[Serum glycocalyx markers in patients after cardiac arrest: association with outcomes]

Objective: To assess the levels of serum glycocalyx markers in the first 24 hours after cardiac arrest (CA) and investigate their relationship with 30-day outcomes. Methods: A retrospective cohort study was conducted on prospectively collected data from CA patients, who were admitted to the intensive care units of the Affiliated Hospital of Xuzhou Medical University and obtained return of spontaneous circulation for more than 24 hours between September 2021 and October 2022. Serum samples obtained at the 24-hour after CA were utilized to measure the levels of glycocalyx markers, including heparan sulfate (HS), hyaluronic acid (HA), and syndecan-1 (Sdc-1). Patients were allocated into good function (CPC1-2) and poor function (CPC3-5) groups on the basis of cerebral performance category (CPC) at 30 days post-CA. Logistic regression analysis was used to determine the association between serum glycocalyx markers and neurological outcomes. Patients were regrouped in light of 30-d mortality and Cox regression analysis was used to determine the association between serum glycocalyx markers and 30-d mortality. Results: A total of 71 patients were included in the study, including 31 (43.7%) females and 40 (56.3%) males, with an average age of (59.0±17.0) years. The poor function group (n=49) demonstrated significantly elevated levels of HS and HA when compared to the good function group (n=22) [HS: 2 461.0(1 623.0, 5 492.0) μg/L vs 1 492.0 (914.0, 2 550.0) μg/L, P=0.008; HA: 124.0(97.0, 365.0)μg/L vs 337.0(135.0, 1 421.0) μg/L, P=0.033]. Adjusted logistic regression analysis revealed that HS was independently associated with poor neurological outcome [odds ratio (OR)=0.389, 95% confidence interval (CI): 0.182-0.828, P=0.014]. In the 30-day mortality analysis, the death group (n=32) exhibited significantly higher levels of HS and HA when compared to the survival group (n=39) [HS: 1 880.0(1 011.0, 3 554.0) μg/L vs 2 500.0(1 726.0, 6 276.0) μg/L, P=0.027; HA: 162.0(99.0, 537.0) μg/L vs 813.0(148.0, 1 531.0) μg/L, P=0.025]. Adjusted Cox regression analysis indicated that elevated levels of HS and HA were independent risk factors (HS: HR=1.697, 95%CI: 1.126-2.557, P=0.011; HA: HR=1.336, 95%CI: 1.047-1.705, P=0.020) for 30-day mortality. Conclusions: High level of serum HS in 24 hours after CA may serve as a potential predictive marker for both neurological function and 30-day mortality. However, high level of serum HA appears to primarily predict 30-day mortality. Sdc-1 does not seem to contribute to outcome prediction.

Structures of strong shocks in low-density helium and neon gases

Strong shocks are essential components in many high-energy-density environments such as inertial confinement fusion implosions. However, the experimental measurements of the spatial structures of such shocks are sparse. In this paper, the soft x-ray emission of a shock front in a helium gas mixture (90% helium, 10% neon) and a pure neon gas was spatially resolved using an imaging spectrometer. We observe that the shock width in the helium mixture gas is about twice as large as in the pure neon gas. Moreover, they exhibit different precursor layers, where electron temperature greatly exceeds ion temperature, extending for more than ∼350µm with the helium gas mixture but less than 30µm in the pure neon. At the shock front, calculations show that the electrons are strongly collisional with mean-free path two orders of magnitude shorter than the characteristic length of the shock. However, the helium ions can reach a kinetic regime as a consequence of their mean-free path being comparable to the scale of the shock. A radiation-hydrodynamic simulation demonstrates the impact of thermal conduction on the formation of the precursors with charge state, Z, playing a major role in heat flow and the precursor formation in both the helium mixture and the pure neon gases. Particle-in-cell simulations are also performed to study the ion kinetic effects on the formation of the observed precursors. A group of fast-streaming ions is observed leading the shock only in the helium gas mixture. Both effects explain the longer precursor layer in the helium shock.

An application research for near-surface repository of strontium-90 sorption kinetic model on mudrocks

In this study,90Sr was used as the test radionuclide to characterize the sorption kinetics and effects of initial 90Sr activity and remaining 90Sr in solid concentration were simulated for a near-surface repository. The study focused on the sorption characteristics of radionuclides in unsaturated groundwater environment (or vadose zone) is the important information for investigating the near-surface disposal of intermediate and low-level radioactive waste (ILLW). Moreover, the 90Sr sorption experiments reached equilibrium within 56 h, which fit to the first order sorption kinetic model, and the remaining 90Sr in mudrock samples showed obvious sorption equilibrium hysteresis, which fit to the second order sorption kinetic model. Before reaching the maximum sorption capacity, the sorption rate constant increases with 90Sr increasing; the distribution coefficient (Kd) of 56 h decreases with the remaining 90Sr decreasing. In addition, it showed that the slow sorption process dominated before the sorption reaches equilibrium. In fact, a reliable safety assessment methodology for on-going near-surface repository required a lot of the radionuclides parameters with local environment including the radionuclides sorption/desorption rate constant and maximum sorption capacity.

[Analysis of early recurrence within 6 months in patients of esophageal squamous cell carcinoma after neoadjuvant therapy followed by surgery]

Objectives: To examine the prognosis factors of recurrence of esophageal carcinoma within 6 months after neoadjuvant therapy followd by surgery. Methods: The clinical data of 187 patients with esophageal squamous cell carcinoma who underwent neoadjuvant therapy followed by curative esophagectomy between January 2018 and April 2020 at Department of Thoracic Surgery, Shanghai Chest Hospital were analyzed retrospectively. There were 160 males and 27 females, aging (63.0±7.1) years (range:43 to 76 years). The t test, χ2 test and rank-sum test were used for univariate analysis of the prognosis factors for recurrence within 6 months postoperative, while the Logistic regression was used for multivariate analysis. Results: There were 30 patients (16.0%) developed recurrence within 6 months after operation, including local recurrence in 1 case, regional recurrence in 11 cases, hematogenous recurrence in 13 cases, and combined recurrence in 5 cases. Univariate analysis suggested that there was a significant difference in T staging of tumor before neoadjuvant therapy (cT), tumor regression grade, circumferential resection margin, pathological T stage (ypT) and pathological N stage (ypN) between the recurrence patients and non-recurrence patients (all P<0.05). Logistic regression analysis suggested that the cT3-4 (OR=2.701, 95%CI: 1.161 to 6.329, P=0.021) and ypN(+)(OR=1.654, 95%CI: 1.045 to 2.591, P=0.032) were the independent prognosis factors for recurrence within 6 months. Conclusion: The combination of neoadjuvant therapy and surgery is not effective in reducing early postoperative recurrence in patients who have invaded the epineurium before treatment, and still have positive lymph nodes after neoadjuvant therapy.

[Prone position thoracoscopic esophagectomy:preliminary experiences of thirty cases in Shanghai Chest Hospital]

Objective: To examine the safety and short-term outcomes of prone position thoracoscopic esophagectomy. Methods: Clinical data of consecutive thirty patients who accepted prone position thoracoscopic esophagectomy at Department of Thoracic Surgery, Shanghai Chest Hospital between July and December 2020 was analyzed retrospectively. There were 25 males and 5 females, aging 65.5(29.0) years (M(QR))(range: 48 to 82 years). Patients with cT3-4a accounted for 73.3%(22/30) and cN(+) accounted for 43.4%(18/30). All the patients in this study had no serious comorbidity, accepted prone position thoracoscopic esophagectomy. Results: No conversion to thoracotomy occurred. The overall time of operation was 210 (105) minutes (range: 130 to 268 minutes), the time of thoracic procedures was 92 (46) minutes (range: 72 to 136 minutes), the time of abdominal procedures was 32 (14) minutes (range: 20 to 48 minutes), respectively. R0 resection accounted for 93.3%(28/30), the negative ratio of circumferential margin was 96.7%(29/30). The number of lymph nodes dissection was 21.5(7.2) (range: 16.0 to 28.0) in total, 12.0(6.5) (range: 9.0 to 18.0) in thoracic lymph nodes, 2.0(1.5) (range: 1.0 to 5.0) in left recurrent laryngeal nerve lymph nodes, and 1.0(1.0) (range: 1.0 to 3.0) in right recurrent laryngeal nerve lymph nodes, respectively. There was no perioperative death, and the overall postoperative complication rate was 43.3%(13/30). The incidence of anastomotic leakage was 10.0%(3/30), recurrent laryngeal nerve paralysis was 26.7%(8/30), and respiratory complication was 6.7%(2/30). The postoperative hospital stay was 10 (9) days (range: 5 to 42 days). Conclusion: Prone position thoracoscopic esophagectomy is safe and feasible, and the short-term outcomes is satisfactory.

[Preliminary results of Chinese magnetic sphincter augmentation in treating gastroesophageal reflux disease]

Objective: To examine the preliminary clinical efficacy of Chinese magnetic sphincter augmentation (MSA) in the treatment of gastroesophageal reflux disease (GERD). Methods: According to the enrollment criteria for the MSA developed by ShengJieKang Co. and Shanghai Chest Hospital (SS-MSA) clinical trial, a total of 19 GERD patients were treated with SS-MSA from August 2018 to January 2020 at Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University. The majority of registered cases were male patients with age of (32.2±7.3) years (range: 22 to 50 years), height of (170.7±6.2) cm (range: 160 to 179 cm) and weight of (65.2±10.3) kg (range: 47.5 to 90.0 kg). SS-MSA was implanted via laparoscopy. The major evaluation indexs of postoperative efficacy were the total time of acid exposure within 24 hours and the total number of reflux. Secondary efficacy indicators included: (1) evaluation of the average daily dose of proton pump inhibitor medications; (2) the score of GERD health related quality of life questionnaire (GERD-Q) before and after MSA implantation. Paired design t-test was used to evaluate the efficacy of the SS-MSA. Results: A total of 19 patients underwent SS-MSA surgery successfully. The history of the GERD were 19 (54) months (M(Q(R))). The operation time was 63 (22) minutes and the in-hospital stay was 3 (2) days. No obvious surgical complications occurred. Postoperative adverse events included 14 cases with mild to moderate dysphagia exited after surgery, gradually eased within 1 to 3 months, 1 case with the removal of the device after 1 month of severe swallowing difficulties, 1 case of diarrhea. No corrosion, perforation, displacement occurred. The GERD-Q score (11.0(4.5) vs. 6(1.0), t=4.274, P=0.013), 24-hour acid exposure time (6.2(4.8)% vs. 0.1(0.9)%, t=5.814, P=0.004), and Demeester score (23.72(16.20) vs. 0.96(3.10), t=6.678, P=0.003) were significantly decreased 1 year after surgery(n=5). Proton pump inhibitor reuse rates were 6/18, 5/15, 3/10, and 1/5 in 1, 3, 6 and 12 months after the operation, respectively. Conclusions: SS-MSA implantation is feasible and safe with short hospital stay and rare perioperative complications. The preliminary results is good after 1 year follow-up. It could be expected to be an ideal substitutive for future GERD treatment.

Short- and mid-term outcomes of robotic versus thoraco-laparoscopic McKeown esophagectomy for squamous cell esophageal cancer: a propensity score-matched study

Controversy exists on the advantages of robotic McKeown esophagectomy (RME) versus thoraco-laparoscopic McKeown esophagectomy (TLME). The aim was to evaluate the short- and mid-term outcomes of RME and TLME in the treatment of patients with esophageal squamous cell carcinoma (ESCC). A consecutive series of 652 patients, 280 in RME and 372 in TLME, who underwent minimally invasive McKeown esophagectomy for ESCC at our department from November 2015 to June 2018 was analyzed. A propensity score-matched comparison with clinicopathological covariates was performed between the two groups. Complications were categorized based on the Esophagectomy Complications Consensus Group (ECCG) recommendation. To identify the recurrence, all patients with R0 resection were followed with a median follow-up period of 20.2 months (range 1-33 months). After propensity score matching, 271 patients were identified for each cohort. In the matched cohorts, two patients died within 90 days in TLME, whereas no patients died in RME. RME was associated with similar intraoperative blood loss (P = 0.895), but with shorter surgical duration (244.5 vs. 276.0 min, P < 0.001), shorter thoracic duration (85.0 vs. 102.9 min, P < 0.001) and lower thoracic conversions (0.7% vs. 5.9%, P = 0.001). In spite of the similar results on total and thoracic lymph nodes dissection, RME yielded more lymph nodes along recurrent laryngeal nerve (4.8 vs. 4.1, P = 0.012), as well as the higher incidence of recurrent nerve injury (29.2% vs. 15.1%, P < 0.001) when compared to TLME. Tumor recurrence occurred in 30 patients and was locoregional only in 9 (3.5%) patients, systemic only in 17 (6.7%) patients, and combined in 4 (1.6%) patients in RME, while in 26 patients and was locoregional only in 10 (10.6%) patients, systemic only in 7 (2.8%) patients, and combined in 9 (3.6%) patients in TLME. RME was associated with a lower rate of mediastinal lymph nodes recurrence (2.0% vs. 5.3%, P = 0.044). Overall and disease-free survival was not different between the two cohorts (P = 0.097 and P = 0.248, respectively). RME was shown to be a safe and oncologically effective approach with favorable short- and mid-term outcomes in the treatment of patients with ESCC.

Self-Generated Magnetic and Electric Fields at a Mach-6 Shock Front in a Low Density Helium Gas by Dual-Angle Proton Radiography

Shocks are abundant both in astrophysical and laboratory systems. While the electric fields generated at shock fronts have recently attracted great attention, the associated self-generated magnetic field is rarely studied, despite its ability to significantly affect the shock profile in the nonideal geometry where density and temperature gradients are not parallel. We report here the observation of a magnetic field at the front of a Mach ∼6 shock propagating in a low-density helium gas system. Proton radiography from different projection angles not only confirms the magnetic field's existence, but also provides a quantitative measurement of the field strength in the range ∼5 to 7 T. X-ray spectrometry allowed inference of the density and temperature at the shock front, constraining the plasma conditions under which the magnetic and electric fields are generated. Simulations with the particle-in-cell code lsp attribute the self-generation of the magnetic field to the Biermann battery effect (∇n_{e}×∇T_{e}).

[Experiences of esophageal replacement with ileocolon graft: a series of 34 cases]

Objective: To evaluate the safety and effectiveness of esophageal replacement with ileocolon graft. Methods: Totally 34 cases of esophageal replacement with ileocolon graft from July 2015 to November 2017 at Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University were analyzed retrospectively, including 24 male and 10 female, aging from 7 to 72 years old. Esophageal replacement with ileocolon graft by right and/or middle colic artery as a blood supply using retrosternal route except one subcutaneous route. The primary esophageal disease, postoperative complication rate and quality of life were analyzed. Results: The overall postoperative complication rate was 23.5% (8/34), cervical anastomotic leakage rate of 5.9% (2/34), necrosis of colon graft of 5.9% (2/34). There were 3 patients experienced re-operation including 2 patients with colon graft necrosis and 1 patient with intestinal obstruction after ERC. One patient with colon graft necrosis died of septic shock after reoperation. Six cases of cervical esophago-jejunal anastomosis stenosis and 1 case of diarrhea occurred in the later time. All patients were followed up for a median time of 9 months (range: 1 to 28 months), 32 cases survived but 1 patient died until last follow-up by the end of December 2017. Conclusion: Esophageal replacement with ileocolon graft by right and/or middle colic artery as a blood supply using retrosternal route was safe and effective.

Experimental evidence for the enhanced and reduced stopping regimes for protons propagating through hot plasmas

Our understanding of the dynamics of ion collisional energy loss in a plasma is still not complete, in part due to the difficulty and lack of high-quality experimental measurements. These measurements are crucial to benchmark existing models. Here, we show that such a measurement is possible using high-flux proton beams accelerated by high intensity short pulse lasers, where there is a high number of particles in a picosecond pulse, which is ideal for measurements in quickly expanding plasmas. By reducing the energy bandwidth of the protons using a passive selector, we have made proton stopping measurements in partially ionized Argon and fully ionized Hydrogen plasmas with electron temperatures of hundreds of eV and densities in the range 1020-1021 cm-3. In the first case, we have observed, consistently with previous reports, enhanced stopping of protons when compared to stopping power in non-ionized gas. In the second case, we have observed for the first time the regime of reduced stopping, which is theoretically predicted in such hot and fully ionized plasma. The versatility of these tunable short-pulse laser based ion sources, where the ion type and energy can be changed at will, could open up the possibility for a variety of ion stopping power measurements in plasmas so long as they are well characterized in terms of temperature and density. In turn, these measurements will allow tests of the validity of existing theoretical models.

Thermal conductivity measurements of proton-heated warm dense aluminum

Thermal conductivity is one of the most crucial physical properties of matter when it comes to understanding heat transport, hydrodynamic evolution, and energy balance in systems ranging from astrophysical objects to fusion plasmas. In the warm dense matter regime, experimental data are very scarce so that many theoretical models remain untested. Here we present the first thermal conductivity measurements of aluminum at 0.5–2.7 g/cc and 2–10 eV, using a recently developed platform of differential heating. A temperature gradient is induced in a Au/Al dual-layer target by proton heating, and subsequent heat flow from the hotter Au to the Al rear surface is detected by two simultaneous time-resolved diagnostics. A systematic data set allows for constraining both thermal conductivity and equation-of-state models. Simulations using Purgatorio model or Sesame S27314 for Al thermal conductivity and LEOS for Au/Al release equation-of-state show good agreement with data after 15 ps. Discrepancy still exists at early time 0–15 ps, likely due to non-equilibrium conditions.

A broadband proton backlighting platform to probe shock propagation in low-density systems

A proton backlighting platform has been developed for the study of strong shock propagation in low-density systems in planar geometry. Electric fields at the converging shock front in inertial confinement fusion implosions have been previously observed, demonstrating the presence of-and the need to understand-strong electric fields not modeled in standard radiation-hydrodynamic simulations. In this planar configuration, long-pulse ultraviolet lasers are used to drive a strong shock into a gas-cell target, while a short-pulse proton backlighter side-on radiographs the shock propagation. The capabilities of the platform are presented here. Future experiments will vary shock strength and gas fill, to probe shock conditions at different Z and T_e.

Influence of plasma exchange on transplantation related immune function in patients with liver failure

This study aimed to evaluate the influence of plasma exchange (PE) treatment of patients with liver failure on the patient's immune function, including peripheral blood T lymphocytes and cytokines. Patients accepting PE for liver failure from October 2011 to February 2012 were included prospectively in the research group. Peripheral blood samples were collected at set time points. The percentages of T lymphocyte subtypes were detected by flow cytometry using different fluorescence labels including CD3-FITC, CD4-PerCP, CD8-PE, CD25-FITC, and Foxp3-PE. Changes in serum IL-17 concentration were followed by ELISA. In all fifteen patients who accepted PE, the percentages of CD3(+) and CD8(+) T cells increased immediately after the procedure and then reduced gradually. These significant changes were confirmed by statistical analysis (P < 0.05). The percentage of CD4(+) T cells also increased after PE to a certain extent, but failed to show statistical significance. The positive ratio of CD4(+)CD25(+)Foxp3(+) T cells (Treg) increased after the treatment with statistical difference (P < 0.05). The concentration of IL-17 in patient serum increased significantly following PE treatment (P < 0.05). These results demonstrated that T lymphocyte subgroups of patients with liver failure could be influenced after PE treatment, and that cellular immunity could be recovered. PE treatment, therefore, can be viewed as providing reliable protection for the reconstruction of the patient immune system.

The role of 3D computed tomography (CT) imaging in the diagnosis of foreign body aspiration in children

OBJECTIVE

The aim of this study was to improve the understanding of FBA in children and to decrease the rate of misdiagnosis, missed diagnosis and morbidity.

PATIENTS AND METHODS

We analyzed the clinical features and the three-dimensional reconstructed CT images of 590 children with foreign body aspiration (FBA) in the Xuzhou area of the Jiangsu province.

RESULTS

CT imaging revealed common complications of FBA including emphysema (n = 379), pneumonia (n = 174), and atelectasis (n = 26). The remaining 120 patients had no visible complications on the three-dimensional reconstructed CT images. Serious complications including pneumothorax, pneumomediastinum, subcutaneous emphysema, pneumatorrhachis could also be observed. The types of foreign bodies were diverse: the most common were peanuts and sunflower seeds. The diagnostic accuracy of the three-dimensional CT imaging was high, with a sensitivity and specificity of 99.83% and 99.89%, respectively.

CONCLUSIONS

3D CT imaging is an accurate, non-invasive technique to evaluate children with suspected FBA that can help decrease the rate of misdiagnosis and eliminate a delay in treatment for this potentially life-threatening condition.

A novel long non-coding RNA ENST00000480739 suppresses tumour cell invasion by regulating OS-9 and HIF-1α in pancreatic ductal adenocarcinoma

BACKGROUND

Invasion and metastasis are the distinct biologic characteristics of cancer, resulting in an exceptionally low 5-year survival rate in pancreatic ductal adenocarcinoma (PDAC). Understanding in detail the mechanisms underlying PDAC metastasis is critical for prevention and effective interventions. Long non-coding RNAs (lncRNAs) have been documented as having a critical role in cancer development and progression.

METHODS

We examined the expression levels of lncRNA ENST00000480739 and osteosarcoma amplified-9 (OS-9) mRNA in a cohort of 35 PDAC patients. Cell proliferation, invasion and migration were examined with and without ENST00000480739 overexpression in PDAC cells.

RESULTS

We determined that the ENST00000480739 expression level was remarkably decreased in tumorous tissues compared with their corresponding non-tumorous tissues. The expression of ENST00000480739 was negatively associated with tumour node metastasis stage and lymph node metastasis. In addition, ENST0000048073 was an independent prognostic factor of survival time in PDAC patients following surgery. Besides, enforced expression of ENST00000480739 suppressed PDAC cells' invasion in vitro. Overexpression of ENST00000480739 significantly increased both mRNA and protein levels of OS-9, and the luciferase assays confirmed that ENST00000480739 positively regulates OS-9 by activating the transcription level of the OS-9 promoter. We further found that ENST00000480739 may target hypoxia-inducible factor-1α (HIF-1α) expression by upregulating OS-9.

CONCLUSIONS

These findings suggest that the frequently downregulated ENST00000480739 in PDAC contributes to tumour metastasis and progression by regulating HIF-1α. Long non-coding RNA ENST00000480739 may provide not only a therapeutic potential to suppress metastasis but it may also be a novel biomarker for risk prognostication and personal therapy screening of PDAC patients.

Spinal toll-like receptor 4-mediated signalling pathway contributes to visceral hypersensitivity induced by neonatal colonic irritation in rats

BACKGROUND

Although visceral hypersensitivity is a major pathophysiological feature of irritable bowel syndrome (IBS), its underlying mechanisms remain elusive. Toll-like receptor 4 (TLR4) is a critical pattern recognition molecule of the innate immune system. In this study, we investigated whether the TLR4/myeloid differentiation factor 88 (MyD88)/nuclear factor-kappa B (NF-κB) signalling pathway in the spinal cord contributed to the visceral hypersensitivity induced by neonatal colonic irritation (CI) in rats.

METHODS

The Sprague-Dawley rat model of IBS was induced by colon irritation on post-natal day (PND) 8, PND10 and PND12. Experiments were conducted in adult rats. TLR4 mRNA and protein, and its downstream signalling molecules, MyD88, inhibitory nuclear factor-kappa B (IκB) and NF-κB protein expressions in L2-S4 spinal segments were detected by quantitative real-time reverse transcription-polymerase chain reaction as well as Western blotting. TLR4 co-localization was determined by immunohistochemistry. Levels of tumour necrosis factor-alpha (TNF-α) and interleukin 1β (IL-1β) were measured with enzyme-linked immunosorbent assay.

RESULTS

We found that neonatal CI treatment induced long-lasting visceral hypersensitivity without identifiable structural abnormalities in descending colons of adult rats. Neonatal CI treatment evoked a significant up-regulation of the expressions of TLR4 in glia, MyD88, p-IκB-α and NF-κB in adult rats. Neonatal CI treatment also increased the levels of its downstream inflammatory agents TNF-α and IL-1β in the L2-S4 regions of the spinal cord of adult rats.

CONCLUSIONS

These results suggest that neonatal CI stimulates the production of IL-1β and TNF-α through the TLR4/MyD88/NF-κB signalling pathway in the spinal cord, which contributed to visceral hypersensitivity induced by neonatal CI in rats.

First report of primary pancreatic natural killer/T-cell nasal type lymphoma

BACKGROUND

Primary pancreatic lymphoma (PPL) is an extremely rare form of extranodal malignant lymphoma and pancreatic tumour. Natural killer/T-cell lymphoma is an aggressive rare form extranodal lymphoma with a predilection for the nasal cavity/nasopharynx, it can arise in other organs such as skin, testicles, spleen, adrenal, or GI tract, but the initial presentation of our patient in the pancreas is unreported.

CASE PRESENTATION

We present a case of primary pancreatic natural killer/T-cell nasal type lymphoma in a 62-year-old man. The presenting symptoms were non-specific only for upper abdominal pain and weight loss. Imaging techniques showed the lesion was located in the head of pancreas. Computed tomography (CT) scanning and otorhinolaryngology examination were negative for nasopharyngeal lymphoma. The initial concern was for pancreatic tumor and the patient underwent pancreaticoduodenectomy. The diagnosis of primary pancreatic natural killer/T-cell nasal type lymphoma was established as the combination of NK-lineage antigens (TIA-1, granzyme B, CD56) with EBV-expression.

CONCLUSIONS

This is the first case of primary pancreatic natural killer (NK)/T-cell nasal type lymphoma. PPL, although a rare pathologic entity, should be considered in the differential diagnosis for a large homogeneous mass with extrapancreatic extension in the head especially in those of normal serum CA 19-9 level.

Analysis of the causes and types of traumatic spinal cord injury based on 561 cases in China from 2001 to 2010

OBJECTIVES

A remarkable increase in traumatic spinal cord injury (TSCI) morbidity has occurred in China from 2001 to 2010 due to rapid industrial and economic development; this increase seriously threatens public health. The current study investigated the major causes and severity of TSCI in 561 hospitalized TSCI patients who came from all over China to the General Hospital of Chinese People's Armed Police Forces.

METHODS

Information (including each patient's age, gender, time and cause of injury and severity of spinal cord injury (SCI, complete or incomplete)) regarding 561 hospitalized TSCI patients whose injuries occurred between 2001 and 2010 was retrospectively analyzed.

RESULTS

Among the 561 patients, the youngest was 9 months old and the oldest was 67 years old; the average patient age was 34.74 ± 12.24 years. The sex ratio was 4.1:1 (male:female). The injuries were primarily caused by transportation accidents (51.2%), falling from a height (23.9%), tamping (8.6%), stumbling (8.0%), stabbing (3.0%) and crushing (1.8%). Although no statistically significant associations were observed between the different injury causes and severity of the injury, a statistically significant association was observed between the different injury causes and levels of the lesion.

CONCLUSION

Transportation accidents, falling from a height, tamping, stumbling, stabbing and crushing are the most common causes of TSCI. No statistically significant relationships were observed between certain injury causes and either complete or incomplete injury. However, different injury causes usually led to different levels of the lesion. No statistical differences were observed between the levels of the lesion and either complete or incomplete injury.

The betaine-GABA transporter (BGT1, slc6a12) is predominantly expressed in the liver and at lower levels in the kidneys and at the brain surface

The Na+- and Cl−-dependent GABA-betaine transporter (BGT1) has received attention mostly as a protector against osmolarity changes in the kidney and as a potential controller of the neurotransmitter GABA in the brain. Nevertheless, the cellular distribution of BGT1, and its physiological importance, is not fully understood. Here we have quantified mRNA levels using TaqMan real-time PCR, produced a number of BGT1 antibodies, and used these to study BGT1 distribution in mice. BGT1 (protein and mRNA) is predominantly expressed in the liver (sinusoidal hepatocyte plasma membranes) and not in the endothelium. BGT1 is also present in the renal medulla, where it localizes to the basolateral membranes of collecting ducts (particularly at the papilla tip) and the thick ascending limbs of Henle. There is some BGT1 in the leptomeninges, but brain parenchyma, brain blood vessels, ependymal cells, the renal cortex, and the intestine are virtually BGT1 deficient in 1- to 3-mo-old mice. Labeling specificity was assured by processing tissue from BGT1-deficient littermates in parallel as negative controls. Addition of 2.5% sodium chloride to the drinking water for 48 h induced a two- to threefold upregulation of BGT1, tonicity-responsive enhancer binding protein, and sodium- myo-inositol cotransporter 1 (slc5a3) in the renal medulla, but not in the brain and barely in the liver. BGT1-deficient and wild-type mice appeared to tolerate the salt treatment equally well, possibly because betaine is one of several osmolytes. In conclusion, this study suggests that BGT1 plays its main role in the liver, thereby complementing other betaine-transporting carrier proteins (e.g., slc6a20) that are predominantly expressed in the small intestine or kidney rather than the liver.

Uterine stretch and progesterone action

CONTEXT

Progesterone administration reduces the risk of preterm labor in high-risk women with singleton pregnancies but has no effect in women with a multiple pregnancy.

OBJECTIVE

We investigated whether progesterone is able to inhibit stretch-induced gene expression and/or whether stretch in turn inhibits progesterone action, perhaps providing an explanation for the functional progesterone withdrawal associated with human labor.

METHODS AND RESULTS

In a series of in vitro studies using primary cultures of human myometrial cells, we found that preincubation with progesterone did not block stretch-induced ERK1/2 activation and cyclooxygenase-2 mRNA expression. Furthermore, we found that stretch did not alter the ability of progesterone to: 1) modulate progesterone-responsive gene expression; 2) activate a luciferase-linked progesterone response element; or 3) repress IL-1β-driven cyclooxygenase-2 mRNA expression. We did find that stretch reduced the expression of progesterone receptor mRNA via nuclear factor κB activation but that this did not alter myometrial progesterone response.

CONCLUSION

These data show that progesterone does not inhibit stretch-induced MAPK activation or gene expression, possibly explaining why progesterone is ineffective in the prevention of preterm labor in multiple pregnancy. Although stretch did reduce progesterone receptor expression in a nuclear factor κB-dependent manner, this was not sufficient to inhibit progesterone action, suggesting that it is not responsible for the functional progesterone withdrawal observed with the onset of human labor.

Deletion of the betaine-GABA transporter (BGT1; slc6a12) gene does not affect seizure thresholds of adult mice

Gamma-aminobutyric acid (GABA) is the major inhibitory neurotransmitter in the mammalian brain. Once released, it is removed from the extracellular space by cellular uptake catalyzed by GABA transporter proteins. Four GABA transporters (GAT1, GAT2, GAT3 and BGT1) have been identified. Inhibition of the GAT1 by the clinically available anti-epileptic drug tiagabine has been an effective strategy for the treatment of some patients with partial seizures. Recently, the investigational drug EF1502, which inhibits both GAT1 and BGT1, was found to exert an anti-convulsant action synergistic to that of tiagabine, supposedly due to inhibition of BGT1. The present study addresses the role of BGT1 in seizure control and the effect of EF1502 by developing and exploring a new mouse line lacking exons 3-5 of the BGT1 (slc6a12) gene. The deletion of this sequence abolishes the expression of BGT1 mRNA. However, homozygous BGT1-deficient mice have normal development and show seizure susceptibility indistinguishable from that in wild-type mice in a variety of seizure threshold models including: corneal kindling, the minimal clonic and minimal tonic extension seizure threshold tests, the 6Hz seizure threshold test, and the i.v. pentylenetetrazol threshold test. We confirm that BGT1 mRNA is present in the brain, but find that the levels are several hundred times lower than those of GAT1 mRNA; possibly explaining the apparent lack of phenotype. In conclusion, the present results do not support a role for BGT1 in the control of seizure susceptibility and cannot provide a mechanistic understanding of the synergism that has been previously reported with tiagabine and EF1502.

Ultrafast noncollinear optical parametric chirped pulse amplification in KTiOAsO4

Amplification of femtosecond pulses at 1.56 microm based on noncollinear parametric chirped pulse amplification in a potassium titanyl arsenate (KTA) crystal with pumping at 1.05 microm is reported. The 100 fs pulses of an erbium fiber laser are parametrically amplified while synchronously pumped by an amplified mode-locked Nd:YLF laser. This amplifier has a saturated gain of 65 dB with 30% conversion efficiency and has produced 160 fs pulses with peak powers of up to 0.75 GW. The system produced 380 mW before compression and can be readily scaled to the multiwatt range with bandwidths to support sub-100 fs pulses.

[Analysis of the contents of Zn, Cu, Fe, Mn and Ni in suxiaoweiningchongji]

The contents of Zn, Cu, Fe, Mn and Ni in five groups of Suxiaoweiningchongii were determined by AAS. The results showed that he Fe content is the highest and Cu is the lowest, and the reduced order of contents from highest to lowest is Fe to Zn to Mn to Ni to Cu. The relationship between the trace elements in Suxiaoweiningchongji and the curative effect was discussed.

Versatile, compact, TEM(00)-mode resonator for side-pumped single-rod solid-state lasers

We propose the use of an auxiliary lens or mirror to design a compact dynamically stable resonator for single-rod lasers. It was found that an intracavity divergent element (divergent lens or convex mirror) is suitable for obtaining a large TEM(00)-mode volume, whereas a convergent one renders the resonator insensitive to mechanical misalignment. A reliable and compact dynamically stable resonator can be designed conveniently by use of such characteristics. Both three- and four-element resonators were designed and tested with a laser-diode side-pumped Nd:YAG laser.

[Contents analysis of zinc, manganese, copper and iron in 7 kinds of treatment gastritis Chinese traditional medicines]

The contents of Zn, Mn, Cu and Fe in 7 kinds of treatment gastritis Chinese traditional medicines are determined by FAAS. The results show that element Fe in medicines is very rich, but element Cu is lower. The relationship between trace elements and the factor that causes gastritis is discussed. It provides useful reference data for discussing the relations of trace elements and treatment of gastroenteritis.

[Determination of trace elements Fe, Cr, Co and Ni in serum of middle-aged and aged people with slight and severe diabetes]

The contents of trace elements Fe, Cr, Co and Ni in serum of middle-aged and aged people with slight and severe diabetes were determined and compared with the control group. The results showed that the concentrations of Fe and Cr of the case groups were lower than those of the control group, and there was a significant difference between the two case groups (P < 0.01). The content of Ni was lowered during the initial stage of diabetes, and changed into normal gradually. There was significant difference between group of higher blood sugar and the control group (P < 0.05), and even more significant difference between the two case groups(P < 0.01). The content of Co rose with the patient's condition worsened, but there was no statistical significance (P < 0.05).

[Analysis of 4 metal elements in 11 kidney tonic Chinese traditional medicines]

The contents of Zn, Cd, K and Na in 11 kidney tonic Chinese traditional medicines usually used in clinical practice were determined by FAAS. The results showed that element Zn, which is closely related to yang deficiency of the kidney, and the macro elements K and Na, which are essential to human-body, are very rich, but element Cd is lower. The relations between trace elements and the therapeutic efficacy were discussed, and it is concluded that the results are in agreement with clinical usage of medicines by herbalists.

Cardiac hemangioendothelioma

A 42-year-old man with a rare huge primary cardiac hemangioendothelioma that arose from the right atrium is reported. With review of literature, the pathological character, the diagnostic images given by transesophageal echocardiography and magnetic resonance imaging and surgical treatment are discussed.