[Risk factors for progression to chronic kidney disease in patients with cardiac valve replacement surgery-associated acute kidney injury].

Objective: To explore the risk factors for progression to chronic kidney disease (CKD) in patients with cardiac valve replacement surgery-associated acute kidney injury (AKI). Methods: A retrospective, nested case-control study was conducted at Fuwai Central China Cardiovascular Hospital. The study subjects were patients who underwent cardiac valve replacement surgery from January 1, 2018 to December 31, 2020, with a baseline estimated glomerular filtration rate (eGFR)>60 ml·min-1·(1.73 m2)-1 and postoperative complication of AKI. The patients were followed up for 90 days after discharge from hospital. The endpoint event was defined as progression to CKD 90 days after the occurrence of cardiac valve replacement surgery-associated AKI. The patients were divided into CKD group and non-CKD group based on whether they experienced endpoint event. The baseline clinical data were compared between the two groups. The measurement data with non-normal distribution was represented as M (Q1,Q3). Logistic regression model was used to analyze the risk factors of endpoint event. The receiver-operating characteristic (ROC) curve was drawn to evaluate the performance for predicting CKD in cardiac valve replacement surgery-associated AKI patients. Results: A total of 149 cardiac valve replacement surgery-associated AKI patients (86 males and 63 females) were included in the study, aged (59.0±10.2) years. There were 27 patients (18.1%) who progressed to new-onset CKD 90 days after the occurrence of cardiac valve replacement surgery-associated AKI. Compared with non-CKD group, patients in CKD group had older age [66 (58, 70) vs 59 (53, 64) years], lower baseline eGFR [76.3 (65.8, 98.5) vs 92.7 (78.5, 101.6) ml·min-1·(1.73 m2)-1], higher proportion of preoperative hypertension [51.9% (14/27) vs 27.9% (34/122)] and serum creatinine at discharge [136 (101, 165) vs 86 (65, 104) µmol/L], and the differences were statistically significant (all P<0.05). The multivariate logistic regression analysis results revealed that older age (OR=1.063, 95%CI: 1.001-1.129, P=0.047), preoperative hypertension (OR=3.070, 95%CI: 1.105-8.532, P=0.031) and higher serum creatinine at discharge (OR=1.026, 95%CI:1.013-1.038, P<0.001) were risk factors for progression to CKD in patients with cardiac valve replacement surgery-associated AKI. The clinical risk model including age, preoperative hypertension, preoperative baseline eGFR, and serum creatinine at discharge produced a moderate performance for predicting progression to CKD in patients with cardiac valve replacement surgery-associated AKI [the area under the curve (AUC)=0.865, 95%CI: 0.790-0.940, P<0.001]. Conclusion: Older age, preoperative hypertension and higher serum creatinine at discharge are risk factors for progression to CKD in patients with cardiac valve replacement surgery-associated AKI.

[Pathogenic detection and molecular tracing of a bacillary dysentery outbreak by Shigella sonnei in Huainan city].

Objective: To understand the virulence gene and drug resistance profile of Shigella sonnei outbreak in Huainan city, and conduct pathogenic traceability analysis. Methods: Water samples and feces related to an infectious diarrhea outbreak in Huainan city in August 2020 were collected for multiple pathogen detection. Virulence gene, drug sensitivity, pulse-field gel electrophoresis and whole genome sequencing of Shigella isolates were analyzed respectively. Results: 38 strains of Shigella sonnei were detected in 56 samples of mucilage feces with a positive rate 67.86%, and all serotypes were Shigella sonnei Phase I. Three strains of Shigella sonnei were detected by fluorescence PCR in the Gram-negative (GN) bacterial enrichment solution of terminal water and well water. Virulence genes were ipaH positive (38), ipaH/ial (31) and ipaH/ial/sen positive (1), respectively. The drug resistance spectrum showed that 9 of 14 antibiotics were 100% resistant, and only imipenem, chloramphenicol, ceftazidime and ciprofloxacin were effective drugs. XbaⅠ restriction enzyme map type of 36 isolates was completely consistent, and the ST type analysis of 3 strains was ST152. Whole genome sequencing and analysis verified that the outbreak was caused by a single clonal group of strains, and revealed that the isolates of the outbreak were clustered into a large cluster with 3 Chinese strains and 1 Korean strain in the database, far away from the strains of other countries. Conclusion: The outbreak is caused by a single clone of Shigella sonnei, which are low virulence strains and have multiple drug resistance.

[CD7 expression and its prognostic significance in acute myeloid leukemia patients with wild-type or mutant CEBPA].

Objective: To analyze the prognostic value of CD7 expression in newly diagnosed acute myeloid leukemia (AML) patients, and to further explore the correlation between CD7 expression and CEBPA mutation, and to clarify the prognostic value of CD7(+) in AML patients with wild-type (WT) or mutant-type (MT) CEBPA. Methods: The clinical data of 298 newly diagnosed non-M(3) AML patients between January 2010 and December 2016 were analyzed retrospectively. The clinical characteristics and prognosis of CD7(+) and CD7(-) patients were respectively compared in all patients, and in patients with WT and MT CEBPA. The relationship between CD7 expression and CEBPA mutation was determined by chi-square, and the effects of CEBPA mutation on survival and prognosis in CD7(+) group by Kaplan-Meier method. Results: In CD7(+) group, the frequencies of CEBPA mutation were 10.1% (single site) and 33.9% (double site) , significantly higher than those of the CD7(-) group (5.3% and 4.2%) (P=0.000) . Subgroup prognostic analysis showed a lower CR rate (P=0.001) and a higher RR (P=0.023) in CD7(+) group comparing to those of CD7(-) group in AML patients with wild type CEBPA. There were no statistical difference between CD7(+) group and CD7(-) group in overall survival (OS) and disease free survival (P>0.05) , while in the CEBPA mutant group the CD7(+) group has higher OS (P=0.019) and DFS (P=0.010) . Based on the CD7 expression and CEBPA mutation, 298 cases were divided into 3 subgroups, named as CD7(+)-CEBPA MT group, CD7(-) and CD7(+)-CEBPA WT group. The 3-year OS of the 3 groups were 80.2%, 48.0% and 30.6%, respectively (P<0.001) , and the 3-year DFS were 74.1%, 37.4% and 22.2%, respectively (P<0.001) . Conclusion: The CEBPA mutation rate was higher in CD7(+) AML patients then that of CD7(-) patients. CD7 expression has opposite prognostic significance in AML patients carrying the wild-type or mutant-type CEBPA. Based on CD7 expression and CEBPA mutation, a new risk stratification model can be established, which is helpful to guide the clinical individualized treatment for AML patients.

[Clinical-pathological analysis of 71 cases of dermatosis papulosa nigra of Han Chinese people].

Objective: To analyze and summarize the clinical-pathological features of dermatosis papulosa nigra of Han Chinese people. Methods: We collected 71 cases of dermatosis papulosa nigra in the Third people's Hospital of Hangzhou Affiliated to Zhejiang Chinese Medical University of Department of Dermatology from January 2010 to January 2019 which were confirmed clinically and pathologically. The clinical and histopathological data of all patients were analyzed and summarized, and relevant literature were reviewed. Results: Among the 71 patients, 51 were female and 25 were male, their average age was (44±13) years, the average age of onset was (39±14) years, and the average time of diagnosis was (65±51) months. The lesions were multiple dark brown papules with smooth surface, and mostly distributed in the chest and abdomen, 46 cases (64.8%), followed by the back and neck. The mean diameter of the lesions was (1.76±0.99) mm. Meanwhile, the initial onset of pruritus was observed in 15 patients. The pathological features of all lesions were similar to seborrheic keratosis. According to pathological classification, there were 49 (69.0%) cases of the acanthotic type, 11(15.5%) cases of the hyperkeratotic type, 6 (8.5%) cases of spiroid type, 4 (5.6%) cases of irritated type, and 1 (1.4%) case of clonal type. Epidermal pigmentation and/or dermal papillary pigmented granules were observed in 56 cases (78.9%), of which 46 cases (64.8%) had basal layer pigmentation. In addition, inflammatory cell infiltration was found in the superficial dermis of lesions of 10 patients (14.1%) with symptom of itching. Conclusion: Dermatosis papulosa nigra of Han Chinese people has some unique clinical and pathological features.

[Regulatory effect of miR-30b on migration and invasion of pancreatic cancer stem cells].

Objective: To detect the expression of micro RNA(miRNA, miR)-30bin pancreatic cancer stem cells (PCSCs) and to observe the regulatory effect of miR-30b on epithelial-mesenchymal transformation (EMT) process, migration and invasion of PCSCs. Methods: CD24, CD44 and EpCAM triple-positive PCSCs in pancreatic ductal adenocarcinoma(PDAC) cell line PANC-1 were sorted out by flow cytometry and the expression of Nanog and Oct4 were evaluated. The expression profile of miR-30 family in PCSCs and common cancer cells was analyzed, and the memberwith the most obvious differential expression was selected.miR-30b mimic was transfected into PCSCs and then RT-qPCR or Western Blot were performed to investigate the expression of EMT markers. The effect of miR-30b on the migration and invasion ability of PCSCs was detected by Transwell assay. Then, miR-30b agomir was transfected into PCSCs and inoculated in nude mice to study the effect of mir-30b on the tumorigenic ability. Results: PCSCs accounted for 4.52-8.09% of the total. The mRNA and protein levels of Oct4 and Nanog of PCSCswere significantly higher than those of PANC-1(P<0.001). The expression levels of miR-30b, c and d were significantly down-regulated, among which miR-30b was the most significant. After miR-30b overexpression in PCSCs, E-cadherin was significantly up-regulated (P<0.001), N-cadherin (P<0.001) and transcription factor Snail (P<0.001) were significantly down-regulated, while vimentin expression was not significantly changed. Transwell assay showed that both migration and invasiveness of PCSCs were significantly decreased after transfection (P<0.001). In vivo experiments, the tumor volume and weight of the nude mice injected with PCSCs overexpressing miR-30b were also significantly lower than those of the control group (P<0.01). Conclusions: CD24, CD44 and EpCAMtriple positive PCSCs in pancreatic cancer cells showed obvious stemness characteristics. miR-30b can reverse the EMT process of PCSCs, reduce their migration and invasion, and inhibit the tumorigenicity of PCSCs.

The association between sarcopenia and osteoporotic vertebral compression refractures.

Sarcopenia was reported to be significantly associated with osteoporosis. In this study, we reported for the first time that sarcopenia was an independent risk predictor of osteoporotic vertebral compression refractures (OVCRFs). Other risk factors of OVCRFs are low bone mass density T-scores, female sex, and advanced age. INTRODUCTION: The purpose of this study was to investigate the association between osteoporotic vertebral compression refractures (OVCRFs) and sarcopenia, and to identify other risk factors of OVCRFs. METHODS: We evaluated 237 patients with osteoporotic vertebral compression fracture who underwent percutaneous kyphoplasty (PKP) in our hospital from August 2016 to December 2017. To diagnose sarcopenia, a cross-sectional computed tomography (CT) image at the inferior aspect of the third lumbar vertebra (L3) was selected for estimating muscle mass. Grip strength was used to assess muscle strength. Possible risk factors, such as age, sex, body mass index (BMI), bone mineral density (BMD), location of the treated vertebra, anterior-posterior ratio (AP ratio) of the fractured vertebra, cement leakage, and vacuum clefts, were assessed. The multivariable analysis was used to determine the risk factors of OVCRFs. RESULTS: During the follow-up period, OVCRFs occurred in 64 (27.0%) patients. Sarcopenia was present in 48 patients (20.3%), including 21 OVCRFs and 27 non-OVCRFs patients. Sarcopenia was significantly correlated with advanced age, lower BMI, lower BMD, and hypoalbuminemia. Compared with non-sarcopenic patients, sarcopenic patients had higher OVCRFs risk. In univariate analysis, sarcopenia (p = 0.003), female (p = 0.024), advanced age (≥ 75 years; p < 0.001), lower BMD (p < 0.001), lower BMI (p = 0.01), TL junction (vertebral levels at the thoracolumbar junction) (p = 0.01), cardiopulmonary comorbidity (p = 0.042), and hypoalbuminemia (p = 0.003) were associated with OVCRFs. Multivariable analysis revealed that sarcopenia (OR 2.271; 95% CI 1.069-4.824, p = 0.033), lower BMD (OR 1.968; 95% CI 1.350-2.868, p < 0.001), advanced age (≥ 75 years; OR 2.431; 95% CI 1.246-4.744, p = 0.009), and female sex (OR 4.666; 95% CI 1.400-15.552, p = 0.012) were independent risk predictors of OVCRFs. CONCLUSIONS: Sarcopenia is an independent risk predictor of osteoporotic vertebral compression refractures. Other factors affecting OVCRFs are low BMD T-scores, female sex, and advanced age.

LncRNA KCNQ1OT1 delayed fracture healing through the Wnt/ß-catenin pathway.

OBJECTIVE: The aim of this study was to explore the effect of long non-coding ribonucleic acid (lncRNA) KCNQ1 overlapping transcript 1 (KCNQ1OT1) on fracture healing and its possible mechanism. PATIENTS AND METHODS: Abnormal lncRNAs were compared between patients with delayed fracture healing and those with normal fracture healing using gene expression profiling method. LncRNA expression in patients was verified by quantitative Reverse Transcription-Polymerase Chain Reaction (qRT-PCR). Subsequently, the model of tibial fracture was successfully established in rabbits. The effect of lncRNA KCNQ1OT1 expression on tibial fracture healing in rabbits was explored. Meanwhile, the effects of lncRNA KCNQ1OT1 on cell proliferation and apoptosis were investigated by knockdown and overexpression experiments with HC-a as a cell model. Furthermore, Western blotting was used to explore the expressions of proteins in signaling pathway affected by lncRNA KCNQ1OT1. RESULTS: Gene expression profiling and qRT-PCR revealed that lncRNA KCNQ1OT1 was significantly down-regulated in bone tissues of patients with delayed fracture healing. Compared with the control group, knocking down lncRNA KCNQ1OT1 remarkably reduced the serum levels of alkaline phosphatase (ALP) and osteoprotegerin (OPG) in rabbits, and markedly decreased bone trabecular growth index (p<0.05). In HC-a cells, overexpression of lncRNA KCNQ1OT1 activated the Wnt/ß-catenin signaling pathway, which could be suppressed by knocking down lncRNA KCNQ1OT1. Cell Counting Kit-8 (CCK-8) assay and 5(6)-carboxyfluorescein diacetate, succinimidyl ester (CFSE) results manifested that lncRNA KCNQ1OT1 remarkably promoted the proliferation and inhibited apoptosis of HC-a cells by activating the Wnt/ß-catenin signaling pathway. CONCLUSIONS: LncRNA KCNQ1OT1 plays a vital role in delayed fracture healing. Moreover, it can induce cell proliferation and inhibit cell apoptosis by activating the Wnt/ß-catenin signaling pathway. Therefore, KCNQ1OT1 may be used as a biomarker to predict the occurrence of delayed fracture healing.

Dynamic corrosion behavior of superhydrophobic surfaces.

For superhydrophobic surfaces immersed in water, a thin layer of air could be entrapped in the solid/liquid interface. This air may hinder the diffusion of dissolved corrosive species (such as Cl- ions in water) to the metallic substrate and, consequently, protect the metal from corrosion. However, in the dynamic water, the relative motion between the solid and the liquid would labilize the entrapped air and, consequently, decrease the corrosion resistance. In this work, to clarify the role of water flow velocity in such corrosion behavior, a superhydrophobic surface on aluminum substrates coded as Al-HCl-H2O-BT-SA was prepared by sequential treatment with HCl, boiling water, bis-(γ-triethoxysilylpropyl)-tetrasulfide (KH-Si69, BT) and stearic acid (SA). The contrast samples coded as Al-HCl-BT-SA, Al-HCl-H2O-SA, and Al-HCl-SA were also prepared similarly by omitting the treatment in boiling-water, the BT passivation, and the treatment in boiling-water/passivation by BT, respectively. These samples were then immersed into an aqueous solution of NaCl with different flow velocity (0, 0.5, 1.0, 1.5, and 2.0 m s-1), and its dynamic corrosion behavior was investigated. The results showed that, as the flow velocity increased, the corrosion resistance of the Al-HCl-H2O-BT-SA sample indeed deteriorated. However, compared with the contrast samples of Al-HCl-BT-SA, Al-HCl-H2O-SA, and Al-HCl-SA, the deterioration in corrosion resistance for the Al-HCl-H2O-BT-SA sample was much lower, implying that the dynamic corrosion resistance of the superhydrophobic surfaces was closely related with the micro-structures and the organic passivated layers. The present study therefore provided a fundamental understanding for the applications of superhydrophobic samples to prevent the corrosion, especially, for various vessels in dynamic water.

Recognition of Core- and Polymerase-derived immunogenic peptides included in novel therapeutic vaccine by T cells from Chinese chronic hepatitis B patients.

Chronic hepatitis B (CHB) is one of the major public health challenges in the world. Due to a strong interplay between specific T-cell immunity and elimination of hepatitis B virus (HBV), efforts to develop novel immunotherapeutics are gaining attention. TG1050, a novel immunotherapy, has shown efficacy in an animal study. To support the clinical development of TG1050 in China, specific immunity to the fusion antigens of TG1050 was assessed in Chinese patients. One hundred and thirty subjects were divided into three groups as CHB patients, HBV spontaneous resolvers, and CHB patients with HBsAg loss after antiviral treatment. HBV-specific T-cell responses to pools of HBV Core or Polymerase genotype D peptides included in TG1050 were evaluated. HBV Core- or Polymerase-specific cells were detected in peripheral blood mononuclear cells (PBMCs) from the different cohorts. The frequencies and intensities of HBV Core-specific immune responses were significantly lower in CHB patients than in HBsAg loss subjects. In CHB patients, a dominant pool derived from Polymerase (Pol1) was the most immunogenic. CHB patients with low viral loads (<106 IU/mL) were more likely to have a positive response specific to the Core peptide pool. Overall, genotype D-derived peptides included in TG1050 could raise broad and functional T-cell responses in PBMCs from Chinese CHB patients infected with genotype B/C isolates. Core-specific immunogenic domains appeared as "hot spots" with the capacity to differentiate between CHB vs HBsAg loss subjects. These observations support the extended application and associated immune monitoring of TG1050 in China.

[The advances in research on precisely inducing retinal ganglion cells from stem cells].

The injury and repair of retinal neurons is a common scientific problem in the occurrence, development and prognosis of neuronal visual impairment. Transplant of retinal ganglion cells (RGCs) differentiated from stem cells opens a new avenue for treatment of glaucoma and optic neuronal degenerative diseases. For the goal to explore the optimal method for RGCs replacement, this review summarizes the current information regarding the classification and application of stem cells, the growth characteristics of RGCs and the precise methods to induce RGCs, and discusses some important issues that need resolving and are related to RGCs transplantation. It is hoped that this article will provide useful theoretical basis for the research of this field. (Chin J Ophthalmol, 2017, 53: 381-385).

[Workplace social capital and intention to stay among Chinese nurses: a structural equation model].

Objective: To explore a model that workplace social capital is associated with intention to stay (ITS) in the nursing profession and that this association is partially mediated by organizational commitment, job satisfaction, and job stress among Chinese nurses. Methods: A cross-sectional, observationalstudy was conducted in Shanghai, China between September and December 2014. Two thousandforty-two nurses from 23 healthcare organizations were recruited for the current study using a two-stage sampling process.Intention to stay, workplace social capital, job satisfaction, organizational commitment, and job stress was measured by validated scale. Measured variable path analysis (MVPA) was used to test their hypothesized relationships. Results: There were significant positive direct effects from workplace social capital (ß=0.11, P<0.01) , organizational commitment (ß=0.81, P<0.01) and job satisfaction (ß=0.03, P<0.01) to ITS, and a negative direct effects from job strain to ITS (ß=-0.03, P<0.01) . The model explained 84% of the variability in ITS. Additionally, workplace social capital had significant positive direct effects on organizational commitment (ß=0.65, P<0.01) , job satisfaction (ß=0.44, P<0.01) and negative direct effects on job strain (ß=-0.35, P<0.01) . The indirect effect of social capital to ITS was 0.55. Job satisfaction was positively associated with organizational commitment (r=0.47, P<0.01) , and negtively associated with job stress (r=-0.12, P<0.01) . Job stress was negtively associated with organizational commitment (r=-0.20, P<0.01) . Conclusion: This study suggests that greater workplace social capital may lead to higher ITS in nursing primarily by increasing commitment to the nursing occupation and their job satisfaction and by reducing their sense of job stress.

[Three-dimensional circulation perfusion culture of hepatocytes in the liver decellularizedscaffold].

Objective: The intact rat liver decellularized scaffolds were preparedand repopulated hepatocytes by continuous perfusion technology.Toprovideexperimental support for the application of decellularized liver scaffolds in liver engineering. Method: Decellularized liver scaffolds were obtained by perfusing method. The composition and structure was examined by HE, Masson, Sirius red stain and immunofluorescence. The ultrastructure was examined by scanning electron microscope (SEM). DNA content was used to confirm the effect of decellularization. The circulation perfusion device was established. Hepatocytes were recellularized into the scaffolds by multiposition parenchymal injection method and infusion method, thenthe scaffolds were cultured in the circulation perfusion device in vitro. After cultivation, HE staining, immunofluorescence and SEM were conducted to observe the growth situation of hepatocytes in the scaffolds. Results: The rat decellularized liver scaffolds were successfully obtained by perfusion method. Histological staining demonstrated the remove of cellular component and the reservation of extracellular cellmatrix. Immunofluorescence staining demonstrated the retention of collagen I. SEM showed that the ultrastructure of the extracellular cell matrix presented thereticular structure. DNA content of the scaffolds was 47.5±18.1 ng/mg. The circulation perfusion device was composed of a peristaltic pump, oxygenator, chamber and the convey tubes. The multipositional parenchymal injection method resulted in a better engraftment rate. HE staining, immunofluorescence and SEM revealed that the growth and function of hepatocytes were goodin the scaffold. Conclusion: The decellularized rat liver scaffolds have favorable biochemical properties. The liver decellularized scaffolds applied with the circulation perfusion device could provide a well 3D plat form for culture of hepatocytes.

A novel noninvasive algorithm for the assessment of liver fibrosis in patients with chronic hepatitis B virus infection.

Several noninvasive blood biomarkers have been established for the assessment of liver fibrosis in patients with chronic hepatitis B virus (HBV) infection, but their clinical performance remains inconclusive. Here, we compared the diagnostic performance of these biomarkers and developed a novel algorithm for assessing liver fibrosis. Six hundred and sixteen chronically HBV-infected and treatment-naïve patients who underwent liver biopsy were enrolled and randomly divided into training (N=410) and internal validation cohorts (N=206). One hundred and fifty-nine patients from another centre were recruited as an external validation cohort. Receiver operating characteristic (ROC) curves were used to analyse the performance of the gamma-glutamyltransferase-to-platelet ratio (GPR), red cell volume distribution width-to-platelet ratio (RPR), FIB-4 index, aspartate aminotransferase-to-platelet ratio index (APRI) and HBV DNA level against liver histology, and a novel algorithm was developed using the recursive partitioning and regression tree (RPART) method. In the training cohort, the area under the ROC curve of FIB-4 was significantly higher than that of APRI (P=.038) but was comparable to those of GPR, RPR and HBV DNA; however, the performance of the biomarkers was similar among the validation cohort. The established RPR-HBV DNA algorithm performed better in the training cohort than any individual blood biomarker, and the corresponding sensitivity, specificity, positive predictive value and negative predictive value were 63%, 90%, 72% and 80%, respectively. In the internal and external validation cohorts, the performance of the algorithm in assessing liver fibrosis was also superior to that of other biomarkers. These results suggest that the established RPR-HBV DNA algorithm might improve the diagnostic accuracy of liver fibrosis in treatment-naïve patients with chronic HBV infection, although additional studies are warranted to confirm these findings.

[Inhibitory effect of quercetin on the biofilm formation of Streptococcus mutans].

OBJECTIVE: To observe the inhibitory effect of quercetin on the biofilm formation of Streptococcus mutans(Sm), to preliminarily reveal the possible underlying mechanisms, and to evaluate the cytotoxicity of quercetion to human dental pulp cells so as to provide the theoretical basis for the application of quercetin in oral biomaterials. METHODS: Quercetin storage solution was diluted to 0, 3.125, 6.25, 12.5, 25, 50, 100, 200, 400 and 800 mg/L, and added into Sm medium for 4 h and 24 h, crystal violet staining was used to evaluate the biofilm volume. In subsequent detections, three groups were set: control(0 mg/L), 200 mg/L quercetin and 400 mg/L quercetin. Confocal laser scanning microscopy was used to observe the morphology of the biofilm; qPCR for gtfB, gtfC, comD, comE, and luxS were assessed to preliminarily investigate the mechanisms. Finally, the methyl thiazolyl tetrazolium(MTT)test using human dental pulp cells was used to investigate cytotoxicity. RESULTS: Quercetin could significantly inhibit up to(86.16±0.45)% of the biofilm formation of Sm(Compared with the control group P=0.00)and effectively removed(43.04±0.53)% of the mature biofilm(Compared with the control group P=0.00). Confocal laser scanning microscopy photographs showed that after co-incubated for 24 h, the dense biofilm structures of the experimental group were destroyed by quercetin both at 200 mg/L and 400 mg/L. Quercetin suppressedover 50% of the expression of gtfB, gtfC, comD, comE(compared with the control group P<0.05)and promoted the expression of luxS up to 2.18 ± 0.24 and 2.84 ± 0.26 after 4 h and 24 h, respectively(compared with the control group P<0.05). Quercetin also exhibited acceptable compatibility for human dental pulp cells. CONCLUSIONS: Quercetin could effectively reduce the biofilm formation of Sm by inhibiting the expression of the related genes, and exhibited no cytotoxicity for human dental pulp cells. Quercetin has good potential to be applied in oral biological materials.

The combinational therapy of trastuzumab and cetuximab inhibits tumor growth in a patient-derived tumor xenograft model of gastric cancer.

PURPOSE: Gastric cancer (GC) is one of the leading causes of cancer mortality worldwide. Although therapeutic strategies for GC have improved, the prognosis for advanced GC remains poor. Herein, the present study sought to design a personalized cancer therapy specific to a stage III GC patient. METHODS: The tumor was surgically removed and was used to establish a patient-derived tumor xenograft (PDTX) model utilizing nude mice. Various molecular-targeted anticancer treatments were tested in the study, including control (no treatment), bevacizumab, cetuximab, bevacizumab + cetuximab, trastuzumab, and trastuzumab + cetuximab. RESULTS: Trastuzumab + cetuximab treatment exhibited the best antitumor growth effect, followed by trastuzumab, bevacizumab + cetuximab, cetuximab, and bevacizumab. Similarly, trastuzumab + cetuximab was also the most effective treatment at inducing apoptosis and cell cycle arrest in primary cultures of the patient's gastric cancer cells. Among all treatments tested in the study, trastuzumab + cetuximab showed the most profound effect in reducing the protein expression of proliferation and metastatic markers (VEGF, MMP-7, EGFT, Ki-67 and, PCNA) in tumors obtained from PDTX models, which may be the mechanism underlying the profound antitumor growth effect exerted by trastuzumab + cetuximab. CONCLUSIONS: The data indicate that trastuzumab + cetuximab combinational therapy should be the most effective antitumor growth therapy for the GC patient whom we took the cancer cells from.

Impact of adherence to GOLD guidelines on 6-minute walk distance, MRC dyspnea scale score, lung function decline, quality of life, and quality-adjusted life years in a Shanghai suburb.

We performed a 1-year cluster-randomized field trial to assess the effect of standardized management of chronic obstructive pulmonary disease (COPD) on lung function and quality of life (QOL) measures in patients in China. We used the Global Initiative for Chronic Obstructive Lung Disease (GOLD) treatment guidelines and assessed indexes including pulmonary function, QOL, quality-adjusted life years (QALY), Medical Research Council (MRC) dyspnea scale, 6-min walk distance (6-MWD), number of emergency visits, and frequency of hospitalization. Of a total of 711 patients with chronic cough and asthma, 132 were diagnosed as having COPD and 102 participated in this study [intervention group (N = 47); control group (N = 55)]. We found that adherence to GOLD guidelines had a perceivable impact on 6-MWD, MRC dyspnea scale score, and QOL. The average QALY increased by 1.42/person/year in the intervention group, but declined by 0.95/person/year in the control group. We conclude that standardized management improves disease severity, QOL, and QALY in COPD patients when treatment protocols adhere to GOLD guidelines.

Outbreak of primary inoculation tuberculosis in an acupuncture clinic in southeastern China.

Outbreak of Mycobacterium tuberculosis infections associated with acupuncture has not been reported. Thirteen patients with a painful swollen lump were referred to our hospital. The index patient received acupuncture and paraspinal muscular injection at a local acupuncture clinic in April 2011 and was diagnosed with M. tuberculosis 1 month later. From May 2011 to August 2011, 12 more patients with a swollen lump on the nuchal region or in the lower back or the buttocks region were referred to our hospital. Tuberculin skin test (TST), T-SPOT.TB, acid-fast stain, M. tuberculosis culture, chest radiograph, and lump magnetic resonance imaging (MRI) were performed and the patients were diagnosed with tuberculous abscess of the lump. All 13 patients received intramuscular injection at the paraspinal muscle by two acupuncturists at a local clinic and reported a swollen lump at the injection site. The needles and syringes were reused after autoclave sterilization. The TST was positive in all patients. Twelve patients had positive acid-fast stains. Mycobacterial cultures of abscess specimens were positive in all 13 patients. T-SPOT.TB tests were positive in all patients who underwent the test. The lesions and biopsies were subjected to polymerase chain reaction (PCR) and gene sequencing by the Disease Control Center of Zhejiang Province, China and the causative agent was identified as M. tuberculosis, Beijing type. In conclusion, physicians should consider the possibility of mycobacterial infections, apart from other bacterial agents, in patients with a swollen paraspinal lump following intramuscular injection.

Gunshot-caused Facial Injury Combined with Lower Cervical Spine Injury: A Case Report.

A 32-year old male patient was wounded by a pistol. As shown in computed tomography (CT) scanning images, there was comminuted fracture of the left mandible and the bullet was found in the left side behind the sixth cervical vertebra. After the patient was hospitalized, the debridement was done in the emergency room and the operation of open reduction and internal fixation for comminuted fracture of left mandible was performed successfully. Eighteen days later, the patient was taken to surgery for anterior cervical decompression and fusion with autogenous iliac bone grafting for the sixth cervical vertebra. Postoperative follow-up of the patient over two years indicated that the left biceps muscle strength was recovered to level 4. Gunshot wound to the face associated with injury of the low cervical spine has the possibility of survival. It is safe to treat facial wounds early in the patient's treatment course, even if the bullet remains in the cervical vertebral body and there is neurological function damage.