Prediction of pathological complete response of breast cancer patients who received neoadjuvant chemotherapy with a nomogram based on clinicopathologic variables, ultrasound, and MRI

OBJECTIVE

To establish a nomogram for predicting the pathologic complete response (pCR) in breast cancer (BC) patients after NAC by applying magnetic resonance imaging (MRI) and ultrasound (US).

METHODS

A total of 607 LABC women who underwent NAC before surgery between January 2016 and June 2022 were retrospectively enrolled, and then were randomly divided into the training (n = 425) and test set (n = 182) with the ratio of 7:3. MRI and US variables were collected before and after NAC, as well as the clinicopathologic features. Univariate and multivariate logistic regression analyses were applied to confirm the potentially associated predictors of pCR. Finally, a nomogram was developed in the training set with its performance evaluated by the area under the receiver operating characteristics curve (ROC) and validated in the test set.

RESULTS

Of the 607 patients, 108 (25.4%) achieved pCR. Hormone receptor negativity (odds ratio [OR], 0.3; P < .001), human epidermal growth factor receptor 2 positivity (OR, 2.7; P = .001), small tumour size at post-NAC US (OR, 1.0; P = .031), tumour size reduction ≥50% at MRI (OR, 9.8; P < .001), absence of enhancement in the tumour bed at post-NAC MRI (OR, 8.1; P = .003), and the increase of ADC value after NAC (OR, 0.3; P = .035) were all significantly associated with pCR. Incorporating the above variables, the nomogram showed a satisfactory performance with an AUC of 0.884.

CONCLUSION

A nomogram including clinicopathologic variables and MRI and US characteristics shows preferable performance in predicting pCR.

ADVANCES IN KNOWLEDGE

A nomogram incorporating MRI and US with clinicopathologic variables was developed to provide a brief and concise approach in predicting pCR to assist clinicians in making treatment decisions early.

[Comparison of two different intramedullary rods combined with Ilizarov external fixation and wrapped autologous iliac bone grafting for the treatment of congenital tibial pseudarthrosis in children]

Objective: To compare the initial clinical efficacy of extensible intramedullary rod fixation and Williams intramedullary rod fixation combined with Ilizarov external fixation and wrapped autologous iliac bone grafting in the treatment of congenital tibial pseudarthrosis in children. Methods: A retrospective analysis was conducted on the clinical data of 60 children with Crawford Ⅳtype congenital pseudarthrosis of the tibia treated with combined surgery at the Orthopedics Department of Hunan Children's Hospital from January 2013 to December 2020.According to different internal fixation methods,patients were divided into the extensible intramedullary rod group (30 cases) and the Williams intramedullary rod group (30 cases). There were 12 males and 18 females in the extendable intramedullary rod group, aged (33.6±6.3) months (range: 18 to 44 months), while there were 10 males and 20 females in the Williams intramedullary rod group, aged (47.8±8.6) months (range: 36 to 66 months). The anteroposterior and lateral views of tibia and fibula and the full length anteroposterior film of both lower limbs were examined to compare the clinical treatment effects of the two groups at 1-,3-,6-,9-, and 12-month after surgery. Independent sample t-test, χ2 test or Fisher exact test was used for inter group comparison. Results: Both groups of children underwent surgery successfully, with postoperative follow-up time greater than 2 years. The extensible intramedullary rod group was followed up for (49.5±6.4) months, while the Williams intramedullary rod group was followed up for (53.7±10.5) months. The initial bone healing time between the broken ends of the tibial pseudarthrosis was (5.1±0.8) months in the extensible intramedullary rod group and (5.0±0.6) months in the Williams intramedullary rod group. There was no statistically significant difference between the two groups (t=0.584, P=0.562). The initial postoperative bone healing rate of the extensible intramedullary rod group was 93.3% (28/30), while that of the Williams intramedullary rod group was 96.7% (29/30). There was no statistically significant difference between the groups (χ2=0.351 P=0.554).The postoperative fracture rate of the extensible intramedullary rod group was 20.0% (6/30), while that of the Williams intramedullary rod group was 16.7% (5/30);Six cases (20.0%) in the extensible intramedullary rod group had unequal limb lengths in both lower limbs after surgery, with a limb length difference of (2.5±1.4)cm (range: 1.5 to 5.2 cm). Eight cases (26.7%) in the Williams intramedullary rod group had a limb length difference of (2.8±1.4)cm (range: 1.8 to 6.0 cm);After surgery, there were 4 (13.3%) cases of proximal tibial valgus deformity in the extensible intramedullary rod group, with an valgus angle range of (12.5±4.9)° (range: 7 °to 18°), and 3 (10.0%) cases in the Williams intramedullary rod group, with an valgus angle of (15.0±6.0)° (range: 9°to 21°). There were 2 (6.7%) cases of ankle valgus deformity in the extensible intramedullary rod group, with an valgus angle of (11.5±4.9)° (range: 8 °to 15°), and 4 (13.3%) cases in the Williams intramedullary rod group, with an valgus angle of (14.8±6.2)° (range: 6 °to 20°). The postoperative activities of the knee and ankle joints in the extensible intramedullary rod group were normal and unrestricted, with 4 cases of extensible intramedullary rod displacement.In the Williams intramedullary rod group, there were 30 cases of postoperative ankle joint stiffness and no displacement of the fixation position of the intramedullary rod.There was no statistically significant difference in postoperative complications between the two groups of children (all P>0.05). Conclusions: The use of both extensible intramedullary rods and Williams intramedullary rods in the combined surgery for congenital tibial pseudarthrosis in children can achieve effective internal fixation results. The initial postoperative bone healing rate is high, and there is no difference in the incidence of postoperative complications between groups. Both internal fixation methods have their own advantages and disadvantages, and suitable internal fixation methods can be selected based on the characteristics of the patient.

Case report: Open-heart removal for a cement embolism formed 10 years ago in the right ventricle and pulmonary artery

Bone cement embolism is a known complication after a kyphoplasty operation. Cement embolisms without immediate fatal complication such as cardiac perforation or hypoxemia were often stable during observation. We report a case of a large volume bone cement embolism involving the right ventricle and the pulmonary artery system. The patient developed mild exertional shortness of breath and chest pain after a percutaneous kyphoplasty (PKP) operation 10 years ago. However, her mild symptoms were attributed to multiple myeloma, and no chest imaging was taken until the symptoms exacerbated after a COVID-19 infection 6 months ago. A large, tree-branch-shaped embolus was found, causing severe obstruction of the ascending and middle-lobe branch of the right pulmonary artery. The pulmonary perfusion scintigraphy demonstrated an impaired perfusion of the right upper and middle lobe. An open-heart removal was performed, and the symptoms were relieved afterward. We report this case to highlight the importance of routine chest imaging after a PKP operation and to claim that open-heart removal for chronic cement pulmonary embolism is technically feasible and safe.

Mechanism of gastrointestinal injury in COVID-19 and potential use of ghrelin therapy

In Corona Virus Disease 2019 (COVID-19), the most obvious symptoms occur in the respiratory and digestive systems, posing a serious threat to the health of patients. Decreased appetite is the most common digestive system symptom and is an important predictor of mortality. A large number of patients have decreased appetite after infection and do not show obvious organic disease characteristics. Currently, no drugs can directly alleviate such symptom. In order to reduce the number of severe and critically ill patients and decrease the hospitalization rate, it is very important to understand the pathogenic mechanism of appetite loss caused by COVID-19 and manage such symptom. Ghrelin is a key gastric hormone that has anti-inflammatory, neuroprotective, and antidepressant effects. In this paper, we will review the progress in the understanding of the mechanism of appetite loss associated with COVID-19, and introduce a potential therapeutic drug, ghrelin.

Intra-atrial coronary artery reconstruction during surgery for cardiac angiosarcoma

A cardiac angiosarcoma is usually located in the right atrium and tends to involve the right coronary artery. Our goal was to report a novel reconstruction technique after en bloc resection of a cardiac angiosarcoma with right coronary artery invasion. This technique includes orthotopic reconstruction of the invaded artery and atrial patch suturing onto the epicardium lateral to the reconstructed right coronary artery. Intra-atrial reconstruction with an end-to-end anastomosis can enhance the graft patency compared to a distal side-to-end anastomosis and can reduce the risk of anastomotic stenosis. Moreover, suturing the graft patch to the epicardium did not increase the risk of bleeding because the pressure in the right atrium was low.

Construction and validation of a personalized nomogram of ultrasound for pretreatment prediction of breast cancer patients sensitive to neoadjuvant chemotherapy

OBJECTIVE

To construct a combined radiomics model based on pre-treatment ultrasound for predicting of advanced breast cancers sensitive to neoadjuvant chemotherapy (NAC).

METHODS

A total of 288 eligible breast cancer patients who underwent NAC before surgery were enrolled in the retrospective study cohort. Radiomics features reflecting the phenotype of the pre-NAC tumors were extracted. With features selected using the least absolute shrinkage and selection operator (LASSO) regression, radiomics signature (Rad-score) was established based on the pre-NAC ultrasound. Then, radiomics nomogram of ultrasound (RU) was established on the basis of the best radiomic signature incorporating independent clinical features. The performance of RU was evaluated in terms of calibration curve, area under the curve (AUC), and decision curve analysis (DCA).

RESULTS

Nine features were selected to construct the radiomics signature in the training cohort. Combined with independent clinical characteristics, the performance of RU for identifying Grade 4-5 patients was significantly superior than the clinical model and Rad-score alone (p < 0.05, as per the Delong test), which achieved an AUC of 0.863 (95% CI, 0.814-0.963) in the training group and 0.854 (95% CI, 0.776-0.931) in the validation group. DCA showed that this model satisfactory clinical utility, suggesting its robustness as a response predictor.

CONCLUSION

This study demonstrated that RU has a potential role in predicting drug-sensitive breast cancers.

ADVANCES IN KNOWLEDGE

Aiming at early detection of Grade 4-5 breast cancer patients, the radiomics nomogram based on ultrasound has been approved as a promising indicator with high clinical utility. It is the first application of ultrasound-based radiomics nomogram to distinguish drug-sensitive breast cancers.

Characteristics and Diagnostic Challenge of Antineutrophil Cytoplasmic Antibody Positive Infective Endocarditis

OBJECTIVE

Antineutrophil cytoplasmic antibody (ANCA) has been reported in patients with infective endocarditis. Whether ANCA is associated with certain characteristics of infective endocarditis is unclear. The principal aim of this study is to investigate the clinical implications of ANCA in infective endocarditis and highlight the diagnostic challenge in ANCA-positive patients with infective endocarditis.

METHODS

A retrospective study was conducted in a tertiary hospital in China from August 2012 to December 2021. Patients with a diagnosis of infective endocarditis and available ANCA results were included in the study. The clinical and pathological characteristics were compared between ANCA-positive and ANCA-negative patients.

RESULTS

A total of 237 patients were included. Forty three (18.1%) were ANCA-positive, predominantly c-ANCA/anti-PR3. Compared to ANCA-negative patients, ANCA-positive patients had longer disease duration (P = .004), more frequent purpura (P = .015), macrohematuria (P = .002), proteinuria (P = .043), acute kidney injury (P = .004), and rapidly progressive glomerulonephritis (P = .010). Histologic findings of 8 patients with infective endocarditis-associated glomerulonephritis were reviewed. Two ANCA-positive patients with infective endocarditis presented with pauci-immune necrotizing and crescentic glomerulonephritis. A total of 18.6% of ANCA-positive patients with infective endocarditis were misdiagnosed as ANCA-associated vasculitis.

CONCLUSIONS

ANCA is detected in a substantial proportion of patients with infective endocarditis. The presence of ANCA in infective endocarditis is associated with longer disease duration, more frequent purpura, and kidney involvement. ANCA-positive infective endocarditis may mimic ANCA-associated vasculitis, and the differential diagnosis is challenging. Whether ANCA is pathogenic in infective endocarditis-associated small vessel vasculitis requires further study.

Surgery for Angiosarcoma and Other Cardiac Sarcomas: A Single-Institution Experience

Background

Cardiac sarcomas are rare malignancies with a poor prognosis. Although angiosarcoma is the most common histological subtype, its features are poorly characterized. This study aimed to compare the clinical characteristics of the various cardiac sarcomas and the surgical techniques used and to identify factors influencing the prognosis.

Methods

Forty patients who underwent surgery for cardiac sarcomas were included; 60% of them had angiosarcoma. Clinical characteristics, tumor location, surgical techniques used, and the prognosis were compared between patients with angiosarcoma and patients with other subtypes. Kaplan-Meier curves and multivariable Cox regression were used to identify predictors of postoperative survival.

Results

Angiosarcomas were more likely than the other subtypes to present as pericardial effusion (85% vs 50%, P = .014). Early surgery was performed (median 24.0 days) regardless of histological subtype. The surgical technique varied according to histological subtype. Mean postoperative survival was 10 months. A positive margin (P = .13), high Ki-67 index (P = .19), younger age (P = .86), and angiosarcoma (P = .87) were identified to be potentially poor prognostic factors in univariate analyses. Cox regression identified R0 resection to be the only significant independent predictor of the prognosis after surgery (hazard ratio, 0.423, P = .039).

Conclusions

Angiosarcoma differs from other subtypes of cardiac sarcoma in terms of clinical symptoms, tumor location, surgical techniques used, and prognosis. Early surgery is needed regardless of subtype. R0 resection is the only independent predictor of postoperative survival, and complete resection is usually achievable. The prognosis may be poorer in patients with a positive margin, high Ki-67 index, younger age, and angiosarcoma.

Repair versus replacement for active endocarditis of the mitral valve: 9 years of experience

BACKGROUND AND AIM

To determine the factors contributing to successful mitral valve repair (MVP) and to discuss the effect of complex techniques on the durability of MVP for active infective endocarditis (IE) affecting the mitral valve.

METHODS

One hundred and eighty-seven patients were enrolled; 39.6% underwent mitral valve replacement (MVR) and 60.4% underwent MVP. We used logistic regression to identify influencing factors of the choice of surgical technique. The results were compared between groups and subgroups after propensity score matching (PSM).

RESULTS

Risk factors for MVR included poor valve quality (odds ratio [OR] 23.3, p = .001), a large defect after debridement (OR 16.4, p < .001), and heavy valve infection (OR 3.7, p = .027). After PSM, we did not find a significant difference in the frequency of major postoperative complications or the in-hospital or postdischarge death rate. The reintervention rate for MVP was significantly higher than that for MVR (p = .047). Subgroup analysis found a significant relationship between the use of a complex repair technique and the need for reoperation (p = .020).

CONCLUSIONS

The choice of valve repair or replacement for patients with active IE affecting the mitral valve was influenced by the intraoperative characteristics of the infected valve rather than the severity of systemic infection or overall health status. The choice of surgical treatment strategy had no effect on major postoperative complications, in-hospital mortality, or medium-term survival. However, the medium-term durability of MVP was poorer than that of MVR. The use of the patch technique for free margins or extensive leaflet defects was associated with a need for reintervention.

[Analysis of clinical phenotype and genotype of Chinese children with disorders of sex development]

Objective: To explore the heterogeneity and correlation of clinical phenotypes and genotypes in children with disorders of sex development (DSD). Methods: A retrospective study of 1 235 patients with clinically proposed DSD in 36 pediatric medical institutions across the country from January 2017 to May 2021. After capturing 277 DSD-related candidate genes, second-generation sequencing was performed to analyzed the heterogeneity and correlation combined with clinical phenotypes. Results: Among 1 235 children with clinically proposed DSD, 980 were males and 255 were females of social gender at the time of initial diagnosis with the age ranged from 1 day of age to 17.92 years. A total of 443 children with pathogenic variants were detected through molecular genetic studies, with a positive detection rate of 35.9%. The most common clinical phenotypes were micropenis (455 cases), hypospadias (321 cases), and cryptorchidism (172 cases) and common mutations detected were in SRD5A2 gene (80 cases), AR gene (53 cases) and CYP21A2 gene (44 cases). Among them, the SRD5A2 mutation is the most common in children with simple micropenis and simple hypospadias, while the AMH mutation is the most common in children with simple cryptorchidism. Conclusions: The SRD5A2 mutation is the most common genetic variant in Chinese children with DSD, and micropenis, cryptorchidism, and hypospadias are the most common clinical phenotypes. Molecular diagnosis can provide clues about the biological basis of DSD, and can also guide clinicians to perform specific clinical examinations. Target sequence capture probes and next-generation sequencing technology can provide effective and economical genetic diagnosis for children with DSD.

Ultrasound-based radiomics nomogram for differentiation of triple-negative breast cancer from fibroadenoma

OBJECTIVE

This study aimed to develop a radiomics nomogram that incorporates radiomics, conventional ultrasound (US) and clinical features in order to differentiate triple-negative breast cancer (TNBC) from fibroadenoma.

METHODS

A total of 182 pathology-proven fibroadenomas and 178 pathology-proven TNBCs, which underwent preoperative US examination, were involved and randomly divided into training (n = 253) and validation cohorts (n = 107). The radiomics features were extracted from the regions of interest of all lesions, which were delineated on the basis of preoperative US examination. The least absolute shrinkage and selection operator model and the maximum relevance minimum redundancy algorithm were established for the selection of tumor status-related features and construction of radiomics signature (Rad-score). Then, multivariate logistic regression analyses were utilized to develop a radiomics model by incorporating the radiomics signature and clinical findings. Finally, the usefulness of the combined nomogram was assessed by using the receiver operator characteristic curve, calibration curve, and decision curve analysis (DCA).

RESULTS

The radiomics signature, composed of 12 selected features, achieved good diagnostic performance. The nomogram incorporated with radiomics signature and clinical data showed favorable diagnostic efficacy in the training cohort (AUC 0.986, 95% CI, 0.975-0.997) and validation cohort (AUC 0.977, 95% CI, 0.953-1.000). The radiomics nomogram outperformed the Rad-score and clinical models (p < 0.05). The calibration curve and DCA demonstrated the good clinical utility of the combined radiomics nomogram.

CONCLUSION

The radiomics signature is a potential predictive indicator for differentiating TNBC and fibroadenoma. The radiomics nomogram associated with Rad-score, US conventional features, and clinical data outperformed the Rad-score and clinical models.

ADVANCES IN KNOWLEDGE

Recent advances in radiomics-based US are increasingly showing potential for improved diagnosis, assessment of therapeutic response and disease prediction in oncology. Rad-score is an independent predictive indicator for differentiating TNBC and fibroadenoma. The radiomics nomogram associated with Rad-score, US conventional features, and clinical data outperformed the Rad-score and clinical models.

[Metagenomic data-analysis reveals enrichment of lipopolysaccharide synthesis in the gut microbiota of atrial fibrillation patients]

Objective: To investigate the functional changes of key gut microbiota (GM) that produce lipopolysaccharide (LPS) in atrial fibrillation (AF) patients and to explore their potential role in the pathogenesis of AF. Methods: This was a prospective cross-sectional study. Patients with AF admitted to Beijing Chaoyang Hospital of Capital Medical University were enrolled from March 2016 to December 2018. Subjects with matched genetic backgrounds undergoing physical examination during the same period were selected as controls. Clinical baseline data and fecal samples were collected. Bacterial DNA was extracted and metagenomic sequencing was performed by using Illumina Novaseq. Based on metagenomic data, the relative abundances of KEGG Orthology (KO), enzymatic genes and species that harbored enzymatic genes were acquired. The key features were selected via the least absolute shrinkage and selection operator (LASSO) analysis. The role of GM-derived LPS biosynthetic feature in the development of AF was assessed by receiver operating characteristic (ROC) curve, partial least squares structural equation modeling (PLS-SEM) and logistic regression analysis. Results: Fifty nonvalvular AF patients (mean age: 66.0 (57.0, 71.3), 32 males(64%)) were enrolled as AF group. Fifty individuals (mean age 55.0 (50.5, 57.5), 41 males(82%)) were recruited as controls. Compared with the controls, AF patients showed a marked difference in the GM genes underlying LPS-biosynthesis, including 20 potential LPS-synthesis KO, 7 LPS-biosynthesis enzymatic genes and 89 species that were assigned as taxa harbored nine LPS-enzymatic genes. LASSO regression analysis showed that 5 KO, 3 enzymatic genes and 9 species could be selected to construct the KO, enzyme and species scoring system. Genes enriched in AF group included 2 KO (K02851 and K00972), 3 enzymatic genes (LpxH, LpxC and LpxK) and 7 species (Intestinibacter bartlettii、Ruminococcus sp. JC304、Coprococcus catus、uncultured Eubacterium sp.、Eubacterium sp. CAG:251、Anaerostipes hadrus、Dorea longicatena). ROC curve analysis revealed the predictive capacity of differential GM-derived LPS signatures to distinguish AF patients in terms of above KO, enzymatic and species scores: area under curve (AUC)=0.957, 95%CI: 0.918-0.995, AUC=0.940, 95%CI 0.889-0.991, AUC=0.972, 95%CI 0.948-0.997. PLS-SEM showed that changes in lipopolysaccharide-producing bacteria could be involved in the pathogenesis of AF. The key KO mediated 35.17% of the total effect of key bacteria on AF. After incorporating the clinical factors of AF, the KO score was positively associated with the significantly increased risk of AF (OR<0.001, 95%CI:<0.001-0.021, P<0.001). Conclusion: Microbes involved in LPS synthesis are enriched in the gut of AF patients, accompanied with up-regulated LPS synthesis function by encoding the LPS-enzymatic biosynthesis gene.

Outcomes of surgical treatment for active infective endocarditis under COVID-19 pandemic

Background

The coronavirus disease 2019 (COVID‐19) pandemic has been and will continue to be a challenge to the healthcare system worldwide. In this context, we aimed to discuss the impact of the COVID‐19 pandemic on the diagnosis, timing, and prognosis of surgical treatment for active infective endocarditis (IE) during the pandemic and share our coping strategy.

Methods

A total of 39 patients were admitted for active IE in the year 2020. The number of the same period last year was 50. Medical information of these two groups was extracted from our surgical database. Data were compared between the two groups and differences with or without statistical significance were discussed.

Results

In the pandemic year, we admitted fewer transferred patients (64.1% vs. 80%, p = .094). Timespan for diagnosis were prolonged (60 vs. 34.5 days, p = .081). More patients were admitted in emergency (41% vs. 20%, p = .030) More patients had heart failure (74.4% vs. 40%, p = .001), sepsis (69.2% vs. 42.0%, p = .018), or cardiogenic shock (25.6% vs. 8.0%, p = .038). Overall surgical risk (EuroSCORE II) was higher (4.15% vs. 3.24%, p = .019) and more commando surgery was performed (7.7% vs. 2.0%, p = .441). However, we did not see more postoperative complications, and early mortality was not worse either (0 vs. 4%, p = .502).

Conclusions

The negative impact of the COVID‐19 pandemic on the clinical practice of surgical treatment for active IE was multifaceted. However, with the preservation of the effectiveness of multidisciplinary IE surgical team, the early outcomes were comparable with those in the normal years.

[Efficacy and safety of Kangbingdu granules in the treatment of influenza: a randomized, double-blind, double-dummy, positive-drug parallel control multicenter clinical trial]

Objective: To observe the efficacy and safety of Kangbingdu granules (KBD) in the treatment of influenza. Methods: A multicenter, randomized, double-blind, double-dummy, and positive-drug parallel control trial was conducted in 27 Grade ⅢA hospitals in China and the subjects were randomly assigned to the KBD test group or the oseltamivir phosphate capsule control group at a ratio of 1∶1. 200 subjects were planned to be enrolled in each group. The experimental group was given KBD (18g each time, 3 times a day) and oseltamivir phosphate simulator orally, while the control group was given oseltamivir phosphate capsule (75 mg each time, twice a day) and KBD simulator orally for 5 days. The primary efficacy indicators included the remission time of major clinical symptoms and the time of complete defervescence. The secondary efficacy indicators included dosage of acetaminophen, the change of traditional Chinese medicine (TCM) syndrome score and the remission time of other important clinical symptoms. The efficacy of KBD in the test group and Oseltamivir phosphate control group were compared. Adverse events or adverse reactions were observed at the same time to evaluate the safety of KBD Granules. Results: A total of 393 subjects from 27 Grade ⅢA hospitals in China were enrolled. The experimental group included 195 subjects and 191 subjects (97.95%) completed the trial, While the control group included 198 subjects and 195 subjects (98.48%) completed the trial. There was no significant difference in the shedding rate and rejection rate between the two groups (P>0.05). In the Full Analysis Set (FAS), the mean age of the experimental group was (34.9±14.4) years old, with 83 males (42.78%). The mean age of the control group was (33.3±13.5) years old, with 78 males (39.59%). There were no statistically significant differences between the two groups in demographic data, physical examination, viral pathogen detection, total score of TCM syndromes and scores of each symptom at baseline (P>0.05). In the FAS, the remission time M (Q₁, Q₃) of major clinical symptoms was 3.0 (3.0, 4.0) days in the experimental group and 3.0 (3.0, 4.0) days in the control group, and the difference was not statistically significant (P>0.05). The time M (Q₁, Q₃) of complete defervescence was 34.0 (20.3, 49.0) hours in the experimental group and 36.5 (19.6, 48.8) hours in the control group, and the difference was not statistically significant (P>0.05). KBD granules had the same effect as Oseltamivir phosphate capsule (P>0.05) in terms of acetaminophen dosage, TCM syndrome effect and disappearance rate of most important clinical symptoms. Meanwhile, the disappearance rate of dizziness and chest distress on day 3 in the KBD granules group was better than that of oseltamivir phosphate capsule (P<0.05). Conclusion: KBD granules have the same efficacy as Oseltamivir Phosphate capsule in the treatment of influenza and the drug safety is good.

Preoperative ultrasound-based radiomics score can improve the accuracy of the Memorial Sloan Kettering Cancer Center nomogram for predicting sentinel lymph node metastasis in breast cancer

PURPOSE

To develop a combined nomogram by incorporating the Memorial Sloan Kettering Cancer Center (MSKCC) nomogram and ultrasound (US)-based radiomics score (Radscore) for predicting sentinel lymph node (SLN) metastasis in invasive breast cancer.

MATERIALS AND METHODS

This retrospective study was approved by the ethics committee of our institution, and written informed consent was waived. A total of 452 patients with invasive breast cancer who received SLN Biopsy in a single center were included between January 2016 and December 2019. The patients were divided into a training set (n = 318) and a validation set (n = 134). A total of 1216 features were extracted from the regions of interest (ROIs) of the tumors on conventional ultrasound. The maximum relevance minimum redundancy (mRMR) and the least absolute shrinkage and selection operator (LASSO) algorithm were used to build the Radscore. Afterward, the diagnostic performance was assessed and validated. Comparison of receiver operating characteristic (ROC) curves and decision curve analysis (DCA) were performed to evaluate the incremental value of the combined model.

RESULTS

Obtained from 18 features, the Radscore indicated a favorable discriminatory capability in the training set with an area under the curve (AUC) of 0.834, whereas a value of 0.770 was observed in the validation set. The AUC of the combined model was 0.901 (95 % confidence interval (95 % CI): 0.865-0.938) in the training set and 0.833 (95 % CI: 0.788-0.878) in the validation set. Both of them were superior to MSKCC or imaging Radscore alone (P < 0.05). DCA demonstrated that the combined model was superior to the others in terms of clinical practicability.

CONCLUSION

Preoperative US-based Radscore can improve the accuracy of clinical MSKCC nomogram for SLN metastasis prediction in breast cancer.

[Brain protection strategy and effectivity in pulmonary thromboendarterectomy]

Objective: To summarize the experience and effectivity of brain protection in 25 patients who suffered from chronic thromboembolic pulmonary hypertension (CTEPH) and received pulmonary thromboendarterectomy (PTE) under deep hypothermic circulatory arrest. Methods: Retrospective analysis of 25 PTE surgeries in our center from December 2016 to August 2018. All cases were completed underdeep hypothermic circulatory arrest. Standard brain protections were strictly executed, including: balanced and controlled extracorporeal circulation cooling, cerebral oxygen saturation (rSO(2)) monitoring, strictly control of circulatory arrest time, and etc. The neurological adverse events during the perioperative period were recorded and statistically analyzed, and the intelligence level and cognitive function of the patients were evaluated by MMSE scale and MoCA scale before surgery and discharge. Results: All the 25 patients successfully completed the surgery, and 1 patient (4%) died of postoperative infection. The mean pulmonary arterial pressure decreased from (52.9±16.7) mmHg before surgery to (23.6±8.1) mmHg immediately after surgery (t=10.01, P<0.01), and(20.7±7.9) mmHg at 3 months follow-up (t=10.73, P<0.01). Pulmonary vascular resistance decreased from 975.4 (788.6-1 292.8) dyn·s·cm(-5) to 376.1 (283.6-565.5) dyn·s·cm(-5) (Z=5.34, P<0.01). Neurological complications occurred in 3 patients during the perioperative period, including 2 patients with hypoxic encephalopathy, and 1 patient with cerebral hemorrhage. All 3 patients fully recovered before discharge. Univariate analysis showed that the duration of rSO(2)<40% and the maximum decrease rate of rSO(2) from baseline were significantly correlated with postoperative neurological damage. Multivariate analysis showed only time of rSO(2)<40% was significantly correlated with postoperative neurological damage. There was no significant difference in MMSE and MoCA score before and after surgery (P>0.05). Conclusions: Adequate brain protection measures are essential to reduce the neurological complications of PTE surgery. Real-time intraoperative monitoring of rSO(2) and strict control of circulatory arrest time can further reduce the occurrence of neurological damage.

[Surgical technique and mid-and-long curative effect analysis of primary repair of chronic Achilles tendon rupture]

Objective: To examine the surgical method and clinical outcome of primary repair of chronic Achilles tendon rupture. Methods: From March 2012 to August 2017, clinical data of 35 consecutive patients with chronic Achilles tendon rupture who were treated with primary repair by the same doctor at Department of Sports Medicine, Peking University Third Hospital were retrospectively analyzed.There were 29 males and 6 females with age of (41.0±9.3)years(range:29-65 years), the follow-up period was (45.6±17.2) months(range:17-82 months). All the patients had unilateral tendon rupture with 22 cases on the left and 13 cases on the right.The preoperative and postoperative Visual Analogue Scale(VAS), American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score(AOFAS), the Victorian Institute of Sport Assessment-Achilles(VISA-A), the Achilles tendon Total Rupture Score(ATRS)and the Tegner Activity Score of patients were collected and compared by paired-t test. Results: Among 47 patients with chronic Achilles tendon rupture, 35 patients were followed up for (45.6 ± 17.2)months(range: 17-28 months). No serious postoperative complications such as infection or nerve damage and rerupture outcomes were reported. At the last follow-up,the VAS decreased from 1.0(2.0) (M(Q(R))) preoperative to 0.0(0.8)(Z=-3.586, P=0.00), AOFAS increased from 64.3±12.5 to 97.0±5.0(t=-14.359,P<0.001), VISA-A increased from 51.3± 9.8 to 87.8±18.0(t=- 17.656, P=0.00), Tegner increased from 0.9±0.3 to 4.6±1.7(t=- 12.524, P=0.00)and ATRS increased from 40.0±3.5 to 97.9±3.9(t=-64.133,P=0.00). Twenty-eight patients (80.0%) had returned to their preinjury activity levels, and 7 patients (20.0%) no longer participate in recreational sports. According to Arner-Lindholm curative effect evaluation criteria, 32 cases(91.4%)gained the excellent results, 1 case(2.9%) of good and 2 cases(5.7%) bad, and the percentage of the cases with the excellent or good results was 94.3%. All except 2 patients with bad results could perform a single-limb heel rise painlessly. Conclusions: Primary repair is an efficient approach for chronic Achilles tendon rupture. The mid-and-long curative effect is satisfactory and stable.Compared with other surgical techniques, operation is relatively simple and economical. The primary repair is considerably safe, with few serious complications such as infection or nerve damage and reruptures.

Multilocus sequence typing analysis of Candida africana from vulvovaginal candidiasis

BACKGROUND

Candida africana is distributed worldwide and colonized in human genitalia and cause mainly vulvovaginal candidiasis (VVC). We report the multilocus sequence typing (MLST) analysis of C. africana from VVC.

METHODS

MLST analysis of 43 strains of C. africana, which were isolated from vaginal specimens of patients with VVC, was performed. The enzymatic activity of phospholipase, esterase and haemolysis enzyme production was evaluated.The level of virulent genes and resistant genes mRNA expression was determined by using real-time PCR. Antifungal susceptibilities of the isolates were assayed by using the broth microdilution method. The statistical of the results was determined by the T test and Pearson chi-squared test.

RESULTS

The MLST analysis revealed a substantial degree of genetic homogeneity. The DST782 and DST182 were the main MLST genotypes in C. africana. All the patients were symptomatic and with a high mycological cure rate when treated with commonly used antifungal agents.There were statistically significant differences in biofilm formation and phospholipase activity between C. africana and C.albicans. The level of virulent genes and resistant genes mRNA expression was higher in fluconazole-resistant strains. All C. africana isolates were susceptible to fluconazole, itraconazole, voriconazole, caspofungin, and micafungin. These isolates also exhibited low MICs to amphotericin B, flucytosine, and posaconazole.

CONCLUSIONS

Candida africana appear to be with a low level of sequence variation in MLST loci. Candida africana, a lower virulence candida, is susceptible to commonly used antifungal agents. This paper was presented at the conference of 8th Trend in Medical Mycology (6-9 October 2017, Belgrade, Serbia) and was published on conference abstract.

Inhibition of vascular endothelial growth factor in young adult mice causes low bone blood flow and bone strength with no effect on bone mass in trabecular regions

Objective

To determine the effect of an antibody to vascular endothelial growth factor (VEGF) on bone blood flow, bone strength, and bone mass in the young adult mouse.

Methods

Ten-week-old male BALB/cJ mice were body weight-randomized into either a rodent anti-VEGF monoclonal antibody (anti-VEGF, B20-4.1.1; 5 mg/kg 2×/wk.; n = 12) group or a vehicle (VEH; n = 12) group. After 42 days, mice were evaluated for bone blood flow at the distal femur by ¹⁸F-NaF-PET/CT and then necropsied. Samples from trabecular and cortical bone regions were evaluated for bone strength by mechanical testing, bone mass by peripheral quantitative computed tomography (pQCT), and micoarchitecture (MicroCT). Hydration of the whole femur was studied by proton nuclear magnetic resonance relaxometry (¹H NMR).

Results

Distal femur blood flow was 43% lower in anti-VEGF mice than in VEH mice (p = 0.009). Ultimate load in the lumbar vertebral body was 25% lower in anti-VEGF than in VEH mice (p = 0.013). Bone mineral density (BMD) in the trabecular region of the proximal humeral metaphysis by pQCT, and bone volume fraction and volumetric BMD by MicroCT were the same in the two groups. Volume fraction of bound water (BW) of the whole femur was 14% lower in anti-VEGF than in VEH mice (p = 0.003). Finally, BW, but not cortical tissue mineral density, helped section modulus explain the variance in the ultimate moment experienced by the femur in three-point bending.

Conclusion

Anti-VEGF caused low bone blood flow and bone strength in trabecular bone regions without influencing BMD and microarchitecture. Low bone strength was also associated with low bone hydration. These data suggest that bone blood flow is a novel bone property that affects bone quality.

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An antibody to vascular endothelial growth factor (anti-VEGF) caused low bone blood flow in a trabecular bone rich region.

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Anti-VEGF did not affect trabecular bone region and bone hydration of the whole femur were also low, trabecular bone mass was not affected by anti-VEGF.

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Bone blood flow may be a bone property that affects bone quality through bone hydration.

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Anti-VEGF caused low trabecular bone strength in the vertebral body and low bone hydration of the whole femur.

Brachytherapy using elastin-like polypeptide with different concentrations of 131I for treatment of VX2 liver tumor in rabbits

BACKGROUND

Brachytherapy is a targeted radiation therapy for cancer. The elastin-like peptide (ELP) is a genetically engineered peptide that has unique advantages such as self-assembly, temperature responsiveness, and non-immunogenicity, which make it possible to become the carrier of the radionuclide ¹³¹I.

AIM

To evaluate the effectiveness of brachytherapy in a rabbit model of VX2 liver tumor using elastin-like polypeptide as a radionuclide ¹³¹I carrier and compare the effectiveness of ¹³¹I-ELP at different radioactive concentrations to provide evidence for its clinical application.

METHODS

ELP as a carrier was labeled with ¹³¹I by the iodogen method, and different concentrations of ¹³¹I-ELP were prepared. Under ultrasound guidance, different concentrations of ¹³¹I-ELP and ELP solution were randomly injected into 15 rabbits with VX2 liver tumor for brachytherapy and blank control observation. The rabbits were divided into the following groups: high-dose radiation group (injection with 100 mCi/mL ¹³¹I-ELP; group H, n = 5); low-dose radiation group (injection with 50 mCi/mL ¹³¹I-ELP; group L, n = 5); and blank control group (injection with ELP solution; group C, n = 5). Periodic biochemical and sonographic examinations were performed to assess the therapeutic efficacy after treatment. Single-photon emission computed tomography/computed tomography (SPECT/CT) was additionally performed in the treatment groups. The natural survival time of animals in the three groups was determined. In addition, histopathological examination was performed.

RESULTS

The survival time of animals was the longest in group H (61.4 d ± 10.50 d) and the shortest (39.2 d ± 5.63 d) in group C. The survival time of animals in group L was 52.6 d ± 8.85 d. Significant differences were observed in the survival time among the three groups (P < 0.05). At 7 and 14 d after treatment, SPECT/CT showed that ¹³¹I-ELP was continuously localized in liver tumors in groups H and L. The tumor growth rates in groups H and L were significantly lower than that in group C (P < 0.05). Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) at 14 d after treatment in groups H and L were significantly lower than those in group C (P < 0.05). At 7 d after treatment, ALT level in group L was significantly lower than that in group H (P < 0.05). At 14 d after treatment, AST value in group L was significantly lower than that in group H (P < 0.05), suggesting that group L is better than group H with regard to ameliorating ALT and AST levels (P < 0.05). There were no significant differences in Hb or RBC levels between the three groups at 7 and 14 d after treatment. Histopathological examination showed that normal tissues around the tumor in group H were destroyed; proliferation of cord-like fibers, expansion of hepatic sinus, and dilatation of small bile ducts in the portal area were observed. In group L, no radioactive damage was observed in normal liver tissues around the tumor.

CONCLUSION

¹³¹I-ELP brachytherapy has curative effects in inhibiting tumor growth. ¹³¹I-ELP at a radiation dose of 100 mCi/mL inhibits tumor growth better than ¹³¹I-ELP at a radiation dose of 50 mCi/mL; however, the higher dose causes greater radiation damage to normal liver tissues around the tumor.

A new discussion of the cutaneous vascular reactivity in sensitive skin: A sub-group of SS?

BACKGROUND

Sensitive skin (SS) seems not to be a one-dimensional condition and many scholars concentrate on skin barrier disruption or sensorineural change, but few focus on its increased vascular reactivity. This study explored the possibility of using the different selection methods and measurement methods to verify a high vascular reactivity in SS without an impaired cutaneous barrier function.

METHODS

Sixty "self-perceived sensitive skin" volunteers were enlisted and each one completed three kinds of screening tests: assess cutaneous sensory using questionnaire survey and Lactic Acid Sting Test (LAST); assess barrier function using Sodium lauryl sulphate (SLS) skin irritation test and assess cutaneous vascular reactivity using 98% DMSO test and non-invasive measurement. Volunteers were divided into different groups based on response to SLS. The DMSO clinical score and the biophysical parameters obtained by non-invasive measurement were subsequently analysed.

RESULTS

(1) The positive correlations could be seen between sum LAST score and sum DMSO score regardless of the observation time; (2) The biological parameters (CBF、a*values and L* values) are all keeping with DMSO score; (3) If the participants were divided into SLS reactors and non-reactors, a composition ratio of DMSO score was significant difference in these two groups and in SLS non-reactors, there were still seven participants showed high reaction to DMSO.

CONCLUSIONS

There is a sub-group of SS for characteristics of a high vascular reactivity without an impaired cutaneous barrier function. The DMSO test and novel non-invasive measurements which are conducive to assess cutaneous vascular reactivity, combined with SLS skin irritation test could help us to screen this kind of SS.

[Bibliometric analysis on relations between cardiovascular disease and erectile dysfunction]

Objective: To understand the current situation and trend on the relations between erectile dysfunction (ED) and cardiovascular disease (CVD) through analyzing the epidemiologic research data. Methods: We conducted a literature search on the Scopus for potentially relevant epidemiologic studies on ED and CVD published from 1957 to October, 28, 2016. Age of the article, types, regions, citation, and co-authorship of the documents were recorded. Results: A total number of 412 pieces of literature were published in the past six decades, with original articles the most common types of ED and CVD. ED and CVD associated epidemiologic topics had an annual increase in number, and remained stable in the past decade, with occident countries as the United States and Italy taking the lead in this area. Clinical and epidemiological studies were the hottest areas, with most authors sharing a co-authorship. Conclusion: Our results suggested that inter-disciplinary cooperation with emphasize on clinical application were the effective starting points for ED and CVD associated epidemiologic studies.

Size-dependent assembly of ligated gold nanocrystals in two dimensions

Brownian dynamics (BD) simulation based on a coarse-grained model is performed to study the assembly of dodecanethiol-ligated Au nanocrystals (NCs) at a toluene-air interface. With increasing diameter from 3 nm to 9 nm, the NCs are found to form three different phases-a dispersed phase without aggregation, a mixture of dispersed NCs and rounded clusters, and a compactly packed solid phase of the fractal structure. Such size dependence of the assembled phase is attributed to the variation in the well depth [Formula: see text] of the interaction potential between NCs, and the value of [Formula: see text] for 6 nm NCs turns out to be most suitable to form monolayers with hexagonal packing. The result is of universal importance for assembling complete monolayers, because the valley of the interaction potential can be well tailored by properly choosing the NC size, ligand length and solvent.

[Drug coated balloon with paclitaxel for the treatment of symptomatic peripheral artery disease: early and midterm results]

OBJECTIVE

To evaluate the safety and efficacy of the drug coated balloon (DCB) with paclitaxel in patients with symptomatic peripheral artery disease (PAD).

METHODS

The clinical data of 18 patients, who were diagnosed as PAD and treated with DCB from October 2013 to June 2014 in Department of Vascular Surgery, People's Liberation Army General Hospital, were retrospectively analyzed.Thirteen male and 5 female patients were in the series, the mean age of the patients was (65±7) years, and the Rutherford's categories were level 3 to 5. Patients were followed up at 3- and 6-month postoperative. The main efficacy end point were late lumen loss(LLL), rate of restenosis and clinically driven target lesion revascularization (TLR). Meanwhile, the clinical events were recorded.

RESULTS

Mean lesion length, the percentage of total occlusions and the percentage of in-stent restenosis were (138±91) mm, 9/18 and 2/18, respectively. Rate of technical success was 18/18. At 6-month postoperative, LLL, rate of restenosis and TLR were (0.1±0.9) mm, 2/14 and 0, respectively. There was no deaths or no amputations.

CONCLUSION

DCB with paclitaxel is safe in patients with PAD, and associated with reductions in LLL, restenosis and clinically driven TLR 6-month postoperative.

[Reconstruct abdominal aortic branch arteries totally by endovascular repair in complex aortic aneurysms: a single-centre experience]

OBJECTIVE

To report experiences and results of complex aortic aneurysms involving the visceral arteries treating by total endovascular repair.

METHODS

Seventy cases of thoracoabdominal aortic lesions treating by total endovascular repair in Department of Vascular Surgery, People's Liberation Army General Hospital from January 2011 to December 2014 were retrospectively analyzed. There were 47 cases underwent chimney technique, 6 underwent sandwich technique, 15 underwent fenestration technique and 2 underwent branched stent grafts technique.

RESULTS

The average follow-up time was 21 months, range from 3 to 47 months. Completion angiography showed that typeⅠ endoleak of chimney, sandwich, fenestration and branched stent grafts group were 9/47, 5/6, 2/15 and 0, respectively. While at 30-day typeⅠ endoleak reduced to 7/47, 2/6, 0 and 0. During follow-up, there were 3 target vessel stents occlusion in chimney group, the patency rate of target vessel stent was 95.1% (58/61). In sandwich, fenestration and branched stent grafts group, all the target vessel stents kept patent.

CONCLUSION

In this study, chimney, sandwich, fenestration and branched stent grafts techniques show good short-term and midterm results, the long-term effects still need further studies.

Characterization of the NLRC5 promoter in chicken: SNPs, regulatory elements and CpG islands

NLRC5 plays an important role in the innate immunity and cellular immunity in many species, but the regulatory mechanism of NLRC5 expression in chickens remains unclear. In this study, a series of deletion fragments of the NLRC5 promoter region were constructed and dual-luciferase assay was performed. Then, we detected the SNP in the core region and its function. Important transcriptional regulatory elements were predicted and identified. Methylation of CpG islands was measured. The results revealed that the two core regions of -4372 to -3756 and -2925 to -2265 in the NLRC5 promoter were essential for NLRC5 mRNA expression in which a SNP (A/G), located at -2470, was found to have an effect on the transcriptional activity. Also, the STAT1 element in the second core region of the NLRC5 promoter was identified to bind with the STAT1 transcription factor, which was necessary for the transcriptional activity. In addition, many other elements in the NLRC5 promoter, including YY1 and CEBP, may contribute significantly to the expression activity of NLRC5. Moreover, two CpG islands were searched. Part of one was located in the first core region, which suggests that epigenetic modification may regulate the activity of the first promoter region, and the other was mostly in an unmethylated state. Collectively, these results suggest the complex regulation of NLRC5 expression includes SNPs, transcription factors and methylation.

Differentiating origins of outflow tract ventricular arrhythmias: a comparison of three different electrocardiographic algorithms

Our objective is to evaluate the accuracy of three algorithms in differentiating the origins of outflow tract ventricular arrhythmias (OTVAs). This study involved 110 consecutive patients with OTVAs for whom a standard 12-lead surface electrocardiogram (ECG) showed typical left bundle branch block morphology with an inferior axis. All the ECG tracings were retrospectively analyzed using the following three recently published ECG algorithms: 1) the transitional zone (TZ) index, 2) the V₂ transition ratio, and 3) V₂ R wave duration and R/S wave amplitude indices. Considering all patients, the V₂ transition ratio had the highest sensitivity (92.3%), while the R wave duration and R/S wave amplitude indices in V₂ had the highest specificity (93.9%). The latter finding had a maximal area under the ROC curve of 0.925. In patients with left ventricular (LV) rotation, the V₂ transition ratio had the highest sensitivity (94.1%), while the R wave duration and R/S wave amplitude indices in V₂ had the highest specificity (87.5%). The former finding had a maximal area under the ROC curve of 0.892. All three published ECG algorithms are effective in differentiating the origin of OTVAs, while the V₂ transition ratio, and the V₂ R wave duration and R/S wave amplitude indices are the most sensitive and specific algorithms, respectively. Amongst all of the patients, the V₂ R wave duration and R/S wave amplitude algorithm had the maximal area under the ROC curve, but in patients with LV rotation the V₂ transition ratio algorithm had the maximum area under the ROC curve.

Elastic properties of gold supracrystals: Effects of nanocrystal size, ligand length, and nanocrystallinity

Atomistic molecular dynamics simulations are performed to study the elastic properties of alkylthiol-functionalized gold supracrystals. The predicted Young's and shear moduli are around 1 GPa and 100 MPa, respectively. We show that, with increasing NC size, the Young's modulus decreases while the shear modulus essentially remains invariant; with increasing ligand length, the Young's modulus increases but the shear modulus decreases. Moreover, significant increase in the Young's modulus is seen when the polycrystalline NCs are replaced by single-crystal ones of the same size. All these are in reasonable agreement with available experiments. We attribute the mechanisms to the interaction between capping ligands as well as its variations caused by the change in ligand length and NC geometry. The results may deepen our understanding of elastic properties of the supracrystals and their influential factors.

Molecular dynamics simulation of interparticle spacing and many-body effect in gold supracrystals

Interparticle spacing in supracrystals is a crucial parameter for photoelectric applications as it dominates the transport rates between neighboring nanoparticles (NPs). Based on large-scale molecular dynamics simulations, we calculate interparticle spacing in alkylthiol-stabilized gold supracrystals as a function of the NP size, ligand length and external pressure. The repulsive many-body interactions in the supracrystals are also quantified by comparing the interparticle spacing with that between two individual NPs at equilibrium. Our results are consistent with available experiments, and are expected to help precise control of interparticle spacing in supracrystal devices.

Root-soil air gap and resistance to water flow at the soil-root interface of Robinia pseudoacacia

During periods of water deficit, growing roots may shrink, retaining only partial contact with the soil. In this study, known mathematical models were used to calculate the root-soil air gap and water flow resistance at the soil-root interface, respectively, of Robinia pseudoacacia L. under different water conditions. Using a digital camera, the root-soil air gap of R. pseudoacacia was investigated in a root growth chamber; this root-soil air gap and the model-inferred water flow resistance at the soil-root interface were compared with predictions based on a separate outdoor experiment. The results indicated progressively greater root shrinkage and loss of root-soil contact with decreasing soil water potential. The average widths of the root-soil air gap for R. pseudoacacia in open fields and in the root growth chamber were 0.24 and 0.39 mm, respectively. The resistance to water flow at the soil-root interface in both environments increased with decreasing soil water potential. Stepwise regression analysis demonstrated that soil water potential and soil temperature were the best predictors of variation in the root-soil air gap. A combination of soil water potential, soil temperature, root-air water potential difference and soil-root water potential difference best predicted the resistance to water flow at the soil-root interface.

Single nucleotide polymorphism screening, molecular characterization, and evolutionary aspects of chicken Piwi genes

The P-element-induced wimpy testis (Piwi) gene is involved in germline stem cell self-renewal, meiosis, RNA silencing, and transcriptional regulation. Piwi genes are relatively well conserved in many species, but their function in poultry species is unclear. In this study, Piwi genes were sequenced using a target-sequence capture assay in quail and 28 breeds of chicken. Single nucleotide polymorphisms (SNPs) and evolutionary aspects of these chicken breeds were then analyzed. We found that SNP sites existed mainly in the introns of a few chicken breeds, and we selected an SNP on intron 4 for further verification by Sanger sequencing, the results of which were similar to those obtained by the target-capture sequencing assay. The evolutionary analysis revealed that there were more mutations in the Chahua and Leghorn breeds than in the other breeds, and that the phylogenetic tree was divided into four main categories that suggested that Piwi is evolutionarily conserved, and mutations in the introns might be associated with gametogenesis. The screened SNPs can be used as candidate markers for Piwi, and our results provide basic information for the further study of Piwi function in poultry.

Strain analysis of misfit dislocations in α-Fe₂O ₃/α-Al₂O ₃ heterostructure interface by geometric phase analysis

The α-Fe2O3/α-Al2O3 heterostructure interfaces have been studied using transmission electron microscopy (TEM). The interface exhibited coherent regions separated by equally spaced misfit dislocations. The misfit dislocations were demonstrated to be edge dislocations with dislocation spacing of ∼4 nm. The strain fields around the misfit dislocation core were mapped using a combination of geometric phase analysis and high-resolution transmission electron microscopy images. The strain measurement results were compared with the Peierls-Nabarro dislocation model and the Foreman dislocation model. These comparisons show that the Foreman model (a=2) is the most appropriate theoretical model to describe the strain fields of the dislocation core.

A coarse-grained simulation for tensile behavior of 2D Au nanocrystal superlattices

We performed a coarse-grained. molecular dynamics (MD) simulation to study the unidirectional tension of 2D superlattices of alkythiol-ligated Au nanocrystals (NCs). Consistent with available experiments, the predicted Young's modulus is in the range of 6-15 GPa, exhibiting a trend of decreasing with the increasing NCs' size and decreasing ligand length. Our simulation shows that the deformation of the superlattice experiences elastic and nonelastic stages before defect nucleation at the NC level. The larger tensile strain gives rise to slips along the most densely packed lines, making them equal to [Formula: see text] with the tensile direction before deformation, which further triggers the occurrence of cavities and cracks and finally leads to the fracture of the specimen. These results provide a clear picture for the tensile behavior of 2D superlattices from deformation to rupture.

Microstructure of spinel islands on the sapphire surface grown by ion implantation and annealing

Fe ions were implanted into α-Al2O3 single crystals (sapphire) at energy of 50 keV and annealed in an oxidizing environment. Transmission electron microscopy (TEM) investigation indicated that Fe ions in the near surface region precipitated as α-Fe2O3 islands and spinel islands on the specimen surface, at the same time, Fe ions in the region away from the surface precipitated as α-Fe particles in the interior region of specimen. Two orientation relationships (ORs) between the spinel islands and sapphire substrate were discovered as follows: (111)spinel∥(0001)sapphire, [1 1 2¯]spinel∥[1 1 2¯ 0]sapphire and (1 1 2¯)spinel∥(0 0 0 1)sapphire, [1 1 1]spinel∥[1 1 2¯ 0]sapphire. The first OR was frequently observed in the spinel/sapphire system, however, the second OR has never been reported before. The interfaces between the spinel islands and sapphire substrate are a type-3 incoherent interface (i.e. low-index OR in at least one direction with an ill-matched low-index habit planes). The formation of spinel islands on the specimen surface can be attributed to the oxidizing atmosphere and the low accelerating voltage for ion implantation.

Orientation relationship between α-Fe precipitate and α-Al2O3 matrix in iron-implanted sapphire

Fe ions were implanted into α-Al2O3 single crystals (sapphire) at room temperature and annealed in a reducing atmosphere. The orientation relationships (ORs) between α-Fe particles and sapphire matrix were investigated using transmission electron microscopy (TEM). All the α-Fe particles have the orientation relationship (OR) of (111)α-Fe||(0001)sapphire and [11¯0]α-Fe||[112¯0]sapphire with sapphire. This OR is predicted precisely by the coincidence of reciprocal lattice points (CRLP) method. The other OR of (110)α-Fe||(0001)sapphire and [111]α-Fe||[51¯4¯0]sapphire reported before is confirmed by the same method to be one of the secondary preferred orientation relationships in the α-Fe/sapphire system.

Regulation of autophagy by miR-30d impacts sensitivity of anaplastic thyroid carcinoma to cisplatin

miR-30d has been observed to be significantly down-regulated in human anaplastic thyroid carcinoma (ATC), and is believed to be an important event in thyroid cell transformation. In this study, we found that miR-30d has a critical role in modulating sensitivity of ATC cells to cisplatin, a commonly used chemotherapeutic drug for treatment of this neoplasm. Using a mimic of miR-30d, we demonstrated that miR-30d could negatively regulate the expression of beclin 1, a key autophagy gene, leading to suppression of the cisplatin-activated autophagic response that protects ATC cells from apoptosis. A reporter gene assay demonstrated that the binding sequences of miR-30d in the beclin 1-3' UTR was the region required for the inhibition of beclin 1 expression by this miRNA. We further showed that inhibition of the beclin 1-mediated autophagy by the miR-30d mimic sensitized ATC cells to cisplatin both in vitro (cell culture) and in vivo (animal xenograft model). These results suggest that dysregulation of miR-30d in ATC cells is responsible for the insensitivity to cisplatin by promoting autophagic survival. Thus, miR-30d may be exploited as a potential target for therapeutic intervention in the treatment of ATC.

Analysis of concentration fluctuations in gas dispersion around high-rise building for different incident wind directions

This article presents experimental results that illustrate the unsteady characteristics of gas dispersion around a complex-shaped high-rise building for different incident wind directions. A series of wind tunnel experiments were conducted using a 1:30 scale model that represented the real structures under study. The objective of this paper is to study the behaviour of concentration fluctuations through transient analysis. Tracer gas was continuously released from a point source located at different positions, and a time series of fluctuating concentrations were recorded at a large number of points using fast flame ionization detectors. The experimental data were analysed to provide a comprehensive data set including variances and associated statistical quantities. Both the unsteady characteristics of the system and their potential practical impact are presented and discussed. Under crowd living conditions, the air pollutant exhausted from one household could probably re-enter into the neighbouring households, traveling with ambient airflow. Such pollutant dispersion process is defined as air cross-contamination in this study. The results indicate that the wind-induced cross-contamination around the studied type of high-rise building should not be overlooked, and the fluctuating concentrations should be paid attention to particularly during the evaluation of a potential contamination risk. This study can help deepen our understanding of the mechanisms of air cross-contamination, and will be useful for implementing optimization strategies to improve the built environments in metropolitan cities such as Hong Kong.

Local characteristics of cross-unit contamination around high-rise building due to wind effect: mean concentration and infection risk assessment

In this present work, the characteristics of hazardous gas dispersion and possible cross-unit contamination around a complex-shaped high-rise residential building due to wind effect are thoroughly studied using physical modeling method. Experiments were performed in a boundary layer wind tunnel for a 1:30 scale model that represented a 10-story residential building in prototype. Tracer gas, simulating exhausted room air, was continuously released from different floor levels, and its concentrations on the adjacent envelope surfaces were measured using fast flame ionization detectors. The mean concentration fields were reported and analyzed under different configurations during the experiment to consider the effects on pollutant dispersion behavior due to changes in source position and approaching wind condition, with the main emphasis on the differences between open-window and closed-window conditions. In particular, the measured concentration fields were further examined from a practical point of view, with respect to hazard assessment. Understanding these hazardous plume dispersion features is useful for employing effective intervention strategies in modern residential building environment in case of hazardous substance release. The study on this physical process is not only helpful to reduce the hazardous effect of routine release of harmful pollutant near the building, but also useful for the purpose of prevention and control of accidental infectious diseases outbreak.

Local characteristics of cross-unit contamination around high-rise building due to wind effect: mean concentration and infection risk assessment

In this present work, the characteristics of hazardous gas dispersion and possible cross-unit contamination around a complex-shaped high-rise residential building due to wind effect are thoroughly studied using physical modeling method. Experiments were performed in a boundary layer wind tunnel for a 1:30 scale model that represented a 10-story residential building in prototype. Tracer gas, simulating exhausted room air, was continuously released from different floor levels, and its concentrations on the adjacent envelope surfaces were measured using fast flame ionization detectors. The mean concentration fields were reported and analyzed under different configurations during the experiment to consider the effects on pollutant dispersion behavior due to changes in source position and approaching wind condition, with the main emphasis on the differences between open-window and closed-window conditions. In particular, the measured concentration fields were further examined from a practical point of view, with respect to hazard assessment. Understanding these hazardous plume dispersion features is useful for employing effective intervention strategies in modern residential building environment in case of hazardous substance release. The study on this physical process is not only helpful to reduce the hazardous effect of routine release of harmful pollutant near the building, but also useful for the purpose of prevention and control of accidental infectious diseases outbreak.

Mutation L437P in the 2B domain of keratin 1 causes diffuse palmoplantar keratoderma in a Chinese pedigree

Diffuse palmoplantar keratoderma (DPPK) is an autosomal dominant genodermatosis characterized by uniform hyperkeratosis of the palm and sole epidermis. This disorder can be caused by mutations in the genes keratin 1, keratin 9, keratin 16, desmoglein 1 and plakoglobin. Here we present a DPPK Chinese pedigree and identify the aetiology as a novel missense mutation, L437P, located in a highly conserved helix motif in domain 2B of KRT1. Functional analysis shows that overexpression of the L437P mutant in cultured cells leads to abnormal intermediate filament networks and filament aggregation. This gain-of-function mutation highlights the role of domain 2B in mediating filament assembly.

Human defensins and cytokines in vaginal lavage fluid of women with bacterial vaginosis

OBJECTIVE

To measure the concentrations of interferon gamma (IFN-gamma), interleukin (IL)-2, IL-4, IL-5, human beta-defensin 2 (HBD-2), and human defensin 5 (HD-5) in the vaginal lavage fluid (VLF) of healthy women and women with bacterial vaginosis (BV).

METHODS

VLF samples were obtained from 73 women with BV, 15 women with intermediate vaginal flora, 33 healthy women with vaginal pH greater than or equal to 4.5, and a control group of 39 healthy women with vaginal pH less than 4.5. The concentrations of IFN-gamma, IL-2, IL-4, IL-5, HBD-2, and HD-5 were measured using enzyme-linked immunosorbent assay kits.

RESULTS

Concentrations of HBD-2 and HD-5 in the VLF of women with BV were significantly higher than in the control group (P<0.05). IL-4 concentration was significantly lower in the VLF of women with BV than in the control group (P<0.05).

CONCLUSIONS

HBD-2 and HD-5 may be involved in defending against invasion by BV-related microorganisms and the decrease in IL-4 concentration may increase susceptibility to BV.

Antifungal susceptibility and genotypes of Candida albicans strains from patients with vulvovaginal candidiasis

Studies of the genetic diversity of Candida albicans strains and the correlation between the antifungal susceptibility and gene diversity of C. albicans were carried out and the results were found to be inconsistent. To investigate antifungal susceptibility and genotypes of C. albicans strains from patients with vulvovaginal candidiasis (VVC), the genotypes of C. albicans in patients with VVC were studied using a recently developed polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) of CAI microsatellite method and antifungal susceptibility was tested using E-test methods. Twenty-six genotypes were identified from 89 strains of C. albicans isolated from patients with VVC. Candida albicans isolates were susceptible to amphotericin B, flucytosine, ketoconazole and fluconazole. The dominant genotypes (A, B, C, D) account for 69.7% (62/89) of C. albicans. The resistant rate of C. albicans genotype B to itraconazole (ITR) and that of C. albicans non-genotype B strains were 66.7% (14/21) and 4.4% (3/68) respectively at P < 0.05. We concluded that C. albicans genotype B from patients with VVC was more resistant to ITR.

Genotype distribution of Candida albicans strains associated with different conditions of vulvovaginal candidiasis, as revealed by microsatellite typing

OBJECTIVE

To compare genotypes of Candida albicans strains causing different conditions of vulvovaginal candidiasis (VVC) in Chinese women.

METHODS

C albicans strains were isolated from the vaginas of patients with different conditions of VVC. The genotypes of the strains were investigated based on single-strand conformation polymorphisms (SSCP) of the PCR amplified microsatellite locus CAI.

RESULTS

A total of 93 independent C albicans strains was isolated from patients with mild-to-moderate (n = 37) or severe (n = 56) VVC. Thirty of the patients enrolled suffered recurrent VVC. Twenty-six distinct genotypes tentatively designated as A to Z were identified from the 93 C albicans strains compared on the basis of their CAI SSCP patterns. The majority (72.0%) of the strains possessed genotypes A to D, which were similar in the CAI SSCP profiles and were designated as the dominant genotypes. The overall frequencies of the four dominant genotypes were 87.5% (49/56) and 48.6% (18/37; p<0.001) in the C albicans strains from patients with severe and mild-to-moderate VVC, respectively. The strains with the dominant genotypes occupied 83.3% (25/30) and 66.7% (42/63; p = 0.094) in the C albicans strains from patients with recurrent VVC and sporadic VVC, respectively.

CONCLUSION

The frequency of C albicans strains with the dominant genotypes (A to D) from patients with severe VVC was significantly higher than that from patients with mild-to-moderate VVC, implying that the CAI genotype distribution of C albicans strains correlates with the severity of VVC.

Methylrosaniline chloride stained vaginal smears for the diagnosis of vulvovaginal candidiasis

OBJECTIVE

To study the sensitivity and specificity of methylrosaniline chloride stained vaginal smears for the diagnosis of vulvovaginal candidiasis (VVC).

METHOD

Between September 2005 and February 2006, 214 cases of patients with VVC and 102 cases of controls were investigated at Peking University Shenzhen Hospital. All strains were identified with the API Candida system.

RESULTS

The average age of the patients was 29.87 years. The sensitivity and specificity of methylrosaniline chloride stained vaginal smears for the diagnosis of vulvovaginal candidiasis were 88.3% (189/214) and 96.1 (98/102). The sensitivity of the vaginal smears for the diagnosis of recurrent vulvovaginal candidiasis, mild vulvovaginal candidiasis and severe vulvovaginal candidiasis were 85.2% (46/54), 74.7% (71/95) and 99.2% (118/119).

CONCLUSION

Methylrosaniline chloride stained vaginal smears for the diagnosis of vulvovaginal candidiasis are reliable and inexpensive.