支气管内光学相干断层成像技术评估兔创伤性气道狭窄类型的诊断价值

目的使用支气管内光学相干断层成像技术(EB-OCT)获得兔创伤性气道狭窄模型的图像,评估EB-OCT在判断良性气道狭窄类型中的诊断价值。方法建立黏膜破坏联合软骨破坏的兔创伤性气道狭窄模型,建模成功12只,获取12只气道狭窄兔术后2、4、6和8周支气管镜、EB-OCT图像特点和气管组织病理学图像,测量EB-OCT和病理图像匹配部分软骨层及非软骨层的厚度,并比较两者的相关性。结果12只建模成功的气道狭窄兔的EB-OCT图像特点:低信号反射的软骨层结构,从断裂、不连续到软骨膜逐渐修复;EB-OCT诊断气管结构层次:黏膜破坏3例,黏膜破坏及软骨破坏9例,与组织病理学比较,差异无统计学意义(P>0.05)。EB-OCT和病理图像匹配部分软骨层及非软骨层的厚度呈线性正相关,相关曲线分别是:软骨层Y=3.7498+0.9717X,r=0.9992(P<0.01);非软骨层Y=-9.4328+0.9935X,r=0.9999(P<0.01)。结论EB-OCT可以很好地观察到良性气道狭窄中气管黏膜破坏和/或软骨破坏以及两者的破坏程度,具有病理组织学的诊断优势。

Relationship between intestinal microbiota and ulcerative colitis:Mechanisms and clinical application of probiotics and fecal microbiota transplantation

Ulcerative colitis(UC) is an inflammatory disease that mainly affects the colon and rectum. It is believed that genetic factors, host immune system disorders, intestinal microbiota dysbiosis, and environmental factors contribute to the pathogenesis of UC. however, studies on the role of intestinal microbiota in the pathogenesis of UC have been inconclusive. Studies have shown that probiotics improve intestinal mucosa barrier function and immune system function and promote secretion of anti-inflammatory factors, thereby inhibiting the growth of harmful bacteria in the intestine. Fecal microbiota transplantation(FMT) can reduce bowel permeability and thus the severity of disease by increasing the production of short-chain fatty acids, especially butyrate, which help maintain the integrity of the epithelial barrier. FMT can also restore immune dysbiosis by inhibiting Th1 differentiation, activity of T cells, leukocyte adhesion, and production of inflammatory factors. Probiotics and FMT are being increasingly used to treat UC, but their use is controversial because of uncertain efficacy. Here, we briefly review the role of intestinal microbiota in thepathogenesis and treatment of UC.

Metastasis-associated protein 1 induces VEGF-C and facilitates lymphangiogenesis in colorectal cancer

AIM:To study the correlation between high metastasisassociated protein 1(MTA1)expression and lymphangiogenesis in colorectal cancer(CRC)and its role in production of vascular endothelial growth factor-C(VEGF-C). METHODS:Impact of high MTA1 and VEGF-C expression levels on disease progression and lymphovasculardensity(LVD,D2-40-immunolabeled)in 81 cases of human CRC was evaluated by immunohistochemistry. VEGF-C mRNA and protein expressions in human LoVo and HCT116 cell lines were detected by real-time polymerase chain reaction and Western blotting,respectively,with a stable expression vector or siRNA. RESULTS:The elevated MTA1 and VEGF-C expression levels were correlated with lymph node metastasis and Dukes stages(P<0.05).Additionally,high MTA1 expression level was correlated with a large tumor size(P< 0.05).A significant correlation was found between MTA1 and VEGF-C protein expressions in tumor cells(r=0.371, P<0.05).Similar to the VEGF-C expression level,high MTA1 expression level was correlated with high LVD in CRC(P<0.05).Furthermore,over-expression of MTA1 significantly enhanced the VEGF-C mRNA and protein expression levels,whereas siRNAs-knocked down MTA1 decreased the VEGF-C expression level. CONCLUSION:MTA1,as a regulator of tumor-associated lymphangiogenesis,promotes lymphangiogenesis in CRC by mediating the VEGF-C expression.

Effects of acute kidney injury on acute pancreatitis patients’ survival rate in intensive care unit: A retrospective study

BACKGROUND Acute kidney injury(AKI)is one of the most common acute pancreatitis(AP)-associated complications that has a significant effect on AP,but the factors affecting the AP patients’survival rate remains unclear.AIM To assess the influences of AKI on the survival rate in AP patients.METHODS A total of 139 AP patients were included in this retrospective study.Patients were divided into AKI group(n=72)and non-AKI group(n=67)according to the occurrence of AKI.Data were collected from medical records of hospitalized patients.Then,these data were compared between the two groups and further analysis was performed.RESULTS AKI is more likely to occur in male AP patients(P=0.009).AP patients in AKI group exhibited a significantly higher acute physiologic assessment and chronic health evaluation II score,higher Sequential Organ Failure Assessment score,lower Glasgow Coma Scale score,and higher demand for mechanical ventilation,infusion of vasopressors,and renal replacement therapy than AP patients in non-AKI group(P<0.01,P<0.01,P=0.01,P=0.001,P<0.01,P<0.01,respectively).Significant differences were noted in dose of norepinephrine and adrenaline,duration of mechanical ventilation,maximum and mean values of intra-peritoneal pressure(IPP),maximum and mean values of procalcitonin,maximum and mean serum levels of creatinine,minimum platelet count,and length of hospitalization.Among AP patients with AKI,the survival rate of surgical intensive care unit and in-hospital were only 23%and 21%of the corresponding rates in AP patients without AKI,respectively.The factors that influenced the AP patients’survival rate included body mass index(BMI),mean values of IPP,minimum platelet count,and hospital day,of which mean values of IPP showed the greatest impact.CONCLUSION AP patients with AKI had a lower survival rate and worse relevant clinical outcomes than AP patients without AKI,which necessitates further attention to AP patients with AKI in surgical intensive care unit.

Protective effect of Bifidobacterium infantis CGMCC313-2 on ovalbumin-induced airway asthma and b-lactoglobulininduced intestinal food allergy mouse models

AIM To determine whether oral administration of Bifidobacterium infantis CGMCC313-2(B. infantis CGMCC313-2) inhibits allergen-induced airway inflammation and food allergies in a mouse model.METHODS Ovalbumin(OVA)-induced allergic asthma and b-lactoglobulin-induced food allergy mouse models were used in this study. Following oral administration of B. infantis CGMCC313-2 during or after allergen sensitization, histopathologic changes in the lung and intestine were evaluated by hematoxylin and eosin(HE) staining. In the allergic asthma mouse model, we evaluated the proportion of lung-infiltrating inflammatory cells. OVAspecific IgE and IgG1 levels in serum and cytokine levels in bronchoalveolar lavage fluid(BALF) were also assessed. In the food allergy mouse model, the levels of total Ig E and cytokines in serum were measured.RESULTS Oral administration of B. infantis CGMCC313-2 during or after allergen sensitization suppressed allergic inflammation in lung and intestinal tissues, while the proportion of infiltrating inflammatory cells was significantly decreased in the BALF of allergic asthma mice. Moreover, B. infantis CGMCC313-2 decreased the serum levels of total Ig E in food allergy mice, and reductions in IgE and IgG1 were also observed in OVA-induced allergic asthma mice. The expression of interleukin-4(IL-4) and IL-13 in both serum and BALF was suppressed following the administration of B. infantis CGMCC313-2, while an effect on serum IL-10 levels was not observed.CONCLUSION B. infantis CGMCC313-2 inhibits the secretion of allergen-induced IgE, IL-4 and IL-13, and attenuates allergic inflammation.

Boosting the polysulfide confinement in B/N–codoped hierarchically porous carbon nanosheets via Lewis acid–base interaction for stable Li–S batteries

Carbon materials have shown remarkable usefulness in facilitating the performance of insulating sulfur cathode for lithium–sulfur batteries owing to their excellent conductivity and porous structure. However,the anxiety is the poor affinity toward polar polysulfides due to the intrinsic nonpolar surface of carbon.Herein, we report a direct pyrolysis of the mixture urea and boric acid to synthesize B/N–codoped hierarchically porous carbon nanosheets(B–N–CSs) as efficient sulfur host for lithium–sulfur battery. The graphene–like B–N–CSs provides high specific surface area and porous structure with abundant micropores(1.1 nm) and low–range mesopores(2.3 nm), thereby constraining the sulfur active materials within the pores. More importantly, the codoped B/N elements can further enhance the polysulfide confinement through strong Li–N and B–S interaction based on the Lewis acid–base theory. These structural superiorities significantly suppress the shuttle effect by both physical confinement and chemical interaction, and promote the redox kinetics of polysulfide conversion. When evaluated as the cathode host, the S/B–N–CSs composite displays the excellent performance with a high reversible capacity up to 772 m A h g–1 at 0.5 C and a low fading rate of ^0.09% per cycle averaged upon 500 cycles. In particular, remarkable stability with a high capacity retention of 87.1% can be realized when augmenting the sulfur loading in the cathode up to 4.6 mg cm^(-2).

Potential protection of indocyanine green on parathyroid gland function during near-infrared laparoscopic-assisted thyroidectomy: A case report and literature review

BACKGROUND In recent decades,significant advances have been made in protecting the parathyroid glands and recurrent laryngeal nerves during thyroidectomy.However,reliable and convenient technical means are still lacking.In this study,the reliability,safety and feasibility of near-infrared(NIR)laparoscopyassisted thyroid lobectomy with isthmectomy and prophylactic central lymph node dissection(CLND)were reported.CASE SUMMARY A 63-year-old female patient with a free previous medical history,was admitted to our department due to multiple thyroid nodules.Ultrasonic examination suggested diffuse thyroid changes and one thyroid nodule in the right upper lobe with the largest diameter of 1.5 cm adjacent to the trachea and Breast Imaging Reporting and Data System grade 4B.Imaging examination of the neck showed no obvious enlarged lymph nodes.Fine needle aspiration biopsy suggested a papillary thyroid carcinoma.Combined with thyroid function examination,the patient was diagnosed with papillary thyroid carcinoma and Hashimoto's thyroiditis.Considering the risk of invading the capsule and the patient's extreme anxiety,a right thyroid lobectomy with isthmectomy and prophylactic CLND was planned.No significant abnormalities were found during preoperative examinations,except for an increased thyroid stimulating hormone level.The patient underwent NIR laparoscopy-assisted thyroid lobectomy with isthmectomy and prophylactic CLND.During the operation,two right parathyroid glands(PGs)adjacent to the thyroid gland capsule and the right recurrent laryngeal nerve(RLN)were examined by indocyanine green(ICG)fluorescence using a NIR fluorescence camera,and the PGs and RLN were reliably preserved.Considering the ICG-positive PG,prophylactic CLND was performed.The postoperative parathyroid hormone level was in the normal range and no significant hypocalcemia symptoms were observed.CONCLUSION During NIR laparoscopy-assisted thyroidectomy,ICG fluorescence may aid PG identification and protection.

Oral and maxillofacial pain as the first sign of metastasis of an occult primary tumour:A fifteen-year retrospective study

BACKGROUND Metastatic adenocarcinoma of the jaw(MAJ)is a rare disease that accounts for 1%-3%of all oral and maxillofacial malignant tumours.Oral and maxillofacial pain may be the first symptom of metastatic spread of an occult primary tumour.Therefore,early identification of oral and maxillofacial pain by dental professionals is critical.AIM To explore the clinical and computerized tomography(CT)features of MAJ with oral and maxillofacial pain as the first symptom.METHODS The medical records of all patients who were treated in our hospital between January 2006 and February 2020,and diagnosed with MAJ with oral and maxillofacial pain as the first symptom,were reviewed retrospectively.Clinical data were collected on age,sex,medical history,clinical manifestations,site of metastasis,and site of the primary lesion.CT features were analysed in detail,and a radiological classification scheme comprising five types:Osteolytic,osteoblastic,mixed,cystic,and alveolar bone resorption was proposed.RESULTS The primary sites of MAJ were the lungs(n=6),liver(n=4),kidneys(n=2),prostate(n=1),and gastric cardia(n=1).Five tumours were classified as the osteolytic type,all with a permeative margin(100%,P<0.05),and three were classified as the mixed type,mostly with a moth-eaten margin(80%,P<0.05).The cystic(n=3)and alveolar bone resorption(n=1)types had geographic margins,and the osteoblastic type(n=1)had sclerotic margins.Moreover,nine tumours showed periosteal reaction and five showed a localised soft tissue mass,while the occurrence of jaw expansion was relatively rare.CONCLUSION MAJ has complex clinical and CT features.Oral and maxillofacial pain may be the first sign of a primary tumour affecting other sites.

Influence of platform position on stray grain nucleation in Ni-based single-crystal dummy blade clusters

Stray grains are the most severe of the solidification defects that occur in the industrial single-crystal blade preparation process.In this study,a single-crystal dummy blade cluster with different crystal orientations controlled by the seeding method was prepared,and the influence of the position of the circular platform(relative to the sample and furnace body)on stray grain nucleation was investigated.Results show that the microstructure of the circular platforms could be divided into the center,expansion,and stray grain regions.The inside of the circular platform facing the center of the cluster is more prone to stray grain formation than the outside of the circular platform facing the furnace body.With an increase in the distance between the circular platform and the bottom of the dummy blade cluster,the stray grain region expands,whereas the expansion region narrows.The stray grain is slightly aggravated with increase of the misorientation.Finally,the mechanism underlying the influence of platform position on the formation of stray grains in single-crystal dummy blade clusters is discussed based on the temperature evolution during directional solidification.

Neoadjuvant targeted therapy for apocrine carcinoma of the breast:A case report

BACKGROUND Apocrine carcinoma of the breast is a special type of invasive ductal carcinoma of the breast that is rare in clinical practice.Neoadjuvant therapy,especially neoadjuvant targeted therapy,has rarely been reported for apocrine carcinoma of the breast.CASE SUMMARY A 63-year-old woman presented with apocrine carcinoma of the left breast underwent core needle biopsy.The patient was diagnosed with apocrine carcinoma by immunohistochemical staining and negative hormone status(estrogen receptor and progesterone receptor)but showed overexpression of human epidermal factor receptor 2(HER-2).Moreover,positive expression of androgen receptor(approximately 60%)and gross cystic disease fluid protein 15 was observed.The patient was treated with neoadjuvant targeted therapy consisting of the TCH regimen(docetaxel,carboplatin area under curve 6 and trastuzumab)every 21 d.The mass in the left breast was significantly reduced,and pain in the breast and left upper arm also improved.CONCLUSION HER-2 positive apocrine carcinoma of the breast can be improved by neoadjuvant chemotherapy combined with targeted therapy.

Uncovering the prominent role of satellite cells in paravertebral muscle development and aging by single-nucleus RNA sequencing

To uncover the role of satellite cells(SCs)in paravertebral muscle development and aging,we constructed a single-nucleus transcriptomic atlas of mouse paravertebral muscle across seven timepoints spanning the embryo(day 16.5)to old(month 24)stages.Eight cell types,including SCs,fast muscle cells,and slow muscle cells,were identified.An energy metabolism-related gene set,TCA CYCLE IN SENESCENCE,was enriched in SCs.Forty-two skeletal muscle disease-related genes were highly expressed in SCs and exhibited similar expression patterns.Among them,Pdha1 was the core gene in the TCA CYCLE IN SENESCENCE;Pgam2,Sod1,and Suclg1 are transcription factors closely associated with skeletal muscle energy metabolism.Transcription factor enrichment analysis of the 42 genes revealed that Myod1 and Mef2a were also highly expressed in SCs,which regulated Pdha1 expression and were associated with skeletal muscle development.These findings hint that energy metabolism may be pivotal in SCs development and aging.Three ligand-receptor pairs of extracellular matrix(ECM)-receptor interactions,Lamc1-Dag1,Lama2-Dag1,and Hspg2-Dag1,may play a vital role in SCs interactions with slow/fast muscle cells and SCs self-renewal.Finally,we built the first database of a skeletal muscle single-cell transcriptome,the Musculoskeletal Cell Atlas(http://www.mskca.tech),which lists 630,040 skeletal muscle cells and provides interactive visualization,a useful resource for revealing skeletal muscle cellular heterogeneity during development and aging.Our study could provide new targets and ideas for developing drugs to inhibit skeletal muscle aging and treat skeletal muscle diseases.

Recyclable cobalt-molybdenum bimetallic carbide modified separator boosts the polysulfide adsorption-catalysis of lithium sulfur battery

The polysulfide shuttling and sluggish redox kinetics,due to the notorious adsorption-catalysis underperformance,are the ultimate obstacles of the practical application of lithium-sulfur(Li-S)batteries.Conventional carbon-based and transition metal compound-based material solutions generally suffer from poor catalysis and adsorption,respectively,despite the performance gain in terms of the other.Herein,we have enhanced polysulfide adsorptioncatalytic capability and protected the Li anode using a complementary bimetallic carbide electrocatalyst,Co3 Mo3 C,modified commercial separator.With this demonstration,the potentials of bimetal compounds,which have been well recognized in other environmental catalysis,are also extended to Li-S batteries.Coupled with this modified separator,a simple cathode(S/Super P composite)can deliver high sulfur utilization,high rate performance,and excellent cycle stability with a low capacity decay rate of^0.034%per cycle at 1 C up to1000 cycles.Even at a high S-loading of 8.0 mg cm^-2 with electrolyte/sulfur ratio=6 m L g^-1,the cathode still exhibits high areal capacity of^6.8 m A h cm^-2.The experimental analysis and the first-principles calculations proved that the bimetallic carbide Co3 Mo3 C provides more binding sites for adsorbing polysulfides and catalyzing the multiphase conversion of sulfur/polysulfide/sulfide than monometallic carbide Mo2 C.Moreover,the modified separator can be reutilized with comparable electrochemical performance.We also showed other bimetallic carbides with similar catalytic effects on Li-S batteries and this material family has great promise indifferent energy electrocatalytic systems.

Impact of thymosinα1 as an immunomodulatory therapy on long-term survival of non-small cell lung cancer patients after R0 resection:a propensity score-matched analysis

Background:There is limited information about thymosinα1(Tα1)as adjuvant immunomodulatory therapy,either used alone or combined with other treatments,in patients with non-small cell lung cancer(NSCLC).This study aimed to evaluate the effect of adjuvant Tα1 treatment on long-term survival in margin-free(R0)-resected stage IA–IIIA NSCLC patients.Methods:A total of 5746 patients with pathologic stage IA-IIIA NSCLC who underwent R0 resection were included.The patients were divided into the Tα1 group and the control group according to whether they received Tα1 or not.A propensity score matching(PSM)analysis was performed to reduce bias,resulting in 1027 pairs of patients.Results:After PSM,the baseline clinicopathological characteristics were similar between the two groups.The 5-year disease-free survival(DFS)and overall survival(OS)rates were significantly higher in the Tα1 group compared with the control group.The multivariable analysis showed that Tα1 treatment was independently associated with an improved prognosis.A longer duration of Tα1 treatment was associated with improved OS and DFS.The subgroup analyses showed that Tα1 therapy could improve the DFS and/or OS in all subgroups of age,sex,Charlson Comorbidity Index(CCI),smoking status,and pathological tumor-node-metastasis(TNM)stage,especially for patients with non-squamous cell NSCLC and without targeted therapy.Conclusion:Tα1 as adjuvant immunomodulatory therapy can significantly improve DFS and OS in patients with NSCLC after R0 resection,except for patients with squamous cell carcinoma and those receiving targeted therapy.The duration of Tα1 treatment is recommended to be>24 months.

A multi-center cross-sectional study on blood purification among adult patients in intensive care unit in China: a study protocol

Background: Blood purification (BP) is one of the most important rescue measures for patients with critical illness in the intensive care unit (ICU), espedally for those with acute kidney injury. The purpose of this nationwide survey was to reveal the real world of current BP practice in different ICUs all over China. This study was designed to be a multi-center cross-sectional study. Methods: All adult patients (over 18 years of age), who were admitted to ICU and required BP in 35 sub-centers across China were included during 30-day survey period in 2018. Demographic characteristics and clinical data were recorded including the timing of treatment initiation, indications, modality, relative contraindication, establishment of vascular access, selection of filter/membrane, settings, anti-coagulation, executive department, complication, intake, and output. Discussion: This nationwide survey may contribute to reveal the real world of current BP practice in different ICUs all over China.

Low-Cycle Fatigue and Creep-Fatigue Behaviors of a Second-Generation Nickel-Based Single-Crystal Superalloy at 760℃

Low-cycle fatigue(LCF)behaviors of a second-generation nickel-based single-crystal superalloys with[001]orientation at 760℃ have been investigated.Different strain amplitudes were introduced to investigate the creep-fatigue effects.The LCF life of none tensile holding(NTH)was higher than that of the 60-s tensile hold(TH)at any strain amplitude.As the strain amplitude was 0.7%,the stacking and cross-slip dislocations appeared together at the γ/γ’coherent microstructure in both TH and NTH specimens.At the strain amplitude of 0.9%,plenty of the cross-slip dislocations appeared inγchannel and other dislocations were stacking at γ/γ’interfaces.However,the SFs still appeared in γ’phase with 60-s TH which caused cyclic softening.As the strain amplitude increased up to 1.2%,the dislocations are piling up at the γ/γ’interfaces and cutting through the γ’phase in both TH and NTH tests,which caused cyclic hardening.The influences of strain amplitude and holding time were complicated.Different stress response behaviors occurred in different loading conditions.The surface characteristic and fracture mechanism were observed by scanning electron microscopy.This result is helpful for building the relationship of various blade fatigue failure modes,cyclic stress response and microstructure deformation under different strain amplitudes.

Predictors of efficacy of corticosteroid switching from abiraterone plus prednisone to dexamethasone in patients with metastatic castration-resistant prostate cancer

Corticosteroid switching can reverse abiraterone resistance in some patients with metastatic castration-resistant prostate cancer(mCRPC).Here,we investigated the potential biomarkers for predicting the efficacy of corticosteroid switching during treatment with abiraterone acetate(AA).We retrospectively analyzed 101 mCRPC patients receiving corticosteroid switching from West China Hospital and Sun Yat-Sen University Cancer Center between January 2016 and December 2018.All cases received AA plus prednisone as first-line therapy during mCRPC.Primary end points were biochemical progression-free survival(bPFS)and overall survival(OS).The risk groups were defined based on multivariate analysis.A total of 42(41.6%)and 25(24.8%)patients achieved 30%and 50%decline in prostate-specific antigen(PSA),respectively,after corticosteroid switching.The median bPFS and median OS on AA plus dexamethasone were 4.9(95%confidence interval[CI]:3.7–6.0)months and 18.8(95%CI:16.2–30.2)months,respectively.Aldo-keto reductase family 1 member C3(AKR1C3)expression(hazard ratio[HR]:2.15,95%Cl:1.22–3.80,P=0.008)and baseline serum alkaline phosphatase(ALP;HR:4.95,95%Cl:2.40–10.19,P<0.001)were independent predictors of efficacy before corticosteroid switching in the multivariate analysis of bPFS.Only baseline serum ALP>160 IU l−1(HR:3.41,95%Cl:1.57–7.38,P=0.002)together with PSA level at switch≥50 ng ml−1(HR:2.59,95%Cl:1.22–5.47,P=0.013)independently predicted poorer OS.Based on the predictive factors in multivariate analysis,we developed two risk stratification tools to select candidates for corticosteroid switching.Detection of serum ALP level,PSA level,and tissue AKR1C3 expression in mCRPC patients could help make clinical decisions for corticosteroid switching.