Relative decline in serum albumin help to predict anastomotic leakage for female patients following sphincter-preserving rectal surgery.

BACKGROUND: Patients with normal preoperative serum albumin still suffer from a significant reduction in serum albumin after major abdominal surgery. The current study aims to explore the predictive value of ∆ALB for AL in patients with normal serum albumin and examine whether there is a gender difference in the prediction of AL. METHODS: Medical reports of consecutive patients undergoing elective sphincter-preserving rectal surgery between July 2010 and June 2016 were reviewed. Receiver operating characteristic (ROC) analysis was adopted to examine the predictive ability of ∆ALB and determine the cut-off value according to the Youden index. The logistic regression model was performed identify independent risk factors for AL. RESULTS: Out of the 499 eligible patients, 40 experienced AL. Results of the ROC analyses showed that ΔALB displayed a significant predictive value for females, and the AUC value was 0.675 (P = 0.024), with a sensitivity of 93%. In male patients, the AUC was 0.575 (P = 0.22), but did not reach a significant level. In the multivariate analysis, ∆ALB ≥ 27.2% and low tumor location prove to be independent risk factors for AL in female patients. CONCLUSIONS: The current study suggested that there may be a gender difference in the prediction of AL and ∆ ALB can serve as a potential predictive biomarker for AL in females. A cut-off value of the relative decline in serum albumin can help predict AL in female patients as early as postoperative day 2. Although our study needs further external validation, our findings may provide an earlier, easier and cheaper biomarker for the detection of AL.

Robotic versus laparoscopic left colectomy with complete mesocolic excision for left-sided colon cancer: a multicentre study with propensity score matching analysis.

PURPOSE: Robotic surgery for right-sided colon and rectal cancer has rapidly increased; however, there is limited evidence in the literature of advantages of robotic left colectomy (RLC) for left-sided colon cancer. The purpose of this study was to compare the outcomes of RLC versus laparoscopic left colectomy (LLC) with complete mesocolic excision (CME) for left-sided colon cancer. METHODS: Patients who had RLC or LLC with CME for left-sided colon cancer at five hospitals in China between January 2014 and April 2022 were included. A one-to-one propensity score matched analysis was performed to decrease confounding. The primary outcome was postoperative complications occurring within 30 days of surgery. Secondary outcomes were disease-free survival, overall survival and the number of harvested lymph nodes. RESULTS: A total of 292 patients (187 male; median age 61.0 [20.0-85.0] years) were eligible for this study, and propensity score matching yielded 102 patients in each group. The clinicopathological characteristics were well-matched between groups. The two groups did not differ in estimated blood loss, conversion to open rate, time to first flatus, reoperation rate, or postoperative length of hospital stay (p > 0.05). RLC was associated with a longer operation time (192.9 ± 53.2 vs. 168.9 ± 52.8 min, p = 0.001). The incidence of postoperative complications did not differ between the RLC and LLC groups (18.6% vs. 17.6%, p = 0.856). The total number of lymph nodes harvested in the RLC group was higher than that in the LLC group (15.7 ± 8.3 vs. 12.1 ± 5.9, p < 0.001). There were no significant differences in 3-year and 5-year overall survival or 3-year and 5-year disease-free survival. CONCLUSION: Compared to laparoscopic surgery, RLC with CME for left-sided colon cancer was found to be associated with higher numbers of lymph nodes harvested and similar postoperative complications and long-term survival outcomes.

The impact of postoperative complications severity on stoma reversal following sphincter-preserving surgery for rectal cancer.

BACKGROUND: Currently, the relationship between temporary stoma reversal and the severity of postoperative complications (POCs) after the index surgery based on the Clavien-Dindo classification has not yet been explored. METHODS: From July 2010 to June 2016, 380 patients undergoing sphincter-preserving surgery for rectal cancer with a temporary stoma in our hospital were included. Temporary stoma nonclosure rates, disease-free survival rates, and overall survival rates were estimated utilizing the Kaplan-Meier method. RESULTS: Of all the 380 patients, primary stomas were created in 335 patients and secondary stomas in 45 patients. After the index surgery, 36.6% (139/380) of patients developed at least one postoperative complication. In the first analysis, which included all the patients, 24.7% of temporary stomas remained unclosed. In the second analysis for 335 patients with a primary stoma, 23.3% were left with unclosed stomas. After the COX regression analysis, both major POCs and minor POCs were found to be independent risk factors for the permanent stoma, and there was an increasing tendency toward the risk of permanent stoma with the increase in POC severity. CONCLUSION: POCs are independent predictors of permanent stoma after rectal cancer surgery. Even minor POCs may affect the outcome, while there is a clear direct relationship between POC severity and permanent stoma rates.

The impact of sedation on quality metrics of colonoscopy: a single-center experience of 48,838 procedures.

PURPOSE: Investigation of the role of sedation during colonoscopy is meaningful as the advantages of colonoscopy performing with sedation are still controversial. METHODS: Medical records of patients who underwent colonoscopy in our institution were retrospectively analyzed. The sedation rate, adenoma detection rate (ADR), polyp detection rate (PDR), cecal intubation rate (CIR), iatrogenic colonic perforation rate (ICP) were calculated. RESULTS: A total of 48,838 colonoscopies (24,498 in males) dated from July 2007 to February 2017 were analyzed. The median age was 50 years (range 16-85 years). An overall sedation rate was 80.38%. The PDR was 26.77%, and was not statistically different between colonoscopy with or without sedation (26.67% vs 27.22, p = 0.474). ADR was 12.9% regardless of applying sedation or not (13.0% vs 12.44%, p = 0.337). The CIR was 87.42% in all examinations with an adjusted CIR of 90.34%, and was higher when performed with sedation than without sedation (88.92% vs 80.64%, p < 0.0001). Five cases (0.01%) of ICP were reported, all of which occurred in patients under sedation. CONCLUSIONS: The use of sedation is associated with increased CIR, but ADR and PDR remain unchanged with or without sedation. However, perforation rate, albeit very low, is significantly higher in sedated patients.

Inorganic Gel-Derived Metallic Frameworks Enabling High-Performance Silicon Anodes.

Metallic matrix materials have emerged as an ideal platform to hybridize with next-generation electrode materials such as silicon for practical applications in Li-ion batteries. However, these metallic species commonly exist in the form of isolated particles, failing to provide enough free space for silicon volume changes as well as continuous charge transport pathways. Herein, three-dimensional (3D) metallic frameworks with interconnected pore channels and conductive skeletons, have been synthesized from inorganic gel precursors as buffering/conducting matrices to boost lithium storage performance of silicon anodes. As a proof-of-concept demonstration, commercial Si particles are in situ immobilized within the Sn-Ni alloy framework via a facile gel-reduction route, and the rearrangement of Si particles during cycling increases the dispersity of Si in the Sn-Ni framework as well as their synergic effects toward lithium storage. The Si@Sn-Ni all-metallic framework manifests high structural integrity, 3D Li+/e- mixed conduction pathway, and synergic effects of interfacial bonding and concurrent reaction dynamics between active Si and Sn, enabling long-term cycle life (1205 mA h g-1 after 100 cycles at 0.5 A g-1) and superior rate capability (653 mA h g-1 at 10 A g-1).

Bach2 regulates aberrant activation of B cell in systemic lupus erythematosus and can be negatively regulated by BCR-ABL/PI3K.

OBJECTIVE: This study was aimed to explore the effect of Bach2 on B cells in systemic lupus erythematosus (SLE), as well as the underlying mechanisms. METHODS: Expression of Bach2, phosphorylated-Bach2 (p-Bach2), Akt, p-Akt and BCR-ABL (p210) in B cells isolated from SLE patients and the healthy persons were assessed by Western blot. Immunofluorescence staining was performed to assess the localization of Bach2 in B cells. Enzyme-linked immunosorbent assay (ELISA) was employed to detect IgG produced by B cells. Cell counting kit-8 (CCK-8) and Annexin-V FITC/PI double staining assay were adopted to evaluate cell proliferation and apoptosis in B cells, respectively. RESULTS: Compared to the healthy controls, Bach2, p-Akt and p210 were significantly decreased, while nuclear translocation of Bach2, IgG, CD40 and CD86 obviously up-regulated in B cells from SLE patients. Bach2 significantly inhibited the proliferation, promoted apoptosis of B cells from SLE patients, whereas BCR-ABL dramatically reversed cell changes induced by Bach2. Besides, BCR-ABL also inhibited nuclear translocation of Bach2 in B cells from SLE patients. Further, LY294002 treatment had no effect on decreased expression of Bach2 induced by BCR-ABL, but significantly eliminated BCR-ABL-induced phosphorylation of Bach2 and restored reduced nuclear translocation of Bach2 induced by BCR-ABL in B cells from SLE. CONCLUSIONS: Bach2 may play a suppressive role in B cells from SLE, and BCR-ABL may inhibit the nuclear translocation of Bach2 via serine phosphorylation through the PI3K pathway.

Enhanced emissions of brominated flame retardants from indoor sources by direct contact with dust.

The emissions of brominated flame retardants (BFRs) from consumer products have been considered the major to the ubiquitous occurrence of contaminants in indoor environments. Direct contact with dust covering the surface of source materials in a real environment could introduce significant uncertainty. This study investigated the effects of dust coverage on the emissions of four BFRs, including 1, 2, 5, 6, 9, and 10-hexabromocyclododecane (HBCD), bis(2-ethyl-1-hexyl) tetrabromophthalate (BEHTBP), tetrabromobisphenol A (TBBPA), and hexabromobenzene (HBBZ), from decorative laminate, cotton sound insulation, PVC floor, and carpet. Direct contact with dust was confirmed to increase the total emissions by 30.8-98.1% compared with the emissions in the non-dust group. The emissions of HBCD, TBBPA, and HBBZ from cotton sound insulation were obviously enhanced by dust with smaller particles but did not linearly increase along with the dust amounts. Thus, these findings have practical implications in that the frequent removal of dust could be important to minimize the exposure risk from indoor emissions of BFRs.

Preparation of Fe-Co based MOF-74 and its effective adsorption of arsenic from aqueous solution.

To obtain a cost-effective adsorbent for the removal of arsenic in water, a novel nanostructured Fe-Co based metal organic framework (MOF-74) adsorbent was successfully prepared via a simple solvothermal method. The adsorption experiments showed that the optimal molar ratio of Fe/Co in the adsorbent was 2:1. The Fe2Co1 MOF-74 was characterized by various techniques and the results showed that the nanoparticle diameter ranged from 60 to 80 nm and the specific surface area was 147.82 m2/g. The isotherm and kinetic parameters of arsenic removal on Fe2Co1 MOF-74 were well-fitted by the Langmuir and pseudo-second-order models. The maximum adsorption capacities toward As(III) and As(V) were 266.52 and 292.29 mg/g, respectively. The presence of sulfate, carbonate and humic acid had no obvious effect on arsenic adsorption. However, coexisting phosphate significantly hindered the removal of arsenic, especially at high concentrations (10 mmol/L). Electrostatic interaction and hydroxyl and metal-oxygen groups played important roles in the adsorption of arsenic. Furthermore, the prepared adsorbent had stable adsorption ability after regeneration and when used in a real-water matrix. The excellent adsorption performance of Fe2Co1 MOF-74 material makes it a potentially promising adsorbent for the removal of arsenic.

The molecular landscape of synchronous colorectal cancer reveals genetic heterogeneity.

Synchronous colorectal cancers (syCRCs), which present two or more lesions at diagnosis, are rare and pose a great challenge for clinical management. Although some predisposing factors associated with syCRCs have been studied with limited accession, the full repertoire of genomic events among the lesions within an individual and the causes of syCRCs remain unclear. We performed whole-exome sequencing of 40 surgical tumour samples of paired lesions from 20 patients to characterize the genetic alterations. Lesions from same patient showed distinct landscapes of somatic aberrations and shared few mutations, which suggests that they originate and develop independently, although they shared the similar genetic background. Canonical genes, such as APC, KRAS, TP53 and PIK3CA, were frequently mutated in the syCRCs, and most of them show different mutation profile compared with solitary colorectal cancer. We identified a recurrent somatic alteration (K15fs) in RPL22 in 25% of the syCRCs. Functional analysis indicated that mutated RPL22 may suppress cell apoptosis and promote the epithelial-mesenchymal transition (EMT). Potential drug targets were identified in several signalling pathways, and they present great discrepancy between lesions from the same patient. Our data show that the syCRCs within the same patient present great genetic heterogeneity, and they may be driven by distinct molecular events and develop independently. The discrepancy of potential drug targets and mutation burden in lesions from one patient provides valuable information in clinical management for patients with syCRCs.

Exome-wide association study identifies four novel loci for systemic lupus erythematosus in Han Chinese population.

OBJECTIVES: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease of considerable genetic predisposition. Genome-wide association studies have identified tens of common variants for SLE. However, the majority of them reside in non-coding sequences. The contributions of coding variants have not yet been systematically evaluated. METHODS: We performed a large-scale exome-wide study in 5004 SLE cases and 8179 healthy controls in a Han Chinese population using a custom exome array, and then genotyped 32 variants with suggestive evidence in an independent cohort of 13 246 samples. We further explored the regulatory effect of one novel non-coding single nucleotide polymorphism (SNP) in ex vivo experiments. RESULTS: We discovered four novel SLE gene regions (LCT, TPCN2, AHNAK2 and TNFRSF13B) encompassing three novel missense variants (XP_016859577.1:p.Asn1639Ser, XP_016859577.1:p.Val219Phe and XP_005267356.1:p.Thr4664Ala) and two non-coding variants (rs10750836 and rs4792801) with genome-wide significance (pmeta <5.00×10-8). These variants are enriched in several chromatin states of primary B cells. The novel intergenic variant rs10750836 exhibited an expression quantitative trait locus effect on the TPCN2 gene in immune cells. Clones containing this novel SNP exhibited gene promoter activity for TPCN2 (P=1.38×10-3) whose expression level was reduced significantly in patients with SLE (P<2.53×10-2) and was suggested to be further modulated by rs10750836 in CD19+ B cells (P=7.57×10-5) in ex vivo experiments. CONCLUSIONS: This study identified three novel coding variants and four new susceptibility gene regions for SLE. The results provide insights into the biological mechanism of SLE.

NFKB1 mediates Th1/Th17 activation in the pathogenesis of psoriasis.

This study was aimed to investigate whether NFKB1 participates in the pathogenesis of psoriasis by mediating Th1/Th17 cells. In this study, expression of NFKB1 was assessed in skin tissues from psoriasis patients and the healthy controls through Western blot and Immunohistochemistry. Enzyme-linked immunosorbent assay (ELISA) was used to analyze the serum levels of IFN-γ, IL-17 (IL-17A) and IL-17RA. The imiquimod-induced psoriasis mouse model was employed to examine the role of NFKB1 in psoriasis via the assessment of psoriasis area and severity index (PASI), including erythema, thickness and scales. The effects of NFKB1 on Th1/Th17 cells in were examined by flow cytometry. In vitro co-culture of Th1/Th17 cells isolated from different mice with HaCat cells was conducted to elucidate the effect of Th1/Th17 cells-mediated by NFKB1 on HaCat cells by MTT, wound healing and transwell invasion assay, respectively. The results showed that NF-κB p105/p50 expression in skin tissues was significantly increased in psoriasis (n = 21) compared to the healthy controls (n = 16), as well as levels of serum INF-γ and IL-17. Additionally, NF-κB p105/p50 expression in lesional skin tissues was much higher than that in non-lesional skin tissues of the same patients. In the psoriasis mouse model, NFKB1 overexpression significantly elevated the scores of erythema, thickness and scales. Besides, NFKB1 up-regulated the level of NF-κB p105/p50, INF-γ, T-bet, IL-17 and RORγt, as well as Th1/Th17 cells in skin tissues of psoriasis mice. Finally, in vitro assay confirmed that the activation of Th1 and Th17 mediated by NFKB1 in psoriasis promoted the proliferation, migration and invasion of keratinocytes. These findings suggest a critical role for NFKB1 in the regulation of Th1 and Th17 in psoriasis.

Retraction: Origin of colossal permittivity in (In1/2Nb1/2)TiO2via broadband dielectric spectroscopy.

Retraction of 'Origin of colossal permittivity in (In1/2Nb1/2)TiO2via broadband dielectric spectroscopy' by Xiao-gang Zhao et al., Phys. Chem. Chem. Phys., 2015, 17, 23132-23139.

Association analysis revealed one susceptibility locus for vitiligo with immune-related diseases in the Chinese Han population.

Generalized vitiligo is an autoimmune disease characterized by melanocyte loss, which results in patchy depigmentation of skin and hair, and is associated with an elevated risk of other immune-related diseases. However, there is no reported study on the associations between immune susceptibility polymorphisms and the risk of vitiligo with immune-related diseases. The aim of this study was to evaluate the potential influence of 10 single-nucleotide polymorphisms (SNPs) at 18q21.31 (rs10503019), 4p16.1 (rs11940117), 3q28 (rs1464510), 14q12 (rs2273844), 12q13.2 (rs2456973), 16q12.2 (rs3213758), 10q25.3 (rs4353229), 3q13.33 (rs59374417), and 10p15.1 (rs706779 and rs7090530) on vitiligo with immune-related diseases in the Chinese Han population. All SNPs were genotyped in 552 patients with vitiligo-associated immune-related diseases and 1656 controls using the Sequenom MassArray system. Data were analyzed with PLINK 1.07 software. The C allele of rs2456973 at 12q13.2 was observed to be significantly associated with vitiligo-associated immune-related diseases (autoimmune diseases and allergic diseases) (P = 0.0028, odds ratio (OR) = 1.27). In subphenotype analysis, the rs2456973 C allele was also significantly associated with early-onset vitiligo by comparing with controls (P = 0.0001) and in the case-only analysis (P = 0.0114). We confirmed that 12q13.2 was an important candidate locus for vitiligo with immune-related diseases (autoimmune diseases and allergic diseases) and affected disease phenotypes with early onset.

Correction: Origin of colossal permittivity in (In1/2Nb1/2)TiO2via broadband dielectric spectroscopy.

Correction for 'Origin of colossal permittivity in (In1/2Nb1/2)TiO2via broadband dielectric spectroscopy' by Xiao-gang Zhao et al., Phys. Chem. Chem. Phys., 2015, 17, 23132-23139.

Origin of colossal permittivity in (In1/2Nb1/2)TiO2via broadband dielectric spectroscopy.

(In1/2Nb1/2)TiO2 (IN-T) ceramics were prepared via a solid-state reaction route. X-ray diffraction (XRD) and Raman spectroscopy were used for the structural and compositional characterization of the synthesized compounds. The results indicated that the sintered ceramics have a single phase of rutile TiO2. Dielectric spectroscopy (frequency range from 20 Hz to 1 MHz and temperature range from 10 K to 270 K) was performed on these ceramics. The IN-T ceramics showed extremely high permittivities of up to ∼10(3), which can be referred to as colossal permittivity, with relatively low dielectric losses of ∼0.05. Most importantly, detailed impedance data analyses of IN-T demonstrated that electron-pinned defect-dipoles, interfacial polarization and polaron hopping polarization contribute to the colossal permittivity at high temperatures (270 K); however, only the complexes (pinned electron) and polaron hopping polarization are active at low temperatures (below 180 K), which is consistent with UDR analysis.

Exome sequencing identifies SLC17A9 pathogenic gene in two Chinese pedigrees with disseminated superficial actinic porokeratosis.

BACKGROUND: Disseminated superficial actinic porokeratosis (DSAP) is a rare autosomal dominant genodermatosis characterised by annular lesions that has an atrophic centre and a prominent peripheral ridge distributed on sun exposed area. It exhibits high heterogeneity, and five linkage loci have been reported. The mevalonate kinase (MVK) gene located on 12q24 has been confirmed as one of the disease-causing genes. But, the pathogenesis of a large part of DSAP remains unclear so far. METHODS: The recruited with DSAP carried no MVK coding mutations. Exome sequencing was performed in two affected and one unaffected individual in Family 1. Cosegregation of the candidate variants was tested in other family members. Sanger sequencing in 33 individuals with familial DSAP and 19 sporadic DSAP individuals was performed for validating the causative gene. RESULTS: An average of 1.35×10(5) variants were generated from exome data and 133 novel NS/SS/indels were identified as being shared by two affected individuals but absent in the unaffected individual. After functional prediction, 25 possible deleterious variants were identified. In Family 1, a missense variant c.932G>A (p.Arg311Gln) in exon 10 of SLC17A9 was observed in cosegregation with the phenotype; this amino acid substitution was located in a highly conserved major facilitator superfamily (MFS) domain in multiple mammalian. One additional missense variant c.25C>T (p.Arg9Cys) in exon 2 of SLC17A9 was found in Family 2. CONCLUSIONS: The result identified SLC17A9 as another pathogenic gene for DSAP, which suggests a correlation between the aberrant vesicular nucleotide transporter and the pathogenesis of DSAP.

Evaluation of mitochondrial divisions in mouse with type-2 diabetes and effect of glucose-oxidase on mouse islet cells RIN-m5F.

To elucidate the relationship between dynamic variations of insular ß cell mitochondria and type-2 diabetes by using a mouse model, the dynamic variation (fusion or fission) of insular ß cell mitochondria present in two groups of Wistar mice with type-2 diabetes (high fat feeding and streptozotocin (STZ) adding with low dose and high frequency, high fat feeding and STZ adding with high dose and low frequency), and normal Wistar mouse were systematically compared. By analysing the insulin secretion level and other related indexes, the molecular mechanism of the fusion or fission phenomenon of insular ß cell mitochondria in two different models (high fat feeding and STZ adding with low dose and high frequency, high fat feeding and STZ adding with high dose and low frequency) of mice with type-2 diabetes were initially elucidated. The phenomenon of mitochondrial fusion and fission was clearly seen. In initially determining the relationship between the change of insular ß cell mitochondrial structure and its cell apoptosis generated by some factors such as treatment by glucose-oxidase (GO), the effect of GO on the mouse islet cells RIN-m5F including the effects on cell growth, reactive oxygen species (ROS), cell cycle, cell apoptosis of RIN-m5F were systematically examined. GO showed some influence on the mouse islet cells RIN-m5F cell activity, ROS and apoptosis, but its effect on the cell cycle was not significant.

Effect of different surgical options on curative effect, nutrition, and health status of patients with slow transit constipation.

OBJECTIVE: This study aims to investigate the influence of total colectomy with ileorectal anastomosis (IRA) and subtotal colectomy with cecorectal anastomosis (CRA) on curative effects, nutritional status, and health of patients with slow transit constipation (STC). METHODS: The purpose of the present study is to compare the hemoglobin, the total protein level, the albumin, and the percentage of lymphocytes before and after operations. The 36-item short-form health survey questionnaire (SF-36), the mininutritional assessment (MNA), the postoperative general condition questionnaire, and the social activities questionnaire were used. The questionnaires were modified. The patients with higher scores were shown to recover better postoperatively. RESULTS: More than 87.5 % of patients in both groups were satisfied with the surgery. Increased stool frequency was improved 6 months after surgery. Antidiarrheal agent use, abdominal pain, and distention in the IRA group were more frequent than in the CRA group (p < 0.05). Postoperative levels of hemoglobin, total protein level, albumin, and percentage of lymphocytes in the IRA group were higher than in the CRA group (p < 0.05). There was no difference in MNA for both groups (p > 0.05). There was no difference in the postoperative general condition questionnaire for both groups (p > 0.05). But the scores for health condition, emotion, and feeling for life were low, only 68.8 to 82.4 % at their highest. CONCLUSIONS: Symptoms can be relieved by IRA and CRA surgeries. The postoperative nutritional conditions are fine. Health conditions and social life are affected. Both IRA and CRA surgeries are compliant for the treatment of STC.