Ultra-high resistive switching current ratio and improved ferroelectricity and dielectric tunability performance in a BaTiO3/La0.7Sr0.3MnO3 heterostructure by inserting a SrCoO2.5 layer

A BaTiO3/SrCoO2.5 (BTO/SCO) bilayer and a BTO single film were prepared by radio frequency magnetron sputtering on La0.7Sr0.3MnO3 (LSMO) buffered SrTiO3 (001) substrates. Interestingly, compared with reported BTO-based films, the BTO/SCO/LSMO heterostructure has a maximum ON/OFF current ratio of ∼945. More interestingly, compared with the BTO single layer, a larger Pr (∼18.4 μC cm-2) and larger dielectric tunability (∼71.9%) were achieved in the BTO/SCO bilayer. The improved performance may be attributed to the large tetragonality and improved oxygen vacancy concentrations in the BTO/SCO/LSMO heterostructure. Furthermore, our BTO/SCO/LSMO stacks exhibit potential for flexible electronic informational devices.

[Clinical features of peripheral neuropathy with livedo reticularis: an analysis of seven cases]

The clinical characteristics, auxiliary examinations, skin and neuropathological features of 7 patients who had reticular cyanosis with peripheral neuropathy from the Department of Neurology, Huashan Hospital, Fudan University from January 2019 to December 2022 were retrospectively analyzed. Among the 7 patients, 5 were female and 2 were male.The age of onset of peripheral neuropathy was (39.8±21.3) years and the disease duration of peripheral neuropathy was (2.7±2.3) years. Three patients had acute onset and 4 patients had chronic onset. All the patients had limb numbness, with limb weakness in 6 patients and pain in 5 cases. Neuroelectrophysiological examination revealed 1 case of mononeuropathy, 2 cases of polyneuropathy, 2 cases of peripheral neuropathy, and 2 cases of sensory neuron neuropathy. Skin biopsy was performed in 3 patients, which presented hyperplasia and expansion of blood vessels in the dermis with lymphocyte infiltration. Nerve biopsy was performed in 3 patients, indicating axonal damage. Reticular cyanosis with peripheral neuropathy characterizes with numbness and weakness of limbs, most of which were accompanied by pain. Electrophysiological changes are in various forms. The pathological changes are dominated by the damage of axonal.

[Establishing adult vaccination system to improve the quality of immunization services over the life course]

The scientific setting and standardized management of adult vaccination clinics will improve the accessibility of vaccination services, thereby increasing the vaccination rate. Currently, some provinces and cities in China have been exploring the construction of adult vaccination systems for many years, effectively improving the level of vaccination services, and forming some useful experiences and models. However, the construction of China's adult vaccination system is not yet perfect, and the service mode needs to be optimized. In the future, we should continue to improve the guarantee measures for adult vaccination, scientifically lay out the network, optimize the service mode, and improve the overall quality of immunization services over the life course.

[Research progress on the effectiveness of smallpox vaccination against mpox virus infection]

With the expansion of mpox virus infection from endemic to a global epidemic in 2022, the WHO declared that the mpox event constituted a Public Health Emergency of International Concern. Due to the high degree of gene sequence similarity among orthopox viruses and cross-reactive antibodies induced by orthoviruses, smallpox vaccination may affect the immune response induced by mpox virus infection. The analysis of the protective effects of smallpox vaccination against mpox virus infection will help define the focus of prevention and control. In this review, we clarify the protection of the smallpox vaccine against mpox virus infection by analyzing the correlation between smallpox vaccination, immune response status, and clinical data and providing evidence for the prevention, control, and strategies of mpox epidemics.

[The study of a key molecule Caspase-1 of inflammasome in hepatitis B virus-related diseases]

Objective: To investigate the expression and role of asparte-specific cysteine protease (Caspase)-1, inflammasomes key molecule, in hepatitis B virus (HBV)-related diseases. Methods: HBV-related liver disease patients' serum (438 cases) and liver tissue (82 cases) samples were collected from Beijing You'an Hospital affiliated with Capital Medical University. The mRNA expression level of caspase-1 in liver tissue was detected by real-time fluorescence quantitative PCR (qRT-PCR). The protein expression level of Caspase-1 in liver tissue was detected by the immunofluorescence method. The activity of Caspase-1 was detected using the Caspase-1 colorimetric assay kit. The level of Caspase-1 in the serum was detected by an ELISA kit. Results: The results of qRT-PCR showed that the mRNA level of Caspase-1 was downregulated in patients with chronic hepatitis B (CHB), cirrhosis (LC), and hepatocellular carcinoma (HCC), while up-regulated in patients with acute-on-chronic liver failure (ACLF) (P＜0.01) compared with normal subjects. Immunofluorescence assays showed that Caspase-1 protein levels were elevated in ACLF patients, decreased in HCC and LC patients, and slightly elevated in CHB patients. The activity of Caspase-1 was slightly higher in liver tissue from CHB, LC, and HCC patients than in the normal control group, and there was no statistically significant difference between the groups. Additionally, compared with the control group, Caspase-1 activity was significantly reduced in the ACLF group (P＜0.01). Serum Caspase-1 levels were significantly lower in patients with CHB, ACLF, LC, and HCC than in normal subjects, and serum Caspase-1 levels were lowest in patients with ACLF (P＜0.001). Conclusion: Caspase-1, a key molecule of inflammasomes, plays an important role in HBV-related diseases and has significant differences, showing distinct features for ACLF than other HBV-related diseases.

[Application of pretrained model based on electronic medical record in recognition of acute respiratory infection]

Objective: To evaluate the recognition of acute respiratory infection (ARI) by a pretrained model based on electronic medical records (EMRs). Methods: 38 581 EMRs were obtained from Chongqing University Three Gorges Hospital in December 2021. Bidirectional encoder representation from transformers (BERT) pretrained model was used to identify ARI in EMRs. The results of medical professionals were considered as the gold standard to calculate the sensitivity, specificity, Kappa value, and area under the curve of the receiver operating characteristic (AUC). Results: There were 3 817 EMRs in the test set, with 1 200 ARIs. A total of 1 205 cases were determined as ARI by the model, with a sensitivity of 92.67% (1 112/1 200) and a specificity of 96.45% (2 524/2 617). The model identified ARI with similar accuracy in males and females (AUCs 0.95 and 0.94, respectively), and was more accurate in identifying ARI cases in those aged less than 18 than in adults 18-59 and adults 60 and older (AUCs 0.94, 0.89 and 0.94, respectively). The current model had a better identification of ARIs in outpatient patients than that in hospitalized patients, with AUCs of 0.74 and 0.95, respectively. Conclusion: The use of the BERT pretrained model based on EMRs has a good performance in the recognition of ARI cases, especially for the outpatients and juveniles. It shows a great potential to be applied to the monitoring of ARI cases in medical institutions.

BAG3 promotes autophagy and suppresses NLRP3 inflammasome activation in Parkinson's disease

Background

Neuroinflammation mediated by microglia plays a key role in the pathogenesis of Parkinson's disease (PD), and our previous studies showed this was significantly inhibited by enhanced autophagy. In the autophagy pathway, Bcl2-associated athanogene (BAG)3 is a prominent co-chaperone, and we have shown BAG3 can regulate autophagy to clear the PD pathogenic protein α-synuclein. However, the connection between BAG3 and microglia mediated neuroinflammation is not clear.

Methods

In this study, we explored whether BAG3 regulated related neuroinflammation and its original mechanism in PD. An inflammatory model of PD was established by injecting adeno-associated virus (AAV)-BAG3 into the bilateral striatum of C57BL/6 male mice to induce overexpression of BAG3, followed by injection of lipopolysaccharide (LPS). The striatum was extracted at 3 days after injection of LPS for Western blotting and reverse transcription quantitative polymerase chain reaction (RT-qPCR), and immunohistochemical staining was performed at 21 days after injection. At the same time, LPS was used to induce activation of BV2 cells to verify the effect of BAG3 in vitro.

Results

Overexpression of BAG3 reduced LPS-induced pyroptosis by reducing activation of caspase-1, the NOD-like receptor family, and the pyrin domain-containing 3 (NLRP3) inflammasome, and by release of interleukin (IL)-1β and tumor necrosis factor (TNF)-α. The LPS-induced inflammatory environment inhibits autophagy, and overexpression of BAG3 can restore autophagy, which may be the mechanism by which BAG3 reduces neuronal inflammation in PD.

Conclusions

Our results demonstrate BAG3 promotes autophagy and suppresses NLRP3 inflammasome formation in PD.

[Evaluation of demand of resources for laboratory testing and prevention and control of COVID-19 in the context of global pandemic]

Objective: To rapidly evaluate the level of healthcare resource demand for laboratory testing and prevention and control of corona virus disease 2019 (COVID-19) in different epidemic situation, and prepare for the capacity planning, stockpile distribution, and funding raising for infectious disease epidemic response. Methods: An susceptible, exposed, infectious, removed infectious disease dynamics model with confirmed asymptomatic infection cases and symptomatic hospitalized patients was introduced to simulate different COVID-19 epidemic situation and predict the numbers of hospitalized or isolated patients, and based on the current COVID-19 prevention and control measures in China, the demands of resources for laboratory testing and prevention and control of COVID-19 were evaluated. Results: When community or local transmission or outbreaks occur and total population nucleic acid testing is implemented, the need for human resources is 3.3-89.1 times higher than the reserved, and the current resources of medical personal protective equipment and instruments can meet the need. The surge in asymptomatic infections can also increase the human resource demand for laboratory testing and pose challenge to the prevention and control of the disease. When vaccine protection coverage reach ≥50%, appropriate adjustment of the prevention and control measures can reduce the need for laboratory and human resources. Conclusions: There is a great need in our country to reserve the human resources for laboratory testing and disease prevention and control for the response of the possible epidemic of COVID-19. Challenges to human resources resulted from total population nucleic acid testing and its necessity need to be considered. Conducting non-pharmaceutical interventions and encouraging more people to be vaccinated can mitigate the shock on healthcare resource demand in COVID-19 prevention and control.

[Feasibility multi-center study of artificial intelligence assistance in cervical fluid-based cytology diagnosis]

Objective: To propose a method of cervical cytology screening based on deep convolutional neural network and compare it with the diagnosis of cytologists. Method: The deep segmentation network was used to extract 618 333 regions of interest (ROI) from 5, 516 cytological pathological images. Combined with the experience of physicians, the deep classification network with the ability to analyze ROI was trained. The classification results were used to construct features, and the decision model was used to complete the classification of cytopathological images. Results: The sensitivity and specificity were 89.72%, 58.48%, 33.95% and 95.94% respectively. Among the smears derived from four different preparation methods, this algorithm had the best effect on natural fallout with a sensitivity of 91.10%, specificity of 69.32%, positive predictive rate of 41.41%, and negative predictive rate of 97.03%. Conclusion: Deep convolutional neural network image recognition technology can be applied to cervical cytology screening.

Correlations between retinal nerve fiber layer thickness and cognitive progression in Parkinson's disease: A longitudinal study

BACKGROUND

Retinal abnormalities measured by optical coherence tomography (OCT) have been detected in both Parkinson's disease (PD) and Alzheimer's disease (AD). Cognitive impairment is not only found in AD, but 75-90% of PD patients will also develop dementia in the late stage of disease. We assessed whether baseline retinal nerve fiber layer (RNFL) thickness predicted worsening of cognitive status over time and the correlation between RNFL thickness and the detailed impaired cognitive domains in PD.

METHODS

RNFL thickness was measured using high-definition OCT in 78 non-dementia PD patients. Clinical and cognitive assessments were performed at baseline and at 3.61 ± 0.65 years follow-up. Linear mixed-effects models were used to examine associations between RNFL thickness and the changes in cognitive test scores, after adjusting for age, sex, disease duration and education.

RESULTS

Analysis of outcomes according to baseline RNFL tertiles showed worse performance in global cognitive tests, delayed memory, and executive functions in patients with a thin RNFL. During follow-up, greater cognitive deterioration was found in thin RNFL tertile patients. Lower baseline average RNFL thickness was associated with greater annualized decline in Mini-Mental State Examination and Montreal Cognitive Assessment.

CONCLUSION

The correlation between RNFL thickness and cognitive dysfunction suggests that OCT may be useful for predicting cognitive dysfunction in PD patients.

[Clinical analysis of children with cardiac syncope caused by anomalous origin of the left coronary artery from the right sinus]

Objective: To analysis the clinical characteristics and to summarize therapy experience of pediatric patients with cardiac syncope caused by anomalous origin of the left coronary artery from the right sinus (ALCA-R). Methods: We retrospectively analyzed the clinical data including clinical manifestations, myocardial injury biomarkers, radiological features, treatments and prognoses of pediatric patients with ALCA-R who were admitted to Beijing Children's Hospital from November 2015 to June 2018. Results: Four female patients were included in this analysis, age of onset was 7 to 14 years. All the patients presented with exercise-induced syncope and acute myocardial infarction. During the course, three patients presented with acute left heart failure, and one patient had history of sudden cardiac arrest. Laboratory data showed significant elevation of both the creatine kinase and troponin levels in four patients. All electrocardiogram (ECG) showed left main coronary artery occlusion, echocardiography suggested the possible anomalous origin of the left coronary artery in one child. Coronary CT angiography (CTA) revealed there was no coronary ostium in the left coronary sinus, and the left coronary artery had an anomalous origin from the right sinus. The left main coronary artery passed between the ascending artery and the root of the main pulmonary artery, which was compressed by these two large vessels. Two patients underwent cardiac magnetic resonance examination, which detected late gadolinium enhancement in ALCA-R with an interarterial course. Unroofing of the left coronary ostium (cut-back procedure) was performed in two patients, and the other two patients who were not operated were recommended to restrict their physical activities. During a regular follow-up period of 12-43 months, all the children survived without recurrent cardiovascular event. Conclusion: If an adolescent presents with exercise-induced syncope, acute myocardial infarction and even sudden death, and ECG shows left main coronary artery occlusion characteristics, we should consider the possibility of developmental abnormality of coronary artery, particularly the ALCA-R. Once diagnosed as ALCA-R, patients should be recommended to avoid strenuous activities，early recognition and surgical treatment are imperative for these patients.

[Analysis of four children with anomalous origin of the left coronary artery from the right sinus with interarterial course]

Objective: To investigate the clinical features and improve the diagnosis and treatment of anomalous origin of the left coronary artery from the right coronary sinus with an interarterial course (ALCA-R-IAC) between the ascending aorta and main pulmonary artery in children. Methods: A retrospective analysis of the clinical manifestation, laboratory test, radiological feature, treatment and prognosis were conducted in four female children presented with ALCA-R-IAC in Beijing Children's Hospital from November 2015 to June 2018. Results: The four girls with onset age of 7.5-14.7 years were diagnosed with ALCA-R-IAC by CT coronary angiography (CTCA). Four children presented with exercise-induced syncope and clinical manifestations of acute myocardial infarction including 3 patients with acute left heart failure, 1 cardiogenic shock and 1 cardiac arrest. Nervous system involvement was found in one patient. Troponin I increased significantly to 20.65-50.00 μg/L in the four patients. Electrocardiogram (ECG) developed signs of left main coronary artery involvement. Echocardiography revealed reduced left ventricular ejection fraction (LVEF) of 25%-45% in three children and suspected anomalous origin of the left coronary artery in one child. CTCA showed an anomalous left coronary artery originating from the right coronary sinus, which had an interarterial course between the aorta and pulmonary artery leading to a slim left main coronary trunk. Two children underwent unroofing procedure and the other two children in whom physical activities were restricted received conservative managements. During a regular follow-up period of 12-43 months, all the children survived without recurrent symptoms and had good prognosis. Conclusions: ALCA-R-IAC can present as exercise-related syncope and acute myocardial infarction, even sudden death in children and adolescents. CTCA is helpful to clarify the early diagnosis of ALCA-R-IAC. Surgical intervention is the main treatment for ALCA-R-IAC and strenuous physical activities should be avoided.

[Effect of induced labor on delivery outcome of pregnant women undergoing vaginal trial of labor after cesarean section]

Objective: To explore the effect of induced labor on delivery outcome of pregnant women undergoing vaginal trial of labor after cesarean section. Methods: Totally, 173 pregnant women undergoing vaginal trial of labor after cesarean from April 1st, 2016 to October 31st, 2017 were involved. According to whether or not induced labor, pregnant women were divided into induced labor group (n=47) and natural labor group (n=126). The two groups of the general situation, the situation of delivery and delivery outcome were compared. Further more, the induced labor group were divided into cesarean section patients (n=20) and vaginal delivery patients (n=27) based on pregnancy outcomes, induction situation and delivery situation were analyzed. Results: (1) The gestational weeks was 39.2±1.1 in induced labor group, 38.7±1.0 in natural labor group. The 1-minute Apgar score was 9.98±0.15 in induced labor group, and 9.87±0.60 in natural labor group. The neonatal weight was (3 497±426) g in induced labor group, and (3 288±350) g in natural labor group. The thickness of lower uterine segment at 36-39 weeks of pregnancy was (2.4±0.6) mm in induced labor group, (2.1±0.6) mm in natural labor group. There were obviously differences in the gestational week, the 1-minute Apgar score, the neonatal weight and the thickness of lower uterine segment at 36-39 weeks of pregnancy between the two groups (all P<0.05). There were no significant differences in 5-minute Apgar score, the interval between previous cesarean delivery, postpartum hemorrhage, fetal distress, and intrauterine infection, secondary uterine inertia, placental abruption and uterine ruption between the two groups (all P>0.05). (2) In induced labor group, the cervical score of cesarean section patients was 3.8±1.7, while the cervical score of vaginal delivery patients was 5.2±1.7. The induced labor days of cesarean section patients was (1.6±0.9) days, while the induced labor days of vaginal delivery patients was (1.2±0.4) days. There were obviously differences in the cervical score and the induced labor days among the two subgroup patients (all P<0.05). There were no significiant differences in Apgar score, neonatal weight, the thickness of lower uterine segment at 36-39 gestational weeks and the interval times of previous cesarean delivery between the two subgroup patients (P>0.05). Conclusion: Induction of labor does not reduce neonatal Apgar score, and does not increase the incidence of postpartum complications, and eliminats the increase of cesarean section rate caused by increased gestational weeks and fetal enlargement, and increases the vaginal delivery rate of pregnant women undergoing vaginal trail of labor after cesarean section.

[Meta-analysis of the outcomes of associating liver partition and portal vein ligation for staged hepatectomy versus portal vein embolization for the treatment of liver cancer with insufficient future liver remnant]

Objective: To explore the feasibility, safety and efficacy of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) and portal vein embolization (PVE) for the treatment of liver cancer with insufficient future liver remnant (FLR) . Methods: The data regarding the clinical controlled trials in comparison of ALPPS and PVE in liver surgery were collected from the both domestic and international publications searched through the datebases of PubMed, Cochrane Library, Embase, CNKI, and VIP.Meta analysis was performed by RevMan 5.3 software. Results: Total 10 studies with clinical control were analyzed (9 cohort studies and 1 randomized controlled study) .A total of 620 patients were included, with 165 cases in ALPPS group, 455 cases in PVE group.Results of Meta-analysis showed that there was statistically significant difference (P<0.05) between the two groups in the completion rate of two-steps surgery (OR=6.04, 95%CI: 2.97-12.31, Z=4.96) , FLR growth rate (MD=19.91, 95% CI: 8.64-31.18, Z=3.46) , two-steps surgical interval (MD=-30.48, 95%CI: -37.87--23.09, Z=8.09) , and R0 resection rate (OR=2.29, 95%CI=1.07-4.90, Z=2.13) .While there was no significant differences between the two groups in the mortality rate of postoperative within 90-days, postoperative the total complication rates, postoperative liver failure, and total hospital stay (all P>0.05) . Conclusions: Compared to the PVE procedures, ALPPS appears an effective treatment method for liver tumor with insufficient FLR.Therefore, the applications of ALPPS and PVE are limited and depending on further investigation.

[Retrospective cohort study on subtotal colonic bypass plus colostomy with antiperistaltic cecoproctostomy in the treatment of senile slow transit constipation]

Objective: To investigate the clinical efficacy of laparoscopic subtotal colonic bypass plus colostomy with antiperistaltic cecoproctostomy (SCBCAC) in the treatment of senile slow transit constipation. Methods: A retrospective cohort study was performed. Clinical data of 30 colonic slow transit constipation patients aged ≥70 years old undergoing laparoscopic SCBCAC from July 2012 to October 2016 (bypass plus colostomy group), and 28 patients undergoing laparoscopic subtotal colonic bypass with antiperistaltic cecoproctostomy (SCBAC) from February 2009 to June 2012 (bypass group) at our institute were collected. Efficacy was compared between the two procedures. Inclusion criteria: (1) meeting the Rome III diagnosis criteria for constipation; (2) confirmed diagnosis of slow transit constipation; (3) age ≥ 70 years old; (4) receiving non-surgical treatment for more than 5 years, and Wexner constipation score > 15; (5) follow-up for more than 2 years. Those with psychiatric symptoms or previous psychiatric history, obvious signs of outlet obstructive constipation, organic diseases of the colon and life-threatening cardiovascular diseases or cancer were excluded. In the bypass plus colostomy group, laparoscopy was performed via five trocars. The ileocecal junction and the ascending colon were mobilized and the ileocecal junction was pulled down to the pelvic inlet. The ascending colon was transected and the appendix was excised. The lateral peritoneum of the sigmoid colon and the rectal mesentery were dissected and the upper rectum was transected. The avil of a circular stapler was placed in the bottom of the cecum. The shaft of the stapler was placed in the rectum via the anal canal to complete end-to-side anastomosis (end rectum to lateral cecum). The end of the rectal-sigmoid colon was used for colostomy via an extraperitoneal approach to complete the operation. The following efficacy indexes were collected before surgery and 3, 6, 12, and 24 months after surgery: the number of daily bowel movements, the Wexner incontinence scale (WIS, 0-20, the lower the better), the Wexner constipation scale (WCS, 0-30, the lower the better), the gastrointestinal quality of life index (GIQLI, 0-144, the higher score, the better), abdominal pain intensity indicated by the numerical rating scale (NRS, 0-10, the lower score, the better), and the abdominal bloating score (ABS, 0-4, the lower score, the better). The complications defined as Clavien-Dindo class II or above were observed and recorded. Results: No significant differences in preoperative WCS, WIS, GIQLI, NRS, and ABS were observed between bypass plus colostomy group and bypass group (all P>0.05). All the patients successfully underwent laparoscopic surgery and no patient in either group experienced postoperative fecal incontinence. WCS and GIQLI were significantly improved (all P<0.001) at 3, 6, 12, and 24 months after surgery in both groups. At 12 months after surgery, the number of bowel movements was significantly less in bypass plus colostomy group than that in bypass group [(2.4±0.7) times vs. (3.4±1.2) times, t=4.048, P<0.001]. At 3, 6, 12 and 24 months after surgery, the improvement of GIQLI in bypass plus colostomy group was significantly better than that in bypass group (all P<0.001). At 24 months after surgery, GIQLI in bypass plus colostomy group and bypass group was 122.3±5.3 and 92.8±16.6, respectively, with a significant difference (t=9.276, P<0.001). At 12 and 24 months after surgery, NRS in bypass plus colostomy group was significantly better than that in bypass group (both P<0.001). At 24 months after surgery, NRS in bypass plus colostomy group was 0.9±0.7, while that in bypass group was 3.7±2.7. There was a significant difference between two groups (t=5.585, P<0.001). At 6, 12 and 24 months after surgery, the improvement of ABS in bypass plus colostomy group was also significantly better than that in bypass group. At 24 months after surgery, ABS in bypass plus colostomy group was 0.6±0.6, while that in bypass group was 2.5±1.0, with a significant difference between two groups (t=8.797, P<0.001). At 1 year after surgery, barium enema examination was performed in all the patients of both groups. The barium emptying time was (21.2±3.8) hours and (95.8±86.2) hours in bypass plus colostomy group and bypass group respectively. The former group was significantly better than the latter group (t=4.740, P<0.001). Conclusions: Laparoscopic SCBCAC is an effective and safe procedure for the treatment of senile slow transit constipation and can significantly improve prognosis. Its clinical efficacy is better than laparoscopic SCBAC.

[Survey of prevalence of iron deficiency and iron deficiency anemia in pregnant women in urban areas of China]

Objective: To investigate the prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) in pregnant women in urban areas of China. Methods: The study was a national cross-sectional survey conducted from September 19th, 2016 to November 20th, 2016. According to the classification of the National Bureau of Statistics, all survey sites were set up in 6 regions of the country.Pregnant women were continuously selected using multistage stratified sampling. A total of 12 403 pregnant women were collected and examined for serum ferritin and hemoglobin levels. Results: The median serum ferritin level during pregnancy was 20.60 μg/L (11.78-36.98 μg/L) , the hemoglobin level was (118±12) g/L. With the progress of pregnancy, the levels of serum ferritin and hemoglobin decreased gradually. The median serum ferritin levels in the first, second trimester and third trimester were 54.30 μg/L (34.48-94.01 μg/L) , 28.60 μg/L (16.40-50.52 μg/L) , and 16.70 μg/L (10.20-27.00 μg/L) respectively (P<0.01) . The mean hemoglobin levels were (127±10) g/L, (119±11) g/L and (117±11) g/L respectively (P<0.01) . The prevalence of ID in urban pregnant women was 48.16% (5 973/12 403) , and IDA prevalence was 13.87% (1 720/12 403) . The prevalence of IDA in the first, second trimester and third trimester were 1.96% (20/1 019) , 8.40% (293/3 487) and 17.82% (1 407/7 897) ,respectively (P<0.01) . The prevalence of standardized ID and IDA were significantly different in various regions of China (P<0.01) . The standardized prevalence of ID were relatively higher in East China and Northeast China, 57.37% and 53.41% respectively, while it was the lowest in Southwest China, 30.51%. The standardized prevalence of IDA in South Central, Northwest, and East China were relatively high, 21.30%, 16.97% and 17.53% respectively, and the standardized prevalence of IDA in Southwest China was the lowest, 5.44%, the differents in various regions were significant (all P<0.01) . Conclusion: The current phenomenon of ID and IDA in pregnant women is still very common, and nutrition and health care during pregnancy should be strengthened.

Effect of Rapid Eye Movement Sleep Behavior Disorder on Obstructive Sleep Apnea Severity and Cognition of Parkinson's Disease Patients

Background:

Rapid eye movement (REM) sleep behavior disorder (RBD) and obstructive sleep apnea (OSA) are the most common sleep disorders in Parkinson's disease (PD). The aim of this study was to identify whether RBD could alleviate OSA severity in PD patients and its effect on cognitive impairment.

Methods:

From February 2014 to May 2017, we recruited 174 PD patients from the Second Affiliated Hospital of Soochow University, all of whom underwent polysomnography (PSG). We collected clinical data, PSG results, and compared information between patients with and without RBD or OSA by analysis of covariance. We also investigated the effect of these sleep disorders on cognitive impairment using linear regression.

Results:

We grouped participants as follows: PD only (n = 53), PD + OSA (n = 29), PD + RBD (n = 61), and PD + RBD + OSA (n = 31). Minimum oxygen saturation (SaO₂) during whole sleep and in REM sleep was higher in PD + RBD + OSA patients than that in PD + OSA patients. PD + RBD patients had worse Mini-Mental Status Examination and Montreal Cognitive Assessment (MoCA) scores than those in the PD group (P < 0.001), especially in visuospatial/executive, attention, and memory functions. The PD + OSA group performed worse than the PD group in the delayed recall domain. After adjusting for age, sex, body mass index, education, disease severity, and other sleep disorders, MoCA was negatively associated with OSA (β = −0.736, P = 0.043) and RBD (β = −2.575,P < 0.001). The severity of RBD (tonic/phasic electromyography activity) and OSA (apnea-hypopnea index/oxygen desaturation index/minimum SaO₂) were also associated with MoCA. The adjusted β values of RBD-related parameters were higher than that for OSA.

Conclusions:

We found that RBD alleviated OSA severity; however, RBD and OSA together exacerbated PD cognitive impairment. Further studies are needed to evaluate whether OSA treatment can improve cognition in PD.

[Current status of ALPPS in the treatment of advanced liver cancer with insufficient future liver remnant]

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) which represented a new two-steps liver resection procedures has been considered a revolutionary innovation for liver surgery technique in recent 10 years, it was first discovered by Professor Lang in Germany in 2007.The first step of the classic surgical procedures for portal vein ligation and liver parenchyma, until the future liver remnant (FLR) increased to a sufficient remnant then resect the right three-leaf liver.With the development of ALPPS, the method of hepatic parenchyma separation and isolation materials have been modified, which improves the safety of operation.ALPPS can speed up the regeneration of FLR in short period of time and therefore accurate assessment of FLR and liver reserve function preoperatively, which also can effectively prevent postoperative liver failure.However, it still remains controversy due to the high incidences of mobility and mortality perioperatively, how to solve this problem and chose the indications is the key.In China, 80% of liver cancer patients are associated with liver cirrhosis which the potential of FLR regeneration is limited. Whether ALPPS is applicable to the liver cancer patients in China remains to be further investigated, looking forward to a large number report of cases to give a more objective assessment.

Th1/Th2 cytokine expression in diabetic retinopathy

Diabetic retinopathy (DR), an important complication of diabetes mellitus (DM), is not well understood. T helper cell balance (Th1/Th2) is involved in various autoimmune diseases; however, its role in DR is not understood. This study explores changes in Th1 and Th2 cytokine expression during DR. Blood samples were collected from 25 healthy volunteers (normal control group), 35 patients with type 2 DM (T2DM group) without DR, and 30 cases of T2DM patients with DR (DR group). Real-time PCR was used to measure mRNA expression of IL-2 and TNF-α, secreted from Th1 cells, and of IL-4 and IL-10, secreted from Th2 cells. We used ELISA to detect cytokine expression in serum to analyze the correlation between Th1 and Th2 cytokines. IL-2 and TNF-αmRNA and protein expression levels in the T2DM and DR groups were significantly higher than in the normal control group (P < 0.05). Compared with the T2DM group, the DR group had higher IL-2 and TNF-αlevels (P < 0.05). IL-4 and IL-10 levels were lower in the DR group compared with the normal and T2DM groups (P < 0.05), while T2DM showed no difference compared with the normal control (P > 0.05). IL-2 and TNF-αwere negatively correlated with IL-4 and IL-10 in the DR group, respectively. We found that Th1 cytokine secretion was higher and Th2 cytokines secretion was lower during DR, leading to a Th1/ Th2 imbalance, suggesting that Th1/Th2 imbalance is a side effect for DR occurrence and development.

Simple template fabrication of porous MnCo2O4 hollow nanocages as high-performance cathode catalysts for rechargeable Li-O2 batteries

Porous MnCo2O4 hollow nanocages have been fabricated via a simple template method using carbon spheres as a template. The hydrophilic surface of carbon spheres can adsorb Mn(2+) and Co(2+) ions simultaneously to form Mn,Co-adsorbed carbon spheres. The calcination of Mn,Co-adsorbed carbon spheres can result in porous hollow nanocages of MnCo2O4. The MnCo2O4 hollow nanocages are built by nanoscale MnCo2O4 crystals. Because of the unique porous hollow nanostructures, the resulting MnCo2O4/KB cathode shows an efficient electrocatalytic performance in LiTFSI/TEGDME electrolyte-based Li-O2 batteries. The MnCo2O4 hollow nanocages as the cathode catalysts can deliver better performance during the discharge/charge processes and good cycle stability compared with that of the pure KB carbon. The preliminary results manifest that porous MnCo2O4 hollow nanocages are promising high-performance cathode catalysts for Li-O2 batteries. This template technique is a simple, general, low-cost and controllable method and can be extended to prepare other transition metal oxide hollow nanostructures.

[The clinical study of IgA nephropathy with severe chronic periodontitis and aggressive periodontitis]

OBJECTIVE

To explore the clinical characteristics of IgA nephropathy (IgAN) with severe chronic periodontitis and aggressive periodontitis.

METHODS

A total of 436 hospitalized patients who underwent renal needle biopsy in the department of nephrology of China-Japan Friendship Hospital from November 2013 to December 2014 were recruited in the study and blindly had periodontal examination. The patients were divided into IgAN group and non-IgAN group according to the renal pathology. The patients with IgAN were further categorized as non-periodontitis, chronic periodontitis and aggressive peridontitis group by Haas classification. The chronic periodontitis group was continually divided into mild, moderate and severe periodontitis group. The levels of interleukin (IL)-1β and IL-6 in gingival crevicular fluid were analyzed by enzyme-linked immunosorbent assays.

RESULTS

The prevalence of periodontitis in the study was 88.3% (385/436). The prevalence of chronic periodontitis and aggressive periodontitis were higher in patients with IgAN than those with non-IgAN (P<0.05). Degree of chronic periodontitis was correlated with pathologic grading of IgAN (r=0.48, P<0.001). Compared with IgAN patients with other types of periodontitis, those with severe chronic and aggressive periodontitis had more severe pathology, more frequent recurrent gross hematuria, higher levels of 24 h proteinuria, serum triglyceride and uric acid, higher periodontal probing depth and clinical attatchment level, as well as higer levels of IL-1β and IL-6, but had lower creatinine clearance rate (all P<0.05).

CONCLUSIONS

The prevalence of severe chronic and aggressive periodontitis was higher in patients with IgAN. Chronic periodontitis is correlated with the onset and development of IgAN. Patients with IgAN have worse condition with the aggravation of periodontitis.

A pivotal role of FOS-mediated BECN1/Beclin 1 upregulation in dopamine D2 and D3 receptor agonist-induced autophagy activation

Autophagy dysfunction is implicated in the pathogenesis of Parkinson disease (PD). BECN1/Beclin 1 acts as a critical regulator of autophagy and other cellular processes; yet, little is known about the function and regulation of BECN1 in PD. In this study, we report that dopamine D2 and D3 receptor (DRD2 and DRD3) activation by pramipexole and quinpirole could enhance BECN1 transcription and promote autophagy activation in several cell lines, including PC12, MES23.5 and differentiated SH-SY5Y cells, and also in tyrosine hydroxylase positive primary midbrain neurons. Moreover, we identified a novel FOS (FBJ murine osteosarcoma viral oncogene homolog) binding sequence (5′-TGCCTCA-3′) in the rat and human Becn1/BECN1 promoter and uncovered an essential role of FOS binding in the enhancement of Becn1 transcription in PC12 cells in response to the dopamine agonist(s). In addition, we demonstrated a critical role of intracellular Ca²⁺ elevation, followed by the enhanced phosphorylation of CAMK4 (calcium/calmodulin-dependent protein kinase IV) and CREB (cAMP responsive element binding protein) in the increases of FOS expression and autophagy activity. More importantly, pramipexole treatment ameliorated the SNCA/α-synuclein accumulation in rotenone-treated PC12 cells that overexpress wild-type or A53T mutant SNCA by promoting autophagy flux. This effect was also demonstrated in the substantia nigra and the striatum of SNCA^A53T transgenic mice. The inhibition of SNCA accumulation by pramipexole was attenuated by cotreatment with the DRD2 and DRD3 antagonists and Becn1 siRNAs. Thus, our findings suggest that DRD2 and DRD3 agonist(s) may induce autophagy activation via a BECN1-dependent pathway and have the potential to reduce SNCA accumulation in PD.

TNF compromises lysosome acidification and reduces α-synuclein degradation via autophagy in dopaminergic cells

Tumor necrosis factor-α (TNF) is increasingly implicated as a critical pro-inflammatory cytokine involved in chronic inflammation and neurodegeneration of Parkinson's disease (PD). However, the cellular and molecular events that lead to dopaminergic neuron degeneration are not fully understood. In this study, we demonstrated that microglia-released and recombinant TNF disrupted α-synuclein (α-SYN) degradation and caused its accumulation in PC12 cells and midbrain neurons. At subtoxic doses, recombinant TNF was found to increase the number of LC3 puncta dots and LC3II protein level, associated with the increases of P62 protein level. Inhibition of lysosomal degradation with Bafilomycin A1 pretreatment abrogated the TNF-induced elevation in LC3II protein level whereas autophagy inhibitor 3-methyladenine did not affect it. Moreover, TNF led to a marked increase in the number of yellow LC3 dots with a marginal elevation in red-only dots in RFP-GFP-tandem fluorescent LC3 (tf-LC3) transfected PC12 cells, implying the impairment in autophagic flux. Furthermore, TNF treatment reduced lysosomal acidification, as LysoTracker Red fluorescence and LysoSensor fluorescence shift from blue to yellow was markedly decreased in TNF-treated PC12 cells. Co-treatment with mammalian target of rapamycin kinase complex 1 (mTORC1) inhibitor PP242, which activated transcription factor EB (TFEB) signaling and lysosome biogenesis, partially rescued the accumulation of α-SYN in PC12 cells and midbrain neurons. Taken together, our results demonstrated that at subtoxic levels, TNF was able to impair autophagic flux and result in α-SYN accumulation by compromising lysosomal acidification in dopaminergic cells. This may represent a novel mechanism for TNF-induced dopaminergic neuron degeneration in PD.

Changes of peripheral-type benzodiazepine receptors in the penumbra area after cerebral ischemia-reperfusion injury and effects of astragaloside IV on rats

This study investigated the changes in peripheral benzodiazepine receptors (PBRs) in the penumbra after cerebral ischemia-reperfusion injury, and examined the effects of astragaloside IV (AST) on PBRs in rats. Sixty Sprague-Dawley rats were divided into a sham operation group, a model group, and three AST treatment groups. Cerebral ischemic models were induced by the clue-blocked method. Neurological deficits were examined. The animals were sacrificed after 2 h of ischemia and 24 h of reperfusion, and mitochondria from the penumbra were purified. PBR density (Bmax) and affinity were measured by radioligand assays. Mitochondrial [(3)H]PK11195 binding was correlated with neurological deficits in rats. Compared to the model group, the 10 mg/kg AST group, 40 mg/kg AST group, and 100 mg/kg AST group had fewer neurological deficits. The effects in the 40 mg/ kg group did not significantly differ from the effects in the 100 mg/ kg group. Compared to the model group, the 10 mg/kg AST group, 40 mg/kg group, and 100 mg/kg group had a decreased Bmax in the penumbra. The Bmax decreased in the 40 mg/kg AST group and in the 100 mg/kg AST group compared with the 10 mg/kg group. The Bmax and neurological deficits in the 40 mg/kg did not significantly differ from those in the 100 mg/kg group. By contrast, the AST-treated rats showed no significant changes in the binding parameter equilibrium dissociation constant compared with those in the sham operation group and the model group. AST protects ischemic brain tissue by inhibiting PBR expression after cerebral ischemia.

Cross-leg repair of large soft-tissue defects in distal sites of the feet by distally based neuro-fasciocutaneous flaps with perforating vessels

The objective of this study was to introduce a method for repairing large soft-tissue defects on the foot. Distally based neuro-fasciocutaneous flaps with perforating vessels were designed along the saphenous and sural neurovascular axes. The cutaneous perforating branches of the major arteries of the lower extremities were used as pedicles, which provided a rotation arc for the cross-leg flap to cover the large-sized soft-tissue defects on the foot. We transferred 6 neurocutaneous vascular axial flaps, including 4 saphenous neurocutaneous axial flaps (ranging from 25 x 13 to 17 x 9 cm in area) with posterior tibial perforators as the pedicle, and 2 sural neurocutaneous axial flaps (ranging from 29 x 12 to 18 x 7 cm in area) supplied by the perforating branches of the peroneal vessels. These 6 cases of neuro-fasciocutaneous flaps survived with satisfactory cosmetic appearances and functional results on follow-up at 8 to 17 months post-surgery. Placing a distally based neuro-fasciocutaneous cross-leg flap with perforating vessels is an effective method for repairing large-sized soft-tissue defects on the foot.

An all-organic rechargeable battery using bipolar polyparaphenylene as a redox-active cathode and anode

An all-organic rechargeable battery is realized by use of polyparaphenylene as both cathode- and anode-active material. This new battery can operate at a high voltage of 3.0 V with fairly high capacity, offering a renewable and cheaper alternative to conventional batteries.

In-situ phosphrous doping in ZnTe nanowires with enhanced p-type conductivity

Single-crystalline undoped and phosphrous-doped (P-doped) p-type ZnTe nanowires (NWs) were synthesized via a simple vapor transport and deposition method. Both undoped and P-doped ZnTe nanowires have zinc blende structure and uniform geometry. X-ray diffraction peaks of the P-doped ZnTe nanowires show an obvious shift toward higher diffraction angle as compared with the undoped ZnTe nanowires. X-ray photoelectron spectroscopy confirms the existence of P-dopant in the ZnTe nanowires. Field-effect transistors based on both undoped and P-doped ZnTe nanowires were fabricated and characterized. Electrical measurements demonstrated that P-doping led to an enhancement in ptype conductivity of ZnTe nanowires. A defect reaction mechanism was proposed to explain the p-type behaviors of both undoped and P-doped ZnTe nanowires.

Single-crystalline ZnTe nanowires for application as high-performance green/ultraviolet photodetector

Single-crystalline ZnTe nanowires were prepared by a simple vapor transport and deposition method. Photodetectors of individual ZnTe nanowires were fabricated to study photoconductivity of the nanowires. It was observed the nanowire photodetectors show the highest visible-light photoconductive gains among all reported photodetectors based on 1D nanostructure semiconductors, including CdS, CdSe, ZnSe, etc. The high photosensitivity and relatively fast response speed are attributable to the high crystal quality of the ZnTe nanowires. These results reveal that such single-crystalline ZnTe nanowires are excellent candidates for optoelectronic applications.

Transport stress in broilers. II. Superoxide production, adenosine phosphate concentrations, and mRNA levels of avian uncoupling protein, avian adenine nucleotide translocator, and avian peroxisome proliferator-activated receptor-gamma coactivator-1alpha in skeletal muscles

The effect of transport stress on superoxide production and adenosine phosphate concentration in addition to avian uncoupling protein (avUCP), avian adenine nucleotide translocator, and avian peroxisome proliferator-activated receptor-gamma coactivator-1alpha mRNA levels of skeletal muscles in broilers was investigated. Arbor Acres chicks (n = 360, 46 d old, males) were randomly allotted to 1 of 5 treatments: unstressed control, 45-min (short-term) transport with 45-min (short-term) recovery, 45-min transport with 3-h (long-term) recovery, 3-h (long-term) transport with 45-min recovery, and 3-h transport with 3-h recovery. Each treatment consisted of 6 replicates with 12 birds each. All birds (except control group) were transported according to a designed protocol. Transport time affected reactive oxygen species production in the thigh muscle (P < 0.05), adenosine triphosphate (ATP) content and energy charge (EC) in both breast and thigh muscles (P < 0.05 for all 4 comparisons), ATP:adenosine diphosphate (ADP) ratio in the breast muscle (P < 0.05), and avUCP mRNA levels in the thigh muscle (P < 0.05). Long-term transport increased (P < 0.05) reactive oxygen species production, ATP content, ATP:ADP ratio, and EC in the thigh muscle, but it decreased ATP content, ATP:ADP ratio, and EC in the breast muscle. Long-term transport increased avUCP mRNA in the thigh muscle (P < 0.05). Long-term recovery increased the ATP (P < 0.05) and ADP (P < 0.05) concentrations, avian adenine nucleotide translocator mRNA (P < 0.05), and avian peroxisome proliferator-activated receptor-gamma coactivator-1alpha mRNA (P < 0.05) in the thigh muscle, whereas EC decreased (P < 0.05) in the breast muscle. There were interactions between transport and recovery time on ATP (P < 0.05), EC (P < 0.05), and avUCP mRNA level (P < 0.05) in the thigh muscle. This study suggests that long-term transport accelerates muscle energy metabolism and lipid peroxidation. A long-term recovery may help alleviate cellular damage and maintain meat quality by reducing the rate of energy metabolism and scavenging of free radicals formed.

Coaxial nanocables of p-type zinc telluride nanowires sheathed with silicon oxide: synthesis, characterization and properties

Coaxial nanocables with a single-crystalline zinc telluride (ZnTe) nanowire core and an amorphous silicon oxide (SiO(x)) shell have been synthesized via a simple one-step chemical vapor deposition (CVD) method on gold-decorated silicon substrates. The single-crystal ZnTe nanowire core is in zinc-blende structure along the [111] direction, while the uniform SiO(x) shell fully covers the core with no observable pin-hole or crack. Formation mechanisms of the ZnTe-SiO(x) nanocables are discussed. The ZnTe nanowire core shows p-type electrical properties while the SiO(x) shell acts as an effective insulating layer. The ZnTe-SiO(x) nanocables may have potential applications in nanoscale devices, such as p-type FETs and nanosensors.

Micro- and nanocubes of carbon with C8-like and blue luminescence

Micro- and nanocubes of carbon have been synthesized by laser ablation in liquid. The morphology and structure analyses indicated that these micro- and nanocubes are single crystals with a body-centered cubic structure with a lattice constant of 5.46 angstroms, which is so-called C 8-like structure, and they have a slightly truncated shape bounded mainly by (200) facets. A blue-purple luminescence at room temperature was observed in the cathodoluminescence spectrum of the synthesized single micro- and nanocube of carbon, which exhibited that this unique carbon nanomaterial is a new semiconductor with blue luminescence. The physical and chemical mechanisms of the synthesis of carbon micro- and nanocubes were pursued upon laser ablation in liquid.

Properties of MSW fly ash-calcium sulfoaluminate cement matrix and stabilization/solidification on heavy metals

In this paper, investigations were undertaken to formulate the properties of fly ash-calcium sulfoaluminate (CSA) cement matrix by blending MSW fly ash with CSA cement. The compressive strength, pore structure, hydration phases, and leaching behavior of Zn and Pb doped MSW fly ash-CSA cement matrices were determined by XRD, MIP, DSC, FTIR, EDX, TCLP leaching test and other experiments. The results showed that the addition of MSW fly ash to form fly ash-CSA cement matrix reduced the compressive strengths of matrices and made the pore distribution of matrices coarser, compared to that of pure CSA cement matrix. However, fly ash-CSA cement matrix could effectively immobilize high concentration of heavy metal such as lead and zinc with much lesser leaching of TCLP. Besides ettringite AFt, Friedel phase was a new hydration phase formed in the matrix. The formation of these hydration phases was responsible for huge reservoir of heavy metal stabilization by chemical fixing. Therefore, it could be postulated that MSW fly ash-CSA cement matrix was a potential new constituent of S/S matrix for high concentration of heavy metals such as Zn and Pb ions.

The cryopreservation of a tissue engineered dermal replacement by programmed freezing

Long-term storag of engineered bio-artificial tissues is required to ensure the off-the-shelf availability to clinicians due to their long production cycle. Cryopreservation is likely the choice for long-term preservation. This study investigated the effects of dimethyl sulfoxide (DMSO) concentrations, cooling rates, cryoprotectant medium treatment methods and seeding on the cell viability of a tissue-engineered dermal substitute. The dermal fibroblast was cultured on a polyglycolic acid (PGA) scaffolding at 37degree C and a 5% CO<inf>2</inf>atmosphere for 14 days, and dermal slices (10&#215;3&#215;1.5mm) were used in the experimental group. The freezing was carried out in a computer-controlled programmable freezer at 0.5degree C/min, 1degree C/min and 2degree C/min in1.4M, 2.1M and 2.8M DMSO from 4degree C to -60degree C and then plunged into the liquid nitrogen tank immediately. After 24th of cryopreservation, the samples wereped in removed from liquid nitrogen and placed at room temperature in air for 0.5-1min, prior to submergence in a water bath at 37 degree C. viability of fresh control and cryopreserved dermal slices were determined with our modification of the MTT (3-[4,5-Dimethythiazol-2-yl] -2,5-diphenyltetrazolium bromide) assay. The effects of two cryoprotectant medium treatment methods and seeding (at -7degree C)on cell viability were also assessed. A cryopreservation protocol of 1degree C/min in 1.4M DMSO from 4degree C to -60degree C, and seeding at -7degree C proved optimal for this tissue-engineered dermal replacement, provided the dermal slice was transferred into the cryopreservation bag containing 1mL 1.4M DMSO bag and hold for 15min at 4degree C prior to freezing.

Experimental study on sludge reduction by ultrasound

In recent years, considerable impetus emerges to develop strategies for reducing excess sludge produced in biological wastewater treatment (BWT) systems. In this study, an experiment on sludge reduction by ultrasound treatment was conducted. The influences of sonication on observed yield, sludge reduction, effluent quality, sludge settleability and stability were extensively evaluated. It was found that ultrasound had an impressive potential to reduce sludge production. Moreover, it was also concluded that a treatment time of 10 minutes was more cost-effective for sludge reduction, and a reduction by 44% was reached with an ultrasonic intensity of 0.25 w/ml. The reduction could be mainly attributed to disintegration of bio-flocs and cryptic growth. In addition, sonication time seemed to be more effective to reduce sludge production compared with ultrasonic intensity. Slight deterioration of the effluent quality and some variations of the sludge settleability and stability were observed after ultrasound treatment.

TGF-beta: a fibrotic factor in wound scarring and a potential target for anti-scarring gene therapy

Hypertrophic scar and keloid are common and difficult to treat diseases in plastic surgery. Results of wound healing research over the past decades have demonstrated that transforming growth factor-beta (TGF-beta) plays an essential role in cutaneous scar formation. In contrast, fetal wounds, which heal without scarring, contain a lower level of TGF-beta than adult wounds. How to translate the discovery of basic scientific research into the clinical treatment of wound scarring has become an important issue to both clinicians and basic researchers. The development of gene therapy techniques offers the potential to genetically modify adult wound healing to a healing process similar to fetal wounds, and thus reduces wound scarring. This article intends to review the roles of TGF-beta in the formation of wound scarring, the possible strategies of antagonizing wound TGF-beta, and our preliminary results of scar gene therapy, which show that wound scarring can be significantly reduced by targeting wound TGF-beta.

Preparation and use of thermosensitive polymers

Restoration of organ structure and function, utilizing tissue engineering technologies, often requires the use of a temporary porous scaffold. The function of the scaffold is to direct the growth of cells migrating from the surrounding tissue (tissue conduction), or of cells seeded within the porous structure of the scaffold. The scaffold must therefore provide a suitable substrate for cell attachment, differentiated function, and, in certain cases, cell proliferation (1-3). These critical requirements may be met by the choice of an appropriate material from which to construct the scaffold, although the suitability of the scaffold may also be affected by the processing technique. There are many biocompatible materials that could potentially be used to construct scaffolds, however, a biodegradable material is normally desirable, since the role of the scaffold is usually only a temporary one. Many natural and synthetic biodegradable polymers, such as collagen, poly(α-hydroxyesters), and poly(anhydrides), have been widely and successfully used as scaffolding materials because of their versatility and ease of processing. Many researchers have used poly(α-hydroxyesters) as starting materials from which to fabricate scaffolds, using a wide variety of processing techniques. These polymers have proven successful as temporary substrates for a number of cell types, allowing cell attachment, proliferation, and maintenance of differentiated function (10). Poly(α-hydroxyesters) such as the polyoxamers are a family of more than 30 different nontoxic, nonionic surface active agents. These compounds are made at elevated temperature and pressure by the sequential additi on of propylene oxide and then ethylene oxide to neutralize the salt that is generally retained in the final product.

[Experimental study for repair of cranial defects with bone marrow stromal cells and modified alginate]

OBJECTIVE

The primary aim of this investigation was to determine whether expanded BMSCs in vitro mixed with modified alginate gelatin could repair critical defects in rats without the addition of exogenous growth or bone morphogenetic factors.

METHODS

Bone marrow stem cells from syngeneic rats cultured in vitro and mixed with modified alginate gel to paint the cranial critical size defect. A full-thickness cranial plate defect was created without damage of dura mater. Modified alginate gelatin with or without BMSCs were painted over the cranial defects. Animals being made cranial defect but received no implant served as sham-operated controls. Craniotomy defects were divided into three groups, which included defects left unpainted (group I, n=6), defects painted with modified alginate gelatin alone (group II, n=6), and defects painted with a modified alginate mixed with BMSCs (group III, n=6). A total of 18 implant experiments were carried out, with postsurgical radiographic and histological analysis completed at 12 week.

RESULTS

None of the implants exhibited extrusion or infection. Radiographs showed a likely increased calcification in group III, without finally new calcification in group I and in group II. Histology showed that group I and group II were featured by thinning of the bone at the edges of the defect margins with minimal bone growth inward and dense fibrous tissue with rudimentary alginate material spanning the intervenient gap. The results demonstrated that a great amount of new bone in growth took place in BMSCs-alginate group, stemming from cranial defect edges and proceeding inward.

CONCLUSION

Transplantation of syngeneic BMSCs with alginate gel can serve as an example of a cell-based treatment for skeletal reformation and would be especially useful for augmenting or regenerating bone in skeletal defects. So syngeneic BMSCs with alginate gel demonstrate a potential technique to regenerate a variety of skeletal defects that occur in different clinical scenaries.

[Autologous tissue engineered skin for full thickness skin replacement]

OBJECTIVE

To evaluate the feasibility of regenerating or repairing damaged skin utilizing tissue engineering techniques.

MATERIALS AND METHODS

Yorkshire pigs were used in the study. A critical size defect of six, full thickness, 4 cm in diameter round wounds, which were marked on the paravertebral region of the animal were excised. The skin defects were randomly divided into three groups. Group I as control group received no cells or polymer. Group II as a second control group received pluronic hydrogel with no cells. Group III as the experimental group received a mixture of cells (keratinocytes and fibroblasts) and pluronic hydrogel. All specimens were harvested at 4 and 6 weeks in vivo, and underwent gross, histological, and transmission electron microscope evaluation.

RESULTS

Histologically, the skin in the experimental group was similar to normal skin with stratified epidermis overlying a moderately thick collageneous dermis. The interface of the tissue was apparently demarcated by epidermal ridges and dermal papillae. The control groups showed no skin formation except for granulation with infiltrating inflammatory cells in the wound. Transmission electron microscopy showed that the basal lamina of the experimental group was well developed and attached to the extracellular matrix.

CONCLUSION

This finding demonstrates the successful use of tissue engineered skin with Pluronic F-127 as a cell carrier.

[Shear bond test of HF acid etching porcelain bonded to enamel with different concentration and disposing time]

OBJECTIVE:Understand the effect of shear bond test of HF acid etching porcelain bonded to enamel with different concentration and disposing time. METHODS:After HF acid etching under 30 groups composed of 5 different HF concentrations and 6 exposing times,shear bonding strength of porcelain to enamel was tested under imitating occlusion and debonding types of the composite were examined by microscope.RESULTS:The favorable concentration-time groups for clinics were 2.5%-5min;5.0%-2.5min;10%-30s;7.5%,15%-5min.The debonding type of porcelain resin enamel composite body was mixed one.CONCLUSION:The results showed HF acid etching technique had a positive influence on the bonding strength of porcelain to enamel.

[The experimental study on optimal cell density and formation time of tissue engineered autologous cartilage]

OBJECTIVE

This paper aims to investigate the suitable cell density and the best formation time of tissue engineered autologous cartilage and to provide theoretical basis and parameters for clinical application.

METHODS

The chondrocytes isolated from mini swines' ears were mixed with injectable biocompatible matrix (Pluronic), and the density of cell suspensions were 10, 20, 30, 40, 50, 60, 70 x 10(4)/ml. The chondrocyte-polymer constructs were subcutaneously injected into the abdomen of autologous swine. The specimens were observed grossly and histologically after 6 weeks, and investigated the suitable cell density. Then the chondrocyte-polymer constructs with suitable cell density were transplanted into the abdomen of autologous swine and evaluated grossly and histologically in 1, 3, 6, 9, 15 weeks after transplantation to investigate the best formation time of tissue engineered cartilage.

RESULTS

The experiments demonstrated that the tissue engineered autologous cartilage was similar to the natural cartilage on animals with normal immune system in histological characteristics. The optimal chondrocyte density is 50 x 10(6)/ml, and the proper harvest time is the sixth week.

CONCLUSION

With tissue engineering skills, we have identified the optimal chondrocyte density and the proper harvest time.

Characteristics of cartilage engineered from human pediatric auricular cartilage

In the repair of cartilage defects, autologous tissue offers the advantage of lasting biocompatibility. The ability of bovine chondrocytes isolated from hyaline cartilage to generate tissue-engineered cartilage in a predetermined shape, such as a human ear, has been demonstrated; however, the potential of chondrocytes isolated from human elastic cartilage remains unknown. In this study, the authors examined the multiplication characteristics of human auricular chondrocytes and the ability of these cells to generate new elastic cartilage as a function of the length of time they are maintained in vitro. Human auricular cartilage, harvested from patients 5 to 17 years of age, was digested in collagenase, and the chondrocytes were isolated and cultured in vitro for up to 12 weeks. Cells were trypsinized, counted, and passaged every 2 weeks. Chondrocyte-polymer (polyglycolic acid) constructs were created at each passage and then implanted into athymic mice for 8 weeks. The ability of the cells to multiply in vitro and their ability to generate new cartilage as a function of the time they had been maintained in vitro were studied. A total of 31 experimental constructs from 12 patients were implanted and compared with a control group of constructs without chondrocytes. In parallel, a representative sample of cells was evaluated to determine the presence of collagen. The doubling rate of human auricular chondrocytes in vitro remained constant within the population studied. New tissue developed in 22 of 31 experimental implants. This tissue demonstrated the physical characteristics of auricular cartilage on gross inspection. Histologically, specimens exhibited dense cellularity and lacunae-containing cells embedded in a basophilic matrix. The specimens resembled immature cartilage and were partially devoid of the synthetic material of which the construct had been composed. Analyses for collagen, proteoglycans, and elastin were consistent with elastic cartilage. No cartilage was detected in the control implants. Human auricular chondrocytes multiply well in vitro and possess the ability to form new cartilage when seeded onto a three-dimensional scaffold. These growth characteristics might some day enable chondrocytes isolated from a small auricular biopsy to be expanded in vitro to generate a large, custom-shaped, autologous graft for clinical reconstruction of a cartilage defect, such as for congenital microtia.

Tissue-engineered nipple reconstruction

We describe a simple, effective approach to the creation of autologous tissue-engineered cartilage in the shape of a human nipple by injecting a reverse thermosensitive polymer seeded with autologous chondrocytes in an immunocompetent porcine animal model. A biodegradable, biocompatible copolymer of polyethylene oxide and polypropylene oxide (Pluronic F-127), which exists as a liquid below 4 degrees C and polymerizes to a thick gel when it is exposed to physiologic temperatures (body temperatures), was used as a vehicle for chondrocyte delivery and as a scaffold to guide growth. Autologous chondrocytes isolated from porcine auricular elastic cartilage and suspended in 30% (weight/volume) Pluronic F-127 were injected on the ventral surface of the pigs from which the cells had been isolated. A circumferential subdermal suture was used to support the contour of the implant and assist in its projection in the form of a human nipple. After 3 weeks, the skin over and surrounding the implant was tattooed to create the appearance of a human nipple-areolar complex. As controls, an equal number of injections were made using either cells alone (not suspended in hydrogel), or hydrogel alone. After 10 weeks, all specimens were excised and examined both grossly and histologically. Before harvesting, visual inspection of the tattooed chondrocyte-Pluronic F-127 hydrogel implant sites revealed that they closely resembled a human female nipple-areolar complex. Nodules were similar in size, shape, and texture to a human nipple at each injection site. Glistening opalescent tissue was surgically isolated from each implant site. Hematoxylin and eosin, safranine o, trichrome blue, and Verhoeff's stains of the experimental implants showed nodules with the characteristic histologic signs of elastic cartilage. Control injections of copolymer hydrogel alone exhibited no evidence of cartilage formation. Control injections of chondrocytes alone showed evidence of dissociated microscopic nodules of elastic cartilage.

Tissue engineered neocartilage using plasma derived polymer substrates and chondrocytes

This study demonstrates that fibrin monomers can be polymerized into moldable gels and used for the encapsulation of isolated chondrocytes. This biologically derived scaffold will maintain three-dimensional spatial support, allowing new tissue development in a subcutaneous space. Chondrocytes isolated from the glenohumeral and humeroradioulnar joints of a calf were combined with cyroprecipitate and polymerized with bovine thrombin to create a fibrin glue gel with a final cell density of 12.5 x 10(6) cells/ml. The polymer-chondrocyte constructs were implanted subcutaneously in 12 nude mice and incubated for 6 and 12 weeks in vivo. Histologic and biochemical analysis including deoxyribonucleic acid (DNA) and glycosaminoglycan quantitation confirmed the presence of actively proliferating chondrocytes with production of a well-formed cartilaginous matrix in the transplanted samples. Control specimens from 12 implantation sites consisting of chondrocytes alone or fibrin glue substrates did not demonstrate any gross or histologic evidence of neocartilage formation. Moldable autogenous fibrin glue polymer systems have a potential to serve as alternatives to current proprietary polymer systems used for tissue engineering cartilage as well as autogenous grafts and alloplastic materials used for facial skeletal and soft-tissue augmentation.

Microsurgical replantation of the avulsed scalp: report of six cases

This article reports the successful microsurgical replantation of six scalps avulsed for over 3 to 11 hr, after trauma and before repair, including five total and one partial avulsion. The authors believe that one key to successful replantation is effective vessel anastomoses. In the reported series, three scalps were reconstructed with two superficial temporal vessels and in five cases, with a 1:1 ratio between arteries and veins. The partially avulsed scalp was replanted successfully with only one artery and one vein. The management of postoperative complications is discussed.

Synthesis and application of Fmoc-hydrazine for the quantitative determination of saccharides by reversed-phase high-performance liquid chromatography in the low and subpicomole range

A new derivatization reagent, Fmoc-hydrazine, has been synthesized from the reaction of Fmoc-chloroformate with hydrazine as a precolumn fluorometric labeling reagent for reducing sugars such as glucose, galactose, mannose, fructose, fucose, ribose, xylose, arabinose, lactose, and maltose. The optimization of derivatization conditions was examined in detail. Using a reversed-phase high-performance C-8 column and a mobile phase consisting of acetonitrile-aqueous acetic acid, seven sugar derivatives were separated under either isocratic or gradient conditions within 20 min. The Fmoc-hydrazine and sugar Fmoc-hydrazone derivatives exhibit excellent stability. The extent of the hydrazone formation was 77 and 82% for mannose and fucose as assessed by Dionex high-performance anion-exchange chromatography with pulsed amperometric detection. Linear calibration graphs were established in the range from 0.5 to 2 pmol and 12 to 110 pmol for individual sugar derivatives. The determination limits were 0.05-0.09 pmol for mannose, galactose, and ribose; 0.1 pmol for maltose, xylose, and glucose; 0.2 pmol for fucose and lactose; 0.3 pmol for arabinose; and 0.4 pmol for fructose. The component monosaccharides of ultramicroquantities of two glycoproteins (e.g., from 7 ng fetuin and ovalbumin) were determined in the subpicomole range.

Clinical application of the free flap based on the cutaneous branch of the acromiothoracic artery

The nasal reconstruction in 8 patients and cheek reconstruction in 1 using a free flap from the deltoid region has been successfully undertaken in our department since August 1987. The flap has a direct cutaneous artery--the acromial artery--as its vascular axis. The experiences and a brief anatomical review of the donor site are reported.