clinical applications.

Multisensory Information Facilitates the Categorization of Untrained Stimuli

Although it has been demonstrated that multisensory information can facilitate object recognition and object memory, it remains unclear whether such facilitation effect exists in category learning. To address this issue, comparable car images and sounds were first selected by a discrimination task in Experiment 1. Then, those selected images and sounds were utilized in a prototype category learning task in Experiments 2 and 3, in which participants were trained with auditory, visual, and audiovisual stimuli, and were tested with trained or untrained stimuli within the same categories presented alone or accompanied with a congruent or incongruent stimulus in the other modality. In Experiment 2, when low-distortion stimuli (more similar to the prototypes) were trained, there was higher accuracy for audiovisual trials than visual trials, but no significant difference between audiovisual and auditory trials. During testing, accuracy was significantly higher for congruent trials than unisensory or incongruent trials, and the congruency effect was larger for untrained high-distortion stimuli than trained low-distortion stimuli. In Experiment 3, when high-distortion stimuli (less similar to the prototypes) were trained, there was higher accuracy for audiovisual trials than visual or auditory trials, and the congruency effect was larger for trained high-distortion stimuli than untrained low-distortion stimuli during testing. These findings demonstrated that higher degree of stimuli distortion resulted in more robust multisensory effect, and the categorization of not only trained but also untrained stimuli in one modality could be influenced by an accompanying stimulus in the other modality.

Integrin-mediated interactions with a laminin-presenting substrate modulate biosynthesis and phenotypic expression for cells of the human nucleus pulposus

With aging and pathology, cells of the nucleus pulposus (NP) de-differentiate towards a fibroblast-like phenotype, a change that contributes to degeneration of the intervertebral disc (IVD). Laminin isoforms are a component of the NP extracellular matrix during development but largely disappear in the adult NP tissue. Exposing human adult NP cells to hydrogels made from PEGylated-laminin-111 (PEGLM) has been shown to regulate NP cell behaviors and promote cells to assume a biosynthetically active state with gene/protein expression and morphology consistent with those observed in juvenile NP cells. However, the mechanism regulating this effect has remained unknown. In the present study, the integrin subunits that promote adult degenerative NP cell interactions with laminin-111 are identified by performing integrin blocking studies along with assays of intracellular signaling and cell phenotype. The findings indicate that integrin α3 is a primary regulator of cell attachment to laminin and is associated with phosphorylation of signaling molecules downstream of integrin engagement (ERK 1/2 and GSK3β). Sustained effects of blocking integrin α3 were also demonstrated including decreased expression of phenotypic markers, reduced biosynthesis, and altered cytoskeletal organization. Furthermore, blocking both integrin α3 and additional integrin subunits elicited changes in cell clustering, but did not alter the phenotype of single cells. These findings reveal that integrin- mediated interactions through integrin α3 are critical in the process by which NP cells sense and alter phenotype in response to culture upon laminin and further suggest that targeting integrin α3 has potential for reversing or slowing degenerative changes to the NP cell.

Synovial mesenchymal stem cells effectively alleviate osteoarthritis through promoting the proliferation and differentiation of meniscus chondrocytes

OBJECTIVE

To investigate the relationship between the meniscal defect area and OA progression and explore the effect and mechanism of SMSCs cell therapy in knee osteoarthritis (OA) rat model.

MATERIALS AND METHODS

For animal experiments, knee osteoarthritis (OA) model was constructed in Sprague Dawley (SD) rats by removing the medial meniscus of the right knee. Synovial mesenchymal stem cells (SMSCs) were engrafted by injecting into the right knee cavity. For in vitro experiments, CCK-8 assay was performed to evaluate the proliferation and differentiation of BMSCs and ATDC5 cells after co-cultured with SMSCs. qRT-PCR analysis was performed to detect the expressions of chondrogenic genes in BMSCs and ATDC5 cells after co-cultured with SMSCs. Western blot analysis was conducted to detect the phosphorylations of c-Jun N-terminal kinase (JNK) and extracellular regulated protein kinases (ERK) in MAPK signaling of BMSCs and ATDC5 cells. Enzyme-linked immunosorbent assay (ELISA) was performed to detect the serum levels of interleukin (IL)-1β, IL-1β, IL-6, IL-18 and C-reactive protein (CRP).

RESULTS

Results showed that meniscus damaged area is positively correlated to serum inflammatory factor levels. In vitro study showed that the proliferation and differentiation of BMSCs and ATDC5 cells were promoted after co-cultured with SMSCs. By co-culturing with SMSCs, the MAPK signaling pathway was activated and the expression of chondrogenic markers such as aggrecan (acan), SRY-related high mobility group-box gene 9 (sox9) and Type II collagen a1 (col2a1), was up-regulated both in BMSCs and ATDC5 cells. In vivo study showed SMSCs cell therapy significantly decreased serum inflammatory factor levels and protected cartilage by upregulating the expression of chondrogenic genes of meniscus chondrocytes derived from OA rats.

CONCLUSIONS

For the first time, we found the positive correlation between meniscal defect area and OA progression and demonstrated the effect and mechanism of SMSCs cell therapy in knee osteoarthritis (OA) treatment.

Eltrombopag, oral immunosuppressant and androgen combination therapy in twelve patients with refractory severe aplastic anemia

Objective: Eltrombopag monotherapy or eltrombopag combined with immunosuppressant has achieved robust hematologic responses in severe aplastic anemia (SAA). In patients with refractory SAA, for whom hematopoietic stem cell transplantation is unavailable, we attempted to combine eltrombopag with oral immunosuppressant and androgen, to further improve hematologic response. Methods: We collected and analyzed data retrospectively from twelve refractory SAA cases who had received combination therapy of eltrombopag, oral immunosuppressant and androgen. All these patients had received intensive immunosuppressive treatment (IST) for more than 6 months and were evaluated as nonresponders. Results: A total of 12 SAA patients were treated with a combination of eltrombopag, an oral immunosuppressant (cyclosporine, N = 9; tacrolimus, N = 3) and androgen. The median maximum dose of eltrombopag was 75 mg/day (range, 75-150). After a median follow-up of 8.5 months (7-23), the overall response rate (ORR) was 42% (5/12, including trilineage, N = 4; hemoglobin + platelet, N = 1). Two of 5 responders reached normal blood counts. Optimal hematological response rates were reached at 6 months. The median increase in neutrophil, hemoglobin and platelet count were 1.64 × 10⁹ /L (0.71-2.66), 53 g/L (25-66.5) and 25 × 10⁹ /L (14-230), respectively. In general, the combination therapy was well tolerated; however, two patients suffered from non-lethal upper extremity venous thrombosis when they were platelet transfusion-dependent. Conclusion: Eltrombopag, oral immunosuppressant and androgen combination therapy in patients with IST-refractory SAA is feasible and could restore multi-lineage hematopoiesis. Thrombosis risk of eltrombopag still needs to be monitored.

Long noncoding RNA LSINCT5 is upregulated and promotes the progression of esophageal squamous cell carcinoma

OBJECTIVE

Long stress-induced noncoding transcripts 5 (LSINCT5) has been reported to be upregulated in several human cancers and related to poor prognosis. However, its involvement in esophageal squamous cell carcinoma (ESCC) remains largely unknown. We aim to evaluate the expression and putative role of LSINCT5 on the progression of ESCC.

MATERIALS AND METHODS

LSINCT5 expression was first examined in the ESCC cell lines using RT-qPCR, and the next-generation RNA-Seq technology was employed to analyze and functionally annotate the differential gene expression before and after LSINCT5 knockdown in ESCC was made. Based on the functional annotation results, the effects of LSINCT5 knockdown on cell growth, migration, invasion, and epithelial-to-mesenchymal transition (EMT) were assessed in the ESCC cell lines. Finally, the expression and clinicopathological significance of LSINCT5 in ESCC and corresponding nontumor tissues were further explored using RT-qPCR.

RESULTS

The RT-qPCR results showed that LSINCT5 expression was significantly upregulated in the ESCC cell lines. The differential gene expression analysis by next-generation RNA-Seq showed that 138 genes were up-regulated, and 227 genes were downregulated after LSINCT5 was knocked down in the ECA 109 cells. In addition, the functional annotation revealed that the differentially expressed genes were mainly functionally involved in tight junctions, ECM-receptor interactions, and MAPK signaling pathway. Further in vitro studies indicated that the knockdown of LSINCT5 significantly suppressed proliferation, migration, invasion, and EMT in ESCC cells. Finally, a comparative study of paired ESCC and corresponding nontumor tissues showed that LSINCT5 was upregulated in the ESCC tissues, and the increased LSINCT5 expression was related to late clinical stages, large tumor sizes, and lymph node metastasis.

CONCLUSIONS

The results indicate that LSINCT5 is upregulated in ESCC and may act as an oncogene promoting the progression of ESCC.

53BP1 regulates cell cycle arrest in esophageal cancer model

OBJECTIVE

This study aims to investigate effects of checkpoint kinase, mediator of DNA damage checkpoint 1 (MDC1) and p53-binding protein 1 (53BP1) silencing on p53, checkpoint kinase 1 and 2 (CHK1 and CHK2), and CHK2-T68 expression.

MATERIALS AND METHODS

Eca109 cells were divided into untransfected Eca109, Blank-vector, MDC1-RNAi transfection, and 53BP1-RNAi transfection group. Streptavidin-peroxidase (SP) immunohistochemical assay was used to examine CHK2-T68 expression. About 4 groups were used to establish esophageal carcinoma nude-mouse models, and assigned as Eca-109 control (or Eca-109 plus 15 Gy γ-rays irradiation, Eca-109+IR), Blank-vector (or Blank-vecor+IR), 53BP1-RNAi (or 53BP1-RNAi+IR), and MDC1-RNAi group (or MDC1-RNAi+IR group) by injecting. The expression of p53, CHK1, CHK2 were evaluated using SP immunohistochemical assay.

RESULTS

53BP1 and MDC1 down-regulation significantly inhibited expression of CHK2-T68 in Eca-109 cells compared to untreated group (p<0.05). There were significant differences for CHK2-T68 expressions in different time and groups (p<0.05). 53BP1 down-regulation significantly reduced p53 and enhanced CHK1 and CHK2 expression compared to that of Eca-109 control group (p<0.05) in Eca-109 cells. 53BP1 down-regulation significantly regulated CHK1, CHK2, and p53 in xenograft nude mice models exposed to γ-ray irradiation compared to that of untreated group (p<0.05). p53 was negatively correlated with CHK1 and CHK2 in xenograft nude mice models.

CONCLUSIONS

53BP1 regulated the cell cycle arrest by modulating p53, CHK1, and CHK2 expression in both Eca-109 cells and xenograft nude mice models.

Robust Unsupervised Cross-modal Hashing for Multimedia Retrieval

With the quick development of social websites, there are more opportunities to have different media types (such as text, image, video, etc.) describing the same topic from large-scale heterogeneous data sources. To efficiently identify the inter-media correlations for multimedia retrieval, unsupervised cross-modal hashing (UCMH) has gained increased interest due to the significant reduction in computation and storage. However, most UCMH methods assume that the data from different modalities are well paired. As a result, existing UCMH methods may not achieve satisfactory performance when partially paired data are given only. In this article, we propose a new-type of UCMH method called robust unsupervised cross-modal hashing ( RUCMH ). The major contribution lies in jointly learning modal-specific hash function, exploring the correlations among modalities with partial or even without any pairwise correspondence, and preserving the information of original features as much as possible. The learning process can be modeled via a joint minimization problem, and the corresponding optimization algorithm is presented. A series of experiments is conducted on four real-world datasets (Wiki, MIRFlickr, NUS-WIDE, and MS-COCO). The results demonstrate that RUCMH can significantly outperform the state-of-the-art unsupervised cross-modal hashing methods, especially for the partially paired case, which validates the effectiveness of RUCMH.

MRI Signal Intensity and Electron Ultrastructure Classification Predict the Long-Term Outcome of Skull Base Chordomas

BACKGROUND AND PURPOSE

MR imaging is a useful and widely used evaluation for chordomas. Prior studies have classified chordomas into cell-dense type and matrix-rich type according to the ultrastructural features. However, the relationship between the MR imaging signal intensity and ultrastructural classification is unknown. We hypothesized that MR imaging signal intensity may predict both tumor ultrastructural classification and prognosis.

MATERIALS AND METHODS

Seventy-nine patients with skull base chordomas who underwent 95 operations were included in this retrospective single-center series. Preoperative tumor-to-pons MR imaging signal intensity ratios were calculated and designated as ratio on T1 FLAIR sequence (R_T1), ratio on T2 sequence (R_T2), and ratio on enhanced T1 FLAIR sequence (R_EN), respectively. We assessed the relationships among signal intensity ratios, ultrastructural classification, and survival.

RESULTS

Compared with the matrix-rich type group, the cell-dense type chordomas showed lower R_T2 (cell-dense type: 1.90 ± 0.38; matrix-rich type: 2.61 ± 0.60 P < .001). The model of predicting cell-dense type based on R_T2 had an area under the curve of 0.83 (95% CI, 0.75-0.92). In patients without radiation therapy, both progression-free survival (P = .003) and overall survival (P = .002) were longer in the matrix-rich type group than in the cell-dense type group. R_EN was a risk factor for progression-free survival (hazard ratio = 10.24; 95% CI, 1.73-60.79); R_T2 was a protective factor for overall survival (hazard ratio  = 0.33; 95% CI, 0.12-0.87); and R_EN was a risk factor for overall survival (hazard ratio = 4.76; 95% CI, 1.51-15.01).

CONCLUSIONS

The difference in MR imaging signal intensity in chordomas can be explained by electron microscopic features. Both signal intensity ratios and electron microscopic features may be prognostic factors.

[Prevalence and risk factors of ischemic stroke in rural areas of Liaoning province]

Objective: To explore the prevalence and risk factors of ischemic stroke in rural areas of Liaoning province. Methods: The study was a cross-sectional survey. From September 2017 to May 2018, a total of 10 926 rural residents aged ≥40 years were investigated in Chaoyang county, Lingyuan, Liaoyang county and Donggang city of Liaoning province. The investigation included questionnaire survey, physical examination and laboratory examination.Univariate and multivariate logistic regression models were used to analyze the risk factors of ischemic stroke. Results: The prevalence of ischemic stroke in the rural areas of Liaoning province was 5.51% (602/10 926), and the standardized prevalence rate was 4.04%. The standardized prevalence rate of male (5.05%) is higher than that of female (3.44%). The prevalence of ischemic stroke increased with age in both males (P<0.01) and females (P<0.01). Multivariate logistic regression analysis showed that age increase(compared with 40-49 years old group, 50-59 years old, OR=2.08, 95%CI 1.31-3.30, P=0.02; 60-69 years old, OR=3.90, 95%CI 2.51-6.05, P<0.01; 70-79 years old, OR=5.32, 95%CI 3.37-8.34, P<0.01; ≥80 years old, OR=3.64, 95%CI 2.00-6.62, P<0.01), male(OR=2.35, 95%CI 1.95-2.84, P<0.01),family history of stroke(OR=2.18, 95%CI 1.83-2.60, P<0.01),coronary heart disease (OR=2.01, 95%CI 1.52-2.66, P<0.01), hypertension (OR=2.82, 95%CI 2.21-3.60, P<0.01), diabetes mellitus (OR=1.36, 95%CI 1.11-1.67, P=0.03) and overweight/obese (OR=1.22, 95%CI 1.02-1.47, P=0.03) were the major risk factors of ischemic stroke. Conclusions: The prevalence of ischemic stroke in rural areas of Liaoning province is high. Age, male, family history of stroke, coronary heart disease, hypertension, diabetes mellitus, overweight/obesity are the risk factors of ischemic stroke in rural areas of Liaoning province.

Efficacy and safety of porcine ALG compared to rabbit ATG as first-line treatment for children with acquired aplastic anemia

OBJECTIVE

To assess the outcomes of children with acquired aplastic anemia (AA) treated in China with first-line porcine anti-lymphocyte immunoglobulin (p-ALG)/rabbit anti-thymocyte immunoglobulin (r-ATG) combined with cyclosporine A (CSA).

METHODS

We performed a single-center, non-randomized, retrospective cohort study to assess the outcomes of 189 children with AA treated in China with first-line p-ALG/r-ATG combined with CSA between 2014 and 2018.

RESULTS

No significant differences were observed in the overall response rates at 3, 6, 12, or 24 months (3 months: 61.9% vs 67.4%, P = .5; 6 months: 70.9% vs 73.9%, P = .69; 12 months: 77.3% vs 73.3%, P = .58; 24 months: 81.6% vs 78.6%, P = .59) after either p-ALG- or r-ATG-based immunosuppressive therapy. No significant differences were observed in overall survival or failure-free survival between the p-ALG group and the r-ATG group.

CONCLUSION

Our results reveal that the therapeutic efficacy and safety of p-ALG combined with CSA did not differ significantly from those of r-ATG combined with CSA as first-line therapy for pediatric patients with AA. Moreover, p-ALG has the advantage of significantly lower cost compared with r-ATG.

[The correlation between left atrial sphericity and thromboembolic events in patients with atrial fibrillation]

Objective: To study the correlation between left atrial sphericity (LASP) and thromboembolic events (TE) in patients with atrial fibrillation (AF). Methods: This study was conducted in patients with AF underwent radiofrequency ablation in the Department of Cardiology of First Affiliated Hospital of Zhengzhou University from January 2011 to October 2018. The AF patients with TE (study group, n=157) and the AF patients without TE (control group, n=157) were matched for age and gender. The differences of LASP and other related indexes between the two groups were compared, and the correlation between LASP and TE was analyzed by conditional logistic regression. The receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic value of LASP for TE. Results: (1) The LASP in the study group was significantly higher than that in the control group [ (87.5±7.1) % vs. (82.8±6.1) %, P=0.001]. (2) Conditional logistic regression analyses showed that LASP (OR=1.10, 95%CI 1.05-1.16, P=0.001), left atrial volume index (OR=1.01, 95%CI 1.00-1.02, P=0.016) and CHA(2)D-VASc score (OR=1.77, 95%CI 1.30-2.41, P=0.001) were independently and positively correlated with TE. (3) The ROC curve analysis showed that the area under the curve (AUC) of left atrial sphericity (AUC=0.712, 95%CI 0.656-0.768, P=0.001) was larger than the AUC of either left atrial volume index (AUC=0.650, 95%CI 0.589-0.710, P=0.001) or CHA(2)D-VASc score (AUC=0.612, 95%CI 0.550-0.674, P=0.001). (4) CHA(2)D-VASc-LASP(2) score was positively correlated with TE (OR=1.95, 95%CI 1.55-2.42, P=0.001). Conclusion: LASP is independently and positively correlated with TE in patients with AF.

Adaptive Sample-level Graph Combination for Partial Multiview Clustering

Multiview clustering explores complementary information among distinct views to enhance clustering performance under the assumption that all samples have complete information in all available views. However, this assumption does not hold in many real applications, where the information of some samples in one or more views may be missing, leading to partial multiview clustering problems. In this case, significant performance degeneration is usually observed. A collection of partial multiview clustering algorithms has been proposed to address this issue and most treat all different views equally during clustering. In fact, because different views provide features collected from different angles/feature spaces, they might play different roles in the clustering process. With the diversity of different views considered, in this study, a novel adaptive method is proposed for partial multiview clustering by automatically adjusting the contributions of different views. The samples are divided into complete and incomplete sets, while a joint learning mechanism is established to facilitate the connection between them and thereby improve clustering performance. More specifically, the method is characterized by a joint optimization model comprising two terms. The first term mines the underlying cluster structure from both complete and incomplete samples by adaptively updating their importance in all available views. The second term is designed to group all data with the aid of the cluster structure modeled in the first term. These two terms seamlessly integrate the complementary information among multiple views and enhance the performance of partial multiview clustering. Experimental results on real-world datasets illustrate the effectiveness and efficiency of our proposed method.

Adaptive Local Low-rank Matrix Approximation for Recommendation

Low-rank matrix approximation (LRMA) has attracted more and more attention in the community of recommendation. Even though LRMA-based recommendation methods (including Global LRMA and Local LRMA) obtain promising results, they suffer from the complicated structure of the large-scale and sparse rating matrix, especially when the underlying system includes a large set of items with various types and a huge amount of users with diverse interests. Thus, they have to predefine the important parameters, such as the rank of the rating matrix and the number of submatrices. Moreover, most existing Local LRMA methods are usually designed in a two-phase separated framework and do not consider the missing mechanisms of rating matrix. In this article, a non-parametric unified Bayesian graphical model is proposed for A daptive Lo cal low-rank M atrix A pproximation ( ALoMA ). ALoMA has ability to simultaneously identify rating submatrices, determine the optimal rank for each submatrix, and learn the submatrix-specific user/item latent factors. Meanwhile, the missing mechanism is adopted to characterize the whole rating matrix. These four parts are seamlessly integrated and enhance each other in a unified framework. Specifically, the user-item rating matrix is adaptively divided into proper number of submatrices in ALoMA by exploiting the Chinese Restaurant Process. For each submatrix, by considering both global/local structure information and missing mechanisms, the latent user/item factors are identified in an optimal latent space by adopting automatic relevance determination technique. We theoretically analyze the model’s generalization error bounds and give an approximation guarantee. Furthermore, an efficient Gibbs sampling-based algorithm is designed to infer the proposed model. A series of experiments have been conducted on six real-world datasets ( Epinions , Douban , Dianping , Yelp , Movielens (10M), and Netflix ). The results demonstrate that ALoMA outperforms the state-of-the-art LRMA-based methods and can easily provide interpretable recommendation results.

Human resource management in China (in the financial sector)

Systematically carried out over the past forty years economic reforms have given impetus to the development of the financial industry in China. Any changes suggest new approaches in the management system. Despite the results obtained there are some problems in the financial industry of China. In modern China there is a synthesis of Western and Eastern management theories, but it is necessary to pay tribute to traditional values, that influence on the thinking of leaders. The problems of human resource management in China in the financial industry have been considered in the article. The areas, where the most revolutionary changes are currently taking place, such as cross-border e-commerce, also have been indicated. In China, the proliferation of the Internet finance industry has been made possible by the surge in e-commerce. The fundamental factor in the psychology of the Chinese is Confucianism, on which they rely in all spheres of life. Despite the fact that in modern China there is a synthesis of the Western and Eastern theories of governance, it is necessary to pay tribute to the traditional values, which influence the thinking of the leaders of Chinese organizations. But new areas of activity require other, more advanced approaches to personnel training. The advantages and disadvantages of human resources management in the banking sector of China have been considered in the article. As a result of the analysis of indicators and problems of personnel management in the financial sphere, the main conclusions and recommendations on the structure of human resource management at this stage of improving society in China have been presented.

Therapeutic effect of transforaminal endoscopic spine system in the treatment of prolapse of lumbar intervertebral disc

OBJECTIVE

To investigate the clinical efficacy and safety of transforaminal endoscopic spine system (TESSYS) in treating the prolapse of lumbar intervertebral disc.

PATIENTS AND METHODS

462 patients with prolapse of lumbar intervertebral disc who were treated in our hospital from June 2012 to May 2016 were enrolled. All patients were randomly divided into 2 groups: the study group (n=231) and the control group (n=231). Patients in the study group received TESSYS, while those in the control group received conventional surgical treatment with posterior approach. Venous blood was collected before the surgery and 6 h, 12 h, 24 h, and 48 h after surgery. C reactive protein (CRP), interleukin-6 (IL-6), creatine phosphokinase (CPK) and white blood cell (WBC) in each patient were measured. The operation time, intraoperative blood loss, length of stay, postoperative ambulation time and complications were compared between the two groups. Clinical efficacy before and after surgery (1st day, 1st month, 3rd month, and 6th month after surgery) was evaluated according to visual analogue scale (VAS), Oswestry disability index (ODI) and modified MacNab criteria.

RESULTS

The operation time, intraoperative blood loss, length of stay, postoperative ambulation time and complications of patients in the study group were less than those of the control group (p<0.05). There were no significant differences in VAS score and ODI score on the 1st day before surgery, 1st day, 1st, 3rd, and 6th month after surgery (p>0.05). According to the improved MacNab standard, the excellent and good rate was 87.88% in the study group and 84.85% in the control group, the difference was not statistically significant (p>0.05). There were no significant differences in CRP, IL-6, CPK and WBC between the two groups before surgery (p>0.05). Postoperative levels of CRP, IL-6, CPK, and WBC in study group were better than those in control group, the differences were statistically significant (p<0.05).

CONCLUSIONS

TESSYS has the advantages of less bleeding, less traumatic reactions, fewer complications, rapid postoperative recovery, and exact short-term effect in treatment for prolapse of lumbar intervertebral disc.

Novel Models for Identification of the Ruptured Aneurysm in Patients with Subarachnoid Hemorrhage with Multiple Aneurysms

BACKGROUND AND PURPOSE

In patients with SAH with multiple intracranial aneurysms, often the hemorrhage pattern does not indicate the rupture source. Angiographic findings (intracranial aneurysm size and shape) could help but may not be reliable. Our purpose was to test whether existing parameters could identify the ruptured intracranial aneurysm in patients with multiple intracranial aneurysms and whether composite predictive models could improve the identification.

MATERIALS AND METHODS

We retrospectively collected angiographic and medical records of 93 patients with SAH with at least 2 intracranial aneurysms (total of 206 saccular intracranial aneurysms, 93 ruptured), in which the ruptured intracranial aneurysm was confirmed through surgery or definitive hemorrhage patterns. We calculated 13 morphologic and 10 hemodynamic parameters along with location and type (sidewall/bifurcation) and tested their ability to identify rupture in the 93 patients. To build predictive models, we randomly assigned 70 patients to training and 23 to holdout testing cohorts. Using a linear regression model with a customized cost function and 10-fold cross-validation, we trained 2 rupture identification models: RIM_C using all parameters and RIM_M excluding hemodynamics.

RESULTS

The 25 study parameters had vastly different positive predictive values (31%-87%) for identifying rupture, the highest being size ratio at 87%. RIM_C incorporated size ratio, undulation index, relative residence time, and type; RIM_M had only size ratio, undulation index, and type. During cross-validation, positive predictive values for size ratio, RIM_M, and RIM_C were 86% ± 4%, 90% ± 4%, and 93% ± 4%, respectively. In testing, size ratio and RIM_M had positive predictive values of 85%, while RIM_C had 92%.

CONCLUSIONS

Size ratio was the best individual factor for identifying the ruptured aneurysm; however, RIM_C, followed by RIM_M, outperformed existing parameters.

Janus particles: design, preparation, and biomedical applications

Janus particles with an anisotropic structure have emerged as a focus of intensive research due to their diverse composition and surface chemistry, which show excellent performance in various fields, especially in biomedical applications. In this review, we briefly introduce the structures, composition, and properties of Janus particles, followed by a summary of their biomedical applications. Then we review several design strategies including morphology, particle size, composition, and surface modification, that will affect the performance of Janus particles. Subsequently, we explore the synthetic methodologies of Janus particles, with an emphasis on the most prevalent synthetic method (surface nucleation and seeded growth). Following this, we highlight Janus particles in biomedical applications, especially in drug delivery, bio-imaging, and bio-sensing. Finally, we will consider the current challenges the materials face with perspectives in the future directions.

IL-37- and IL-35/IL-37-Producing Plasma Cells in Chronic Periodontitis

Periodontitis is one of the most prevalent chronic inflammatory diseases and is induced by the interaction between oral microorganisms and the host immune system. Plasma cells are of special interest in chronic periodontitis (CP), as they represent ~50% of infiltrated immune cells in periodontal lesions. Plasma cells constitute the only known cell type capable of antibody production; however, recent evidence supports an emerging role for distinct sets of plasma cells in cytokine production. However, the presence of cytokine-producing plasma cells in CP is unknown. In this study, we used immunohistochemistry to detect significantly elevated levels of IL-35 and IL-37 (2 recently identified anti-inflammatory cytokines) in CP gingival tissue as compared with healthy tissue. Remarkably, we demonstrate that CD138⁺ CD38⁺ plasma cells are the major immune cell type in CP gingival tissues and that these cells produce IL-35 and IL-37. We used immunofluorescence and confocal microscopy analysis to identify a subset of plasma cells with robust cytoplasmic expression of IL-37-we denote this subset as IL-37-producing plasma cells (CD138⁺CD38⁺P_IL-37). Another subset of plasma cells coproduces IL-35 and IL-37 and is denoted as IL-37/IL-35-coproducing plasma cells (CD138⁺CD38⁺P_IL-35/IL-37). We determined that these 2 plasma cell subsets are IgG⁺plasma cells. Moreover, we show that human recombinant IL-35 and IL-37 exhibit a dose-dependent inhibition of osteoclast formation in vitro (~78.9% and 97.7% inhibition in 300 ng/mL of IL-35 and IL-37, respectively, P < 0.05). Overall, our findings suggest that P_IL-37 and P_IL-35/IL-37 exist as subsets of plasma cells in CP lesions and that these 2 new types of plasma cells may regulate periodontitis pathogenesis by inhibiting alveolar bone loss through directly blocking osteoclast formation. Importantly, these data suggest a novel role of plasma cells and offer potential new mechanistic and regulatory targets to be investigated in the context of periodontal health and disease.

Dexmedetomidine attenuation of renal ischaemia-reperfusion injury requires sirtuin 3 activation

BACKGROUND

Dexmedetomidine attenuates renal ischaemia and reperfusion (I/R) injury, but its mechanism of action is unclear. As sirtuin 3 (SIRT3) activation can alleviate acute kidney injury, we investigated whether dexmedetomidine acts through SIRT3 to reduce renal I/R injury.

METHODS

The potential involvement of SIRT3 in dexmedetomidine attenuation of renal I/R injury was tested in HK2 cells subjected to hypoxia/reoxygenation and C57BL/6J mice subjected to renal I/R. A short interfering RNA targeting SIRT3 was used in some experiments to examine the potential role of SIRT3. Cell death and mitochondrial membrane potential (Δψm) were analysed in cultured cells. Mitochondrial damage in mice was assessed using electron microscopy and markers for renal function. Expression of cyclophilin D, cytochrome c, and SIRT3, and the level of cyclophilin D acetylation were determined.

RESULTS

Hypoxia/reoxygenation of HK2 cells increased cell death, cytochrome C expression, and cyclophilin D acetylation, and decreased Δψm and SIRT3 expression (P<0.05). Dexmedetomidine attenuated these changes. The dexmedetomidine effects were enhanced by SIRT3 overexpression and eliminated by SIRT3 knockdown. I/R in mice damaged renal function, and increased histological lesions, mitochondrial damage, cytochrome c expression, and cyclophilin D acetylation, while SIRT3 activity was decreased by 51% (P<0.05). Dexmedetomidine inhibited these changes in mice expressing normal levels of SIRT3, but not in SIRT3-knockdown mice.

CONCLUSIONS

Dexmedetomidine appears to act, at least in part, by up-regulating SIRT3 to inhibit mitochondrial damage and cell apoptosis and thereby protect against renal I/R injury.

Tensor-based Low-dimensional Representation Learning for Multi-view Clustering

With the development of data collection techniques, multi-view clustering becomes an emerging research direction to improve the clustering performance. Existing work has shown that leveraging multi-view information is able to provide a rich and comprehensive description. One of the core problems is how to sufficiently represent multi-view data in the analysis. In this paper, we introduce a tensor-based Representation Learning method for Multi-view Clustering (tRLMvC) that can unify heterogenous and high-dimensional multi-view feature spaces to a low-dimensional shared latent feature space and improve multi-view clustering performance. To sufficiently capture plenty multi-view information, tRLMvC represents multi-view data as a third-order tensor, expresses each tensorial data point as a sparse t-linear combination of all data points with t-product, and constructs a self-expressive tensor through reconstruction coefficients. The low-dimensional multi-view data representation in the shared latent feature space can be obtained via Tucker decomposition on the self-expressive tensor. These two parts are iteratively performed so that the interaction between selfexpressive tensor learning and its factorization can be enhanced and the new representation can be effectively generated for clustering purpose. We conduct extensive experiments on eight multi-view data sets and compare the proposed model with the state-of-the-art methods. Experimental results have shown that tRLMvC outperforms the baselines in terms of various evaluation metrics.

Iron Deficiency in Patients with Paroxysmal Nocturnal Hemoglobinuria: A Cross-Sectional Survey from a Single Institution in China

Background

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired clonal hematopoietic disorder that often manifests with chronic intravascular hemolysis. Iron deficiency in patients with PNH is most often due to urinary losses of iron secondary to chronic intravascular hemolysis.

Material/Methods

This cross-sectional survey assessed the prevalence of iron deficiency in a Chinese population of PNH patients who were enrolled between May 2012 and October 2014.

Results

A total of 742 PNH cases were selected by FLARE and classified as classical PNH (15.36%), PNH in the setting of another specified bone marrow disorder (12.26%), and subclinical PNH (72.38%). The median age of all the patients was 32 years (range 5–77 years). The overall prevalence of iron deficiency was 17.9% among all the PNH patients enrolled in the survey, 76.3% (87/144) among those with classical PNH, 33.0% (30/91) among those with PNH in the setting of another specified bone marrow disorder, and 3.0% (16/537) among the subclinical PNH patients. The incidence of iron deficiency among classical PNH patients was higher than that in the other 2 subcategories (P-value=0.000). Multivariate analyses showed that age and disease duration were independent risk factors for iron deficiency in classical patients.

Conclusions

This survey shows that PNH patients were prone to iron deficiency, especially patients with classical PNH.