Evaluating the consistency in different methods for measuring left atrium diameters.

BACKGROUND: The morphological information of the pulmonary vein (PV) and left atrium (LA) is of immense clinical importance for effective atrial fibrillation ablation. The aim of this study is to examine the consistency in different LA diameter measurement techniques. METHODS: Retrospective imaging data from 87 patients diagnosed with PV computed tomography angiography were included. The patients consisted of 50 males and 37 females, with an average age of (60.74 ± 8.70) years. Two physicians independently measured the anteroposterior diameter, long diameter, and transverse diameter of the LA using six different methods. Additionally, we recorded the post-processing time of the images. Physician 1 conducted measurements twice with a one-month interval between the measurements to assess intra-rater reliability. Using the intraclass correlation coefficient (ICC), the consistency of each LA diameter measurement by the two physicians was evaluated. We compared the differences in the LA diameter and the time consumed for measurements using different methods. This was done by employing the rank sum test of a randomized block design (Friedman M test) and the q test for pairwise comparisons among multiple relevant samples. RESULTS: (1) The consistency of the measured LA diameter by the two physicians was strong or very strong. (2) There were statistical differences in the anteroposterior diameter, long diameter, and transverse diameter of LA assessed using different methods (χ2 = 222.28, 32.74, 293.83, P < 0.001). (3) Different methods for measuring the diameters of LA required different amounts of time (χ2 = 333.10, P < 0.001). CONCLUSION: The results of left atrium (LA) diameter measurements conducted by different physicians were found to be reliable. However, the LA diameters obtained through various techniques exhibited variations. It was observed that measuring LA long diameters using only the VR (volume rendering) picture was the most clinically applicable method.

Integrated farming with intercropping increases food production while reducing environmental footprint.

Food security has been a significant issue for the livelihood of smallholder family farms in highly populated regions and countries. Industrialized farming in more developed countries has increased global food supply to meet the demand, but the excessive use of synthetic fertilizers and pesticides has negative environmental impacts. Finding sustainable ways to grow more food with a smaller environmental footprint is critical. We developed an integrated cropping system that incorporates four key components: 1) intensified cropping through relay planting or intercropping, 2) within-field strip rotation, 3) soil mulching with available means, such as crop straw, and 4) no-till or reduced tillage. Sixteen field experiments, conducted with a wide range of crop inputs over 12 consecutive years (2006 to 2017), showed that the integrated system with intercropping generates significant synergies-increasing annual crop yields by 15.6 to 49.9% and farm net returns by 39.2% and decreasing the environmental footprint by 17.3%-when compared with traditional monoculture cropping. We conclude that smallholder farmers can achieve the dual goals of growing more food and lowering the environmental footprint by adopting integrated farming systems.

Effects on soil carbon storage from municipal biosolids application to agricultural fields.

This study investigated the influence of biosolid applications on soil carbon storage and evaluated nutrient management strategies affecting soil carbon dynamics. The research assessed alterations in soil pH, soil carbon stock, and soil nitrogen content within short-term and long-term biosolids-amended soils in Bible Hill, Nova Scotia, Canada, extending to a depth of 0-60 cm. The findings indicated an increase in soil pH with alkaline treatment biosolids (ATB) applications across both study sites, with a legacy effect on soil pH noted in the long-term biosolids-amended soil following a single ATB application over 13 years. Both sites demonstrated significant increases in soil total carbon (STC) and soil organic carbon (SOC) within the 0-30 cm soil depth after biosolid application, and soil inorganic carbon (SIC) accounted for approximately 5-10% of STC, specifically in the surface soil layer (0-15 cm). In the long-term study site, annual 14, 28 and 42 Mg ATB ha-1 treatments resulted in a substantial rise in soil carbon stock (59.5, 60.1 and 68.0 Mg C ha-1), marking a 25% increase compared to control soil. The SOC content in biosolids-amended soil showed a declining trend with increasing soil depth at both study sites. Notably, the carbon stock in the short-term site was observed in composted biosolids (COMP) > ATB > liquid mesophilic anaerobically digested biosolids (LMAD) from the 0-60 cm soil depth. Approximately 79-80% of the variation in SOC response at both sites was concentrated within the top 30 cm soil. Soil total nitrogen (STN) showed no significant differences at the short-term site, and STN in biosolids-amended soil decreased with increasing soil depth at the long-term site. Biosolids-induced C retention coefficients (BCR) for ATB remained consistent at both sites, ranging from -13% to 31.4% with a mean of 11.12%. BCR values for COMP ranged from 1.9% to 34.4% with a mean of 18.73%, while those for LMAD exhibited variability, spanning from -6.2% to 106.3% with a mean of 53.9%.

Depression Exacerbates Dextran Sulfate Sodium-Induced Colitis via IRF5-Mediated Macrophage Polarization.

BACKGROUND AND AIMS: Patients with inflammatory bowel disease (IBD) and concurrent depression are predisposed to severer disease activity and a worse prognosis. Macrophage polarization toward the M1 phenotype may contribute to the exacerbation of IBD with comorbid depression. Moreover, interferon regulatory factor 5 (IRF5) is involved in the pathogenesis of IBD. The aim of this study was to explore the role of IRF5 in macrophage polarization in the impact of depression upon colitis. METHODS: Depressive-like behavior was induced by repeated forced swim stress. Colon length, disease activity index (DAI), colon morphology, histology, ultrastructure of epithelial barrier, lamina propria macrophage polarization, and expression of IRF5 were compared between DSS colitis rats with and without depressive-like behavior. IRF5 shRNA was constructed to affect the rat peritoneal macrophages polarization in vitro. After IRF5 shRNA lentivirus was introduced into colon by enema, the colitis severity, lamina propria macrophage polarization, and TNF-α, IL-1ß, and IL-10 of colon tissues were measured. RESULTS: The study found severer colonic inflammation in depressed versus non-depressed DSS-colitis rats. Depressed DSS-colitis rats exhibited smaller subepithelial macrophages size and reduced intracellular granule diversity compared with nondepressed DSS-colitis rats. Increased polarization toward the M1 phenotype, elevated expression of IRF5, and co-expression of IRF5 with CD86 were found in depressed versus nondepressed DSS-colitis rats. Lentivirus-mediated shRNA interference with IRF5 expression switched rat peritoneal macrophage polarization from the M1 to the M2 phenotype, downregulated TNF-α, IL-1ß expression to a greater extent in depressed versus nondepressed colitis rats. CONCLUSIONS: IRF5-mediated macrophage polarization may likely underlie the deterioration of DSS-induced colitis caused by depression.

Evolution of the frequency-comb structure and coherence from a Keldysh multiphoton into a tunneling regime.

We present a theoretical study of the characteristics of the frequency-comb structure and coherence via high-order harmonic generation (HHG) driven by the laser pulse trains when the ionization process is pushed from Keldysh multiphoton into tunneling regime. HHG is obtained by solving accurately the time-dependent Schrödinger equation by means of the time-dependent generalized pseudospectral method. We find that the nested comb structures are formed from each harmonic order in the Keldysh multiphoton ionization regime. But it is severely suppressed or even disappeared in the Keldysh tunneling ionization regime. It implies that the temporal coherence of the emitted frequency comb modes is very sensitive to the Keldysh ionization regime. To understand the evolution of frequency-comb structure and coherence, we perform the calculation of the time-dependent ionization probability and the spectral phase of frequency-comb HHG. We find that the frequency-comb HHG driven by the laser pulse trains in the Keldysh multiphoton regime has a good coherence because the ionization probability of the atom driven by each laser pulse is stable, leading to a phase-coherent frequency-comb structure rather than those cases in the Keldysh tunneling regime with high laser intensity. Our results shed light on current interest and significance to the experimental realization of controllable and frequency-comb vacuum-ultraviolet light sources.

Flexible and Precise Droplet Manipulation by a Laser-Induced Shape Temperature Field on a Lubricant-Infused Surface.

Light actuation on a lubricant-infused surface (LIS) has attracted great attention because of its flexibility and remote control of droplet motion. However, to actuate a droplet on a LIS flexibly and precisely by light, the key issue is to control two degrees of freedom of the droplet motion in real time. In this paper, we propose a C-shape temperature field (CSTF) induced by rapid and selective laser irradiation on a LIS. The CSTF could not only manipulate a single droplet precisely and flexibly but also process multiple droplets automatically and orderly in real time. The mechanism showed that the droplet was confined by the Marangoni force in two orthogonal directions. For single droplet manipulation, the CSTF had the capability of correcting the off-track droplet motion. Moreover, the droplet motion, including rectilinear motion and curvilinear motion, could be precisely and flexibly controlled by the motion of the CSTF. For manipulation of multiple droplets, coalescence of multiple droplets was successfully achieved by triple rotating CSTFs. Such a method was applied in the detection of 5 µL of bovine serum albumin (BSA) by triggering chromogenic reactions automatically and orderly, which improved the efficiency of the whole process. We believe that this method is a significant candidate for intelligent droplet manipulation.

Development and validation of a computed tomography-based immune ecosystem diversity index as an imaging biomarker in non-small cell lung cancer.

OBJECTIVES: To date, there are no data on the noninvasive surrogate of intratumoural immune status that could be prognostic of survival outcomes in non-small cell lung cancer (NSCLC). We aimed to develop and validate the immune ecosystem diversity index (iEDI), an imaging biomarker, to indicate the intratumoural immune status in NSCLC. We further investigated the clinical relevance of the biomarker for survival prediction. METHODS: In this retrospective study, two independent NSCLC cohorts (Resec1, n = 149; Resec2, n = 97) were included to develop and validate the iEDI to classify the intratumoural immune status. Paraffin-embedded resected specimens in Resec1 and Resec2 were stained by immunohistochemistry, and the density percentiles of CD3+, CD4+, and CD8+ T cells to all cells were quantified to estimate intratumoural immune status. Then, EDI features were extracted using preoperative computed tomography to develop an imaging biomarker, called iEDI, to determine the immune status. The prognostic value of iEDI was investigated on NSCLC patients receiving surgical resection (Resec1; Resec2; internal cohort Resec3, n = 419; external cohort Resec4, n = 96; and TCIA cohort Resec5, n = 55). RESULTS: iEDI successfully classified immune status in Resec1 (AUC 0.771, 95% confidence interval [CI] 0.759-0.783; and 0.770 through internal validation) and Resec2 (0.669, 0.647-0.691). Patients with higher iEDI-score had longer overall survival (OS) in Resec3 (unadjusted hazard ratio 0.335, 95%CI 0.206-0.546, p < 0.001), Resec4 (0.199, 0.040-1.000, p < 0.001), and TCIA (0.303, 0.098-0.944, p = 0.001). CONCLUSIONS: iEDI is a non-invasive surrogate of intratumoural immune status and prognostic of OS for NSCLC patients receiving surgical resection. KEY POINTS: • Decoding tumour immune microenvironment enables advanced biomarkers identification. • Immune ecosystem diversity index characterises intratumoural immune status noninvasively. • Immune ecosystem diversity index is prognostic for NSCLC patients.

Effects of polyacrylic acid molecular weights on V2C-MXene nanocoatings for obtaining ultralow friction and ultralow wear in an ambient working environment.

Two modified V2C-MXene nanocoatings are prepared through different molecular weights of polyacrylic acid (polyacrylic acid with ∼4 50 000 is marked as LPAA, and polyacrylic acid with ∼4 000 000 is marked as HPAA) and two-dimensional V2C-MXene. Their properties are characterized using a ball-on-disc tribometer, three-dimensional white-light interferometry topography images, optical microscope, Raman spectrometer, focused ion beam/scanning electron microscope and high-resolution transmission electron microscope/energy dispersive X-ray spectrometer (HRTEM/EDS). As a result, an ultralow friction (µ ≈ 0.073 ± 0.024) and an ultralow wear (3.41 × 10-7 mm3 N-1 m-1 for ball scar, and 7.49 × 10-8 mm3 N-1 m-1 for disc track) are achieved for the LPAA@V2C vs. steel ball system tested under 4 N in the air through tribo-physicochemical interactions. During the rubbing process, the LPAA@V2C nanocoating is transferred onto counter-bodies to form mixed-phase lubricative tribofilms. Monitoring via a HRTEM/EDS, the mixed-phase lubricative tribofilms are found to be mainly composed of amorphous carbon phases containing O and V and layered nano-debris along the sliding surface. The tribofilm's stable structure is the key to realizing ultralow friction and ultralow wear through the LPAA modification. These findings disclose that MXene-based nanomaterials can be applied for material engineering and mechanical engineering under common working conditions.

Influence of dietary protein on serum phosphorous levels in peritoneal dialysis patients with different initial transport function.

INTRODUCTION: This cross-sectional study investigated the influence of dietary protein intake (DPI) on serum phosphate levels in peritoneal dialysis (PD) patients and determined the DPI cutoff required to prevent hyperphosphatemia. METHODS: A total of 504 PD patients were categorized into fast (4 h dialysate/plasma [D/P] creatinine clearance ≥0.65) or slow (<0.65) peritoneal transporters. Serum phosphorus and peritoneal solute clearance were compared between the groups with different DPI. RESULTS: The fast peritoneal transporters (n = 233) were older, had lower serum albumin and phosphorus levels, and had higher peritoneal phosphorus clearance (all p < 0.001). Among the slow transporters (n = 271), serum phosphorus levels were significantly higher among patients with DPI > 1.0 g/kg/d (p < 0.001). High DPI only increased the hyperphosphatemia risk in slow transporters (not in high transporters). DPI ≥1.026 g increased the hyperphosphatemia risk in those patients (area under the curve: 0.66, p = 0.001). CONCLUSION: High DPI increases the hyperphosphatemia risk in PD patients with slower peritoneal transport function.

First Discovery of Beta-Sitosterol as a Novel Antiviral Agent against White Spot Syndrome Virus.

The outbreak of white spot syndrome (WSS) is a looming challenge, due to dramatic losses to the crustacean aquaculture industry. However, at present, there are no prophylactic or therapeutic means to control this infectious viral disease. Here, we screened fifteen medicinal plants for their inhibitory activity on the white spot syndrome virus (WSSV), using red swamp crayfish (Procambarus clarkii) as a model species. The results showed that the crude extracts of Pinellia ternata (Thunb.) Breit. had the highest inhibitory effect (91.59%, 100 mg/kg) on WSSV proliferation, and its main component, beta-sitosterol, showed a much higher activity (95.79%, 50 mg/kg). Further, beta-sitosterol potently reduced (p < 0.01) viral loads and viral gene transcription levels in a concentration-dependent fashion, and significantly promoted the survival rate of WSSV-challenged crayfish (57.14%, 50 mg/kg). The co-incubation assay indicated that beta-sitosterol did not influence the infectivity of WSSV particles. Both pre- and post-treatment of beta-sitosterol exerted a significant inhibitory effect (p < 0.01) on the viral load in vivo. Mechanistically, beta-sitosterol not only interfered with the expression of viral genes (immediate early gene 1, ie1; DNA polymerase, DNApol) that are important in initiating WSSV transcription, but it also attenuated the hijacking of innate immune signaling pathways (Toll, IMD, and JAK/STAT pathways) by viral genes to block WSSV replication. Moreover, the expression of several antiviral immune, antioxidant, pro-inflammatory, and apoptosis-related genes changed significantly in beta-sitosterol-treated crayfish. Beta-sitosterol is a potent WSSV inhibitor and has the potential to be developed as an effective anti-WSSV agent against a WSS outbreak in crustacean aquaculture.

General deep learning model for detecting diabetic retinopathy.

BACKGROUND: Doctors can detect symptoms of diabetic retinopathy (DR) early by using retinal ophthalmoscopy, and they can improve diagnostic efficiency with the assistance of deep learning to select treatments and support personnel workflow. Conventionally, most deep learning methods for DR diagnosis categorize retinal ophthalmoscopy images into training and validation data sets according to the 80/20 rule, and they use the synthetic minority oversampling technique (SMOTE) in data processing (e.g., rotating, scaling, and translating training images) to increase the number of training samples. Oversampling training may lead to overfitting of the training model. Therefore, untrained or unverified images can yield erroneous predictions. Although the accuracy of prediction results is 90%-99%, this overfitting of training data may distort training module variables. RESULTS: This study uses a 2-stage training method to solve the overfitting problem. In the training phase, to build the model, the Learning module 1 used to identify the DR and no-DR. The Learning module 2 on SMOTE synthetic datasets to identify the mild-NPDR, moderate NPDR, severe NPDR and proliferative DR classification. These two modules also used early stopping and data dividing methods to reduce overfitting by oversampling. In the test phase, we use the DIARETDB0, DIARETDB1, eOphtha, MESSIDOR, and DRIVE datasets to evaluate the performance of the training network. The prediction accuracy achieved to 85.38%, 84.27%, 85.75%, 86.73%, and 92.5%. CONCLUSIONS: Based on the experiment, a general deep learning model for detecting DR was developed, and it could be used with all DR databases. We provided a simple method of addressing the imbalance of DR databases, and this method can be used with other medical images.

Ophiopogon japonicus inhibits white spot syndrome virus proliferation in vivo and enhances immune response in Chinese mitten crab Eriocheir sinensis.

White spot syndrome virus (WSSV) is a fatal pathogen threatening global crustacean industry with no commercially available drugs to control. Herbal medicines have been widely used to treat a number of viral infections, which could offer a rich reserve for antiviral drug discovery. Here, we evaluated the inhibition activities of 30 herbal medicines against WSSV in Chinese mitten crab Eriocheir sinensis. A WSSV infection model in E. sinensis was firstly established in order to determine the antiviral effects of the plant extracts and to explore the potential action mechanisms. Results showed that the highest anti-WSSV activity was obtained by the treatment of Ophiopogon japonicus extract (93.03%, 100 mg/kg). O. japonicus treatment decreased viral loads in a dose-dependent manner and significantly improved the survival of WSSV-challenged crabs. O. japonicus reduced the expression of vital genes in viral life cycle in vivo, particularly for the immediate-early stage gene ie1. Further results indicated that O. japonicus could repress the JAK-STAT signaling pathway to block ie1 transcription. Moreover, O. japonicus could modulate certain immune genes such as the myosin, toll-like receptor, crustin, and prophenoloxidase in the interactions between WSSV and crabs. The up-regulated expression of pro-autophagic factors (Gabarap and Atg7) and elevated levels of antioxidant enzymes (SOD, CAT and GSH) suggested that O. japonicus may induce autophagy and attenuate WSSV-induced oxidative stress. Taken together, O. japonicus could inhibit WSSV proliferation and improve the survival of WSSV-challenged crabs. Thus, O. japonicus may have the potential to be developed as a preventive or therapeutic agent against WSSV, and its effective compounds merit further isolation and identification.

Computed tomography manifestations in super early stage 2019 novel coronavirus pneumonia.

BACKGROUND: The recent outbreak of pneumonia cases in Wuhan, PR China, was caused by a novel beta coronavirus, the 2019 novel coronavirus (COVID-19). PURPOSE: To summarize chest computed tomography (CT) manifestations of the early stage of COVID-19 infection and provide a piece of reliable imaging evidence for initial screening and diagnosis. MATERIAL AND METHODS: From 10 January 2020 to 10 February 2020, we continuously observed chest CT imaging of 14 patients with clinically suspected new coronavirus infection in the two weeks after onset of symptoms. Ground-glass opacity (GGO), consolidation, reticular pattern, and ground-glass mimic nodules in each patient's chest CT image were recorded. RESULTS: We enrolled 14 patients, of which nine patients had the infection confirmed by reverse transcription polymerase chain reaction (RT-PCR). Five patients were highly suspected of infection. All cases had epidemiological evidence. GGO was a dominant imaging manifestation in the initial days of infection. GGO performance accounts for 40% in 1- 2 days, 90% in 3- 6 days, and 85% in 7- 10 days. With disease progression, consolidation appeared on follow-up CT. Consolidation performance accounts for 0% in 1- 2 days, 40% in 3- 6 days, and 71% in 7- 10 days. The lesions are mostly near the pleura. The number of lesions and the extent of the lesions increased as the disease progressed. CONCLUSION: Patients with novel coronavirus pneumonia have characteristic CT features in the initial stage of infection, which can be used as an essential supplement for nucleic acid examination.

A Novel Procedure for the Management of Severe Hyphema after Glaucoma Filtering Surgery: Air-Blood Exchange under a Slit-Lamp Biomicroscopy.

Background and Objectives: This study introduces a novel office-based procedure involving air-blood exchange under a slit-lamp microscope for treatment of severe hyphema after filtering surgery. Materials and Methods: This retrospective study enrolled 17 patients (17 eyes) with a diagnosis of primary open-angle glaucoma with severe hyphema (≥4-mm height) after filtering surgery. All patients were treated with air-blood exchange under a slit-lamp using room air (12 patients) or 12% perfluoropropane (C3F8; five patients). Results: The procedures were successful in all 17 patients; they exhibited clear visual axes without complications during follow-up. In the room air group, the mean visual acuity (VA) and hyphema height significantly improved from 1.70 ± 1.07 LogMAR and 5.75 ± 1.14 mm before the procedure to 0.67 ± 0.18 LogMAR and 2.83 ± 0.54 mm after the procedure (p = 0.004; p < 0.001). In the C3F8 group, the mean VA showed a trend, though not significant, for improvement from 1.70 ± 1.10 LogMAR to 0.70 ± 0.19 LogMAR (p = 0.08); the mean hyphema height showed a trend for improvement from 5.40 ± 0.96 mm to 3.30 ± 0.45 mm. Compared with the C3F8 group, the room air group showed the same efficacy with a shorter VA recovery time. Conclusions: "Air-blood exchange under a slit-lamp using room air" is a convenient, rapid, inexpensive, and effective treatment option for severe hyphema after filtering surgery, and may reduce the risk of failure of filtering surgery.

Downregulation of hsa-microRNA-204-5p and identification of its potential regulatory network in non-small cell lung cancer: RT-qPCR, bioinformatic- and meta-analyses.

BACKGROUND: Pulmonary malignant neoplasms have a high worldwide morbidity and mortality, so the study of these malignancies using microRNAs (miRNAs) has attracted great interest and enthusiasm. The aim of this study was to determine the clinical effect of hsa-microRNA-204-5p (miR-204-5p) and its underlying molecular mechanisms in non-small cell lung cancer (NSCLC). METHODS: Expression of miR-204-5p was investigated by real-time quantitative PCR (RT-qPCR). After data mining from public online repositories, several integrative assessment methods, including receiver operating characteristic (ROC) curves, hazard ratios (HR) with 95% confidence intervals (95% CI), and comprehensive meta-analyses, were conducted to explore the expression and clinical utility of miR-204-5p. The potential objects regulated and controlled by miR-204-5p in the course of NSCLC were identified by estimated target prediction and analysis. The regulatory network of miR-204-5p, with its target genes and transcription factors (TFs), was structured from database evidence and literature references. RESULTS: The expression of miR-204-5p was downregulated in NSCLC, and the downtrend was related to gender, histological type, vascular invasion, tumor size, clinicopathologic grade and lymph node metastasis (P<0.05). MiR-204-5p was useful in prognosis, but was deemed unsuitable at present as an auxiliary diagnostic or prognostic risk factor for NSCLC due to the lack of statistical significance in meta-analyses and absence of large-scale investigations. Gene enrichment and annotation analyses identified miR-204-5p candidate targets that took part in various genetic activities and biological functions. The predicted TFs, like MAX, MYC, and RUNX1, interfered in regulatory networks involving miR-204-5p and its predicted hub genes, though a modulatory loop or axis of the miRNA-TF-gene that was out of range with shortage in database prediction, experimental proof and literature confirmation. CONCLUSIONS: The frequently observed decrease in miR-204-5p was helpful for NSCLC diagnosis. The estimated target genes and TFs contributed to the anti-oncogene effects of miR-204-5p.

Glucosamine impedes transforming growth factor ß1-mediated corneal fibroblast differentiation by targeting Krüppel-like factor 4.

BACKGROUND: Transforming growth factor (TGF) family members play important roles in the regulation of corneal integrity, and the pathogenesis of corneal fibrosis. Currently, there are no effective agents targeting TGF-ß signaling to diminish corneal fibrosis. Glucosamine (GlcN), which is widely used in the treatment of osteoarthritis, abrogates the morphologic effects of TGF-ß2 on retinal pigmented epithelial cells in a mouse disease model. Here, we sought to determine whether GlcN would exert beneficial effects against TGF-ß1-induced corneal fibrosis. METHODS: In human corneal fibroblasts (HCFs) treated with GlcN, the expression of Krüppel-like factor 4 (KLF4) and its downstream signaling effects were determined in the presence and absence of TGF-ß1 using immunoblot analysis. We further explored GlcN inhibition of fibroblast-to-myofibroblast differentiation via KLF4 siRNA. The effect of cycloheximide on KLF4 protein levels with or without GlcN administration was assessed to determine whether GlcN affects the stability of the KLF4 protein. RESULTS: In HCFs, GlcN induced the expression of KLF4, which regulated the maturation and maintenance of the ocular surface. GlcN partially suppressed the TGF-ß1-induced expression of alpha-smooth muscle actin (α-SMA) and reduced the collagen contraction capacity in HCFs, suggesting a decrease in fibroblast-to-myofibroblast differentiation. This effect appeared to be mediated through suppression of Smad2 phosphorylation and ERK-dependent signaling. The levels of KLF4 mRNA were increased by GlcN and decreased by TGF-ß1 and the TGF-ß1-induced α-SMA mRNA expression was upregulated when the KLF4 gene was silenced. GlcN also appeared to stabilize the KLF4 protein, reducing its turnover in corneal fibroblasts. CONCLUSION: These findings shed light on a novel mechanism by which GlcN suppresses TGF-ß1-induced fibroblast-to-myofibroblast differentiation through the upregulation of KLF4 expression. Current strategies for treating corneal fibrosis were not effective. Elevating KLF4 levels through the use of GlcN might provide an effective alternative to alleviate the development and progression of corneal fibrosis.

Analysis of petrous apex meningocele associated with meningioma: is there any relation with chronic intracranial hypertension?

PURPOSE: Petrous apex meningocele (PAM) is an uncommon cystic lesion involving the petrous apex. The underlying cause of PAM may be related to chronic elevated intracranial pressure. The aim of the study was to explore the relationship between PAM and meningioma and between PAM and other intracranial hypertension findings. METHODS: Two hundred seventy-eight consecutive patients with meningiomas were retrospectively studied. Fifty age- and gender-matched controls were also enrolled in this study. The incidence of PAM, empty sella, tortuosity of the optic nerve, and hydrops of optic nerve sheath was evaluated. The maximum width, area, volume of each PAM, or Meckel's cave and volume of meningioma were measured in controls and patients, separately. RESULTS: One hundred fifty-nine (57.19%) patients were detected with coexistent PAMs. One hundred twenty-five patients had bilateral PAMs, 34 had unilateral lesions, and the remaining 119 did not have PAM. Two subjects (4/50) had unilateral PAMs in normal controls. The maximum width, area, volume of PAM, or Meckel's cave were significantly larger in the patients with bilateral PAM group than those in the unilateral PAM group, in the group without PAM, and those in control group (p = 0.000). The volume of meningioma was positively correlated with the PAM volume (r = 0.48). There was a positive correlation for the incidence between PAM and (1) empty sella (r = 0.901) and (2) tortuosity of the optic nerves and hydrops of the optic sheath (r = 0.825). CONCLUSION: Coexistence of PAMs with meningiomas is not rare in incidence, and it suggests a potential role for chronically elevated intracranial pressure and disturbance of CSF circulation in their pathophysiology.

Using integrated problem- and lecture-based learning teaching modes for imaging diagnosis education.

BACKGROUND: There are two parts included in traditional imaging diagnosis teaching: theoretical lessons and experimental lessons. Most of the time, the experimental lesson is a review of the theoretical lesson. The teacher is the centre of the course and students are passive learners. Thus, in this study we included the patient problem of the imaging centre in our imaging diagnosis education. The traditional theoretical lessen was used to discuss prior knowledge, the discussion and analysis of patient problems was arranged under class, and the experimental lesson was used to synthesize and test the newly acquired information. The aim of this study is to determine whether or not integration of problem- and lecture-based learning teaching modes in imaging diagnosis education was associated with a good teaching effect. Forty-six of sixty students (76.7%) like integrated problem- and lecture-based learning teaching mode and 53 of 60 students (88.3%) think that integrated problem- and lecture-based learning teaching mode can make their ability of self-study be improved. METHODS: Sixty students participated in a prospective study with a two-phase cross-over design. All of the students were divided into 2 groups of 30 each. In the first term, the first group participated in an integration of the problem- and lecture-based learning teaching mode, whereas students in the second group underwent the lecture-based learning teaching mode alone. During the second term, the teaching modes were exchanged between the two groups. A close-exam and survey were used to evaluate the teaching effect, and the data were analysed means of analysis of variance with a two-phase cross-over design and a χ2 test with a 2-tailed α of 0.05. RESULTS: There was a statistically significant difference in the test scores between the integration of the problem- and lecture-based learning teaching mode and the lecture-based learning teaching mode alone (P < 0.05). The integration of problem- and lecture-based learning teaching mode was well-appraised. CONCLUSION: Integration of the problem- and lecture-based learning teaching modes in teaching imaging diagnosis education resulted in a good teaching effect.

Glucosamine-Induced Autophagy through AMPK⁻mTOR Pathway Attenuates Lipofuscin-Like Autofluorescence in Human Retinal Pigment Epithelial Cells In Vitro.

Age-related macular degeneration (AMD) is a vision-threatening age-associated disease. The retinal pigment epithelial (RPE) cells phagocytose and digest photoreceptor outer segment (POS). Incomplete digestion of POS leads to lipofuscin accumulation, which contributes to the pathology of the AMD. Autophagy could help reduce the amount of lipofuscin accumulation. In the present study, we evaluated the effects of glucosamine (GlcN), a natural supplement, on the induction of autophagy and POS-derived lipofuscin-like autofluorescence (LLAF) in ARPE-19 cells in vitro, and investigated the potential molecular pathway involved. Our results revealed that GlcN had no effect on phagocytosis of POS at the lower doses. GlcN treatment induced autophagy in cells. GlcN decreased the LLAF in native POS-treated cells, whereas malondialdehyde or 4-hydroxynonenal-modified POS attenuated this effect. 3-Methyladenine inhibited GlcN-induced autophagy and attenuated the effect of GlcN on the decrease of the native POS-derived LLAF. Furthermore, GlcN induced the phosphorylation of AMP-activated protein kinase (AMPK) and inhibited the phosphorylation of mammalian target of rapamycin (mTOR), whereas Compound C inhibited these effects of GlcN. Altogether, these results suggest that GlcN decreased the native POS-derived LLAF through induction of autophagy, at least in part, by the AMPK⁻mTOR pathway. This mechanism has potential for the preventive treatment of lipofuscin-related retinal degeneration such as AMD.