The value of quantitative contrast-enhanced ultrasonography analysis in evaluating central retinal artery microcirculation in patients with diabetes mellitus: comparison with colour Doppler imaging

AIM

To compare the efficacy of quantitative contrast-enhanced ultrasonography (CEUS) analysis and colour Doppler ultrasound (CDU) in evaluating central retinal artery (CRA) microcirculation in patients with diabetes mellitus (DM).

MATERIALS AND METHODS

In this prospective study, a total of 55 patients (98 eyes) with DM were enrolled as the study group. They were compared to 46 age-matched healthy volunteers (92 eyes) who were selected as the control group. Each patient underwent CDU and subsequent CEUS examination. CDU and quantitative CEUS parameters were evaluated. The diagnostic efficiency of the diagnostic performance of CEUS and CDU was evaluated and compared, and the scale thresholds of predictive indicators for the diagnosis of proliferative diabetic retinopathy (PDR) were evaluated using receiver operating characteristics (ROC) curve analyses.

RESULTS

Group pairwise comparisons showed that the end diastolic velocity (EDV) and arrival time (AT) of CRA were significant predictors for PDR by CDU and by quantitative CEUS analysis, respectively (all p<0.05). The ROC curve analysis showed that the area under the curve value of AT was significantly higher than that of EDV (0.875 versus 0.634, p=0.0002). Accordingly, an AT cut-off value of 1.07 seconds resulted a sensitivity of 90.62 % and a specificity of 79.31 %.

CONCLUSION

Quantitative CEUS analysis can improve the accuracy of clinical staging of diabetic retinopathy for the patients with DM, and the AT showed the best diagnostic efficiency.

Computational Design of Peptide Assemblies

With the ongoing development of peptide self-assembling materials, there is growing interest in exploring novel functional peptide sequences. From short peptides to long polypeptides, as the functionality increases, the sequence space is also expanding exponentially. Consequently, attempting to explore all functional sequences comprehensively through experience and experiments alone has become impractical. By utilizing computational methods, especially artificial intelligence enhanced molecular dynamics (MD) simulation and de novo peptide design, there has been a significant expansion in the exploration of sequence space. Through these methods, a variety of supramolecular functional materials, including fibers, two-dimensional arrays, nanocages, etc., have been designed by meticulously controlling the inter- and intramolecular interactions. In this review, we first provide a brief overview of the current main computational methods and then focus on the computational design methods for various self-assembled peptide materials. Additionally, we introduce some representative protein self-assemblies to offer guidance for the design of self-assembling peptides.

Ferroptosis in cardiovascular diseases: role and mechanism

In multicellular organisms, regulatory cell death is a crucial aspect of growth and development. Ferroptosis, which was postulated roughly ten years ago, is a mode of cell death that differs from apoptosis, autophagy, and pyrodeath. This distinct pattern of cell death is triggered by an imbalance between oxidants and antioxidants and strongly associated with the metabolism of iron, lipids, amino acids, and glutathione. A growing body of research has implicated ferroptosis in the incidence and progression of many organ traumas and degenerative diseases. Recently, ferroptosis has gained attention as a crucial regulatory mechanism underlying the initiation and development of a variety of cardiovascular diseases, including myocardial ischemia/reperfusion injury, cardiomyopathy, arrhythmia, chemotherapy, and Corona Virus-2-induced cardiac injury. Pharmacological therapies that inhibit ferroptosis have great potential for the management of cardiovascular disorders. This review discusses the prevalence and regulatory mechanisms of ferroptosis, effect of ferroptosis on the immune system, significance of ferroptosis in cardiovascular diseases, and potential therapeutic value of regulating ferroptosis in a variety of heart diseases.

[Wine-processed Chuanxiong Rhizoma enhances efficacy of aumolertinib against EGFRmutant non-small cell lung cancer xenografts in nude mouse brain]

OBJECTIVE

To investigate the effect of wine-processed Chuanxiong Rhizoma (WCR) for enhancing the efficacy of aumolertinib against xenografts of epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) in the brain of nude mice.

METHODS

In a co-culture system of hCMEC/D3 and PC9 NSCLC cells, the effect of aqueous extract of WCR (2 mg/mL) combined with aumolertinib (10 and 20 μmol/L) on apoptosis of PC9 cells was investigated using flow cytometry. The effects of WCR extract (0.5, 1, and 2 mg/mL) on transmembrane transport of 8 μmol/L aumolertinib was examined in ABCB1-MDCK monolayer cells. Western blotting was used to detect the expressions of the tight junction proteins related with blood- brain barrier integrity. A nude mouse model bearing NSCLC xenograft in the brain was established to observe the inhibitory effect of WCR (1 mg/g) combined with aumolertinib (10 mg/kg) on tumor growth.

RESULTS

Compared with aumolertinib (20 μmol/L) alone, WCR extract (2 mg/mL) combined with aumolertinib significantly increased the apoptosis rate of PC9 cells by 21% (P < 0.01). The combined treatment with WCR (0.5, 1, 2 mg/mL) obviously increased apical-basolateral transport of aumolertinib in ABCB1-MDCK monolayer cells (P < 0.05) and significantly lowered the expression levels of zonula occludens-1, claudin-5 and P-glycoprotein (P < 0.05). In the tumor-bearing mice, compared with aumolertinib alone, the combined treatment with WCR and aumolertinib produced stronger inhibitory effect on tumor growth, improved weight loss, and prolonged the survival time of the nude mice (P < 0.05). Pathological examination showed that the combined treatment obviously increased the apoptosis rate of the tumor cells and alleviated neural injuries in the brain. Immunohistochemistry revealed that WCR treatment significantly reduced the expressions of ZO-1 and claudin-5 in the brain of the mice.

CONCLUSION

WCR combined with aumolertinib shows stronger inhibitory effects against tumor xenografts of EGFR-mutant NSCLC possibly due to the effect of WCR in facilitating the transmembrane transport of aumolertinib by downregulating ZO-1, claudin-5 and P-glycoprotein expression.

Peptidyl Virus-Like Nanovesicles as Reconfigurable "Trojan Horse" for Targeted siRNA Delivery and Synergistic Inhibition of Cancer Cells

The self-assembly of peptidyl virus-like nanovesicles (pVLNs) composed of highly ordered peptide bilayer membranes that encapsulate the small interfering RNA (siRNA) is reported. The targeting and enzyme-responsive sequences on the bilayer's surface allow the pVLNs to enter cancer cells with high efficiency and control the release of genetic drugs in response to the subcellular environment. By transforming its structure in response to the highly expressed enzyme matrix metalloproteinase 7 (MMP-7) in cancer cells, it helps the siRNA escape from the lysosomes, resulting in a final silencing efficiency of 92%. Moreover, the pVLNs can serve as reconfigurable "Trojan horse" by transforming into membranes triggered by the MMP-7 and disrupting the cytoplasmic structure, thereby achieving synergistic anticancer effects and 96% cancer cell mortality with little damage to normal cells. The pVLNs benefit from their biocompatibility, targeting, and enzyme responsiveness, making them a promising platform for gene therapy and anticancer therapy.

One-Step Synthesis of Peptide-Gold Nanoclusters with Tunable Fluorescence and Enhanced Gene Delivery Efficiency

In this study, peptide-gold nanoclusters with tunable fluorescence were prepared by a simple "one-pot" method, which were used for gene localization and delivery in vivo to achieve efficient intracellular colocalization, uptake, and transfection. The efficiency of pDNA transfection was up to 70.6%, and there was no obvious cytotoxicity. This study proves that the simple-composition and bio-friendly peptide-gold nanoclusters are promising gene delivery carriers and can provide a powerful theoretical and experimental basis for the application of peptide-metal nanocomplexes in gene delivery and other biomedicine fields.

Risk of hypovolemia associated with sodium-glucose cotransporter-2 inhibitors treatment: A meta-analysis of randomized controlled trials

AIM OF THE REVIEW

To assess the risk of hypovolemia for sodium-glucose cotransporter-2 (SGLT2) inhibitors treatment.

METHOD

A systematic literature retrieval was performed in PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and Scopus from inception up to 4 October 2022, Data for study characteristics and outcomes of interest were extracted from each eligible study. Risk ratios (RRs) with a 95% confidence interval (CI) for hypovolemia were calculated using a random-effect model.

RESULTS

A total of 57 studies (n = 68,622) were included in our meta-analysis, with a result of 1,972 hypovolemia incidents (1,142 in the SGLT2 inhibitors group and 830 in the control group). The pooled RR was 1.12 (95% CI: 1.02-1.22). It is evident that receiving SGLT2 inhibitors increased the risk of hypovolemia. When stratified by category of SGLT2 inhibitors the result was consistent; when the subgroup was analyzed by age, the pooled RR was 1.07 (95% CI: 0.94-1.23) in patients aged ≥65 years and 1.14 (95% CI: 1.02-1.28) in those aged <65 years. When comparing the baseline estimated glomerular filtration rate (eGFR) of less than or equal to 60 mL/min/1.73 m2 with a baseline eGFR greater than 60 mL/min/1.73 m2, the pooled RR was 1.21, (95% CI: 1.00-1.46) and 1.08, (95%CI: 0.98-1.20), respectively.

CONCLUSION

Our meta-analysis has demonstrated that SGLT2 inhibitors increased the risk of hypovolemia in patients with Type 2 Diabetes Mellitus (T2DM). It is necessary to pay attention to the risk of hypovolemia associated with SGLT2 inhibitors, especially in older individuals and those with moderate renal impairment.

SYSTEMATIC REVIEW REGISTRATION

[https://www.crd.york.ac.uk/prospero/], identifier [CRD42020156254].

Risk factors and characteristics of ischemic stroke in patients with immune thrombocytopenia: A retrospective cohort study

OBJECTIVES

Previous research has found that patients with immune thrombocytopenia (ITP) have an increased risk of thrombosis, such as venous thromboembolism (VT), ischemic stroke (IS)/transient ischemic attack (TIA), and cardiovascular disease (CVD), but the risk factors for stroke in patients with ITP have yet to be determined. This study aims to determine the risk factors and characteristics of ischemic stroke in patients with ITP.

MATERIALS AND METHODS

This study included adults with incident primary ITP diagnosed in a tertiary medical center between 2010 and 2020. The t-test and Mann-Whitney U test were used to compare the variables between IS and non-IS groups, and the multivariate logistic regression model was employed to evaluate correlations.

RESULTS

The study enrolled 1824 individuals, of whom 17 (0.93%) had IS, and 138 (1:8) were randomly chosen from 1807 non-IS patients. Age was found to be substantially associated with stroke in the multivariate analysis (OR 1.07, 95% CI: 1.026-1.116; p = 0.001). We found no correlation between platelet counts (PLT) (OR 1.013, 95% CI: 0.995-1.033; p = 0.164), mean platelet volume (MPV), platelet larger cell ratio (P-LCR), prothrombin time (PT) (OR 1.455, 95% CI 0.979-2.164; p = 0.064), activated partial thromboplastin time (APTT), D-dimer, fibrinogen or antinuclear antibody (ANA) and stroke. Of 17 ITP-IS patients, 7 (53.8%) were cryptogenic, greater than the general IS population. Three (23.1%) of them had an embolic pattern.

CONCLUSION

For ITP patients, age was a significant predictor of stroke. ITP-IS patients had a more cryptogenic origin, with some showing an embolic pattern.

[Therapeutic mechanism of emodin for treatment of rheumatoid arthritis: a network pharmacology-based analysis]

OBJECTIVE

To investigate the therapeutic mechanism of emodin in the treatment of rheumatoid arthritis (RA) using a network pharmacology-based method and validate this mechanism in a fibroblast-like synovial cell line.

METHODS

The PubChem, Targetnet, SwissTargetPrediction, Genecards, OMIM, and DisGeNET databases were searched to obtain emodin targets and RA-related genes. A protein-protein interaction (PPI) network was constructed, and GO and KEGG pathway enrichment analyses were carried out to analyze the intersection genes. AutoDock4.2.6 software was used to simulate molecular docking between emodin and its candidate targets. In a cultured fibroblast-like synovial cell line (MH7A), the effects of different concentrations of emodin on proliferation of tumor necrosis factor-α (TNF-α)-induced cells were investigated using CCK-8 assay, cell scratch experiment and flow cytometry; the changes in the expressions of nuclear factor-κB (NF-κB) pathway proteins were detected using Western blotting, and the mRNA expressions of the hub genes were examined with RT-qPCR.

RESULTS

We identified 32 intersection genes of emodin and RA, and the key targets including CAPS3, ESR1, and MAPK14 involved mainly the NF-κB signaling pathway. Cell scratch experiment and flow cytometry demonstrated a strong inhibitory effect of emodin on MH7A cell proliferation. Treatment with TNF-α significantly increased the cellular expressions of the NF-κB pathway proteins, which were obviously lowered by treatment with 80 μmol/L emodin. The results of RT-qPCR showed that TNF-α treatment obviously up-regulated the expressions of the hub genes COX2 and P38MAPK, and emodin treatment significantly down-regulated the expressions of MAPK and PTGS2 and up-regulated the expression of CASP3.

CONCLUSION

The therapeutic effect of emodin on RA is mediated mainly through regulation of cell proliferation, apoptosis, and the NF-κB pathway.

Enhancing Therapeutic Efficacy of Donepezil by Combined Therapy: A Comprehensive Review

Combination therapy involving different therapeutic strategies mostly provides more rapid and effective results as compared to monotherapy in diverse areas of clinical practice. The most worldwide famous acetylcholinesterase inhibitor (AChEIs) donepezil for its dominant role in Alzheimer's disease (AD) has also attracted the attention of many pharmaceuticals due to its promising pharmacological potencies such as neuroprotective, muscle relaxant, and sleep inducer. Recently, a combination of donepezil with other agents has displayed better desirable results in managing several disorders, including the most common Alzheimer's disease (AD). This study involves all the data regarding the therapeutic effect of donepezil in its combination with other agents and explains its therapeutic targets and mode of action. Furthermore, this review also puts light on the current status of donepezil with other agents in clinical trials. The combination therapy of donepezil with symptomatic relief drugs and disease-modifying agents opens a new road for treating multiple pathological disorders. To the best of our knowledge, this is the first report encircling all the pharmacologic effects of donepezil in its combination therapy with other agents and their current status in clinical trials.

State of the art in parallel ankle rehabilitation robot: a systematic review

Background

The ankle joint complex (AJC) is of fundamental importance for balance, support, and propulsion. However, it is particularly susceptible to musculoskeletal and neurological injuries, especially neurological injuries such as drop foot following stroke. An important factor in ankle dysfunction is damage to the central nervous system (CNS). Correspondingly, the fundamental goal of rehabilitation training is to stimulate the reorganization and compensation of the CNS, and to promote the recovery of the motor system’s motor perception function. Therefore, an increasing number of ankle rehabilitation robots have been developed to provide long-term accurate and uniform rehabilitation training of the AJC, among which the parallel ankle rehabilitation robot (PARR) is the most studied. The aim of this study is to provide a systematic review of the state of the art in PARR technology, with consideration of the mechanism configurations, actuator types with different trajectory tracking control techniques, and rehabilitation training methods, thus facilitating the development of new and improved PARRs as a next step towards obtaining clinical proof of their rehabilitation benefits.

Methods

A literature search was conducted on PubMed, Scopus, IEEE Xplore, and Web of Science for articles related to the design and improvement of PARRs for ankle rehabilitation from each site’s respective inception from January 1999 to September 2020 using the keywords “ parallel”, “ ankle”, and “ robot”. Appropriate syntax using Boolean operators and wildcard symbols was utilized for each database to include a wider range of articles that may have used alternate spellings or synonyms, and the references listed in relevant publications were further screened according to the inclusion criteria and exclusion criteria.

Results and discussion

Ultimately, 65 articles representing 16 unique PARRs were selected for review, all of which have developed the prototypes with experiments designed to verify their usability and feasibility. From the comparison among these PARRs, we found that there are three main considerations for the mechanical design and mechanism optimization of PARRs, the choice of two actuator types including pneumatic and electrically driven control, the covering of the AJC’s motion space, and the optimization of the kinematic design, actuation design and structural design. The trajectory tracking accuracy and interactive control performance also need to be guaranteed to improve the effect of rehabilitation training and stimulate a patient’s active participation. In addition, the parameters of the reviewed 16 PARRs are summarized in detail with their differences compared by using figures and tables in the order they appeared, showing their differences in the two main actuator types, four exercise modes, fifteen control strategies, etc., which revealed the future research trends related to the improvement of the PARRs.

Conclusion

The selected studies showed the rapid development of PARRs in terms of their mechanical designs, control strategies, and rehabilitation training methods over the last two decades. However, the existing PARRs all have their own pros and cons, and few of the developed devices have been subjected to clinical trials. Designing a PARR with three degrees of freedom (DOFs) and whereby the mechanism’s rotation center coincides with the AJC rotation center is of vital importance in the mechanism design and optimization of PARRs. In addition, the design of actuators combining the advantages of the pneumatic-driven and electrically driven ones, as well as some new other actuators, will be a research hotspot for the development of PARRs. For the control strategy, compliance control with variable parameters should be further studied, with sEMG signal included to improve the real-time performance. Multimode rehabilitation training methods with multimodal motion intention recognition, real-time online detection and evaluation system should also be further developed to meet the needs of different ankle disability and rehabilitation stages. In addition, the clinical trials are in urgent need to help the PARRs be implementable as an intervention in clinical practice.

[Effects of preoperative segmental mobility on the clinical and radiographic outcomes following one-level artificial cervical disc replacement]

Objective: To investigate the effects of preoperative segmental range of motion (ROM) on clinical and radiographical outcomes after artificial cervical disc replacement (ACDR) and explore whether ACDR could be indicated for patients with preoperative limited or excessive segmental ROM. Methods: From January 2008 to December 2017, patients who underwent Prestige-LP ACDR in West China Hospital were retrospectively reviewed. The preoperative and postoperative X-rays of the cervical spine were collected to measure the radiographic parameters, including cervical lordosis (CL), C(2-7) ROM, disc height (DH), disc angle (DA) and ROM at the arthroplasty level. Clinical outcomes were evaluated using the Japanese Orthopedic Association (JOA) and the Neck Disability Index (NDI) scores. The correlation between preoperative segmental ROM and postoperative clinical and radiographical outcomes were also analyzed. Results: A total of 161 patients were analyzed, with 73 males and 88 females. The mean age was (44±8) years, and the follow-up period was 34 months (12-120 months). JOA and NDI scores improved after ACDR (P<0.05). However, postoperative C(2-7) ROM and ROM at the arthroplasty level were comparable with preoperative counterparts (both P>0.05). Preoperative segmental ROM positively correlated with C(2-7) ROM and ROM at the arthroplasty segment (r=0.213、0.271, both P<0.05), but was negatively correlated with the change of ROM (r=-0.534, P<0.05). The segmental ROM was 4.0°±1.0° in the limited-ROM group (A) and 14.6°±1.3° in the excessive-ROM group (B), respectively. There were significantly more patients diagnosed with cervical spondylosis in group A than in group B (35.5% vs 10.7%, P<0.05). The level-distribution was statistically different between the two groups. C(5/6) and C(6/7) were prone to limited motion in group A, while C(4/5) and C(5/6) were predisposed to excessive motion in group B (all P<0.05). After surgery, C(2-7) ROM increased for 14.2°±16.8° in group A, while paradoxically decreased for 2.2°±14.4° in group B. However, C(2-7) ROM in group B was still larger than that in group A (P<0.05). Similarly, the ROM at the arthroplasty level increased by 3.1°±3.7° in group A, whereas the values decreased by 4.4°±4.2° in group B postoperatively. In addition, group A still had less segmental ROM than group B (P<0.05). The preoperative DH in group A was less than that in group B (P<0.05). The rates of ASD, HO, and high-grade HO in group A were all higher than those in group B but without significant differences (all P>0.05). Conclusion: Preoperative segmental ROM has no significant effects on clinical outcomes after ACDR; it has a positive correlation with postoperative global and segmental ROM while is negatively correlated with ROM change.

The prevalence and risk factors of high-altitude pulmonary hypertension among native Tibetans in Sichuan Province, China

Background

High-altitude pulmonary hypertension (HAPH) remains a concern due to its high mortality, however, studies evaluating its prevalence and risk factors are lacking.

Objective

To determine the prevalence of HAPH and its correlated factors among the highlanders living at 3200 metres above sea level in Ganzi Tibetan Automous Prefecture, Sichuan Province, China.

Methods

This was a single-center cross-sectional study involved 1129 subjects (mean age 46.6±14 years, 39% men). Native Tibetans with HAPH were defined as mean pulmonary artery pressure &gt;30mmHg achieved from transthoracic echocardiography.

Results

The crude prevalence of HAPH was 6.2%, and was more prevalent in men compared to women (8.6% vs 4.6%, P=0.005). The elder was more likely to develop HAPH (OR: 5.308, 95% CI: 2.562–10.993). Highlanders with HAPH had more severe metabolic abnormalities (including elevated blood pressure, blood glucose, blood lipids, BMI, etc. P value&lt;0.05) and significantly increased hemoglobin level (P=0.001). On multivariate logistic regression analysis, independent risk factors for HAPH were metabolic syndrome (OR: 3.128, 95% CI: 1.110–8.818), age (&gt;60 years vs &lt;40 years) (OR: 2.924, 95% CI: 1.282–6.669), and decreased SpO2 (OR: 1.072 per 1-unit decrease; 95% CI: 1.010–1.136).

Conclusion

It could be concluded that HAPH was prevalent among 6.2% native Tibetans in Sichuan Province, China. Increasing age, metabolic syndrome and decreased SpO2 were independent predisposing factors for HAPH

Funding Acknowledgement

Type of funding source: Public Institution(s). Main funding source(s): This study was funded by one Science and Technology Pillar Programs in Sichuan Province (Grant no. 2017SZ0008).

Internet-based patient- primary care physician-cardiologist integrated management model of hypertension in China: study protocol for a multicentre randomised controlled trial

INTRODUCTION

The control rate of hypertension is low in China, especially in rural, western and minority areas. This is related to poor medical skills among physicians in primary care institutions and low levels of trust among patients. However, primary healthcare institutions are the main battleground for the prevention and treatment of hypertension. It is worth exploring how to most effectively integrate patients, primary care physicians and cardiologists in tertiary hospitals, to build a long-term mechanism for the prevention and treatment of hypertension. In this study, we aim to evaluate the clinical effectiveness and conduct a health economic evaluation of an internet-based patient-primary care physician-cardiologist integrated management model of hypertension in areas of China with different socioeconomic levels.

METHODS AND ANALYSIS

This is a 12-month, multicentre, randomised controlled trial involving patients with hypertension in urban communities and rural areas of Sichuan Province, China. Each primary healthcare institution will cooperate with their tertiary hospital through the Red Shine Chronic Disease Management System (RSCDMS). Patients will be randomly assigned 1:1 to two groups: (1) a traditional care group; (2) an intervention group in which primary care physicians and cardiologists can share patient data and manage patients together through the RSCDMS. Patients can upload their blood pressure (BP) values and communicate with physicians using the system. The primary outcome is the change in systolic BP over a 12-month period. Secondary outcomes are changes in diastolic BP, BP control rate, values of 24-hour ambulatory BP monitoring, difference in cost-effectiveness between the groups, patient satisfaction, medication adherence and home BP monitoring compliance. All data will be recorded and stored in the RSCDMS and analysed using IBM SPSS V.26.0.

ETHICS AND DISSEMINATION

This study has been approved by the Biomedical Research Ethics Committee of the West China Hospital of Sichuan University in Sichuan, China (No. 2020-148). Written informed consent will be obtained from all participants. The results of this study will be disseminated to the public through academic conferences and peer-reviewed journals.

TRIAL REGISTRATION NUMBER

ChiCTR2000030677.

The Prevalence and Risk Factors of High-Altitude Pulmonary Hypertension Among Native Tibetans in Sichuan Province, China

Gou, Qiling, Rufeng Shi, Xin Zhang, Qingtao Meng, Xinran Li, Xi Rong, Zhabu Gawa, Nage Zhuoma, and Xiaoping Chen. The prevalence and risk factors of high-altitude pulmonary hypertension among native Tibetans in Sichuan Province, China. High Alt Med Biol. 21:327-335, 2020. Background: Studies evaluating the prevalence and risk factors of high-altitude pulmonary hypertension (HAPH) are lacking. Objective: To determine the prevalence of HAPH and its correlated factors among highlanders living 3200 m above sea level in Ganzi Tibetan Autonomous Prefecture, Sichuan Province, China. Methods: This was a single-center, cross-sectional study involving 1129 subjects (mean age 46.6 ± 14 years, 39% men). In native Tibetans, HAPH was defined as a mean pulmonary artery pressure >30 mmHg as measured by transthoracic echocardiography. Results: HAPH had a crude prevalence of 6.2% and was more prevalent in men than in women (8.6% vs. 4.6%, p = 0.005). Elderly adults were more likely to develop HAPH than young adults (odds ratio [OR] = 5.308, 95% confidence interval [CI] = 2.562-10.993). Highlanders with HAPH had more severe metabolic abnormalities (including elevated blood pressure, blood glucose, blood lipids, BMI, etc., p < 0.05) and significantly increased hemoglobin and hematocrit levels (p < 0.01). In multivariate logistic regression analysis, independent risk factors for HAPH were metabolic syndrome (OR = 3.128, 95% CI = 1.110-8.818), age (>60 years vs. <40 years) (OR = 2.924, 95% CI = 1.282-6.669), and decreased SpO₂ (OR = 1.072 per 1-unit decrease; 95% CI = 1.010-1.136). Conclusion: It could be concluded that HAPH was prevalent among 6.2% of native Tibetans in Sichuan Province, China. Increasing age, metabolic syndrome, and decreased SpO₂ were independent predisposing factors for HAPH.

Mini review: The FDA-approved prescription drugs that induce ovulation in women with ovulatory problems

Infertility is defined as not being able to become pregnant after 12 months or more of unprotected sexual intercourse. Female infertility as a serious health issue can result from ovulation disorders, menstrual cycle problems, structural problems, and environmental factors. Ovulation occurs once a month between the time of menarche and menopause. The release of a mature egg from the ovary is controlled with the hypothalamic-pituitary-ovarian axis. Several hormones such as gonadotropin-releasing hormone (GnRH), FSH (follicle-stimulating hormone), LH (luteinizing hormone), estrogen, and progesterone play fundamental roles in the ovulation process. Both FSH and LH are the main treatment for women with ovulation disorders. Depending on the reasons for infertility, several different types of treatment are available for infertile women. Fertility drugs as an important part of treatment work like the natural hormones to treat infertility. Several fertility drugs can regulate ovulation and the release of an egg from the ovary in women with polycystic ovary syndrome (PCOS) or undergoing in vitro fertilization (IVF) treatment. This mini-review is about the FDA-approved prescription drugs that induce ovulation in women with ovulatory problems.

[Effect of high-titer plasma in pediatric patients with severe adenovirus pneumonia]

Objective: To explore the efficacy and safety of high-titer plasma in the treatment of pediatric patients with severe adenovirus pneumonia. Methods: The clinical data of 92 pediatric patients with severe adenovirus pneumonia admitted to pediatric intensive care unit (PICU) in Guangzhou Women and Children's Medical Center from January 2016 to October 2019 were retrospectively collected. According to the treatment with or without high-titer plasma, the patients were divided into plasma treatment group (n=41) and non-plasma treatment group (n=51). The 51 patients with chest radiograph showing more than half the lungs involved were divided into plasma treatment group (n=29) and non-plasma treatment group (n=22). According to fever duration before plasma treatment, patients were divided into early group (≤5 days, n=5), middle group (>5-10 days, n=14), and late group (>10 days, n=22). Baseline data, therapeutic effects, and prognosis of patients in each group were analyzed with t test, non-parametric rank sum test, one-way ANOVA and chi-square test. Results: Ninety-two patients were included. There were no significant differences in age, gender, body weight, fever duration, sequential organ failure assessment, and Murray lung injury score between plasma treatment group and non-plasma treatment group before admission (all P>0.05). The proportion of patients whose temperature drop to normal within 5 days was higher in plasma treatment group than that in non-plasma treatment group (88% (36/41) vs. 69% (35/51), χ(2)=4.745, P=0.029). However, there were no significant differences between the two groups in the proportions of invasive ventilator weaning within 14 days (63% (26/41) vs. 76% (39/51), χ(2)=1.868, P=0.172), transfer out from PICU within 14 days (49% (20/41) vs. 69% (35/51), χ(2)=3.724, P=0.054), discharge within 28 days (51% (21/41) vs. 61%(31/51), χ(2)=0.846, P=0.358) and survived patients (85% (35/41) vs. 76%(39/51), χ(2)=1.143, P=0.285). Among patients with severe chest radiograph, the proportions of patients whose temperature drop to normal within 5 days and survived patients were higher in plasma treatment group than those in non-plasma treatment group (86% (25/29) vs. 59% (13/22), χ(2)=4.843, P=0.028; 83% (24/29) vs. 55%(12/22), χ(2)=4.796, P=0.029, respectively). However, there were no significant differences between the two groups in the proportions of invasive ventilator weaning within 14 days (52% (15/29) vs. 59% (13/22), χ(2)=0.274, P=0.601), transfer out from PICU within 14 days (34% (10/29) vs. 45% (10/22), χ(2)=0.632, P=0.427), and discharge within 28 days (45% (13/29) vs. 45% (10/22), χ(2)=0.002, P=0.964). Among early, middle and late group, the proportions of invasive ventilator weaning within 14 days were 2/5, 13/14 and 50% (11/22), respectively, with statistically significant difference (χ(2)=8.119, P=0.017). There were no significant differences in the proportions of patients whose temperature drop to normal within 5 days (4/5, 14/14, 82% (18/22), χ(2)=2.965, P=0.227), transfer out from PICU within 14 days (2/5, 10/14, 36%(8/22), χ(2)=4.386, P=0.112), discharge within 28 days (2/5, 8/14, 50% (11/22), χ(2)=0.462, P=0.794) and survived patients (4/5, 13/14, 82% (18/22), χ(2)=0.966, P=0.617) in the three groups. Only one case with high-titer plasma therapy had rash in the course of infusing plasma and no other adverse reactions were observed. Conclusions: High-titer plasma can shorten the fever time and improve the proportion of survival patients in pediatric severe adenovirus pneumonia. The clinical effect of high-titer plasma is better in 5-10 days of fever course. High-titer plasma is an effective and safe treatment.

Risk of orthostatic hypotension associated with sodium-glucose cotransporter-2 inhibitor treatment: A meta-analysis of randomized controlled trials

OBJECTIVE

The aim of this study was to assess the association between sodium-glucose cotransporter-2 (SGLT2) inhibitors and the risk of orthostatic hypotension (OH) in patients with type 2 diabetes mellitus (T2DM).

METHOD

A systematic literature retrieval was performed using PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception up to 16 October 2019. Data for study characteristics and outcomes of interest were extracted from each eligible study. Pooled risk ratios (RRs) with 95% confidence intervals (CI) for OH were calculated using a random-effects model.

RESULT

A total of 16 studies (n = 12,749) were included in our meta-analysis, with a result of 44 incident OH cases (29 in the SGLT2 inhibitor group, and 15 in the control group). The pooled RR was 1.17 (95% CI: 0.65-2.09). There was no evidence that receiving SGLT2 inhibitors increased the risk of OH, when stratified by age, duration of T2DM, or placebo-control or active-control and baseline blood pressure.

CONCLUSION

This meta-analysis suggested that, in general, SGLPT2 inhibitors did not increase the risk of OH in patients with T2DM. The possibility of OH should be, therefore, considered on an individual basis, especially in patients with a history of OH, long duration of T2DM, or comorbidities.

[Results analysis of occupational physical examination for major occupational hazards exposed laborer in 2018 in Guangzhou]

Objective: To analyze the results of occupational physical examination for major occupational hazard exposed laborer in 2018 in Guangzhou, to provide scientific basis for occupational health supervise. Methods: In January 2019, descriptive epidemiological methods were used as the data sources of the Occupational Disease and Occupational Health Information Surveillance System and the report data of Guangzhou Occupational Health Inspection Agency, collecting 2733 employers from 28 Occupational Health Inspection Organizations in 11 administrative regions of Guangzhou from January to December 2018, as well as the occupational health examination data of 97688 workers exposed to the occupational-disease-risk factors, to analyze the inspection of suspected occupational diseases and contraindications during the period of work of the workers who were monitored for the occupational hazard factors (silicon dust, welding fume, benzene, lead, Ethylene Dichloride, N-hexane, high temperature and hand-transmitted vibration) . Results: Total 128 cases of suspected occupational disease were detected, including 3 suspected silicosis, 8 suspected welder＇s pneumoconiosis, 17 suspected other pneumoconiosis, 10 suspected benzene poisoning, 1 suspected lead poisoning and 89 suspected noise deafness. There were 2061 cases of occupational contraindication, among which 550 cases were contraindication of high temperature, 261 cases were benzene and 1089 cases were noise. Conclusion: The Occupational Health Inspection Institution of this city should continuously monitor the occupational health status of the harmful workers during their work, do a good job of prevention, and strengthen the labor protection.

Liraglutide Lowers Body Weight Set Point in DIO Rats and its Relationship with Hypothalamic Microglia Activation

OBJECTIVE

This study aimed to investigate the effects of liraglutide on the body weight set point (BWSP) in diet-induced obese rats and to determine the relationship between BWSP and hypothalamic arcuate nucleus (ARC) microglial activation.

METHODS

Diet-induced obesity (DIO) rats were divided into three groups: continuous high-fat diet (HFD) plus saline, HFD with liraglutide, and HFD with liraglutide pair feeding. Body weight, BWSP, inflammatory cytokines, suppressor of cytokine signaling 3, orexigenic/anorexigenic proteins, apoptosis, and microglia in the ARC were assessed. The effect of liraglutide on the Notch-1 signaling pathway and its relationships with  nuclear factor-κB and p38 mitogen-activated protein kinase were also investigated in a lipopolysaccharide (LPS)-induced microglia activation model.

RESULTS

Liraglutide reduced BWSP; reversed adverse changes in hypothalamic inflammation, suppressor of cytokine signaling 3, and apoptosis; and diminished microgliosis in DIO rats. The BWSP showed a linear correlation with ARC microglial density. Liraglutide inhibited LPS-induced M1 microglial polarization and promoted microglial polarization to the M2 phenotype, diminishing inflammatory cytokine expression. Liraglutide inhibited Notch-1 signaling pathway activation and decreased nuclear factor-κB and p38 mitogen-activated protein kinase pathway activation in LPS-stimulated microglia.

CONCLUSIONS

Liraglutide can reduce BWSP in DIO rats. There is a linear correlation between hypothalamic microgliosis and BWSP. Liraglutide reduces excessive microglial activation and inflammation, which may contribute to BWSP reduction.

[Impact of artificial disc height on the morphology of cervical facet joint]

Objective: To investigate the impact of implant height on the morphology of cervical facet joints in artificial cervical disc replacement (ACDR). Methods: A finite element model of the cervical spine from C(2) to C(7) was constructed. The surgical processes of ACDR were simulated by insertion of 5 mm, 6 mm or 7 mm Prestige-LP artificial cervical discs. The morphological changes of cervical facet joints were recorded in terms of facet overlap distance, facet overlap area and facet angle. Results: The normal height Prestige-LP cervical disc could restore the natural status of the cervical spine. Compared with the intact condition, the model with ≥2 mm height implant would reduce the overall range of motion (ROM) by 19.2% in flexion, 19.4% in extension, 18.4% in lateral bending and 19.0% in axial rotation. Besides, the ROM at the surgical level reduced by 15.8% in flexion, 15.4% in extension and lateral bending and 19.0% in rotation. The upper and lower adjacent levels (C(4/5) and C(5/6)) showed more obvious changes in ROM, which reduced by 26.8% and 26.5% in flexion, 26.6% in extension, 26.5% and 26.4% in lateral bending, and 26.4% and 26.3% in rotation, respectively. The reduction of facet overlap distance, facet angle and facet overlap area with the ≥2 mm height artifact was 9.6%, 30.7%, and 17.9% respectively at the upper adjacent level, and 22.3%, 35.3% and 28.2% respectively at the surgical level, compared with the intact model.The morphology of facet joints at the lower adjacent level were slightly changed. Conclusion: The implant height selection in ACDR should be in accordance with the physiological intervertebral disc height. Artifact with ≥2 mm in height would obviously change the morphology of facet joints, thus should not be used in clinical practice.

Problems and challenges: development of blood transfusion services in Mainland China within the context of health-care system reform

OBJECTIVE

To evaluate the development of blood transfusion services in Mainland China within the context of health-care system reform.

BACKGROUND

China launched a health-care reform program in 2009 to redistribute health-care resources, which are currently over-concentrated in well-developed cities. A geographically equitable blood transfusion service is key to achieving this goal.

METHODS

Based on the national survey of blood establishments in July 2015, total blood collection, whole-blood donations per 1000 population and the supply and demand relationship were analysed at the administrative region level. Areas at different developmental levels were compared in terms of total blood collection and human resources.

RESULTS

In 2014, Mainland China's 31 provinces showed wide variation, with total blood collection in blood facilities ranging from about 1000 units to over 600 000 units (each 200 mL), and the whole-blood donation rate per 1000 population, ranging from 1·48 to 17·09. 69% of the country's total collection, was concentrated in 29 provincial capitals, and 31% was in 311 non-capital cities. Of 97 personnel with doctorates, 74 worked in 32 provincial blood establishments, whereas the remaining 23 worked at the other 318 blood stations. In most provinces, per permanent resident donation was within 2-4 mL, and blood volume per inpatient was 10-35 mL regardless of the development of the transfusion service.

CONCLUSION

In 2014, China had an imbalanced development and insufficient access to blood transfusion services. This service must be redeployed at the national level to facilitate health-care reform in China.

Effect of dexmedetomidine anesthesia on respiratory function in pediatric patients undergoing retinoblastoma resection

The aim of this study was to investigate the effect of dexmedetomidine (Dex) on the respiratory function during anesthesia induction in pediatric patients undergoing retinoblastoma (RB) resection. A total of 87 pediatric patients who underwent RB resection in Yidu Central Hospital of Weifang were recruited into this study. General anesthesia was first induced for all patients, of which 45 were randomly assigned to the experimental group and received Dex through an intravenous infusion pump to maintain general anesthesia. The remaining 42 patients were assigned to the control group and received saline through an intravenous infusion pump. Respiratory function and hemodynamic indexes at five time-points, i.e., before anesthesia induction (T0), 5 min after injection of anesthetic agents (T1), before intubation (T2), 15 min after intubation (T3), and 30 min after extubation (T4), were recorded and compared. Incidence of perioperative cardiac and respiratory adverse events was counted in both groups, and post-anesthesia resuscitation was evaluated and compared. Compared with T0, the respiratory rate (R) of the experimental group was lower at T1-T4, but there was no statistical difference (P<0.05). Compared with T0, the control group had a higher R at T2, lower R at T3 and T4 (P<0.05), and there was no significant difference in R between T0 and T1 (P>0.05). At the same time-point, compared with the experimental group, the R was higher at T2, and lower at T3 and T4 in the control group (P<0.05), and no significant difference was found at T1. Blood oxygen saturation (SpO₂) of the experimental group was slightly lower than that of T0 at T1-T4 (P>0.05). In the control group, the levels of SpO₂ were significantly lower at T1-T4 than those at T0 (P<0.05). Compared with the experimental group at the same time-point, SpO₂ of the control group at T1-T4 decreased significantly (P<0.05). The heart rate (HR) of the experimental and control groups was lower at T1-T4 than that at T0 (P<0.05). The HR of the experimental group was higher than that of the control group at T1-T4 (P<0.05). Mean arterial pressure (MAP) of the experimental and control groups was lower at T1-T4 than that at T0 (P<0.05). MAP of the control group was higher than that of the experimental group at T2 but lower than that at T0 of the control group. MAP of the control group was lower than that of the experimental group at T1-T4. There was no significant difference in incidence of tachycardia, bradycardia, vomiting, hypoxia and laryngism between the two groups (P>0.05). There was no difference in resuscitation and extubation time between the two groups (P>0.05). Finally, agitation of the control group was more severe than that of the experimental group (P<0.05). Therefore, Dex can improve the respiratory function and hemodynamic stability during anesthesia induction in children with RB resection.

[Results analysis of occupational physical examination for silica dust, benzene and noise-exposed laborer in 2016 in Guangzhou City]

Objective: To analyze the results of occupational physical examination for silica dust, benzene and noise-exposed laborer in 2016 in Guangzhou, to provide basis for occupational health supervise. Methods: The data were derived from "occupational disease and health information surveillance system" and the summary data reported by all the occupational physical examination agencies, and analyzed by descriptive epidemiology method. Results: 77506 data from 21 agencies of 12 district were collected, and 63 suspected occupational disease were detected, which including 1 silicosis, 8 benzene poisoning, 54 noise deafness. Conclusion: Noise exposure was distributed widely, noise deafness had to be focused on, occupational chronic benzene poisoning and silicosis should be monitored continuously. Small, foreign economy and manufacturing industry should be supervised firstly.

Incidence of hepatitis B virus infection in young Chinese blood donors born after mandatory implementation of neonatal hepatitis B vaccination nationwide

This study was carried out to determine the incidence of hepatitis B virus (HBV) infection in the young generation born after mandatory implementation of hepatitis B vaccination since 1992. Repeat blood donors born between 1992 and 1997 were enrolled, who gave blood at least twice during the past 3 years. Donors were tested for HBV infection markers of HBsAg, anti-HBc, anti-HBs and viral DNA by immunoassays (EIAs) and nucleic acid tests (NAT). A total of 14 937 pre-donation screening qualified young repeat donors aged 18-23 years were tested with 9 (0.06%) being HBsAg by EIA and 10 (1:1494) HBV DNA positive by Ultrio NAT (10.4 IU/mL), respectively. HBV DNA was further detected in 1:192 (9/1732) anti-HBc+ repeat donors with Ultrio Plus NAT (3.4 IU/mL). Most cases were identified as occult HBV infection (OBI). Of 14 937 repeat donors, 20.9% were anti-HBc+ positive, while approximately 50% of 12 024 repeat donors were anti-HBs negative or had levels <100 IU/L. HBsAg+ or OBI strains were classified as wild type of genotype B or genotype C. Incident HBV infection in repeat donors was approximately 1:18.5 person-years (1.1%/year) but significantly less frequent in donors with confirmed HBV vaccination (2.4%-3.3%) than those unsure of vaccination status (10.5%; P = .0023). Hepatitis B virus vaccination appears largely protective of HBV infection, but incidence of infections increases in young adults with mostly undetectable or low anti-HBs or occasionally high anti-HBs. A boost of hepatitis B vaccine for adolescents prior to age 18 years may reduce HBV infection, and implementation of more sensitive NAT in blood donation screening may improve HBV safety in blood transfusion.

Exceptional electrocatalytic oxygen evolution via tunable charge transfer interactions in La0.5Sr1.5Ni1-xFexO4±δ Ruddlesden-Popper oxides

The electrolysis of water is of global importance to store renewable energy and the methodical design of next-generation oxygen evolution catalysts requires a greater understanding of the structural and electronic contributions that give rise to increased activities. Herein, we report a series of Ruddlesden–Popper La_0.5Sr_1.5Ni_1−xFe_xO_4±δ oxides that promote charge transfer via cross-gap hybridization to enhance electrocatalytic water splitting. Using selective substitution of lanthanum with strontium and nickel with iron to tune the extent to which transition metal and oxygen valence bands hybridize, we demonstrate remarkable catalytic activity of 10 mA cm⁻² at a 360 mV overpotential and mass activity of 1930 mA mg⁻¹_ox at 1.63 V via a mechanism that utilizes lattice oxygen. This work demonstrates that Ruddlesden–Popper materials can be utilized as active catalysts for oxygen evolution through rational design of structural and electronic configurations that are unattainable in many other crystalline metal oxide phases.

Water electrolysis provides a potential means to large-scale renewable fuel generation, although sluggish oxygen evolution kinetics challenges progress. Here, authors report on Ruddlesden–Popper oxides as active oxygen evolution electrocatalysts that provide impetus for overcoming kinetic barriers.

Discrimination of Single Living Rat Pancreatic α, β, δ, and Pancreatic Polypeptide (PP) Cells Using Raman Spectroscopy

Primary pancreatic α, β, δ, and pancreatic polypeptide (PP) cells are reliable cell models for diabetes research. However, the separation and purification of these cells in living conditions remains an obstacle for researchers. The interaction of visible light with cellular molecules can produce Raman scattering, which can be analyzed to obtain cellular intrinsic molecular fingerprints. It has been speculated that primary pancreatic α, β, δ, and PP cells can be identified and separated from each other according to their spectral differences. To test this hypothesis, Raman spectra detection was performed on rat islet cells. Single islet cells identified by Raman scattering under living conditions were verified using immunohistochemistry. Thus, Raman data were acquired from a pure line of islet cells as a training sample and then used to establish the discriminant function. Then, using the principal component analysis-linear discriminate analysis (PCA-LDA) method, the four types of islet cells could be identified and discriminated by Raman spectroscopy. This study provides a label-free and noninvasive method for discriminating islet cell types in a randomly distributed mixed islet cell population via their physical properties rather than by using antibodies or fluorescence labeling.

Electronic Origin and Kinetic Feasibility of the Lattice Oxygen Participation During the Oxygen Evolution Reaction on Perovskites

Density functional theory is employed to investigate the electronic origin and feasibility of surface lattice oxygen (O_surf) participation during the oxygen evolution reaction (OER) on perovskites. O_surf participation occurs via the nonelectrochemical pathway in which adsorbed atomic oxygen (O*) diffuses from the transition-metal site to the oxygen site, and then O_surf shifts out of the surface plane to react with O* to form O_surf-O* and a surface oxygen vacancy. The different thermodynamic driving forces of O_surf participation on LaMO_3-δ (M = Ni, Co, and Cu) are explained by the changes in the oxidation state of the transition-metal site throughout the reaction. We show that O_surf participation on LaNiO₃ cannot be hindered by O_surf protonation in the OER potential range. By including the coverage effect and utilizing the implicit solvent model, we finally show that lattice oxygen mechanism is more feasible than the conventional mechanism for OER on LaNiO₃.

HBV/HCV co-infection is associated with a high level of HCV spontaneous clearance among drug users and blood donors in China

Understanding the biology of spontaneous clearance of hepatitis C virus (HCV) infection could lead to improved strategies to prevent the sequelae associated with chronic HCV infection. Chronic infections with hepatitis virus are very common in China, but the factors associated with spontaneous clearance of HCV have not been adequately studied. We evaluated the spontaneous clearance of HCV among 1918 drug users and 1526 HCV-seropositive blood donors in Guangzhou, China. Among participants who were co-infected with hepatitis B virus (HBV), 41.38% of drug users and 39.47% of blood donors had cleared their HCV infection without antiviral therapy compared to 9.41% of drug users and 16.73% of blood donors who were mono-infected with a single virus (P<.01). The proportion of subjects who had cleared their HCV infection was significantly greater in the co-infected subjects whose serum HBV DNA was greater than 2000IU/mL than those with lower levels. A multiple logistic regression analysis found female gender, IL28B rs8099917 TT genotype, HBV co-infection and blood donors (vs drug users) associated with increased spontaneous clearance of HCV infection. Although acute HCV infections are common in China, the incidence of chronic HCV may be reduced among the high prevalence of chronic HBV and IL28B genotypes associated with spontaneous clearance of HCV in Chinese populations.

Real-Time, Label-Free Detection of Local Exocytosis Outside Pancreatic β Cells Using Laser Tweezers Raman Spectroscopy

The examination of insulin (Ins) exocytosis at the single-cell level by conventional methods, such as electrophysiological approaches, total internal reflection imaging, and two-photon imaging technology, often requires an invasive microelectrode puncture or label. In this study, high concentrations of glucose and potassium chloride were used to stimulate β cell Ins exocytosis, while low concentrations of glucose and calcium channel blockers served as the blank and negative control, respectively. Laser tweezers Raman spectroscopy (LTRS) was used to capture the possible Raman scattering signal from a local zone outside of the cell edge. The results show that the frequencies of the strong signals from the local zones outside the cellular edge in the stimulated groups are greater than those of the control. The Raman spectra from the cellular edge, Ins and cell membrane were compared. Thus, local Ins exocytosis activity outside pancreatic β cells might be observed indirectly using LTRS, a non-invasive optical method.

Methylation-mediated loss of SFRP2 enhances invasiveness of non-small cell lung cancer cells

The malignancy of non-small cell lung cancer (NSCLC) largely results from its invasive manner. Secreted frizzled-related proteins (SFRPs) have been recently found to suppress the invasiveness of some cancers. On the other hand, the methylation of SFRPs increases protein degradation to reduce the activity of SFRPs, resulting in increased tumor cell invasion and cancer metastasis. However, the role of SFRPs in the invasion of NSCLC has not been reported. Here we analyzed the regulation of SFRPs in NSCLC cells and its effects on cell invasion. We found that SFRP2 mRNA was significantly decreased and methylation of SFRP2 gene was significantly increased in NSCLC tissue, compared to the paired adjacent nontumor tissue. Moreover, SFRP2 expression was significantly decreased in NSCLC cell lines. In NSCLC cell lines, the SFRP2 expression would be restored by the demethylation of SFRP2 gene with 5'-aza-deoxycytidine in NSCLC cell lines, at the levels of both mRNA and protein. Thus, the cell invasion would be suppressed. Furthermore, the demethylation of SFRP2 gene appeared to inhibit Zinc Finger E-Box Binding Homeobox 1 (ZEB1) and matrix metallopeptidase 9 (MMP9), two key factors that enhance NSCLC cell invasion. Thus, SFRP2 may inhibit NSCLC invasion by suppressing ZEB1 and MMP9, while its methylation promotes NSCLC invasion.

An integrated device with high performance multi-function generators and time-to-digital convertors

A highly integrated, high performance, and re-configurable device, which is designed for the Nitrogen-Vacancy (N-V) center based quantum applications, is reported. The digital compartment of the device is fully implemented in a Field-Programmable-Gate-Array (FPGA). The digital compartment is designed to manage the multi-function digital waveform generation and the time-to-digital convertors. The device provides two arbitrary-waveform-generator channels which operate at a 1 Gsps sampling rate with a maximum bandwidth of 500 MHz. There are twelve pulse channels integrated in the device with a 50 ps time resolution in both duration and delay. The pulse channels operate with the 3.3 V transistor-transistor logic. The FPGA-based time-to-digital convertor provides a 23-ps time measurement precision. A data accumulation module, which can record the input count rate and the distributions of the time measurement, is also available. A digital-to-analog convertor board is implemented as the analog compartment, which converts the digital waveforms to analog signals with 500 MHz lowpass filters. All the input and output channels of the device are equipped with 50 Ω SubMiniature version A termination. The hardware design is modularized thus it can be easily upgraded with compatible components. The device is suitable to be applied in the quantum technologies based on the N-V centers, as well as in other quantum solid state systems, such as quantum dots, phosphorus doped in silicon, and defect spins in silicon carbide.

Elevation of Vδ1 T cells in peripheral blood and livers of patients with primary biliary cholangitis

Primary biliary cholangitis (PBC), hitherto called primary biliary cirrhosis, is a cholestatic liver disease of unclear aetiology with autoimmune features. Accumulating evidence revealed that γδ T cells were involved in the development of autoimmune diseases. As one of γδ T cells subsets, however, the role of Vδ1 T cells in the immunopathogenesis of PBC is poorly understood. We analysed peripheral blood Vδ1 T cells in PBC patients in active stage (ASP, n = 18), adequate responders (AR, n = 10) and inadequate responders (IAR, n = 4) to ursodeoxycholic acid (UDCA) and an age-matched healthy control group (n = 16) by flow cytometric analysis. The ASP group exhibited a significantly higher proportion and absolute number of Vδ1 T cells, which were also observed in immunofluorescence staining of liver biopsy specimens of PBC patients. Moreover, these Vδ1 T cells expressed a series of activation markers and intracellular cytokines, which may contribute to the immunopathogenesis of PBC. Our study will help to clarify the role of Vδ1 T cells in the development of PBC.

Prevalence of hepatitis A viral RNA and antibodies among Chinese blood donors

Like other developing countries, China was reported to have a relatively high seroprevalence of anti-hepatitis A antibodies (anti-HAV). However, no studies have evaluated the prevalence of anti-HAV and HAV RNA among voluntary blood donors with or without elevated serum alanine transaminase (ALT) levels. Anti-HAV antibodies were detected using an enzyme-linked immunosorbent assay, and reverse transcription quantitative polymerase chain reaction was carried out for detection of HAV RNA. In the current study, we analyzed a total of 450 serum samples with elevated ALT levels (≥40 U/L) and 278 serum samples with non-elevated ALT levels. Seroprevalence rates of anti-HAV were 51.6% in donors with elevated ALT and 41.4% in donors with non-elevated ALT; however, none of the samples was positive for HAV RNA. The results of our study showed lower seroprevalence rates of anti-HAV in blood donors (irrespective of ALT levels) than those in published data on Chinese populations. Although donors with elevated ALT had statistically higher prevalence rates of anti- HAV than did those with non-elevated ALT, none of the serum samples had detectable levels of the active virus. In conclusion, our results demonstrate that the transmission of hepatitis A by blood transfusion will occur rarely.

Mid-infrared Photoconductive Response in AlGaN/GaN Step Quantum Wells

AlGaN/GaN quantum structure is an excellent candidate for high speed infrared detectors based on intersubband transitions. However, fabrication of AlGaN/GaN quantum well infrared detectors suffers from polarization-induced internal electric field, which greatly limits the carrier vertical transport. In this article, a step quantum well is proposed to attempt solving this problem, in which a novel spacer barrier layer is used to balance the internal electric field. As a result, a nearly flat band potential profile is obtained in the step barrier layers of the AlGaN/GaN step quantum wells and a bound-to-quasi-continuum (B-to-QC) type intersubband prototype device with detectable photocurrent at atmosphere window (3-5 μm) is achieved in such nitride semiconductors.

Regulation of the Heme Oxygenase-1/carbon monoxide system by hydrogen sulfide in murine coxsackievirus B3-induced myocarditis

To explore the impact of hydrogen sulfide (H2S) on the heme oxygenase&mdash;1 (HO&mdash;1)/carbon monoxide (CO) system in coxsackie virus B3 (CVB3)&mdash;induced myocarditis. A total of 80 Balb/c mice were divided randomly into four groups designated N, C, P and S. Group N served as the negative control while groups C, P, and S were infected with CVB3 to induce myocarditis. Group P was additionally treated with DL&mdash;propargylglycine (PAG) to inhibit the generation of H2S while Group S was treated with NaHS, an H2S donor. Ten days after infection, heart sections were scored for histopathology. We also measured carboxyhemoglobin (COHb) levels in the blood and HO&mdash;1 expression by immunohistochemistry. 1. Each CVB3&mdash;infected group (C, P, and S) exhibited increased pathology, COHb levels, and HO&mdash;1 expression compared to uninfected controls. 2. Regarding histopathology, the score of group P was worse, while that of group S was better, than that of group C. 3. The P group COHb level was lower than group C, while the S group COHb level was higher than group C. 4. Positive HO&mdash;1 expression was seen in group C with reduced expression in group P and increased expression in group S. 5. A positive correlation was observed between the COHb concentration and HO&mdash;1expression; alternatively, a negative correlation was found between the histopathologic scores and both the concentration of COHb and the expression level of HO&mdash;1. Modulation of H2S can play a regulatory role in the pathogenesis of VMC by impacting the HO&mdash;1/CO pathway.

Ab Initio Approach for Prediction of Oxide Surface Structure, Stoichiometry, and Electrocatalytic Activity in Aqueous Solution

The design of efficient, stable, and inexpensive catalysts for oxygen evolution and reduction is crucial for the development of electrochemical energy conversion devices such as fuel cells and metal-air batteries. Currently, such design is limited by challenges in atomic-scale experimental characterization and computational modeling of solid-liquid interfaces. Here, we begin to address these issues by developing a general-, first-principles-, and electrochemical-principles-based framework for prediction of catalyst surface structure, stoichiometry, and stability as a function of pH, electrode potential, and aqueous cation concentration. We demonstrate the approach by determining the surface phase diagram of LaMnO3, which has been studied for oxygen evolution and reduction and computing the reaction overpotentials on the relevant surface phases. Our results illustrate the critical role of solvated cation species in governing the catalyst surface structure and stoichiometry, and thereby catalytic activity, in aqueous solution.

Different Raman spectral patterns of primary rat pancreatic β cells and insulinoma cells

As a noninvasive and label-free analytical technique, Raman spectroscopy has been widely used to study the difference between malignant cells and normal cells. Insulinomas are functional β-cell tumors of pancreatic islet cells. They exhibit many structural and immunohistochemical features in common with normal pancreatic β cells; thus, they are typically difficult to distinguish under the microscope, especially in vivo. We investigated insulinoma and primary rat pancreatic β-cell populations using Raman spectroscopy. The details of the optical heterogeneity between these two populations were determined based on different Raman regions primarily involving nucleic acid and protein contents, which are the most distinct cellular contents in these two types of cells. Using principal component analysis–linear discriminant analysis, these two cell types can be readily separated. The results of this work indicate that Raman spectroscopy is a promising tool for the noninvasive and label-free differentiation of insulinoma cells and normal pancreatic β cells.