Osteogenic properties of bioactive titanium in inflammatory environment

OBJECTIVES

It is very important that the effects of surface modified titanium on osteogenic differentiation of bone marrow mesenchymal stem cells in the process of bone regeneration. The bio-function of modified titanium could be affected by the inflammatory micro-environment. The aim of this study was to investigate the effects of modified titanium on osteogenic differentiation in the inflammatory conditions and the osteogenic properties of the modified titanium dental implant in vivo.

METHODS

The medical pure titanium metals (PT-Ti) subjected to Anodic Oxidation (AO-Ti), Sand Blasting/acid etching (SLA-Ti) and Plasma-sprayed HA coating (HA coating-Ti) were used for regulating the osteogenic properties of MSCs in the normal and inflammatory conditions.

RESULTS

The amount of the MSCs in the inflammatory environment were more similar to that in the non-inflammatory environment after cultured on AO-Ti samples for 7D. However, the proliferation of the MSCs was obviously inhibited on the other groups in the inflammatory condition. The morphology of MSC cells on the modified titanium surface was affected in the inflammatory conditions and the AO-Ti was more conducive to maintain the skeletal morphology of MSCs. The results of osteogenic related proteins expression showed that the amount of BMP-2 on AO-Ti group was the highest in the inflammatory conditions, and followed the order of AO-Ti > HA coating-Ti > SLA-Ti > PT-Ti. What's more, the AO-Ti samples were more beneficial to promote the expression of osteogenic genes ALP, OCN, COL-I and Runx2 in the inflammatory conditions. The results of osteogenic properties in vivo showed that the gingival depth of the AO-Ti group was smaller than that on the other groups. Some new bone could be observed around the AO-Ti implant at two weeks. The bone binding rates on AO-Ti group was the highest of 81.3% after implanted for one year.

SIGNIFICANCE

The AO-Ti was beneficial to osteogenic differentiation than other modified titanium metals in inflammatory condition. The anodic oxidation is an effective surface modification method on titanium to promote bone regeneration.

Mechanism underlying Fanmugua () leaf multicomponent synergistic therapy for anemia: data mining based on hematopoietic network

OBJECTIVE

To investigate the underlying mechanism of Fanmugua (Fructus Caricae) Leaf (CPL) multicomponent synergistic therapy for anemia.

METHODS

The components were identified in the literature. Six databases were searched for targets of CPL. Enrichment analysis was used to determine the targets associated with anemia and in bone marrow. Based on the Kyoto Encyclopedia of Genes and Genomes database, pathways and targets related to hematopoiesis were obtained. The key targets were obtained by protein-protein interaction analysis. Molecular docking was used to analyze the binding ability of key targets and active components. Bone marrow cells were used as an experimental model to verify the drug efficacy.

RESULTS

A total of 139 components and 1868 targets of CPL were retrieved from the literature. By disease enrichment analysis, 543 targets for hemorrhagic anemia, 223 targets for aplastic anemia, and 126 targets for sickle cell anemia were obtained. Target organ enrichment yielded 27, 29, and 20 targets of bone marrow. Based on KEGG pathway enrichment, a total of 47 shared hematopoietic pathways and 42 related targets were found. The key targets were vascular endothelial growth factor A (VEGFA), interleukin 10 (IL-10), platelet-endothelial cell adhesion molecule-1 (PECAM1), C-C motif chemokine 2 (CCL2), and vascular cell adhesion molecule 1 (VCAM1). The CPL active components included ursolic acid, quercetin, and hesperidin. The expression of VEGFA was significantly increased after CPL treatment. Quercetin and ursolic acid acted on VEGFA. Quercetin and Hesperidin acted on VCAM1. Quercetin acted on IL-10, CCL2, VCAM1, and VEGFA. Cell experiments revealed that CPL could promote the proliferation and migration of bone marrow cells.

CONCLUSIONS

CPL has the synergistic efficacy of treating anemia through multiple components, targets, and pathways.

Sediments are important in regulating the algae-derived off-flavor (β-cyclocitral) in eutrophic lakes

In recent years, due to global warming and water eutrophication, cyanobacterial blooms have occurred frequently worldwide, resulting in a series of water quality problems, among which the odor problem in lakes is one of the focuses of attention. In the late stage of the bloom, a large amount of algae accumulated on the surface sediment, which will be a great hidden danger to cause odor pollution in lakes. β-Cyclocitral is one of the typical algae-derived odor compounds that cause odor in lakes. In this study, an annual survey of 13 eutrophic lakes in the Taihu Lake basin was investigated to assess the effects of abiotic and biotic factors on β-cyclocitral in water. Our results showed that high concentrations of β-cyclocitral in the pore water (pore-β-cyclocitral) were detected in the sediment and far exceeded that in the water column, with an average of about 100.37 times. Structural equation modeling indicated that algal biomass and pore-β-cyclocitral can directly regulate the concentrations of β-cyclocitral in the water column, and total phosphorus (TP) and temperature (Temp) promoted the algal biomass which further enhanced the production of β-cyclocitral both in the water column and pore water. It was worth noting that when Chla ≥30 μg/L, the effects of algae on pore-β-cyclocitral were significantly enhanced, and pore-β-cyclocitral played a major role in the regulation of β-cyclocitral concentrations in water column. Overall, our study facilitated a comprehensive and systematic understanding of the effects of algae on odorants and the dynamic regulatory processes in complex aquatic ecosystems, and revealed a long-neglected process, that was, the important contribution of sediments to β-cyclocitral in the water column in eutrophic lakes, which would conduce to a more accurate understanding of the evolution of off flavors in lakes and also useful for the management of odors in lakes in the future.

A vanished gastric gastrointestinal stromal tumor

BACKGROUND

Local resection is the standard treatment for gastrointestinal stromal tumors (GISTs). Laparoscopic and endoscopic cooperative surgery (LECS) is a minimally invasive surgery used to resect GISTs. Herein, we report an extremely rare case of a gastric GIST that grossly vanished during LECS.

CASE PRESENTATION

A 50-year-old Japanese female was referred to our hospital after an abnormality was detected during an esophagogastroduodenoscopy (EGD) at her annual health checkup. Based on EGD, endoscopic ultrasound (EUS), and computer tomography (CT) findings, the patient was diagnosed with a 50-mm submucosal tumor (SMT) with intraluminal growth on the anterior wall of the lesser curvature of the upper body of the stomach. We routinely use LECS to treat the intraluminal growth type of GISTs. During the intraoperative endoscopy, the intraluminal submucosal tumor, which was detected preoperatively, had vanished. A red-white scar was observed in the regressed tumor region. LECS was performed by resecting at a distance away from the scar tissue and closing the gastric wall with intracavitary sutures. In the evaluation from the tumor section view of the original resected specimen, a 22 × 14 × 8 mm lobular neoplasm was observed that was predominantly located in the gastric submucosa to the muscularis propia. Pathological findings confirmed the diagnosis of GIST with intermediate risk indicated by the Fletcher classification. The patient continued postoperative adjuvant chemotherapy with imatinib and no recurrence was detected over 12 months after surgery.

CONCLUSION

LECS was performed on the vanished gastric GIST, providing the best surgical treatment and leading to an accurate diagnosis and optimal postoperative care.

Pathological complete response with nivolumab for recurrence of liver metastasis after gastrectomy of gastric cancer

BACKGROUND

Advanced gastric cancer has an unfavorable prognosis and poor curability. Immune checkpoint inhibitors, such as nivolumab, have recently emerged as a potential solution for this aggressive disease. However, there is a lack of established evidence on the clinical efficacy of these agents, particularly in the perioperative period for advanced gastric cancer patients who are unresectable, recurrent, or preoperative. Despite the limited data available, there have been rare cases of dramatic therapeutic effects. In this study, we present a successful case of nivolumab treatment along with surgery.

CASE PRESENTATION

A 69-year-old female presented with pericardial discomfort and was diagnosed with advanced gastric cancer following upper gastrointestinal endoscopy. Laparoscopic distal gastrectomy with D2 lymph node dissection was performed, resulting in a final pathological diagnosis of Stage IIIA. The patient received postoperative adjuvant chemotherapy with oral S-1 therapy, but was found to have multiple liver metastases at 8 months postsurgery. Weekly paclitaxel and ramucirumab therapy was initiated, but the patient experienced adverse side effects, leading to the discontinuation of treatment. Nivolumab monotherapy was then administered for 18 cycles, resulting in a partial therapeutic response and PET-CT revealed a complete metabolic response. However, the patient developed a Grade 3 pemphigoid as an immune-related adverse event, leading to the cessation of nivolumab. The patient underwent laparoscopic partial hepatectomy. Postoperative pathology showed no residual tumor cells, indicating a complete response. At present, 25 months after surgery, the patient was alive without recurrence.

CONCLUSION

In this report, we present a case of gastric cancer with liver metastatic recurrence, in which a complete pathological response was achieved with nivolumab treatment. Although determining whether surgical intervention is necessary following successful drug treatment can be challenging, PET-CT imaging may be useful in decision-making regarding surgical treatment.

Developing a nomogram-based scoring model to estimate the risk of pulmonary embolism in respiratory department patients suspected of pulmonary embolisms

Objective

Pulmonary embolisms (PE) are clinically challenging because of their high morbidity and mortality. This study aimed to create a nomogram to accurately predict the risk of PE in respiratory department patients in order to enhance their medical treatment and management.

Methods

This study utilized a retrospective method to collect information on medical history, complications, specific clinical characteristics, and laboratory biomarker results of suspected PE patients who were admitted to the respiratory department at Affiliated Dongyang Hospital of Wenzhou Medical University between January 2012 and December 2021. This study involved a total of 3,511 patients who were randomly divided into a training group (six parts) and a validation group (four parts) based on a 6:4 ratio. The LASSO regression and multivariate logistic regression were used to develop a scoring model using a nomogram. The performance of the model was evaluated using receiver operating characteristic curve (AUC), calibration curve, and clinical decision curve.

Results

Our research included more than 50 features from 3,511 patients. The nomogram-based scoring model was established using six predictive features including age, smoke, temperature, systolic pressure, D-dimer, and fibrinogen, which achieved AUC values of 0.746 in the training cohort (95% CI 0.720-0.765) and 0.724 in the validation cohort (95% CI 0.695-0.753). The results of the calibration curve revealed a strong consistency between probability predicted by the nomogram and actual probability. The decision curve analysis (DCA) also demonstrated that the nomogram-based scoring model produced a favorable net clinical benefit.

Conclusion

In this study, we successfully developed a novel numerical model that can predict the risk of PE in respiratory department patients suspected of PE, which can not only appropriately select PE prevention strategies but also decrease unnecessary computed tomographic pulmonary angiography (CTPA) scans and their adverse effects.

Case report: Acne vulgaris treatment with 5-Aminolaevulinic acid photodynamic therapy and adalimumab: a novel approach

Acne vulgaris is a common skin condition that affects a large proportion of teenagers and young adults. Despite the availability of various treatment options, many patients experience inadequate relief or intolerable side effects. Photodynamic therapy (PDT) is a growing interest in the treatment of acne vulgaris, with 5-Aminolaevulinic acid (ALA) being one of the most commonly used photosensitizers. Adalimumab is a biologic medication used to treat inflammatory skin conditions such as Psoriasis and Hidradenitis suppurativa (HS), which targets TNF-α. Combining different therapies, such as ALA-PDT and adalimumab, can often provide more effective and longer-lasting results. This report presents the case of a patient with severe and refractory acne vulgaris who was treated with a combination of ALA-PDT and adalimumab, resulting in significant improvement in the condition. The literature review highlights the significant comorbidity associated with acne, emphasizing the need for potential of TNF-α inhibitors for its effective treatments that address physical symptoms and ALA-PDT is known to treat scar hyperplasia, and to prevent or minimize the formation of post-acne hypertrophic scars. The combination of TNF inhibitors and ALA-PDT or adalimumab has shown promising results in treating inflammatory skin conditions, including severe and refractory acne vulgaris, as per recent studies.

TOTAL ARTHROSCOPIC RECONSTRUCTION OF THE ANTERIOR CRUCIATE LIGAMENT

ABSTRACT Introduction: Total internal arthroscopic anterior cruciate ligament reconstruction is one of the new technologies in recent years. The main advantage is the need for only one tendon for the surgical procedure. Objective: Compare the clinical effects of total internal and traditional anterior cruciate ligament reconstruction techniques. Methods: From January 2019 to January 2022, the clinical data of 45 patients with anterior cruciate ligament reconstruction were retrospectively analyzed, including 32 males and 13 females aged 18-33 years, mean of 24.2 ± 3.3 years. Total internal reconstruction was performed in 22 cases (total internal group) and traditional reconstruction in 23 cases (traditional group). The two groups recorded and compared the time of injury, duration of surgical procedure, postoperative VAS score, and recovery of knee function. The International Knee Literature Committee (IKDC) and the Lysholm scoring system were used to evaluate clinical efficacy. Results: 45 patients were followed for 14 to 18 months, mean (15.4 ± 1.3) months. There were no significant differences between the two groups in time between operation and injury, duration of operation, IKDC, and Lysholm score of the affected knee at the last follow-up. However, there were significant differences in the VAS score on day one, day three, day seven, two weeks, and one month after the operation (P < 0.05), with no significant difference at three months, six months, and one year after the operation. Conclusion: The effect of total internal reconstruction of the anterior cruciate ligament is equivalent to that of traditional methods, with less postoperative pain, making it the ideal choice for this treatment. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

IMPACTS OF SOCCER ON EXECUTIVE FUNCTION IN BOYS WITH ADHD

ABSTRACT Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is a neurobiological disorder of genetic causes that appears in childhood. The main manifestations are inattention, hyperactivity, and emotional impulsivity. It is often accompanied by cognitive impairments and learning disabilities that seriously affect children's life, academic and social functions. Objective: Explore the impacts of soccer practice on executive function in boys with ADHD. Methods: Boys were selected from first and second graders in a public elementary school. They were randomly divided into an experimental group and a control group, and 8 boys in the control group were recruited according to the age difference of less than half a year. All children participated in various school sports activities, and the experimental group was added to soccer practice for 6 weeks. Results: There was no significant difference in cognitive subfunction between the soccer activity group, the conventional physical education teaching activity group, and the control group; however, the interaction between time and group factors proved to be significant P (4142) = 6.296, F< 0.01, it can be understood that the effect of the time factor on cognitive flexibility varies with different groups. Conclusion: The six-week soccer practice intervention can improve the executive function of 6-8-year-old boys with ADHD, especially inhibition control and cognitive flexibility, but does not represent a significant effect on memory. Level of evidence II; Therapeutic studies - investigating treatment outcomes.

A novel multi-epitope vaccine of HPV16 E5E6E7 oncoprotein delivered by HBc VLPs induced efficient prophylactic and therapeutic antitumor immunity in tumor mice model

Human papilloma virus type 16 (HPV16) is the most prevalent etiologic agent associated with cervical cancer, and its early proteins E5, E6 and E7 play important roles in cervical epithelium transformation to cervical intraepithelial neoplasia and even cervical cancer. Hence, these oncoproteins are ideal target antigens for developing immunotherapeutic vaccines against HPV-associated infection and cervical cancer. Currently, multi-epitope vaccines have been a promising strategy for immunotherapy for viral infection or cancers. In this study, the E5aa28-46, E6aa37-57 and E7aa26-57 peptides were selected and linked to form a novel multi-epitopes vaccine (E765m), which was inserted into the major immune dominant region (MIR) of hepatitis B virus core antigen (HBc) to construct a HBc-E765m chimeric virus-like particles (cVLPs). The immunogenicity and immunotherapeutic effect of the cVLPs vaccine was evaluated in immunized mice and a tumor-bearing mouse model. The results showed that HBc-E765m cVLPs elicited high E5-, E6- and E7- specific CTL and serum IgG antibody responses, and also relatively high levels of the cytokines IFN-γ, IL-4 and IL-5. More importantly, the cVLPs vaccine significant suppressed tumor growth in mice bearing E5-TC-1 tumors. Our findings provide strong evidence that this novel HBc-E765m cVLPs vaccine could be a candidate vaccine for specific immunotherapy in HPV16-associated cervical intraepithelial neoplasia or cervical cancer.

Application of motion-sensitized driven equilibrium based black blood 3D TSE sequence in the detection of brain metastases

PURPOSE

To investigate the value of contrast-enhanced motion-sensitized driven equilibrium (MSDE) based black blood three-dimensional (3D) turbo spin echo (TSE) sequence in the detection of brain metastases compared with 3D Turbo Field Echo (TFE) sequence.

MATERIAL AND METHODS

53 patients with suspected brain metastases were included in this study between November 2021 and February 2022. Contrast-enhanced cranial 3D TFE and MSDE-based 3D black blood TSE MR imaging were performed for each patient. Two senior neuroradiologists independently evaluated all contrast-enhanced 3D TFE and 3D black blood TSE images to detect brain metastases. The images were divided into two groups: the TFE group and the black blood TSE group. Agreement between the two reviewers for detection of the brain metastases in each group was performed using the kappa test. The two reviewers determined the final result for brain metastasis in the two groups by consensus. A paired t-test was performed for the final detection of brain metastases between the black blood TSE group and the TFE group.

RESULTS

There was a very good agreement between the two reviewers for the TSE group (kappa = 0.823) and a good agreement for the TFE group (kappa = 0.663). There was a statistical difference in the detection of small cortical and subcortical metastases between the TFE and the black blood TSE groups (t = 5.039, P = 0.000 < 0.05). There was no statistical difference in the detection of small supratentorial deep lesions and subtentorial lesions between the two groups.

CONCLUSION

Compared with conventional 3D TFE sequence, MSDE-based black blood 3D TSE sequence was superior for visualizing small brain metastases, especially small cortical and subcortical metastases.

ROS-mediated time-varying cytotoxic effects on Phaeodactylum tricornutum under the stress of commercial naphthenic acids

The aquatic toxicity and ecological risks of naphthenic acids (NAs) in marine environments have attracted an increasing amount of attention. However, there remains a lack of methodologies for the long-term risk assessment of NAs on marine ecosystems after high acid crude oil spill accidents. In this study, using the model microalgae Phaeodactylum tricornutum as the target object, the time-effect manner under NAs stress is investigated for a continuous 24-144 h. We found that: 1) NAs caused photosynthetic damage and persistent oxidative stress that slowed the growth rate and limited the maximum growth of P. tricornutum population within 24 h to 144 h of exposure, especially under the high concentration treatment; 2) Within 144 h, NAs can cause oxidative stress to P. tricornutum. The damage to cell membrane and radical oxidative species (ROS) accumulation of P. tricornutum were observed as obvious time-effect; 3) Under NAs stress, the two types of cell death (accidental cell death and regulated cell death) of P. tricornutum cell mediated by ROS played different roles in the population growth inhibition of P. tricornutum. Moreover, regulated cell death of the P. tricornutum cell was accompanied by PS externalization, DNA fragment and the G2/M phase stagnation acted as an adaptive regulatory mechanism under NAs stress. This explained the dose-time-effects of NAs on the population growth of P. tricornutum. Overall, the results suggested that NAs have a lasting effect on marine phytoplankton populations, and long-term risk assessments are required after high acid crude oil spill accidents. This is the first attempt to identify the different types of death at the cellular level to explain the time-effect toxicity at the population level of marine microalgae when exposed to NAs. This research will provide a new approach to facilitate further risk assessments for NAs and related contaminants in marine ecosystems.

Quantifying the potential of morphological parameters for human dental identification: part 2-selecting the strongest identifiers in mandibular permanent teeth

The current study aimed to select the best dental morphological identifiers for human identification. Sixty-two panoramic radiographs were collected retrospectively, in which six measurements were performed on all seven mandibular left permanent teeth: tooth length (TL), crown length (CL), root length (RL), crown width (CW), cervical width (CEJW), and root width (RW). Nine length-width ratios were then calculated using these measurements. Three groups of statistics were considered: (1) inter-observer reliability quantified by intra-class correlation (ICC); (2) mean "potential set"; and (3) Spearman correlation. A step-by-step cascade was then established based on selected parameters. In a univariate approach, the following parameters were the best identifiers: TL/CW for tooth 36 (ICC 0.82; mean potential set 13.7%), TL/CEJW for tooth 35 (ICC 0.87; mean potential set 15.2%), and TL/RW for tooth 32 (ICC 0.89; mean potential set 16.0%). The correlations between these three parameters ranged from 0.24 to 0.47. In a multivariate approach, the following parameters had the best identifying capacity: all parameters combined for tooth 31 (mean potential set 8.1%), for tooth 35 (mean potential set 11.9%), and for tooth 32 (mean potential set 16.3%). In conclusion, a single ratio in a specific tooth narrows down the potential set of matches, but the mean potential set remains relatively large. Combining all ratios of a single specific tooth increases the certainty of the match. In particular, tooth 31 was the strongest identifier.

The crystal structure of 1-(2-bromoethane)-4-amine-3,5-dinitropyrazole, C5H6Br1N5O4

C5H6Br1N5O4, orthorhombic, Pbca (no. 61), a = 11.4370(4) Å, b = 6.9921(2) Å, c = 22.8443(9) Å, β = 90°, V = 1826.83(11) Å3, Z = 8, R gt (F) = 0.0357, wR ref (F 2) = 0.1062, T = 100 K.

Neutrophil-to-lymphocyte ratio is a powerful predictor of adult patients with acute respiratory distress syndrome who might benefit from corticosteroid therapy

BACKGROUND

There is no convincing pharmacological treatment for patients withacute respiratory distress syndrome (ARDS). The efficacy of corticosteroids in ARDS patients remains controversial. Neutrophil-to-Lymphocyte Ratio (NLR) has displayed as a good biomarker for inflammation and immune status, and thus a prognostic marker in some critical patients of ARDS. In this study, we hypothesized that NLR could also serve as an indicator for the efficacy of corticosteroid therapy in ARDS patients.

METHODS

Subjects included in this retrospective cohort study with ARDS patients who were admitted to an academic hospital in Wuhan, China, from May 1st, 2020 to April 20th, 2021. Multivariable logisitic regression model was used to evaluate risk factors of 30-day in-hospital mortality and ventilator-free days. Multi-Cox regression model was used to assess the efficacy of corticosteroid treatment in terms of NLR cutoff value.

RESULTS

Among the 357 patients in our study, 89 (24.9%) had NLR≥14.35 and 268 (75.1%) had NLR<14.35. Among them, 53 patients with NLR≥14.35 (58.9%) received corticosteroids and 99 patients with NLR<14.35 (37.1%) received corticosteroids. Post-adjustment analysis (by APACHE II score and age) revealed that corticosteroid treatment was associated with a decreased risk of 30-day mortality in the NLR≥14.35 group but with an increased risk of death in the NLR<14.35 group. Use of corticosteroid in NLR≥14.35 group significantly increased ventilator-free days (7.0 vs. 13.0, P<0.001).

CONCLUSION

NLR may be used to help identify ARDS patients who may benefit from corticosteroid treatment. Large-sized randomized controlled trials are warranted to determine the optimal cutoff value of NLR.

Penetration of MeV electrons into the mesosphere accompanying pulsating aurorae

Pulsating aurorae (PsA) are caused by the intermittent precipitations of magnetospheric electrons (energies of a few keV to a few tens of keV) through wave-particle interactions, thereby depositing most of their energy at altitudes ~ 100 km. However, the maximum energy of precipitated electrons and its impacts on the atmosphere are unknown. Herein, we report unique observations by the European Incoherent Scatter (EISCAT) radar showing electron precipitations ranging from a few hundred keV to a few MeV during a PsA associated with a weak geomagnetic storm. Simultaneously, the Arase spacecraft has observed intense whistler-mode chorus waves at the conjugate location along magnetic field lines. A computer simulation based on the EISCAT observations shows immediate catalytic ozone depletion at the mesospheric altitudes. Since PsA occurs frequently, often in daily basis, and extends its impact over large MLT areas, we anticipate that the PsA possesses a significant forcing to the mesospheric ozone chemistry in high latitudes through high energy electron precipitations. Therefore, the generation of PsA results in the depletion of mesospheric ozone through high-energy electron precipitations caused by whistler-mode chorus waves, which are similar to the well-known effect due to solar energetic protons triggered by solar flares.

Auxiliary diagnostic value of D2-40 in early lung adenocarcinoma and precursor lesions

AIMS

Objective to investigate whether D2-40 can be used as a marker of early lung adenocarcinoma and precursor lesions.

METHODS

In order to explore the value of D2-40, a monoclonal antibody that recognises the podoplanin, as an auxiliary diagnostic marker to aid the diagnosis of these conditions, we performed the immunohistochemical (IHC) staining using early lung adenocarcinoma, infiltrating adenocarcinoma, benign lung lesions and relevant peritumour normal tissues. The microscopic examination was performed to analyse the D2-40 IHC staining.

RESULTS

We found that there was no D2-40 staining in 47 cases of early stage lung adenocarcinoma and precursor lesions; only 1 of the 32 cases (3.13%) of infiltrating adenocarcinoma stained positive. There was 100% D2-40 staining in 30 cases of benign lung lesions and 79 cases of peritumour normal tissues. The positivity rate in carcinoma group was 1.27% and the normal tissue group was 100%, (p<0.01). Based on our findings, we concluded that D2-40 IHC staining in lung adenocarcinoma and precursor lesions compared with normal alveolar epithelia displayed the 'none or all' phenomenon.

CONCLUSIONS

The results from our study suggested that D2-40 can be sued as auxiliary diagnostic tool in early lung adenocarcinoma and its precursor lesions.

Analysis of Later Stage Morbidity and Mortality after Pancreatic Surgery Because of Abdominal Trauma

Background: Pancreatic trauma surgery is a complicated surgical procedure for severe pancreatic injuries, accompanied by a high incidence of complications and mortality. This study was designed to explore the long-term prognosis of pancreatic surgery because of abdominal trauma. Patients and Methods: The clinical data of 103 patients who were admitted to Jinling Hospital between August 2012 and August 2019 who had pancreatic trauma surgery were analyzed retrospectively. Results: All admissions involved pancreatic trauma surgery performed at an outside hospital network, which later transferred patients to our institution because of post-operative later-stage complications. Eight patients received American Association for the Surgery of Trauma (AAST) grade 1 or 2 pancreatic injuries and 95 received AAST grade 3, 4, or 5 pancreatic injuries. The primary surgical management of pancreatic injuries included drainage of the pancreatic injury (n = 28), repair of the pancreas (n = 35), partial pancreatectomy (n = 15), pancreaticojejunostomy (n = 6), and pancreaticoduodenectomy (n = 19). The most common mechanism of trauma was motor vehicle collision (n = 72), crush injury (n = 26), and stab wound (n = 5). Of 103 patients suffered varying degrees of gastrointestinal fistulae and intra-abdominal infections, there were 66 cases of pancreatic fistulae (64.1%), 49 cases of enteric fistulae (47.6%), 26 cases of colonic fistulae (25.2%), 14 cases of gastric or gastrointestinal anastomotic fistulae (13.6%), and 13 cases of biliary fistulae (12.6%). Ninety-five patients survived and eight patients died after therapy; the mean length of intensive care unit stay was 33 days. The number of patients who underwent emergency pancreaticoduodenectomy (EPD), the incidence of blood transfusion, the number of fistulae per patient, and the duration of mechanical ventilation and bacteremia in the mortality group were substantially higher than in the survival group (p < 0.05 each). The patients who underwent EPD had more grade 5 pancreatic injuries, more blood transfusions, higher peak total bilirubin, greater numbers of fistulae and open abdomen, and longer duration of mechanical ventilation and mortality than other patients (p < 0.05 each). Conclusions: The grade of pancreatic injury was associated with mortality and post-operative complications. The post-operative mortality and occurrence of complications of EPD because of abdominal trauma were significant; use of damage control surgery could potentially reduce the morbidity and mortality related to this procedure.

Study on the Fingerprints and Quality Evaluation of Angelica Sinensis Radix by HPLC Coupled With Chemometrics Based on Traditional Decoction Process of ACPTCM

Objective

To establish a HPLC fingerprints evaluation method for Angelica Sinensis Radix (ASR) based on traditional decoction process of Ancient Classical Prescriptions of Traditional Chinese Medicine (ACPTCM).

Methods

The fingerprints of 10 batches of ASR were further evaluated by chemometrics methods. The similarity analyzed with "Similarity Evaluation System for Chromatographic Fingerprint of Traditional Chinese Medicine 2004A," and hierarchical clustering analysis (HCA) and principal component analysis (PCA) were performed by SPSS (version 22.0, SPSS Inc., Chicago, IL, USA).

Results

There were 12 common peaks, and the similarity degrees of 10 batches of samples were more than 0.923 and showed that all the samples from different origins were of good consistency. The samples were divided into 4 clusters by HCA. The results of PCA showed that the 3 factors were chosen, the quality of samples could be evaluated basically. The comprehensive score results show that the ASR with Lot.Nos.DG-18007, DG-18008 in Weiyuan County, Gansu and DG-18009 produced in Minle County, Gansu Province rank among the top 3 in all samples.

Conclusions

These results demonstrated that the combination of HPLC chromatographic fingerprint and chemometrics offers an efficient and reliable approach for quality evaluation of ASR from different sources as Ancient Classical Prescriptions ingredients.

The kite flap for reconstructing tumour excision wounds in the middle and lower face: a retrospective study

OBJECTIVE

The aim of this study was to present our experience with a kite flap in reconstruction of facial wounds after malignant tumour excision.

METHOD

From October 2008 to September 2017, patients with facial malignant tumour were treated in the Xinjiang Uygur Autonomous Region Bazhou People's Hospital with kite flaps after complete excision. The survival rate, colour, cicatrix of the flap and patient satisfaction were recorded after surgery.

RESULTS

A total of 95 patients were included in the study. During follow-up, from six months to 8 years, all the kite flaps achieved primary closure and survived well, and the colour and texture were similar to the surrounding skin with no obvious scar. Dysfunction, complications and recurrence had not been reported.

CONCLUSION

The kite flap may be a good option in reconstructing facial wounds after malignant tumour excision (diameters 1-5cm). It is a simple surgical method with sufficient blood supply and extensive adaptability. For patients in this study, no obvious scars were formed and the recipient site matched well with the donor site.

Metagenomics Study Reveals Changes in Gut Microbiota in Centenarians: A Cohort Study of Hainan Centenarians

Several studies based on 16SrDNA analysis have revealed certain unique characteristics of gut microbiome in centenarians. We established a prospective cohort of fecal microbiota and conducted the first metagenomics-based study among centenarians. The objective was to explore the dynamic changes of gut microbiota in healthy centenarians and centenarians approaching end of life and to unravel the characteristics of aging-associated microbiome. Seventy-five healthy centenarians residing in three regions of Hainan participated in follow-up surveys and collection of fecal samples at intervals of 3 months. Data pertaining to dietary status, health status scores, cause of disease and death, and fecal specimens were collected for 15 months. Twenty participants died within 20 months during the follow-up period. The median survival time was 8-9 months (range, 1-17) and the mortality rate was 14.7% per year. The health status scores before death were significantly lower than those at 3 months before the end of the follow-up period [median score: 3 (range, 1-5), P < 0.05]. At this time, the participants mainly exhibited symptoms of anorexia and reduced dietary intake and physical activity. Metagenomics sequencing and analysis were carried out to characterize the gut microbiota changes in the centenarians during their transition from healthy status to death. Anosim analysis showed a significant change in gut microbiota from 7 months prior to death (R = 0.10, P = 0.02). All participants were grouped with 7 months before death as cut-off; no significant difference in α diversity was found between the two groups (P = 0.45). Semi-supervised monitoring and log rank sum analysis revealed significant changes in the abundance of ten bacterial species before death; of these, eight species were significantly reduced (Akkermansia muciniphila, Alistipes finegoldii, Alistipes shahii, Bacteroides faecis, Bacteroides intestinalis, Butyrivibrio crossotus, Bacteroides stercoris, and Prevotella stercorea) while two were significantly increased before death (Bifidobacterium longum and Ruminococcus bromii). Compared to centenarians in northern Italy, Hainan centenarians exhibited unique characteristics of gut microbiome. The abundance of ten bacterial species showed significant changes starting from 7 months before death. We speculate that these changes might occur before the clinical symptoms of deterioration in health status.

Thecodont tooth attachment and replacement in bolosaurid parareptiles

Permian bolosaurid parareptiles are well-known for having complex tooth crowns and complete tooth rows in the jaws, in contrast to the comparatively simple teeth and frequent replacement gaps in all other Paleozoic amniotes. Analysis of the specialized dentition of the bolosaurid parareptiles Bolosaurus from North America and Belebey from Russia, utilizing a combination of histological and tomographic data, reveals unusual patterns of tooth development and replacement. The data confirm that bolosaurid teeth have thecodont implantation with deep roots, the oldest known such example among amniotes, and independently evolved among much younger archosauromorphs (including dinosaurs and crocodilians) and among synapsids (including mammals). High-resolution CT scans were able to detect the density boundary between the alveolar bone and the jawbone, as confirmed by histology, and revealed the location and size of developing replacement teeth in the pulp cavity of functional teeth. Evidence provided by the paratype dentary of Belebey chengi indicates that replacement teeth are present along the whole tooth row at slightly different stages of development, with the ontogenetically more developed teeth anteriorly, suggesting that tooth replacement was highly synchronized. CT data also show tooth replacement is directly related to the presence of lingual pits in the jaw, and that migration of tooth buds occurs initially close to these resorption pits to a position immediately below the functional tooth within its pulp cavity. The size and complex shape of the replacement teeth in the holotype of Bolosaurus grandis indicate that the replacement teeth can develop within the pulp cavity to an advanced stage while the previous generation remains functional for an extended time, reminiscent of the condition seen in other amniotes with occluding dentitions, including mammals.

Two-shift operation mode can improve the efficiency and comfort of flexible ureteroscopic holmium laser lithotripsy for the treatment of renal calculi larger than 1.5cm

Purpose:

To compare two-shift operation mode and single player mode different impact on surgical results and operator comfort in flexible ureteroscopic holmium laser lithotripsy for renal calculi larger than 1.5cm.

Materials and Methods:

From december 2017 to december 2018, 92 patients with renal calculi admitted to Qilu Hospital and were treated through flexible ureteroscopy. They were randomized in two-shift group (n=50) and single player group (n=42). The operative time, blood loss, hospitalization stay after operation, residual fragments (≥4mm) rate, fragmentation speed, postoperative complications and operator's fatigue score were compared.

Results:

There was no significant difference between two groups regarding age, gender, illness side, stone size, blood loss, operative time, postoperative hospitalization stay, complications, etc (p >0.05). The fragmentation speed was 44.5±20.0mm3/min in two-shift group compared with 34.2±17.3mm3/min in single player group (p=0.037). Residual fragments (≥4mm) rate after first surgery was 18% in two-shift group, while the residual fragments (≥4mm) rate was 40.5% after first surgery in single player group (p=0.017). The total fatigue score of two-shift group was 8.4 compared to 29.9 in single player group (p <0.001).

Conclusion:

In flexible ureteroscopic holmium laser lithotripsy for the treatment of renal calculi larger than 1.5cm, two-shift operation mode can raise the fragmentation speed and stone clearance rate, as well as significantly lower operator's fatigue level and improve operator's comfort.

Combination of metformin and luteolin synergistically protects carbon tetrachloride-induced hepatotoxicity: Mechanism involves antioxidant, anti-inflammatory, antiapoptotic, and Nrf2/HO-1 signaling pathway

Liver diseases are one of the fatal disorders due to the vital role of the liver. Carbon tetrachloride (CCl₄ ) is the most perceived chemical substance utilized in developing models of hepatic damage. Metformin (Met) is a potent antidiabetic and redox modulatory agent that has shown anticancer and protective effects on various organs. Therefore, addition of therapy with natural antioxidative agents or herbal extracts shows defensive impacts against different injuries inside the body. Luteolin (Lut) can be found in several customary Chinese remedies. It has been reported for various pharmacological actions such as antitumor, antioxidative, and anti-inflammatory impacts. Here, the liver injury rat model was established using CCl₄ (1.00 mL/kg body weight) in vivo. The protective roles of Met and Lut separately or in combination were observed in hepatotoxicity induced by CCl₄ . The result was shown that both Met and Lut, while individually used, were normally active in diminishing CCl₄ -caused hepatotoxicity. The combination of two drugs performed synergistically to improve liver damage caused by CCl₄ , as shown by the considerably improved liver dysfunction. Met and Lut showed highly antioxidative effects on CCl₄ -treated rats moderately by increasing the activities and expression of the antioxidant enzymes. Along with this, a combination of Met and Lut significantly suppressed inflammatory responses, which is evidenced by the reduced level of inflammatory cytokines together with interleukin 1 beta (IL-1β), tumor necrosis factor alpha (TNF-α), and interleukin 6 (IL-6). Additionally, CCl₄ -agitated apoptosis was intensely reduced by Met and Lut through reducing cleaved caspase-3 and Bax (pro-apoptotic factor) while increasing Bcl-2 (antiapoptotic factor) signaling pathways. Cotreatments of Met and Lut upregulated nuclear factor erythroid 2-related factor 2 (NRF2) and heme oxygenase-1 (HO-1) expression in the CCl₄ -intoxicated rat's liver. The above result recommended that combination of Met and Lut may have a substantial potential and synergizing impact against CCl₄ -induced hepatotoxicity.

An efficient or methodical review of immunotherapy against breast cancer

Breast cancer (BC) is one of the most widespread malignancies in women worldwide. Breast cancer is mainly classified into a few key molecular subtypes in accordance with hormone and growth factor receptor expression, etc. In spite of numerous advances in the remedy of breast cancer, the development of metastatic disease remains an untreatable and repeated basis of cancer death for women. Preclinical and clinical studies of immunotherapy in cancer remedy have been in progress for the past quite a few decades by an effort to accelerate, augment, and modulate the immune system to spot and devastate cancer cells. Advancement of cancer immunotherapy is rapidly increasing with eminent and most interesting therapy compared to other therapy like targeted therapy, cytotoxic chemotherapy, radiation as well as surgery. Cancer immunotherapy, also known as biological therapy, which denotes the controlling and by means of the patient's own immune system to goal the cancer cells rather than using an extrinsic therapy. In that way, focusing of cancer immunotherapy developing mediators that stimulates or enhances the immune system's recognition and destroying the cancer cells. This review describes a holistic outlook and deeper understanding of the biology of immunotherapy within the system of tumor microenvironment of breast cancer that improve clinical research and constructive impact on the study conclusion.

The crystal structure of 1,4-dinitroso-2,3,5,6-tetraacetoxy-piperazine, C12H16N4O10

C12H16N4O10, monoclinic, C2/c (no. 15), a = 21.953(3) Å, b = 7.0292(9) Å, c = 13.5984(19) Å, β = 127.569(4)°, V = 1663.23(40) Å3, Z = 4, R gt(F) = 0.0555, wR ref(F 2) = 0.1224, T = 122(2) K.

Risk factors analysis of nosocomial pneumonia in elderly patients with acute cerebral infraction

To investigate the risk factors of nosocomial pneumonia (NP) in elderly patients with acute cerebral infarction (ACI).In this study, 324 aged 70 years and over patients with ACI who were admitted to the inpatient department of TianJin First Hospital (China) from January 2012 to February 2018 were retrospectively analyzed. The patients were divided into NP group (80 patients) and non-NP group (244 patients) according to whether NP was occurred 48 hours after hospitalization. Baseline profiles and biochemical analyses were compared between 2 groups. Information regarding risk factors for NP in elderly patients with ACI was collected from all patients. Associations with NP and outcome were evaluated.Among the total patients, NP occurred in 80 (24.69%) patients. There were no statistically significant differences between risk of NP and sex, current drinking, diabetes mellitus, stroke history, and levels of serum UA, TG, HDL-C, LDL-C, Glucose, chloride, potassium. Multivariate logistic regression analysis showed that the independent risk factors for NP were living alone (OR 4.723; CI 1.743∼12.802; P = .002), initial NIHSS score (OR 1.441; CI 1.191∼1.743; P = .000), NRS2002 score (OR 0.139; CI 0.087∼0.223; P = .000), BMI (OR 1.586; CI 1.353∼1.858; P = .000), a past pneumonia history (OR 0.073; CI 0.017∼0.321; P = .001), atrial fibrillation (AF) (OR 0.129; CI 0.033∼0.499; P = .003), CRP (OR 1.050; CI 1.017∼1.085; P = .003), BUN (OR 0.603; CI 0.448∼0.812; P = .001) and Cr (OR 1.036; CI 1.015∼1.057; P = .001). Level of albumin was an independent protective factor of NP in elderly patients with ACI (OR 0.865; CI 0.750∼0.999; P = .048). Furthermore, elderly patients with ACI who had NP had worse clinical outcomes both during hospitalization and after discharge (P < .05).We identified significant risk factors for NP in elderly patients with ACI, including living alone, initial NIHSS score, malnutrition, a past pneumonia history, AF, CRP, and Renal function were associated with NP in elderly patients with ACI. The clinical course was worse and the duration of hospital stay was longer in NP patients than in non-NP patients.

The relationships between odors and environmental factors at bloom and non-bloom area in Lake Taihu, China

Lake Taihu has been experiencing taste and odor (T&O) events recently. And for the purpose of seeking the environmental factors having great influences on T&O compounds and supplying theory information for preventing the occurrence of T&O problems, Redundance analysis (RDA) was conducted for the dissolved and particle-bound forms of T&O compounds. And the whole lake was divided into the blooming and non-blooming areas. Results indicated that environmental factors, including biotic and abiotic factors, made great contributions to the variation of T&O compounds in Lake Taihu. The key biotic factors included Microcystis, Oscillatoria and chlorophyll-a. Microcystis made great contribution of these compounds in the blooming area and had close relationship with those particulate forms of odorants in Taihu. Oscillatoria made great and absolute contribution to odorants in the non-blooming area. Chlorophyll-a influenced greatly the odorants in the blooming area and had significant relationship with the particle-bound fractions in the whole lake. Dissolved oxygen and water temperature were the dominant abiotic factors with large contributions.

Corilagin Attenuates the Parkinsonismin Japanese Encephalitis Virus Induced Parkinsonism

This study evaluates the protective effect of corilagin against Parkinsonismin Japanese encephalitis virus (JEV) induced Parkinson’s disease. The JaGAr-01 strain of virus was used to induce JE. The virus was injected into the rats (13 days age) at the midpoint between the two ears. Adult rats, 12 week after the inoculation of virus, were used for the further study. Corilagin (20 mg/kg) and levodopa with dopa decarboxylase inhibitor (LEV, 10 mg/kg) were administered intraperitoneally for the duration of one week. Bradykinesia and the levels of dopamine in the brain were estimated at the end of protocol. There was a significant decrease inthe motor function in the corilagin, LEV and LEV + corilagin treated groupscompared to the negative control group. However treatment with corilagin, LEV and LEV + corilagin significantly increases the level of dopamine in the brain compared to the negative control group. This study concludes that corilagin ameliorates the Parkinsonismin JEV induced Parkinsonism. Moreover it shows a synergistic effect when treated with LEV. Data presented in the investigation supports that corilagin can be used clinically.

[Enzyme kinetic analysis of Oncomelania hupensis exposed to active ingredient of Buddleja lindleyana (AIBL)]

OBJECTIVE

To analyze the enzyme kinetics of active ingredient of Buddleja lindleyana (AIBL) against Oncomelania hupensis, the intermediate host of Schistosoma japonicum.

METHODS

O. hupensis snails were placed in 1 000 ml of 3.55 mg/L AIBL solution for 24, 48 h and 72 h, respectively, and the enzyme kinetics of alanine aminotransferase (GPT) was determined by Reitman-Frankel assay, lactate dehydrogenase (LDH) by the chemical inhibition lactic acid substrate method, alkaline phosphatase (AKP) by the disodium phenyl phosphate colorimetric method, acetylcholine esterase (AChE) and malate dehydrogenas (MDH) by ELISA, and succinate dehydrogenase (SDH) by the phenazine methyl sulfate reaction method (PMS) in the soft tissues of O. hupensis before and after AIBL treatment.

RESULTS

Following exposure to 3.55 mg/L AIBL solution for 24 h, the GPT, LDH, and AKP activities significantly improved in the soft tissues of O. hupensis, while the SDH and MDH activities were significantly lowered in the head-foot and liver. However, AIBL treatment did not cause significant effect on AChE activity in O. hupensis.

CONCLUSIONS

AIBL causes significant damages to O. hupensis liver and can efficiently act on anaerobic and aerobic respiration loci, which will hinder energy metabolism, and cause inadequate energy supply in cells used for normal secretion, eventually leading to O. hupensis death.

Investigations on surface morphology and bandgap engineering of single crystal boron-doped silicon irradiated by a nanosecond laser

We irradiate the single crystal boron-doped silicon (Si) at various laser fluences with 100 laser shots in ambient air at room temperature using an Nd:YAG laser and investigate its surface morphology and optical properties. The optical microscopy gives evidence of the formation of a crater and reveals that the heat-affected zone and melted area are increased with increase in laser fluence from 1.1 to 15.4  J/cm². The micrographs obtained by scanning electron microscopy (SEM) show that the micro- and nano-structures such as microcracks, bubbles, nucleation sites, clusters, redeposited layered material, nanoparticles, and alike water droplet structures are formed on a laser-exposed Si surface. The optical profilometry of the irradiated Si further confirms the ablation and redeposition of the material and shows that the depth of the crater is increased from 12.1 to 15.2 μm with increase in fluence from 1.1 to 15.4  J/cm². Raman spectroscopy of the samples shows that the irradiation generates anneal effects due to higher temperature, which increases the crystallinity of the Si. The ellipsometric analysis shows that the irradiation of Si with increasing laser fluence changes its optical constants (refractive index and extinction coefficient), which further influence its optical properties, e.g., reflectivity, absorptivity, and energy bandgap. The absorptivity of laser irradiated Si tends to increase with increasing laser fluence, and the energy bandgap is decreased accordingly due to increase in structural disorders. Our study shows that the controlled laser irradiation can tune the energy bandgap of exposed Si, and it makes the Si materials useful for the fabrication of optoelectronic devices such as solar cells, photovoltaic cells, and LEDs.

[Epidemiological analysis of malaria prevalence in Jiangsu Province in 2015]

Objective To understand the malaria epidemic situation and characteristics in Jiangsu Province in 2015, so as to provide the evidence for malaria elimination. Methods The data of malaria cases in Jiangsu Province in 2015 were collected from China's routine diseases surveillance information system. Results Totally 405 imported cases were reported in Jiangsu Province in 2015, and the cases increased by 14.08% compared with those in 2014. All the malaria cases were imported, and 5 cases (1.23%) were from Southeast Asia and 400 (98.77%) were from 25 African countries or regions. The imported malaria cases were reported in 13 cities across Jiangsu Province, where Taizhou, Lianyungang, Nantong, Huaian and Yangzhou cities accounted for 68.64% of all the cases in the province. Jiangsu Institute of Parasitic Diseases (JIPD) reference lab checked all the cases and classified 299 falciparum malaria cases, 13 vivax malaria cases, 18 quartan malaria cases, 71 ovale malaria cases, and 4 mixed Plasmodium infection cases. Conclusions In Jiangsu Province, there are no local malaria cases for 4 consecutive years, but the imported cases are on the rise. Compared to 2014, the imported vivax cases increased significantly in 2015. It should be the key points to strengthen the surveillance of imported malaria cases, improve malaria diagnosis and treatment abilities for all levels of medical institutions, and promote the abilities of Plasmodium check, and focus survey and disposal of all Center for Disease Control (CDC) staffs across Jiangsu Province.

[Diagnostic knowledge and skills of parasitic diseases based on competition of professional personnel in Jiangsu Province, China]

Objective To understand the integrated ability of parasitic disease prevention and control of professional personnel of Jiangsu Province through the contest. Methods Totally 56 players from the whole province were selected, and all the players participated in the contest. The theory knowledge and skill scores were collected and the statistical analyses were conducted. Results The average theoretical score of the participants was 88.86±15.56 and the passing rate was 91.1%. The average skill operating score was 69.16±16.01 and the passing rate was 67.9%. The average Plasmodium microscopy score was 16.54±8.09 and the passing rate was 50%. The average helminth egg microscopy score was 34.27±10.66 and the passing rate was 67.9%. There were statistical differences among the age groups and different levels of schistosomiasis endemic situation (F = 5.10, 6.39, both P < 0.01). The theoretical knowledge including schistosomiasis, malaria, hydatid disease and others and the score rates were 91.07%, 90.94%, 85.83% and 90.93%, respectively. The hydatid disease score rate was lower (χ² = 19.17, P < 0.01). The radar chart displayed that the score rates of tabletting and microscopy test in Kato-Katz film production, malaria blood film production and microscopy test were all low. Conclusion In Jiangsu Province, the participants have higher score in the theory test. However, they have lower skill test score, especially in the parasite species identification. The operational skills still need to be strengthened for center for disease control (CDC) participants.

Corrosion wear characteristics of TC4, 316 stainless steel, and Monel K500 in artificial seawater

Wear-induced corrosion can accelerate material degradation, and the passive film in the wear track is only partially destroyed.

Safety, Tolerability and Pharmacokinetic and Pharmacodynamic Learnings from a Double-Blind, Randomized, Placebo-Controlled, Sequential Group First-in-Human Study of the TRPV1 Antagonist, JNJ-38893777, in Healthy Men

BACKGROUND AND OBJECTIVE

Nociceptive and neuropathic pain, one of common reasons of disability and loss of quality life, are often undertreated due to safety concerns with current therapies. This study assessed the safety, tolerability, pharmacokinetics and pharmacodynamics of JNJ-38893777, a potent and selective transient receptor potential vanilloid 1 (TRPV1) channel antagonist in healthy men.

METHODS

In a single-center, double-blind, placebo-controlled, sequential group, single-ascending-dose phase 1 study, 80 healthy men (18-45 years old; body mass index 18.5 to <30 kg/m(2)), randomized to two groups, received either JNJ-38893777 (n = 6) or placebo (n = 2) in a dose-escalation manner. The study was designed in two parts: Part 1, an early tablet formulation was administered under fasting conditions at 5, 15, 45, 125, 250, or 500 mg; Part 2, a new tablet formulation was administered in a fasting state (250 mg) and a high-fat fed state (250 mg, 375 mg, or 500 mg). Serial plasma and urine samples (collected over 120 h post-dose) were analyzed using LC-MS/MS for pharmacokinetic evaluations.

RESULTS

JNJ-38893777 concentrations peaked from 3.0 to 5.5 h (median) post-administration, and then declined multi-exponentially with a prolonged terminal phase. Renal clearance was negligible. Maximum concentration (C max) and area under the concentration-time curve from time zero to infinity (AUC∞) of the early formulation increased with increasing doses but less than dose-proportionally over 5-500 mg (fasted) doses. The new tablet formulation showed no improvements in the fasting state but showed an 11- to 22-fold increase in JNJ-38893777 exposure; interindividual variability reduced from 73-85% to 23-24%, and a significant increase (P < 0.05) in heat pain detection threshold (~3 °C) was observed in the fed state. Mild to moderate adverse events were observed, with no evidence of exposure dependence up to 500 mg (fed). Concentration-related increases in body temperature or changes in Fridericia-corrected QT interval (QTcF) were not observed.

CONCLUSION

JNJ-38893777 was tolerated at single doses up to 500 mg (fed) and is suitable for further clinical development.

Changes in mast cell infiltration: a possible mechanism in detrusor overactivity induced by visceral hypersensitivity

OBJECTIVE

To establish the detrusor overactivity (DO) model induced by visceral hypersensitivity (VH) and investigate the relationship between mast cell (MC) infiltration and DO.

MATERIALS AND METHODS

Sixty rats are divided into 4 groups randomly: Group 1:Baseline group; Group 2: DO group; Group 3: CON group; Group 4: VH group. The colorectal distension (CRD) and abdominal withdral reflex (AWR) scores are performed to evaluate VH. The cystometric investigation and histological test of MC infiltration are assessed.

RESULTS

The threshold pressure of CRD in the VH group is significantly lower than that in the CON group (P<0.001). At the distension pressure ≥20 mmHg, the AWR scores of the VH group are significantly higher than those of the CON group (10 mmHg: P=0.33; 20 mmHg: P=0.028; 40 mmHg: P<0.001; 60 mmHg: P<0.001; 80 mmHg: P<0.001). DO model is successfully established in the VH group (DO rate=100%). Compared with the CON group, the numbers of MC infiltration are significantly increased in the VH group, including submucosa of bladder (P<0.001), mucosa lamina propria/mesentery of small intestine (P<0.001), and mucosa lamina propria/mesentery of large intestine (P<0.001). Furthermore, more MC activation as well as degranulation are observed in the VH group.

CONCLUSIONS

It is indicated that DO model can be established in the VH rats. The MC infiltration may play an important role in DO induced by VH, and may be helpful to understand the mechanisms of DO in VH patients.

Laparoscopic Resection of Retroperitoneal Paragangliomas: A Comparison with Conventional Open Surgical Procedures

OBJECTIVE

Paraganglioma (PGL) is a rare type of tumor that arises from the extra-adrenal paraganglia. Laparoscopic adrenalectomy is well established for the treatment of adrenal pheochromocytomas, but laparoscopic resection of PGLs is controversial. In this study, we compared the clinical outcomes of laparoscopic and conventional open surgical procedures for PGLs. We also analyze the safety and feasibility of laparoscopic technique for renal hilar PGLs.

METHODS

A retrospective review of all patients who underwent resection of retroperitoneal PGLs from 2002 to 2014 in our hospital was performed. Twelve patients underwent open procedures, and 15 underwent laparoscopic procedures. The preoperative, intraoperative, and postoperative data were collected and analyzed.

RESULTS

PGLs located at the renal hilum were predominantly both in the Lap group (n = 9) and open group (n = 7). Laparoscopic procedures in 14 of 15 patients were effectively completed without conversion to open surgery; one case with renal hilar tumor was converted to open surgery because of bleeding. The baseline characteristic of the patients in each group was well equivalent with respect to patient age, gender, body mass index, and tumor size. In the Lap group, the perioperative indexes were significantly different from those of the open group (each p < 0.05), including operative time (217.36 ± 51.90 vs 175.67 ± 36.79; p = 0.029), estimated blood loss (80.71 ± 83.52 vs 172.50 ± 160.86 mL; p = 0.047), and postoperative hospital stay (5.64 ± 1.95 vs 8.58 ± 1.97 days; p = 0.001). However, the intraoperative hemodynamic parameters and intensive care unit stay days were similar in both the groups. The perioperative data of the two procedures for renal hilar PGLs were compared. The Lap group showed estimated blood loss, and postoperative hospital stay outcomes were more favorable than the open group. Other data were similar in both the groups.

CONCLUSION

Laparoscopic procedure is safe and feasible in the treatment of patients with retroperitoneal PGLs. Laparoscopic resection of PGLs from the renal hilum is technically challenging. However, it is possible to safely undertake laparoscopic resection of these tumors by an experienced surgeon.

[Reconstruction and measurement of a digital dental model using grating projection and reverse engineering]

OBJECTIVE

This work lays the foundation for establishing a digital model database with normal occlusion. A digital dental cast is acquired through grating projection, and model features are measured through reverse engineering.

METHODS

The grating projection system controlled by a computer was projected onto the surface of a normal dental model. Three-dimensional contour data were obtained through multi-angle shooting. A three-dimensional model was constructed, and the model features were analyzed by using reverse engineering. The digital model was compared with the plaster model to determine the accuracy of the measurement system.

RESULTS

The structure of three-dimensional reconstruction model was clear. The digital models of two measurements exhibited no significant difference (P > 0.05). When digital and plaster models were measured, we found that the crown length and arch width were not statistically different (P > 0.05), whereas the difference between the crown width and arch length was statistically significant (P < 0.05).

CONCLUSION

The reconstruction of a digital model by using the grating projection technique and reverse engineering can be used for dental model measurement in clinic al and scientific research and can provide a scientific method for establishing a digital model database with normal occlusion.