[A multicenter prospective study on early identification of refractory Mycoplasma pneumoniae pneumonia in children]

Objective: To explore potential predictors of refractory Mycoplasma pneumoniae pneumonia (RMPP) in early stage. Methods: The prospective multicenter study was conducted in Zhejiang, China from May 1st, 2019 to January 31st, 2020. A total of 1 428 patients with fever >48 hours to <120 hours were studied. Their clinical data and oral pharyngeal swab samples were collected; Mycoplasma pneumoniae DNA in pharyngeal swab specimens was detected. Patients with positive Mycoplasma pneumoniae DNA results underwent a series of tests, including chest X-ray, complete blood count, C-reactive protein, lactate dehydrogenase (LDH), and procalcitonin. According to the occurrence of RMPP, the patients were divided into two groups, RMPP group and general Mycoplasma pneumoniae pneumonia (GMPP) group. Measurement data between the 2 groups were compared using Mann-Whitney U test. Logistic regression analyses were used to examine the associations between clinical data and RMPP. Receiver operating characteristic (ROC) curves were used to analyse the power of the markers for predicting RMPP. Results: A total of 1 428 patients finished the study, with 801 boys and 627 girls, aged 4.3 (2.7, 6.3) years. Mycoplasma pneumoniae DNA was positive in 534 cases (37.4%), of whom 446 cases (83.5%) were diagnosed with Mycoplasma pneumoniae pneumonia, including 251 boys and 195 girls, aged 5.2 (3.3, 6.9) years. Macrolides-resistant variation was positive in 410 cases (91.9%). Fifty-five cases were with RMPP, 391 cases with GMPP. The peak body temperature before the first visit and LDH levels in RMPP patients were higher than that in GMPP patients (39.6 (39.1, 40.0) vs. 39.2 (38.9, 39.7) ℃, 333 (279, 392) vs. 311 (259, 359) U/L, both P<0.05). Logistic regression showed the prediction probability π=exp (-29.7+0.667×Peak body temperature (℃)+0.004×LDH (U/L))/(1+exp (-29.7+0.667×Peak body temperature (℃)+0.004 × LDH (U/L))), the cut-off value to predict RMPP was 0.12, with a consensus of probability forecast of 0.89, sensitivity of 0.89, and specificity of 0.67; and the area under ROC curve was 0.682 (95%CI 0.593-0.771, P<0.01). Conclusion: In MPP patients with fever over 48 to <120 hours, a prediction probability π of RMPP can be calculated based on the peak body temperature and LDH level before the first visit, which can facilitate early identification of RMPP.

[The efficacy and safety of Bruton tyrosine kinase inhibitors as monotherapy in the treatment of newly diagnosed patients with Waldenström macroglobulinemia]

Objective: To investigate the efficacy and safety of Bruton tyrosine kinase inhibitors (BTKi) ibrutinib or zanubrutinib monotherapy in newly diagnosed patients with Waldenström macroglobulinemia (WM) . Methods: The efficacy and adverse effects of 58 patients with newly diagnosed WM receiving BTKi monotherapy in Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were analyzed retrospectively from January 2018 to August 2022. Results: The response of 55 patients may be examined. Forty patients received ibrutinib monotherapy for a median of 15 months, with an overall response rate (ORR) of 85%, a main remission rate (MRR) of 70%, and a very good partial remission (VGPR) rate of 10%. Fifteen patients received zanubrutinib monotherapy for a median of 13 months, with an ORR of 93%, an MRR of 73%, and a VGPR rate of 0%. For various reasons, 10 patients were converted from ibrutinib to zanubrutinib. Ibrutinib treatment lasted an average of 7.5 months before conversion. The median duration of zanubrutinib therapy after conversion was 3.5 months. The ORRs before and after conversion were 90% and 100%, MRRs were 80% and 80%, and VGPR rates were 10% and 50%, respectively. After a median of 16 months, the 24-month progression-free survival (PFS) rate of patients who received both BTKi was 86%. PFS did not differ statistically across individuals with low, medium, and high-risk ISS scores (P=0.998). All of the patients survived. The most common side effects of BTKi were neutropenia and thrombocytopenia, which occurred in 12% and 10% of all patients, respectively. Ibrutinib accounts for 5% of atrial fibrillation, and zanubrutinib has a 7% risk of bleeding. Conclusions: In treating WM, ibrutinib or zanubrutinib provides good efficacy and tolerable adverse effects.

[The beginnings and evolution of a pancreatic surgeon: a technical morphological analysis in first 5 years]

Objective: To explore the development of the pancreatic surgeon technique in a high-volume center. Methods: A total of 284 cases receiving pancreatic surgery by a single surgeon from June 2015 to December 2020 were retrospectively included in this study. The clinical characteristics and perioperative medical history were extracted from the medical record system of Zhongshan Hospital,Fudan University. Among these patients,there were 140 males and 144 females with an age (M (IQR)) of 61.0 (16.8) years(range: 15 to 85 years). The "back-to-back" pancreatic-jejunal anastomosis procedure was used to anastomose the end of the pancreas stump and the jejunal wall. Thirty days after discharge,the patients were followed by outpatient follow-up or telephone interviews. The difference between categorical variables was analyzed by the Chi-square test or the CMH chi-square test. The statistical differences for the quantitative data were analyzed using one-way analysis of variance or Kruskal-Wallis H test and further analyzed using the LSD test or the Nemenyi test,respectively. Results: Intraoperative blood loss in pancreaticoduodenectomy between 2015 and 2020 were 300,100(100),100(100),100(0),100(200) and 150 (200) ml,respectively. Intraoperative blood loss in distal pancreatectomy was 250 (375),100 (50),50 (65),50 (80),50 (50),and 50 (100) ml,respectively. Intraoperative blood loss did not show statistical differences in the same operative procedure between each year. The operative time for pancreaticoduodenectomy was respectively 4.5,5.0(2.0),5.5(0.8),5.0(1.3),5.0(3.3) and 5.0(1.0) hours in each year from 2015 to 2020,no statistical differences were found between each group. The operating time of the distal pancreatectomy was 3.8 (0.9),3.0 (1.5),3.0 (1.8),2.0 (1.1),2.0 (1.5) and 3.0(2.0) hours in each year,the operating time was obviously shorter in 2018 compared to 2015 (P=0.026) and 2020 (P=0.041). The median hospital stay in 2020 for distal pancreatectomy was 3 days shorter than that in 2019. The overall incidence of postoperative pancreatic fistula gradually decreased,with a incident rate of 50.0%,36.8%,31.0%,25.9%,21.1% and 14.8% in each year. During this period,in a total of 3,6,4,2,0 and 20 cases received laparoscopic operations in each year. The incidence of clinically relevant pancreatic fistula (grade B and C) gradually decreased,the incident rates were 0,4.8%,7.1%,3.4%,4.3% and 1.4%,respectively. Two cases had postoperative abdominal bleeding and received unscheduled reoperation. The overall rate of unscheduled reoperation was 0.7%. A patient died within 30 days after the operation and the overall perioperative mortality was 0.4%. Conclusion: The surgical training of a high-volume center can ensure a high starting point in the initial stage and steady progress of pancreatic surgeons,to ensure the safety of pancreatic surgery.

[Long term results of central hole type posterior chamber intraocular lens in the correction of moderate to high myopia]

Objective: To evaluate the long-term safety,effectiveness,predictability and stability of ICL V4c implantation for moderate to high myopia. Methods: In this retrospective case series study, 95 eyes from 50 patients with moderate to severe myopia who were treated in 2015 underwent central hole type posterior chamber intraocular lens (ICL V4c) implantation at Eye & ENT Hospital of Fudan University. The patients were followed up for a period of five years, during which we assessed various parameters including uncorrected visual acuity (UDVA), corrected visual acuity (CDVA), refractive error, axial length, intraocular pressure, endothelial cell density (ECD), vault, and complications. We used the paired t-test and repeated measures one-way ANOVA in SPSS statistical software to analyze the data. Results: The mean spherical equivalent refraction (SE) decreased significantly from (-12.16±3.04) D preoperatively to (-0.19±0.55) D at one month and (-1.14±0.84) D at five years postoperatively. The safety indices (postoperative CDVA/preoperative CDVA) were 1.24±0.27 and 1.13±0.27, respectively, and the efficacy indices (postoperative UDVA/preoperative CDVA) were 1.14±0.25 and 0.87±0.26 at one month and five years postoperatively. At one month after surgery, 80.00% of the eyes were within ±0.50 D of the expected correction, and 96.84% were within ±1.00 D. There was no significant difference in IOP between preoperative and postoperative measurements. The rate of ECD was 3.87%, and the vault decreased by 106.32 μm at five years postoperatively. Conclusion: ICL V4c implantation is safe and effective with good predictability and stability for long term.

[Pancreas multidisciplinary team optimizes the diagnosis and treatment of pancreas-related diseases and improves the prognosis of pancreatic cancer patients]

Objectives: To evaluate the role of pancreas multidisciplinary team(MDT) clinic in the diagnosis of pancreatic diseases,patient compliance with MDT advice,and the impact of MDT on the postoperative survival of patients with pancreatic cancer. Methods: The study included 927 patients(554 males,373 females,aged (58.1±13.3)years (range: 15 to 89 years)) that had visited the pancreas MDT clinic of Zhongshan Hospital from May 2015 to December 2021,and 677 patients(396 males, 281 females, aged (63.6±8.9)years(range: 32 to 95 years)) who underwent radical surgery and with pathologically confirmed pancreatic adenocarcinoma from January 2012 to December 2020,of whom 79 patients had attended the pancreas MDT. The clinical and pathological data were collected and analyzed retrospectively. Diseases were classified in accordance with 2010 WHO classification of tumors of the digestive system and usual clinical practices. The Kaplan-Meier method was used for drawing the survival curve and calculating the survival rate. The univariate analysis was done by Log-rank test and the multivariate analysis was done by COX proportional hazards model. Survival rates were compared using χ2 test. Results: Among the 927 patients that had visited the MDT clinic,233 patients(25.1%) were referred due to undetermined diagnosis. A direct diagnosis was made in 109 cases (46.8%,109/233) by the MDT clinic, of which 98 were consistent with the final diagnosis,resulting in an accuracy of 89.9%(98/109). The direct diagnosis rate in the recent years(36.6%(41/112),from June 2019 to December 2021) decreased compared to that in the previous years(56.2%(68/121),from May 2015 to May 2019),yet the accuracy in the recent years(90.2%,37/41) was basically the same as before (89.7%,61/68). The rate of compliance of the entire cohort was 71.5%(663/927), with the compliance rate in the recent two and a half years(81.4%,338/415) remarkably higher than that in the previous four years(63.4%,325/512). Patients with pancreatic cancer that attended the MDT exhibited a trend toward longer median postoperative survival than patients that did not attend the MDT,but the difference was not statistically significant(35.2 months vs.30.2 months,P>0.05). The 1-year and 3-year survival rates of patients that attended the MDT were significanly higher than patients that did not attend the MDT(88.6% vs. 78.4%,P<0.05;32.9% vs. 21.9%,P<0.05,respectively),but the 5-year survival rate was not statistically different(7.6% vs. 4.8%,P>0.05). Conclusions: The pancreas MDT clinic is an accurate and convenient way to diagnose intractable pancreatic diseases,and in the recent years the patients' compliance rate with MDT advice has increased. Pancreatic cancer patients that have attended the MDT have higher 1-year and 3-year postoperative survival rates,but the long-term survival benefits of MDT still needs to be proved by clinical studies on a larger scale.

[Establishment of an animal model of Sparganum mansoni infection and study on therapeutic methods II Establishment of a mouse model of sparganosis mansoni via oral administration of procercoids]

OBJECTIVE

To establish an animal model of sparganosis mansoni through oral administration of Cyclops infected with procercoids.

METHODS

Domestic cats were infected with Sparganum mansoni under laboratory conditions, and fresh cat stool samples were collected, washed in dechlorinated water, and filtered. Spirometra mansoni eggs were collected and prepared into suspensions. Twenty C57BL/6j mice were randomly divided into the experimental group (n = 15) and the control group (n = 5). Wild Cyclops were infected with Spirometra mansoni coracidia to allow 3 to 5 procercoids in each Cyclop. Then, each mouse in the experimental group was given 15 Cyclops infected with procercoids by gavage, while mice in the control group were orally administered with the same volume of dechlorinated water. All mice were sacrificed after 5 months, and dissected, and suspicious Sparganum mansoni worms were collected. The serum specific IgG antibody against Sparganum mansoni was measured in mice using enzyme-linked immunosorbent assay (ELISA). Genomic DNA was isolated from suspicious Sparganum mansoni worms, and the specific Sparganum mansoni cytochrome oxidase I (COI) gene was amplified using PCR assay.

RESULTS

Among the 15 mice in the experimental group, six were positive for the serum specific IgG antibody against Sparganum mansoni, and milky white worms were found and collected from the subcutaneous regions of 4 out of 6 mice. Only one worm was detected in each mouse, and the worm morphology was similar to Sparganum mansoni. Capillary electrophoresis of the PCR amplification products of COI gene presented a specific band with 151 bp in size, and sequencing analysis revealed 100% homology with Sparganum mansoni.

CONCLUSIONS

A mouse model of sparganosis mansoni is successfully created through oral administration of Cyclops infected with Spirometra mansoni procercoids.

[Comprehensive treatment options and influencing factors in elderly patients with breast cancer]

Objective: To investigate the treatment options for breast cancer patients aged 65 and over, and analyze the influencing factors. Methods: The clinical data of 521 elderly patients aged 65 years or older,who underwent surgery in Peking Union Medical College Hospital from January 2009 to December 2015, were collected. They were all female and 65-98 years old. The patients were divided into 65-74 years old group (n=353) and ≥ 75 years old group (n=168). The differences of variables including age, functional status, treatment methods, pathological characteristics, comorbidities and survival time between the two groups were compared, and the differences of comprehensive treatment methods and their impact on clinical efficacy were analyzed. Results: The main operation methods of the two groups were modified radical mastectomy [39.1% (138/353) and 33.9% (57/168), respectively], breast conserving surgery [56.9% (201/353) and 61.3% (103/353), respectively]. Among the patients choosing adjuvant therapy, there was no significant difference between the two groups except chemotherapy (all P>0.05). Univariate analysis showed that the choice of chemotherapy was related to age, surgical methods, pathological types, tumor burden, molecular typing, functional status and comorbidities (all P<0.05). The Eastern Cooperative Oncology Group (ECOG) score and the number of comorbidities were independent factors affecting the choice of chemotherapy for breast cancer in the elderly: [ECOG score: adjusted OR=0.45 (95CI: 0.26-0.75), number of comorbidities: adjusted OR = 0.63 (95CI:0.41-0.98); all P<0.05]. The 5-year disease-free survival rate of 521 elderly patients with breast cancer was 86.3%, 5-year overall survival rate was 88.8%, and the breast cancer specific survival rate was 94.3%. Conclusions: The comprehensive treatment of breast cancer patients aged 65 and above is not affected by age, but is associated with tumor burden, pathological type, molecular typing, comorbidities and ECOG score. Among them, ECOG score and the number of comorbidities are the independent factors influencing the choice of adjuvant chemotherapy.

[A comparative study of breast cancer mass screening and opportunistic screening in Chinese women]

Objective: To compare the population characteristics, the positive rate of screening, the detection rate of breast cancer, early diagnosis rate and the cost between the mass screening group and opportunistic screening group of breast cancer. Methods: This study is a prospective multicenter cohort study conducted from January 1, 2014 to December 31, 2016. The participants were enrolled for mass screening or opportunistic screening of breast cancer. After completing the questionnaire, all the participants received breast physical examination and breast ultrasound examination every year for 3 rounds by year. The participants' characteristics and screening results of the two groups were compared by χ² test, Fisher exact test or Wilcoxon rank-sum test. Results: A total of 20 080 subjects were enrolled. In the mass screening group, 9 434 (100%), 8 111 (85.98%) and 3 940 (41.76%) cases completed the 3 rounds of screening, and 10 646 (100%), 6 209 (58.32%) and 2 988 (28.07%) cases in the opportunistic screening group, respectively. In the opportunistic screening group, the proportions of less than 3 months lactation (1 275/9 796 vs. 1 061/8 860, χ²=4.597, P=0.032), non-fertility (850/10 646 vs. 574/9 434, χ²=27.400, P<0.01), abortion history (6 384/10 646 vs. 5 062/9 434, χ²=81.232, P<0.01), postmenopausal (2 776/10 646 vs. 2 217/9 434, χ²=17.757, P<0.01), long-term oral contraceptives(>6 months) (171/10 646 vs. 77/9 434, χ²=25.593, P<0.01) and family history of breast cancer in first-degree relatives (464/10 646 vs. 236/9 434, χ²=51.257, P<0.01) were significantly higher than those in mass screening group. The positive rate of screening (514/10 646 vs. 128/9 434, χ²=194.736, P<0.01), the detection rate of breast cancer (158/10 646 vs. 13/9 434, χ²=107.374, P<0.01), and positive rate of biopsy (158/452 vs. 13/87, χ²=13.491, P<0.01) in the opportunistic screening group were significantly higher than those of the mass screening group. The early diagnosis rate of the mass screening group was significantly higher than the opportunistic screening group (10/12 vs. 66/141, χ²=5.902, P=0.015). The average cost for detecting each breast cancer case of the mass screening group was 215 038 CNY, which was 13.6 times of the opportunistic screening group (15 799 CNY/case). In the opportunistic screening group, the positive rate of biopsy in primary hospitals was significantly lower than that in large-volume hospitals (79/267 vs. 79/185, χ²=8.267, P=0.004), but there was no significant difference in the mass screening group (6/37 vs. 7/50, χ²=0.082, P=0.774). Conclusions: Breast cancer screening can improve early detection rate. Compared with the mass screening mode, the opportunistic screening mode has the advantages of higher proportion of high-risk factors, higher positive rate of screening, higher detection rate of breast cancer, higher positive rate of biopsy, and lower cost of screening. However, the early diagnosis rate of breast cancer of opportunistic screening is lower than that of mass screening. The positive rate of opportunistic screening in primary hospitals is lower than that of large-volume hospitals. The two screening modes have their own advantages and should be chosen according to local conditions of different regions in China.

[Prevalence and predictors of intraplaque hemorrhage in stroke patients with intracranial atherosclerosis]

Objective: To investigate the prevalence and predictors of intraplaque hemorrhage (IPH) in ischemic stroke patients with intracranial atherosclerosis. Methods: Ischemic stroke patients with intracranial atherosclerosis who were consecutively admitted to Beijing Tsinghua Changgung Hospital from January 2017 to April 2018 were retrospectively analyzed. High-resolution magnetic resonance vessel wall imaging was used to assess atherosclerotic plaque characteristics of intracranial artery. Possible variables correlated with IPH were compared between IPH and no-IPH groups, as well as in symptomatic IPH and no symptomatic IPH groups. Logistic regression analysis was used to determine the predictors of all IPH and symptomatic IPH in intracranial artery. Results: A total of 276 ischemic stroke patients with intracranial atherosclerosis were included, of which, 41.3% (114/276) were IPH-postive, and 28.1%(32/114) of them were symptomatic. In multivariate regression analysis, maximum wall thickness was independently associated with the presence of all IPH and symptomatic IPH (OR=2.15, 95%CI: (1.42-3.24) and OR=3.46, 95%CI: (1.94-6.17), respectively). Conclusion: The prevalence of IPH in ischemic stroke patients with intracranial atherosclerosis is much higher than expected. Moreover, atherosclerosis plaque burden is independently associated with IPH, but it is non-specific in identifying symptomatic IPH.

[Total neoadjuvant therapy followed by watch and wait approach or organ preservation for MRI stratified low-risk rectal cancer: early result from a prospective, single arm trial]

Objective: To explore the safety and efficacy of watch and wait strategy and organ preservation surgery after total neoadjuvant treatment for MRI stratified low-risk rectal cancer. Methods: A prospective single arm phase Ⅱ trial developed at Department of Gastrointestinal Cancer, Peking University Cancer Hospital & Institute was preliminarily analyzed. Subjects were enrolled from August 2016 to January 2019. Low-risk rectal cancer with following MRI features were recruited: mid-low tumor, mrT2-3b, MRF (-), EMVI (-), CRM (-), differentiation grade 1-3. Patients received intensity-modulated radiotherapy (IMRT) 50.6 Gy/22f with concurrent capecitabine and 4 cycles of consolidation CAPEOX. Patients with cCR/near-cCR confirmed by physical examination, rectal MRI, endoscopy, and serum CEA were recommended for watch & wait approach or local excision (LE). The main study outcomes were 2-year organ preservation rate (OPR) and sphincter preservation rate (SPR). Results: Thirty-eight patients were eligible for analysis, including 24 males and 14 females with median age of 56 years; 9 cases of mrT2 (23.7%), 14 cases of mrT3a (36.8%) and 15 cases of mrT3b (39.5%); 5 cases of well differentiated adenocarcinoma (13.2%), 32 cases of moderately differentiated adenocarcinoma (84.2%) and 1 case of mucinous adenocarcinoma (2.6%). Carcinoemobryonic antigen (CEA) was elevated before treatment in 1 case. One case (2.6%) of grade 3 radiation dermatitis occurred during IMRT; 18 cases (47.4%) occurred grade 3 to 4 adverse events during consolidation chemotherapy. After total neoadjuvant treatment, the cCR and near-cCR rates were 42.1% (16/38) and 23.7% (9/38), respectively, while non-cCR rate was 34.2% (13/38). Twenty patients (20/38, 52.6%) of cCR or near-cCR underwent watch & wait approach, with a local regrowth rate of 20% (4/20). Four patients received LE, including one salvage LE. Thirteen patients (4 were ypCR) received radical resection, including 10 cases of initial low anterior resections (LAR), 1 cases of initial abdominal perineal resection (APR) and 2 cases of salvage LAR, four patients refused operation. The median follow-up time was 23.5 (8.5-38.3) months. At the last interview of follow-up, the OPR and SPR were 52.6% (20/38) and 84.2% (32/38), respectively. Only one patient developed lung metastasis and no local recurrence occurred after radical resection or LE. Conclusion: Total neoadjuvant treatment for low-risk rectal cancer achieves high cCR/near-cCR rate, with increased probability of receiving watch and wait approach and organ preservation in this subgroup.

[Safety evaluation on different ventilation strategies set for neonatal respiratory distress syndrome: a network Meta-analysis]

Objective: To evaluate the relative safety of different ventilation methods regarding mortality and rates of complication, on neonatal respiratory distress syndrome (NRDS). Methods: Network Meta-analysis was used to collect data on randomized controlled trials of pulmonary ventilation strategies in preterm infants with a mean gestational age of less than 32 weeks. Diagnostic criteria on NRDS were published in the PubMed, Cochrane, Web of Science, EBSCO, and Springer Link databases from January 1986 to June 2018. Revman 5.3 software was used to evaluate the quality of studies, based on the Cochrane quality assessment tool. Data were analyzed by Bayesian and frequency methods, using both Win BUGS 1.4.3 and STATA 13.0 software. Safety of different ventilation strategies for NRDS mortality and complications would include intraventricular hemorrhage (IVH), patent ductus arteriosus (PDA) and retinopathy of prematurity (ROP) and were evaluated. Counted data was displayed by OR and 95%CI. Results: A total of 31 RCTs were included in this paper, including 5 827 preterm infants and 11 ventilation strategies. There were no statistically significant differences appearing in 11 ventilation strategies on mortality, PDA or ROP. IVH results were reported in 28 studies. Compared with nasal intermittent positive pressure ventilation (NIPPV), both high- frequency oscillation ventilation (HFOV) (OR=3.33, 95%CI: 1.08-16.67, P<0.05) and synchronized intermittent mechanical ventilation (SIMV) (OR=8.22, 95%CI: 1.25-29.44, P<0.05) schemes seemed to have increased the risk of IVH in preterm infants with NRDS. NIPPV appeared the optimal ventilation strategy in the rankings of cumulative probability. Results on clustering showed that NIPPV was probably the best ventilation strategy for children with NRDS after considering the orders of IVH, PDA and ROP on mortality, respectively. However, HFOV, IMV, and SIMV did not seem to be the ideal ventilated strategies. Conclusions: Most of the clinical decision makers might prefer using NIPPV in the treatment of children with NRDS through mechanical ventilation systems to reduce both the incidence and death caused by IVH, PDA and ROP. It was not recommended to use HFOV, SIMV and IMV in treating NRDS with gestational less than 32 weeks. We suggested that larger numbers of multi-center RCTs ba carried out to make the above conclusions more convincing.

Promoted diffusion mechanism of Fe2.7wt.%Si-Fe10wt.%Si couples under magnetic field by atomic-scale observations

Diffusion behavior of newly designed Fe2.7wt.%Si-Fe10wt.%Si couples at 1100 °C for up to 12 h has been investigated under the 0, 0.8 and 3 T magnetic fields. Diffusion thickness of solid solution layer and weight percent of Si on Fe2.7wt.%Si side increase significantly under a magnetic field. Application of a magnetic field promotes the diffusion of solid solution layer through the possible diffusion of vacancies mainly due to the appearance of defects, which has been demonstrated by the increased dislocation density and broadening of the typical XRD peaks. Replacement of Si sits by Fe atoms in the crystal structure leads to the appearance of Fe diffraction peaks, which has been confirmed by the increased interplanar spacings under a magnetic field. The magnetic field benefits the depinning of dislocations and leads to higher dislocation density because of the magnetoplastic effect which has been confirmed by the significantly reduced thickness of Fe2.7wt.%Si. Nano-sized Fe₃Si particles precipitate in the matrix with an orientation relationship on Fe10wt.%Si side as {220}_Fe3Si || {220}_matrix & < 1–10 >_Fe3Si || < 1–10 >_matrix. Fe₃Si particles pin dislocation moving and lead to higher dislocation density.

[Imaging characteristics of patients with large vestibular aqueduct syndrome and its relationship with the acoustically evoked short latency negative response]

Objective: To explore the imaging characteristics of large vestibular aqueduct syndrome (LVAS) patients and their relationship with the acoustically evoked short latency negative response (ANSR), so as to provide reference for the diagnosis of LVAS. Methods: Clinical data of 174 patients(334 ears) with LVAS diagnosed and treated by the Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Guangxi Medical University, from October 2009 to December 2017 were retrospectively analyzed, including 117 males and 57 females, aged from 5 months to 47 years old, with the median age of 4 years and 4 months. ABR and imaging data of patients were collected. Midpoint diameter and the outlet diameter of the vestibular aqueduct were measured on CT images, the midpoint diameter of the intraosseous parts and the extraosseous parts of enlarged endolymphatic sac(EES) were measured on MRI images. The correlation between the above measurements was analyzed by Pearson test using SPSS 17.0. According to whether ASNR was detected in ABR, the above data were divided into two groups, and the differences of the above imaging measurements were compared by the Independent-Sample Test. Results: The average midpoint diameter of the vestibular aqueduct was (1.87±0.58) mm (x±s, the following was the same), and the outlet diameter was (3.07±0.99) mm on CT; the average midpoint diameter of the intraosseous parts in enlarged endolymphatic sac(EES) was (2.39±1.37) mm, and the extraosseous parts was (2.50±2.18) mm on MRI. There was a correlation between the four measurements (P<0.05), among which the midpoint diameter of vestibular aqueduct was strongly positively correlated with the outlet diameter (r=0.760), and the remaining pairs were weakly correlated. ASNR was detected in 241 ears (72.16%,241/334) and undetected in 93 ears (27.84%, 93/334) of the 334 ears with LVAS. Midpoint diameter and the outlet diameter of the vestibular aqueduct in no ASNR group were smaller than the ASNR group, and the difference was statistically significant (t value was 2.814 and 2.754, P<0.05). There was no significant difference in the midpoint diameter of the intraosseous parts and the extraosseous parts of enlarged endolymphatic sac between the two groups, and the difference was no statistically significant(t value was 0.101 and 0.683, P>0.05). Conclusions: There is a strong positive correlation between the midpoint diameter of vestibular aqueduct and the outlet diameter in LVAS patients. There is a certain correlation between the size of vestibular aqueduct and the size of endolymphatic sac. The smaller the diameter of vestibular aqueduct, the lower the occurrence rate of ASNR.

Bacillus licheniformis, a potential probiotic, inhibits obesity by modulating colonic microflora in C57BL/6J mice model

AIMS

This study evaluated the effects of a potential probiotic, Bacillus sp., on the growth, serum and hepatic triglyceride, histological features of liver tissues and colonic microflora in high-fat diet-induced obese mice.

METHODS AND RESULTS

Sixty male C57BL/6J mice were randomly divided into five groups: mice fed a low-fat diet (Cont), mice fed a high-fat diet (Hf), Hf and orally challenged with Bacillus subtilis (Bs), B. licheniformis (Bl) and a mixture of B. subtilis and B. licheniformis (Bls). Gavage feeding was provided at week 9 and the experiment was continued for 8 weeks. Treatment with B. licheniformis and a mixture of Bacillus sp. attenuated body weight gain at the end of study and enhanced glucose tolerance by sensitizing insulin action in the Hf-fed mice. Lower serum and hepatic triglyceride and epididymal fat weight were observed in Bl and Bls groups than that of Hf group. Lesser hepatic fat deposition was observed in the Bl and Bls groups than in the Hf group. High-throughput sequencing showed that Bacillus sp. supplementation dramatically changed the colonic bacterial community in obese mice.

CONCLUSIONS

Bacillus licheniformis reduced body weight and improved glucose tolerance, obesity and insulin resistance in Hf-fed mice by changing colonic microbiota composition.

SIGNIFICANCE AND IMPACT OF THE STUDY

Orally administration of Bacillus licheniformis may reduce body weight and decrease fat deposition by modulating colonic bacterial community in Hf model.

[Carcinogenicity study of CD133(+)CD44(+) laryngeal cancer stem cells and identification of related microRNAs]

Objective: To compare the carcinogenic abilities of CD133(+)CD44(+) laryngeal cancer stem cells and general laryngeal cancer stem cells and to identify the mechanism underlying the action of miRNAs. Methods: Solid tumor-derived laryngeal carcinoma stem cells and Hep-2-derived laryngeal carcinoma stem cells were cultured, and CD133(+)CD44(+) laryngeal cancer stem cells were sorted by flow cytometry. Boden chamber invasion assay, cell migration assay and tumor formation assay were then performed to compare the invasion, migration and tumorigenic abilities of CD133(+)CD44(+) laryngeal cancer stem cells and general laryngeal cancer stem cells. And then, miRNAs isolated from two laryngeal cancer stem cells were detected and analysed with miRNA chip. Results: (1)In Boyden chamber invasion assay, the cell invasion rate of CD133(+)CD44(+) laryngeal cancer stem cells was obviously higher (80.2%±2.3% vs. 63.9%±3.2%, t=5.011, P=0.027); (2)CD133(+)CD44(+) laryngeal cancer stem cells also had higher mobility in cell migration assay (82.9%±1.1% vs. 70.9%±0.6%, t=4.514, P=0.031); (3)In tumor formation assay, the tumor formation rate of CD133(+)CD44(+) laryngeal cancer stem cells was also higher (80% vs. 50%). What's more, we identified 15 miRNAs that were significantly upregulated in CD133(+)CD44(+) laryngeal cancer stem cells and 3 miRNAs that were significantly downregulated in CD133(+)CD44(+) laryngeal cancer stem cells, compared with normal laryngeal cancer stem cells. Conclusions: CD133(+)CD44(+) laryngeal cancer stem cells have stronger invasion, migration and tumorigenic abilities compared with normal laryngeal cancer stem cells, and the difference of miRNAs' expression is one of the possible causes.

[The regulation of tight junction protein via PKCα/β for abnormal permeability of brain microvascular endothelial cells exposed to paraquat]

Objective: To explore if conventional protein kinase C (cPKC: PKCα and PKCβ) contributes to paraquat (PQ) -induced abnormal permeability of mouse brain microvascular endothelial cells (BMECs) via the regulation of tight junction (TJ) proteins. Methods: The immortalized mouse brain endothelial cell line (bEnd.3) was used to establish a monolayer blood-brain barrier (BBB) model. In order to evaluate the function of the in vitro BBB model, the transendothelial electrical resistance (TEER) and permeability were measured by a Millicell-ERS volt-ohmmeter and sodium fluorescent (Na-FLU) , respectively. MTT assay was used to determine the relative survival rate of cells. The dose-response relationship was determined by treating cells with 0, 50, 100, 200, and 300 μmol/L PQ for 24 hours. The time-response relationship was determined by treating cells with 200 μmol/L PQ for 6, 12, 24, 48, and 72 hours. After the treatment of cells with 0, 100, 200, and 300 μmol/L PQ for 24 hours, the protein and mRNA expression levels of ZO-1, Occludin, and Claudin-5 were measured by immunofluorescence (IF) and quantitative real-time RT-PCR (qRT-PCR) , respectively; the expression of PKCα, PKCβ, phosphorylated (p) -PKCα, and p-PKCβ was determined by Western blot. After the treatment of cells with 200? mol/L PQ for 24 hours following the pretreatment with a classical PKC inhibitor (Go 6983, 1 μmol/L) for 1 hour, the protein expression of ZO-1, Occludin, Claudin-5, p-PKCα, and p-PKCβ was measured by Western blot. Results: The TEER of the bEnd. 3 cells increased gradually with the cell culture time, and reached a peak value of 114.3±6.9 Ω·cm(2) on day 6. According to the permeability analysis by Na-FLU, cell permeability gradually decreased with the cell culture time, and reached 1.7±0.2 cm/min on day 6, suggesting a well-behaved barrier function of cells. Compared with the control group, the survival rates of the bEnd.3 cells were significantly reduced after exposure to 100, 200, or 300 μmol/L PQ for 24 hours (P<0.05) , or after exposure to 200 μmol/L PQ for 6, 12, 24, 48, or 72 hours (P <0.05) , indicating a dose-and time-dependent relationship. The IF and qRT-PCR results showed that the protein and mRNA expression levels of ZO-1, Occludin, and Claudin-5 were significantly reduced with the increase in the concentration of PQ (P<0.05) . The Western blot analysis showed that compared with the control group, cells exposed to PQ had significantly higher protein expression of p-PKCα and p-PKCβ and significantly lower protein expression of ZO-1, Occludin, and Claudin-5 (P<0.05) . Compared with the PQ treatment group, the Go 6983 intervention group had significantly higher protein expression of ZO-1, Occludin, and Claudin-5 and significantly lower protein expression of p-PKCα and p-PKCβ (P<0.05) . Conclusion: By activation of cPKC (PKCα and PKCβ) , PQ reduces the protein and mRNA expression of TJ proteins and enhances the permeability of murine BMECs.

Astragalus and Ginseng Polysaccharides Improve Developmental, Intestinal Morphological, and Immune Functional Characters of Weaned Piglets

Antibiotic resistance is a major issue in animal industries and antibiotic-free alternatives are needed to treat infectious diseases and improve performance of pigs. Plant extracts have been suggested as a potential solution. The present study was conducted to investigate the effects of Astragalus polysaccharides (Aps) and ginseng polysaccharide (Gps) on growth performance, intestinal morphology, immune function, volatile fatty acids (VFAs), and microfloral community in weaned piglets. A total of 180 weaned piglets were randomly divided into three treatment groups during a 28-days feeding experiment, including a basal diet (Con), basal diet supplemented with 800 mg/kg Aps (Aps), and basal diet supplemented with 800 mg/kg Gps (Gps). Results showed that both Aps and Gps increased body weight, average daily gain and feed conversion rate, and reduced the rate of diarrhea. Gps also decreased aspartate aminotransferase compared to the Con piglets after 14 days. No significant effects on alanine aminotransferase were observed. Both Aps and Gps piglets exhibited higher serum immunoglobulin M levels after 14 and 28 days, and also decreased jejunal crypt depth, increased jejunal villus length and villus height/crypt depth ratio, and increased expression of toll-like receptor 4, myeloid differentiation primary response 88, nuclear factor-kappa B proteins in the jejunum. Aps and Gps piglets also had higher concentrations of acetic acid, isobutyric acid, and butyrate in their colon. Data of high-throughput sequencing revealed that Aps and Gps affected bacterial quantity and diversity in the colon. Species richness and evenness were higher in both Aps and Gps piglets than the control piglets. Aps and Gps piglets also had a higher relative abundance of Lachnospiraceae and Anaerostipes, and the Aps piglets had a higher relative abundance of Lactobacillus gasseri and L. amylovorus. Therefore, dietary supplementation with Aps and Gps could be beneficial for optimizing the performance of industry pigs and reducing dependence on antibiotics. Furthermore, Plant polysaccharides play a great role in promoting the sustainable development of animal husbandry.

[The role of the AMPK-mTOR pathway in paraquat-induce autophagy in PC12 cells]

Objective: To investigate the regulation of AMPK-mTOR signal transduction pathway in paraquat-induced autophagy of pheochromocytoma cells (PC12) . Methods: The PC12 cell were treated with terminal concentrations of 0, 25, 50, 100, 200, 300 and 400 μmol/L PQ for 24 hours, and the cells were induced by 300 μmol/L PQ for different time (6, 12, 24, 48 h) . MTT was used to detect the relative survival rate of cells, and the dose/time-effect relationship was determined respectively. The cells were treated with PQ at concentrations of 0, 100, 200 and 300 μmol/L PQ for 24 hours, the lactate dehydrogenase (LDH) activity in the culture supernatant was detected by spectrophotometry. The expression and distribution of autophagic lysosomes were observed by MDC staining. The intracellular reactive oxygen species (ROS) was detected by dichlorofluorescein diacetate (DCFH-DA) . The expression of microtubule-related protein 1 light chain 3 (LC3) was measured by immunofluorescence. The protein level of LC3Ⅱ, p62, Beclin1 and p-AMPK, p-mTOR were detected by Western blot. Results: Compared with the control group, the cell survival rate of the 100, 200, 300, 400 μmol/L PQ group decreased significantly, and showed a dose-dependent pattern (P<0.05) . The survival rate of cells treated with 300 μmol/L PQ decreased significantly with the prolongation of exposure time (12, 24, 48 h) (P<0.05) . Compared with the control group, the activity of LDH in 100, 200, 300 μmol/L PQ-treated group were significantly higher while The fluorescence intensity of ROS was significantly increased (P<0.05) . MDC staining showed the density of autophagic lysosomes and fluorescence intensity in PQ-treated group significantly decreased (P<0.05) . Immunofluorescence results showed the LC3 fluorescence intensity of PQ-treated group decreased which was consistent with MDC staining results. Western blot showed that compared with the control group, the expression levels of autophagy related proteins LC3Ⅱand Beclin1 in PQ-treated group were significantly lower, while the expression level of p62 protein was higher (P<0.05) . p-AMPK protein level decreased and p-mTOR protein expression increased in 200 and 300μmol/L PQ-treatd groups, with statistically significant difference (P<0.05) . Conclusion: AMPK-mTOR signaling pathway played a regulatory role in PQ-induced decreased autophagy of PC12 cell.

Protective effect of Lycium barbarum polysaccharides against high-fat diet-induced renal injury and lipid deposition in rat kidneys

This study aimed to explore the protective effect of Lycium barbarum polysaccharides (LBPs) against hyperlipidemia and lipid-induced renal injury in a rat model. Male Sprague-Dawley rats (n=30) were randomly divided into three equal groups: a control group (fed a regular diet) and two experimental groups (fed a high-fat diet). By feeding rats a high-fat diet for 12 weeks, an animal model of hyperlipidemia was established, after which one experimental group received oral LBPs at a dose of 300 mg/kg per day. Blood lipids, renal function, and urinary proteins were measured after 12 weeks. Changes in renal pathology and expression levels of sterol regulatory element binding transcription factor 1 (SREBP-1), interleukin-6 (IL- 6), tumor necrosis factor-alpha (TNF-α), AMP-activated protein kinase (AMPK) were determined. Rats with hyperlipidemia induced by a high-fat diet showed increases in blood lipids and blood urea nitrogen, serum creatinine, and urinary protein, as well as increases in renal levels of SREBP-1, TNF-α, and IL-6 and decreases in renal levels of adiponectin and AMPK. Administration of LBPs restored blood lipid, blood urea nitrogen, serum creatinine, and urinary protein levels, downregulated renal levels of SREBP-1, TNF-α, and IL-6, and upregulated renal levels of adiponectin and AMPK. These results indicate that LBPs may mediate lipid metabolism, enhance anti-inflammatory responses, and ameliorate renal injury caused by lipid metabolism isorders in a rat model of hyperlipidemia.

[Evaluation of transperineal sonography for lower urinary tract symptoms after pelvic floor reconstruction]

Objective: To evaluate transperineal sonography for lower urinary tract symptoms after pelvic floor reconstruction. Methods: Eighty-three patients with severe pelvic organ prolapse received surgeries in Fuzhou General Hospital from September 2014 to September 2015, dividing into two groups: 27 patients were selected to receive transvaginal mesh (TVM) pelvic floor reconstruction surgery with tension-free vaginal tape-Abbrevo (TVT-Abbrevo) incontinence surgery, named TVM+TVT-Abbrevo group; 56 patients were selected to receive TVM pelvic floor reconstruction surgery only, named TVM group. The ultrasonic parameters at rest, on contraction and Valsalva condition respectively were observed and measured, including the bladder neck descent (BND), urethral rotation angle, retrovesical angle, levator urethra gap (LUG), the existence of bladder neck funneling, position of the tape, by using 2D and 3D transperineal ultrasound. Results: The two groups were compared with the ultrasonic parameters before and after operation: two groups of patients with postoperative BND [(2.3±0.5) versus (3.1±0.7) cm, (1.6±0.4) versus (3.6±0.4) cm] were significantly reduced, the difference was statistically significant (P=0.02, P<0.01). The two groups of LUG before and after operation [(3.62±0.45) versus (3.26±0.92) cm, (2.96±0.47) versus (2.72±0.38) cm] both had significant difference by maximum Valsalva (P<0.01, P=0.04). There was statistical significance difference of urethral rotation angle in TVM+TVT-Abbrevo group by maximum Valsalva (P=0.01). Observation of morphology: (1) 2 patients with difficulty in urination in TVM+TVT-Abbrevo group, ultrasound showed when the position of the bladder down the urethra discount; 4 patients with stress urinary incontinence (SUI), ultrasound showed slings off or release. (2) One patient with difficulty in urination in TVM group, but ultrasound showed lower urinary tract anatomy were normal; 5 patients with SUI, ultrasound showed the position of the bladder neck were significantly lower in 3 patients, showing high mobility, and the other 2 patients had a larger urethral diameter, showing a tendency of natural deletion. Conclusion: s Anatomy of lower urinary tract could be clearly showed by transperineal sonography. This could provide imaging support for the diagnosis of lower urinary tract symptoms after pelvic floor reconstruction.

[Distribution and drug resistance of pathogens at hematology department of Jiangsu Province from 2014 to 2015: results from a multicenter, retrospective study]

Objective: To describe the distribution and drug resistance of pathogens at hematology department of Jiangsu Province from 2014 to 2015 to provide reference for empirical anti-infection treatment. Methods: Pathogens were from hematology department of 26 tertiary hospitals in Jiangsu Province from 2014 to 2015. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or agar dilution method. Collection of drug susceptibility results and corresponding patient data were analyzed. Results: The separated pathogens amounted to 4 306. Gram-negative bacteria accounted for 64.26%, while the proportions of gram-positive bacteria and funguses were 26.99% and 8.75% respectively. Common gram-negative bacteria were Escherichia coli (20.48%) , Klebsiella pneumonia (15.40%) , Pseudomonas aeruginosa (8.50%) , Acinetobacter baumannii (5.04%) and Stenotropho-monas maltophilia (3.41%) respectively. CRE amounted to 123 (6.68%) . Common gram-positive bacteria were Staphylococcus aureus (4.92%) , Staphylococcus hominis (4.88%) and Staphylococcus epidermidis (4.71%) respectively. Candida albicans were the main fungus which accounted for 5.43%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were 3.5%-6.1% and 5.0%-6.3% respectively. The rates of Pseudomonas aeruginosa resistant to tobramycin and amikacin were 3.2% and 3.3% respectively. The resistant rates of Acinetobacter baumannii towards tobramycin and cefoperazone/sulbactam were both 19.2%. The rates of Stenotrophomonas maltophilia resistant to minocycline and sulfamethoxazole were 3.5% and 9.3% respectively. The rates of Staphylococcus aureus, Enterococcus faecium and Enterococcus faecalis resistant wards vancomycin were 0, 6.4% and 1.4% respectively; also, the rates of them resistant to linezolid were 1.2%, 0 and 1.6% respectively; in addition, the rates of them resistant to teicoplanin were 2.8%, 14.3% and 8.0% respectively. Furthermore, MRSA accounted for 39.15% (83/212) . Conclusions: Pathogens were mainly gram-negative bacteria. CRE accounted for 6.68%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were lower compared with other antibacterial agents. The rates of gram-positive bacteria resistant to vancomycin, linezolid and teicoplanin were still low. MRSA accounted for 39.15%.

[Analysis of high-risk HPV infection and cervical cytologic screening in HIV positive women]

Objective: To analysis of high-risk HPV infection and cervical cytologic screening in HIV positive women, and to study the relationship between HIV infection and high-risk HPV infection. Methods: From June 2011 to May 2016, 58 cases of HIV positive women in Beijing Ditan Hospital for cervical screening were selected as the experimental group, and 59 cases of HIV negative women were selected as control group, thin-prep cytologic test(TCT)and HPV detection were used in two groups of subjects. The abnormal rate of TCT and the incidence rate of HPV were observed in the two groups, the relationship between HIV infection and HPV infection was analyzed. Results: TCT abnormal rate(91.4%, 53/58)of the experimental group was obviously higher than that of the control group(45.8%, 27/59), with statistically significant(χ²=12.365, P=0.036). High-risk HPV infection incidence(34.5%, 20/58)of the experimental group was significantly higher than that of the control group(16.9%, 10/59), with traditional significance(χ²=10.359, P=0.041). CD₄⁺ T lymphocytes and CD₄⁺/CD₈⁺ ratio of high-risk HPV positive patients had significant difference with high-risk HPV negative patients(χ²=10.378, P=0.042; χ²=9.245, P=0.045). The proportion of different AIDS clinical stages of high-risk HPV positive patients had obvious difference with high-risk HPV negative patients(P<0.05). Conclusion: HIV positive women maybe have a large proportion of abnormal TCT and the infection with high-risk HPV, and infection of high-risk HPV in HIV positive women has relationship with CD₄⁺ T lymphocytes, CD₄⁺/CD₈⁺ ratio and AIDS clinical stage.

FOXC1 overexpression is a marker of poor response to anthracycline-based adjuvant chemotherapy in sporadic triple-negative breast cancer

Purpose

Because of its aggressive characteristics and poor prognosis, triple-negative breast cancer (TNBC) has become a hot topic in cancer research. Chemotherapy is currently the only treatment for patients with TNBC. The transcription factor FOXC1 has been associated with TNBC prognosis, but little is known about its effect on chemosensitivity. The aim of this study was to investigate the effects of FOXC1 on chemosensitivity.

Methods

A case–control study was performed on 25 TNBC patients who experienced relapse and/or metastasis. Another 25 patients without relapse or metastasis were randomly selected as controls. Medical records were reviewed for relevant information, and immunohistochemistry was performed to measure FOXC1 levels. The Kaplan–Meier method and Cox analysis were used to analyze differences in disease-free survival (DFS) and overall survival (OS). The correlation of FOXC1 expression with chemosensitivity was analyzed. Data were analyzed using SPSS 21.0 software, and a P value <0.05 was considered to be statistically significant.

Results

In 15 of 22 case patients, FOXC1 was overexpressed, whereas only 8 control patients exhibited FOXC1 overexpression (P < 0.05). FOXC1 expression had no correlation with pathological indicators. An anthracycline-based regimen was administered to 21 study patients and 23 control patients. FOXC1 expression was significantly associated with a worse DFS (HR 2.62, 95% CI 1.05–6.50, P = 0.038) but presented no correlation with OS (HR 2.53, 95% CI 0.76–8.40, P = 0.131) among these 44 patients.

Conclusions

This study shows that FOXC1 is correlated with chemosensitivity to anthracycline and could be used as an indicator of chemosensitivity in sporadic TNBC.

Electronic supplementary material

The online version of this article (doi:10.1007/s00280-017-3319-4) contains supplementary material, which is available to authorized users.

[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.

Microbial diversity in the oral cavity of healthy Chinese Han children

OBJECTIVE

This study aimed to identify the oral microbial diversity of healthy Chinese Han children.

METHODS

Dental plaques were sampled from the oral cavity of ten healthy Chinese Han children. The oral microbiome was examined using the 16S rRNA-based Human Oral Microbe Identification Microarray. The microbial diversity and similarity were analyzed using the Chao-Jaccard similarity index.

RESULTS

A total of 112 species, which belonged to nine bacterial phyla and 41 genera, were detected. Each individual harbored an average of 54.1 microbial species (ranging from 37 to 69) and 26.2 genera (ranging from 21 to 31), with interindividual variations both at the species and genus level. Thirteen genera were conserved among all individuals. The Chao-Jaccard similarity index averages, at the genus and species level, were 0.642 (ranging from 0.485 to 0.871) and 0.506 (ranging from 0.338 to 0.676), respectively, suggesting that the healthy oral community was more conserved at the genus level than at the species level.

CONCLUSION

Although there was interindividual variation in the oral microflora, some bacterial genera were conserved among individuals, supporting the existence of a core microbiome in the oral cavity of healthy Chinese Han children.

Investigation of characteristics of feather follicle stem cells and their regeneration potential

Feather follicles have the extraordinary ability to regenerate and undergo molting cycles. Being tissue-specific stem cells, feather follicle stem cells (FFSCs) have a strong capacity for proliferation and are presumed to be progenitor cells for various epidermal organs. In order to characterize FFSCs and to understand how the feather epidermis and FFSCs produce such a reliable differentiation program resulting in the formation of complex feathers, We developed a culture scheme to select and expand FFSCs from chick feather follicles. FFSCs were examined with cell profiles, mutilpotential differentiation and immunocytochemical staining. FFSCs from a single clone were capable of self-renewal and proliferation. These cells expressed integrin β1, CD49c, cytokeratin 15 (K15), cytokeratin 19 (K19) and a neural-genic cell marker, nestin, but not a teminal differentiation-related keratinocyte marker, cytokeratin 10 (K10). FFSCs could trans-differentiate into adipocytes, neurocytes and keratinocytes. The formation of micro-feather like structures ex-vivo also revealed the potential of regeneration. These results demonstrate that FFSCs possess the properties of stem/progenitor cells and may therefore serve as a useful model for studying mechanisms of stem cell differentiation and their involvement in organ regeneration.

Low propagation loss SiN optical waveguide prepared by optimal low-hydrogen module

We investigated low-hydrogen SiN films prepared by a low temperature (350 degrees C) PECVD method. The impact of SiH(4)/N(2) flow ratio and radio frequency power on the hydrogen content in the SiN films was studied. In this work, we demonstrated a low-loss sub-micron SiN waveguide by using the corresponding optimal SiN films. The propagation loss was found to be as low as -2.1+/-0.2 dB/cm at 1550 nm with waveguide cross-section of 700 nm x 400 nm. The results suggest that the SiN films grown by PECVD with low hydrogen can be used in photonics integrated circuits for new generation communications applications.

Proteomic analysis of human bone marrow mesenchymal stem cells transduced with human telomerase reverse transcriptase gene during proliferation

OBJECTIVES

Previous studies have reported immortalization and tumorigenicity of human mesenchymal stem cells (hMSCs) transduced with exogenous human telomerase reverse transcriptase (hTERT). We also have established a line of hMSCs transduced with hTERT (hTERT-hMSCs) and we have cultured these cells for 290 population doublings (PDs) during which they demonstrated a large proliferation potential but with no tumorigenicity. The aim of this study was to investigate the protein expression profile of hTERT-hMSCs with two-dimensional gel electrophoresis and peptide mass fingerprinting by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, to be able to analyse the effects of exogenous hTERT on protein expression in hMSCs.

MATERIALS AND METHODS

We generated proteome maps of primary hMSCs and hTERT-hMSCs at PD 95 and PD 275.

RESULTS

A total of 1543 +/- 145 protein spots in gels of primary MSCs at PD 12, 1611 +/- 186 protein spots in gels of hTERT-hMSCs at PD 95 and 1451 +/- 126 protein spots in gels of hTERT-hMSCs at 275 PD were detected. One hundred of these were successfully identified, including 20 which were differentially expressed.

CONCLUSIONS

The results suggest that sustaining levels of prohibitin and p53 expression along with differential expression of proteins in hTERT-hMSCs provide an insight into lack of transforming activity of hTERT-hMSCs during cell proliferation.

Two new diterpenoids from Coleus forskohlii

Two new diterpenoids, forskolins I and J, have been isolated in our further investigation on Coleus forskohlii (Willd.) Briq. collected in Yunnan Province. Their structures have been determined as 1alpha,6beta-diacetoxy-7beta,9alpha-dihydroxy-8,13-epoxylabd-14-en-11-one (1) and 1alpha,9alpha-dihydroxy-6beta,7beta-diacetoxy-8,13-epoxylabd-14-en-11-one (2) by spectral methods (including 1D and 2D NMR techniques).

ent-Isopimarane diterpenoids of the leaves from Rabdosia forrestii

Two new diterpenes, forrestin H, ent-isopimaran-8 beta, 15R, 16-triol (1), forrestin I, ent-isopimaran-16-acetoxy-8 beta, 15R-diol (2) and the acetonide derivative of forrestin H were isolated from the leaves of Rabdosia forrestii. The structures were established on the basis of NMR spectroscopic analysis and of the modified Mosher's (1H) method.

[Screening the mimic antigen epitopes of triosephosphate isomerase of Schistosoma japonicum Chinese strain (Sjc-Tpi) with random phage peptide library]

OBJECTIVE

To screen the mimic antigen epitopes of the triose phosphate isomerase of Schistosoma japonicum Chinese strain (SjC-TPI) and investigate their immunogenicity.

METHODS

The random phage peptide library (PH.D.-12) was screened with the purified antibody(IgG) against SjC-TPI to get the positive phage which contained the mimic antigen epitopes of SjC-TPI, and the immuno-characterization of the mimic antigen epitopes were investigated.

RESULTS

Two mimic antigen epitopes (M1, M2) of SjC-TPI were obtained. The immuno-sera of mice (Kunming strain) against the positive phages could recognize both the SjC-TPI and the protein of the positive phages. The DNA sequencing data showed no homology between the sequences of the deduced amino acid of the two mimic antigen peptides and the amino acid of SjC-TPI.

CONCLUSION

The two mimic antigen epitopes of SjC-TPI obtained are imitative epitopes of the configuration antigen of SjC-TPI.

[Protective immunity induced by 23 kDa membrane protein DNA vaccine of Schistosoma japonicum Chinese strain in mice]

OBJECTIVE

To develop 23 kDa membrane protein DNA vaccine of Schistosoma japonicum Chinese strain and test its protective efficacy in infected C57BL/6 mice.

METHODS

The full length cDNA encoding SjC23 amplified from pUC19-SjC23 subcloned into pcDNA3.1. 48 female mice were divided into three groups: A, B and C. Group A (control group) was each immunized i.m. with 100 micrograms of pcDNA3.1; group B (SjC23 group) was each immunized i.m. with 100 micrograms of pcDNA3.1-SjC23; group C (SjC23 + IL-12) was each immunized i.m. with a mixture of 100 micrograms of pcDNA3.1-SjC23, 100 micrograms of pcDNA3.1-p35 and 100 micrograms of pcDNA-p40, followed by two boosts of the same DNA once every two weeks. All the mice were challenged with 45 cercariae at week 8, killed and perfused for worms at week 14. The expression of SjC23 and p35, p40 in muscle tissue was determined by immuno-histochemical method. By the culture of spleen cells, the production of IL-2, IL-4, IL-10 and IFN-gamma after the stimulation of rSjC23-HD was determined two weeks before and after challenge. Anti-SjC23 antibodies were tested by Western blotting.

RESULTS

SjC23 and p35, p40 were all expressed on the membrane and in the plasma of muscle cells of the infected mice. Significant increase of IL-2 and IFN-gamma in SjC23 and SjC23 + IL-12 groups was observed before and after challenge. Western blotting showed that after the third immunization (before challenge) 8 out of 10 sera from SjC23 group and 9 out of 10 sera from SjC23 + IL-12 group were positive. The worm reduction rate in SjC23 group and SjC23 + IL-12 group was 26.9% and 35.4%, respectively; the number of eggs in liver tissue was reduced by 22.2% and 28.4%, respectively.

CONCLUSION

pcDNA3.1-SjC23 DNA vaccine could induce partial protection against Schistosoma japonicum in C57BL/6 mice.

Seroprevalence of known and putative hepatitis markers in United States blood donors with ALT levels at least 120 IU per L

BACKGROUND

ALT testing of blood donors was initiated as a surrogate marker for non-A, non-B hepatitis. Increased sensitivity of subsequent HBV and HCV tests used for standard donor screening make any residual value of ALT testing questionable.

STUDY DESIGN AND METHODS

A prospective study was conducted in 166 of 645 eligible blood donors from three American Red Cross regions whose ALT was > or =120 IU per L and whose standard donor screening tests were negative. Of these enrolled donors, 124 (75%) completed follow-up. Samples obtained from the index donation, at enrollment (1 month), and at follow-up (6 months) underwent the standard donor screening tests, as well as those for HCV RNA and HGV RNA (RT-PCR), antibodies to the virus envelope E2 protein of GB virus type C (GBV-C E2 antibody), and IgM antibody for CMV, parvovirus B19, EBV VCA, and HAV. Participants completed a brief demographic and exposure history questionnaire at follow-up.

RESULTS

All study samples were negative in standard donor-screening tests. ALT levels were variable at return visits, with 80 to 86 percent <120 IU per L. No participants were positive for HCV RNA; 4 percent were positive for HGV RNA, and 10 percent were positive for GBV-C E2 antibody. Results of CMV, parvovirus B19, EBV VCA, and HAV testing were similar to published background rates. No demographic or exposure history variables had significant correlation with ALT or other testing results.

CONCLUSION

These data suggest that an ALT > or =120 IU per L in blood donors with negative standard screening tests has questionable value as a surrogate marker for seronegative HBV or HCV infection. Continued ALT testing may contribute little, if anything, to the safety of blood components or plasma for further manufacture.

[The application of submental island flap in head and neck surgery]

OBJECTIVE

This article discusses the anatomy, surgical procedure,indication, advantages and disadvantages of the submental island flap in reconstruction of the defects after head and neck tumor surgery, based on our clinical experience.

METHODS

The submental island flap was transferred with the submental vessels(A/V) as pedicle. In harvesting the flap, the flap was raised commencing from the contralateral side, dissecting all tissues off the mylohyoid muscles. Submandibular triangle dissection was taken until the facial artery and the facial vein. Then the submandibular gland and submandibular nodes were removed and submental vessels were left. This produces a large skin paddle which can be tunnelled to its recipient site.

RESULTS

From Aug. 1998 to Oct. 1999, 16 submental island flaps were performed in our department. 15 flaps survived well and 1 flap failed, with a success rate of 15/16 (93.8%).

CONCLUSION

The submental island flap is appropriate for primary reconstruction of the defect after various head and neck tumor surgery. It has a long and reliable pedicle, rapid and simple to raise and free from vessel anastomosis. It leaves a well hidden donor site. However, it can't be applied to these cases whose donor site had been radiated before surgery and whose submental and submandibular triangles lymph nodes were positive.

Calculation of the heat-source function in photophoresis of aggregated spheres

We present theoretical results for the source function in photophoresis of an arbitrary aggregate of spheres that are homogeneous and isotropic piecewise. This source function directly represents the distribution of electric fields inside the spheres. Our calculation is based on a rigorous analytic solution to the radiative multisphere-scattering problem developed recently [Y.-l. Xu, Appl. Opt. 34, 4573 (1995); 36, 9496 (1997); Phys. Lett. A 249, 30 (1998)]. When an aggregate degenerates to a single sphere, the results are exactly the same as those given by the Mie theory. We also discuss the numerical techniques necessary for obtaining an accurate numerical solution for the source function.

Feedback regulation of GA5 expression and metabolic engineering of gibberellin levels in Arabidopsis

The gibberellin (GA) 20-oxidase encoded by the GA5 gene of Arabidopsis directs GA biosynthesis to active GAs, whereas that encoded by the P16 gene of pumpkin endosperm leads to biosynthesis of inactive GAs. Negative feedback regulation of GA5 expression was demonstrated in stems of Arabidopsis by bioactive GAs but not by inactive GA. In transgenic Arabidopsis plants overexpressing P16, there was a severe reduction in the amounts of C20-GA intermediates, accumulation of large amounts of inactive GA25 and GA17, a reduction in GA4 content, and a small increase in GA1. However, due to feedback regulation, expression of GA5 and GA4, the gene coding for the subsequent 3beta-hydroxylase, was greatly increased to compensate for the effects of the P16 transgene. Consequently, stem height was only slightly reduced in the transgenic plants.

Concordance between hepatitis C virus serotyping assays

Hepatitis C virus testing has evolved from a simple enzyme-linked immunosorbent assay (ELISA) to complex molecular tests including qualitative and quantitative polymerase chain reaction (PCR) as well as multiple methods to determine geno and serotypes. Serotyping assays have been described and are being further refined to aid describing the epidemiology of hepatitis C virus (HCV) infection and may have a role in predicting response treatment. This study describes the concordance between two serotyping assay systems, a recombinant immunoblot assay Chiron RIBA Strip Immunoblot Assay (SIA) and a more competitive ELISA peptide assay, using PCR as the standard. Serotype was successfully determined in 144/202 (71%) patients by the Murex ELISA assay and 179/202 (89%) by the Chiron strip immunoblot assay (SIA) assay (P < 0.001). Concordance between restriction fragment length polymorphism (RFLP) and the Murex assay was 139/144 (97%) between RFLP and the Chiron SIA was 171/179 (96%) and between the Murex and Chiron SIA was 136/144 (94%). These assays provided a reliable, simple, and rapid method of determining HCV serotype.

Electromagnetic scattering by an aggregate of spheres: far field

In electromagnetic multisphere-scattering calculations the reexpansion method for seeking a single-field representation of the total scattered field is found impracticable because of severe numerical problems. We present a simple single-field expansion of the total scattered far field based on an asymptotic form of vector translational addition theorems. With this asymptotic expansion of the far field, we derive analytical expressions for the scattering properties of an arbitrary aggregate of spheres. Resulting formulas are free from numerical problems in practical applications. Theoretical predictions from this far-field solution for various aggregates of spheres that we tested agree favorably with laboratory microwave scattering measurements. Some numerical results are presented and compared with experimental data.

Experimental and theoretical results of light scattering by aggregates of spheres

We present laboratory microwave scattering measurements for complex amplitude scattering matrices of three aggregates of 2, 8, and 27 identical spheres and compare them with theoretical predictions. Electromagnetic multiparticle-scattering calculations involve the determination of a large number of vector translation coefficients introduced by the addition theorems for vector spherical harmonics. For one of the two classes of vector translation coefficients there is an overall-sign discrepancy between two groups of formulations that exist in the literature. We compare our experimental data with the theoretical results from scattering calculations using the two different sets of formulas for computation of the translation coefficients. This comparison of experiment with theory reveals that Cruzan's original research on the vector addition theorems [Q. Appl. Math. 20, 33-40 (1962)] is correct, although many authors believe that Cruzan's formulation contains an overall-sign error.