Identification of a novel m6A-related lncRNA pair signature for predicting the prognosis of gastric cancer patients.

BACKGROUND: Accumulating studies have demonstrated that lncRNAs play vital roles in the prognosis of gastric cancer (GC); however, the prognostic value of N6-methyladenosine-related lncRNAs has not been fully reported in GC. This study aimed to construct and validate an m6A-related lncRNA pair signature (m6A-LPS) for predicting the prognosis of GC patients. METHODS: GC cohort primary data were downloaded from The Cancer Genome Atlas. We analysed the coexpression of m6A regulators and lncRNAs to identify m6A-related lncRNAs. Based on cyclical single pairing along with a 0-or-1 matrix and least absolute shrinkage and selection operator-penalized regression analyses, we constructed a novel prognostic signature of m6A-related lncRNA pairs with no dependence upon specific lncRNA expression levels. All patients were divided into high-risk and low-risk group based on the median risk score. The predictive reliability was evaluated in the testing dataset and whole dataset with receiver operating characteristic (ROC) curve analysis. Gene set enrichment analysis was used to identify potential pathways. RESULTS: Fourteen m6A-related lncRNA pairs consisting of 25 unique lncRNAs were used to construct the m6A-LPS. Kaplan-Meier analysis showed that the high-risk group had poor prognosis. The area under the curve for 5-year overall survival was 0.906, 0.827, and 0.882 in the training dataset, testing dataset, and whole dataset, respectively, meaning that the m6A-LPS was highly accurate in predicting GC patient prognosis. The m6A-LPS served as an independent prognostic factor for GC patients after adjusting for other clinical factors (p < 0.05). The m6A-LPS had more accuracy and a higher ROC value than other prognostic models for GC. Functional analysis revealed that high-risk group samples mainly showed enrichment of extracellular matrix receptor interactions and focal adhesion. Moreover, N-cadherin and vimentin, known biomarkers of epithelial-mesenchymal transition, were highly expressed in high-risk group samples. The immune infiltration analysis showed that resting dendritic cells, monocytes, and resting memory CD4 T cells were significantly positively related to the risk score. Thus, m6A-LPS reflected the infiltration of several types of immune cells. CONCLUSIONS: The signature established by pairing m6A-related lncRNAs regardless of expression levels showed high and independent clinical prediction value in GC patients.

Exploring the diversity and role of microbiota during material pretreatment of light-flavor Baijiu.

Baijiu (Chinese liquor) is a type of traditional distilled alcoholic beverage produced through spontaneous solid-state fermentation with sorghum as the primary material. Material processing, including sorghum soaking, steaming and cooling which is carried out in an open environment, is an integral part of Baijiu manufacturing. However, the microbiota involved in material pretreatment and its associate with the alcoholic fermentation is unclear. This research is aimed to exploring the diversity and role of microbiota during material pretreatment of light-flavor Baijiu. Results showed that Cyanobacteria, Epicoccum, and Cladosporium predominated in the sorghum at the beginning of soaking. Lactobacillus and Pichia became the predominant bacterial and fungal genera by the end of soaking. With the dynamics of microbiota, the pH declined sharply and the categories and concentration of volatile flavors such as alcohols, esters, acids, phenols, ketones, and aldehydes increased. Correlation analysis indicated that Lactobacillus and Pichia showed positive correlation with various flavors during soaking. Furthermore, SourceTracker analysis revealed that the microbiota involved during cooling processing was an important source of the Lactobacillus during fermentation of light-flavor Baijiu. This study illustrates the role of microbiota during material pretreatment and the association with alcoholic fermentation, which contributes to reveal the mechanism of Baijiu manufacturing.

A Comparison by Meta-Analysis of Papillary Early Gastric Carcinoma to Its Tubular Counterpart for the Risk of Lymph Node Metastasis and Submucosal Invasion.

BACKGROUND AND AIM: At present, the decision to perform endoscopic resection for treating either papillary early gastric cancer (EGC) or tubular EGC is made according to identical criteria. However, there is controversy in the literature whether the risk of lymph node metastasis (LNM) and submucosal invasion for both disease modalities is equal, and this prompts investigation to clarify this issue. METHODS: The PubMed and Web of Science databases were searched for relevant studies published up to January 2017. Data were extracted, and the pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using a random-effects or a fixed-effects model, according to heterogeneity. RESULTS: A total of 13 studies were included in this analysis. Papillary EGC had a significantly higher LNM risk (OR, 1.97; 95% CI, 1.38-2.82) and submucosal invasion risk (OR, 1.44; 95% CI, 1.08-1.93), compared with tubular EGC. Stratified by geographic location, a significantly increased risk of LNM (OR, 2.28; 95% CI, 1.57-3.30) and submucosal invasion (OR, 1.52; 95% CI, 1.13-2.04) associated with papillary EGC was found in Asian studies. In addition, papillary EGC exhibited significantly more frequent elevated/flat growth patterns (OR, 7.54, 95% CI, 4.76-11.96). CONCLUSIONS: Our study identifies an increased risk for submucosal invasion and LNM in papillary EGC compared with tubular EGC, indicating that papillary EGC requires more careful clinical management compared with tubular EGC.

A Meta-analysis of Traffic-related Air Pollution and Risk of Childhood Leukemia.

BACKGROUND: Many studies have analyzed the association between traffic-related air pollution and risk of childhood leukemia, but the results are inconsistent. Therefore, we performed this meta-analysis to investigate the association between traffic-related air pollution and risk of childhood leukemia. METHODS: PubMed, Cochrane, and Embase databases were searched by the index words to identify eligible case-control studies, and relevant literature sources were also searched. The latest research was performed in September 2017. Odds ratio (OR) along with 95% confidence interval (95% CI) were used to analyzed the main outcomes. RESULTS: Twenty-one case-control studies were included in the meta-analysis. The results indicated that in the studies of overall traffic density (OR: 1.01, 95% CI: 0.98-1.04), high traffic density (OR: 1.04, 95% CI: 0.91-1.17), moderate exposure to NO2 (OR: 1.02, 95% CI: 0.93-1.10), and benzene (OR: 1.04, 95% CI: 0.71-1.37), the risks of childhood leukemia incidence were higher in the case group than the control group, but no significant difference was found. In other analysis, no significant difference was observed in the risk of childhood leukemia in the 2 groups. CONCLUSIONS: Current evidence suggests that childhood leukemia is associated with traffic density, and moderate exposure to NO2 and benzene. However, more high-quality studies are required to confirm the conclusions.

Interaction of H. pylori with toll-like receptor 2-196 to -174 ins/del polymorphism is associated with gastric cancer susceptibility in southern China.

BACKGROUND: Genetic polymorphisms of Toll-like receptors play important roles in gastric carcinogenesis. The aim of this study was to determine the role of TLR2-196 to -174 ins/del polymorphism in gastric cancer susceptibility and prognosis. METHODS: This study included 520 people from southern China. Samples were genotyped by the allele-specific polymerase chain reaction, among which 10% were randomly selected for sequencing. The serological method was used to determine Helicobacter pylori. RESULTS: The TLR2 genotype was not associated with the risk of H. pylori infection. The del/del genotype exhibited significantly higher gastric cancer risk (adjusted OR 2.59, 95% CI 1.33‒5.07) than that of the ins/ins genotype. Further stratification analyses demonstrated that the del/del genotype was associated with a risk of intestinal gastric cancer (adjusted OR 2.62, 95% CI 1.34-5.14). In addition, the presence of the del/del genotype and the H. pylori infection conferred a synergistic effect (OR 3.04, 95% CI 1.33‒6.98) for the development of gastric cancer. The del/del genotype was not associated with a poor prognosis in gastric cancer patients. CONCLUSION: The del/del genotype is associated with an increased gastric cancer risk in the southern Chinese population. However, TLR2 polymorphism is neither associated with H. pylori infection, nor with a poor prognosis.

Characterization of bacteria and yeasts isolated from traditional fermentation starter (Fen-Daqu) through a 1H NMR-based metabolomics approach.

Daqu is a traditional fermentation starter for the production of baijiu and vinegar. It is an important saccharifying and fermenting agent associated with alcoholic fermentation and also a determining factor for the flavour development of these products. Bacterial and yeast isolates from a traditional fermentation starter (Fen-Daqu) were examined for their amylolytic activity, ethanol tolerance and metabolite production during sorghum-based laboratory-scale alcoholic fermentation. The selected strains (Bacillus licheniformis, Pediococcus pentosaceus, Lactobacillus plantarum, Pichia kudriavzevii, Wickerhamomyces anomalus, Saccharomyces cerevisiae, and Saccharomycopsis fibuligera) were blended in different combinations, omitting one particular strain in each mixture. 1H nuclear magnetic resonance (NMR) spectroscopy coupled with multivariate statistical analysis was used to investigate the influence of the selected strains on the metabolic changes observed under the different laboratory-controlled fermentation conditions. Principal component analysis showed differences in the metabolites produced by different mixtures of pure cultures. S. cerevisiae was found to be superior to other species with respect to ethanol production. S. fibuligera and B. licheniformis converted starch or polysaccharides to soluble sugars. Lactic acid bacteria had high amylolytic and proteolytic activities, thereby contributing to increased saccharification and protein degradation. W. anomalus was found to have a positive effect on the flavour of the Daqu-derived product. This study highlights the specific functions of S. cerevisiae, S. fibuligera, B. licheniformis, W. anomalus and lactic acid bacteria in the production of light-flavour baijiu (fen-jiu). Our results show that all investigated species deliver an important contribution to the functionality of the fermentation starter Daqu.

A potential link between polycystic ovary syndrome and non-alcoholic fatty liver disease: an update meta-analysis.

BACKGROUND: Epidemiological literature regarding the effect of polycystic ovary syndrome (PCOS) as a risk factor for non-alcoholic fatty liver disease (NAFLD) remains inconsistent. Furthermore, it remains debatable whether NAFLD is associated with PCOS as a consequence of shared risk factors or whether PCOS contributes to NAFLD in an independent fashion. Therefore, this meta-analysis was conducted. METHODS: This meta-analysis was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Relevant studies published before May 2017 were identified and retrieved from PubMed and Web of Science databases. The data were extracted, and the pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. RESULTS: A total of 17 studies were included into the present analysis. Compared to the control group, the risk of NAFLD in the PCOS group was higher (OR = 2.25, 95% CI = 1.95-2.60). When stratified by BMI and geographic location, the results indicated that the frequency of NAFLD risk was significantly higher in obese subjects (OR = 3.01, 95% CI = 1.88-4.82), non-obese subjects (OR = 2.07, 95% CI = 1.12-3.85), subjects from Europe (OR = 2.00, 95% CI = 1.58-2.52), subjects from the Asia-Pacific Region, (OR = 2.32, 95% CI = 1.89-2.84) and subjects from America (OR = 2.96, 95% CI = 1.93-4.55). In addition, PCOS patients with hyperandrogenism (HA) had a significantly higher risk of NAFLD, compared with controls (OR = 3.31, 95% CI = 2.58-4.24). However, there was no association between PCOS patients without HA and higher risk of NAFLD (OR = 1.46; 95% CI =0.55-3.87). The results of this meta-analysis should be interpreted with caution due to the small number of observational studies and possible confounding factors. CONCLUSION: The meta-analysis results suggest that PCOS is significantly associated with high risk of NAFLD. Although this association was independent of obesity and geographic region, it might be correlated with HA.

Bioinspired Nano-Prodrug with Enhanced Tumor Targeting and Increased Therapeutic Efficiency.

Nanotechnology-based drug delivery has a great potential to revolutionize cancer treatment by enhancing anticancer drug efficacy and reducing drug toxicity. Here, a bioinspired nano-prodrug (BiNp) assembled by an antineoplastic peptidic derivative (FA-KLA-Hy-DOX), a folate acid (FA)-incorporated proapoptotic peptide (KLAKLAK)(2) (KLA) to doxorubicin (DOX) via an acid-labile hydrozone bond (Hy) is constructed. The hydrophobic antineoplastic agent DOX is efficiently shielded in the core of nano-prodrug. With FA targeting moieties on the surface, the obtained BiNp shows significant tumor-targeting ability and enhances the specific uptake of cancer cells. Upon the trigger by the intracellular acidic microenvironment of endosomes, the antineoplastic agent DOX is released on-demand and promotes the apoptosis of cancer cells. Simultaneously, the liberated FA-KLA can induce the dysfunction of mitochondria and evoke mitochondria-dependent apoptosis. In vitro and in vivo results show that the nano-prodrug BiNp with integrated programmed functions exhibits remarkable inhibition of tumor and achieves a maximized therapeutic efficiency with a minimized side effect.

A Hydration Model to Evaluate the Properties of Cement-Quartz Powder Hybrid Concrete.

Although quartz powder is a common concrete filling material, the importance and originality of this study lies in the development of a hydration model for quartz powder-cement binary mixtures and the adoption of this model to predict the development of concrete material properties. The purpose of this study is to use this model to promote the material design of environmentally friendly concrete and to elucidate the relationships in the development of the various properties of quartz powder concrete. The method used in this study was as follows: The parameters of the hydration model were obtained through seven days of hydration heat experiments. The hydration heat up to 28 days was also calculated, and the various properties of the concrete were predicted from the heat of hydration. The main findings of this study were as follows: (1) The ultimate hydration heat released per gram of cement for the different quartz powder substitution rates and quartz powder particle fineness was the same, at 390.145 J/g cement, as was the shape index of the hydration model at -1.003. (2) Moreover, through the model calculations, we found that, at the twenty-eighth day of the curing period for the quartz powder specimens with different quartz powder substitution amounts and different fineness, the reaction level of the cement was similar, at 0.963, as were the values of the cumulative heat of hydration, with both at 375.5 J/g cement. (3) The model showed that, in the late stage (28 days) of hydration for quartz powders of different fineness and when the substitution amount was the same, the cumulative heat of hydration over 28 days was similar. (4) The properties of concrete were evaluated using the calculated hydration heat. Overall, the predictive performance of the power and linear functions was similar, with no significant differences being found.

Influence of Eggshell Powder on the Properties of Cement-Based Materials.

Replacing cement with industrial by-products is an important way to achieve carbon neutrality in the cement industry. The purpose of this study is to evaluate the effect of eggshell powder on cement hydration properties, and to evaluate its feasibility as a substitute for cement. The substitution rates of eggshell powder are 0%, 7.5%, and 15%. Studying the heat of hydration and macroscopic properties can yield the following results. First: The cumulative heat of hydration based on each gram of cementitious material falls as the eggshell powder content rises. This is a result of the eggshell powder's diluting action. However, the cumulative heat of hydration per gram of cement rises due to the nucleation effect of the eggshell powder. Second: The compressive strengths of ES0, ES7.5, and ES15 samples at 28 days of age are 54.8, 43.4, and 35.5 MPa, respectively. Eggshell powder has a greater negative impact on the compressive strength. The effect of eggshell powder on the speed and intensity of ultrasonic waves has a similar trend. Third: As the eggshell powder content increases, the resistivity gradually decreases. In addition, we also characterize the microscopic properties of the slurry with added eggshell powder. X-ray Diffraction (XRD) shows that, as the age increases from 1 day to 28 days, hemicaboaluminate transforms into monocaboaluminate. As the content of the eggshell powder increases, FTIR analysis finds a slight decrease in the content of CSH. Similarly, thermogravimetric (TG) results also show a decrease in the production of calcium hydroxide. Although the additional nucleation effect of eggshell powder promotes cement hydration and generates more portlandite, it cannot offset the loss of portlandite caused by the decrease in cement. Last: A numerical hydration model is presented for cement-eggshell powder binary blends. The parameters of the hydration model are determined based on hydration heat normalized by cement mass. Moreover, the hydration heat until 28 days is calculated using the proposed model. The strength development of all specimens and all test ages can be expressed as an exponential function of hydration heat.

Protein extract of ultraviolet-irradiated human skin keratinocytes promote the expression of mitogen-activated protein kinases, nuclear factor-κB and interferon regulatory factor-3 in Langerhans cells via Toll-like receptor 2 and 4.

AIM: In this study, we investigated whether the protein extract of ultraviolet-irradiated human skin keratinocytes can activate Toll-like receptor 2 and Toll-like receptor 4 of Langerhans cells and induce the downstream gene expression of mitogen-activated protein kinases, nuclear factor-κB and interferon regulatory factor-3. METHODS: The protein expression of mitogen-activated protein kinases, nuclear factor-κB and interferon regulatory factor-3 in Langerhans cells and the protein expression of HSP60, HSP70 and ß-defensin 2 in keratinocytes were examined using Western blot analysis. Langerhans cells were pretreated with or without Toll-like receptor 2 and Toll-like receptor 4 siRNA. RESULTS: We found that the protein extract of ultraviolet-irradiated keratinocytes upregulated the expression of mitogen-activated protein kinases, nuclear factor-κB and interferon regulatory factor-3 in Langerhans cells via Toll-like receptor 2 and Toll-like receptor 4. We also found that ultraviolet radiation upregulated the expression HSP60, HSP70 and ß-defensin 2 in keratinocytes. CONCLUSIONS: Our previous study demonstrated that ultraviolet radiation upregulated Toll-like receptor 2 and Toll-like receptor 4 expression in Langerhans cells. Ultraviolet radiation also upregulated mitogen-activated protein kinases and nuclear factor-κB/p65 expression via Toll-like receptor 2 and Toll-like receptor 4, and upregulated interferon regulatory factor-3 expression partially via Toll-like receptor 4. So we conclude that ultraviolet radiation can directly or indirectly activate keratinocytes to induce endogenous ligands which stimulate Toll-like receptor 2- or Toll-like receptor 4-dependent signaling cascade in Langerhans cells, sequentially influence innate and adaptive immune responses.

Optimization design of low-carbon hybrid concrete containing slag and limestone powder.

Slag and limestone powder are common mineral admixtures to produce environmentally friendly concrete. This paper presents an optimal design method for low-carbon concrete containing slag and limestone powder that considers the influence of strength (30, 40, 50 MPa), carbonation service life (50, 100 years), and CO2 concentration of microclimate (0.04% and 0.052%). By using a genetic algorithm to determine the global optimal solution that satisfies different constraints, the optimal mixtures and decisive factors of a concrete mix can be found. The analysis results are as follows: (1) When the carbonation service life is 50 years, the durability of carbonation is the decisive factor for designing concrete with ordinary strength (30 MPa), but for medium strength (40 MPa) and high strength (50 MPa) concrete, strength is the decisive factor. (2) When carbonation service life is 100 years, for ordinary (30 MPa) and medium strength (40 MPa) concrete, carbonation durability is the decisive design factor, while for high-strength concrete (50 MPa), it is compressive strength. (3) As carbonation durability is the decisive design factor, when the CO2 concentration of microclimate increases from 0.04 to 0.052%, the real strengths of concrete increase from 44.34 to 48.53 MPa. (4) The relations between CO2 emissions and compressive strengths and between water-binder ratios and compressive strengths of the optimized concrete design were consistent with the project, which proved the effectiveness of the proposed method.

Carbon Peaking and Carbon Neutrality in the Cement-Based Materials.

The cement industry plays a significant role in global carbon emissions, accounting for approximately 8% of global anthropogenic carbon dioxide (CO2) emissions [...].

Enhancing performance and sustainability of ultra-high-performance concrete through solid calcium carbonate precipitation.

Ultra-high-performance concrete (UHPC) exhibits high compressive strength and good durability. However, owing to the dense microstructure of UHPC, carbonation curing cannot be performed to capture and sequester carbon dioxide (CO2). In this study, CO2 was added to UHPC indirectly. Gaseous CO2 was first converted into solid calcium carbonate (CaCO3) using calcium hydroxide, and the converted CaCO3 was then added to UHPC at 2, 4, and 6 wt% based on the cementitious material. The performance and sustainability of UHPC with indirect CO2 addition were investigated through macroscopic and microscopic experiments. The experimental results showed that the method used did not negatively affect the performance of UHPC. Compared with the control group, the early strength, ultrasonic velocity, and resistivity of UHPC containing solid CO2 improved to varying degrees. Microscopic experiments, such as heat of hydration and thermogravimetric analysis (TGA), demonstrated that adding captured CO2 accelerated the hydration rate of the paste. Finally, the CO2 emissions were normalized according to the compressive strength and resistivity at 28 days. The results indicated that the CO2 emissions per unit compressive strength and unit resistivity of UHPC with CO2 were lower than those of the control group.

The Effect of Oyster Shell Powder on the High-Temperature-Properties of Slag-Ceramic Powder-Based Geopolymer.

There is a lack of scientific understanding of adding an oyster shell powder (OSP) to geopolymer concrete. The purpose of this study is: (1) to evaluate the high-temperature resistance of the alkali-activated slag ceramic powder (CP) mixture added with OSP at different temperatures, (2) to address the lack of application of environmentally friendly building materials, and (3) to reduce solid waste of OSP pollution and protect the environment. OSP replaces granulated blast furnace slag (GBFS) and CP at 10% and 20% (based on binder), respectively. The mixture was heated to 400.0, 600.0, and 800.0 °C after curing for 180 days. The results of the experiment are summarized as follows: (1) The thermogravimetric (TG) results indicated that the OSP20 samples produced more CASH gels than the control OSP0. (2) As the temperature increased, the compressive strength and ultrasonic pulse velocity (UPV) both decreased. (3) Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) results reveal that the mixture undergoes a phase transition at 800.0 °C, and compared with the control OSP0, OSP20 undergoes a different phase transition. (4) The size change and appearance image results indicate that the mixture with added OSP inhibits shrinkage, and calcium carbonate decomposes to produce off-white CaO. To sum up, adding OSP can effectively reduce the damage of high temperatures (800.0 °C) on the properties of alkali-activated binders.

Prediction of lymph node metastasis in early gastric signet-ring cell carcinoma: A real-world retrospective cohort study.

BACKGROUND: Signet-ring cell carcinoma (SRCC) was previously thought to have a worse prognosis than other differentiated gastric cancer (GC), however, recent studies have shown that the prognosis of SRCC is related to pathological type. We hypothesize that patients with SRCC and with different SRCC pathological components have different probability of lymph node metastasis (LNM). AIM: To establish models to predict LNM in early GC (EGC), including early gastric SRCC. METHODS: Clinical data from EGC patients who had undergone gastrectomy at the First Affiliated Hospital of Nanjing Medical University from January 2012 to March 2022 were reviewed. The patients were divided into three groups based on type: Pure SRCC, mixed SRCC, and non-signet ring cell carcinoma (NSRC). The risk factors were identified through statistical tests using SPSS 23.0, R, and Em-powerStats software. RESULTS: A total of 1922 subjects with EGC were enrolled in this study, and included 249 SRCC patients and 1673 NSRC patients, while 278 of the patients (14.46%) presented with LNM. Multivariable analysis showed that gender, tumor size, depth of invasion, lymphovascular invasion, ulceration, and histological subtype were independent risk factors for LNM in EGC. Establishment and analysis using prediction models of EGC showed that the artificial neural network model was better than the logistic regression model in terms of sensitivity and accuracy (98.0% vs 58.1%, P = 0.034; 88.4% vs 86.8%, P < 0.001, respectively). Among the 249 SRCC patients, LNM was more common in mixed (35.06%) rather than in pure SRCC (8.42%, P < 0.001). The area under the ROC curve of the logistic regression model for LNM in SRCC was 0.760 (95%CI: 0.682-0.843), while the area under the operating characteristic curve of the internal validation set was 0.734 (95%CI: 0.643-0.826). The subgroups analysis of pure types showed that LNM was more common in patients with a tumor size > 2 cm (OR = 5.422, P = 0.038). CONCLUSION: A validated prediction model was developed to recognize the risk of LNM in EGC and early gastric SRCC, which can aid in pre-surgical decision making of the best method of treatment for patients.

Safety and effectiveness of vonoprazan-based rescue therapy for Helicobacter pylori infection.

BACKGROUND: Vonoprazan (VPZ)-based regimens are an effective first-line therapy for Helicobacter pylori (H. pylori) infection. However, their value as a rescue therapy needs to be explored. AIM: To assess a VPZ-based regimen as H. pylori rescue therapy. METHODS: This prospective, single-center, clinical trial was conducted between January and August 2022. Patients with a history of H. pylori treatment failure were administered 20 mg VPZ twice daily, 750 mg amoxicillin 3 times daily, and 250 mg Saccharomyces boulardii (S. boulardii) twice daily for 14 d (14-d VAS regimen). VPZ and S. boulardii were taken before meals, while amoxicillin was taken after meals. Within 3 d after the end of eradication therapy, all patients were asked to fill in a questionnaire to assess any adverse events they may have experienced. At least 4-6 wk after the end of eradication therapy, eradication success was assessed using a 13C-urea breath test, and factors associated with eradication success were explored. RESULTS: Herein, 103 patients were assessed, and 68 patients were finally included. All included patients had 1-3 previous eradication failures. The overall eradication rates calculated using intention-to-treat and per-protocol analyses were 92.6% (63/68) and 92.3% (60/65), respectively. The eradication rate did not differ with the number of treatment failures (P = 0.433). The rates of clarithromycin, metronidazole, and levofloxacin resistance were 91.3% (21/23), 100.0% (23/23), and 60.9% (14/23), respectively. There were no cases of resistance to tetracycline, amoxicillin, or furazolidone. In 60.9% (14/23) patients, the H. pylori isolate was resistant to all 3 antibiotics (clarithromycin, metronidazole, and levofloxacin); however, eradication was achieved in 92.9% (13/14) patients. All patients showed metronidazole resistance, and had an eradication rate of 91.3% (21/23). The eradication rate was higher among patients without anxiety (96.8%) than among patients with anxiety (60.0%, P = 0.025). No severe adverse events occurred; most adverse events were mild and disappeared without intervention. Good compliance was seen in 95.6% (65/68) patients. Serological examination showed no significant changes in liver and kidney function. CONCLUSION: VAS is a safe and effective rescue therapy, with an acceptable eradication rate (> 90%), regardless of the number of prior treatment failures. Anxiety may be associated with eradication failure.

Low-CO2 Optimization Design of Quaternary Binder Containing Calcined Clay, Slag, and Limestone.

Blended cement is commonly used for producing sustainable concretes. This paper presents an experimental study and an optimization design of a low-CO2 quaternary binder containing calcined clay, slag, and limestone using the response surface method. First, a Box-Behnken design with three influencing factors and three levels was used for the combination design of the quaternary composite cement. The lower limit of the mineral admixtures was 0%. The upper limits of slag, calcined clay, and limestone powder were 30%, 20%, and 10%, respectively. The water-to-binder ratio (water/binder) was 0.5. Experimental works to examine workability and strength (at 3 and 28 days) were performed for the composite cement. The CO2 emissions were calculated considering binder compositions. A second-order polynomial regression was used to evaluate the experimental results. In addition, a low-CO2 optimization design was conducted for the composite cement using a composite desirability function. The objectives of the optimization design were the target 28-day strength (30, 35, 40, and 45 MPa), target workability (160 mm flow), and low CO2 emissions. The trends of the properties of optimal combinations were consistent with those in the test results. In summary, the proposed optimization design can be used for designing composite cement considering strength, workability, and ecological aspects.

Predictive value of prognostic nutritional index on infection after radical gastrectomy: a retrospective study.

Background: The prognostic nutritional index (PNI) is a useful tool to evaluate nutritional status, which is associated with postoperative complications and prognosis of patients with cancer. Recent studies have shown that PNI has important predictive value for postoperative infection in cancer patients. However, the role and clinical value of PNI in infection after radical gastrectomy remains unclear. This study investigated the relationship between PNI and infection after radical surgery for gastric cancer (GC), focusing on the predictive value of PNI. Methods: A total of 1,111 patients with primary gastric cancer who underwent radical surgery in our hospital from December 2010 to December 2020 were included in this retrospective study. The demographic and clinicopathological data of all patients were acquired through hospital information system (HIS). Preoperative serum albumin (ALB) level and peripheral blood lymphocyte count were obtained for PNI calculation. We selected 812 patients by propensity score matching to reduce biases due to the different distributions of co-variables among the comparable groups. The factors influencing postoperative infection in the matched patients were explored using univariate and multivariate analyses. Results: Baseline characteristics significantly differed among patients with different PNI scores. After one-to-one matching, the clinicopathological data of the 2 groups were comparable, and 812 patients were included for further analysis. Among these patients, 101 developed infections, with an infection rate of 12.4%, which were mainly caused by gram-negative bacteria. The incidence of infection was significantly higher in the low PNI group than in the high PNI group. Univariate and multivariate analyses identified body mass index (BMI) ≥25 kg/m2 [odds ratio (OR) =2.314, P=0.004], diabetes mellitus (OR =1.827, P=0.042), PNI score <45 (OR =2.138, P=0.037), combined multi-organ resection (OR =2.946, P<0.001), operation time ≥240 minutes (OR =2.744, P=0.023), and perioperative blood transfusion (OR =2.595, P=0.025) as risk factors for infection after radical surgery for GC. Conclusions: Infection is the most common complication after radical gastrectomy for GC, and a low preoperative PNI score is a risk factor for postoperative infection.

17ß-Estradiol promotes cell proliferation in rat osteoarthritis model chondrocytes via PI3K/Akt pathway.

Osteoarthritis (OA) is the most common cause of musculoskeletal pain and disability. The importance of chondrocytes in the pathogenesis of OA is unequivocal. 17ß-estradiol (E2) has a potential protective effect against OA. However, the mechanism of E2 in OA chondrocytes remains unclear. In this study, we investigated the regulative effect of E2 on cell growth and the relationship between E2 and the PI3K/Akt pathway in rat OA model chondrocytes (pretreated with interleukin-1ß). We found that E2 induced chondrocyte proliferation, and increased the expression level of Akt simultaneously, especially the expression level of P-Akt. Furthermore, the inhibition of P-Akt could block chondrocyte proliferation induced by E2. These results suggest that PI3K/Akt activation induced by E2 may be an important factor in the mechanism of E2 in cell proliferation in rat OA model chondrocytes, and help further understanding the role of E2 in OA progression.