Shikonin suppresses rheumatoid arthritis by inducing apoptosis and autophagy via modulation of the AMPK/mTOR/ULK-1 signaling pathway.

BACKGROUND: The overproliferation of fibroblast-like synoviocytes (FLS) contributes to synovial hyperplasia, a pivotal pathological feature of rheumatoid arthritis (RA). Shikonin (SKN), the active compound from Lithospermum erythrorhizon, exerts anti-RA effects by diverse means. However, further research is needed to confirm SKN's in vitro and in vivo anti-proliferative functions and reveal the underlying specific molecular mechanisms. PURPOSE: This study revealed SKN's anti-proliferative effects by inducing both apoptosis and autophagic cell death in RA FLS and adjuvant-induced arthritis (AIA) rat synovium, with involvement of regulating the AMPK/mTOR/ULK-1 pathway. METHODS: SKN's influences on RA FLS were assessed for proliferation, apoptosis, and autophagy with immunofluorescence staining (Ki67, LC3B, P62), EdU incorporation assay, staining assays of Hoechst, Annexin V-FITC/PI, and JC-1, transmission electron microscopy, mCherry-GFP-LC3B puncta assay, and western blot. In AIA rats, SKN's anti-arthritic effects were assessed, and its impacts on synovial proliferation, apoptosis, and autophagy were studied using Ki67 immunohistochemistry, TUNEL, and western blot. The involvement of AMPK/mTOR/ULK-1 pathway was examined via western blot. RESULTS: SKN suppressed RA FLS proliferation with reduced cell viability and decreased Ki67-positive and EdU-positive cells. SKN promoted RA FLS apoptosis, as evidenced by apoptotic nuclear fragmentation, increased Annexin V-FITC/PI-stained cells, reduced mitochondrial potential, elevated Bax/Bcl-2 ratio, and increased cleaved-caspase 3 and cleaved-PARP protein levels. SKN also enhanced RA FLS autophagy, featuring increased LC3B, reduced P62, autophagosome formation, and activated autophagic flux. Autophagy inhibition by 3-MA attenuated SKN's anti-proliferative roles, implying that SKN-induced autophagy contributes to cell death. In vivo, SKN mitigated the severity of rat AIA while also reducing Ki67 expression, inducing apoptosis, and enhancing autophagy within AIA rat synovium. Mechanistically, SKN modulated the AMPK/mTOR/ULK-1 pathway in RA FLS and AIA rat synovium, as shown by elevated P-AMPK and P-ULK-1 expression and decreased P-mTOR expression. This regulation was supported by the reversal of SKN's in vitro and in vivo effects upon co-administration with the AMPK inhibitor compound C. CONCLUSION: SKN exerted in vitro and in vivo anti-proliferative properties by inducing apoptosis and autophagic cell death via modulating the AMPK/mTOR/ULK-1 pathway. Our study revealed novel molecular mechanisms underlying SKN's anti-RA effects.

Development and validation of LightGBM algorithm for optimizing of Helicobacter pylori antibody during the minimum living guarantee crowd based gastric cancer screening program in Taizhou, China.

Gastric cancer continues to be a significant health concern in China, with a high incidence rate. To mitigate its impact, early detection and treatment is key. However, conducting large-scale endoscopic gastric cancer screening is not feasible in China. Instead, a more appropriate approach would be to initially screen high-risk groups and follow up with endoscopic testing as needed. We conducted a study on 25,622 asymptomatic participants aged 45-70 years from a free gastric cancer screening program in the Taizhou city government's Minimum Living Guarantee Crowd (MLGC) initiative. Participants completed questionnaires, blood tests, and underwent gastrin-17 (G-17), pepsinogen I and II (PGI and PGII), and H. pylori IgG antibody (IgG) assessments. Using the light gradient boosting machine (lightGBM) algorithm, we developed a predictive model for gastric cancer risk. In the full model, F1 score was 2.66%, precision was 1.36%, and recall was 58.14%. In the high-risk model, F1 score was 2.51%, precision was 1.27%, and recall was 94.55%. Excluding IgG, the F1 score was 2.73%, precision was 1.40%, and recall was 68.62%. We conclude that H. pylori IgG appears to be able to be excluded from the prediction model without significantly affecting its performance, which is important from a health economic point of view. It suggests that screening indicators can be optimized, and expenditures reduced. These findings can have important implications for policymakers, as we can focus resources on other important aspects of gastric cancer prevention and control.

Comparison of induction chemotherapy combined with concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in Lymph-Node-Stage III nasopharyngeal carcinoma based on propensity score-matching.

PURPOSE: To explore the role of induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT) versus CCRT alone in patients diagnosed with N3 nasopharyngeal carcinoma (NPC). PATIENTS AND METHODS: A total of 787 patients with newly diagnosed N3 NPC treated with IC + CCRT or CCRT alone were included. Progression-free survival (PFS) was the primary endpoint. We balanced variables using propensity score matching (PSM). Kaplan-Meier curves with log-rank tests were applied to evaluate the survival condition of each group. Independent prognostic factors were identified using the Cox regression analysis. RESULTS: PSM assigned 228 patients to IC + CCRT and CCRT alone groups. Survival analysis for the matched data set showed that IC + CCRT achieved better survival outcomes compared with CCRT alone, and significant difference was observed in 5-year PFS [74.8% (95%CI 69.2 âˆ¼ 80.9%) vs 65.4% (95%CI 59.4 âˆ¼ 72.0%), P = 0.008], 5-year OS [(77.4%(95%CI 71.9 âˆ¼ 83.3%) vs66.3%(95%CI 60.3 âˆ¼ 72.9%), P = 0.005)] and 5-year distant metastasis-free survival (DMFS)[(81.8%(95%CI 76.7 âˆ¼ 87.2%) vs72.4%(95%CI 66.7 âˆ¼ 78.7%), P = 0.007)] between the two treatment groups. In multivariate analysis, IC + CCRT remained an independent protective factor for PFS (adjusted HR, 0.603; 95% CI, 0.433-0.841; P = 0.003), OS (adjusted HR, 0.568; 95% CI, 0.406-0.793; P < 0.001), and DMFS (adjusted HR, 0.541; 95% CI, 0.364-0.805; P = 0.002). CONCLUSION: More chemotherapy should be considered in patients with N3 NPC because of its ability to improve survival time. This could be from the use of IC or adjuvant metronomic chemotherapy.

Efficacy of hydrosurgical excision combined with skin grafting in the treatment of deep partial-thickness and full-thickness burns: A two-year retrospective study.

INTRODUCTION: Deep partial-thickness and full-thickness burn wounds often undergo tangential excision or escharectomy to expose healthy tissue, combined with skin grafting to promote wound healing. However, conventional tangential excision with the humby knife leads to inevitable damage to the dermis while excising burn tissue due to the lack of precision. Indeed, the preservation of dermal tissue is a key factor in determining wound healing and scar quality. The precision and tissue selectivity of the Versajet Hydrosurgical System has been established for excising burn tissue while preserving dermal tissue. In this study, we retrospectively compared the efficacy of "Hydrosurgical excision combined with skin grafting" and "Conventional tangential excision combined with skin grafting" in treating deep partial-thickness and full-thickness burn wounds to demonstrate that hydrosurgery improved the treatment of deep partial-thickness and full-thickness burns. METHODS: A total of 86 patients with deep partial-thickness and/or full-thickness burns with a total burn surface area (TBSA) ≤ 25% from July 2018 to July 2020 were included in this study and were divided into experimental (hydrosurgical excision combined with skin grafting, n = 43) and control (conventional tangential excision combined with skin grafting, n = 43) groups. Parameters were analyzed, including the intraoperative blood loss volume per unit area of grafted skin, surgery duration, wound healing time, skin graft survival, and the treatment costs per unit of burned area. Scar assessment was performed at 1 year with the modified Vancouver Scar Scale linked with TBSA (mVSS-TBSA). RESULT: No significant difference was found in male to female ratio, age, weight, TBSA, burn depth, skin grafting area (SKA), skin grafting methods, cases treated with carbon dioxide fractional laser or incidence of inhalation injury, and the incidence of hypovolemic shock between two groups(p > 0.05). Compared with the control group, patients treated with hydrosurgical excision combined with skin grafting experienced less intraoperative blood loss volume per unit area of grafted skin (p < 0.05). The mVSS-TBSA of patients that underwent hydrosurgical excision combined with skin grafting was significantly improved in comparison to the control group (p < 0.01). No significant difference was found in surgery duration, wound healing time, skin graft survival and treatment costs per unit of burned area between the two groups (p > 0.05). CONCLUSION: Hydrosurgical excision combined with skin grafting reduced intraoperative blood loss volume per unit area of grafted skin, improved scarring 1-year after injury, and did not increase the treatment costs per unit of burned area. This technique provides a novel alternative for managing deep partial-thickness and full-thickness burn wounds.

[Diversity and functional prediction of gut microbiota in children with autism spectrum disorder]. / å­¤ç‹¬ç—‡è°±ç³»éšœç¢å„¿ç«¥è‚ é“èŒç¾¤å¤šæ ·æ€§ç ”ç©¶åŠåŠŸèƒ½é¢„æµ‹åˆ†æž.

OBJECTIVES: To study the structure and diversity of gut microbiota in children with autism spectrum disorder (ASD), and to predict the metabolic function of gut microbiota. METHODS: Fecal samples were collected from 30 ASD children (ASD group) and 20 typically developing (TD) children (TD group). Genomic DNA was extracted, the 16S rDNA V4 region was amplified by PCR, and Illumina NovaSeq6000 platform was used for high-throughput sequencing. The composition and distribution characteristics of gut microbiota were analyzed for the two groups, and the metabolic function of gut microbiota was predicted. RESULTS: There were no significant differences in alpha diversity indices (Chao1, Shannon, and Simpson) of gut microbiota between the ASD and TD groups (P>0.05). At the phylum and class levels, there was no significant difference in the structure of gut microbiota between the two groups (P>0.05). Compared with the TD group, the ASD group had significantly higher abundance of Megamonas, Barnesiella, Dialister, Megasphaera, Ruminococcus_torques_group, and Fusobacterium at the genus level (P<0.05). Functional prediction analysis showed that compared with the TD group, the ASD group had a significantly lower abundance of the gut microbiota with the metabolic functions such as tryptophan degradation, glutamate degradation, and butyrate production (P<0.05) and a significantly higher abundance of the gut microbiota with the metabolic function of GABA degradation (P<0.05). CONCLUSIONS: There is no significant difference in the alpha diversity of gut microbiota between ASD children and TD children, while there are differences in the composition of species at the genus level and the metabolic functions of gut microbiota.

Treatment of ursodeoxycholic acid with glucocorticoids and immunosuppressants may improve the long-term survival rate in primary biliary cholangitis patients.

Primary biliary cholangitis (PBC) is an autoimmune cholestatic liver disease. The clinical effectiveness of ursodeoxycholic acid (UDCA) plus glucocorticoids and/or immunosuppressants remains controversial in PBC patients. The study aimed to compare the efficacy of monotherapy and combination therapy in patients with PBC and to assess the factors affecting the efficacy. In this retrospective study, 266 patients diagnosed with PBC were divided into monotherapy group (UDCA), double therapy group (UDCA plus glucocorticoids or immunosuppressants), and triple therapy group (UDCA plus glucocorticoids and immunosuppressants) according to different treatments. Demographic characteristics, immune parameters, biochemistry profiles, and other indicators were evaluated at baseline, 6 months, and 1 year following treatment. The prognosis was evaluated using the Paris II standard. The liver transplant-free survival at 3, 5, 10, and 15 years was predicted by GLOBE score. All statistical analyses were conducted using SPSS (version 24) software (SPSS Inc, Chicago, IL). The long-term survival rate of the triple therapy group was significantly improved compared with the monotherapy group (P = .005). In addition, multivariate analysis showed that abnormal platelet count, alkaline phosphatase, and albumin levels were risk factors for poor response. When IgG levels were elevated but below twice the upper limit of normal, the clinical benefit was not significant compared with monotherapy (P > .05). Compared with monotherapy and double therapy, triple therapy may improve the long-term survival rate of PBC patients. Abnormal platelet count, alkaline phosphatase, and albumin levels were associated with a poor prognosis.

Tuberculosis-associated hemophagocytic lymphohistiocytosis misdiagnosed as systemic lupus erythematosus: A case report.

BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is a rare disorder with rapid progression and high mortality. HLH occurs mostly due to infection, malignant tumors, and immune disorders. Among infections that cause HLH, viral infections, especially Epstein-Barr virus infections, are common, whereas tuberculosis is rare. Tuberculosis-associated HLH has a wide range of serological and clinical manifestations that are similar to those of systemic lupus erythematosus (SLE). CASE SUMMARY: This study describes a case of tuberculosis-associated HLH misdiagnosed as SLE because of antinuclear antibody (ANA), Smith (Sm) antibody and lupus anticoagulant positivity; leukopenia; thrombocytopenia; pleural effusion; decreased C3, quantitatively increased 24 h urinary protein and fever. The patient was initially treated with glucocorticoids, which resulted in peripheral blood cytopenia and symptom recurrence. Then, caseating granulomas and hemophagocytosis were observed in her bone marrow. She was successfully treated with conventional category 1 antituberculous drugs. In addition, we reviewed the literature on tuberculosis-associated HLH documented in PubMed, including all full-text articles published in English from December 2009 to December 2019, and summarized the key points, including the epidemiology, clinical manifestations, diagnosis, and treatment of tuberculosis-associated HLH and the differences of the present case from previous reports. CONCLUSION: Tuberculosis should be considered in patients with fever or respiratory symptoms. Antituberculous drugs are important for treating tuberculosis-associated HLH.

Combination therapy of ursodeoxycholic acid and glucocorticoid and (or) immunosuppressant in patients with primary biliary cholangitis: A meta-analysis.

BACKGROUND/OBJECTIVES: Primary biliary cholangitis (PBC) is a chronic inflammatory autoimmune cholestasis liver disease. There were many studies comparing a combination of glucocorticoids and/or immunosuppressants to a single UDCA therapy in PBC patients, while the literature demonstrated divergent finds. To evaluate the effectiveness of ursodeoxycholic acid (UDCA) combined with glucocorticoids and (or) immunosuppressants on biochemistry, immunology, histology, clinical symptoms, and adverse reactions of PBC from the perspective of evidence-based medicine. MATERIALS AND METHODS: PubMed, web of science, the Cochrane Library, EMBASE databases were searched to collect clinical randomized trials and self-control studies of UDCA combined with glucocorticoids and (or) immunosuppressants and UDCA monotherapy in the treatment of PBC. The retrieval time is from the establishment of the database to August 2020. Two reviewers independently screened literature, extracted data and evaluated the bias of included studies. Revman 5.3 software was used for meta-analysis. RESULTS: Six studies including 201 patients were included. The meta-analysis found that the combination therapy can improve some biochemical indexes, immunological indexes, and clinical symptoms of patients with PBC. However, combination therapy has no significant improvement in other biochemical indicators which respond to liver and bile duct damage, such as ALT, GGT, and ALB. Besides, the improvement of liver histology is limited, and the incidence of adverse events is higher. CONCLUSION: Overall, the combination therapy showed no improvement in key biochemical parameters and limited improvement in liver pathology. Besides, the side effects were more serious. Therefore, in the current treatment regimen, it is not recommended for PBC patients.

Rapid detection of Mycoplasma mycoides subsp. capri and Mycoplasma capricolum subsp. capripneumoniae using high-resolution melting curve analysis.

Mycoplasma capricolum subsp.subsp. capripneumonia (Mccp) and Mycoplasma mycoides subsp.sbusp. capri (Mmc) cause caprine pleuropneumonia (CCPP) and mycoplasmal pneumonia in goats and sheep (MPGS), respectively. These diseases cannot be identified on clinical symptoms alone and it is laborious to distinguish them using biochemical methods. It is therefore important to establish a simple, rapid identification method for Mccp and Mmc. Here, we report a high-resolution melting (HRM) curve analysis using specific primers based on the Mmc 95010 strain MLC_0560 and Mccp F38 strain MCCPF38_00984 gene sequences. The method was highly specific with intra- and inter-batch coefficients of variation < 1%. The lower limit of detection for Mccp and Mmc was 55 copies/µL and 58 copies/µL, respectively. HRM and fluorescence qPCR results were compared using 106 nasal swabs and 47 lung tissue samples from goats (HRM-qPCR coincidence rate 94.8%; 145/153). Mycoplasma isolation and identification was performed on 30 lung tissue samples and 16 nasal swabs (HRM-culturing coincidence rate 87.0%; 40/46). HRM analysis was more sensitive than fluorescence qPCR and Mycoplasma isolation, indicating the practicality of HRM for accurate and rapid identification of Mccp and Mmc, and diagnosis and epidemiology of CCPP and MPGS.

[Aerobic Granular Sludge System with Multiple Influent-Aeration Operation Strategy].

SBR reactors R1 and R2 were used to inoculate activated sludge from a sewage treatment plant, and domestic sewage was used as the influent. The operation was carried out using a single and multiple influent-aeration operation strategy, respectively, and the particle size change and removal effect during the operation was studied. The results show that R1 and R2 successfully achieved sludge granulation after 56 days and 39 days of operation, respectively. The concentrations (mg·L-1) of chemical oxygen demand, total nitrogen, and total phosphorus (TP) in the effluent of R1 and R2 after stable operation were 29.7, 13.7, 0.31, 19.2, 8.1, and 0.37, respectively. The removal rates were respectively 87.7%, 75.6%, 95.1%, and 90.1%, 85.6%, and 94.2%, and the average particle size of the particles reached 740 µm for R1 and 791 µm for R2. The results showed that for the same running time, the effluent NO3--N concentration and TP concentration in R2 were lower than those in R1. In the later stage of operation, the ratio of denitrifying phosphorus-accumulating organisms (DPAO) to total phosphorus-accumulating organisms (PAOs) in R1 and R2 increased from an initial 11.17% to 25.47% and 34.08%, respectively. Compared with the one influent-aeration operation strategy, the multiple influent-aeration operation strategy had a lower concentration of NO3--N in the initial stage of the startup, the PAOs received less impact, the DPAO enrichment was better, the phosphorus removal performance was better, and it helped to form aerobic granular sludge.

Carbon resistive probe memory designed for ultra-high storage density.

Probe-based storage memories are considered one of the most promising solutions to address the mass storage issues in the near future. However, data size arising from conventional probe memories is usually larger than probe size due to the thermal diffusion effect. To eliminate such thermal interference and make data dimension fully dominated by probe dimension, we proposed a concept of carbon-based resistive probe memory and developed a comprehensive computational model to predict its write, rewrite and readout performances governed by electro-thermal and mass concentration processes. The physical reality of such a theoretical model was demonstrated through the good agreement between the calculated and experimental measured threshold voltages for different layered thickness. The data bit of carbon-based resistive probe memory, considered as the sp2 filament inside sp3 background, is formed completely underneath the tip edge due to the localized electric field induced here. This makes the bit size fully determined by the probe tip dimension and allows for the achievement of ultra-high density using an ultra-small probe tip with low energy consumption. Such a conductive filament can be also rewritten back to its pristine sp3 state at relatively high temperature (~250 °C) and detected by sensing the device reading contrast (~1). The designed carbon-based resistive probe memory can retain its bit completeness even if we reduce the bit pitch to 28 nm for a probe size of 25 nm, exhibiting a superior immunity to thermal cross-talk effect. It, however, induces strong readout cross-talk, which is revealed from the resistance image of the multiple bit pattern. This adversely reduces the achievable recording density due to the required large bit pitch, which can be alleviated using either a very sharp tip apex or the optical readout scheme.

Combined Use of Trichoderma atroviride CCTCCSBW0199 and Brassinolide to Control Botrytis cinerea Infection in Tomato.

Tomato gray mold caused by Botrytis cinerea is one of the main diseases of tomato and significantly impacts the yield and quality of tomato fruit. The overuse of chemical fungicides has resulted in the development of fungicide-resistant strains. Biological control is becoming an alternative method for the control of plant diseases to replace or decrease the application of traditional synthetic chemical fungicides and genus Trichoderma is widely used as a biological agent for controlling tomato gray mold. Brassinolide (BR) is a plant-growth-promoting steroid. To enhance the efficiency and stability of Trichoderma activity against B. cinerea, an optimal combination of Trichoderma atroviride CCTCCSBW0199 and BR that controls B. cinerea infection in tomato was identified. Strain CCTCCSBW0199 was found to have antagonistic activity against B. cinerea both in vitro and in vivo. In addition, a fermented culture of chlamydospores and metabolites, or metabolites only of strain CCTCCSBW0199 also reduced growth of B. cinerea. BR reduced growth of B. cinerea and had no effect on the sporulation and growth of Trichoderma spp. An application of metabolites of a Trichoderma sp. + BR reduced gray mold on tomato leaves by approximately 70.0%. Furthermore, the activities of induced defense response-related enzyme, such as peroxidase, superoxide dismutase, catalase, and phenylalanine ammonia-lyase were increased in tomato plants treated with a Trichoderma sp. + BR. Our data suggested that applying a mix of metabolites of T. atroviride CCTCCSBW0199 + BR was effective at reducing gray mold of tomato and may lay a theoretical foundation for the development of novel biofungicides.

Bio-friendly titania-grafted chitosan film with biomimetic surface structure for photocatalytic application.

A series of biomimetic chitosan (CS) films grafted with titanium dioxide (TiO2) were successfully prepared for photocatalytic reduction of carbon dioxide (CO2). The replication of the hierarchical structure of natural leaves to the surface of CS was conducted by nanocasting technique. The presence of amine and hydroxyl groups on CS matrix was able to anchor TiO2 nanoparticles. The addition of cross-linking agent, glutaraldehyde, improved the denseness of CS matrix but affected the distribution of TiO2. The existence of biomimetic structures on films enhanced the hydrophobicity, thermal stability and CO2 adsorption. Moreover, the surface patterns influenced the optical absorption edge of TiO2-grafted films. Under the illumination of UVA (8-Watt) light source, the TiO2-grafted CS films were able to convert CO2 into carbon monoxide and trace amounts of methanol. The biofriendly CS-supported photocatalysts exhibited the potential for sustainable CO2 reduction for cleaner production of chemical fuels.

[Effects of Intermittent Starvation on the Operation of the SNAD Process].

We report on and discuss the effects of intermittent starvation on the operation of the simultaneous partial nitrification, ANAMMOX, and denitrification (SNAD) process. The SNAD process was carried out in a sequencing batch reactor (SBR) at room temperature (22℃±3℃), and the intermittent starvation was achieved by periodically extending the hydraulic retention time (HRT) of the system. The results showed that after the operation of intermittent starvation, the NO3--N concentration at the end of the aerobic phase decreased to 8.72 mg·L-1 and the NO2- accumulation percentage reached 83.18%, which indicated that the nitrite oxidizing bacteria (NOB) activity was effectively inhibited and that the nitritation performance improved. After the operation of the intermittent starvation, the ratio of NO2- to NH4+-N at the end of the aerobic phase was adjusted to provide more suitable substrates for the subsequent ANAMMOX process, such that the concentration of NH4+-N in the effluent fell below 1.0 mg·L-1. At the same time, due to the decrease of the NO3- concentration, the total N removal rate reached 92.07%, which indicated that the treatment performance improved. By determining the activity of the functional bacteria, we found that the main reason for the improvement in the nitritation performance after starvation was that the decay rate of the ammonia oxidizing bacteria (AOB) activity during the starvation period was lower than of the decay rate of the NOB activity, and that the recovery rate of the AOB activity during the recovery period was significantly higher than that of the NOB.

[Effects of Different Intermittent Aeration Strategies on the Start-up of SNAD Process].

In this experiment, two reactors, R1 and R2, were inoculated with anaerobic ammonium oxide sludge at room temperature (20℃±3℃). R1 employed intermittent constant aeration while R2 employed intermittent gradient aeration to start up the SNAD granular sludge process, to study the effects of different intermittent aeration ways. The results showed that the time for R2 to stabilize the performance in each stage was shorter, and the actual start-up speed was faster; after successful startup, the eigenvalues of R1 and R2 were 6.46 and 10.34, respectively. The suppression effect for NOB is better in R2; the DO fluctuation in a typical cycle was stable in R2 while the DO in R1 gradually rose overall and reached over 0.5mg·L-1 by the end of the cycle. R2 can maintain low DO more stably and inhibit NOB proliferation; after successful startup, the PN/PS values in the R1 and R2 reached 2.745 and 2.823, respectively, and the particle size reached 365.8 µm and 402.1 µm, respectively. The stability and sedimentation of the particles in R2 were stronger and the particle size increased faster.

Perfusion, Diffusion, Or Brain Tumor Barrier Integrity: Which Represents The Glioma Features Best?

PURPOSE: This study aims to incorporate informative histogram indicator analyses and advanced multimodal MRI parameters to differentiate low-grade gliomas (LGGs) from high-grade gliomas (HGGs) and to explore the features associated with patients' survival. PATIENTS AND METHODS: A total of 120 patients with pathologically confirmed LGGs or HGGs receiving conventional and advanced MRI such as three-dimensional arterial spin labeling (3D-ASL), intravoxel incoherent motion-diffusion weighted imaging (IVIM-DWI), and dynamic contrast-enhanced MRI (DCE-MRI) were included. The mean and histogram indicators from advanced MRI were calculated from the entire tumor. The efficacies of a single indicator or multiple parameters were tested in distinguishing HGGs from LGGs and predicting patients' survival. Receiver operating characteristic (ROC) curve and multivariable stepwise logistic regression were used to evaluate the diagnostic efficacies. Leave-one-out cross-validation was further used to validate the accuracy of the parameter sets in glioma grading. Log-rank test using the Kaplan-Meier curve was utilized to predict patients' survival. RESULTS: Overall, parameters from DCE-MRI performed better than those from 3D-ASL or IVIM-DWI in both glioma grading and survival prediction. The histogram metrics of Ve were demonstrated to have higher accuracies (the accuracies for Extended Tofts_Ve mean and Extended Tofts_Ve median were 68.33% and 71.67%, respectively, while those for the Incremental_Ve mean and Incremental_Ve 75th were 68.33% and 72.50%, respectively) in grading LGGs from HGGs. The combination of Tofts_Ve histogram metrics was the one with the highest accuracy (81.67%) and area under ROC curve (AUC = 0.840). On the other hand, Patlak_Ktrans 95th (AUC = 0.9265) and Extended Tofts_Ve 95th (AUC = 0.9154) performed better than their corresponding means (Patlak_Ktrans mean: AUC = 0.9118 and Extended Tofts_Ve mean: AUC = 0.9044) in predicting patients' overall survival (OS) at 18-month follow-up. CONCLUSION: DCE-MRI-derived histogram features from the entire tumor were promising metrics for glioma grading and OS prediction. Combining single modal histogram features improved glioma grading. TRIAL REGISTRATION: NCT02622620.

[Pre-precipitation of Sewage-SNAD Granular Sludge Process Test].

Using artificial water, the simultaneous partial nitrification, ANAMMOX (anaerobic ammonium oxidation), and denitrification (SNAD) granular sludge process was started in a sequencing batch reactor (SBR), and then the ammonia concentration in the influent was reduced gradually. After stable operation for a period of time under the low ammonia concentration, sewage treated by a pre-precipitation process was used as a substrate to investigate the performance and stability of the SNAD granular sludge process. The results show that after the SNAD process was successfully started, the ammonia removal rate was greater than 98%, and total the nitrogen removal rate was about 89%. As the influent ammonia concentration decreased, the nitride-oxidizing bacteria (NOB) activity was increased and the total nitrogen removal rate gradually decreased to 75%. When the pre-precipitated domestic sewage (NH4+-N 52-63 mg·L-1, COD 99-123 mg·L-1) was used as the inflow, the average effluent removal rate of the total effluent was 73.2%, the effluent COD concentration was below 35 mg·L-1, and the maximum effluent ammonia nitrogen and total nitrogen concentration were 0.7 mg·L-1 and 12.8 mg·L-1. The ammonia and total nitrogen concentration in the continuous 30 day effluent reached the 1A level of the integrated discharge standard of water pollutants for municipal wastewater treatment, indicating that the removal of organics and nitrogen from domestic sewage was achieved efficiently and synchronously.

[Startup Strategies for the SNAD Granular Sludge Process at Low Temperature].

To study the effect of the startup strategies on the simultaneous partial nitrification, ANAMMOX, and denitrification (SNAD) granular sludge processes, these processes were initiated by starting the completely autotrophic nitrogen removal over nitrite (CANON) process and anaerobic ammonia oxidation-denitrification (SAD) process at 12.7℃ and 18.3℃, respectively. The results show that the ammonia nitrogen was almost completely removed and the total nitrogen removal rate reached 86.7% after the R1 reactor was successfully started. When the ammonia concentration was low, the total nitrogen removal rate in the effluent decreased to 75.3%, the total nitrogen concentration in the effluent was~10 mg·L-1, and excessive proliferation of the NOB was observed. The total nitrogen concentration in the effluent exceeded the 1A level of the integrated discharge standard of water pollutants applied in Beijing City. After the R2 reactor was successfully started, the effluent contained almost no ammonia nitrogen and the total nitrogen removal rate was~89.1%, that is, slightly higher than that of the R1 reactor. When the ammonia concentration was low, the concentration of ammonia nitrogen in effluent was less than 1.0 mg·L-1 and the total nitrogen concentration in the effluent was less than 6 mg·L-1. The concentrations of ammonia nitrogen and total nitrogen in the effluent reached the 1A level of the integrated discharge standard of water pollutants applied in Beijing City. First, the startup of the SAD process gradually eliminated the NOB from the system through anaerobic operation in the initial stage of the startup, maintained the stability of the system, provided a good basis for the subsequent aeration to start the SNAD process, maintained the stable operation of the reactor, and the long-term discharge of total nitrogen reached the standard.

Optimizing Texture Retrieving Model for Multimodal MR Image-Based Support Vector Machine for Classifying Glioma.

BACKGROUND: Accurate glioma grading plays an important role in patient treatment. PURPOSE: To investigate the influence of varied texture retrieving models on the efficacy of grading glioma with support vector machine (SVM). STUDY TYPE: Retrospective. POPULATION: In all, 117 glioma patients including 25, 29, and 63 grade II, III, and IV gliomas, respectively, based on WHO 2007. FIELD STRENGTH/SEQUENCE: 3.0T MRI/ T1 WI, T2 fluid-attenuated inversion recovery, contrast enhanced T1 , arterial spinal labeling, diffusion-weighted imaging (0, 30, 50, 100, 200, 300, 500, 800, 1000, 1500, 2000, 3000, and 3500 sec/mm2 ), and dynamic contrast-enhanced. ASSESSMENT: Texture attributes from 30 parametric maps were retrieved using four models, including Global, gray-level co-occurrence matrix (GLCM), gray-level run-length matrix (GLRLM), and gray-level size-zone matrix (GLSZM). Attributes derived from varied models were input into radial basis function SVM (RBF-SVM) combined with attribute selection using SVM-recursive feature elimination (SVM-RFE). The SVM model was trained and established with 80% randomly selected data of each category using 10-fold crossvalidation. The model performance was further tested using the remaining 20% data. STATISTICAL TESTS: Ten-fold crossvalidation was used to validate the model performance. RESULTS: Based on 30 parametric maps, 90, 240, 390, or 390 texture attributes were retrieved using the Global, GLCM, GLRLM, or GLSZM model, respectively. SVM-RFE was able to reduce attribute redundancy as well as improve RBF-SVM performance. Training data were oversampled by applying the Synthetic Minority Oversampling Technique (SMOTE) method to overcome the data imbalance problem; test results were able to further demonstrate the classifying performance of the final models. GLSZM using gray-level 64 was the optimal model to retrieve powerful image texture attributes to produce enough classifying power with an accuracy / area under the curve of 0.760/0.867 for the training and 0.875/0.971 for the independent test. Fifteen attributes were selected with SVM-RFE to provide comparable classifying efficacy. DATA CONCLUSION: When using image textures-based SVM classification of gliomas, the GLSZM model in combination with gray-level 64 and attribute selection may be an optimized solution. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:1263-1274.

Risk of skin cancers in thiopurines-treated and thiopurines-untreated patients with inflammatory bowel disease: A systematic review and meta-analysis.

BACKGROUND AND AIM: The thiopurines are effective in the management of patients with inflammatory bowel disease (IBD), but the association between thiopurines use and the risk of skin cancer (including nonmelanoma skin cancer [NMSC] and melanoma skin cancer) has already been sufficiently reported. However, the results of these studies are inconsistent, and thus, the objective of our analysis was to explore whether thiopurines can lead to an excess risk of skin cancer in IBD patients. METHODS: MEDLINE, EMBASE, and the Cochrane Library were searched to identify relevant studies that evaluated the risk of skin cancer in IBD patients treated with thiopurines. A random effects meta-analysis was conducted to calculate the pooled incidence rate ratios as well as risk ratios (RRs). Subgroup analysis was performed to explore the potential source of heterogeneity. RESULTS: Thirteen studies comprising 149 198 participants were included. The result suggested that thiopurines significantly increased the risk of overall skin cancer in IBD patients (random effects: RR = 1.80, 95% confidence interval [CI] 1.14-2.87, P = 0.013), among which NMSC showed an excess risk associated with thiopurines use (random effects: RR = 1.88, 95% CI 1.48-2.38, P < 0.001) while no increased risk was observed with respect to melanoma skin cancer (random effects: RR = 1.22, 95% CI 0.90-1.65, P = 0.206). Subgroup analysis regarding sample size and geographic distribution in skin cancer and follow-up duration in NMSC reached statistical significance, while other subgroups showed no significance. CONCLUSION: Exposition of thiopurines in patients with IBD is associated with a higher risk of skin cancer. Routine skin screening and daily skin protective practice are recommended for these patients.