Better performance of PIVKA-II for detecting hepatocellular carcinoma in patients with chronic liver disease with normal total bilirubin

BACKGROUND Serum protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ) is a promising biomarker for hepatocellular carcinoma(HCC) surveillance.AIM To identify the contributing factors related to the abnormal elevation of PIVKA-Ⅱ level and assess their potential influence on the performance of PIVKA-Ⅱ in detecting HCC.METHODS This study retrospectively enrolled in 784 chronic liver disease(CLD) patients and 267 HCC patients in Mengchao Hepatobiliary Hospital of Fujian Medical University from April 2016 to December 2019. Logistic regression and the area under the receiver operating characteristic curve(AUC) were used to evaluate the influencing factors and diagnostic performance of PIVKA-Ⅱ for HCC, respectively.RESULTS Elevated PIVKA-Ⅱ levels were independently positively associated with alcohol-related liver disease, serum alkaline phosphatase(ALP), and total bilirubin(TBIL) for CLD patients and aspartate aminotransferase(AST) and tumor size for HCC patients(all P < 0.05). Serum PIVKA-Ⅱ were significantly lower in patients with viral etiology, ALP ≤ 1 × upper limit of normal(ULN), TBIL ≤ 1 × ULN, and AST ≤ 1 × ULN than in those with nonviral disease and abnormal ALP, TBIL, or AST(all P < 0.05), but the differences disappeared in patients with early-stage HCC. For patients with TBIL ≤ 1 × ULN, the AUC of PIVKA-Ⅱ was significantly higher compared to that in patients with TBIL > 1 × ULN(0.817 vs 0.669, P = 0.015), while the difference between ALP ≤ 1 × ULN and ALP > 1 × ULN was not statistically significant(0.783 vs 0.729, P = 0.398). These trends were then more prominently perceived in subgroups of patients with viral etiology and HBV alone.CONCLUSION Serum PIVKA-Ⅱ has better performance in detecting HCC at an early stage for CLD patients with normal serum TBIL.

Effect of moisture on the aging behavior of asphalt binder

The moisture aging effect and mechanism of asphalt binder during the in-service life of pavement were investigated by laboratory simulating tests.Pressure aging vessel（PAV） test simulating the long-term aging of binder during the in-service life of pavement was modified to capture the long-term moisture aging effect of binder.Penetration grade tests including penetration test,soften point test,and ductility test as well as SuperpaveTM performance grade tests including viscosity test,dynamic shear rheometer test,and bending beam rheometer test were conducted to fully evaluate the moisture aging effect of binder.Fourier transform infrared spectroscopy test and Gel-permeation chromatography test were applied to provide a fundamental understanding of the moisture aging mechanism of binder.The results indicate that moisture condition can accelerate the aging of asphalt binder and shorten the service life of asphalt binder.The modified PAV test with moisture condition can well characterize the moisture aging properties of asphalt binder.

Risk factors for recurrence after bowel resection for Crohn’s disease

BACKGROUND Complications of Crohn’s disease such as intestinal obstruction,fistula or perforation often need surgical treatment.Nearly 70%-80%patients with Crohn’s disease would receive surgical treatment during the lifetime.However,surgical treatment is incurable for Crohn’s disease.The challenge of recurrence postoperatively troubles both doctors and patients.Over 50%patients would suffer recurrence postoperatively.Some certain risk factors are associated with recurrence of Crohn’s disease.AIM To evaluate the risk factors for endoscopic recurrence and clinical recurrence after bowel resection in Crohn’s disease.METHODS Patients diagnosed Crohn’s disease and received intestinal resection between April 2007 and December 2013 were included in this study.Data on the general demographic information,preoperative clinical characteristics,surgical information,postoperative clinical characteristics were collected.Continuous data are expressed as median(inter quartile range),and categorical data as frequencies and percentages.Kaplan-Meier method was applied to estimate the impact of the clinical variables above on the cumulative rate of postoperative endoscopic recurrence and clinical recurrence,then log-rank test was applied to test the homogeneity of those clinical variables.Multivariate Cox proportional hazard regression analysis was performed to identify the risk factors of postoperative endoscopic recurrence and clinical recurrence.RESULTS A total of 64 patients were included in this study.The median follow-up time for the patients was 17(9.25-25.75)mo.In this period,41 patients(64.1%)had endoscopic recurrence or clinical recurrence.Endoscopic recurrence occurred in 34(59.6%)patients while clinical recurrence occurred in 28(43.8%)patients,with the interval between the operation and recurrence of 13.0(8.0-24.5)months and 17.0(8.0-27.8)mo,respectively.In univariate analysis,diagnosis at younger age(P<0.001),disease behavior of penetrating(P=0.044)and preoperative use of anti-tumor necrosis factor(TNF)(P=0.020)were significantly correlated with endoscopic recurrence,while complication with perianal lesions(P=0.032)and preoperative use of immunomodulatory(P=0.031)were significantly correlated with clinical recurrence.As to multivariate analysis,diagnostic age(P=0.004),disease behavior(P=0.041)and preoperative use of anti-TNF(P=0.010)were independent prognostic factors for endoscopic recurrence,while complication with perianal lesions(P=0.023)was an independent prognostic factor for clinical recurrence.CONCLUSION Diagnostic age,disease behavior,preoperative use of anti-TNF and complication with perianal lesions were independent risk factors for postoperative recurrence in Crohn’s disease.

Overexpression of G protein-coupled receptor 31 as a poor prognosticator in human colorectal cancer

AIM To investigate the expression of G protein-coupled receptor 31 (GPR31) and its clinical significance in human colorectal cancer (CRC).METHODS To determine the association between the GPR31 expression and the prognosis of patients, we obtained paraffin-embedded pathological specimens from 466 CRC patients who underwent initial resection. A total of 321 patients from the First Affiliated Hospital of Sun Yat-sen University from January 1996 to December 2008 were included as a training cohort, whereas 145 patients from the Sixth Affiliated Hospital of Sun Yat-sen University from January 2007 to November 2008 were included as a validation cohort. We examined GPR31 expression levels in CRC tissues from two independent cohorts via immunohistochemical staining. All patients were categorized into either a GPR31 low expression group or a GPR31 high expression group. The clinicopathological factors and the prognosis of patients in the GPR31 low expression group and GPR31 high expression group were compared.RESULTS We compared the clinicopathological factors and the prognosis of patients in the GPR31 low expression group and GPR31 high expression group. Significant differences were observed in the number of patients in pM classification between patients in the GPR31 low expression group and GPR31 high expression group (P = 0.007). The five-year survival and tumor-free survival rates of patients were 84.3% and 82.2% in the GPR31 low expression group, respectively, and both rates were 59.7% in the GPR31 high expression group (P < 0.05). Results of the Cox proportional hazard regression model revealed that GPR31 upregulation was associated with shorter overall survival and tumor-free survival of patients with CRC (P < 0.05). Multivariate analysis identified GPR31 expression in colorectal cancer as an independent predictive factor of CRC patient survival (P < 0.05).CONCLUSION High GPR31 expression levels were found to be correlated with pM classification of CRC and to serve as an independent predictive factor of poor survival of CRC patients.

Detecting plasma Epstein-Barr virus DNA to diagnose postradiation nasopharyngeal skull base lesions in nasopharyngeal carcinoma patients:a prospective study

The diagnosis of postradiation nasopharyngeal skull base lesions in petients with nasopharyngeal carcinoma(NPC) is still a tough problem in clinical practice.An early and accurate diagnosis is important for subsequent management.We prospectively evaluated the diagnostic value of plasma Epstein-Barr virus(EBV) DNA in detecting postradiation nasopharyngeal skull base lesions in NPC patients.From July 2006 to September 2010,90 patients with postradiation NPC(34 women and 56 men;median age:42 years) met the selection criteria and were recruited in this study.All postradiation nasopharyngeal skull base lesions were found in the latest magnetic resonance imaging(MRI) examinations before endoscopic surgery,and the nasopharyngeal cavity was normal under flexible nasopharyngoscopy.Plasma EBV DNA detection was performed within 2 weeks before endoscopic surgery.A total of 90 endoscopic operations were successfully performed without any postoperative complications.Recurrences confirmed by postoperative pathology were found in 30 patients.The specificity,positive and negative predictive values of plasma EBV DNA detection were better than those of MRI.In addition,combining plasma EBV DNA detection with MRI improved the specificity and positive predictive values of MRI.Plasma EBV DNA detection followed by MRI would help to diagnose recurrence whereas MRI was unable.These results indicate that plasma EBV DNA is an effective and feasible biomarker for detecting postradiation nasopharyngeal skull base lesions in NPC patients.

Solar broadband metamaterial perfect absorber based on dielectric resonant structure of Ge cone array and InAs film

The broadband metamaterial perfect absorber has been extensively studied due to its excellent characteristics and promising application prospect.In this work a solar broadband metamaterial perfect absorber is proposed based on the structure of the germanium(Ge)cone array and the indium arsenide(InAs)dielectric film on the gold(Au)substrate.The results show that the absorption covers the whole ultraviolet-visible and near-infrared range.For the case of A>99%,the absorption bandwidth reaches up to 1230 nm with a wavelength range varied from 200 nm to 1430 nm.The proposed absorber is able to absorb more than 98.7%of the solar energy in a solar spectrum from 200 nm to 3000 nm.The electromagnetic dipole resonance and the high-order modes of the Ge cone couple strongly to the incident optical field,which introduces a strong coupling with the solar radiation and produces an ultra-broadband absorption.The absorption spectrum can be feasibly manipulated via tuning the structural parameters,and the polarization insensitivity performance is particularly excellent.The proposed absorber can possess wide applications in active photoelectric effects,thermion modulators,and photoelectric detectors.

Microbial spectrum and drug resistance of pathogens cultured from gallbladder bile specimens of patients with cholelithiasis:A singlecenter retrospective study

BACKGROUND Bacterial infection is an important cause of cholelithiasis or gallstones and interferes with its treatment.There is no consensus on bile microbial culture profiles in previous studies,and identified microbial spectrum and drug resistance is helpful for targeted preventive and therapeutic drugs in the perioperative period.AIM To analyze the bile microbial spectrum of patients with cholelithiasis and the drug susceptibility patterns in order to establish an empirical antibiotic treatment for cholelithiasis-associated infection.METHODS A retrospective single-center study was conducted on patients diagnosed with cholelithiasis between May 2013 and December 2018.RESULTS This study included 185 patients,of whom 163(88.1%)were diagnosed with gallstones and 22(11.9%)were diagnosed with gallstones and common bile duct stones(CBDSs).Bile culture in 38 cases(20.5%)was positive.The presence of CBDSs(OR=5.4,95%CI:1.3-21.9,P=0.03)and longer operation time(>80 min)(OR=4.3,95%CI:1.4-13.1,P=0.01)were identified as independent risk factors for positive bile culture.Gram-negative bacteria were detected in 28 positive bile specimens,and Escherichia coli(E.coli)(19/28)and Klebsiella pneumoniae(5/28)were the most frequently identified species.Gram-positive bacteria were present in 10 specimens.The resistance rate to cephalosporin in E.coli was above 42%and varied across generations.All the isolated E.coli strains were sensitive to carbapenems,with the exception of one imipenem-resistant strain.K.pneumoniae showed a similar resistance spectrum to E.coli.Enterococcus spp.was largely sensitive to glycopeptides and penicillin,except for a few strains of E.faecium.CONCLUSION The presence of common bile duct stones and longer operation time were identified as independent risk factors for positive bile culture in patients with cholelithiasis.The most commonly detected bacterium was E.coli.The combination ofβ-lactam antibiotics andβ-lactamase inhibitors prescribed perioperatively appears to be effective against bile pathogens and is recommended.Additionally,regular monitoring of emerging resistance patterns is required in the future.

Effects of octreotide combined with gabexate on related cytokines in patients with severe acute pancreatitis

Objective:To study the effects of octreotide combined with gabexate on related cytokines in patients with severe acute pancreatitis (SAP).Methods:A total of 92 patients with SAP from January 2014 to December 2017 in our hospital were enrolled in this study. According to random number table method, the patients were divided into the control group and the treatment group, each groups has 46 patients. The control group were treated with octreotide, the treatment group were treated with octreotide combined with gabexate. To compare the serum B7-H3, PCT, sICAM-1, NF-κB, sTREM-1, BAFF, SAA, NGAL, ghrelin, hs-CRP, MDA and SOD of the two groups before and after treatment.Results: The serum B7-H3, PCT, sICAM-1, NF-κB, sTREM-1, BAFF, SAA, NGAL, ghrelin, hs-CRP, MDA and SOD of the two groups before treatment have no no significantly differences. The serum B7-H3, PCT, sICAM-1, NF-κB, sTREM-1, BAFF, SAA, NGAL, ghrelin, hs-CRP, MDA of the two groups after treatment were significantly lower than before treatment, the serum SOD of the two groups after treatment were significantly better than before treatment, and that of the treatment group were significantly better than the control group after treatment.Conclusion: Octreotide combined with gabexate for patients with SAP can reduce the serum B7-H3, PCT, sICAM-1, NF-κB, sTREM-1, BAFF, SAA, NGAL, ghrelin, hs-CRP, MDA levels, improve serum SOD levels, and it was worthy clinical application.

A first-principle assisted framework for designing high elastocaloric Ni-Mn-based magnetic shape memory alloy

A large adiabatic temperature change(△T_(ad))is a prerequisite for the application of elastocaloric refriger-ation.Theoretically,a large volume change ratio(△V/V_(0))during martensitic transformation is favorable to enhance△T_(ad).However,the design or prediction of△V/V_(0)in experiments is a complex task because the structure of martensite changes simultaneously when the lattice parameter of austenite is tuned by mod-ifying chemical composition.So far,the solid strategy to tailor△V/V_(0)is still urgently desirable.In this work,a first-principles-based method was proposed to estimate△V/V_(0)for Ni-Mn-based alloys.With this method,the substitution of Ga for In is found to be an effective method to increase the value of△V/V_(0)for Ni-Mn-In alloys.Combined with the strategies of reducing the negative contribution of magnetic en-tropy change(via the substitution of Cu for Mn)and introducing strong crystallographic texture(through directional solidification),an outstanding elastocaloric prototype alloy of Ni_(50)(Mn_(28.5)Cu_(4.5))(In_(14)Ga_(3))was fabricated experimentally.At room temperature,a huge△T_(ad)of-19 K and a large specific adiabatic temperature change of 67.8 K/GPa are obtained.The proposed first-principle-assisted framework opens up the possibility of efficiently tailoring△V/V_(0)to promote the design of advanced elastocaloric refrigerants.

Physical properties and device applications of graphene oxide

Graphene oxide(GO),the functionalized graphene with oxygenated groups(mainly epoxy and hydroxyl),has attracted resurgent interests in the past decade owing to its large surface area,superior physical and chemical properties,and easy composition with other materials via surface functional groups.Usually,GO is used as an important raw material for mass production of graphene via reduction.However,under different conditions,the coverage,types,and arrangements of oxygen-containing groups in GO can be varied,which give rise to excellent and controllable physical properties,such as tunable electronic and mechanical properties depending closely on oxidation degree,suppressed thermal conductivity,optical transparency and fluorescence,and nonlinear optical properties.Based on these outstanding properties,many electronic,optical,optoelectronic,and thermoelectric devices with high performance can be achieved on the basis of GO.Here we present a comprehensive review on recent progress of GO,focusing on the atomic structures,fundamental physical properties,and related device applications,including transparent and flexible conductors,field-effect transistors,electrical and optical sensors,fluorescence quenchers,optical limiters and absorbers,surface enhanced Raman scattering detectors,solar cells,light-emitting diodes,and thermal rectifiers.

GenomeSyn:a bioinformatics tool for visualizing genome synteny and structural variations

Advances in the next-generation and long-read sequencing technologies have promoted the development of genome-wide comparative genomics analysis,and constructing pangenomes and identifying structural variations(SVs)are becoming the frontier of genomics.Comparative genomics is of critical importance for determining the gene function and the evolutionary basis of traits.

Antitumor immunity of low-dose cyclophosphamide:changes in T cells and cytokines TGF-beta and IL-10 in mice with colon-cancer liver metastasis

Background:The tumor immune microenvironment is one of the most important prognostic factors in liver metastasis from colorectal cancer.Low-dose cyclophosphamide(CTX)is widely believed to be involved in the modulation of the immune system.However,the underlying mechanism of low-dose CTX remains unknown.This study aimed to investigate the antitumor immunity of low-dose CTX in the treatment of colon-cancer liver metastasis.Methods:Thirty mice were randomly divided into five groups.After liver metastasis was established in colon-cancer models,mice in the treatment groups were injected with low-dose CTX(20 mg/kg)at different time points.Liver and spleen tissues were examined for T-cell markers via flow cytometry.Interleukin(IL)-10 and transforming growth factor(TGF)-b1 expression levels in liver tissues were analysed by immunohistochemistry.Serum interferon(IFN)-c and IL-10 levels were detected by enzyme-linked immunosorbent assay.An additional 20 mice were randomly allocated into two groups and the survival times were recorded.Results:The expression levels of CD4^(+)T cells,CD8^(+)T cells,and IFN-c were down-regulated,whereas those of IL-10 and TGF-b1 were up-regulated in liver metastasis from colon cancer in mice.Furthermore,the local and systemic microenvironments of the liver were altered,which led to reduced antitumor immune responses and subsequently liver metastasis.However,treatment with low-dose CTX reversed these effects.The survival times of mice treated with low-dose CTX were significantly longer than those of the other groups.Conclusions:Low-dose CTX exerts its antitumor activity by changing the systemic and local immune microenvironments and enhancing immune regulation inmice.CTX could be used as a drug to prevent and treat livermetastasis from colon cancer.

An 11-gene signature for the prediction of systemic recurrences in colon adenocarcinoma

Background Prognosis varies among patients within the same colon adenocarcinoma(COAD)stage,indicating the need for reliable molecular markers to enable individualized treatment.This study aimed to investigate gene signatures that can be used for better prognostic prediction of COAD.Methods Gene-expression profiles of COAD patients were obtained from the Gene Expression Omnibus database(n=332)and The Cancer Genome Atlas database(n=431).The relationship between gene signature and relapse-free survival was analysed in the training set(n=93)and validated in the internal validation set(n=94)and external validation sets(n=145 and 431).Results Overall,11 genes(N-myc downstream regulated gene 1[NDRG1],fms-like tyrosine kinase 1[FLT1],lipopolysaccharide binding protein[LBP],fatty acid binding protein 4[FABP4],adiponectin gene[ADIPOQ],angiotensinogen gene[AGT],activin A receptor,type II-like kinase 1[ACVRL1],CC chemokine ligand 11[CCL11],cell division cycle 42[CDC42],T-cell receptor alpha variable 9_2[TRAV9_2],and proopiomelanocortin[POMC])were identified by univariable and least absolute shrinkage and selection operator(LASSO)Cox regression analyses.Based on the risk-score model,the patients were grouped into the high-risk or low-risk groups using the median risk score as the cut-off.The area under the curve(AUC)values for 1-,3-,and 5-year recurrence were 0.970,0.849,and 0.859,respectively.Patients in the high-risk group had significantly poorer relapsefree survival than did those in the low-risk group.The predictive accuracy of the 11-gene signature was proven in the validation sets.Our gene signature showed better predictive performance for 1-,3-,and 5-year recurrence than did the other four models.Conclusions The 11-gene signature showed good performance in predicting recurrence in COAD.The accuracy of the signature for prognostic classification requires further confirmation.