Factors affecting do-not-attempt-resuscitation (DNAR) decisions among adult patients in the emergency department of a general tertiary teaching hospital in China: a retrospective observational study

OBJECTIVE

Do-not-attempt-resuscitation (DNAR) orders are designed to allow patients to opt out of receiving cardiopulmonary resuscitation in the event of a cardiac arrest. While DNAR has become a standard component of medical care, there is limited research available specifically focusing on DNAR orders in the context of emergency departments in China. This study aimed to fill that gap by examining the factors related to DNAR orders among patients in the emergency department of a general tertiary teaching hospital in China.

DESIGN

Retrospective observational study.

SETTING

Emergency department.

PARTICIPANTS

This study and analysis on adult patients with DNAR or no DNAR data between 1 January 2022 and 1 January 2023 in the emergency department of a large academic comprehensive tertiary teaching hospital. A total of 689 were included in our study.

PRIMARY OUTCOME MEASURES

Whether the patient received DNAR was our dependent variable.

RESULTS

Among the total patients, 365 individuals (53.0%) had DNAR orders. The following variables, including age, sex, age-adjusted Charlson comorbidity index (ACCI), primary diagnosis of cardiogenic or cancer related, history of neurological dysfunction or cancer, were independently associated with the difference between the DNAR group and the no DNAR group. Furthermore, there were significant statistical differences observed in the choice of DNAR among patients with different stages of cancer.

CONCLUSIONS

In comparison to the no DNAR group, patients with DNAR were characterised by being older, having a higher proportion of female patients, higher ACCI scores, a lower number of patients with a primary diagnosis of cardiogenic and a higher number of patients with a primary diagnosis of cancer related, history of neurological dysfunction or cancer.

[Urban-rural differentials in the relationship between personality traits and changes in depressive symptoms]

OBJECTIVE

The prevalence of depressive symptoms has become a significant public health issue in China. Research on the relationship between personality traits and changes in depressive symptoms, as well as further exploration of urban-rural differences, not only benefits for the understanding of the prevalence trend of depression in China, but also provides a useful reference for the government to develop personalized mental health prevention strategies.

METHODS

Based on the data from the China Family Panel Studies in 2018 and 2020, a univariate analysis was conducted on 16 198 Chinese residents aged 18 years and above. Five dimensions of personality traits were conscientiousness, extraversion, agreeableness, neuroticism and openness. In the study, 16 198 residents were divided into "keep good group", "better group", "worse group" and "keep bad group" according to the changes in depressive symptoms in 2018 and 2020. After controlling for factors, such as gender and education, multinomial Logistic regression analysis was used to examine whether personality traits were associated with changes in depressive symptoms. In addition, we evaluated whether urban-rural and personality traits interacted to influence depressive symptoms.

RESULTS

The five dimensions of personality traits were significantly correlated with changes in depressive symptoms. Conscientiousness, extroversion, and agreeableness were negatively associated with depressive symptoms, while neuroticism and openness were positively related. Urban and rural differences moderated the relationship between personality traits and depressive symptoms. Compared with urban residents, rural residents showed stronger correlations between neuroticism (OR=1.14; 95%CI: 1.00-1.30) and the group of depression-recovery, as well as conscientiousness (OR=0.79;95%CI: 0.68-0.93) and the group of persistent-depression.

CONCLUSION

The study finds that personality traits have a significant correlation with changes in depressive symptoms, with certain traits showing a negative or positive relationship. Specifically, higher levels of conscientiousness, extraversion, and agreeableness are associated with lower levels of depressive symptoms, while higher levels of neuroticism and openness are associated with higher levels of depressive symptoms. In addition, the study finds that rural residents have a stronger association between their personality traits and persistent or improved depressive symptoms, which highlights the need for tailoring mental health intervention and prevention programs that should take into account personality traits and urban-rural differences in China. By developing targeted strategies that are sensitive to personality differences and geographic disparities, policymakers and mental health professionals can help prevent and reduce the incidence of depressive symptoms, ultimately improving the overall well-being of Chinese adults. Meanwhile, additional studies in independent populations are needed to corroborate the findings of this study.

Collagen changes in rabbit conjunctiva after conjunctival crosslinking

This study aims to determine the ultrastructural changes in collagen fibrils in rabbit conjunctiva after conjunctival crosslinking using riboflavin and ultraviolet A (UVA) light at an irradiation intensity of 45 mW/cm². Conjunctival crosslinking may increase conjunctival stiffness. The supertemporal quadrants of the right eyes of 24 adult rabbits were treated with a topical riboflavin solution (0.25%) before irradiation with UVA light at 45 mW/cm² for 4 min. After 3 weeks, the collagen fibrils in fibril bundles were examined by electron microscopy. Immunohistochemical staining was used to detect the expression levels of collagen I and collagen III in the rabbits' conjunctiva. The diameter of the collagen fibrils in the fibril bundles varied slightly, ranging from 30 to 60 nm in the conjunctival stroma of the control group. In the treatment group, the diameter of collagen fibrils ranged from 60 to 90 nm. The thickest collagen fibrils were observed in the treatment group (up to 90 nm in diameter). In contrast, those in the conjunctival stroma of the control group were considerably smaller (up to 60 nm in diameter). However, thicknesses of collagen fibrils displayed a unimodal distribution. Both collagen I and collagen III increased after treatment with riboflavin and UVA light irradiation at 45 mW/cm². The data indicate that in rabbits, conjunctival crosslinking with riboflavin and UVA light at 45 mW/cm² for 4 min is safe and does not induce ultrastructural alterations of the conjunctival cells. The conjunctival crosslinking with riboflavin and UVA light at 45 mW/cm² can increase the diameter of collagen fibrils, but the average densities of collagen I and collagen III have no statistical significance.

The Promoter SNPs Were Associated with Both the Contents of Poly-Unsaturated Fatty Acids (PUFAs) and the Expressions of PUFA-Related Genes in Common Carp

The allo-tetraploid common carp encodes two duplicated fads2 genes (fads2a and fads2b) and two duplicated elovl5 genes (elovl5a and elovl5b). The coding SNPs (cSNPs) of these genes were reported to be significantly associated with the PUFA contents. Whether the promoter SNPs (pSNPs) were associated with the PUFA contents has not been reported yet. In this study, after sequencing the promoters of these four genes, we identified six pSNPs associated with the contents of PUFAs in common carp, including one elovl5a pSNP, one elovl5b pSNP, and four fads2b pSNPs. The pSNPs were predicted in the locations of transcriptional factor binding sites. Together with previously identified cSNPs in fads2b and elovl5b, the pSNPs and cSNPs of these two genes had the joint effects on the PUFA contents with higher explained percentage of phenotypic variation of the PUFA contents than single gene. The expression levels of both fads2a and fads2b were significantly positively correlated with the contents of six PUFAs. The fads2b pSNPs corresponding to higher fads2b expression levels were associated with higher PUFA contents. The pSNPs and cSNPs will be useful for the future selection breeding of common carp with higher PUFA contents.

Visual analysis of image-guided radiation therapy based on bibliometrics: A review

Radiation therapy plays an important role in tumor treatment. The development of image-guided radiation therapy (IGRT) technology provides a strong guarantee for precise radiation therapy of tumors. However, bibliometric studies on IGRT research have rarely been reported. This study uses literature collected from the Web of Science during 1987 to 2021 as a sample and uses the bibliometric method to reveal the current research status, hotspots, and development trends in IGRT. Based on 6407 papers published from the Web of Science during 1987 to 2021, we utilized Microsoft Excel 2007 and cite space software to perform statistical analysis and visualization of IGRT. A total of 6407 articles were included, this area of IGRT has gone through 4 stages: budding period, growth period, outbreak period, and stationary period. The research category is mainly distributed in Radiology Nuclear Medicine Medical Imaging, which intersects with the research categories of Materials, Physics, and Mathematics. Yin FF, Tanderup K, and Sonke JJ are highly productive scholars who are active in IGRT research, while Jaffray DA, van Herk M and Guckenberger M are authors with high impact in this field. The team of scholars has close cooperation within the team and weak cooperation among teams. The League of European Research Universities, University of Texas System, University of Toronto, and Princess Margaret Cancer are the main research institutions in this field. The United States has the most research literature, followed by China and Germany. Six thousand four hundred seven articles are distributed in 712 journals, and the top 3 journals are Med Phys, Int J Radiat Oncol, and Radiather Oncol. Precise registration, intelligence, magnetic resonance guidance, and deep learning are current research hotspots. These results demonstrate that the research in this field is relatively mature and fruitful in the past 35 years, providing a solid theoretical basis and practical experience for precision radiotherapy.

Analysis of reproductive damage in earthworms (Amynthas corticis) exposed to cypermethrin

Cypermethrin contamination was a potential threat to soil organisms. In the present work, reproductive damage in earthworms (Amynthas corticis) exposed to cypermethrin was investigated. It was found that earthworms could absorb and accumulate residual cypermethrin in soil, and also earthworm activities helped accelerate the degradation of cypermethrin in soil. The accumulation of cypermethrin in earthworms induced sperm damage, and cypermethrin not only caused the imbalance of calcium homeostasis in earthworm sperm cells by inhibiting earthworm sperm Ca²⁺-ATP and Ca²⁺-Mg²⁺-ATP enzyme activities but also caused barriers in acrosome reaction. It also affected sperm energy supply of earthworms by inhibiting the activity of Na⁺-K⁺-ATPase and Mg²⁺-ATPase of earthworm sperm. Meanwhile, the inhibition of acrosome enzyme activity of earthworm sperm by cypermethrin led to hinder fertilization and reduced cocoon production of earthworms, and the damage of cypermethrin to sperm of earthworm was a significant cause of its reproductive toxicity. The results of the evaluation of IBR index showed that reproductive toxicity of cypermethrin to earthworms reduced with the increasing time. The decreased reproductive toxicity of cypermethrin to earthworms at the later stage of exposure (42-56 d) might be due to a combination of reduced absorption of cypermethrin in soil by earthworms, decreased accumulation of cypermethrin in the body, and improved sperm capacitation.

[Effects of Polystyrene Nanoplastics (PS-NPs) on the Physiology of Allium sativum L]

The pollution of micro/nanoplastics in the natural environment is becoming increasingly serious, but the potential effects of nanoplastics on crops remain unclear. In the present study, the effects of polystyrene nanoplastics (PS-NPs) with a particle size of 80 nm on the chlorophyll content, antioxidant enzyme activity, and nutritional quality of Allium sativum L. were explored via hydroponic culture. The results showed that the chlorophyll contents in leaves of A. sativum treated with PS-NPs were significantly lower than those in the control, indicating that the synthesis of chlorophyll was inhibited. The superoxide dismutase (SOD), ascorbate peroxidase (APX) activities, and proline contents in leaves of A. sativum initially increased but then decreased with the increase in ρ(PS-NPs). The activity of guaiacol peroxidase (POD) increased with the increase in ρ(PS-NPs) for 10 days of treatment; however, it was inhibited for 20 days of treatment. The malondialdehyde (MDA) content increased with the rise in ρ(PS-NPs). When ρ(PS-NPs) increased to 100 mg·L^-1, the MDA content in leaves of A. sativum increased by 43.24% and 89.70% for 10 and 20-day treatments, respectively, compared with those in the control. Meanwhile, the contents of soluble protein, soluble sugar, and vitamin C were higher than those in the control for 10-day treatments; however, the vitamin C content decreased by 26.53% after 20 days of treatment. These results indicated that PS-NPs had a significant oxidative stress on A. sativum, and a high concentration of PS-NPs stress would have deleterious effects on the nutritional quality of A. sativum.

[Ozone Formation and Key VOCs of a Continuous Summertime O3 Pollution Event in Ji'nan]

In the summer of 2019, field measurements of ozone (O₃) and its precursors[volatile organic compounds (VOCs) and nitrogen oxides (NO_x)] were carried out at an urban site in Ji'nan. We found that the daily maximum 8-hour averages φ(O₃) were (103.0±14.5)×10^-9. The average φ(NO_x) and φ(VOCs), which are ozone precursors, were (16.7±11.3)×10^-9and (22.4±9.4)×10^-9, respectively. The ·OH reactivity of VOCs was determined (9.6±3.8) s^-1. Ji'nan suffered from serious O₃ pollution. An observation-constrained chemical box model was deployed to evaluate in situ photochemical O₃ production, which indicated that chemical reactions made positive contributions to O₃ production rates between 07:00 and 19:00 LT, with the average hourly O₃ production rate of 35.6×10^-9 h^-1. To evaluate the effectiveness of various ozone precursor control strategies in reducing ozone pollution, we combined the observation-based model (OBM) with the relative incremental reactivity (RIR) method. The key indicators that affect the local ozone production rate were identified. Ji'nan was under VOC-limited conditions and the key VOC precursors were alkenes. The O₃ formation mechanism changed from the VOC-limited regime in the morning to the transitional regime in the afternoon. Correspondingly, the simulated local O₃ production rate was increased from 18.3×10^-9 h^-1 to 29.6×10^-9 h^-1. To further explore the role of anthropogenic emissions in ozone pollution, we used the positive matrix factorization (PMF) model to identify the major sources contributing to VOCs. The major sources in Ji'nan were vehicular exhaust and gasoline evaporation, accounting for more than 50% of the observed VOCs. Therefore, constraints on vehicular emissions is the most effective strategy to control O₃ pollution in Ji'nan.

Parallel subgenome structure and divergent expression evolution of allo-tetraploid common carp and goldfish

How two subgenomes in allo-tetraploids adapt to coexistence and coordinate through structure and expression evolution requires extensive studies. In the present study, we report an improved genome assembly of allo-tetraploid common carp, an updated genome annotation of allo-tetraploid goldfish and the chromosome-scale assemblies of a progenitor-like diploid Puntius tetrazona and an outgroup diploid Paracanthobrama guichenoti. Parallel subgenome structure evolution in the allo-tetraploids was featured with equivalent chromosome components, higher protein identities, similar transposon divergence and contents, homoeologous exchanges, better synteny level, strong sequence compensation and symmetric purifying selection. Furthermore, we observed subgenome expression divergence processes in the allo-tetraploids, including inter-/intrasubgenome trans-splicing events, expression dominance, decreased expression levels, dosage compensation, stronger expression correlation, dynamic functionalization and balancing of differential expression. The potential disorders introduced by different progenitors in the allo-tetraploids were hypothesized to be alleviated by increasing structural homogeneity and performing versatile expression processes. Resequencing three common carp strains revealed two major ecotypes and uncovered candidate genes relevant to growth and survival rate.

Latanoprost eye drops induce conjunctival lymphatic vessel development

AIM

To investigate the effect of latanoprost eye drops on the conjunctival lymphatics.

METHODS

Twenty-four healthy New Zealand White rabbits weighing 1.5 to 2.0 kg were randomly divided into three groups: latanoprost group (n=8) administered with latanoprost eye drops once a day for 2mo, carteolol group (n=8) administered with carteolol eye drops once a day for 2mo, and control group (n=8) without any treatment. The conjunctival tissues in the three groups were extracted to investigate the expression levels of 5'-nucleotidase (5'-Nase) by Western blot, reverse transcription-polymerase chain reaction (RT-PCR), and immunofluorescence staining, respectively.

RESULTS

The protein expression level of 5'-Nase was significantly higher in latanoprost group than carteolol group (F=231.175, P<0.001) and control group (P<0.001), while there was no significant difference between the carteolol group and the control group (P>0.05). The mRNA expression level of 5'-Nase in the latanoprost group was also significantly higher than carteolol group (F=71.169 P<0.005) and control group (P<0.005). The conjunctival lymphatics were positive immunofluorescence stained with the 5'-Nase antibodies in the latanoprost group and not stained in the control group.

CONCLUSION

Latanoprost eye drops can induce conjunctival lymphangiogenesis which may be concerned in clinical implications.

Application of low FODMAP diet-based holistic nursing model combined with moxibustion in patients with irritable bowel syndrome

BACKGROUND

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disease. Although traditional diet therapy can relieve clinical symptoms, it has little effect in improving the quality of life and intestinal function. In recent years, studies have found that short-chain carbohydrates that are difficult to absorb, such as oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP), can increase the amount of fluid in the intestinal cavity and the production of intestinal gas, and induce intestinal barrier dysfunction, which exacerbates the symptoms of IBS. Thus, restricting FODMAP intake is particularly important in alleviating the condition of IBS. This study explored the feasibility of the holistic nursing model based on low FODMAP diet combined with moxibustion in the care of IBS patients, with an aim to find an effective of nursing care model, improve the quality of life of patients, and reduce the severity of IBS.

AIM

To analyze the application effect of the holistic nursing model based on low FODMAP diet combined with moxibustion in the care of patients with IBS.

METHODS

We selected 100 patients with IBS who were treated at our hospital from September 2018 to June 2020. The patients were randomly divided into either a control group (50 cases) to receive classic IBS diet guidance and routine care, or a study group to receive the holistic nursing model based on low FODMAP diet combined with moxibustion. Main symptom scores, IBS severity scale (IBS-SSS) scores, IBS-related quality of life scale (IBS-QOL) scores, Bristol stool trait scale scores, serum Brain-gut peptide levels [vasoactive intestinal peptide (VIP), 5-hydroxytryptamine (5-HT), and substance P (SP)], and changes in main intestinal flora species were compared between the two groups.

RESULTS

The main symptom scores, IBS-SSS scores, and Bristol stool trait scale scores of the study group after intervention were lower than those of the control group, and the BS-QOL scores were higher than those of the control group (P < 0.05). Serum levels of VIP, 5-HT, and SP in the study group after intervention were significantly lower than those of the control group (P < 0.05). The numbers of bifidobacteria, lactobacilli, and E. coli in the study group after intervention were comparable to those of the control group (P > 0.05).

CONCLUSION

The holistic nursing model based on low FODMAP diet combined with moxibustion is feasible in the care of IBS patients, and it can reduce clinical symptoms, improve quality of life, and regulate serum brain-gut peptide levels, with no significant impact on main intestinal flora species.

Prognostic Model to Predict Overall Survival for Metastatic Non-Small Cell Lung Cancer Patients Treated With Chemotherapy Combined With Concurrent Radiation Therapy to the Primary Tumor: Analysis From Two Prospective Studies

Purpose

The role of radiotherapy, in addition to chemotherapy, has not been thoroughly determined in metastatic non-small cell lung cancer (NSCLC). The purpose of the study was to investigate the prognostic factors and to establish a model for the prediction of overall survival (OS) in metastatic NSCLC patients who received chemotherapy combined with the radiation therapy to the primary tumor.

Methods

The study retrospectively reviewed 243 patients with metastatic NSCLC in two prospective studies. A prognostic model was established based on the results of the Cox regression analysis.

Results

Multivariate analysis showed that being male, Karnofsky Performance Status score < 80, the number of chemotherapy cycles <4, hemoglobin level ≤120 g/L, the count of neutrophils greater than 5.8 ×10⁹/L, and the count of platelets greater than 220 ×10⁹/L independently predicted worse OS. According to the number of risk factors, patients were further divided into one of three risk groups: those having ≤ 2 risk factors were scored as the low-risk group, those having 3 risk factors were scored as the moderate-risk group, and those having ≥ 4 risk factors were scored as the high-risk group. In the low-risk group, 1-year OS is 67.7%, 2-year OS is 32.1%, and 3-year OS is 19.3%; in the moderate-risk group, 1-year OS is 59.6%, 2-year OS is 18.0%, and 3-year OS is 7.9%; the corresponding OS rates for the high-risk group were 26.2%, 7.9%, and 0% (P<0.001) respectively.

Conclusion

Metastatic NSCLC patients treated with chemotherapy in combination with thoracic radiation may be classified as low-risk, moderate-risk, or high-risk group using six independent prognostic factors. This prognostic model may help design the study and develop the plans of individualized treatment.

Mid-term results of total hip arthroplasty with modified trochanteric osteotomy in Crowe type IV developmental dysplasia of the hip

Background

This study aimed to explore mid-term clinical results of cementless total hip arthroplasty (THA) with modified trochanteric osteotomy in Crowe type IV developmental dysplasia of the hip (DDH).

Methods

Thirteen patients (13 hips) with Crowe type IV DDH who underwent THA with modified trochanteric osteotomy between May 2013 and October 2015 were retrospectively analyzed. The mean follow-up duration was 5.2 years (range, 4.9–6.1 years).

Results

The mean Harris Hip Score (HHS) significantly (p < 0.05) improved from 30.7 (range, 22–38) to 87.5 (range, 83–93). The mean leg length discrepancy (LLD) was 53.4 mm (range, 42.1–68.5 mm) preoperatively. The final LLD was 5.6 mm (range, 2.4–9.1 mm; p < 0.05). The mean leg length after surgery was 47.4 mm (range, 33.6–67.2 mm) and the femur shortening distance was 43.8 mm (range, 31.2–53.4 mm). The average duration of bone union for the greater trochanter (GT) was 2.5 months (range, 1.5–3.6 months). There was no infection, GT non-union, or loosening (septic or aseptic) of the stem or cup in any case.

Conclusions

THA with modified trochanteric osteotomy with a cementless cup is an effective treatment for Crowe type IV DDH. It can rebuild complex biomechanics and biology of hip dysplasia without increasing complications.

The results of screw augmentation of acetabular cement spacers for the treatment of periprosthetic hip joint infection

Introduction

Prosthesis of antibiotic-loaded acrylic cement (PROSTALAC) is widely used in two-stage revision arthroplasty in periprosthetic joint infection (PJI) after total hip arthroplasty (THA). In our institution, we encountered several cases of acetabular cement spacer dislodgement. The aim of this study was to compare the results of two-stage revision arthroplasties with antibiotic-loaded cement spacers with or without screws on the acetabulum for PJI.

Patients and methods

This retrospective study included 44 patients who underwent a two-stage revision THA for PJI from June 2007 to May 2017. We divided the patients into two groups: group 1 consisted of 21 patients (21 hips) who underwent two-stage revision arthroplasty with screw augmentation, while group 2 consisted of 23 patients (23 hips) who underwent the same surgery without screw augmentation at the acetabular cement spacer. We compared the migration and dislodgement of the acetabular cement spacer between the two groups.

Results

Before the second-stage surgery, there was less vertical migration of the cement spacer in group 1 compared to group 2 (1.2 mm vs 3.1 mm, p < 0.001). There was also less medial migration of the cement spacer in group 1 (0.6 mm vs 1.6 mm, p = 0.001). After the first stage, the mean Harris Hip score was significantly higher in group 1 than in group 2 (75 vs 65, p = 0.033). Cement spacer rotation or total movement out of the acetabular area occurred in six patients, all in group 2. After first stage reinfection occurred in two patients, one in each group.

Conclusions

Screw augmentation to the acetabulum in the first-stage surgery provides better stability of acetabular antibiotic cement spacers without increasing reinfection rate.

Simultaneous integrated boost of intensity-modulated radiation therapy to Stage II-III non-small cell lung cancer with metastatic lymph nodes

Local tumor failure remains a major problem after radiation‐based nonsurgical treatment for unresectable locally advanced nonsmall cell lung cancer (NSCLC）and inoperable stage II NSCLC. The aim of this study was to evaluate the feasibility of simultaneous integrated boost of intensity‐modulated radiation therapy (SIB‐IMRT) to stage II‐III NSCLC with metastatic lymph nodes (ChiCTR 2000029304). Patients were diagnosed by pathology or PET‐CT. PTV was divided into two parts as follows, the PTV of primary tumor (PTVp) and the PTV of metastatic lymph nodes (PTVn). The radiotherapy doses were simultaneously prescripted 78 Gy (BED = 101.48 Gy) for PTVp and 60‐65 Gy (BED = 73.6‐81.25 Gy) for PTVn, 26f/5.2 weeks. Response was scored according to WHO criteria. Radiotherapy toxicity was scored according to RTOG criteria. Hematology and gastrointestinal toxicity were scored according to CTCAE1.0 criteria. A total of 20 patients were enrolled. Seventeen patients were diagnosed by pathology and three patients were diagnosed by PET‐CT. All patients were treated with SIB‐IMRT. The objective response rate (ORR) was 90%, with CR 25%, PR 65%, NC 10%, and PD 0%. Although radiotherapy toxicity was common, there were no grade ≥3, with radiation pneumonitis (10 cases), esophagitis (17 cases), and dermatitis (12 cases). The local control rates at 1, 3, and 5 years were 85%, 75%, and 70%, respectively. The overall survival（OS）and local progression‐free survival (LPFS) rates at 1, 3, and 5 years were 90%, 42.6%, and 35.5% and 84.4%, 35.5%, and 28.4%, respectively. SIB‐IMRT can significantly improve ORR and survival for stage II‐III NSCLC with metastatic lymph nodes, with high safety, and satisfactory efficacy. However, due to the limitation of small sample, these findings are needed to confirm by future trials with a larger sample size.

[Pollution Characteristics and Risk Assessment of Antibiotics in Lianhua Reservoir]

Thirteen typical antibiotics in surface water of the Lianhua Reservoir were analyzed using HPLC/MS/MS to assess the pollution characteristics and risk levels. Ten antibiotics except for erythromycin, sulfadiazine, and sulfamethoxazole were detected in surface water and the total concentration of antibiotics varied between non-detectable (n.d.) and 925.26 ng ·L^-1. Azithromycin had the highest concentration (n.d.-232.61 ng ·L^-1) with the detection frequency of 75%, followed by enrofloxacin (n.d.-187.69 ng ·L^-1), tetracycline (n.d.-155.05 ng ·L^-1), and ciprofloxacin (n.d.-83.66 ng ·L^-1) with the detection frequencies over 60%. The spatial distribution of antibiotics was as follows: total concentration of upstream (sampling point 1) > Aoxi River stream tributary (sampling point 2) > reservoir downstream (sampling point 3) > reservoir entrance (sampling point 4) > reservoir area (sampling point 5). The seasonal variations in the concentrations of antibiotics were evident; total concentrations in the dry season were significantly higher than those in the wet and normal seasons. The results of the environmental risk assessment indicated that ofloxacin, enrofloxacin, and ciprofloxacin pose significant risks to the environment. In the Lianhua Reservoir, ciprofloxacin showed high potential risk to the ecological environment, while the environmental risks of other antibiotics in the reservoir were below the medium level. The combined risk value of the antibiotics in the dry season was higher than that in the wet and normal seasons.

[PARP10 Influences the Proliferation of Colorectal Carcinoma Cells, a Preliminary Study]

PARP10 is an intracellular mono-ADP ribosyltransferase and recent reports suggest that it regulates proliferation of some cell types. However, its effect on the proliferation of colorectal carcinoma cells has not yet been systematically reported. We explored the influence of PARP10 on the proliferation of several colorectal carcinoma cell types and carried out initial studies on the underlying mechanisms. Inhibition of the enzymatic activity of PARP10 led to significantly decreases in proliferative ability in LoVo cells and CT26 cells in vitro and suppressed growth of CT26 tumours in the subaxilliary region in Balb/c mice in vivo. Cell-cycle arrest accompanied these observations. Expression of the nuclear transfer factor β-catenin and it trans-location to the nucleus were also affected and the expression of its associated signal proteins Axin2 and c-Myb were increased and decreased, respectively. We demonstrate that PARP10 promotes proliferation of those colorectal carcinoma cells which express significant levels of PARP10. This promotion is suppressed when the enzymatic activity is inhibited. β-Catenin is likely to be the mediator of the antiproliferative effect.

[Occurrence and Prediction Model of Disinfection By-Products in Tap Water]

Disinfection by-products (DBPs) are defined as important parameters that can deteriorate drinking water quality. The investigation was performed at a laboratory located on a campus in H City of the Zhejiang province. The purpose of the work was to obtain knowledge on the occurrence of DBPs in tap water and boiled water taken from the same pipe, to establish a statistical model to predict DBPs information in tap water based on physicochemical parameters, and to evaluate carcinogenic and non-carcinogenic risks caused by DBPs on a predictional level. The results showed three categories of trihalomethanes (THMs), haloacetonnitrile (HANs), and haloacetic acids (HAAs), including 10 species of disinfection by-products detected in drinking water. The detection rate of target DBPs in tap water was 100% and the concentrations varied in the ranges of 10.12-28.39, 0.98-5.19, and 2.65-7.83 μg·L^-1, respectively. In boiled water, bromochloracetonitrile (BCAN) was not detected; the detection rates of tribromomethane(TBM), trichloroacetonitrile (TCAN), and dibromoacetonitrile (DBAN) were 46.43%, 82.14%, and 92.86%, respectively, while the detection rate for other DBPs was 100%. The concentrations of THMs, HANs, and HAAs were in the ranges of 0.60-12.58, 0.02-0.52, and 2.42-5.86 μg·L^-1, respectively. After heating, the concentrations of THMs and HANs decreased by 84.22% and 91.45%, respectively. No obvious decrease was found for HAAs. The pH value and specific ultraviolet absorbance (SUVA) had positive correlation with DBPs, whereas residual chlorine and ammonia nitrogen had negative correlation with DBPs. Based on the correlation between the physicochemical parameters and DBPs, a multiple linear regression prediction model of THMs was established, with deviation less than 10.00%, which can be used for the prediction of THMs in tap water. Based on the EPA recommended health risk assessment model, the carcinogenic and non-carcinogenic risks of chlorine disinfection by-products through oral intake were calculated. It was found that the carcinogenic risks caused by the disinfection by-products in the tap and boiled water were (17.24-84.63)×10^-6 and (25.49-258.82)×10^-7, respectively, and the non-carcinogenic risks were (4.17-50.32)×10^-2 and (6.52-107.74)×10^-3, respectively. The carcinogenic risk caused mainly by THMs and bromodicloromethane (BDCM) contributed the highest cancer risk in tap water, while for boiled water, trichloromethane (TCM) was found to contribute the highest cancer and non-carcinogenic risk. In boiled water, the reduction of THMs was up to 94.38%, and the cancer risk was reduced by 79.00%.

[Distribution Characteristics of Disinfection By-Products and the Effects of Booster Chlorination in Long-Distance Water Supply Systems]

It is difficult for waterworks that add chlorine into finished water once to maintain sufficient residual chlorine at unfavorable points of the pipe network that supply water for large areas of coverage. Therefore, booster chlorination was employed for a long-distance water distribution system. The study was performed in H City with a water supply system serving about 400 km² of downtown and rural areas. The purpose of this work is to obtain the distribution characteristics of disinfection by-products (DBPs) in the booster chlorination disinfection pipe network through uniformly distributed sampling analysis. The results showed that detected DBPs include trichloromethane (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM) and tribromomethane (TBM), dichloroacetic acid (DCAA), trichloroacetic acid (TCAA), dichloroacetonitrile (DCAN), bromochloroacetonitrile (BCAN), and trichloronitromethane (TCNM). The concentrations of the regulated DBPs were found to be lower than the standard limits specified in the Sanitary Standard for Drinking Water (GB5749-2006). Before booster chlorination, the average concentrations of the DBPs mentioned (expressed as mean±deviation) were (8.08±3.34), (9.77±2.91), (7.38±4.82), (2.65±2.02), (2.95±3.26), (6.02±6.06), (3.13±2.48), (1.61±2.05), and (0.15±0.10) μg·L^-1, while afterwards, they were increased to (10.30±4.55), (11.73±3.60), (8.23±5.22), (2.95±2.45), (3.29±3.60), (8.15±7.58), (3.31±2.61), (1.33±2.04), and (0.12±0.06) μg·L^-1, respectively. Trihalomethanes (THMs) and haloacetic acids (HAAs) increased by 6.32%-26.60% and 5.32%-42.71%, respectively, after booster chlorination. In addition, raw water quality and seasonal changes had a certain impact on the occurrence of DBPs. The levels of DBPs in summer were generally higher than those in spring or autumn. According to the analysis of DBP formation potential of source water, finished water, and tap water, it was found that the risk of DBPs exceeding the standard limit may exist in the water supply system of H City; therefore, further optimization of the treatment process should be considered to ensure water quality.

[Distribution of Four Artificial Sweeteners in Water Treatment and Water Supply System in City H of Zhejiang Province]

Taking the sewage and drinking water treatment system of two cities in Zhejiang Province as the main research target, a systematic investigation on the common artificial sweeteners was carried out by solid phase extraction-high performance liquid chromatography (SPE-HPLC). The results showed that SPE-HPLC can accurately determine micro acesulfame (ACE), saccharin (SAC), aspartame (ASP), and neotame (NEO) in water. The detection limits were 57, 120, 170, and 47 μg·L^-1, and the quantification limits were 190, 400, 567, and 157 μg·L^-1, respectively. After optimization of the solid phase extraction procedure when using PWAX columns, the recoveries of ACE and SAC were enhanced to 86.5% and 97.7%; however, it slightly decreased to 66.5% for NEO. The occurrence rates of ACE, SAC, and NEO in domestic sewage were 100.0%, and it was only 33.3% for ASP. The highest concentrations of four aforementioned artificial sweeteners in domestic sewage were 0.83, 4.52, 1.22, and 7.57 μg·L^-1, respectively. The highest concentrations of acesulfame, saccharin, aspartame, and neotame in source water were 22.94, 39.17, 0.73, and 8.92 μg·L^-1, respectively, and detection rates were 72.7%, 90.9%, 18.2%, and 90.9%, respectively. Most artificial sweeteners were removed by the prozone process; the removal efficiencies of ACE, SAC, and NEO ranged from 67.7% to 100.0%, and the removal efficiencies of ACE, SAC, and NEO by the advanced treatment process ranged from 73.7% to 100.0%, which effectively reduced the risk of drinking water quality. The four artificial sweeteners were not detected in the water supply network.

[Disinfection By-products and the Relevant Health Risk in the Water Supply System in H City of Zhejiang Province]

The occurrence of 18 types of disinfection by-products (DBPs) in two waterworks and the corresponding water supply networks of H City in Zhejiang Province was determined by gas chromatography coupled with electron capture detector (GC-ECD). The correlation between DBPs and organic precursors, and health risks caused by DBPs, were discussed. Results showed that the disinfection by-products detected in drinking water in H City mainly include trihalomethanes (THMs), haloacetic acid (HAAs), haloacetonitrile (HANs) and trichloronitromethane (HNMs), with highest concentrations of THMs followed by HAAs. In the finish water of CX Waterworks and tap water supplied by CX Water works, concentrations of THMs ranged from 7.70 to 32.73μg·L^-1and 9.00 to 51.42μg·L^-1, respectively, and those of HAAs 3.05 to 21.30μg·L^-1 and 6.00 to 26.79μg·L^-1, respectively. The THMs in finished water and tap water of TH Waterworks were in the range 8.65-38.76μg·L^-1 and 12.09-42.04μg·L^-1, respectively, and those of HAAs were 2.42-14.79μg·L^-1 and 2.80-33.40μg·L^-1, respectively. The DBPs in the finished and tap water of the two waterworks were at lower levels than the limitations regulated by the Sanitary Standard for Drinking Water (GB 5749-2006). The index of dissolved organic carbon (DOC) and UV₂₅₄ were adopted to describe the organic compounds, and it was found that trichloromethane (TCM) was significantly negatively correlated with DOC and UV₂₅₄in tap water. Based on the EPA recommended health risk assessment model, the carcinogenic and non-carcinogenic risks of chlorine disinfection by-products in the oral intake route were calculated. It was found that the carcinogenic risks caused by the disinfection by-products in the finished water and tap water of H City were 5.94×10^-6-4.76×10^-5 and 5.94×10^-6-5.56×10^-5, respectively, while the non-carcinogenic risks were 0.91×10^-2-4.20×10^-2 and 1.26×10^-2-4.72×10^-2, respectively. The carcinogenic risk is mainly from THMs:bromodichloromethane (BDCM) contributes the highest cancer risk, and the non-carcinogenic risk is mainly from TCM.

Quercetin is the Active Component of Yang-Yin-Qing-Fei-Tang to Induce Apoptosis in Non-Small Cell Lung Cancer

Yang-Yin-Qing-Fei-Tang (YYQFT) is a well-known traditional Chinese medicine used in the treatment of chronic obstructive pulmonary emphysema, bronchitis, cytomegaloviral pneumonia, but the mechanisms of the medicine are not clear. This study aimed to identify the active components of YYQFT and elucidate the underlying mechanism on non-small cell lung cancer. First, YYQFT was extracted with different solvents, and then the most effective extract was determined by assessing their effects on non-small cell lung cancer cell growth. Second, several active compounds from YYQFT were identified, and quercetin was the one of the important active ingredients. Subsequently, the in vivo antitumor activity of quercetin was confirmed in a lung cancer xenograft model in mice. 200 μ g/mL quercetin significantly reduced tumor volume without affecting body weight of the mice. Furthermore, induction of apoptosis by quercetin was detected in tumor tissues treated with quercetin. Multiple apoptosis related genes including p53, Bax and Fas were upregulated by quercetin in tumor tissue and the ratio of Bax/Bcl-2 was increased accordingly. Our results demonstrated that quercetin, as the main effective component of the YYQFT, has potent inhibitory activity on non-small cell lung cancer by regulating the ratio of Bax/Bcl-2.

Randomized phase II study of pemetrexed-cisplatin or docetaxel-cisplatin plus thoracic intensity-modulated radiation therapy in patients with stage IV lung adenocarcinoma

Systemic chemotherapy is the standard treatment modality for stage IV lung adenocarcinoma patients with EGFR wild-type or unknown mutation status. Recent years, there is increasing evidence showed that selected patients with stage IV disease could benefit from aggressive thoracic radiotherapy. Either pemetrexed or docetaxel, combined with cisplatin, can be used for patients with stage IV lung adenocarcinoma. However, no prospective trials have confirmed that Pem-Cis was superior to Doc-Cis in lung adenocarcinoma. In this randomized phase 2 trial, we evaluated survival outcomes, and toxicity of Pemetrexed-Cisplatin (arm A) or Docetaxel-Cisplatin (arm B) with concurrent IMRT to the primary tumor for stage IV lung adenocarcinoma patients with EGFR wild-type or unknown mutation status. Totally, 101 patients were randomly assigned (50 in arm A and 51 in arm B). Using an intention-to-treat analysis, one-year survival rates were 72.0% and 52.9%, respectively (P=0.020). Progression-free survival was also significantly improved in the arm A (median, 12.6 v 7.5 months, P=0.013). The incidence and severity of acute pneumonitis and esophagitis was similar between two arms. Although more of grade 3 or 4 anemia and thrombocytopenia in arm A, and higher rates grade 3 or 4 neutropenia, and leukopenia were observed in arm B. Pem-Cis first-line chemotherapy with concurrent radiation therapy for stage IV lung adenocarcinoma patients with EGFR wild-type or unknown mutation status represents a potential treatment option with acceptable toxicity and high overall survival rates.

Treatment Effects of Botulinum Toxin Injection and Acupuncture on Blepharospasm Assessed by the Change in Lower Eyelid Tension

Objective: To investigate the treatment effects of botulinum toxin-A (BTA) injection and acupuncture on blepharospasm (BP) evaluated by the change in lower eyelid tension (LET). Methods: A series of 30 patients (male: 8, female: 22) aged between 37 and 83 years (63.80 ± 10.96 yrs) who met the eligibility criteria of BP were recruited in this study, who were randomly assigned to BTA injection group (BTA group, n = 15) and acupuncture treatment group (Acupuncture group, n = 15). BTA injections were administered to the patients in BTA group while patients in acupuncture group received the acupuncture treatment. The LET was measured by a tensiometer in both groups at baseline and at post-treatment. Results: A significant decrease in LETs over 8 weeks was found in acupuncture group (812.76 ± 193.95 Pa at baseline, 549.69 ± 150.04 Pa at 4 weeks, and 510.96 ± 150.66 Pa at 8weeks, respectively; F = 31.127, p << 0.001). There was a significant decrease in LET from 858.61 ± 190.54 Pa at baseline to 414.45 ± 63.38 Pa at 2 weeks after treatment (Z = -4.542, p << 0.01) in BTA group. At the endpoint of the study, a significant difference in LET was found between the acupuncture group (301.80 ± 181.77 Pa) and the BTA group (444.16 ± 193.44 Pa) (t = -2.077, p = 0.047). Conclusions: BP patients have an increased LET. Both BTA and acupuncture are effective in decreasing the LET. Close monitoring of LET holds promise in planning the treatment strategy for Blepharospasm.

[Combining K-line to analyse the relationship between cervical range of motion of patients with ossification of cervical posterior longitudinal ligament and surgical prognosis]

OBJECTIVE

Combining K-line (the connecting line of the midpoint of C₂ and C₇ spinal canal on the cervical lateral X-ray film) to analyze the relationship between cervical range of motion of patients with ossification of posterior longitudinal ligament (OPLL) and surgical prognosis.

METHODS

A total 42 patients with ossification of cervical posterior longitudinal ligament underwent cervical posterior single open-door laminoplasty between April 2014 and March 2017 were retrospectively ananyzed. The patients were dividing into K-line (+) group and K-line (-) group according to the position realationship of OPLL and K-line. The lesion of ossification of the posterior longitudinal ligament was not over than the K-line known as K-line (+). Conversely, the lesion of ossification of the posterior longitudinal ligament crossing the K-line was called K-line (-). Preoperative and postoperative 3 months JOA scores were observed, and postoperative 3 months JOA improvement rate were computed to assess patient's neurological function recovery. Preoperation and postoperative 3 months, OPLL occupation ratio (OOR), cervical lordotic angles (CLA) and cervical lordotic value (CLV) were measured respectively. The realationship between postoperative neurologic functional recovery in patients of CLV>0 group and CLV<=0 group was evaluated in different K-line subgroups.

RESULTS

For the patients in K (+) group and K (-) group, preoperative CLA were (14.7±9.6)° and (-6.4±9.5)°(P<0.05) respectively, postoperative at 3 months CLA were (14.0±8.0)° and (-1.4±10.4)°(P<0.05) respectively; preoperative JOA scores were 10.9±3.2 and 11.2±2.5 (P>0.05) respectively, postoperative at 3 months JOA scores were 14.2±1.8 and 12.6±2.2 (P<0.05) respectively, and postoperative at 3 months JOA score improvement rate were (54.7±17.6)% and (25.5±15.7)%(P<0.05) respectively. In the K-line (+) group, there were 29 patients in CLV>0 group at 3 months after operation, with improvement rate of (52.3±17.2)%, and 4 patients in CLV<=0 group, with improvement rate of (72.2±7.8)%. The improvement rate of the patients in CLV<=0 group was significantly better than that of the patients in CLV>0 group (P<0.05).

CONCLUSIONS

No matter whether the ossification of cervical posterior longitudinal ligament was classified as K-line (+) or K-line (-), the cervical posterior single open-door laminoplasty can improve the neurological symptoms of patients, especially the patients in the K-line(+) group with better prognosis. The patinets in K-line(+) group, when postoperative at 3 months CLV>0, their improvement rate was lower than that of the patients with postoperative at 3 months CLV<=0.

Effect of long-term topical latanoprost medication on conjunctival thickness in patients with glaucoma

AIM

To investigate the effect of long-term use of topically administered latanoprost on conjunctival thickness (CT) and conjunctival epithelium thickness (CET) in the patients with glaucoma.

METHODS

A series of 106 glaucomatous patients were included. Of the 106 eyes, 55 eyes were treated with latanoprost eye drops once a day (latanoprost group), while 51 eyes were treated with carteolol hydrochloride eye drops (carteolol group). All the included patients completed a 2-year follow-up. CT and CET were measured with optical coherence tomography (OCT) in all patients at presentation and at 2-year visit, respectively. Statistical analysis was then performed to compare the change in CT and CET.

RESULTS

At presentation, there was no difference in CET (t=0.400, P=0.689) or CT (t=1.14, P=0.259) between the two groups. No significant difference was found in CET (61.65±5.35 µm at baseline, 60.36±6.36 µm at 2-year follow-up, respectively; t=1.977, P=0.0531), while there was a significant decrease in CT from 201.45±14.99 µm at baseline to 167.81±14.57 µm at 2-year visit (t=14.1407, P<0.001) in the latanoprost group. At 2-year follow-up, no statistically difference was found in CET (62.24±5.27 µm; t=1.086, P=0.282) or CT (201.23±12.45 µm; t=1.44, P=0.154) compared to it at baseline (CET: 61.23±5.42 µm; CT: 198.76±13.68 µm, respectively) in the carteolol group.

CONCLUSION

A significant decrease in conjunctival thickness is found in glaucoma patients treated with long-term topical latanoprost; its potential effect on the outcome of filtration surgery should be considered.

A preliminary study on the establishment of an animal model of conjunctivochalasis

AIM

To explore a feasible method on the establishment of an animal model of conjunctivochalasis (CCH).

METHODS

Twelve clean-grade New Zealand white rabbits were divided into four groups (n=3/group): the control group (one received no interventions, and the others underwent subconjunctival injection of sterile water), the matrix metalloproteinases (MMPs) group (administered subconjunctival injection of MMP-3), the aging group (administered subcutaneous injection of D-galactose), the tumor necrosis factor-α (TNF-α) solution group (administered eye drops of TNF-α). Anterior segment photography, conjunctival tissue light microscopy and transmission electron microscopy (TEM) were performed after 12wk.

RESULTS

Among all groups, the MMPs group had the following changes: the looser connection between the inferior bulbar conjunctiva and sclera; the more disordered collagen fibers (Trichrome staining) and the broken elastic fibers (Aldehyde-fuchsin staining); the focal necrosis of fibroblasts (TEM).

CONCLUSION

Administration of MMPs may be a feasible method for the establishment of an animal model of CCH.

Degradation behavior of triclosan by co-exposure to chlorine dioxide and UV irradiation: influencing factors and toxicity changes

This study investigated the transformation of triclosan (TCS) following co-exposure to UV irradiation and ClO₂. Special attention was given to understand the influencing of water quality parameters and toxicity changes during the co-exposure process. The results show that the co-exposure process prompted TCS elimination quickly and effectively, with more than 99% of TCS degraded under the experimental conditions. The molar yield ratios of 2,4-dichlorophenol/TCS (2,4-DCP/TCS) were calculated to be 35.81-74.49%; however, the by-product of 2,8-dichlorodibenzop-dioxin (2,8-Cl₂DD) was not detected. The TCS degradation was sensitive to ClO₂ dosage, pH, H₂O₂, and natural organic matter (NOM), but not to the carbonate (CO₃^2-) concentration. Neutral and slightly alkaline condition were favorable to TCS elimination. The TCS removal rate increased from 85.33 to 99.75% when the ClO₂ concentration increased from 0.25 to 1.5 mg L^-1. TCS degradation can be promoted at low NOM level (1, 3, and 5 mg L^-1), whereas was inhibited at high NOM concentrations of 7 and 9 mg L^-1. While adding H₂O₂, the degradation rate of TCS increased with increasing H₂O₂ concentration from 1 to 3 mg L^-1; however, too low or overdosed H₂O₂ (0.5 and 5 mg L^-1) hindered TCS degradation. Based on the results of a microtox bioassay, the toxicity did not change following the co-exposure process.

[Distribution of traditional Chinese medicine syndromes of diabetic retinopathy and correlation between symptoms]

To investigate the distribution of traditional Chinese medicine (TCM) Syndromes of diabetic retinopathy and explore the correlation between various symptoms. Based on the literature in databases of China Journal Full-text Database (CNKI), Wanfang database, VIP network, China biomedical literature database (CBM) and PubMed, SPSS 20.0 and IBM SPSS Modeler 14.1 software were used to analyze the location of disease, symptoms, tongue and pulse, and syndrome type distribution through frequency statistics. In addition, association rule algorithm was used to explore the basic rules for underlying symptoms combinations of diabetic retinopathy. A total of 560 articles were retrieved, and a total of 240 articles met the inclusion and exclusion criteria. In these documents, 62 types of TCM syndromes were found, involving 9 820 cases, 201 symptoms, 29 tongue conditions, and 36 pulses conditions; the first two locations for the disease were liver and kidney. Then the association rule analysis of high frequency symptoms was used to dig out 15 groups of latent syndrome, and 3 underlying symptom combinations among high frequency symptoms, tongue conditions and pulse conditions. The results of the study showed that Qi and yin deficiency was most common for the diabetic retinopathy, and the location of the disease was closely related to liver and kidney. In addition, these high-frequency symptoms and tongue conditions, pulse conditions, and underlying symptom combinations can occur as main symptoms at diagnosis, providing reference for us to study the epidemiology of PRO scale of the disease. They can also increase the weight of these symptoms directly as the main symptoms, which can be also used as an alternative entry pool for TCM syndrome diagnostic scale, laying foundation for the construction and optimization of TCM symptom database of diabetic retinopathy.

The role of elastic fibers in pathogenesis of conjunctivochalasis

The PubMed, MEDLINE databases and China National Knowledge Infrastructure (CNKI) were searched for information regarding the etiology and pathogenesis of conjunctivochalasis (CCh) and the synthesis and degradation of elastic fibers. After analysis of the literature, we found elastic fibers was a complex protein molecule from the structure and composition; the degradation of elastic fibers was one of the histopathological features of the disease; the vast majority of the factors related to the pathogenesis of CCh ultimately pointed to abnormal elastic fibers. By reasonably speculating, we considered that abnormal elastic fibers cause the conjunctival relaxation. In conclusion, we hypothesize that elastic fibers play an important role in the pathogenesis of CCh. Studies on the mechanism of synthesis, degradation of elastic fibers are helpful to clarify the pathogenesis of the disease and to find effective treatment methods.

Inhibition of microRNA-214-5p promotes cell survival and extracellular matrix formation by targeting collagen type IV alpha 1 in osteoblastic MC3T3-E1 cells

Objectives

This study aimed to investigate the functional effects of microRNA (miR)-214-5p on osteoblastic cells, which might provide a potential role of miR-214-5p in bone fracture healing.

Methods

Blood samples were obtained from patients with hand fracture or intra-articular calcaneal fracture and from healthy controls (HCs). Expression of miR-214-5p was monitored by qRT-PCR at day 7, 14 and 21 post-surgery. Mouse osteoblastic MC3T3-E1 cells were transfected with antisense oligonucleotides (ASO)-miR-214-5p, collagen type IV alpha 1 (COL4A1) vector or their controls; thereafter, cell viability, apoptotic rate, and the expression of collagen type I alpha 1 (COL1A1), type II collagen (COL-II), and type X collagen (COL-X) were determined. Luciferase reporter assay, qRT-PCR, and Western blot were performed to ascertain whether COL4A1 was a target of miR-214-5p.

Results

Plasma miR-214-5p was highly expressed in patients with bone fracture compared with HCs after fracture (p < 0.05 or p < 0.01). Inhibition of miR-214-5p increased the viability of MC3T3-E1 cells and the expressions of COL1A1 and COL-X, but decreased the apoptotic rate and COL-II expression (p < 0.05 or p < 0.01). COL4A1 was a target of miR-214-5p, and was negatively regulated by miR-214-5p (p < 0.05 or p < 0.01). Overexpression of COL4A1 showed a similar impact on cell viability, apoptotic rate, and COL1A1, COL-II, and COL-X expressions inhibiting miR-214-5p (p < 0.01).

Conclusion

Inhibition of miR-214-5p promotes cell survival and extracellular matrix (ECM) formation of osteoblastic MC3T3-E1 cells by targeting COL4A1.

Cite this article: Q. S. Li, F. Y. Meng, Y. H. Zhao, C. L. Jin, J. Tian, X. J. Yi. Inhibition of microRNA-214-5p promotes cell survival and extracellular matrix formation by targeting collagen type IV alpha 1 in osteoblastic MC3T3-E1 cells. Bone Joint Res 2017;6:464–471. DOI: 10.1302/2046-3758.68.BJR-2016-0208.R2

Genome-wide association study of borderline personality disorder reveals genetic overlap with bipolar disorder, major depression and schizophrenia

Borderline personality disorder (BOR) is determined by environmental and genetic factors, and characterized by affective instability and impulsivity, diagnostic symptoms also observed in manic phases of bipolar disorder (BIP). Up to 20% of BIP patients show comorbidity with BOR. This report describes the first case-control genome-wide association study (GWAS) of BOR, performed in one of the largest BOR patient samples worldwide. The focus of our analysis was (i) to detect genes and gene sets involved in BOR and (ii) to investigate the genetic overlap with BIP. As there is considerable genetic overlap between BIP, major depression (MDD) and schizophrenia (SCZ) and a high comorbidity of BOR and MDD, we also analyzed the genetic overlap of BOR with SCZ and MDD. GWAS, gene-based tests and gene-set analyses were performed in 998 BOR patients and 1545 controls. Linkage disequilibrium score regression was used to detect the genetic overlap between BOR and these disorders. Single marker analysis revealed no significant association after correction for multiple testing. Gene-based analysis yielded two significant genes: DPYD (P=4.42 × 10-7) and PKP4 (P=8.67 × 10-7); and gene-set analysis yielded a significant finding for exocytosis (GO:0006887, PFDR=0.019; FDR, false discovery rate). Prior studies have implicated DPYD, PKP4 and exocytosis in BIP and SCZ. The most notable finding of the present study was the genetic overlap of BOR with BIP (rg=0.28 [P=2.99 × 10-3]), SCZ (rg=0.34 [P=4.37 × 10-5]) and MDD (rg=0.57 [P=1.04 × 10-3]). We believe our study is the first to demonstrate that BOR overlaps with BIP, MDD and SCZ on the genetic level. Whether this is confined to transdiagnostic clinical symptoms should be examined in future studies.

A comparison of two sources of methionine supplemented at different levels on heat shock protein 70 expression and oxidative stress product of Peking ducks subjected to heat stress

The aim of this study was to examine the effects of different sources and levels of methionine (Met) on Heat shock proteins HSP70 expression and protein carbonylation in liver, HSP70 expression and malondialdehyde (MDA) concentration in intestine under heat stress conditions during summer. A total of 720 (4 days old) Peking ducks were placed 20 per pen into six replicates for each of the six treatments with a 2 × 3 factorial arrangement, such that two sources of Met (DL-methionine [DLM] and DL-2-hydroxy-4-methylthiobutyrate [HMTBA] were supplemented at three different levels (0.05%, 0.20%, or 0.35% on as-fed basis respectively). The experiment was divided into a starter (day 4-16) and a grower (day 17-35) period. Diet supplemented with 0.35% Met significantly up-regulated the HSP70 mRNA expression in duodenum, jejunum and ileum on day 16 and 35 as well as in liver on day 35 (p < .05) of ducks. HMTBA-supplemented diets increased the HSP70 mRNA expression in duodenum, jejunum, ileum and liver on day 35 (p < .01). An increased MDA concentration was detected in jejunum of birds in 0.35% DLM-supplemented treatment on day 16 (p < .05). And decreased protein carbonylation concentration was found in DLM-supplemented treatment on day 16 (p < .01). The birds fed with 0.35% Met supplemental diet displayed lower hepatic protein carbonylation on day 16 (p < .05). In conclusion, supplementation of 0.35% Met in the duck diet showed up-regulated HSP70 expression in small intestine and liver, which may provide new perspective to the mechanism of Met function. At the same time, DLM supplemented in diet may ameliorate oxidative status of liver, while HMTBA supplementation may partially improve the intestinal oxidative status of Peking ducks.

Expressions of matrix metalloproteinases 1 and 3 and their tissue inhibitors in the conjunctival tissue and fibroblasts cultured from conjunctivochalasis

AIM

To investigate the expression of matrix metalloproteinases 1 and 3 (MMP-1 and MMP-3) and their tissue inhibitors of metalloproteinases 1 and 3 (TIMP-1 and TIMP-3) in the conjunctiva of eyes with conjunctivochalasis (CCh).

METHODS

The conjunctival tissue was obtained from the CCh patients and controls, the MMPs/TIMPs expression concentration was determined by enzyme-linked immuno-sorbent assay (ELISA) and immunofluorescence staining. The expression levels of MMPs/TIMPs in the CCh fibro-blasts were determined by analyzing its concentration in the cellular supernatant that was abstracted from the in vitro cultured CCh fibroblasts.

RESULTS

MMP-1 and MMP-3 levels determined by ELISA were both significantly higher in the CCh group than that in the control group (P=0.042, 0.022, respectively), so was the levels of TIMP-1 (P=0.010). No significant difference in the expression of TIMP-3 in conjunctiva was found between the two groups (P=0.298). The expression of MMP-1 and MMP-3 were both up-regulated significantly in the CCh group (P=0.040, 0.001, respectively) on immuno-fluorescence staining. MMP-1 and MMP-3 expression in the fibroblasts were both significantly higher in the CCh group than that in the control group (P=0.027, 0.001, respectively), while neither the TIMP-1 nor TIMP-3 expression was significantly different between the two groups (P=0.421, 0.237, respectively).

CONCLUSION

The overexpression of MMP-1 and MMP-3 in conjunctival tissue and fibroblasts may play an important role in the pathogenesis and development of CCh.

[Efficiency and Kinetics of Triclosan Degradation in Aqueous Solution by UV/Sodium Persulfate]

UV activated sodium persulfate was employed to remove triclosan (TCS) in aqueous solution. The effects of several factors such as UV wavelength,UV₂₅₄ intensity,sodium persulfate dosage,pH value,and HA on TCS degradation were investigated. The second-order rate constants of free radicals (·OH, SO₄^·-) reacting with TCS and their contributions to TCS removal were determined,respectively. The dominant free radical was also identified. Furthermore, the TCS degradation efficiency in natural water by UV₂₅₄/SPS and UV₂₅₄/H₂O₂ was compared. Finally,the possible pathway and intermediate products of TCS degradation were analyzed with GC/MS. The results indicated that UV₂₅₄ activated sodium persulfate could effectively remove TCS. The removal rate of TCS could reach 98.15% within 100s under the conditions of UV wavelength of 254 nm,UV intensity of 11.5μW·cm^-2,sodium persulfate dosage of 1mmol·L^-1,and TCS initial concentration of 275 μg·L^-1. TCS degradation followed the pseudo-first-order kinetic model and the pseudo-first-order rate constant was determined to be 0.0392 s^-1. Pseudo-first-order rate constant for TCS degradation increased with the increase of UV₂₅₄ intensity(I)and sodium persulfate dosage within experiment ranges. The effect of UV wavelength on TCS removal was not notable. Neutral condition was detrimental to TCS degradation. TCS removal was inhibited in the presence of HA. The reaction rate constants for·OH and SO₄^·- reacting with TCS were 7.62×10⁹ L·mol^-1·s^-1 and 9.86×10⁹ L·mol^-1·s^-1,respectively. SO₄^·- was the dominant free radical and its contribution rate to TCS removal was 97.63% in UV₂₅₄/SPS system. The K value of UV₂₅₄/SPS was 4.13 times higher than that of UV₂₅₄/H₂O₂ process,which demonstrated that UV₂₅₄/SPS process could remove TCS more effectively than UV₂₅₄/H₂O₂. The main intermediate products found were 2,4-DCP and phenol in the degradation process of TCS in Milli-Q water by UV₂₅₄/SPS.

Might radiation therapy in addition to chemotherapy improve overall survival of patients with non-oligometastatic Stage IV non-small cell lung cancer?: Secondary analysis of two prospective studies

Background

The role of radiation therapy in addition to chemotherapy has not been well established in non-oligometastatic Stage IV non-small cell lung cancer (NSCLC). We aimed to investigate overall survival (OS) of non-oligometastatic Stage IV NSCLC treated with chemotherapy with concurrent radiation to the primary tumor.

Methods

Eligible patients were screened from two prospective studies. Oligometastatic and non-oligometastatic NSCLC were defined as having < 5 and ≥5 metastatic lesions, respectively. Prognostic factors for OS were identified by using univariate and multivariate analysis. Landmark analysis and propensity-score matching (PSM) were each performed to further adjust for confounding.

Results

A total of 274 patients were identified as the study cohort: 183 had non-oligometastatic disease. For all 274 patients, those who received a radiation dose ≥63 Gy to the primary tumor and had oligometastatic disease had better OS (P < 0.001 and P = 0.017, respectively). When patients were subdivided into those with oligometastatic or non-oligometastatic disease, a radiation dose ≥ 63 Gy remained a significant prognostic factor for better OS. For non-oligometastatic patients, multivariate analysis showed that receiving ≥63 Gy radiation, having a GTV <146 cm³, having response to chemotherapy, and having stable or increased post-treatment KPS independently predicted better OS (P = 0.018, P = 0.014, P = 0.014, and P = 0.001). After PSM in non-oligometastatic patients, a higher radiation dose (≥63 Gy) remained to be correlated with better OS. By landmark analysis, aggressive radiation (≥63 Gy) remained to be correlated with better OS in Pre-PSM cohort (P = 0.005) and Post-PSM cohort (P = 0.004).

Conclusions

Radiation dose, primary tumor volume, response to chemotherapy and KPS after treatment are associated with OS in patients with non-oligometastatic disease; on basis of effective system chemotherapy, aggressive thoracic radiotherapy may prolong OS.

Schwannomas of female genitalia from a gynaecologist's perspective: report of two cases and review of the literature

BACKGROUND

Pelvic schwannomas are extremely rare. However, when located in the pelvic cavity, schwannomas are often encountered by a gynaecologist, not a general surgeon, and are misdiagnosed as gynaecologic masses.

CASE REPORT

Here, the authors present two cases of pelvic schwannomas that were preoperatively misdiagnosed as broad ligament fibroid. One schwannoma occurred completely in the left broad ligament and was resected by laparoscopy without any complications. The other lesion was located in the retroperitoneum and had densely adhered to the surrounding tissues; this lesion was excised by laparotomy with considerable blood loss.

CONCLUSIONS

Schwannomas of female genitalia are very scarce and difficulty to diagnose preoperatively. Literature review revealed 63 schwannomas arising from the female genital tract in total, 73.02% (46 cases) were located in the lower genital tract, and 26.98% (17 cases) were located in upper genital tract. The treatment modality is unique depending on the location of the tumor. Complete excision is benefical for diagnosis and treatment. The procedure can be performed safely under laparoscopy.

Mechanism of rat osteosarcoma cell apoptosis induced by a combination of low-intensity ultrasound and 5-aminolevulinic acid in vitro

We investigated the killing effect of low-intensity ultrasound combined with 5-aminolevulinic acid (5-ALA) on the rat osteosarcoma cell line UMR-106. Logarithmic-phase UMR-106 cells were divided into a control group, ultrasound group and 5-ALA group. The cell apoptotic rate, production of reactive oxygen species, and the change in mitochondrial membrane potential were analyzed by flow cytometry; ultrastructural changes were observed by transmission electron microscopy. Using low-intensity ultrasound at 1.0 MHz and 2.0 W/cm(2) plus 5-ALA at a concentration of 2 mM, the apoptotic rate of the sonodynamic therapy group was 27.2 ± 3.4% which was significantly higher than that of the control group, ultrasound group, and 5-ALA group (P < 0.05). The production of reactive oxygen species was 32.6 ± 2.2% and the decrease in mitochondrial membrane potential was 39.5 ± 2.5%. The 33342 staining showed nuclear condensation and fragmentation in the ultrasound group and 5-ALA group. Structural changes in the cell membrane, mitochondria, Golgi apparatus, and other organelles observed by transmission electron microscopy included formation of apoptotic bodies. The killing effect of low-intensity ultrasound combined with 5-ALA on UMR-106 cells was significant. Cell apoptosis played a vital role in the killing effect, and the mitochondria pathway contributed to the apoptosis of UMR-106 cells.

[Removal of triclosan with the method of UV/ClO2 and its degradation products]

The UV/ClO2 process for triclosan ( TCS) removal was studied. The influences of several factors such as the initial pH, dose of ClO2, initial concentration of TCS and humic acid( HA) on TCS degradation in the UV/ClO2 combined process were discussed. The results showed that the UV/ClO2 process could effectively remove TCS and had a synergistic effect. When the light intensity was 6.5 μW x Cm(-2), the dose of ClO2 was 0. 5 mg x L(-1) and the concentration of TCS was 300 μg x L(-1), when UV and ClO2 were applied alone, the TCS removal rates within 1 min were only 5.23% and 84.93% respectively. The removal rate reached up to 99.13% after 1 min degradation using the UV/ClO2 combined process. In test conditions ( pH 6-9), the removal rate increased from 99.4% to 99. 63% with the increase of pH. Increasing dose of CIO2 could promote TCS removal. When the dose of ClO2 was 0.5-1.5 mg x L(-1), the removal rate was increased from 98.1% to 99.89%. The initial concentration of TCS was negatively correlated with the removal rate. When the initial concentration increased from 100 - 500 μg x L(-1), the removal rate of TCS was decreased from 99.98% to 94.39%. Low concentration of humic acid was beneficial to the removal of TCS, and high concentration of it had the opposite effect. Degradation products of TCS were investigated by GC/MS. Degradation of TCS by the processes of UV, ClO2 and UV/ClO2 also indicated that the main degradation products of the TCS were 2, 4-dichlorophenol (2,4-DCP), 2,7-dichlorodibenzo-p-dioxin (2,7-DCDD), etc.

The survival outcomes and prognosis of stage IV non-small-cell lung cancer treated with thoracic three-dimensional radiotherapy combined with chemotherapy

BACKGROUND

The impact of thoracic three-dimensional radiotherapy on the prognosis for stage IV non-small-cell lung cancer is unclear. This study is to investigate survival outcomes and prognosis in patients with stage IV non-small cell lung cancer (NSCLC) treated with thoracic three-dimensional radiotherapy and systemic chemotherapy.

METHODS

Ninety three patients with stage IV NSCLC had received at least four cycles of chemotherapy and thoracic three-dimensional radiotherapy of ≥40 Gy on primary tumors. The data from these patients were retrospectively analyzed.

RESULTS

Of the 93 patients, the median survival time (MST) was 14.0 months, and the 1, 2, and 3-year survival rates were 54.8%, 20.4%, and 12.9%, respectively. The MST of patients received radiation dose to primary tumor ≥63Gy and <63 Gy for primary tumor were 15.0 and 8.0 months, respectively (P = 0.001). Patients had metastasis to a single site and lower tumor volume (<170 cm(3)) also produced longer overall survival time (P = 0.002, P = 0.020, respectively). For patients with metastasis at a single site, thoracic radiation dose ≥63 Gy remained a prognostic factor for better overall survival (P = 0.030); patients with metastases at multiple sites, radiation dose ≥63 Gy had a trend to improve overall survival (P = 0.062). A multivariate analysis showed that radiation dose ≥63 Gy (P = 0.017) and metastasis to a single site (P = 0.038) are associated with better overall survival, and the volume of primary tumor was marginally correlated with OS (P = 0.054).

CONCLUSIONS

In combination with systemic chemotherapy, radiation dose ≥63 Gy on primary tumor and metastasis to a single site are significant factors for better OS, aggressive thoracic radiotherapy may have an important role in improving OS.

Prognosis of non-small cell lung cancer patients with bone oligometastases treated concurrently with thoracic three-dimensional radiotherapy and chemotherapy

Background

To evaluate the efficacy of three-dimensional radiotherapy for non-small cell lung cancer (NSCLC) patients with bone metastases.

Methods

Clinical data for 95 NSCLC patients with bone metastases were collected and prognostic factors were analyzed. All patients received radiation to their thoracic primary tumor and ≥2 cycles of chemotherapy.

Results

Of these 95 patients, 47 patients had only bone metastases and 48 had both bone metastases and other organ metastases. Univariate analysis showed that factors that statistically significantly contributed to patients having longer overall survival (OS) included receiving a radiation dose to the primary tumor ≥63 Gy, responding to treatment and receiving ≥4 cycles of chemotherapy (p = 0.001, p = 0.037 and p = 0.009, respectively). A radiation dose to the primary tumor ≥63 Gy remained significant for patients with bone metastases only as well as those with bone and other organ metastases when they were analyzed separately (p = 0.045 and p = 0.012, respectively). For patients with bone metastases only, those with T1-2 tumors had longer OS than those with T3-4 (p = 0.048); and patients who received ≥4 cycles chemotherapy compared with those who received <4 cycles had similar OS (p = 0.385). On multivariate analysis, only a radiation dose ≥63 Gy (p = 0.028) and having only bone metastases (p = 0.006) were independent prognostic factors for better OS.

Conclusions

A radiation dose to the primary tumor ≥63 Gy and having only bone metastases were associated with better OS in NSCLC patients with bone metastases. For patients with bone metastases only, besides radiation dose, T status was also correlated with OS, whereas the number of chemotherapy cycles was not. Therefore, aggressive thoracic radiation may play an important role in improving OS.

Overall survival and toxicities regarding thoracic three-dimensional radiotherapy with concurrent chemotherapy for stage IV non-small cell lung cancer: results of a prospective single-center study

Background

The role of chemotherapy given concurrently with thoracic three-dimensional radiotherapy for stage IV non-small cell lung cancer (NSCLC) is not well defined. We performed this study to investigate overall survival and toxicity in patients with stage IV NSCLC treated with this modality.

Methods

From 2003 to 2010, 201 patients were enrolled in this study. All patients received chemotherapy with concurrent thoracic three-dimensional radiotherapy. The study endpoints were the assessment of overall survival (OS) and acute toxicity.

Results

For all patients, the median survival time (MST) was 10.0 months, and the 1-, 2- and 3-year OS rates were 40.2%, 16.4%, and 9.6%, respectively. The MST was 14.0 months for patients who received a total radiation dose ≥63 Gy to the primary tumor, whereas it was 8.0 months for patients who received a total dose <63 Gy (P = 0.000). On multivariate analysis, a total dose ≥63 Gy, a single site of metastatic disease, and undergoing ≥4 cycles of chemotherapy were independent prognostic factors for better OS (P = 0.007, P = 0.014, and P = 0.038, respectively); radiotherapy involving metastatic sites was a marginally significant prognostic factor (P = 0.063). When the whole group was subdivided into patients with metastasis at a single site and multiple sites, a higher radiation dose to the primary tumor remained a significant prognostic factor for improved OS. For patients who received ≥4 cycles of chemotherapy, high radiation dose remained of benefit for OS (P = 0.001). Moreover, for the subgroup that received <4 chemotherapy cycles, the radiation dose was of marginal statistical significance regarding OS (P = 0.063). Treatment-related toxicity was found to be acceptable.

Conclusions

Radiation dose to primary tumor, the number of metastatic sites, and the number of chemotherapy cycles were independent prognostic factors for OS in stage IV NSCLC patients treated with concurrent chemoradiotherapy. In addition to systemic chemotherapy, aggressive thoracic radiotherapy was shown to play an important role in improving OS.

Trial registration

Registered on (ChiCTR-TNC-10001026)

Diameter-controlled synthesis of α-Mn2O3 nanorods and nanowires with enhanced surface morphology and optical properties

Single crystalline α-Mn(2)O(3) nanorods, and nanowires with and without nanoparticles on them have been successfully synthesized by a template-free hydrothermal route. The variation in hydrothermal temperature has not only affected the diameter of the nanostructure but also noticeably affected the morphology and optical properties of the α-Mn(2)O(3) nanostructure. The influence of temperature on the diameter, crystallinity, surface morphology and optical properties of the α-Mn(2)O(3) nanostructure have been characterized by x-ray diffraction, scanning electron microscopy, energy dispersive x-ray analysis, transmission electron microscopy, high resolution transmission electron microscopy, Raman spectroscopy and UV-visible spectroscopy and photoluminescent (PL) spectroscopy. The results showed in our experimental conditions that single crystalline nanorods of the α-Mn(2)O(3) were obtained at a temperature of 180 °C, while single crystalline nanowires were obtained by increasing the temperature to 240 and 300 °C. Nanowires with nanoparticles on them were obtained by increasing the temperature to 240 °C and nanowires without nanoparticles on them were obtained by increasing the temperature to 300 °C. The nanorods and nanowires obtained had a well-defined morphology. The nanowires synthesized at 300 °C exhibited an intense orange band PL spectrum.

WITHDRAWN: Discrimination of Parkinson-associated LRRK2 alleles by introduction of a single nucleotide mismatch into siRNA

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