Predicting short-term major postoperative complications in intestinal resection for Crohn's disease: A machine learning-based study

BACKGROUND

Due to the complexity and numerous comorbidities associated with Crohn's disease (CD), the incidence of postoperative complications is high, significantly impacting the recovery and prognosis of patients. Consequently, additional studies are required to precisely predict short-term major complications following intestinal resection (IR), aiding surgical decision-making and optimizing patient care.

AIM

To construct novel models based on machine learning (ML) to predict short-term major postoperative complications in patients with CD following IR.

METHODS

A retrospective analysis was performed on clinical data derived from a patient cohort that underwent IR for CD from January 2017 to December 2022. The study participants were randomly allocated to either a training cohort or a validation cohort. The logistic regression and random forest (RF) were applied to construct models in the training cohort, with model discrimination evaluated using the area under the curves (AUC). The validation cohort assessed the performance of the constructed models.

RESULTS

Out of the 259 patients encompassed in the study, 5.0% encountered major postoperative complications (Clavien-Dindo ≥ III) within 30 d following IR for CD. The AUC for the logistic model was 0.916, significantly lower than the AUC of 0.965 for the RF model. The logistic model incorporated a preoperative CD activity index (CDAI) of ≥ 220, a diminished preoperative serum albumin level, conversion to laparotomy surgery, and an extended operation time. A nomogram for the logistic model was plotted. Except for the surgical approach, the other three variables ranked among the top four important variables in the novel ML model.

CONCLUSION

Both the nomogram and RF exhibited good performance in predicting short-term major postoperative complications in patients with CD, with the RF model showing more superiority. A preoperative CDAI of ≥ 220, a diminished preoperative serum albumin level, and an extended operation time might be the most crucial variables. The findings of this study can assist clinicians in identifying patients at a higher risk for complications and offering personalized perioperative management to enhance patient outcomes.

Dipterocarpoidae genomics reveal their demography and adaptations to Asian rainforests

Dipterocarpoideae species form the emergent layer of Asian rainforests. They are the indicator species for Asian rainforest distribution, but they are severely threatened. Here, to understand their adaptation and population decline, we assemble high-quality genomes of seven Dipterocarpoideae species including two autotetraploid species. We estimate the divergence time between Dipterocarpoideae and Malvaceae and within Dipterocarpoideae to be 108.2 (97.8‒118.2) and 88.4 (77.7‒102.9) million years ago, and we identify a whole genome duplication event preceding dipterocarp lineage diversification. We find several genes that showed a signature of selection, likely associated with the adaptation to Asian rainforests. By resequencing of two endangered species, we detect an expansion of effective population size after the last glacial period and a recent sharp decline coinciding with the history of local human activities. Our findings contribute to understanding the diversification and adaptation of dipterocarps and highlight anthropogenic disturbances as a major factor in their endangered status.

Single femtosecond pulse writing of a bifocal lens

In this Letter, a method for the fabrication of bifocal lenses is presented by combining surface ablation and bulk modification in a single laser exposure followed by the wet etching processing step. The intensity of a single femtosecond laser pulse was modulated axially into two foci with a designed computer-generated hologram (CGH). Such pulse simultaneously induced an ablation region on the surface and a modified volume inside the fused silica. After etching in hydrofluoric acid (HF), the two exposed regions evolved into a bifocal lens. The area ratio (diameter) of the two lenses can be flexibly adjusted via control of the pulse energy distribution through the CGH. Besides, bifocal lenses with a center offset as well as convex lenses were obtained by a replication technique. This method simplifies the fabrication of micro-optical elements and opens a highly efficient and simple pathway for complex optical surfaces and integrated imaging systems.

Effect of beinaglutide combined with metformin versus aspart 30 with metformin on metabolic profiles and antidrug antibodies in patients with type 2 diabetes: a randomized clinical trial

Objective

This prospective study aimed to evaluate the effect of beinaglutide combined with metformin versus aspart 30 with metformin on metabolic profiles and antidrug antibodies (ADAs) in patients with type 2 diabetes (T2D).

Methods

A total of 134 eligible participants were randomly assigned to the test group and the control group. Patients in the test group were treated with beinaglutide and metformin, whereas patients in the control group were randomly treated with aspart 30 and metformin, with a follow-up period of 6 months. The metabolic profiles and ADAs over 6 months were evaluated.

Results

After 6 months, 101 (75.37%) patients completed the study. Compared with the control group, the beinaglutide group had significant reductions in 2-h postprandial blood glucose (2hBG) and low blood glucose index (LBGI). Glycated hemoglobin (HbA1c) decreased in both groups relative to baseline. In the test group, one had treatment-emergent beinaglutide ADAs. Significant reductions in triglycerides (TG), non-fasting TG, weight, waist circumference (WC), and body mass index (BMI) were observed. The values of insulin sensitivity index (HOMA-IR) were decreased to a statistically higher degree with beinaglutide treatment.

Conclusion

Beinaglutide reduces metabolic dysfunction, LBGI, and weight in patients of T2D with a low risk of ADAs. Beinaglutide may offer the potential for a disease-modifying intervention in cardiovascular disease (CVD).

Clinical trial registration

www.chictr.org.cn, identifier ChiCTR2200061003.

High-Transmission Biomimetics Structural Surfaces Produced via Ultrafast Laser Manufacturing

Inspired by periodically aligned micro/nanostructures on biological surfaces, researchers have been fabricating biomimetic structures with superior performance. As a promising and versatile tool, an ultrafast laser combined with other forms of processing technology has been utilized to manufacture functional structures, e.g., the biomimetic subwavelength structures to restrain the surface Fresnel reflectance. In this review paper, we interpret the biomimetic mechanism of antireflective subwavelength structures (ARSSs) for high-transmission windows. Recent advances in the fabrication of ARSSs with an ultrafast laser are summarized and introduced. The limitations and challenges of laser processing technology are discussed, and the future prospects for advancement are outlined, too.

Telemedicine-assisted structured self-monitoring of blood glucose in management of T2DM results of a randomized clinical trial

BACKGROUND

This prospective study aimed to compare telemedicine-assisted structured self-monitoring of blood glucose(SMBG) with a traditional blood glucose meter (BGM) in adults of type 2 diabetes mellitus (T2DM).

METHODS

Adult participants with T2DM were assigned to an intervention group or a control group. The patients in the intervention group received a connected BGM with real-time data submission as well as individual needs-based tele-coaching to address and improve motivation and daily diabetes self-management. The patients in the control group received a traditional BGM. Changes in glycated hemoglobin(HbA1c), low blood glucose index(LBGI), and diabetes self-management behaviors were analyzed.

RESULTS

The study demonstrated the superiority of the telemedicine-assisted structured SMBG versus the traditional BGM for improving HbA1c. Additionally, the telemedicine-assisted SMBG reduced the risk of hypoglycemia and enhanced diabetes self-management behaviors, as differences in the LBGI and the Diabetes Self-Management Questionnaire(DSMQ) results between the groups after 6 months were found to be significant.

CONCLUSIONS

Telemedicine-assisted structured SMBG helps physicians and patients to achieve a specific level of glycemic control and reduce hypoglycemia. The use of coaching applications and telemedicine-assisted SMBG indicated beneficial effects for T2DM self-management, which may help limit disease progression.

TRIAL REGISTRATION

Chinese Clinical Trail Registry No: ChiCTR2300072356 on 12/06/2023. Retrospectively registered.

Effect of Benaglutide on Gut Microbiota and Fecal Metabolites in Patients with Type 2 Diabetes Mellitus

Objective

Benaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA) that has been approved in the treatment of type 2 diabetes mellitus (T2DM). It is known to lead to significant weight loss, and it is hypothesized that changes in gut microbiota may play a significant role in such weight loss. However, it is unclear how gut microbiota and metabolites change as a result of benaglutide treatment.

Methods

Healthy participants and patients with T2DM were included in this study. They received differentiated treatments, and stool specimens were collected separately. These stool specimens were subjected to 16S ribosomal RNA amplicon and metagenomic sequencing to create fecal metabolomic profiles. The diversity of gut microbiota and metabolic products in the stools of each participant was analyzed.

Results

The data showed that Faecalibacterium prausnitzii was abundant in the gut microbiota of the control group, which was entirely made up of healthy individuals; however, it showed a statistically significant decrease in patients with T2DM treated with metformin alone, while no significant decrease was observed in patients treated with metformin combined with benaglutide. A metagenomic analysis revealed that benaglutide could improve the fecal microbiota diversity in patients with T2DM. Furthermore, there was a statistically significant correlation between the changes in the metabolites of patients with T2DM and the changes in their gut microbiota (including F. prausnitzii) after treatment with metformin and benaglutide.

Conclusion

These findings suggest that the weight-reducing effect of benaglutide is attributed to its ability to normalize the gut microbiota of patients with T2DM, particularly by increasing the abundance of F. prausnitzii.

[Efficacy and safety of bendamustine-rituximab combination therapy for newly diagnosed indolent B-cell non-Hodgkin's lymphoma and elderly mantle cell lymphoma: a multi-center prospective phase II clinical trial in China]

Objectives: This study aimed to assess the efficacy and safety of bendamustine in combination with rituximab (BR regimen) for the treatment of newly diagnosed indolent B-cell non-Hodgkin's lymphoma (B-iNHL) and elderly mantle cell lymphoma (eMCL) . Methods: From December 1, 2020 to September 10, 2022, a multi-center prospective study was conducted across ten Grade A tertiary hospitals in Shandong Province, China. The BR regimen was administered to evaluate its efficacy and safety in newly diagnosed B-iNHL and eMCL patients, and all completed at least four cycles of induction therapy. Results: The 72 enrolled patients with B-iNHL or MCL were aged 24-74 years, with a median age of 55 years. Eastern Cooperative Oncology Group (ECOG) performance status scores of 0-1 were observed in 76.4% of patients, while 23.6% had scores of 2. Disease distribution included follicular lymphoma (FL) (51.4% ), marginal zone lymphoma (MZL) (33.3% ), eMCL (11.1% ), and the unknown subtype (4.2% ). According to the Ann Arbor staging system, 16.7% and 65.3% of patients were diagnosed with stage Ⅲ and stage Ⅳ lymphomas, respectively. Following four cycles of BR induction therapy, the overall response rate was 98.6%, with a complete response (CR) rate of 83.3% and a partial response (PR) rate of 15.3%. Only one eMCL patient experienced disease progression during treatment, and only one FL patient experienced a relapse. Even when evaluated using CT alone, the CR rate was 63.9%, considering the differences between PET/CT and CT assessments. The median follow-up duration was 11 months (range: 4-22), with a PFS rate of 96.8% and an OS rate of 100.0%. The main hematologic adverse reactions included grade 3-4 leukopenia (27.8%, with febrile neutropenia observed in 8.3% of patients), grade 3-4 lymphopenia (23.6% ), grade 3-4 anemia (5.6% ), and grade 3-4 thrombocytopenia (4.2% ). The main non-hematologic adverse reactions such as fatigue, nausea/vomiting, rash, and infections occurred in less than 20.0% of patients. Conclusion: Within the scope of this clinical trial conducted in China, the BR regimen demonstrated efficacy and safety in treating newly diagnosed B-iNHL and eMCL patients.

Exogenous Insulin Antibody Syndrome in Patients with Type 2 Diabetes

Background

Exogenous insulin antibody syndrome (EIAS) is an immunological disorder caused by circulating insulin antibodies (IAs), featuring hypersensitivity to exogenous insulin and insulin resistance. With the wide use of recombinant human insulin and insulin analogs, there has been a significant proliferation of EIAS.

Case Report

We describe two cases of diabetes mellitus (DM) with hyperinsulinemia and high serum levels of IAs. They had never been exposed to methimazole, glutathione, lipoic acid, and other sulfhydryl drugs, but they all received insulin treatment. The patient in case 1 had recurrent hypoglycemia before hospitalization. A prolonged oral glucose tolerance test (OGTT) showed hypoglycemia with inappropriately high insulin levels. The patient in case 2 was hospitalized for diabetic ketosis. An OGTT indicated hyperglycemia with hyperinsulinemia and low levels of C-peptide. IAs induced by exogenous insulin in the two patients with DM were positive at high titers, prompting a diagnosis of another condition-EIAS.

Conclusion

We discussed the differences between these two cases of EIAS in clinical manifestations and treatment and summarized all patients of EIAS treated in our department to date.

[A prospective study of position selection combined with autologous blood intrathoracic infusion in the treatment of postoperative persistent air leakage with an unexpanded lung]

We prospectively studied 17 patients with spontaneous pneumothorax or giant emphysematous bulla at Rizhao Hospital of Traditional Chinese Medicine from October 2020 to March 2022. All patients underwent thoracoscopic interventional therapy, had experienced continued air leakage for 3 days with closed thoracic drainage postoperatively, had an unexpanded lung on CT, and/or failed to intervention with position selection combined with intra-pleural thrombin injection(referred to as "position plus1.0"). They were all treated with position selection combined with autologous blood (100 ml) and thrombin (5 000 U) intra-pleural injection(referred to as "position plus 2.0").The success rate of the "position plus 2.0" intervention was 16/17, and the recurrence rate was 3/17. There were four cases of fever, four cases of pleural effusion, one case of empyema, and no other adverse reactions. This study has shown that the "position plus 2.0" intervention is safe, effective, and simple for patient with persistent air leakage failed to intervention with"position plus 1.0" after thoracoscopic treatment of pulmonary and pleural diseases related to bulla.

[Analysis of enterovirus infection type among acute respiratory tract infection cases in Luohe City, Henan Province from 2017 to 2021]

Objective: To understand the infection status of Enterovirus (EV) in cases of acute respiratory infections (ARIs) in Luohe City, Henan Province from 2017 to 2021, and analyze the prevalence and type composition of EV in ARIs. Methods: From October 2017 to May 2021, pharyngeal swab samples were collected from 1 828 patients with ARIs in Luohe Central Hospital and the clinical epidemiological data of these cases were also collected. EV-positive samples were identified by Quantitative Real-time Polymerase Chain Reaction (qPCR). The 5'-untranslated region (5'UTR) was amplified by Reverse Transcription-Polymerase Chain Reaction (RT-PCR). The results of 5'UTR region were initially typed by Enterovirus Genotyping Tool Version 1.0. Based on the typing results, the full-length of VP1 region was amplified by RT-PCR. The EV typing was identified again by VP1 region. Results: Among 1 828 cases of ARIs, 56.7% (1 036) were males. The median (Q₁, Q₃) age was about 3 (1, 5) years. Patients under 5 years old accounted for 71.6% (1 309 cases). Among all cases, a total of 71 EV-positive samples were identified by qPCR, with a detection rate of 3.88% (71/1 828). The EV detection rates for men and women were 3.28% (34/1 036) and 4.67% (37/792), without statistically significant differences (χ²=2.32, P=0.14). The EV detection rates for 2 to <6 years, 6 months to <2 years, 6 to <10 years, and <6 months were 6.29% (48/763), 3.00% (18/600), 2.52% (4/159), and 1.67% (1/60) (χ²=27.91, P<0.001). The EV detection rate was 0.92% (3/326) in autumn and winter of 2017. The EV detection rates were 1.18% (6/508), 2.47% (12/485) and 8.31% (34/409) in each year from 2018 to 2020, with an increasing trend year by year(χ²_trend=29.76, P<0.001). The main prevalent seasons were summer and autumn. The detection rate in spring of 2021 was 4.00% (4/100). A total of 12 types were identified and classified as CVA2, CVA4, CVA5, CVA6, CVA10, CVB3, CVB5, E5, E11, E30, PV-1, and EV-D68. The types of CVA2, CVA10, CVA6, and CVB3 were the dominant phenotypes. In 59 sample of EV typing, the main clinical manifestation was upper respiratory tract infection (36/59, 61.01%). The dominant types detected in upper respiratory tract infections were CVA10 (10/36, 27.78%), CVA6 (9/36, 25.00%) and CVB3 (8/36, 22.22%). The dominant type detected in lower respiratory tract infections was CVA2 (7/19, 36.84%). Conclusion: In Luohe City, Henan Province from 2017 to 2021, EV infection in ARIs cases has clear seasonal and age-specific patterns, and the dominant types of upper and lower respiratory tract infections are different.

[Effectiveness and safety of medical glue assisted argon plasma coagulation union giant emphysematous bulla volume reduction via thoracoscope on the treatment of spontaneous pneumothorax with subpleural bullae]

Objective: To evaluate the effectiveness and safety of a new treatment protocol that combined "medical glue assisted argon plasma coagulation"(hereinafter called "APC plus") and "giant emphysematous bulla volume reduction"(hereinafter called "one thoracoscope plus one needle") via medical thoracoscopy on the spontaneous pneumothorax patients whose chest high resolution CT (HRCT) showed multiple subpleural bullae (SPB) and at least one SPB≥4 cm in diameter. Methods: A retrospective analysis was performed on the clinical data of 46 cases of spontaneous pneumothorax with multiple SPB(at least one SPB≥4 cm in diameter), 42 males and 4 females, aged from 31 to 79 (68.5±10.3) years,from June 2018 to December 2021 in Rizhao Hospital of Traditional Chinese Medicine. The time of air leakage discontinuance, the disappearance rate and reduction degree of target subpleural blebs one week after operation, the degree of reduction and the incidence of postoperative complications were observed. Two-year follow-up after operation was carried out to assess the recurrence rate and its short- and long-term complications. Results: Among the 46 patients, SPB disappeared or nearly disappeared in 39 cases (84.78%), decreased in number or reduced in volume in 5 cases (10.87%), and remained unchanged in 2 cases (4.35%) after the intervention of "APC Plus"; 40 patients stopped leaking within 1 week and 6 cases stopped leaking over a week. Eleven patients finished the 3-year follow-up, 13 finished 2-year follow-up and 6 finished 1-year follow-up, with only 1 relapse. No serious complications occurred in all these 46 patients. Conclusion: "APC plus" combining with "one thoracoscope plus one needle" is safe and effective in the treatment of pneumothorax patients with multiple subpleural bullae of varying sizes.

[Consideration on the emerging acute severe hepatitis cases with unknown etiology in children of some countries]

Since January 2022, acute severe hepatitis cases with unknown etiology in children have occurred in many countries in Europe and the United States, and 43.8% of the cases were positive for human adenovirus (HAdV), and some cases were identified as HAdV-41. However, more evidences including etiology, genomics, liver pathology, and immunohistochemistry are needed to determine the main cause of this outbreak. At present, due to the lack of systematic surveillance and research on hepatitis caused by HAdV infection, it is impossible to determine whether there are similar hepatitis cases occurred in China. It is urgent to carry out HAdV virolgocial surveillance based on clinical symptom, and potential risk of acute severe hepatitis should be studied as soon as possible according to the available relevant clinical, epidemiological and virological data, as well as risk factor information, which will provide scientific and technical support for the prevention and control of HAdV-related diseases.

[Advances on molecular typing methods and evolution of human parainfluenza virus]

Human parainfluenza viruses (HPIVs) is one of the main causes of acute respiratory tract infections in children. HPIVs have been grouped into four serotypes (HPIV1~HPIV4) according to serological and genetic variation. Different serotypes of HPIVs have diverse clinical disease spectrum, epidemic characteristics and disease burden. Based on the nucleotide variation in structural protein genes, HPIVs can be further divided into distinct genotypes and subtypes with diverse temporal and spatial distribution features. The standard molecular typing methods are helpful to clarify the gene evolution and transmission patterns of HPIVs in the process of population transmission. However, the development of molecular epidemiology of HPIVs has been hindered by the lack of a standardized molecular typing method worldwide. Therefore, this study reviewed the viral characteristics, genome structure, existing genotyping methods and evolution of HPIVs, and screened the reference strains for molecular typing, so as to improve the understanding of gene characteristics and molecular typing of HPIVs, and provide an important scientific basis for the monitoring and research of molecular epidemiology of HPIVs in China.

Safety and efficacy of thalidomide in patients with transfusion-dependent β-thalassemia: a randomized clinical trial

Thalidomide induces γ-globin expression in erythroid progenitor cells, but its efficacy on patients with transfusion-dependent β-thalassemia (TDT) remains unclear. In this phase 2, multi-center, randomized, double-blind clinical trial, we aimed to determine the safety and efficacy of thalidomide in TDT patients. A hundred patients of 14 years or older were randomly assigned to receive placebo or thalidomide for 12 weeks, followed by an extension phase of at least 36 weeks. The primary endpoint was the change of hemoglobin (Hb) level in the patients. The secondary endpoints included the red blood cell (RBC) units transfused and adverse effects. In the placebo-controlled period, Hb concentrations in patients treated with thalidomide achieved a median elevation of 14.0 (range, 2.5 to 37.5) g/L, whereas Hb in patients treated with placebo did not significantly change. Within the 12 weeks, the mean RBC transfusion volume for patients treated with thalidomide and placebo was 5.4 ± 5.0 U and 10.3 ± 6.4 U, respectively (P < 0.001). Adverse events of drowsiness, dizziness, fatigue, pyrexia, sore throat, and rash were more common with thalidomide than placebo. In the extension phase, treatment with thalidomide for 24 weeks resulted in a sustainable increase in Hb concentrations which reached 104.9 ± 19.0 g/L, without blood transfusion. Significant increase in Hb concentration and reduction in RBC transfusions were associated with non β0/β0 and HBS1L-MYB (rs9399137 C/T, C/C; rs4895441 A/G, G/G) genotypes. These results demonstrated that thalidomide is effective in patients with TDT.

[Attention should be paid to the detection and surveillance of human respiratory syncytial virus]

Human respiratory syncytial virus (HRSV) is the main pathogen of severe lower respiratory tract infection in infants and young children. It seriously endangers children's health. In recent years, great breakthroughs have been made in the research and development of HRSV vaccines and antibody-based biological products. The research and development and use strategies are inseparable from the monitoring of HRSV prevalence and virus variation characteristics. The World Health Organization (WHO) pays great attentions to the surveillance of HRSV epidemiology and virus variation characteristics, but China lacks national level and multi-center HRSV surveillance data, the surveillance case definitions used by various laboratories are inconsistent, and the detection and surveillance methods of HRSV are not unified. Results from different laboratories are difficult to be compared and analyzed. Therefore, it is urgent to establish a nation-wide HRSV surveillance network in China, and to persistently monitor the epidemic characteristics and virus variation characteristics of HRSV by using standardized HRSV detection methods and surveillance guideline, so as to provide basic scientific data for the research and development, use and evaluation of monoclonal antibodies and vaccines.

[Genetic characterization analysis of the whole genome sequence of Coxsackievirus A8 associated with hand, foot and mouth disease in China]

Objective: To study the genomic sequence of Coxsackievirus A8 (CV-A8) associated with hand, foot and mouth disease (HFMD) from 2013 to 2018 in China and to analyze the genetic evolution of each coding region of the full-length genome. Methods: The genome sequences of 11 CV-A8 strains isolated from patients with HFMD in different regions of China from 2013 to 2018 were determined. Sequence alignment and genetic evolution analysis were performed by Sequencher 5.0 and MEGA 7.0 software, etc. Results: Sequence alignment showed that the genome length of 11 CV-A8 strains ranged from 7 393 bp to 7 400 bp. There was no base insertion or deletion in the coding region compared with the prototype strain, but there were individual base insertion or deletion in the non-coding region. The nucleotide and amino acid similarities in the VP1 region of 11 CV-A8 strains were 78.3%-98.6% and 92.6%-99.7%, respectively, and the nucleotide and amino acid sequences identities with the CV-A8 prototype strain were 78.3%-98.2% and 92.6%-99.7%, respectively. Based on the phylogenetic analysis of VP1 region sequences, the CV-A8 can be divided into five genotypes: A, B, C, D and E. The 11 CV-A8 strains in this study belonged to genotypes C (1 strain), D (2 strains) and E (8 strains). The nucleotide and amino acid similarities of 11 CV-A8 full-length genomes were 81.3%-98.8% and 95.9%-99.5%, respectively. The phylogenetic tree of the P2 region showed that the eight E genotypes CV-A8 had the closest evolutionary distance with CV-A4, CV-A14, and CV-A16. The phylogenetic tree of the P3 region showed that the eight E genotypes CV-A8 had a close evolutionary distance with CV-A5, CV-A16, CV-A14 and CV-A4. Conclusions: The 11 CV-A8 stains in this study showed significant intra-genotype diversity in capsid region and recombinant diversity in non-capsid region which indicated that CV-A8 quasispecies were still undergoing dynamics variation. CV-A8 may become an important pathogen of HFMD and the monitoring of CV-A8 needs to be further strengthened.

[Efficacy and safety of giant emphysematous bulla volume reduction via medical thoracoscope]

Objective: To evaluate the efficacy and safety of giant emphysematous bulla (GEB) volume reduction via medical thoracoscope. Methods: This was a prospective, single-arm study conducted between July 2018 and September 2020 in Ri Zhao Hospital of Traditional Chinese Medicine. Patients who met the inclusion criteria were treated with GEB volume reduction via medical thoracoscope and were followed up to evaluate the efficacy and safety of the technique. According to comparison of preoperative and postoperative chest CT results, the self-designed evaluation criteria of imaging efficacy were as follows: complete or nearly complete disappearance of GEB (GEB volume reduction ≥90%), significant reduction of GEB (75%≤GEB volume reduction<90%), reduction of GEB (50%≤GEB volume reduction<75%) and no change (GEB volume reduction<50%). Results: A total of 47 patients were included, among whom 43 were males, with an age M (Q₁, Q₃) of 63.0 (55.0, 67.0). The CT results showed complete or nearly complete disappearance of GEB in 43 patients, significant reduction of GEB in 3 patients and reduction of GEB in 1 patient before discharge. The degree of dyspnea improved significantly (P<0.05). Arterial partial pressure of carbon dioxide (PaCO₂) decreased from (48.2±8.4)mmHg (1 mmHg=0.133 kPa) to (45.4±7.3)mmHg (P<0.05). The 6-minute walk test (6MWT) increased from (245.6±162.4)m to (283.5±152.2)m (P<0.05). Six-month postoperative follow-up was completed in 24 patients, and CT results showed that the efficacy of volume reduction was continuous compared with that before discharge. GEB was further reduced or even disappeared in 3 of the cases. Besides, the degree of dyspnea, 6MWT (384.4±148.2)m and PaCO₂ (42.7±6.6)mmHg were improved significantly (P<0.05). The oxygenation index (356.86±61.21)mmHg was significantly higher than that before surgery (295.20±67.16)mmHg and before discharge (294.50±76.69)mmHg (P<0.05). No perioperative deaths occurred. Conclusions: GEB volume can be completely eliminated or significantly reduced by this innovative technique, while PaCO₂, the degree of dyspnea and exercise endurance can be significantly improved after operation. The 6-month follow-up after surgery showed that the above benefits continued, and that the oxygenation index improved significantly.

[Viral pathogenic spectrum analysis of severe acute respiratory infection cases in Luohe City, Henan province from 2017 to 2019]

Objective: The purpose of this study was to investigate the characteristics of viral pathogen spectrum and the epidemiological characteristics of each viral pathogen in hospitalized cases associated with severe acute respiratory infection (SARI) in Luohe City, Henan Province from 2017 to 2019. Methods: Based the SARI Case Surveillance Platform, SARI cases were collected in Central Hospital of Luohe City, Henan Province from November 2017 to February 2019. In the end, 783 SARI cases were included, whose throat swabs were taken within 24 h of admission, as well as their demographic characteristics, onset time, clinical characteristics and other information recorded. At the same time, viral identification was performed, and the age and time distribution of each virus were analyzed. Results: The age of 783 SARI cases shown as M (P₂₅, P₇₅) was 3 (1, 5) years old, ranging from 1 month to 95 years old. Children under 5 years old were the majority (71.01%). The males (61.81%) were more than females (38.18%). Among the 783 SARI cases, a total of 9 kind of viruses were identified with 64.88% (508/783) of the throat swabs tested positive for at least one virus. The positive rate of influenza virus and human respiratory syncytial virus were both 20.18% (158 cases), which was the highest among all the detected respiratory virus. The co-infection rate was 15.84% (124/783), among which double infection was the most common, accounting for 85.48% (106/124) of the co-infected cases. And human respiratory syncytial virus, human rhinovirus and influenza virus were the most common pathogen in co-infection cases. Moreover, the viral positive rate was 68.71% in children aged 5 years and 63.27% in people aged 60-95 years. Influenza and human respiratory syncytial virus dominated in winter and spring, while human parainfluenza virus was the main infection in summer. Conclusion: Influenza virus and human respiratory syncytial virus were the main viruses in throat swabs of SARI cases from 2017 to 2019 in Luohe City, Henan Province. There were differences in the age and seasonal epidemiological characteristics of each virus.

[Efficacy and safety of position selection combined with intra-pleural thrombin injection in the treatment of postoperative persistent air leakage in bullous pulmonary-pleural diseases]

Objective: To explore the efficacy and safety of position selection in combination with intra-pleural thrombin injection in the treatment of persistent air leakage (PAL) after medical thoracoscopic treatment of bullous pulmonary-pleural diseases (e.g. spontaneous pneumothorax or giant emphysematous bulla). Methods: This was a prospective study conducted in Rizhao Hospital of Traditional Chinese Medicine from August 2018 to November 2020. Twenty patients(19 males,1 female) with a mean age of (62.3±8.1) years met the diagnostic criteria for PAL which was defined as the air leak persisted more than 3 days despite of the closed thoracic drainage after medical thoracoscopic treatment of bullous pulmonary-pleural diseases.They received the following treatment procedures (referred to as "position plus"):①Pleural cavity injection (50% glucose 20 ml+thrombin 5 000 U).②Changing the patient's position under continuous negative pressure suction to find the position causing the complete stop or significant reduction of air leakage, and keeping in the position for 24-48 hours.③If the PAL wasn't stopped 48 hours later, the procedures above would be repeated.The duration of air leakage after "position plus", times of pleural cavity injection, condition of lung re-expansion, recurrence of air leakage and complications during hospitalization were recorded. Descriptive statistics were used to summarize the results:¯x±s or M(P₂₅, P₇₅) for continuous variables; frequency and percentages for categoric variables. Results: A total of 20 patients were included. The average duration of air leakage after"position plus" was (1.32±0.97) days. The times of pleural cavity injection required were 1.0(1.0, 1.0).All the patients showed good lung re-expansion in review of imaging after PAL was stopped. One patient had recurrent air leakage during hospitalization. No serious complications occurred. Conclusion: The comprehensive "position plus" intervention method is effective, safe and easily operating for the treatment of PAL after medical thoracoscopic treatment of bullous pulmonary-pleural diseases.

[Genotype and genetic characteristics of human respiratory syncytial virus circulating in Quanzhou, 2018-2019]

Objective: To study the prevalence and genetic characteristics of human respiratory syncytial virus (HRSV) in Quanzhou city, from 2018 to 2019. Methods: A total of 141 throat swabs were collected from children patients of lower respiratory tract infection in Quanzhou children Hospital, Fujian Province from November 2018 to May 2019. RT-PCR was used to amplify the 3 'end of G gene HRSV. Sequencer 5.0 and MEGA5.05 softwares were used for sequence editing, phylogenetic tree construction and genotyping analysis. Results: Twenty-five samples were positive for HRSV. Seventeen samples succeeded to obtain the target gene, including 13 of HRSVA and 4 of HRSVB. Two genotypes were identified: ON1 genotype (13 samples, HRSVA) and BA9 genotype (4 samples, HRSVB). Five strains of ON1 genotype sequences were clustered with the ON1 sequences prevalent in Beijing, Changchun and Zhejiang from 2012 to 2015 (cluster1); one strain (FJ19-02) was clustered with the sequences of ON1 genotype circulating in many regions of China from 2012 to 2015 (cluster2); Seven strains were clustered independently (cluster FJ). FJ18-02, FJ19-14 and FJ19-15 of HRSVB were clustered with the BA9 genotype sequences prevalent in Changchun, Jilin Province in 2015, while FJ19-13 was closely related to the BA9 genotype sequences prevalent in Guangzhou and Zhejiang Province in 2013. Both the ON1 and BA9 genotypes showed variations of nucleotide and amino acid in 72 and 60 insertion segments. Amino acid mutation (H266L) only occurred among the sequence of cluster-FJ, and the mutations of H261Q and Q265L only appeared in strain FJ19-13. Conclusion: BA9 and ON1 genotypes were prevalent in Quanzhou city, from 2018 to 2019. Cluster-FJ was a newly discovered independent transmission chain, which may continue to circulate in local Quanzhou area.

Construction 7-membered ring via Ni-Al bimetal-enabled C-H cyclization for synthesis of tricyclic imidazoles

The construction of 7-membered ring via direct C7-H cyclization of benzoimidazoles with alkenes would provide a more atom- and step-economical route to tricyclic imidazoles and derivatives that widely exist in a broad range of bioactive molecules. However, transition metal-catalyzed C-H cyclization for medium-ring synthesis has been limited to reactive C-H bonds, instead, the activation of unreactive C-H bonds towards medium synthesis still remains an elusive challenge. Herein, we report a direct construction of 7-membered rings via Ni-Al co-catalyzed unreactive C7-H cyclization of benzoimidazoles with alkenes, providing a series of tricyclic imidazoles in 40-98% yield and with up to 95:5 er.

[Contribution of measles virus IgG antibody avidity assay to the identification of measles cases]

Objective: To evaluate the value of measles IgG antibody avidity assay in identifying the measles cases. Methods: Data from the Measles Surveillance Information System was used to collect laboratory confirmed or discarded cases in 2013-2015, and then tracing back the blood specimens from all measles network laboratories in Tianjin. Measles antibody avidity assay was used to detect and to redefine cases from the discarded ones. Results: A total of 326 measles cases including 267 laboratory-confirmed and 59 discarded cases were enrolled into this study, with 92.33% (301/326) of them aged ≥20 years. Result from the measles IgG antibody avidity assay showed that the ratio of high-avidity was 91.23%(52/57) of the discarded cases, which was significantly higher than 66.95% (158/236) of the laboratory confirmed cases (χ²=13.33, P<0.001). According to the case criterion, 15.25% (9/59) of the discarded cases were redefined as measles cases. Eight out of the nine cases were high-avidity with measles containing vaccine (MCV) vaccination history that named as SVF cases. One in nine cases with low-avidity was with typical clinical symptomatic measles but with no vaccination history of MCV. Conclusion: Measles IgG antibody avidity assay could provide reference serological evidence to reduce the error from those discarded cases caused by false negative results on IgM antibody, when diagnosing the measles cases.

[Distribution of Nitrogen and Phosphorus in Lake Chaohu Sediments and Pollution Evaluation]

We investigated the spatial distribution and storage of nitrogen and phosphorus in Lake Chaohu sediments and evaluated the sediment nitrogen and phosphorus pollution index. Results show that the average total nitrogen (TN) and total phosphorus (TP) content in the surface-layer sediments of Lake Chaohu were 1088 mg·kg^-1 and 585 mg·kg^-1, respectively, and 666 mg·kg^-1 and 509 mg·kg^-1 in the bottom-layer sediments, respectively. TN content in the surface layer was significantly higher than in the bottom layer (P<0.01). Spatially, TN, TP, and sediment thickness were ranked in the order western lake area > eastern lake area > middle lake area, and the TN and TP contents were significantly different in the surface sediments from the middle and eastern areas of the lake (P<0.05, P<0.01). TN and TP storage in the lake sediments was 1.58×10⁵ t and 0.98×10⁵ t, respectively. TN and TP were significantly correlated in both the western and middle parts of the lake (P<0.01). In addition, TN was significantly correlated with sediment thickness in middle area of the lake, which indicated that TN may have the same pollution sources as TP and both were affected by sediment thickness. TN pollution index (S_TN), TP pollution index (S_TP), and comprehensive pollution index (FF) values were 1.09, 1.39, and 1.32, respectively, indicating light-to-moderate levels of pollution. Specifically, the western lake surface sediments were heavily polluted with respect to TP, the eastern lake surface sediments were moderately polluted, and the middle lake surface sediments were slightly polluted. Nutrient pollution varied widely between different areas of the lake, with sediments in the western part of the lake presenting a higher safety risk. Overall, these observations indicate that Lake Chaohu is threatened by internal nutrient loading.

[Progress in research of specific antibody dynamic characteristics in patients with COVID-19]

COVID-19 is an emerging infectious disease caused by SARS-CoV-2. After the infection of the virus, the host immune system is stimulated to produce multifarious specific antibodies to decrease or eliminate effects of the pathogen. Study of the specific antibodies dynamic characteristics in patients with COVID-19 is very important for the understanding and diagnosis of the disease, research and development of vaccine, and planning of prevention and control strategy. This paper reviews and summarizes the domestic and oversea research on dynamic characteristics of specific antibodies of COVID-19 patients, including the antibody producing, duration and level, and its possible influencing factors in order to improve the understanding of the immunological characteristics of COVID-19.

Onboard absolute radiometric calibration and validation of the satellite calibration spectrometer on HY-1C

As the reference radiometric calibration standard of sensors on the Haiyang-1C (HY-1C) satellite platform, the satellite calibration spectrometer (SCS) is equipped with an onboard calibration system composed of double solar diffusers and an erbium-doped diffuser to monitor the postlaunch radiometric response change. Herein, through onboard calibration data analysis, the calibration diffuser performance remains stable without degradation, and the Moderate Resolution Imaging Spectroradiometer (MODIS) on Terra is adopted as a reference to repeatedly verify onboard radiometric calibration results by selecting different dates and reflectance scenes. The SCS equivalent reflectance is obtained by combining the mean digital number (DN) of the SCS crossing area image with the radiometric calibration coefficient. The spectral reflectance is obtained via interpolation and iteration, which is adopted as the actual MODIS incident pupil spectral reflectance because the small imaging time interval can be ignored and almost vertically observed, and it is convoluted with the MODIS spectral response function to obtain the predicted equivalent reflectance. Validation is completed by comparing the predicted MODIS equivalent reflectance to the measured value based on the onboard calibration coefficient. The results show that (1) the difference between the measured and predicted MODIS band equivalent reflectance is between -0.00466 and 0.0039, and (2) the percentage difference between the measured and predicted MODIS band equivalent reflectance ranges from 4.17% and 1.24%, indicating that the calibration system carried on HY-1C can perform high-precision SCS radiometric calibration, meeting the cross-calibration accuracy requirements of other loads on the same platform.

Geranylgeranyl Transferase-I Knockout Inhibits Oxidative Injury of Vascular Smooth Muscle Cells and Attenuates Diabetes-Accelerated Atherosclerosis

The proliferation of vascular smooth muscle cells (VSMCs) induced by oxidative injury is one of the main features in diabetes-accelerated atherosclerosis. Geranylgeranyl transferase-I (GGTase-I) is an essential enzyme mediating posttranslational modification, especially the geranylgeranylation of small GTPase, Rac1. Our previous studies found that GGTase-I played an important role in diabetes-accelerated atherosclerosis. However, its exact role is largely unclear. In this study, mouse conditional knockout of VSMC GGTase-I (Pggt1b Δ/Δ mice) was generated using the CRISPR/Cas9 system. The mouse model of diabetes-accelerated atherosclerosis was induced by streptozotocin injections and an atherogenic diet. We found that GGTase-I knockout attenuated diabetes-accelerated atherosclerosis in vivo and suppressed high-glucose-induced VSMC proliferation in vitro. Moreover, after a 16-week duration of diabetes, Pggt1b Δ/Δ mice exhibited lower α-smooth muscle actin (α-SMA) and nitrotyrosine level, Rac1 activity, p47phox and NOXO1 expression, and phospho-ERK1/2 and phosphor-JNK content than wild-type mice. Meanwhile, the same changes were found in Pggt1b Δ/Δ VSMCs cultured with high glucose (22.2 mM) in vitro. In conclusion, GGTase-I knockout efficiently blocked diabetes-accelerated atherosclerosis, and this protective effect must be related to the inhibition of VSMC proliferation. The potential mechanisms probably involved interfering Rac1 geranylgeranylation, inhibiting the assembly of NADPH oxidase cytosolic regulatory subunits, reducing oxidative injury, and decreasing ERK1/2 and JNK phosphorylation.

Serum miR-632 is a potential marker for the diagnosis and prognosis in laryngeal squamous cell carcinoma

Background: It has been demonstrated that miRNAs play critical roles in the tumorigenesis and progression of various tumors.Objective: The purpose of this research was to determine the serum miR-632 levels in patients with laryngeal squamous cell carcinoma (LSCC) and to investigate its diagnostic and prognostic value.Materials and methods: We detected serum miR-632 levels in 162 LSCC patients and 42 healthy volunteers. The ROC curve was carried out to determine diagnostic accuracy.Results: We observed that serum miR-632 levels were upregulated in LSCC patients compared with healthy volunteers (p < .01). Subsequent results from ROC indicated that high sensitivity and specificity of serum miR-632 for diagnosing LSCC (area under the curve 0.8828). In addition, it was found that high expressions of serum miR-632 were significantly associated with advanced N stage (p = .020), histological grade (p = .001), and TNM stage (p = .014). Furthermore, patients with higher serum miR-632 expression had a shorter OS and DFS time than those with lower serum miR-632 levels.Conclusion: Our data revealed that serum miR-632 may be a potential noninvasive biomarker which may become a potential diagnostic and prognostic biomarker for LSCC patients.

MicroRNA‑125a‑mediated regulation of the mevalonate signaling pathway contributes to high glucose‑induced proliferation and migration of vascular smooth muscle cells

Hyperglycemia contributes to the excessive proliferation and migration of vascular smooth muscle cells (VSMC), which are closely associated with atherosclerosis. MicroRNAs (miRNAs/miRs) constitute a novel class of gene regulators, which have important roles in various pathological conditions. The aim of the present study was to identify miRNAs involved in the high glucose (HG)-induced VSMC phenotype switch, and to investigate the underlying mechanism. miRNA sequencing and reverse transcription-quantitative PCR results indicated that inhibition of miR-125a expression increased the migration and proliferation of VSMCs following HG exposure, whereas the overexpression of miR-125a abrogated this effect. Furthermore, dual-luciferase reporter assay results identified that 3-hydroxy-3-methyglutaryl-coA reductase (HMGCR), one of the key enzymes in the mevalonate signaling pathway, is a target of miR-125a. Moreover, HMGCR knockdown, similarly to miR-125a overexpression, suppressed HG-induced VSMC proliferation and migration. These results were consistent with those from the miRNA target prediction programs. Using a rat model of streptozotocin-induced diabetes mellitus, it was demonstrated that miR-125a expression was gradually downregulated, and that the expressions of key enzymes in the mevalonate signaling pathway in the aortic media were dysregulated after several weeks. In addition, it was found that HG-induced excessive activation of the mevalonate signaling pathway in VSMCs was suppressed following transfection with a miR-125a mimic. Therefore, the present results suggest that decreased miR-125a expression contributed to HG-induced VSMC proliferation and migration via the upregulation of HMGCR expression. Thus, miR-125a-mediated regulation of the mevalonate signaling pathway may be associated with atherosclerosis.

Femtosecond laser self-assembly for silver vanadium oxide flower structures

Flower-like silver vanadium oxide (SVO) micropatterns were realized by femtosecond laser in situ writing from its precursor. Self-assembled petals irradiated by a femtosecond laser were observed standing on the substrate along the scanned routine assisted by the formation of silver seeds and plasmonic-mediated effects. By controlling the concentration of ammonium monovanadate and the laser exposure time, a different thickness of petals was manipulated from ∼100  nm to micrometers. The SVO products were confirmed Ag₄V₂O₇, AgVO₃, and part of Ag₃VO₄ by x-ray diffraction (XRD) measurement. Photon-driven self-assembly for in situ fabrication of microstructures looks to be an effective and facile technique for SVO and other functional compounds.

Nanoscale Photovoltaic Responses in 3D Radial Junction Solar Cells Revealed by High Spatial Resolution Laser Excitation Photoelectric Microscopy

The actual light absorption photovoltaic responses realized in three-dimensional (3D) radial junction (RJ) units can be rather different from their planar counterparts and remain largely unexplored. We here adopt a laser excitation photoelectric microscope (LEPM) technology to probe the local light harvesting and photoelectric signals of 3D hydrogenated amorphous silicon (a-Si:H) RJ thin film solar cells constructed over a Si nanowire (SiNW) matrix, with a high spatial resolution of 600 nm thanks to the use of a high numerical aperture objective. The LEPM scan can help to resolve clearly the impacts of local structural damages, which are invisible to optical and SEM observations. More importantly, the high-resolution photoelectric mapping establishes a straightforward link between the local 3D geometry of RJ units and their light conversion performance. Surprisingly, it is found that the maximal photoelectric signals are usually recorded in the void locations among the standing SiNW RJs, instead of the overhead positions above the RJs. This phenomenon can be well explained and reproduced by finite element simulation analysis, which highlights unambiguously the dominant contribution of inter-RJ-unit scattering against direct mode incoupling in the 3D solar cell architecture. This LEPM mapping technology and the results help to achieve a straightforward and high-resolution evaluation of the local photovoltaic responses among the 3D RJ units, providing a solid basis for further structural optimization and performance improvement.

The effects of tonsillectomy by low-temperature plasma on the growth development and psychological behavior in children with obstructive sleep apnea hypopnea syndrome

We investigated the effects of tonsillectomy by low-temperature plasma on the growth development and psychological behavior in children with obstructive sleep apnea hypopnea syndrome (OSAHS).This study included 72 moderate and severe OSAHS children with tonsils or adenoids hypertrophy, which were randomly assigned into either the study group (n = 36) or the control group (n = 36). Patients in study group underwent tonsillectomy by low-temperature plasma, while in the control group underwent tonsil-pecking, then the efficacy were compared.The time of surgery, VAS scores on postoperative day 1, 3, and 7 were significantly lower in the study group than in the control group, and the efficiency was significantly higher in the study group than the control group (P = .018). In the study group, the BMI was lower, the score of C-WISC (VIQ, PIQ, and FIQ) was higher, the score of CBCL social competence was higher and the score of behavioral questions was lower than that in the control group; differences were statistically significant (P = .022). The serum levels of IgA, IgG, and IgM, as well as the percentage of T lymphocytes, between the study group and the control group were not significantly different (P = .132).Tonsillectomy by low-temperature plasma was effective on the treatment of children with severe OSAHS, and could improve growth development and psychological behavior.

[Characterization analysis of gM, gL genes of varicella zoster virus in six provinces of China]

Objective: To analyze the genetic characterization of glycoprotein M(gM.),glycoprotein L(gL) of varicella zoster virus. Methods: According to the program of "Ministry of Science and Technology of China" , Based on the 12 suspected VZV patients monitored in Beijing (1 case), Shanghai (5 cases), Jilin (2 cases), Qinghai (1 case), Guangdong (2 case) and Sichuan (case) in 2007-2015. A total of 12 Vesicle fluid and throat swab samples were collected. Positive samples were identified by Agarose gel electrophoresis and two glycoprotein genes were amplified by polymerase chain reaction (PCR). Nucleotide sequences were determined and analyzed by PCR amplification of VZV positive specimens V-OKA-BK of the domestic varicella attenuated live vaccine and the Varilrix-1 of the imported attenuated live vaccine. Nucleotide sequences of VZV positive specimens, vaccine strains (V-OKA-BK, varilrix-1) and GenBank foreign wild strains (41 strains), parent strains (P-oka), vaccine strains (V-oka, Varilrix, Varivax) were compared using BioEdit and MEGA 5.0. Results: 12 specimens were VZV positive. Compared with the vaccine strains and the parent strains, the GM gene of 1 positive specimen had radical mutation at 86686 sites, which resulted in amino acid mutation, 5 positive specimens had base mutation at 87844 sites, and 30 strains of foreign wild strains had the same variation at 87 844 sites. 1 positive specimens of gL gene in 101245 sites had base mutation, and led to amino acid mutation, 6 positive specimens at 101624, 101625, 101626 sites had base of loss and the foreign wild strains in these 3 sites had the same variation. Compared with the vaccine strains, the nucleotide and amino acid homology of gM of 12 VZV positive specimens were 99.2%-100% and 98.2%-100%, respectively, and gL of those were 99.3%-100% and 98.6%-100%, respectively. Compared with 41 strains of foreign wild strains, homology of gM's nucleotides and amino acid were 99.3%-100% and 98.5%-100%, respectively; 99.1%-100% and 98.6%-100% for gL. The results of phylogenetic analysis showed that 7 VZV positive samples were on the same branch with 4 vaccine strains and p-oka strain. Based on gL, 12 VZV positive samples were on the same branch as the vaccine strains and p-oka strain. Conclusion: This study demonstrates that the genes of gM, gL are highly conserved and remain stable immunogen, which may be involved in the attenuation of VZV and need to be further researched.

Risk analysis of new oral anticoagulants for gastrointestinal bleeding and intracranial hemorrhage in atrial fibrillation patients: a systematic review and network meta-analysis

BACKGROUND

Antithrombotic therapy using new oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) has been generally shown to have a favorable risk-benefit profile. Since there has been dispute about the risks of gastrointestinal bleeding (GIB) and intracranial hemorrhage (ICH), we sought to conduct a systematic review and network meta-analysis using Bayesian inference to analyze the risks of GIB and ICH in AF patients taking NOACs.

METHODS

We analyzed data from 20 randomized controlled trials of 91 671 AF patients receiving anticoagulants, antiplatelet drugs, or placebo. Bayesian network meta-analysis of two different evidence networks was performed using a binomial likelihood model, based on a network in which different agents (and doses) were treated as separate nodes. Odds ratios (ORs) and 95% confidence intervals (CIs) were modeled using Markov chain Monte Carlo methods.

RESULTS

Indirect comparisons with the Bayesian model confirmed that aspirin+clopidogrel significantly increased the risk of GIB in AF patients compared to the placebo (OR 0.33, 95% CI 0.01-0.92). Warfarin was identified as greatly increasing the risk of ICH compared to edoxaban 30 mg (OR 3.42, 95% CI 1.22-7.24) and dabigatran 110 mg (OR 3.56, 95% CI 1.10-8.45). We further ranked the NOACs for the lowest risk of GIB (apixaban 5 mg) and ICH (apixaban 5 mg, dabigatran 110 mg, and edoxaban 30 mg).

CONCLUSIONS

Bayesian network meta-analysis of treatment of non-valvular AF patients with anticoagulants suggested that NOACs do not increase risks of GIB and/or ICH, compared to each other.

A whole genome sequence association study for puberty in a large Duroc × Erhualian F2 population

A large proportion of gilts and sows are culled from reproduction populations because of anestrus and pubertal reproductive failure. Selecting early onset of puberty gilts has a favorable effect on sows' reproductivity. However, age at puberty is hard to be routinely measured in commercial herds. With molecular genetic predictors, identifying individuals that have a propensity for early onset of puberty can be simplified. We previously performed genome scanning and a genome-wide association study for puberty in an F2 resource population using 183 microsatellites and 62 125 SNPs respectively. The detection power and resolution of identified quantitative trait loci were very low. Herein, we re-sequenced 19 founders of the F2 resource population in high coverage, and whole genome sequences of F2 individuals were imputed to perform an association study for reproductive traits. A total of 2339 SNPs associated with pubertal reproductive failure were identified in the region of 30.94-40.74 Mb on SSC7, with the top one, positioned at 33.36 Mb, explaining 16% of the phenotypic variances. We improved the magnitude of the P-value by 10E+5 to 10E+7 using the whole genome sequence rather than using low/middle density markers as in previous studies, and we narrowed down the QTL confidence interval to 5.25 Mb. Combining the annotation of gene function, RAB23 and BAK1 were perceived as the most compelling candidate genes. The identified loci may be useful in culling sows failing to show estrus by marker-assisted selection to increase reproductive efficiency of swine herds.

GE11 peptide-conjugated nanoliposomes to enhance the combinational therapeutic efficacy of docetaxel and siRNA in laryngeal cancers

In this study, dual therapeutic-loaded GE11 peptide-conjugated liposomes were developed and applied to enhance therapeutic efficacies of standard-of-care regimens for the treatment of laryngeal cancer. The therapeutic strategy used here was a combination treatment with the chemotherapeutic docetaxel (DTX) and siRNA against the ABCG2 gene that regulates multidrug resistance in many tumor types. Liposome-encapsulated DTX/ABCG2-siRNA molecules were targeted to recognize tumor cells of squamous morphology by conjugation to the EGFR-targeting ligand, GE11. Targeted, drug-infused liposomes were nanosized and exhibited controlled release of DTX. Presence of GE11 peptides on liposomal surfaces enhanced the quantities of liposomal constructs taken up by Hep-2 laryngeal cancer cells. GE11 peptide-conjugated liposomes also enhanced cytotoxic effects against Hep-2 laryngeal cancer cells when compared to treatment with free DTX, thereby reducing IC50 values. Additionally, GE11 peptide-conjugated liposomes had significantly increased anti-tumor and apoptotic effects. Treatments with the GDSL nanoparticle formulation inhibited tumor growth in Hep-2 xenograft-bearing nude mouse models when compared to treatments with non-targeted NP constructs. Treatment of the mouse models with GE11 peptide-conjugated liposomes mitigated toxicities observed after treatment with free DTX. Taken together, liposomal encapsulation of DTX and ABCG2-siRNA improved the anti-tumor effects of treatment with free DTX in Hep-2 cell lines, and conjugation of GE11 peptides to liposomal constructs enhanced anti-tumor efficacies and specificities in laryngeal cancer cells.

KCTD12 promotes tumorigenesis by facilitating CDC25B/CDK1/Aurora A-dependent G2/M transition

Cell cycle dysregulation leads to uncontrolled cell proliferation and tumorigenesis. Understanding the molecular mechanisms underlying cell cycle progression can provide clues leading to the identification of key proteins involved in cancer development. In this study, we performed proteomics analysis to identify novel regulators of the cell cycle. We found that potassium channel tetramerization domain containing 12 (KCTD12) was significantly upregulated in M phase compared with S phase. We also found that KCTD12 overexpression not only facilitated the G2/M transition and induced cancer cell proliferation, but also promoted the growth of subcutaneous tumors and Ki-67 proliferation index in mice. Regarding the mechanism underlying these phenomena, cyclin-dependent kinase 1 (CDK1) was identified as an interacting partner of KCTD12 by immunoprecipitation and mass spectrometry analysis, which showed that KCTD12 activated CDK1 and Aurora kinase A (Aurora A) and that the effects of KCTD12 on CDK1 phosphorylation and cell proliferation were abrogated by cell division cycle 25B (CDC25B) silencing. In addition, Aurora A phosphorylated KCTD12 at serine 243, thereby initiating a positive feedback loop necessary for KCTD12 to exert its cancer-promoting effects. Furthermore, we analyzed the expression levels of various genes and the correlations between the expression of these genes and survival using tumor tissue microarray and Gene Expression Omnibus (GEO) data sets. The data showed that KCTD12 expression was significantly upregulated in cervical and lung cancers. More importantly, high KCTD12 expression was associated with larger tumor sizes, higher pathological stages and poor patient survival. Collectively, our study demonstrate that KCTD12 binds to CDC25B and activates CDK1 and Aurora A to facilitate the G2/M transition and promote tumorigenesis and that Aurora A phosphorylates KCTD12 at serine 243 to trigger a positive feedback loop, thereby potentiating the effects of KCTD12. Thus, the KCTD12-CDC25B-CDK1-Aurora A axis has important implications for cancer diagnoses and prognoses.

MicroRNA-377 suppresses initiation and progression of esophageal cancer by inhibiting CD133 and VEGF

Esophageal cancer is one of the most lethal cancers worldwide with poor survival and limited therapeutic options. The discovery of microRNAs created a new milestone in cancer research. miR-377 is located in chromosome region 14q32, which is frequently deleted in esophageal squamous cell carcinoma (ESCC), but the biological functions, clinical significance and therapeutic implication of miR-377 in ESCC are largely unknown. In this study, we found that miR-377 expression was significantly downregulated in tumor tissue and serum of patients with ESCC. Both tumor tissue and serum miR-377 expression levels were positively correlated with patient survival. Higher serum miR-377 expression was inversely associated with pathologic tumor stage, distant metastasis, residual tumor status and chemoradiotherapy resistance. The roles of miR-377 in suppressing tumor initiation and progression, and the underlying molecular mechanisms were investigated. Results of in vitro and in vivo experiments showed that miR-377 overexpression inhibited the initiation, growth and angiogenesis of ESCC tumors as well as metastatic colonization of ESCC cells, whereas silencing of miR-377 had opposite effects. Mechanistically, miR-377 regulated CD133 and VEGF by directly binding to their 3' untranslated region. Moreover, systemic delivery of formulated miR-377 mimic not only suppressed tumor growth in nude mice but also blocked tumor angiogenesis and metastasis of ESCC cells to the lungs without overt toxicity to mice. Collectively, our study established that miR-377 plays a functional and significant role in suppressing tumor initiation and progression, and may represent a promising non-invasive diagnostic and prognostic biomarker and therapeutic strategy for patients with ESCC.

Minimally invasive plate internal fixation in limb fracture patients complicated with stress ulcer: Efficacy and impact on quality of life

AIM

To observe the clinical effect of minimally invasive bone plate fixation in patients with limb fracture complicated with stress ulcer and its effect on quality of life.

METHODS

Ninety limb fracture patients complicated with stress ulcer treated from August 2015 to December 2016 were selected and randomly divided into a control group (n = 45) and an observation group (n = 45). Both groups of patients were given aluminium magnesium carbonate plus lansoprazole for treatment of stress ulcer. The control group adopted traditional internal fixation, and the observation group was treated by minimally invasive plate internal fixation. Physical function, psychological function, social function and quality of life were assessed using the World Health Organization quality of life questionnaire. Clinical curative effect and quality of life were compared between the two groups.

RESULTS

Operative time and wound healing time were significantly shorter in the observation group than in the control group (P < 0.05). Blood loss and incision length of the observation group were significantly less than those of the control group (P < 0.05). The scores of physical function, psychological function, social function and quality of life were significantly better in the observation group than in the control group (P < 0.05). The incidence of postoperative complications was 4.44% in the observation group and 13.33% in the control group, and there was a significant between the two groups (P < 0.05).

CONCLUSION

Minimally invasive plate internal fixation combined with routine treatment has good efficacy and can improve quality of life in limb fracture patients complicated with stress ulcer.

Differentiation potential of human adipose tissue derived stem cells into photoreceptors through explants culture and enzyme methods

AIM

To investigate the retinal photoreceptor differentiation potential of human orbital adipose tissue-derived stem cells (ADSCs) generated by enzyme (EN) and explant (EX) culture methods.

METHODS

We investigated potentials of human orbital ADSCs to differentiate into photoreceptors through EN and EX culture methods. EN and EX orbital ADSCs were obtained from the same donor during rehabilitative orbital decompression, and then were subject to a 3-step induction using Noggin, DKK-1, IGF-1 and b-FGF at different time points for 38d. Stem cell, eye-field and photoreceptor-related gene and protein markers were measured by reverse transcription-polymerase chain reaction (RT-PCR) and immunofluorescent (IMF) staining.

RESULTS

Both EX and EN orbital ADSCs expressed CD133, a marker of cell differentiation. Moreover, PAX6 and rhodopsin, markers of the retinal progenitor cells, were detected from EX and EN orbital ADSCs. In EX orbital ADSCs, PAX6 mRNA was detected on the 17^th day and then the rhodopsin mRNA was detected on the 24^th day. In contrast, the EN orbital ADSCs expressed PAX6 and rhodopsin mRNA on the 31^st day. EX orbital ADSCs expressed rhodopsin protein on the 24^th day, while EN orbital ADSCs expressed rhodopsin protein on the 31^st day.

CONCLUSION

Orbital ADSCs isolated by direct explants culture show earlier and stronger expressions of markers towards eye field and retinal photoreceptor differentiation than those generated by conventional EN method.

[Maple syrup urine disease and gene mutations in twin neonates]

OBJECTIVE

To investigate the clinical features of one pair of twin neonates with maple syrup urine disease (MSUD) in the Chinese Han population and pathogenic mutations in related genes, and to provide guidance for the early diagnosis and treatment of MSUD.

METHODS

The clinical and imaging data of the twin neonates were collected. The peripheral blood samples were collected from the twin neonates and their parents to detect the genes related to MSUD (BCKDHA, BCKDHB, DBT, and DLD). The loci with gene mutations were identified, and a bioinformatic analysis was performed.

RESULTS

Two mutations were detected in the BCKDHB gene, missense mutation c.304G>A (p.Gly102Arg) and nonsense mutation c.331C>T (p.Arg111*), and both of them were heterozygotes. The mutation c.304G>A (p.Gly102Arg) had not been reported in the world. Their father carried the missense mutation c.304G>A (p.Gly102Arg), and their mother carried the nonsense mutation c.331C>T (p.Arg111*).

CONCLUSIONS

The c.331C>T (p.Arg111*) heterozygous mutation in BCKDHB gene is the pathogenic mutation in these twin neonates and provides a genetic and molecular basis for the clinical features of children with MSUD.

[Genetic characterization of varicella zoster virus in Jilin province in 2014, China]

OBJECTIVE

To clarify the genotype of wild-type strains of varicella zoster virus (VZV) in Jilin province in 2014, and to discriminate between v-Oka vaccine strains and wild-type strains.

METHODS

Vesicle fluid and throat swab samples were collected from 13 individuals with suspected VZV in Jilin province from January to December 2014. Viral DNA was extracted, the fragments of 15 open reading fragments (ORFs) were amplified by polymerase chain reaction (PCR), and viral genotypes were determined by single nucleotide polymorphisms (SNP). PCR restriction fragment length polymorphism (RFLP) was used to distinguish between wild-type strains and v-Oka vaccine strains. The results were analyzed with MEGA5 software, using the VZV reference strain sequences from GenBank.

RESULTS

The 13 suspected samples included 5 males and 8 females, aged 11-27 years (mean: (16.69±5.48) years). Sampling was performed on days 0 to 3 of suspected infection. VZV strains were detected in 8 samples, all belonging to Clade 2. There was a synonymous mutation (T>C) in SNP18082 compared with the v-Oka vaccine strain. Analysis of PCR-RFLPs showed that all 8 positive samples were wild-type strains (PstⅠ(+)BglⅠ(+)SmaⅠ(-)).

CONCLUSIONS

The study revealed that the VZV strains circulating in Jilin province in 2014 were wild-type strains belonging to Clade 2.

Influence of microstructural features on thermal expansion coefficient in graphene/epoxy composites

In this paper, theoretical calculations were conducted to determine the coefficient of thermal expansion (CTE) based on the effective medium approach using Green’s function method. The influences of microstructural features were investigated, including volume fraction, aspect ratio, and the orientation of graphene fillers. Calculated results demonstrated strong anisotropy of CTE when all graphene sheets in the composite were aligned in the in-plane direction due to the large difference between the elastic moduli of the graphene and epoxy. The in-plane CTE in the graphene/epoxy composite can be effectively reduced with small additions of graphene additive. Orientation dispersion among the graphene fillers significantly decreases the anisotropy of CTE. Accounting for the influences of all microstructural features, simulation results closely align with current experimental results. This work will provide a general guideline and a solid foundation for the optimal design and preparation of graphene/polymer composites.

Synchrotron quantification of ultrasound cavitation and bubble dynamics in Al-10Cu melts

Knowledge of the kinetics of gas bubble formation and evolution under cavitation conditions in molten alloys is important for the control casting defects such as porosity and dissolved hydrogen. Using in situ synchrotron X-ray radiography, we studied the dynamic behaviour of ultrasonic cavitation gas bubbles in a molten Al-10 wt%Cu alloy. The size distribution, average radius and growth rate of cavitation gas bubbles were quantified under an acoustic intensity of 800 W/cm(2) and a maximum acoustic pressure of 4.5 MPa (45 atm). Bubbles exhibited a log-normal size distribution with an average radius of 15.3 ± 0.5 μm. Under applied sonication conditions the growth rate of bubble radius, R(t), followed a power law with a form of R(t)=αt(β), and α=0.0021 &β=0.89. The observed tendencies were discussed in relation to bubble growth mechanisms of Al alloy melts.

The potential utilizations of hydrogen as a promising therapeutic strategy against ocular diseases

Hydrogen, one of the most well-known natural molecules, has been used in numerous medical applications owing to its ability to selectively neutralize cytotoxic reactive oxygen species and ameliorate hazardous inflammations. Hydrogen can exert protective effects on various reactive oxygen species-related diseases, including the transplantation-induced intestinal graft injury, chronic inflammation, ischemia–reperfusion injuries, and so on. Especially in the eye, hydrogen has been used to counteract multiple ocular pathologies in the ophthalmological models. Herein, the ophthalmological utilizations of hydrogen are systematically reviewed and the underlying mechanisms of hydrogen-induced beneficial effects are discussed. It is our hope that the protective effects of hydrogen, as evidenced by these pioneering studies, would enrich our pharmacological knowledge about this natural element and cast light into the discovery of a novel therapeutic strategy against ocular diseases.