Experimental investigation on chemical clogging mechanism of loose porous media in recharge process of groundwater heat pump

Groundwater heat pumps (GWHP) are an efficient utilisation of shallow geothermal energy technology and of great significance in terms of promoting energy conservation and reducing emissions. However, recharge clogging has been a key problem restricting the continuous operation of GWHP. In this study, a simulation test device for sand column was designed with the aim of addressing chemical clogging induced by heat pump reinjection in a porous saline aquifer in the Huaibei Plain, China. The trend in the variation of the permeability coefficient was studied based on the detection of the sand sample composition, recharge water quality, and sand layer temperature, and the cause of formation was analysed using the saturation index (SI) and ion ratio method. The results indicated that the permeability coefficient in the sand column decreased exponentially, with a maximum and minimum decrease of 8.14% and 71.65% of the original coefficient, respectively, found in sections P2-P3 and P8-P9. Therefore, the clogging effect of the aquifer at approximately 200-400 mm from the recharge well was significant. Water-rock interactions predominantly involved the dissolution of halite, albite, chlorite, anhydrite, and dolomite and the precipitation of calcite, as well as the exchange adsorption of Ca²⁺ and Mg²⁺ to Na⁺, which were the key sources of ions during the water chemical evolution process. Finally, quartz was formed by the weathering and dissolution of aluminosilicate minerals such as albite, and particle migration and precipitation during the hydrodynamic disturbance were the primary causes of the front-end blockage of the column.

Amplicon-based metagenomic association analysis of gut microbiota in relation to egg-laying period and breeds of hens

BACKGROUND

The gut microbiota plays an essential role in maintaining gut homeostasis and improving performance, with the composition of microbial communities visibly differing across different laying stages in hens and significantly correlating with egg production. To gain further insights into the association between microbial community characteristics and laying periods in Hy-Line variety brown and Isa brown laying hens, we conducted a 16S rRNA amplicon sequencing survey.

RESULTS

Our result revealed the diversity of bacteria in the early laying period was commonly higher than peak, and in Hy-Line variety brown laying hens were generally higher than Isa brown. Principal coordinate analysis (PCoA) and permutational multivariate analysis of variance (PERMANOVA) revealed that the structure and composition of the gut microbiota of laying hens exhibited significant differences among different groups. Phylum Firmicutes, Bacteroidota, Proteobacteria, and Fusobacteriota were found that dominant in the host's feces. Therein, the abundance of Fusobacteriota was higher in the peak period than in the early period, while the abundance of Cyanobacteria in the early period was higher in two breeds of hens. Furthermore, random forest based on machine learning showed that there were several distinctly abundant genera, which can be used as potential biomarkers to differentiate the different groups of laying periods and breeds. In addition, the prediction of biological function indicated the existing discrepancy in microbial function among the microbiota of four groups.

CONCLUSIONS

Our findings offer new insights into the bacterial diversity and intestinal flora composition of different strains of laying hens during various laying periods, contributing significantly to the improvement of production performance and the prevention of chicken diseases.

Irradiation stent with 125 I plus TACE versus sorafenib plus TACE for hepatocellular carcinoma with major portal vein tumor thrombosis: a multicenter randomized trial

BACKGROUND AND AIM

Treatment strategy for hepatocellular carcinoma (HCC) and Vp4 [main trunk] portal vein tumor thrombosis (PVTT) remains limited due to posttreatment liver failure. We aimed to assess the efficacy of irradiation stent placement with 125 I plus transcatheter arterial chemoembolization (TACE) (ISP-TACE) compared to sorafenib plus TACE (Sora-TACE) in these patients.

METHODS

In this multicenter randomized controlled trial, participants with HCC and Vp4 PVTT without extrahepatic metastases were enrolled from November 2018 to July 2021 at 16 medical centers. The primary endpoint was overall survival (OS). The secondary endpoints were hepatic function, time to symptomatic progression, patency of portal vein, disease control rate, and treatment safety.

RESULTS

Of 105 randomized participants, 51 were assigned to the ISP-TACE group, and 54 were assigned to the Sora-TACE group. The median OS was 9.9 months versus 6.3 months (95% CI: 0.27-0.82; P =0.01). Incidence of acute hepatic decompensation was 16% (8 of 51) versus 33% (18 of 54) ( P =0.036). The time to symptomatic progression was 6.6 months versus 4.2 months (95% CI: 0.38-0.93; P =0.037). The median stent patency was 7.2 months (interquartile range, 4.7-9.3) in the ISP-TACE group. The disease control rate was 86% (44 of 51) versus 67% (36 of 54) ( P =0.018). Incidences of adverse events at least grade 3 were comparable between the safety populations of the two groups: 16 of 49 (33%) versus 18 of 50 (36%) ( P =0.73).

CONCLUSION

Irradiation stent placement plus TACE showed superior results compared with sorafenib plus TACE in prolonging OS in patients with HCC and Vp4 PVTT.

Transarterial chemoembolization with PD-(L)1 inhibitors plus molecular targeted therapies for hepatocellular carcinoma (CHANCE001)

There is considerable potential for integrating transarterial chemoembolization (TACE), programmed death-(ligand)1 (PD-[L]1) inhibitors, and molecular targeted treatments (MTT) in hepatocellular carcinoma (HCC). It is necessary to investigate the therapeutic efficacy and safety of TACE combined with PD-(L)1 inhibitors and MTT in real-world situations. In this nationwide, retrospective, cohort study, 826 HCC patients receiving either TACE plus PD-(L)1 blockades and MTT (combination group, n = 376) or TACE monotherapy (monotherapy group, n = 450) were included from January 2018 to May 2021. The primary endpoint was progression-free survival (PFS) according to modified RECIST. The secondary outcomes included overall survival (OS), objective response rate (ORR), and safety. We performed propensity score matching approaches to reduce bias between two groups. After matching, 228 pairs were included with a predominantly advanced disease population. Median PFS in combination group was 9.5 months (95% confidence interval [CI], 8.4-11.0) versus 8.0 months (95% CI, 6.6-9.5) (adjusted hazard ratio [HR], 0.70, P = 0.002). OS and ORR were also significantly higher in combination group (median OS, 19.2 [16.1-27.3] vs. 15.7 months [13.0-20.2]; adjusted HR, 0.63, P = 0.001; ORR, 60.1% vs. 32.0%; P < 0.001). Grade 3/4 adverse events were observed at a rate of 15.8% and 7.5% in combination and monotherapy groups, respectively. Our results suggest that TACE plus PD-(L)1 blockades and MTT could significantly improve PFS, OS, and ORR versus TACE monotherapy for Chinese patients with predominantly advanced HCC in real-world practice, with an acceptable safety profile.

Loosening Identification of Multi-Bolt Connections Based on Wavelet Transform and ResNet-50 Convolutional Neural Network

A high-strength bolt connection is the key component of large-scale steel structures. Bolt loosening and preload loss during operation can reduce the load-carrying capacity, safety, and durability of the structures. In order to detect loosening damage in multi-bolt connections of large-scale civil engineering structures, we proposed a multi-bolt loosening identification method based on time-frequency diagrams and a convolutional neural network (CNN) using vi-bro-acoustic modulation (VAM) signals. Continuous wavelet transform was employed to obtain the time-frequency diagrams of VAM signals as the features. Afterward, the CNN model was trained to identify the multi-bolt loosening conditions from the raw time-frequency diagrams intelligently. It helps to get rid of the dependence on traditional manual selection of simplex and ineffective damage index and to eliminate the influence of operational noise of structures on the identification accuracy. A laboratory test was carried out on bolted connection specimens with four high-strength bolts of different degrees of loosening. The effects of different excitations, CNN models, and dataset sizes were investigated. We found that the ResNet-50 CNN model taking time-frequency diagrams of the hammer excited VAM signals, as the input had better performance in identifying the loosened bolts with various degrees of loosening at different positions. The results indicate that the proposed multi-bolt loosening identification method based on VAM and ResNet-50 CNN can identify bolt loosening with a reasonable accuracy, computational efficiency, and robustness.

[Status of HVPG clinical application in China in 2021]

Objective: The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China. Methods: This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems. Results: According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%). Conclusion: Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

A Plastic Optical Fiber Sensing System for Bridge Deflection Measurement

Deflection is one of the key parameters that reflects the state of a bridge. However, deflection measurement is difficult for a bridge that is under operation. Most existing sensors and measuring techniques often do not meet the requirements for health monitoring for various types of bridges. Therefore, based on changes of optical fiber intensity, a novel sensing system using connected pipes to measure bridge deflection in different positions is proposed in this paper. As an absolute reference, the liquid level position along the structure is adopted for the deflection measurement, and an additional external reference to the ground is not needed in this system. The proposed system consists of three parts: connected pipes to connect the measurement points along the structure, liquid to fill in the connected pipes, and the sensing element to detect the change of level. A plastic optical fiber sensor based on the intensity change is used as the sensing element of the developed system. Then, a set of experimental tests are conducted for performance evaluation purposes. Results show that this system has an accurate linear response and high reliability under various environmental conditions. The deflection of the test beam measured by the sensor agrees with linear variable differential transformer (LVDT) within an error margin of 2.1%. The proposed system shows great potential applicability for future health monitoring of long-span bridges.

Seroprevalence of Toxoplasma gondii in horses: A global systematic review and meta-analysis

Toxoplasmosis, one of the most common zoonoses worldwide, is caused by Toxoplasma gondii. T. gondii can infect almost all warm-blooded animals, including humans. Horses are an intermediate host of T. gondii, representing a potential risk for humans. To determine the T. gondii seroprevalence in horses worldwide, a global meta-analysis was conducted. A total of 35 publications were obtained by searching the PubMed, ScienceDirect, Chinese Web of knowledge (CNKI) and Wanfang databases. A total of 12,354 horses were assessed, of which 1580 were positive for T. gondii. The pooled overall seroprevalence of horses infected by T. gondii was 11.29%. No significant difference of T. gondii seroprevalence was observed between male and female horses. The seroprevalence of T. gondii in horses from different countries varied. Our findings suggest that toxoplasmosis is prevalent in horses worldwide. Therefore, it is necessary to implement continuous monitoring of the status of T. gondii seroprevalence in horses. Moreover, powerful regulatory measures should be implemented to prevent and control the spread of toxoplasmosis.

Grouting Quality Evaluation in Post-Tensioning Tendon Ducts Using Wavelet Packet Transform and Bayes Classifier

The grouting quality of tendon ducts is very important for post-tensioning technology in order to protect the prestressing reinforcement from environmental corrosion and to make a smooth stress distribution. Unfortunately, various grouting defects occur in practice, and there is no efficient method to evaluate grouting compactness yet. In this study, a method based on wavelet packet transform (WPT) and Bayes classifier was proposed to evaluate grouting conditions using stress waves generated and received by piezoelectric transducers. Six typical grouting conditions with both partial grouting and cavity defects of different dimensions were experimentally investigated. The WPT was applied to explore the energy of received stress waves at multi-scales. After that, the Bayes classifier was employed to identify the grouting conditions, by taking the traditionally used total energy and the proposed energy vector of WPT components as input, respectively. The experimental results demonstrated that the Bayes classifier input with the energy vector could identify different grouting conditions more accurately. The proposed method has the potential to be applied at key spots of post-tensioning tendon ducts in practice.

Meta-analysis of Toxoplasma gondii in pigs intended for human consumption in Mainland China

Toxoplasma gondii, is one of the most important foodborne zoonotic pathogens, which can infect virtually all warm-blooded animals, including pigs, and causes severe illness in congenitally infected infants and even death in patients with AIDS. Pigs (Sus scrofa) are one of the most important intermediate hosts of T. gondii, and human transmission occurs through consumption of raw or poorly cooked pork. In this systematic review and meta-analysis, we searched Chongqing VIP, Wanfang, Chinese Web of Knowledge, PubMed, and ScienceDirect databases for published papers regarding Toxoplasma infection in pigs in China, from inception to Oct 29, 2017. Search strings included whether they reported the samples of more than 30 pigs and provided information that allowed us to establish the prevalence of Toxoplasma infection. Moreover, we excluded repeated studies, reviews, other host studies, as well as studies with inconsistent data, incomplete information, those that only provided prevalence data, and those outside of Mainland China. We extracted the numbers of pigs with Toxoplasma infection from the obtained studies, and calculated the pooled prevalence of Toxoplasma infection in the pigs using a random-effects model. The data of 44 articles (including data on 46,723 pigs) were compliant with the standards. The pooled prevalence of T. gondii infection in pigs in China was 29% (95% CI 24-34), with 25% (95% CI 18-32) in pigs sampled before 2010 and 28% (95% CI 21-36) in pigs sampled in 2010 or later. The pooled prevalence of T. gondii in pigs from Northeast China (20%, 95% CI 14-26) was significantly lower than those from other regions (North China: 40%, 95% CI 32-47; Northwest China: 32%, 95% CI 13-51; East China: 30%, 95% CI 20-41; and South China: 35%, 95% CI 26-45; Central China: 23%, 95% CI 14-31; Southwest China: 33%, 95% CI 15-52). The estimated pooled prevalence of T. gondii infection was 36% (95% CI 25-47, 8,018/21,892) in pigs tested by ELISA, 24% (95% CI 19-28, 4,304/18,608) in pigs examined by IHA, and 19% (95% CI 8-31, 1,041/6,223) in pigs detected by other methods. Moreover, 1202 of 7470 piglets were detected as T. gondii-positive, and the prevalence (17%) was lower than that in fattening pigs (25%, OR = 1.28), sows (34%, OR = 2.13), and breeding boars (35%, OR = 2.46). Our findings suggested that toxoplasmosis is common in pigs in Mainland China. It is necessary to monitor the prevalence of T. gondii in pigs, and powerful and effective regulatory measures should be undertaken to reduce human exposure to T. gondii via the consumption of pork.

Molecular Detection and Genetic Characterization of Toxoplasma gondii from Horses in Three Provinces of China

Horse meat and milk are an important source of nutrition for many Chinese. Previous studies have shown a fairly high prevalence of Toxoplasma gondii infection in horses. However, there is no data concerning the molecular characterization of T. gondii in horses in China. The present study tested 231 cervical lymph node samples of horses from northern China (97 from Jilin, 54 from Liaoning, and 80 from Xinjiang) for the presence of the T. gondii B1 gene by seminested PCR. The B1-positive samples were genotyped at nine nuclear loci, that is, SAG1, alternative SAG2, SAG3, BTUB, c22-8, GRA6, c29-2, PK1, and an apicoplast locus, using PCR-restriction fragment length polymorphism technique. A total of 14 (6.06%) out of 231 samples were T. gondii positive. The overall prevalence of T. gondii in the horses was 5.15% (5/97) for Jilin Province, 5.55% (3/54) for Liaoning Province, and 7.50% (6/80) for Xinjiang Uygur Autonomous Region. Of the 14 positive samples, only 2 were successfully genotyped at all loci, 5 were successfully genotyped at 5-8 loci, and all typed samples belong to ToxoDB genotype no. 9. To our knowledge, this is the first molecular characterization of the T. gondii isolates from horses in China.

Seroprevalence and Related Factors of Toxoplasma gondii in Pigeons Intended for Human Consumption in Northern China

Toxoplasma gondii, the causative agent of toxoplasmosis, is carried by a range of intermediate hosts, including pigeons. Eating raw or undercooked pigeon meat, as is common in regions of China, can easily pass on a potentially fatal T. gondii infection. However, there are little data about the seroprevalence and genotypes of T. gondii infection in pigeons. In this study, a total of 963 pigeon blood samples were collected from Jilin Province, Liaoning Province, and Inner Mongolia Autonomous Region in China between August 2015 and December 2016. The overall seroprevalence of T. gondii was 10.80% (104/963), with 8.80% (41/466) in males and 12.68% (63/497) in females. The seroprevalence of T. gondii in different regions varied from 9.04% (17/188) in Jilin City to 13.16% (20/152) in Shenyang City, a relatively high prevalence. The seroprevalence of T. gondii in juvenile pigeons (6.38%, 18/282) was significantly lower than in adults (86/681, p < 0.05). These findings could provide useful data for the execution of effective control measures against T. gondii infection in pigeons and/or other hosts. More importantly, the findings also suggest that pigeons should not be eaten raw.

Seroprevalence and risk factors of Toxoplasma gondii infection in horses in Jilin Province and Inner Mongolia Autonomous Region, northern China

Toxoplasmosis is caused by the protozoon Toxoplasma gondii that can infect almost all warm-blooded hosts including horses and humans. Horse meat is one of the most important meat products for human consumption. However, data on seroprevalence of T. gondii in horses intended for human consumption in Northern China is scarce. Thus, a total of 614 serum samples were collected from Jilin Province and Inner Mongolia Autonomous Region (IMAR) between 2015 and 2017, and were detected the seroprevalence for T. gondii by indirect hemagglutination assay test. In the prevalence study, the overall seroprevalence of T. gondii in horses was 17.92% (110/614) by IHA test, at the cut- off 1:64. Horses collected from Changchun (13.58%, P = 0.02) has a significantly lower seroprevalence than those from Meihekou City (21.72%) and Tongliao City (22.81%). Moreover, a significant difference of T. gondii seroprevalence was found between horses ages at less than 12 months (22.75%) and ≥12 months or higher (16.42%, P = 0.002). To our knowledge, this is the first report of seroprevalence of T. gondii in horses in Jilin and IMAR, Northern China. Logistic regression suggested that age and geographical location of horses were identified as risk factors. These findings will provide the useful data for controlling and preventing toxoplasmosis in horses and/or other hosts in China.

Guidelines for Diagnosis and Treatment of Primary Liver Cancer in China (2017 Edition)

BACKGROUND

Hepatocellular carcinoma (HCC) (about 85-90% of primary liver cancer) is particularly prevalent in China because of the high prevalence of chronic hepatitis B infection. HCC is the fourth most common malignancy and the third leading cause of tumor-related deaths in China. It poses a significant threat to the life and health of Chinese people.

SUMMARY

This guideline presents official recommendations of the National Health and Family Planning Commission of the People's Republic of China on the surveillance, diagnosis, staging, and treatment of HCC occurring in China. The guideline was written by more than 50 experts in the field of HCC in China (including liver surgeons, medical oncologists, hepatologists, interventional radiologists, and diagnostic radiologists) on the basis of recent evidence and expert opinions, balance of benefits and harms, cost-benefit strategies, and other clinical considerations.

KEY MESSAGES

The guideline presents the Chinese staging system, and recommendations regarding patients with HCC in China to ensure optimum patient outcomes.

Irradiation stents vs. conventional metal stents for unresectable malignant biliary obstruction: A multicenter trial

BACKGROUND & AIMS

Placement of an irradiation stent has been demonstrated to offer longer patency and survival than an uncovered self-expandable metallic stent (SEMS) in patients with unresectable malignant biliary obstruction (MBO). We aim to further assess the efficacy of an irradiation stent compared to an uncovered SEMS in those patients.

METHODS

We performed a randomized, open-label trial of participants with unresectable MBO at 20 centers in China. A total of 328 participants were allocated in parallel to the irradiation stent group (ISG) or the uncovered SEMS group (USG). Endpoints included stent patency (primary), technical success, relief of jaundice, overall survival, and complications.

RESULTS

The first quartile stent patency time (when 25% of the patients experienced stent restenosis) was 212 days for the ISG and 104 days for the USG. Irradiation stents were significantly associated with a decrease in the rate of stent restenosis (9% vs. 15% at 90 days; 16% vs. 27% at 180 days; 21% vs. 33% at 360 days; p = 0.010). Patients in the ISG obtained longer survival time (median 202 days vs. 140 days; p = 0.020). No significant results were observed in technical success rate (93% vs. 95%; p = 0.499), relief of jaundice (85% vs. 80%; p = 0.308), and the incidence of grade 3 and 4 complications (8.5% vs. 7.9%; p = 0.841).

CONCLUSIONS

Insertion of irradiation stents instead of uncovered SEMS could improve patency and overall survival in patients with unresectable MBO.

LAY SUMMARY

For patients with unresectable malignant biliary obstruction (MBO), placement of a self-expandable metallic stent (SEMS) is a recommended palliative modality to relieve pruritus, cholangitis, pain, and jaundice. However, restenosis is a main pitfall after stent placement. Data from this first multicenter randomized controlled trial showed that insertion of an irradiation stent provided longer patency and better survival than a conventional metal stent. ClinicalTrials.gov ID: NCT02001779.

Comparative Study of Percutaneous Transhepatic Biliary Stent Placement with or without Iodine-125 Seeds for Treating Patients with Malignant Biliary Obstruction

PURPOSE

To prospectively evaluate safety and efficacy of biliary stent placement with iodine-125 (¹²⁵I) seeds in patients with malignant obstructive jaundice (MOJ).

MATERIALS AND METHODS

From July 2011 to June 2014, 55 patients were enrolled (group A, 11 men and 17 women, mean age 70.93 y ± 8.58; group B, 14 men and 13 women, mean age 70.26 y ± 9.71). All patients were randomly assigned to placement of a biliary stent with ¹²⁵I seeds (group A) or biliary stent only (group B). After stent placement, outcomes were measured regarding relief of MOJ. Clinical success rate, survival time, and safety were recorded. P < .05 was considered to indicate significant difference.

RESULTS

Stents were successfully placed in all 55 patients. MOJ was relieved in all patients, and there were no significant differences in complications related to stent insertion between the 2 groups. Mean and median stent patency were 191 days ± 19.8 (95% confidence interval [CI], 152-230 d) and 179 days ± 191.4 (95% CI, 87-267 d) in group A and 88.3 days ± 16.3 (95% CI, 61-114 d) and 77 days ± 88.2 (95% CI, 65-86 d) in group B (P < .001, log-rank test). Mean and median survival time were 222.6 days ± 21.0 (95% CI, 181-263 d) and 241 days ± 18.2 (95% CI, 179-270 d) in group A and 139.1 days ± 14.5 (95% CI, 110-167 d) and 142 days ± 16.3 (95% CI, 83-177 d) in group B (P < .001, log-rank test).

CONCLUSIONS

¹²⁵I seeds combined with biliary stent placement could significantly improve stent patency. The procedure seems to be safe and to extend survival compared with self-expandable biliary stent placement.

Effects of albendazole nanoparticles in mice with hepatic echinococosis: Portal vein cannulation versus intravenous administration

To compare the ABZ and its metabolites concentration in cyst tissue of hepatic alveolar echinococcosis administered by different routes, forty male Wistar rats receiving albendazole nanoparticles from tail vein and portal vein were divided into two groups, the concentration of ABZ and its metabolites ABZSO, ABZSO2, in the cyst tissue, were analyzed by HPLC at 2, 4, 8, 24, 36 h after administration. The parent drug and its metabolites were detected in plasm and the cyst tissue after portal cannulation and intravenous administration. The last results were the concentration of ABZ in the portal cannulation group was higher than in the intravenous group at every time point (p < 0.05). Compared to the intravenous group, the portal cannulation administration of ABZ led to a lower plasm concentration of ABZ. The concentration of ABZ and the active ABZSO were significantly higher in the portal cannulation group than that of the intravenous group.

Design, synthesis and structural exploration of novel fluorinated dabigatran derivatives as direct thrombin inhibitors

Twenty-one fluorinated dabigatran derivatives were designed based on the bioisosteric principle. All derivatives were synthesised and evaluated for their thrombin inhibitory activity in vitro. Among these compounds, 14h, 14m, 14s and 14t were potent and the activity was in the range of reference drug, dabigatran. Three structural changes were introduced in these 21 compounds to elucidate the structure-activity relationship of the drugs. In addition, prodrugs of compounds 14h and 14s were developed to investigate their anticoagulant activities in vivo. In these experiments, compound 16 showed a fairly strong inhibitory effect on thrombin-induced platelet aggregation, and demonstrated potent activity for inhibiting arteriovenous thrombosis with an inhibition rate of (73 ± 6) %, which was comparable to that of dabigatran etexilate (76 ± 2) %. Moreover, molecular docking studies were performed to understand the binding interactions of active compounds 14h, 14s and 14t with thrombin protein (PDB ID:1KTS). Contour maps obtained from the 3D-QSAR model are meaningful in designing more active molecules to act as direct inhibitors of thrombin.

Conventional stents versus stents loaded with (125)iodine seeds for the treatment of unresectable oesophageal cancer: a multicentre, randomised phase 3 trial

BACKGROUND

The combination of stent insertion and single high-dose brachytherapy is a feasible and safe palliative treatment regimen in patients with unresectable oesophageal cancer. We aimed to further assess the efficacy of this treatment strategy compared to a conventional covered stent in patients with dysphagia caused by unresectable oesophageal cancer.

METHODS

In this multicentre, single-blind, randomised, phase 3 trial, we enrolled patients with unresectable oesophageal cancer from 16 hospitals in China. We included adult patients (aged ≥ 20 years) with progressive dysphagia, unresectable tumours due to extensive lesions, metastases, or poor medical condition, and with clear consciousness, cooperation, and an Eastern Cooperative Oncology Group (ECOG) performance status score of 0-3. Eligible patients were randomly assigned (in 1:1 ratio, no stratification) to receive either a stent loaded with (125)iodine radioactive seeds (irradiation group) or a conventional oesophageal stent (control group). The primary endpoint was overall survival. Survival analyses were done in a modified intention-to-treat group. This study is registered with ClinicalTrials.gov, number NCT01054274.

FINDINGS

Between Nov 1, 2009, and Oct 31, 2012, 160 patients were randomly assigned to receive treatment with either an irradiation stent (n=80) or a conventional stent (n=80). During a median follow-up of 138 days (IQR 72-207), 148 stents (73 in the irradiation group and 75 in the control group) were successfully placed into the diseased oesophagus in 148 participants. Median overall survival was 177 days (95% CI 153-201) in the irradiation group versus 147 days (124-170) in the control group (p=0.0046). Major complications and side-effects of the treatment were severe chest pain (17 [23%] of 73 patients in the irradiation group vs 15 [20%] of 75 patents in the control group), fistula formation (six [8%] vs five [7%]), aspiration pneumonia (11 [15%] vs 14 [19%]), haemorrhage (five [7%] vs five [7%]), and recurrent dysphagia (21 [28%] vs 20 [27%]).

INTERPRETATION

In patients with unresectable oesophageal cancer, the insertion of an oesophageal stent loaded with (125)iodine seeds prolonged survival when compared with the insertion of a conventional covered self-expandable metallic stent.

[Pathological changes of after trans-portal vein chemoembolization Echinococcus multilocularis in the liver of infected rats]

OBJECTIVE

To observe the morphological change in the pathological process of Echinococcus multilocularis in liver of infected rats after treatment with liposome entrapped albendazole and iodized oil suspension through portal vein, and investigate its efficacy against hepatic alveolar echinococcosis.

METHODS

One Echinococcus multilocularis-infected rat served as control. Another 19 infected rats were infused with 0.2ml liposome entrapped albendazole and iodized oil suspension through portal vein. At 4, 7 and 10 d after treatment, the rats were sacrificed for further observation. The E. multilocularis metacestodes were collected, and the pathological change of alveolar hydatid was observed with hematoxylin-eosin staining and toluidine blue staining.

RESULTS

In four days post treatment, E. multilocularis metacestodes were normal On the 7th day and 10th day post treatment, the major pathological change was degeneration and necrosis, respectively. A great quantity of liposomes and iodized oil deposited in the metacestodes, and caused breakdown of E. multilocularis tissue, collapse of cysts, cataplasia of germinal layer and laminated layer.

CONCLUSION

Interventional therapy trans-hepatic vein may be an effective way to treat hepatic alveolar echinococcosis.

Ghrelin suppression and fat loss after left gastric artery embolization in canine model

PURPOSE

To evaluate the effects of left gastric artery embolization (LGAE) on plasma ghrelin levels, abdominal fat, and body weight in beagles.

METHODS

The institutional animal care and use committee approved this study. Fifteen healthy adult beagles (12 male and three female animals) were randomly divided into three experimental groups: LGAE was proceeded with mixed emulsion of bleomycin A(5) hydrochloride and lipiodol (group A), and polyvinyl alcohol particles (group B). Transcatheter saline injections in the left gastric artery were performed as a control. Weight and fasting plasma ghrelin levels were obtained at baseline and at weekly intervals for 8 weeks after the procedure in all animals. All animals were scanned and measured by multidetector computed tomography at baseline and at week 8 for evaluation of abdominal fat.

RESULTS

In LGAE-treated animals, plasma ghrelin and body weight significantly decreased compared to control animals (group A: P = 0.007 and P = 0.000; group B: P = 0.004 and P = 0.000, respectively). Subcutaneous fat size was also significantly reduced (P = 0.011 and P = 0.027 for groups A and B, respectively). The decreasing percentage in ghrelin levels at week 6 (peak of recovery) of LGAE-treated animals were negatively correlated with the size of area supplied by left gastric artery (r = -0.693, P = 0.026).

CONCLUSION

LGAE could suppress the plasma concentration of ghrelin, which results in subcutaneous fat size reduction and weight loss. Compensatory ghrelin production might occur in the remnant gastric fundus after LGAE.

[Therapeutic effect of hepatic artery infusion with albendazole microspheres on hepatic alveolar echinococcosis in rats]

OBJECTIVE

To observe therapeutic effect of hepatic artery infusion of albendazole solid dispersion-chitosan microspheres on hepatic alveolar echinococcosis (HAE) in rats.

METHODS

After the establishment of hepatic alveolar echinococcosis model, 30 rats were randomly divided into control group (A), blank microspheres group (B), and albendazole microspheres group (C) with 10 rats in each group 0.3 ml normal saline, 27mg/kg blank microspheres and 2.7 mg/kg albendazole solid dispersion-chitosan microspheres with 0.3 ml normal saline were injected through hepatic artery of rats in the groups of A, B and C, respectively. At 1 d, 3 d, 7 d, 14 d, and 42 d after injection, venous blood were collected, and white blood cells (WBC), aspartate aminotransferase (AST), and alanine aminotransferase(ALT) were evaluated. All the rats were sacrificed on 42 d after injection, and HAE pathological changes were observed.

RESULTS

Transient elevation of white blood cells was observed in all groups at 1 d after infusion [Group A (86.11 +/- 19.14) x 10(9)/L, B (117.11 +/- 21.76) x 10(9)/L, C (118.11 +/- 24.52) x 10(9)/L], at 7d WBC fell to normal level [A (7.85 +/- 6.57)x10(9)/L, B (11.73 +/- 4.85) x 10(9)/L, C (8.49 +/- 136)x10(9)/L]. In groups B and C, AST, ALT reached their peaks on day 3 after infusion [B: AST (193.15 +/- 21.57) U/L, ALT (78.39 +/- 9.78) U/L; C: AST (189.91 +/- 14.06) U/L, ALT (88.43 +/- 9.23) U/L], and decreased to normal level at 14d after infusion [B: AST (109.31 +/- 15.48) U/L, ALT(47.855 +/- 9.49) U/L; C: AST(105.37 +/- 8.16) U/L, ALT (49.53 +/- 6.75) UL]. Histopathological examination at 42d after infusion showed that in groups A and B structure of the cysts was virtually normal, but in group C most cysts showed necrosis in germinal layer.

CONCLUSION

Hepatic artery infusion with albendazole solid dispersion-chitosan microspheres shows certain therapeutic effect on hepatic alveolar echinococcosis in rats.

Characterization of Baylisascaris schroederi from Qinling subspecies of giant panda in China by the first internal transcribed spacer (ITS-1) of nuclear ribosomal DNA

In the present study, a total of 20 nematode isolates, (including 10 male and 10 female worms) representing Baylisascaris schroederi from 5 Qinling subspecies of giant pandas (Ailuropoda melanoleuca) in Shaanxi Province of China, were characterized and grouped genetically by the first internal transcribed spacer (ITS-1) of nuclear ribosomal DNA (rDNA). The rDNA fragment spanning 3' end of 18S rDNA, complete ITS-1 rDNA, and 5' end of 5.8S rDNA were amplified and sequenced. The sequence variability in ITS-1 rDNA was examined within B. schroederi and among parasites in order Ascaridata available in GenBank™, and their phylogenetic relationships were also reconstructed. The sequences of ITS-1 rDNA for all the B. schroederi isolates were 427 bp in length, with no genetic variation detected among these isolates. Phylogenetic analyses based on the ITS-1 rDNA sequences revealed that all the male and female B. schroederi isolates sequenced in the present study were posited into the clade of genus Baylisascaris, sistered to zoonotic nematodes in genus Ascaris, and the ITS-1 rDNA sequence could distinguish different species in order Ascaridata. These results showed that the ITS-1 rDNA provides a suitable molecular marker for the inter-species phylogenetic analysis and differential identification of nematodes in order Ascaridata.