[Estimation of COVID-19 incidence in Shanghai under optimized epidemic prevention and control strategies]

Objective: To quantitatively estimate the incidence of COVID-19 in different backgrounds, including vaccination coverage, non-pharmacological interventions (NPIs) measures, home quarantine willingness and international arrivals, and the demands of healthcare resource in Shanghai in the context of optimized epidemic prevention and control strategies. Methods: Based on the natural history of 2019-nCoV, local vaccination coverage and NPI performance, an age-structured Susceptible-Exposed-Infections-Removed (SEIR) epidemic dynamic model was established for the estimation of the incidence of COVID-19 and demand of hospital beds in Shanghai by using the data on December 1, 2022 as the basis. Results: Based on current vaccination coverage, it is estimated that 180 184 COVID-19 cases would need treatment in hospitals in Shanghai within 100 days. When the booster vaccination coverage reaches an ideal level, the number of the cases needing hospitalization would decrease by 73.20%. School closure or school closure plus workplace closure could reduce the peak demand of regular beds by 24.04% or 37.73%, respectively, compared with the situation without NPI. Increased willingness of home quarantine could reduce the number of daily new cases and delay incidence peak of COVID-19. The number of international arrivals has little impact on the development of the epidemic. Conclusions: According to the epidemiological characteristics of COVID-19 and the actual situation of vaccination in Shanghai, the incidence of COVID-19 and health resource demand might be reduced by increasing vaccination coverage and early implementation of NPI.

[Observational study on perioperative outcomes of pelvic exenteration]

Objective: To investigate the surgical indications and perioperative clinical outcomes of pelvic exenteration (PE) for locally advanced, recurrent pelvic malignancies and complex pelvic fistulas. Methods: This was a descriptive study.The indications for performing PE were: (1) locally advanced, recurrent pelvic malignancy or complex pelvic fistula diagnosed preoperatively by imaging and pathological examination of a biopsy; (2)preoperative agreement by a multi-disciplinary team that non-surgical and conventional surgical treatment had failed and PE was required; and (3) findings on intraoperative exploration confirming this conclusion.Contraindications to this surgical procedure comprised cardiac and respiratory dysfunction, poor nutritional status,and mental state too poor to tolerate the procedure.Clinical data of 141 patients who met the above criteria, had undergone PE in the Sixth Affiliated Hospital of Sun Yat-sen University from January 2018 to September 2022, had complete perioperative clinical data, and had given written informed consent to the procedure were collected,and the operation,relevant perioperative variables, postoperative pathological findings (curative resection), and early postoperative complications were analyzed. Results: Of the 141 included patients, 43 (30.5%) had primary malignancies, 61 (43.3%) recurrent malignancies, 28 (19.9%) complex fistulas after radical resection of malignancies,and nine (6.4%)complex fistulas caused by benign disease. There were 79 cases (56.0%) of gastrointestinal tumors, 30 cases (21.3%) of reproductive tumors, 16 cases (11.3%) of urinary tumors, and 7 cases (5.0%) of other tumors such mesenchymal tissue tumors. Among the 104 patients with primary and recurrent malignancies, 15 patients with severe complications of pelvic perineum of advanced tumors were planned to undergo palliative PE surgery for symptom relief after preoperative assessment of multidisciplinary team; the other 89 patients were evaluated for radical PE surgery. All surgeries were successfully completed. Total PE was performed on 73 patients (51.8%),anterior PE on 22 (15.6%),and posterior PE in 46 (32.6%). The median operative time was 576 (453,679) minutes, median intraoperative blood loss 500 (200, 1 200) ml, and median hospital stay 17 (13.0,30.5)days.There were no intraoperative deaths. Of the 89 patients evaluated for radical PE surgery, the radical R0 resection was achieved in 64 (71.9%) of them, R1 resection in 23 (25.8%), and R2 resection in two (2.2%). One or more postoperative complications occurred in 85 cases (60.3%), 32 (22.7%)of which were Clavien-Dindo grade III and above.One patient (0.7%)died during the perioperative period. Conclusion: PE is a valid option for treating locally advanced or recurrent pelvic malignancies and complex pelvic fistulas.

Broadband photoresponse arising from photo-bolometric effect in quasi-one-dimensional Ta2Ni3Se8

In this paper, we report the synthesis of high-quality Ta₂Ni₃Se₈crystals free of noble or toxic elements and the fabrication and testing of photodetectors on the wire samples. A broadband photoresponse from 405 nm to 1550 nm is observed, along with performance parameters including relatively high photoresponsivity (10 mA W^-1) and specific detectivity (3.5 × 10⁷Jones) and comparably short response time (τ_rise= 433 ms,τ_decay= 372 ms) for 1064 nm, 0.5 V bias and 1.352 mW mm^-2. Through extensive measurement and analysis, it is determined that the dominant mechanism for photocurrent generation is the photo-bolometric effect, which is believed to be responsible for the very broad spectral detection capability. More importantly, the pronounced response to 1310 nm and 1550 nm wavelengths manifests its promising applications in optical communications. Considering the quasi-one-dimensional structure with layered texture, the potential to build nanodevices on Ta₂Ni₃Se₈makes it even more important in future electronic and optoelectronic applications.

MiR-29 inhibits neuronal apoptosis in rats with cerebral infarction through regulating Akt signaling pathway

OBJECTIVE

The aim of this study was to explore the influence of micro ribonucleic acid (miR)-29 on neuronal apoptosis in rats with cerebral infarction by regulating the protein kinase B (Akt) signaling pathway.

MATERIALS AND METHODS

A total of 36 Sprague-Dawley rats were randomly divided into three groups, including: Sham group (n=12), Model group (n=12), and Inhibitor group (n=12). Common carotid artery, external carotid artery, and internal carotid artery were only exposed in the Sham group. However, the ischemia-reperfusion model was established by the suture method in the other two groups. After modeling, artificial cerebrospinal fluid was injected into the lateral ventricle in the rats of the Sham and Model groups. Similarly, miR-29 inhibitor was injected into the lateral ventricle in the rats of the Inhibitor group. At 24 h postoperatively, the sampling was performed. Zea-Longa score was used to evaluate the neurological deficit of rats. Meanwhile, the expressions of B-cell lymphoma 2 (Bcl-2) and Bcl-2 associated X protein (Bax) in cerebral tissues were detected via immunohistochemistry. The protein expression levels of Akt and phosphorylated Akt (p-Akt) were determined using Western blotting. Furthermore, the expression of miR-29 and cell apoptosis were detected via quantitative Polymerase Chain Reaction (qPCR) and terminal deoxynucleotidyl transferase (TdT) dUTP nick-end labeling (TUNEL) assay, respectively.

RESULTS

Compared with Sham group, Model, and Inhibitor groups had substantially raised the Zea-Longa scores (p<0.05). The Zea-Longa score in the Model group was markedly lower than that of the Inhibitor group (p<0.05). The positive expression level of Bax was remarkably upregulated (p<0.05). However, the positive expression level of Bcl-2 declined dramatically in both Model group and Inhibitor group when compared with the Sham group (p<0.05). Besides, the Model group exhibited significantly lower positive expression level of Bax and higher positive expression level of Bcl-2 than the Inhibitor group (p<0.05). The relative protein expression level of p-Akt markedly increased in the Model and Inhibitor groups when compared with the Sham group (p<0.05). However, it was considerably higher in the Model group than that of the Inhibitor group (p<0.05). In comparison with the Sham group, both Model group and Inhibitor group exerted substantially elevated expression level of miR-29 (p<0.05). The relative expression level of miR-29 in the Model group was significantly upregulated when compared with the Inhibitor group (p<0.05). The apoptosis rate of cells in both Model group and Inhibitor group was markedly higher than that of the Sham group (p<0.05). Furthermore, the Model group showed remarkably lower apoptosis rate than the Inhibitor group (p<0.05).

CONCLUSIONS

MiR-29 inhibits neuronal apoptosis in cerebral infarction rats by upregulating the Akt signaling pathway, thereby serving as a protector.

[A model analysis on the knowledge-attitude-practice of children guardians in Jiangxi, Shanghai and Qinghai]

Objective: To understand the knowledge attitude and practice (KAP) on vaccination among children's parents in Jiangxi, Shanghai, and Qinghai and explore the factors influencing KAP. Methods: The study selected two counties/districts in Jiangxi, Shanghai, and Qinghai, respectively, by stratified sampling and used a unified questionnaire to investigate the parental KAP of vaccination. A structural equation model (SEM) was used to explore factors influencing parental KAP, as well as the relationship between knowledge and behavior. Results: Of the 760 valid questionnaires, the knowledge of vaccination among children's parents was better, and the vaccination knowledge of parents in Qinghai and Shanghai were slightly better than those in Jiangxi. Parents mainly obtained vaccination knowledge through medical staff and vaccination manuals. The fitting degree of SEM was relatively good; the root mean square error of approximation of the model is 0.033. The higher the parents' education level, the better their knowledge of vaccination (β̂=0.082). Parental vaccination knowledge could influence whether the vaccinated children stay for half an hour in the clinics (β̂=0.541). It could also impact whether parents giving up vaccinating their children in the face of media reports about the adverse effects of vaccinations (β̂=0.515). Conclusions: The knowledge of vaccination among the parents in Jiangxi, Shanghai, and Qinghai was quite good. Moreover, we should pay more attention to the mass media programs and vaccination knowledge among parents with low or middle education backgrounds. Vaccination knowledge can be disseminated through medical staff, vaccination manuals, or mobile applications.

[Establishment of nutrition literacy core items for Chinese people]

Objective: To establish core items of nutrition literacy for general population in China. Methods: The framework system and preliminary items of nutrition literacy were established through literature review and experts' consultation. Content validity test was used to determine the nutrition literacy item. Thirteen experts in the field of human nutrition, health education and nutrition and diseases were invited to score the importance of each nutrition literacy item via Email. The judgment basis and familiarity of experts towards the items, active coefficient, and content validity were analyzed to generate the final list of nutrition literacy items. Results: 92.3% of questionnaires in two rounds were collected.The active coefficient of experts was satisfied and the authority coefficient was 0.96.In the content validity evaluation, the correlation I-CVI value of each item was above 0.83 and the κ value was above 0.74. The evaluation result was excellent.After the second round of expert consultation, all selected items met the inclusion criteria. We identified the final list of nutrition literacy items consisting of three scales (knowledge and concepts, lifestyles and dietary behaviors, and basic skills), ten subscales (basic nutrition philosophy, food classification and nutrition knowledge, healthy weight, eating behavior and culture, balanced diet, exercise health, food assessment, nutrition information acquisition and decision, nutrition safety, and weight management)with 25 items in total. Conclusions: The framework system and core items of nutrition literacy are established for Chinese people based on the content validity evaluation. The experts involved in the consultation process present a performance with good representativeness, enthusiasm and authority, and the content validity evaluation result is satisfied.

[Research and application of assessment tools for Residents' Nutrition Literacy]

Nutrition literacy is an important part of health literacy, as well as an significant factor to enhance the quality of population, improving the nutritional status of residents and preventing nutrition-related diseases. In 2010, China developed an evaluation tool for health literacy and began to monitor residents' health literacy. So far, eight national surveys on health literacy have been completed, providing an important basis for health promotion intervention strategies and related policies. However, in health literacy evaluation system, there is neither evaluation content of nutrition literacy, nor evaluation tools. In order to achieve the goals of "national nutrition plan (2017-2030)"and evaluate the implementation effect, it is urgent to carry out the assessment and monitoring of nutrition literacy. According to the nutritional characteristics of different populaitons, this research organizes national experts in related fields, following the principles of scientificity, conciseness and generality and through the scientific formulation procedures to construct the nutrition literacy assessment tools for different populations. This assessment tool can enhance the pertinence and scientificity of nutrition education and improve nutrition development strategy. The establishment of the nutrition literacy assessment tool is the premise of gradually establishing the nutrition literacy assessment system of the residents, and also lays a solid foundation for further conducting the national nutrition literacy evaluation work.

[Influence of dietary patterns on type 2 diabetes mellitus in local residents aged 40 years and above in Songjiang district, Shanghai]

Objective: To evaluate the association between dietary pattern and type 2 diabetes mellitus (T2DM) in local residents aged 40 years and above in Songjiang district of Shanghai. Methods: Data was obtained from the baseline investigation of Shanghai Peak-Plan cohort. According to inclusion and exclusion criteria, we selected people with T2DM as the case group, and people without T2DM as controls, matched with gender, age and alcohol intake status. Dietary patterns were established by factor analysis. Conditional logistic regression model (CLRM) was used to explore the relationship between different dietary patterns and T2DM, as well as the association between multiplicative interactions of dietary patterns and T2DM. Results: We used factor analysis to obtain six dietary patterns: including meat, desserts-coarse cereals, condiment-egg, beverage, cereals-tubers and fruit-vegetable. Data from multivariate condition logistic regression suggested that condiment-egg patterns as (OR=0.543, 95%CI: 0.377-0.781), beverage (OR=0.590, 95%CI: 0.409-0.852), cereals-tubers (OR=0.592, 95%CI: 0.414-0.848), fruit-vegetable (OR=0.604, 95%CI: 0.417-0.876) were associated with the reduced risks for T2DM. After analyzing the multiplicative interactions between dietary patterns, there were three interaction items associated with T2DM with statistical significances: the multiplicative interaction between meat pattern and condiments-egg pattern was related with the increased risk for T2MD, and the multiplicative interactions between cereal-tubers pattern, meat pattern between cereal-tubers pattern and fruit-vegetable pattern were related with the reduced risks for T2MD. Conclusions: In the six dietary pattern under study, cereals-tubers pattern undwr studly, fruit-vegetable pattern might be more practical in preventing T2DM. In addition, the dietary pattern with cereals and potatos as the main ingredients, appropriate meat and reduced condiment intake might also play positive roles in reducing the risk for T2DM.

[Related factors of sarcopenia in hospitalized elderly patients with coronary heart disease]

Objective: To explore the incidence and clinical characteristics of sarcopenia in hospitalized elderly patients with coronary heart disease and search for the related factors. Methods: This study was a single-center observational study. According to the inclusion criteria, elderly patients hospitalized with coronary heart disease from Peking Union Medical College Hospital between December 2017 and December 2018 were enrolled. The patients were divided into sarcopenic group and non-sarcopenic group according to the diagnostic criteria of the Asian Working Group for Sarcopenia. Activities of daily living of the patients were assessed (including ADL and IADL) . Comorbidity of the patients was evaluated by the Charlson comorbidity index (CCI). Long-term medication use of the patients was recorded to assesse whether there was polypharmacy. The nutritional status of the patients was examined by the mini nutritional assessment-short form (MNA-SF). The full tandem stance time of the patients was evaluated. The history of falls over the previous year, urinary incontinence, and living conditions of the patients were also recorded. Multivariate logistic regression was used to analyze the related factors for sarcopenia of elderly patients with coronary heart disease. Results: A total of 364 patients were enrolled in the study. The patients were aged 65-96 (74.6±6.5) years and there were 218 (59.9%) male patients. There were 264 cases of stable coronary heart disease and 100 cases of acute coronary syndrome. The median number of long-term used medication was 7. One hundred and fifty-two (41.8%) patients were complicated with type 2 diabetes, 38 (10.4%) patients were complicated with anxiety/depression, and 98 (26.9%) patients had the history of falls over the previous year. Eighty-two (22.5%) patients were complicated with urinary incontinence, 12 patients (3.3%) were complicated with malnutrition and 33 patients (9.2%) were living alone. There were 81 (22.3%) sarcopenic patients and 283 (77.7%) non-sarcopenic patients among all the hospitalized elderly patients with coronary heart disease. The sarcopenic patients were more older, with lower body mass index(BMI)(both P<0.001), higher CCI and more long-term used medication (both P<0.05), higher proportions of malnutrition, urinary incontinence, history of falls, and living alone (all P<0.05) compared to non-sarcopenic patients. ADL and IADL scores of sarcopenic patients were significantly lower than those of non-sarcopenic patients (both P<0.001). There was also a higher proportion of unable to accomplish full tandem stance among sarcopenic patients compared to non-sarcopenic patients (P<0.001). Moreover, higher hs-CRP level (P=0.047) , lower albumin level (P=0.004) and significantly lower prealbumin level (P<0.001) were observed in sarcopenic patients compared to non-sarcopenic patients. Stepwise multivariate binomial logistic regression analysis revealed that male (OR=5.036, 95%CI 1.782-14.230, P=0.002), low BMI (OR=0.883, 95%CI 0.796-0.980, P=0.019), as well as low prealbumin level (OR=0.990, 95%CI 0.980-1.000, P=0.045) were related factors for sarcopenia among elderly patients with coronary heart disease. Conclusions: Sarcopenia is a geriatric condition commonly seen in hospitalized elderly patients with coronary heart disease. Male, low BMI, and low prealbumin level were the factors related to sarcopenia for older adults with coronary heart disease.

[A cross-sectional study on the association between frailty and muscular performances in hospitalized elder patients with coronary artery disease]

Objective: To explore the association between frailty and muscle performances of hospitalized elder adults with coronary artery disease. Methods: A total of 122 hospitalized patients aged 65-85 years old with coronary artery disease from Department of Geriatrics and Cardiology, Peking Union Medical College Hospital between December 2017 and March 2018 were enrolled in the study. A comprehensive geriatric assessment was performed to evaluate existing comorbidity and geriatric syndromes of the patients. Frailty was assessed using the Clinical Fraity Scale. The patients were classified as frail and non-frail, according to the scale. Muscle performances were assessed using grip strength, gait speed, etc. Whole body and appendicular skeletal muscle mass was detected with bioelectrical impedance analysis in patients with reduced grip strength or slowed gait speed. Appendicular skeletal muscle index (ASMI) was calculated. Results: Among all subjects, 28 were with frailty (23.0%) and 94 were without (77.0%). The frail patients were older [(76.7±5.4) years vs. (72.2±5.6)years], had higher Charlson comorbidity index [2.0(1.0,2.75)vs. 1.0(0,2.0)], and higher proportion of malnutrition (14.29% vs. 1.06%), urinary incontinence (39.29% vs. 15.96%), using walking-aid (28.57% vs. 6.38%), and more kinds of taken drugs (8.1±3.0 vs. 6.6±2.7), than the non-frail patients. Prealbumin levels [(207.8±60.0)mg/L vs.(234.3±45.4)mg/L] were lower, and highly sensitive C-reactive protein levels [(5.89±9.57)mg/L vs.(1.89±2.49)mg/L] were higher in the frail patients than in the non-frail patients (all P<0.05). Compared with non-frail patients, the frail patients had poorer grip strength [(19.67±7)kg vs.(29.23±8.29)kg] and slower gait speed [(0.54±0.2)m/s vs.(0.91±0.22)m/s] (all P<0.001). Spearman rank correlation analyses showed that grip strength was positively correlated with the appendicular skeletal muscle mass(r=0.811), whole body skeletal muscle mass(r=0.74) and the ASMI (r=0.783), respectively. Conclusions: The incidence of frailty among hospitalized older adults with coronary artery disease is high. Poor muscle performances were common in these patients. Assessment of frailty and muscle performances can help to evaluate the overall function of older adults with cardiovascular disease in a comprehensive way.

[Prognostic factors and model of primary liver cancer treated with transcatheter arterial chemoembolization combined with radiofrequency ablation]

Objective: To investigate the prognostic factors of primary liver cancer treated with transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA), and then to establish a prognostic model. Methods: Clinicopathological and follow-up data of 145 patients who underwent TACE combined with RFA from January 2010 to December 2012 were retrospectively analyzed. Univariate and multivariate survival analyses were performed using the Cox proportional hazards model, and the prognostic model was established. Results: The 1, 2, and 3-year survival rates were 92.6%, 81.4% and 66.2%, respectively. The 3-year recurrence and metastasis rate was 64.8%.Multivariate analysis showed that female cases and higher serum albumin levels were the protective factors for the 3-year overall and relapse-free survival of patients(P<0.05 for all). High levels of alpha-fetoprotein (AFP), alanine aminotransferase (ALT), total bilirubin (TBIL), portal vein thrombosis and higher Child Pugh stages were the independent risk factors for the 3-year overall survival(P<0.05 for all). High levels of AFP, TBIL, portal vein thrombosis and advanced stages of BCLC staging (B and C) were the independent risk factors for tumor recurrence and metastasis(P<0.05 for all). The predictive model established based on the multivariate analysis showed good sensitivity and specificity. The area under ROC curve were higher than 0.90. Conclusions: The prognosis of liver cancer patients treated with TACE combined with RFA is affected by various clinicopathological factors. The systematic evaluation of the relevant factors before treatment may help to select proper patients and improve prognosis.

[Risk factors and prognosis of neurological complications in patients with infective endocarditis]

OBJECTIVE

To identify risk factors of neurological complications (NC) in left-sided infective endocarditis (IE) and to assess its impact on the outcome and cardiac surgery.

METHODS

Clinical data, NC, treatment and outcome of patients with definite left-sided IE admitted to our hospital during 2001-2012 were retrospectively analyzed.

RESULTS

A total of 308 patients with age of (45.3±15.9) years were enrolled. Among them, 65 (21.1%) experienced at least one NC. Independent risk factors associated with NC were large vegetation (HR=1.681, 95%CI 1.013-2.788, P=0.044), non-neurologic embolism (HR=1.820, 95%CI 1.068-3.100, P=0.028), mitral valve involvement (HR=1.888, 95%CI 1.089-3.274, P=0.024), Staphylococcus aureus infection (HR=2.054, 95%CI 1.097-3.846, P=0.044), and uncontrolled infection (HR=4.680, 95%CI 2.563-8.546, P<0.001). During a median follow-up for 17 months, 70 (22.7%) patients died. NC had a negative impact on long-term outcome (HR=2.292, 95%CI 1.274-4.122, P=0.006). Valve replacement surgery was performed in 156(50.6%)patients, which was associated with a lower rate of 1-year IE-related death (HR=0.160, 95%CI 0.063-0.405, P<0.001). Among patients with NC, valve replacement surgery was associated with lower rates of in-hospital mortality and 1-year IE-related mortality (14.8% vs 5.3%, 18.5% vs 73.7%, respectively, P<0.001).

CONCLUSIONS

Independent risk factors of NC include large vegetation, non-neurologic embolism, mitral valve involvement, Staphylococcus aureus infection, and uncontrolled infection. Neurologic complications link to the poor prognosis in patients with left-sided IE. Valve surgery is considered as a safe procedure and improves the survival.

[Efficacy and mechanism of local delivery of rapamycin and rapamycin-loaded poly(lactic-co-glycolic) acid nanoparticles on coronary restenosis of injury-stenosis model of minipigs]

OBJECTIVE

To determine whether intramural administration of rapamycin (RPM)-loaded polylactic-polyglycolic acid (PLGA) nanoparticles (NPs) can reduce intimal thickening and affect the mRNA expressions of matrix metalloproteinase (MMP)-2, tissue inhibitor of metalloproteinase (TIMP)-2 and p27(kipl) in a coronary injury-stenosis model of minipigs.

METHODS

Twenty eight minipigs were randomly separated into four groups: saline group (n=7), blank PLGA NPs group (5.0 mg/ml)(n=7), RPM group (1.0 mg/ml)(n=7), and RPM-PLGA NPs(5.0 mg/ml)group (n=7), respectively. Different treatments were intracoronary locally delivered via a Dispatch™ catheter for 10 minutes. Serial angiography was performed pre-and post-modeling 30 days and the percent stenosis degree was assessed. Hematoxylin-Eosin (HE) staining, Weigert's resorcin fuchsin staining and picric acid-sirius red staining were used for morphometric analysis. Immunohistochemistry was performed to assess the levels of proliferating cell nuclear antigen (PCNA), MMP-2, and TIMP-2 at early and late time points, respectively. The expression of p27(kip1) mRNA was detected by in situ hybridization staining.

RESULTS

Data from 21 minipigs had been collected at the end of the experiment with 6, 4, 5, and 6 from the former mentioned 4 groups, respectively. For the instant injury index, there was no significant difference among the four groups. The percent stenosis degree of RPM-PLGA NPs group was significantly lower than that of the other three groups respectively (all P< 0.05). The neointima area, net external elastic lamina area to external elastic laminal area ratio, and proliferative index of RPM-PLGA NPs group were significantly less than those of the other three groups, with all the P values less than 0.05. The mean value of integral optical density of p27(kip1)mRNA expression of RPM-PLGA group was 0.35 ± 0.06, higher than that of blank PLGA NPs group (0.12 ± 0.05, P< 0.01), saline group (0.16 ± 0.03, P< 0.05), and RPM group (0.15 ± 0.03, P< 0.05), respectively. The MMP-2/TIMP-2 ratio and the positive expression index of PCNA in RPM-PLGA group were lower than that of the other groups (P< 0.05).

CONCLUSIONS

Locally delivered rapamycin-loaded PLGA NPs significantly reduces MMP-2/TIMP-2 ratio and PCNA expression, increases p27(kip1) mRNA expression and significantly relieves percent stenosis degree and shows excellent acute procedural results in the minipig interventional coronary artery oversized balloon injury model. The results from minipig model further support that this approach could be a potential clinical procedure for vascular proliferative disease.

Effects of cetuximab combined with afatinib on the expression of KDR and AQP1 in lung cancer

In this study, we examined the effect of cetuximab (epidermal growth factor receptor monoclonal antibody) combined with afatinib (epidermal growth factor receptorand human epidermal growth factor receptor 2 tyrosine kinase irreversible inhibitor) on the apoptosis of A549 cells and on kinase domain receptor (KDR) and aquaporin 1 (AQP1) expression in A549 cells. A549 cells were cultured in RPMI-1640 and then divided into 4 groups: control group, 1-nM cetuximab group, 25-μM afatinib group, and 1-nM cetuximab + 25-μM afatinib group. After incubation for 48 h, the cell inhibition rate, cell cycle distribution, and invasive ability of A549 cells before and after treatment were examined using MTT, flow cytometry, and transwell assays, respectively. Gene and protein expression levels of KDR and AQP1 were detected by reverse transcription-polymerase chain reaction and western blot analysis. Cetuximab and afatinib significantly inhibited A549 cell growth. Their combination produced greater growth inhibition (P < 0.01). Cetuximab and afatinib both induced the apoptosis of A549 cells, and their combination produced a higher apoptosis rate (P < 0.01). Compared with monotherapy, cetuximab in combination with afatinib induced G1 phase arrest and downregulated the gene and protein expression of KDR and AQP1 (P < 0.05). Cetuximab in combination with afatinib synergistically inhibited the growth and migration of cells and downregulated the gene and protein expression of KDR and AQP1, indicating that a combination of cetuximab and afatinib is a potential strategy for lung cancer therapy.

Effects of kinase insert domain receptor (KDR) gene silencing on the sensitivity of A549 cells to erlotinib

We investigated the effects of kinase insert domain receptor (KDR) gene silencing on the proliferation of A549 cells and their sensitivity to erlotinib. A KDR small interfering RNA (siRNA) sequence was designed and synthesized; then, it was transfected into A549 cells using Lipofectamine(TM) 2000. KDR mRNA and protein expression after KDR gene silencing was detected by reverse transcription polymerase chain reaction and western blotting; the A549 cell cycle was detected by flow cytometry. A 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and colony formation assay were performed to determine the sensitivity of A549 cells to erlotinib after KDR gene silencing. After 48h of KDR gene silencing, there was a significant decrease in KDR gene and protein expression (P < 0.05). The A549 cell cycle was arrested at the G0/G1 phase, and the number of cells in the S phase decreased; the difference was statistically significant (P < 0.05). In the KDR gene silencing group, the sensitivity of A549 cells to erlotinib was significantly enhanced (P < 0.05). KDR siRNA can significantly silence the KDR gene in A549 cells, inhibit the proliferation of A549 cells, and enhance their sensitivity to erlotinib.

Isoprenylcysteine carboxylmethyltransferase regulates mitochondrial respiration and cancer cell metabolism

Isoprenylcysteine carboxylmethyltransferase (Icmt) catalyzes the last of the three-step posttranslational protein prenylation process for the so-called CaaX proteins, which includes many signaling proteins, such as most small GTPases. Despite extensive studies on Icmt and its regulation of cell functions, the mechanisms of much of the impact of Icmt on cellular functions remain unclear. Our recent studies demonstrated that suppression of Icmt results in induction of autophagy, inhibition of cell growth and inhibition of proliferation in various cancer cell types, prompting this investigation of potential metabolic regulation by Icmt. We report here the findings that Icmt inhibition reduces the function of mitochondrial oxidative phosphorylation in multiple cancer cell lines. In-depth oximetry analysis demonstrated that functions of mitochondrial complex I, II and III are subject to Icmt regulation. Consistently, Icmt inhibition decreased cellular ATP and depleted critical tricarboxylic acid cycle metabolites, leading to suppression of cell anabolism and growth, and marked autophagy. Several different approaches demonstrated that the impact of Icmt inhibition on cell proliferation and viability was largely mediated by its effect on mitochondrial respiration. This previously unappreciated function of Icmt, which can be therapeutically exploited, likely has a significant role in the impact of Icmt on tumorigenic processes.

A time-temperature rheological study of konjac glucomannan hydrocolloid

Konjac glucomannan (KGM) is one of the most versatile soluble biomaterials having wide-ranging applications. The shear storage, G', and loss, G", moduli of this hydrocolloid were recorded as functions of angular frequency varying from 0.1 to 100.0 rad/s and temperature from 5 to 50 degrees C. It was found that both G' and G" mainly increase with angular frequency in the range from 0.1 to 100 rad/s. As the temperature increases from 5 to 95 degrees C, the values of G' and G" decrease. A novel criterion for the thermorheologically simple material, and a procedure to calculate the shift factor from the angular frequency sweep and temperature ramp data were presented. By these methods, the KGM hydrocolloid is found to obey the TTS principle as log G" and log G' are less than 1.529 and 1.436, respectively. The Williams-Landel-Ferry equation can describe the shift factor of the KGM hydrocolloid.

[Evaluation of clinical application of intravascular ultrasound image]

OBJECTIVE

To prospectively evaluate the clinical applications of intravascular ultrasound (IVUS).

METHODS

Four hundred and thirty seven patients with coronary artery disease (CAD) or suspect CAD were imaged with CAD and IVUS, including (1) assessment IVUS in 135 cases with normal coronary angiography (CAG) (2) comparison IVUS with CAG pre and after angioplasty in 52 patients with CAD (3) assessment of detecting calcification lesions with CAG and IVUS in 150 patients (4) predicting the cardiac events after stent implantation guided by IVUS (n = 47) and CAG (N = 53).

RESULTS

IVUS may detect coronary atherosclerosis lesions with normal by CAG. CAG overestimated effect of angioplasty. IVUS was more accurate to determine effect and complications of PTCA compared with CAG. IVUS interpreted the mechanism of vessel dilatation in PTCA. The cardiac events after stent implantation were significantly reduced after IVUS examination as compared with CAG.

CONCLUSIONS

IVUS represents a radically different approach to vascular anatomy. Unlike angiography, which displays the coronary artery as a silhouette of the contrast-filled lumen, IVUS generates a cross-sectional tomographic image of the lumen and vessel wall. IVUS plays an important role as a guidance in cardiac intervention.

Engineering principles applied to implantable otologic devices

The engineering principles of possible actuators and sensors for totally implantable mid-ear or cochlear hearing devices are summarized. The selection considerations are discussed. The frequency response, and the needed force and displacement at the ossicular chain sites were measured on fresh temporal bones to determine approximately the middle ear device requirements and design considerations. A design example of the actuator and sensor is outlined with laboratory and acute animal evaluation results.

Molecular modeling on kappa opioid receptor and its interaction with nonpeptide kappa opioid agonists

AIM

To study the interaction between kappa-opioid receptor and its nonpeptide agonists.

METHODS

The "conservation patterns" for G-protein coupled receptors (GPCR) were used to determine 7 transmembrane (TM) regions. Taking the crystallographic coordinates of bacteriorhodopsin (BR) as the template, the 3D structural model was constructed for 7 TM of kappa-opioid subtype with molecular mechanics (MM) method. Five highly active nonpeptide kappa-opioid agonists were docked into the 7 helices of kappa-opioid receptor to study the ligand-receptor interaction.

RESULTS

Four important interactions between U-50488-like agonists and kappa-opioid receptors were drawn according to our modeling study: (1) the protonated pyrrolidine nitrogen of the ligands formed a hydrogen-bond with the carboxyl of Asp138; (2) the carbonyl oxygen of ligands forms a hydrogen bond to the hydroxyl of Ser187; (3) the aryl groups connected to acylamide of the agonists inserted into a hydrophobic cavity enclosed by residues Val239, Val236, Phe235, Val232, Leu186, and Trp183; (4) the pyrrolidine of the ligands in the complexes was surrounded by Ile290, Asp138, Ile194, Ile135, and Cys131.

CONCLUSION

The proposed interaction mechanism is helpful for further mutant experiments and designing novel potent kappa-opioid agonists.

A 3D-QSAR study on ginkgolides and their analogues with comparative molecular field analysis

Comparative molecular field analysis (CoMFA), a three-dimensional quantitative structure-activity relationship (3D-QSAR) paradigm was used to study the correlation between the physicochemical properties and the in vitro bioactivities of ginkgolide analogues. The correlation derived from CoMFA analysis has a good predictive capability. Based on the result of CoMFA analysis, we designed some compounds. Pharmacological assay indicated that three of these new designed compounds are 2 and 4 times more potent than that of ginkgolides.

Engineering principles of mechanical stimulation of the middle ear

This article presents the transducer principles of possible middle ear hearing devices with their characteristics and selection considerations summarized. The frequency response and the needed force and displacement at the ossicular chain sites were measured to determine approximately the system requirements and design considerations. The power required to vibrate the ossicular chain is estimated to be of the order of 0.1 watt, which is three orders of magnitude smaller than the power consumption of devices being developed in various laboratories. Careful engineering design and evaluation is needed. A design example of the transducer used with a partially implantable, noncontact electromagnetic hearing device is presented in this article with laboratory evaluation results.

Contactless semi-implantable electromagnetic middle ear device for the treatment of sensorineural hearing loss. Short-term and long-term animal experiments

A contactless electromagnetic hearing device has been designed following basic science experiments, improvement of electronics, and precision micromechanics. Different prototypes have been developed and tested in the laboratory, fresh human temporal bones, and acute and chronic animal experimentation. A conductive hearing loss model was first developed in the cat using samarium cobalt as the target magnet. Later, a highly efficient electromagnetic air-core coil was selected to vibrate a neodymium iron boron magnet cemented to the body of the incus and tested in acute and chronic experiments using the cat as the model. In this group of animals, the ossicular chain was left intact. There was no failure of the target magnet, driving coil, or implanted electronics. The only problem encountered in this evaluation was a malfunction of the receiving antenna that had to be redesigned and retrofitted into the implanted units. This system would be suitable for the treatment of moderate to severe sensorineural hearing loss. Planning to begin human clinical trials is ongoing.

[Analysis of risk factors in postinfarction angina]

The clinical and echocardiographic variables related to postinfarction angina were evaluated in 54 patients with acute myocardial infarction. All patients underwent 2D echocardiography at 2-3 weeks after infarction. Wall motion analysis was quantified with a wall motion score index (WMSI) based on 16 left ventricular wall segments. Among the 54 patients with acute myocardial infarction 23 (42.6%) had early postinfarction angina. Multiple regression analysis demonstrated no significant difference between the patients with and without postinfarction angina in age, sex, location of infarction, Killip classification, previous angina, hypertension, hyperlipidemia, diabetes mellitus, creatine kinase level and left ventricular ejection fraction. In comparison with patients without postinfarction angina, patients with postinfarction angina had higher WMSI. It indicates that postinfarction angina appears to be related more to myocardial ischemia rather than to the infarct of myocardium.

A contactless electromagnetic implantable middle ear device for sensorineural hearing loss

Following basic science experiments, improvement of precision micromechanics and electronics design, and development of different prototypes, a contactless electromagnetic hearing device has been successfully implanted in cats (acute experiments). Chronic animal experiments using the cat as well as the rabbit are ongoing to test the components of the device. A highly efficient air core coil is used to vibrate a neodymium-iron-boron magnet cemented to the body of the incus. The parts of the system, including implanted electronics (hybrid circuit, solid state), are laser welded and hermetically sealed. The system allows for the generation of enough force which vibrates the magnet implanted on the incus. It would be suitable for the treatment of moderate to severe sensorineural hearing loss.

[Prognosis and factors predicting the long-term prognosis of myocardial infarction]

200 cases of consecutively admitted acute myocardial infarction (AMI), who had survived for at least 2 weeks, were studied prospectively. 193 cases were followed-up for 0.5-27 (average 15) months; 41 of them (21.2%) had cardiac events, including 3 sudden cardiac death (1.6%) and 35 obvious cardiac failure (18.1%). 11 patients died of heart failure and 4 of reinfarction. Before discharge, noninvasive tests were done: LVEF < or = 40%, age > or = 60, maximum value of creatinine-phosphokinase > or = 1000 IU/dl and positive ventricular late potential were the 4 factors of high risk. Patients with 3 or 4 positive risk factors had poorer prognosis, if they were compared with those with one or none.

[Hemochromatosis: a review of 22 Chinese cases]

22 cases of hemochromatosis were analysed. 19 cases were collected from Chinese medical journals and 3 from our hospital. We showed the similarities and differences between Chinese and western patients. The diagnosis, mode of heredity, possible pathogenesis and management of idiopathic hemochromatosis were also briefly discussed.

[Identification of congenital cardiac malformation and in utero arrhythmia by fetal echocardiography]

M-mode, 2D and Pulsed Doppler Echocardiography were performed on 111 fetuses of high-risk pregnancies. Fetal gestation ages ranged 16-41 weeks. Six congenital cardiac diseases were detected in utero and confirmed at autopsy in 4 cases, and one by Pulsed Doppler Echocardiography after delivery. These included a rhabdomyoma, an endocardial fibroelastosis with hydrops, a pulmonary stenosis with tricuspid regurgitation, a VSD, a VSD with descending aortic stenosis, an AV canal defect with single atrium and single AV valve with regurgitation. Arrhythmia was diagnosed in 23 fetuses, 9 had transient sinus bradycardia, 8 had premature atrial contraction, 2 had premature ventricular contraction which disappeared after birth, 4 had sustained sinus bradycardia, one of them combined PVC occurring in bigeminy and trigeminy, which continued after birth. These 4 fetuses had congenital heart disease.

CONCLUSION

(1) 2 DE and PDE are the most valuable non-invasive technique for detection of fetal structural cardiac abnormalities. (2) M-mode and PDE make correct rhythm diagnosis in fetus. (3) The fetus with transient sinus bradycardia or PAC usually has a favorable prognosis. Sustained bradycardia has a more ominous prognosis, particularly if associated with heart abnormalities. (4) Fetal hydrops may associate with congestive cardiac failure in uterus. The incidence of cardiac disease is high in hydrops.

[Clinical study of fetal echocardiography]

92 fetuses from 52 women who were about to undergo midtrimester termination of pregnancy and 40 fetuses at high risk were studied by M-mode, 2D and pulsed Doppler echocardiography. One fetus of 24 weeks gestation was found to have a cardiac tumor. The pathological diagnosis was rhabdomyoma. The right ventricular tumor was located between the tricuspid and septum. It obstructed the tricuspid valve and caused tricuspid regurgitation and bradycardia. The measurement of atrial and ventricular dimensions by fetal echocardiography in 91 normal fetuses showed an average RV/LV ratio of 1.11. Doppler velocities of mitral and tricuspid valves showed a Peak A/peakE ratio of 1.

[Quantitative evaluation of aortic stenosis using continuous wave Doppler]

Thirteen patients with suspected aortic stenosis were studied with left-heart catheterization and 2 D, Doppler echocardiography. Thickness and abnormal motion of aortic valve was detected by 2 D Echo in 12 cases. One case had thick aortic valve with normal motion. The causes of lesions included rheumatic heart disease in one patient, bicuspid aortic valve in one, and senile calcific aortic valves in eleven. The left ventricular and aortic pressure were recorded simultaneously with left-heart catheterization. Peak-to-peak, instant peak and mean pressure gradients were measured. The aortic velocity was obtained with Continuous Wave (CW) Doppler. Instant peak and mean pressure gradients were calculated from Bernoulli equation. Both catheterization and Doppler demonstrated significant pressure gradient between LV and aorta in twelve patients. The instant peak and mean pressure gradients calculated from CW Doppler were compared with catheterization data. Doppler pressure gradients correlated well with that measured at catheterization: Doppler instant peak pressure gradient compared with that by catheterization, r = 0.89, P less than 0.001, Doppler instant peak pressure gradient compared with peak-to-peak pressure gradient by catheterization, r = 0.79, P less than 0.001, Doppler mean pressure gradient compared with that by catheterization, r = 0.75, P = 0.002. This study demonstrates that CW Doppler provides a valuable method for assessment of the severity of aortic stenosis.