[Degradation of Carbamazepine in Water by UV-activated Sulfite Process].

In this study, the degradation efficiency and mechanism of carbamazepine (CBZ), a typical emerging contaminant in water, in the UV/sulfite process were investigated. The effects of different concentrations of dissolved oxygen [ρ(DO)] on the degradation of CBZ by UV-activated sulfite were investigated. Additionally, under a simulated natural water environment-controlled initial ρ(DO) of (8.0 ±0.2) mg·L-1, the effects of different process parameters (sulfite dosages and reaction pH) and water environmental factors (the presence of HCO3-, Cl-, and humic acids) on the degradation of CBZ were comprehensively analyzed. The results showed that the UV/sulfite process efficiently degraded CBZ with a degradation rate of 85.3% during the 30 min reaction time and followed the pseudo-first order kinetic model with the constant of 0.055 7 min-1. Using the electron spin resonance detection, reactive species quenching tests, and the competition kinetics, the sulfate radicals (SO4-·) and hydroxyl radicals (·OH) in the UV/sulfite process were determined to be the main reactive species and were responsible for the degradation of CBZ with contribution rates of 43.9% and 56.1%, respectively. In addition, the degradation efficiency of CBZ decreased with the increasing concentration of HCO3-, and the presence of Cl- had little effect on the degradation of CBZ, whereas the presence of humic acids significantly inhibited the degradation of CBZ. Moreover, the accumulation of sulfate during the reaction was significantly lower than the limit of the Standard for Drinking Water (GB5749-2022). Additionally, the sulfite consumption rate constant was 0.004 4 min-1, which was significantly lower than the degradation rate constant of CBZ, indicating that sulfite could be activated efficiently by UV light to degrade CBZ in water.

MuNeRF: Robust Makeup Transfer in Neural Radiance Fields.

There has been a high demand for facial makeup transfer tools in fashion e-commerce and virtual avatar generation. Most of the existing makeup transfer methods are based on the generative adversarial networks. Despite their success in makeup transfer for a single image, they struggle to maintain the consistency of makeup under different poses and expressions of the same person. In this paper, we propose a robust makeup transfer method which consistently transfers the makeup style of a reference image to facial images in any poses and expressions. Our method introduces the implicit 3D representation, neural radiance fields (NeRFs), to ensure the geometric and appearance consistency. It has two separate stages, including one basic NeRF module to reconstruct the geometry from the input facial image sequence, and a makeup module to learn how to transfer the reference makeup style consistently. We propose a novel hybrid makeup loss which is specially designed based on the makeup characteristics to supervise the training of the makeup module. The proposed loss significantly improves the visual quality and faithfulness of the makeup transfer effects. To better align the distribution between the transferred makeup and the reference makeup, a patch-based discriminator that works in the pose-independent UV texture space is proposed to provide more accurate control of the synthesized makeup. Extensive experiments and a user study demonstrate the superiority of our network for a variety of different makeup styles.

Interactive NeRF Geometry Editing With Shape Priors.

Neural Radiance Fields (NeRFs) have shown great potential for tasks like novel view synthesis of static 3D scenes. Since NeRFs are trained on a large number of input images, it is not trivial to change their content afterwards. Previous methods to modify NeRFs provide some control but they do not support direct shape deformation which is common for geometry representations like triangle meshes. In this paper, we present a NeRF geometry editing method that first extracts a triangle mesh representation of the geometry inside a NeRF. This mesh can be modified by any 3D modeling tool (we use ARAP mesh deformation). The mesh deformation is then extended into a volume deformation around the shape which establishes a mapping between ray queries to the deformed NeRF and the corresponding queries to the original NeRF. The basic shape editing mechanism is extended towards more powerful and more meaningful editing handles by generating box abstractions of the NeRF shapes which provide an intuitive interface to the user. By additionally assigning semantic labels, we can even identify and combine parts from different objects. We demonstrate the performance and quality of our method in a number of experiments on synthetic data as well as real captured scenes.

Neural Radiance Fields From Sparse RGB-D Images for High-Quality View Synthesis.

The recently proposed neural radiance fields (NeRF) use a continuous function formulated as a multi-layer perceptron (MLP) to model the appearance and geometry of a 3D scene. This enables realistic synthesis of novel views, even for scenes with view dependent appearance. Many follow-up works have since extended NeRFs in different ways. However, a fundamental restriction of the method remains that it requires a large number of images captured from densely placed viewpoints for high-quality synthesis and the quality of the results quickly degrades when the number of captured views is insufficient. To address this problem, we propose a novel NeRF-based framework capable of high-quality view synthesis using only a sparse set of RGB-D images, which can be easily captured using cameras and LiDAR sensors on current consumer devices. First, a geometric proxy of the scene is reconstructed from the captured RGB-D images. Renderings of the reconstructed scene along with precise camera parameters can then be used to pre-train a network. Finally, the network is fine-tuned with a small number of real captured images. We further introduce a patch discriminator to supervise the network under novel views during fine-tuning, as well as a 3D color prior to improve synthesis quality. We demonstrate that our method can generate arbitrary novel views of a 3D scene from as few as 6 RGB-D images. Extensive experiments show the improvements of our method compared with the existing NeRF-based methods, including approaches that also aim to reduce the number of input images.

[Spatial Distribution and Risk Assessment of Heavy Metals in Surface Sediments from the Middle and Upper Reaches of the Yangtze River].

The hydrological regime of rivers significantly changes after dam impoundment, which in turn affects the particle composition and heavy metal fractions of the river sediments. From June to July 2019, the sediments from 26 sampling sections were collected along the main stream of the Yangtze River from Panzhihua City in the upper reaches of the Yangtze River to Hukou City in the middle reaches of the Yangtze River. The concentrations and fractions of As, Cd, Co, Cr, Cu, Ni, Pb, and Zn were measured using the BCR three-step extraction procedure. The pollution status and potential ecological risk of heavy metals in sediments were evaluated using the geo-accumulation index, the sediment quality guideline, and the risk assessment coding method (RAC). The results showed that the average particle size of sediments in the upper reaches of the Yangtze River (Jinsha River cascade reservoir section and the Three Gorges reservoir section) decreased from upstream to downstream, the total concentrations of As and Zn increased, and the variation trend in the middle reaches was not obvious. The content of clay particles was significantly positively correlated with the acid-soluble fraction concentrations of Cd and Ni. Cd was mainly in the residual fraction (59.26%) and acid-soluble fraction (24.67%). Large parts of Cr and Ni were residual fractions accounting for 92.41% and 83.41%, respectively. As, Co, Cu, Pb, and Zn were mainly in the residual fraction and the reducible fraction. The order of decrease for the pollution degree (Igeo) of As, Cd, Co, Cr, Ni, and Zn was the Jinsha River, the middle reaches of the Yangtze River, and the Three Gorges Reservoir. The decrease order of bioavailability (RAC) of Cd, Co, Cr, Cu, Ni, and Zn was the Three Gorges Reservoir, the Jinsha River, and the middle reaches of the Yangtze River. The bioavailability of As and Pb decreased in the order of the middle reaches of the Yangtze River, the Three Gorges, and the Jinsha River. According to the classification of the RAC, Cd in the Three Gorges Reservoir area exhibited a high risk with the RAC accounting for 48.44%. Cu, Ni, and Zn showed a low or medium risk.

Can EMS providers and emergency department nurses work together to identify home risk factors for falls in older people?

Taiwan is an aging society and the ratio of falls among the older persons is high. Most falls occur at home, and multiple risk factors including home safety are involved. We propose a novel model of emergency medical technicians (EMTs) to assess home safety using scalable checklists. This study was conducted to evaluate its feasibility. This study was conducted between April 1, 2020 and March 31, 2021. The development of the risk factor assessment scale for falls in the home environment was divided into 2 stages. In stage 1, 2 researchers reviewed the extant literature. In stage 2, 6 experts judged the content validity index. According to EMT findings, emergency department (ED) nurses checked the items in the Checklist of Risk Factors for Falls in the Home Environment. The checklists were provided to the geriatric care manager (GCM) in the ED, who then discussed potential solutions with the patients or primary caregivers. A total of 235 participants were enrolled, and EMTs carried out environment assessment for 93.2% (219/235) of them. A total of 207 participants were at risk of falls at home and 79.7% (165/207) of them received intervention measures from the GCM according to the risk items. Education was the main intervention method, with 158 subjects. Moreover, seven subjects (4.2%, 7/165) were provided long-term care resources by the GCM with occupational therapists to help improve the environment at home. Our study provides an efficient method for EMTs to assess home fall hazards.

Organic chromium derived from the chelation of Ganoderma lucidum polysaccharide and chromium (III) alleviates metabolic syndromes and intestinal microbiota dysbiosis induced by high-fat and high-fructose diet.

Organic chromium is of great interest and has become an important chromium supplement resource in recent years because of its low toxicity and easy absorption. In our previous study, we synthesized a novel organic chromium [GLP-Cr] through the chelation of Ganoderma lucidum polysaccharide and chromium (III). The purpose of this study was to investigate the beneficial effects of GLP-Cr on the improvement of metabolic syndromes (MetS) in mice fed with a high-fat and high-fructose diet (HFHFD) and its mechanism of action. The results indicated that oral administration of GLP-Cr inhibited the excessive exaltation of body weight, glucose tolerance, fasting blood glucose and lipid levels, hepatic total cholesterol (TC), triglyceride (TG) levels caused by HFHFD. Besides, 16S rRNA amplicon sequencing showed that GLP-Cr intervention evidently ameliorated intestinal microbiota dysbiosis by changing the proportions of some intestinal microbial phylotypes. In addition, correlation network-based analysis indicated that the key intestinal microbial phylotypes were closely related to biochemical parameters associated with MetS under GLP-Cr intervention. Liver metabolomics analysis suggested that GLP-Cr intervention significantly regulated the levels of some biomarkers involved in alpha-linolenic acid metabolism, fatty acid biosynthesis, steroid hormone biosynthesis, glycerophospholipid metabolism, glycerolipid metabolism, steroid hormone biosynthesis, primary bile acid biosynthesis, and so on. Moreover, GLP-Cr intervention regulated liver mRNA levels of key genes associated with glucose and lipid metabolism. The mRNA level of glucose transporter type 4 (Glut4) was markedly increased by GLP-Cr intervention, and the mRNA levels of phosphoenolpyruvate carboxykinase (Pepck) and glucose-6-phosphatase (G6Pase) in the liver were significantly decreased. Meanwhile, GLP-Cr intervention significantly decreased hepatic mRNA levels of cluster of differentiation 36 (Cd36), acetyl-CoA carboxylase 1 (Acc1) and sterol regulatory element binding protein-1c (Srebp-1c), indicating that GLP-Cr intervention inhibited the excessive accumulation of free fatty acids in the liver. These findings suggest that the prevention of hyperglycemia and dyslipidemia by GLP-Cr may be closely related to the regulation of gut microbial composition and hepatic metabolic pathways, thus GLP-Cr can be serving as a functional component in the prevention of MetS.

Use of Plastic Bag to Reduce Risks in Operators During Endotracheal Intubation of Patients With Coronavirus Disease 2019.

The rapid spread of coronavirus disease 2019 (COVID-19) has led to a large number of patients being admitted to hospitals, resulting in a near collapse of the medical system. The shortage of negative pressure isolation rooms and personal protective equipment is a potential problem. It is a pressing challenge to prevent the risk of infection in emergency physicians (EPs) during the endotracheal intubation of patients with COVID-19. We used a large clear plastic bag, cut an opening that covered the patient's head, and created a negative pressure environment inside the plastic bag using the hospital's medical gas pipeline system; thus reducing the amount of virus-containing aerosols leaked out and the risk of infection in the operators performing intubation. The video (http://www.caregiver.com.tw/Article.asp?ID=1258#article) about the detailed preparation of the plastic bag intubation kit (PBIK) has been posted on the website. This technique for safe endotracheal intubation in patients with COVID-19 is being used not only by EPs in Taiwan, but also by physicians and paramedics from other countries. Regarding designing the PBIK, our original intention was to use readily available materials to make tools that can improve the safety of the operators performing the intubations in situations where medical resources are exhausted. However, due to limited time and patients, further research is needed for validation.

Anti-EGFR therapy in metastatic colorectal cancer: mechanisms and potential regimens of drug resistance.

Cetuximab and panitumumab, as the highly effective antibodies targeting epidermal growth factor receptor (EGFR), have clinical activity in the patients with metastatic colorectal cancer (mCRC). These agents have good curative efficacy, but drug resistance also exists at the same time. The effects of KRAS, NRAS, and BRAF mutations and HER2 amplification on the treatment of refractory mCRC have been elucidated and the corresponding countermeasures have been put forward. However, the changes in EGFR and its ligands, the mutations or amplifications of PIK3CA, PTEN, TP53, MET, HER3, IRS2, FGFR1, and MAP2K1, the overexpression of insulin growth factor-1, the low expression of Bcl-2-interacting mediator of cell death, mismatch repair-deficient, and epigenetic instability may also lead to drug resistance in mCRC. Although the emergence of drug resistance has genetic or epigenetic heterogeneity, most of these molecular changes relating to it are focused on the key signaling pathways, such as the RAS/RAF/mitogen-activated protein kinase or phosphatidylinositol 3-kinase/Akt/mammalian target of the rapamycin pathway. Accordingly, numerous efforts to target these signaling pathways and develop the novel therapeutic regimens have been carried out. Herein, we have reviewed the underlying mechanisms of the resistance to anti-EGFR therapy and the possible implications in clinical practice.

Immune-infiltration based signature as a novel prognostic biomarker in gastrointestinal stromal tumour.

BACKGROUND: Accumulating evidence indicates that tumour-infiltrating lymphocytes (TILs) are the primary determinant of survival outcomes in various tumours. Thus, we sought to investigate the TIL distribution and density in gastrointestinal stromal tumours (GISTs) and to develop an immune infiltration (II)-based signature to predict prognosis. METHODS: The expression of 8 immune features in the tumour centre (TC) and tumour margin (TM) and PD-L1 in 435 GIST patients was investigated by immunohistochemistry. Then, a 4-feature-based II-GIST signature integrating the CD3+ TC, CD3+ TM, CD8+ TM and CD45RO+ TM parameters was developed using a LASSO Cox regression model in the training cohort and was validated in two separate validation cohorts. FINDINGS: High CD3+ TC, CD3+ TM, CD8+ TC, CD8+ TM, CD45RO+ TM, NKp46+ TM and CD20+ TM correlated with improved survival. Patients with high II-GIST scores have better RFS and OS outcomes than those with low II-GIST scores. Multivariable analyses demonstrated that the II-GIST signature is an independent prognostic factor. The receiver operating characteristic (ROC) curve demonstrated that the prognostic accuracy of the II-GIST signature is superior to that of the NIH risk criteria. Further analysis showed that moderate- and high-risk GIST patients with high II-GIST scores could gain survival benefits from adjuvant imatinib therapy. INTERPRETATION: The novel II-GIST signature accurately predicted the survival outcomes of GIST patients. In addition, the II-GIST signature was a useful predictor of survival benefit from imatinib therapy amongst moderate- and high-risk patients with GIST. FUNDING: This project was supported by National Natural Science Foundation of China (81702325), Natural Science Foundation of Guangdong Province (2017A030310565), and 3&3 Project of the First Affiliated Hospital of Sun Yat-sen University.

CT-based radiomics scores predict response to neoadjuvant chemotherapy and survival in patients with gastric cancer.

BACKGROUND: Neoadjuvant chemotherapy is a promising treatment option for potential resectable gastric cancer, but patients' responses vary. We aimed to develop and validate a radiomics score (rad_score) to predict treatment response to neoadjuvant chemotherapy and to investigate its efficacy in survival stratification. METHODS: A total of 106 patients with neoadjuvant chemotherapy before gastrectomy were included (training cohort: n = 74; validation cohort: n = 32). Radiomics features were extracted from the pre-treatment portal venous-phase CT. After feature reduction, a rad_score was established by Randomised Tree algorithm. A rad_clinical_score was constructed by integrating the rad_score with clinical variables, so was a clinical score by clinical variables only. The three scores were validated regarding their discrimination and clinical usefulness. The patients were stratified into two groups according to the score thresholds (updated with post-operative clinical variables), and their survivals were compared. RESULTS: In the validation cohort, the rad_score demonstrated a good predicting performance in treatment response to the neoadjuvant chemotherapy (AUC [95% CI] =0.82 [0.67, 0.98]), which was better than the clinical score (based on pre-operative clinical variables) without significant difference (0.62 [0.42, 0.83], P = 0.09). The rad_clinical_score could not further improve the performance of the rad_score (0.70 [0.51, 0.88], P = 0.16). Based on the thresholds of these scores, the high-score groups all achieved better survivals than the low-score groups in the whole cohort (all P < 0.001). CONCLUSION: The rad_score that we developed was effective in predicting treatment response to neoadjuvant chemotherapy and in stratifying patients with gastric cancer into different survival groups. Our proposed strategy is useful for individualised treatment planning.

The prognostic roles of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in gastrointestinal stromal tumours: a meta-analysis.

BACKGROUND: The platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) have been found to be associated with prognosis in several solid tumours. However, the prognostic roles of PLR and NLR in gastrointestinal stromal tumours (GISTs) remain controversial. The aim of this meta-analysis was to assess the prognostic roles of PLR and NLR in GISTs. METHODS: We searched MEDLINE, EMBASE and the Cochrane Library for relevant articles. A systematic review was performed to calculate pooled hazard ratios (HRs) for disease-free survival (DFS) and overall survival (OS) by fixed-effects/random-effects models. RESULTS: Fourteen studies containing 3,151 subjects were finally enrolled in this meta-analysis. Eight studies including 2,560 patients investigated the prognostic effect of PLR, and thirteen studies with 2,751 subjects explored the prognostic effect of NLR. Both elevated PLR (HR: 1.29, 95% CI: 1.10-1.52, P=0.002) and NLR (HR: 1.37, 95% CI: 1.15-1.63, P=0.0005) were significantly associated with decreased DFS. The pooled HR for PLR was not significantly different from that for NLR. High PLR and NLR correlated with increased tumour sizes, more advanced tumour stages and mitotic index (>5/50 HPF). In addition, elevated PLR was related to adjuvant tyrosine kinase inhibitor (TKI) therapy. CONCLUSIONS: Elevated preoperative PLR and NLR are associated with poor outcomes in patients with GISTs.

Predictive ability of prognostic nutritional index in surgically resected gastrointestinal stromal tumors: a propensity score matching analysis.

BACKGROUND: Recent findings have shown that inflammation indices are associated with prognosis in various malignancies. However, the usefulness of inflammation indices including platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio and prognostic nutritional index for gastrointestinal stromal tumors (GISTs) remains controversial. METHODS: We retrospectively reviewed 340 primary localized GIST patients who had received surgical resection between 2005 and 2015 to investigate the effect of platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio and prognostic nutritional index on prognosis. 206 patients were selected by propensity score matching to control selection biases. RESULTS: Kaplan-Meier analysis and the log rank test demonstrated that high prognostic nutritional index (≥43.9) was significantly correlated with better recurrence-free survival (RFS) (P<0.001). Among the three inflammatory indices, only preoperative high prognostic nutritional index was an independent prognostic factor for survival [hazard ratio (HR) 0.509; 95% confidence interval (CI) 0.266-0.872; P = 0.031] in multivariate analysis. After propensity score matching, elevated prognostic nutritional index was still a predictor for RFS (HR = 0.498; 95% CI 0.253-0.971; P = 0.042) in the multivariate analyses. In addition, prognostic nutritional index was a significant prognostic factor for GISTs within the National Institutes of Health (NIH) high and very low/low-risk categories. Incorporation prognostic nutritional index into the NIH risk criteria improved the prognostic stratification (c-index, 0.725 vs. 0.686, p = 0.039). CONCLUSIONS: High prognostic nutritional index is a predictor of improved survival for surgically resected GISTs and incorporation prognostic nutritional index into NIH risk criteria improves the predictive accuracy.

Deregulation of MicroRNA-375 Inhibits Proliferation and Migration in Gastric Cancer in Association With Autophagy-Mediated AKT/mTOR Signaling Pathways.

Gastric cancer is a deadly disease. Some microRNAs are involved in tumor invasion and metastasis. Underexpression of miR-375 has been correlated with tumorigenesis, treatment resistance, and poor prognosis. In this study, we first analyzed the profiles and prognostic values of miR-375 expression in gastric cancer tissues from a public database, and the expression level of miR-375 in gastric cancer samples and gastric cancer cell lines was then analyzed by quantitative real- time polymerase chain reaction. Significant underexpression of miR-375 was seen in all the gastric cancer samples compared to paired paracarcinoma tissues, and the expression level of miR-375 in the gastric cancer cell lines was negatively associated with the cell migration ability. A Cell proliferation (CCK-8) assay was performed to examine cell viability. Overexpression of miR-375 suppressed the proliferation of gastric cancer cells. A Western blot analysis was carried out to test protein expression. Overexpression of miR-375 inhibited autophagy through the AKT/ mammalian target of rapamycin signaling pathway. MiR-375 regulated invasion and migration via AKT/ mammalian target of rapamycin pathway-mediated epithelial-to-mesenchymal transition. Wound healing and migration assays were used to determine the motility of gastric cancer cells. A gastric cancer xenograft nude mouse model was used for an in vivo efficacy evaluation. Overexpression of miR-375 significantly suppressed cell proliferation in the established gastric cancer xenograft nude mouse model. Our results demonstrate that increasing the expression level of miR-375 suppresses proliferation in vitro and in vivo, and they provide a mechanistic and applicable rationale for the future clinical evaluation of miR-375 in gastric cancer treatment. Our findings provide not only new information about the molecular mechanism of microRNAs in regulating invasion and migration in gastric cancer but also a theoretical principle for a potential targeted therapy for gastric cancer.

[Phosphorus Forms and Distribution Characteristics in the Sediment and Soil of the Water-Level-fluctuating Zone in the Main Stream of the Three Gorges Reservoir].

Hydrological regimes changed after the Three Gorges Reservoir (TGR) became fully operational, with the water level fluctuating between 145 m and 175 m. This has altered phosphorus (P) distribution within sediments and soils of the water-level-fluctuating zone (WLFZ). Eleven field investigations within the main stream were carried out in June 2016. The aim of the study was to determine lateral (sediment and WLFZ soil) and longitudinal variations (from the end of the backwater area to the Three Gorges Dam) of phosphorus species. P fractions were analyzed using a Standards, Measurements, and Testing (SMT) protocol. Results showed that both TP and NaOH-P content in sediment exhibited a clear increasing trend from the end of the backwater area to the Three Gorges Dam, while HCl-P declined. Average of totals P, OP (organic P), HCl-extracted P (HCl-P, calcium-bond P), and NaOH-extracted P (NaOH-P, metal oxide-bound P) in sediment were (859.6±106.8), (224.6±113.9), (435.3±77.7), and (101.5±31.6) mg·kg-1, respectively. The concentration average of P species in sediment was higher than in WLFZ soil. In both sediment and soil, HCl-P was the main form of P, accounting for 51.3% and 58.2% of TP, while the ratio of NaOH-P to TP was 11.7% and 8.1%, respectively. P fractions with a higher coefficient of variation had greater spatial heterogeneity.

Systemic immune-inflammation index for predicting prognosis of colorectal cancer.

AIM: To investigate the clinical significance of preoperative systemic immune-inflammation index (SII) in patients with colorectal cancer (CRC). METHODS: A retrospective analysis of 1383 cases with CRC was performed following radical surgery. SII was calculated with the formula SII = (P × N)/L, where P, N, and L refer to peripheral platelet, neutrophil, and lymphocyte counts, respectively. The clinicopathological features and follow-up data were evaluated to compare SII with other systemic inflammation-based prognostic indices such as the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in patients with CRC. RESULTS: The optimal cut-off point for SII was defined as 340. The overall survival (OS) and disease-free survival (DFS) were better in patients with low NLR, PLR, and SII (P < 0.05). The SII was an independent predictor of OS and DFS in multivariate analysis. The area under the receiver-operating characteristics (ROC) curve for SII (0.707) was larger than those for NLR (0.602) and PLR (0.566). In contrast to NLR and PLR, SII could effectively discriminate between the TNM subgroups. CONCLUSION: SII is a more powerful tool for predicting survival outcome in patients with CRC. It might assist the identification of high-risk patients among patients with the same TNM stage.

Up-regulation of long non-coding RNA XLOC_010235 regulates epithelial-to-mesenchymal transition to promote metastasis by associating with Snail1 in gastric cancer.

We previously performed long non-coding RNA (lncRNA) expression microarray analyses to identify novel indicators for gastric cancer (GC) metastasis and prognosis in which we identified lncRNA XLOC_010235 (XLOC) as a candidate RNA. However, XLOC_010235 molecular mechanism of action remains unclear. Gain and loss of function approaches were used to investigate the biological role of XLOC in vitro. The effects of XLOC on cell viability were assessed by CCK-8 proliferation assays. Real-time PCR, western-blot and immunofluorescence were used to evaluate the mRNA and protein expression of Snail and multiple EMT related molecules. The positive XLOC/Snail1 interaction was identified and verified by immunohistochemistry assay and bivariate correlation analysis. Ectopic expression of XLOC facilitate cell viability, migration and invasion, leading to the acceleration of metastasis, while depletion of XLOC expression hindered cell migration and invasion. Moreover, over-expression of XLOC was found to play a important role in epithelial-to-mesenchymal transition (EMT) through the regulation of E-cadherin, N-cadherin and Vimentin expression, in which transcriptional factor Snail1 was involved. These results advance our understanding of the role of lncRNA XLOC_010235 as a active regulator of EMT by associating with Snail1, which may help in the development of new therapeutics.

Expression analysis of nine Toll-like receptors in yellow catfish (Pelteobagrus fulvidraco) responding to Aeromonas hydrophila challenge.

Toll-like receptors (TLRs) are important components of pattern recognition receptors (PRRs), which play significant roles in innate immunity to defense against pathogen invasion. Many TLRs have been found in teleosts, but there are no reports about cloning and expression of TLR genes in yellow catfish (Pelteobagrus fulvidraco). In this study, we analyzed the sequence characters and the relative mRNA expression levels of nine TLRs (TLR1, TLR2, TLR3, TLR4-1, TLR5, TLR7, TLR8-2, TLR9 and TLR22) in different tissues of yellow catfish. The results showed that all nine TLR genes are highly expressed in head kidney, trunk kidney, spleen and liver, all of which are related to host immunity. Subsequently we used Aeromonas hydrophila as a stimulating agent to detect the expression profiles of these nine TLRs in the liver, spleen, trunk kidney and head kidney of yellow catfish at different time points after injection with killed Aeromonas hydrophila. All nine TLRs responded to A. hydrophila challenge with tissue-specific patterns in different immune tissues. The kinetics of up- or down-regulation of these nine TLRs exhibited a similar trend, rising to an elevated level at first and then falling to the basal level, but the peak value differed at different time points in different tissues. The expression levels of the TLR3, TLR4-1, TLR9 and TLR22 genes were significantly up-regulated after bacterial challenge in the liver, spleen, head kidney and trunk kidney. The relatively high expression of TLR genes in the immune tissues in response to the A. hydrophila challenge indicated that TLRs may play important roles in the innate immune response against gram-negative bacteria in yellow catfish.

Use of a Modified Fishbone Diagram to Analyze Diagnostic Errors in Emergency Physicians.

INTRODUCTION: Reilly et al. described a structured approach to the analysis of diagnostic errors by using a novel modifi ed fi shbone diagram. The application of this tool in emergency medicine had not previously been reported. The objective of this study is to use the modified fishbone diagram analysis method in examining the causes of common diagnostic errors committed by emergency physicians and the circumstances associating errors in cognitive processes. METHODS: Sixty-one cases of diagnostic errors involving ten board-certified emergency physicians (EPs) were identifi ed through a peer review process. Using a qualitative study approach, in-depth semi structured interviews with EPs was conducted. All interview audiotapes were transcribed verbatim. Content analysis was performed on all textual data to identify the factors underlying errors using the modified fishbone diagram. RESULTS: In 61 cases, 165 diagnostic errors were identified (2.7 per case). The underlying contributions to errors fell into 7 categories: cognitive process (54/61, 89%), specific presentation (32/61, 52%), clinical data gathering (24/61, 39%), organization issues (12/61, 20%), affective factors (9/61, 15%), context of care (9/61, 15%), and communication (5/61, 8%). Of these cognitive errors were the most common. However, only six cases occurred in isolation (6/54, 11%), with the remaining 48 cases (48/54, 89%) occurring with other types of errors, the most common being specific presentation (28/54, 52%) and clinical data gathering (24/54, 44%). CONCLUSIONS: The modified fishbone diagram is a useful tool to identify various categories of errors on diagnostic process in emergency department (ED). These fi ndings provide a basis on which to build a framework for teaching EPs how to avoid misdiagnoses in the ED setting.

Cordyceps sinensis preserves intestinal mucosal barrier and may be an adjunct therapy in endotoxin-induced sepsis rat model: a pilot study.

BACKGROUND: Cordyceps sinensis (C. sinensis), a traditional Chinese medicine, exhibits various pharmacological activities such as reparative, antioxidant, and apoptosis inhibitory effects. Intestinal barrier dysfunction plays a vital role in the progression of sepsis. We aimed to explore the effect of C. sinensis on the gut barrier and evaluate its efficacy in sepsis. METHODS: A murine model of gut barrier dysfunction was created by intraperitoneal injection of endotoxin. C. sinensis or saline was administered orally after the induction of sepsis. Alterations of intestinal barrier were evaluated and compared in terms of epithelial cell apoptosis, proliferation index (PI), intercellular tight junction (TJ) and proliferating cell nuclear antigen (PCNA). RESULTS: C. sinensis significantly decreased the percentage of apoptotic cells and promoted mucosal cells proliferation indicated by enhanced PI and PCNA expression in the intestinal mucosa compared to control group. The TJs between epithelial cells which were disrupted in septic rats were also restored by treatment of C. sinensis. In survival studies, C. sinensis was demonstrated to confer a protection against the lethal effect of sepsis. CONCLUSION: These results suggest that C. sinensis has gut barrier-protection effect in endotoxin-induced sepsis by promoting the proliferation and inhibiting the apoptosis of intestinal mucosal cells, as well as restoring the TJs of intestinal mucosa. C. sinensis may have the potential to be a useful adjunct therapy for sepsis.