A prediction model of elderly hip fracture mortality including preoperative red cell distribution width constructed based on the random survival forest (RSF) and Cox risk ratio regression.

An independent correlation between pre-RDW and 1-year mortality after surgery in elderly hip fracture can be used to predict mortality in elderly hip fracture patients and has predictive significance in anemia patients. With further research, a treatment algorithm can be developed to potentially identify patients at high risk of preoperative mortality. INTRODUCTION: Red blood cell distribution width (RDW) is an independent predictor of various disease states in elderly individuals, but its association with the prognosis of elderly hip fracture patients is controversial. This study aimed to evaluate the prognostic value of RDW in such patients, construct a prediction model containing RDW using random survival forest (RSF) and Cox regression analysis, and compare RDW in patients with and without anemia. METHODS: We retrospectively analyzed the data of elderly patients who underwent hip fracture surgery, selected the best variables using RSF, stratified the independent variables by Cox regression analysis, constructed a 1-year mortality prediction model of elderly hip fracture with RDW, and conducted internal validation and external validation. RESULTS: Two thousand one hundred six patients were included in this study. The RSF algorithm selects 12 important influencing factors, and Cox regression analysis showed that eight variables including preoperative RDW (pre-RDW) were independent risk factors for death within 1-year after hip fracture surgery in elderly patients. Stratified analysis showed that pre-RDW was still independently associated with 1-year mortality in the non-anemia group and not in the anemia group. The nomogram prediction model had high differentiation and fit, and the prediction model constructed by the total cohort of patients was also used for validation of patients in the anemia patients and obtained good clinical benefits. CONCLUSION: An independent correlation between pre-RDW and 1-year mortality after surgery in elderly hip fracture can be used to predict mortality in elderly hip fracture patients and has predictive significance in anemia patients.

Abnormal expression of FLOT1 correlates with tumor progression and poor survival in patients with non-small cell lung cancer.

Recent studies have revealed that flotillin-1 (FLOT1) plays important roles in cancer progression. However, the role of FLOT1 in development and progression of non-small cell lung cancer (NSCLC) remains largely unknown. The objective of the current study was to investigate the expression pattern and clinicopathological significance of FLOT1 in patients with NSCLC. Real-time quantitative polymerase chain reaction was applied to examine FLOT1 mRNA expression in 52 pairs of NSCLC tissues and adjacent noncancerous tissues. Immunohistochemistry was performed to examine FLOT1 protein expression in paraffin-embedded tissues from 106 NSCLC patients. Statistical analyses were applied to evaluate the diagnostic value and associations of FLOT1 expression with clinicopathological characteristics. FLOT1 mRNA expression was evidently upregulated in NSCLC tissues compared with that in the adjacent noncancerous tissues. In the 106 cases of tested NSCLC samples, FLOT1 protein level was positively correlated with tumor size, tumor stage, and lymph node metastasis. Patients with higher FLOT1 expression had shorter overall survival time, whereas those with lower FLOT1 expression had longer survival time. Taken together, our findings indicate that FLOT1 may play an important role in NSCLC tumorigenesis. Further elucidation of the molecular mechanisms underlying the role of FLOT1 is warranted.

The transcription factor masculinizer in sexual differentiation and achieved full functional sex reversal in prawn.

Some Zinc finger (ZnF) proteins are required for masculinization in silkworms. In the present study, a masculinizer gene (Mr-Masc) with multi-tissue expression is identified in the freshwater prawn Macrobrachium rosenbergii. The Mr-Masc is clustered into a separate branch with ZnF proteins from decapoda by phylogenetic tree analysis. Moreover, Mr-Masc silencing in male postlarvae prawn results in functional sex reversal females known as neo-females, which are applied to all-male monosex offspring breeding. This manipulation has been significant in sexually dimorphic cultured species. In addition, several significantly expressed transcripts are enriched and the effects of crucial signal pathways are focused through the comparative transcriptomic analysis in Mr-Masc gene knockdown. The significantly differentially expressed epidermal growth factor, upregulated low-density lipoprotein receptor, flotillin, and sex-lethal unigenes, downregulated heat shock proteins and forkhead box homologs are focused. The finding offers an innovative perspective on Masc proteins' evolution and physiological function.

[Clinical study on improving decreased gastrointestinal motility of post-operative esophageal cancer patients by unblocking the interior and purgation method].

OBJECTIVE: To observe the clinical effect of unblocking the interior and purgation method on improving decreased gastrointestinal motility of post-operative esophageal cancer patients, and to study its mechanisms. METHODS: 60 patients with post-operative esophageal cancer were randomly assigned to two groups, the treatment group and the control group, 30 in each group. Routine therapies were given to the two groups. Chinese drugs with unblocking the interior and purgation action was infused by enteral nutrition tube to patients in the treatment group, while normal saline was infused to those in the control group. The first flatus time, the first defecation time, the bowel tones recovery time after operation, and the total amount of the gastric juice draining between the first day and the third day after operation of all patients were recorded. Plasma motilin (MTL) and vasoactive intestinal peptide (VIP) contents were detected before operation and the fourth day after operation. RESULTS: The first flatus time, the first defecation time, the bowel tones recovery time after operation, and the total amount of the gastric juice draining were less in the treatment group than in the control group, showing statistical difference (P<0.05, P<0.01). The post-operative MTL contents were higher and VIP contents lower in the treatment group than in the control group, showing statistical difference (P<0.05, P<0.01). There was no significant difference in plasmal MTL and VIP contents of the treatment group between before and after treatment (P>0.05). But there was significant difference in plasmal MTL and VIP contents of the control group between before and after treatment (P<0.01). CONCLUSION: Unblocking the interior and purgation method could significantly promote the gastrointestinal motility recovery of post-operative esophageal cancer patients, showing good clinical effect.

Full Functional Sex Reversal Achieved Through Silencing of MroDmrt11E Gene in Macrobrachium rosenbergii: Production of All-Male Monosex Freshwater Prawn.

The freshwater prawn Macrobrachium rosenbergii is one kind of important economic aquaculture species and displays remarkable sexual dimorphism. The molecular mechanism of sexual differentiation in M. rosenbergii has been primarily unraveled through the research efforts of the androgenic gland and its related genes. However, the understanding of conserved genes involved in the molecular mechanism underpinning sex determination and sexual differentiation of M. rosenbergii is still fragmentary. MroDmrt11E is a member of the doublesex and mab-3-related transcription factor (Dmrt) gene family and is prominently expressed in the testis. In the present study, in vivo knockdown of MroDmrt11E at the postlarva stage in male prawn induced a complete and functional sex reversal and achieved the production of an all-male monosex population. Furthermore, a great deal of new information of upregulated and downregulated transcriptions involved in sexual differentiation of MroDmrt11E knockdown was enriched by comparative transcriptomic analysis. The effects of RNAi-mediated gene knockdown of MroDmrt11E on the differentially expressed and sex-related candidate genes, such as transformer, fruitless, feminization, insulin-like androgenic gland gene, Dmrt gene family, were primarily focused on, and their possible molecular regulatory relationships in sexual differentiation were analyzed. Meanwhile, the response of primary Kyoto Encyclopedia of Genes and Genomes (KEGG) biological pathways was investigated to expound the potential roles of MroDmrt11E in male sexual differentiation, which provided a deeper understanding of the molecular regulatory network underlying sexual differentiation of M. rosenbergii. The finding provided a novel sexual manipulation technique through silencing of Dmrt gene family for achieving a complete and functional sex reversal and offered a new insight regarding the mechanism of the Dmrt gene family in the sexual differentiation of crustaceans.

[Efficiency and Kinetics of Triclosan Degradation in Aqueous Solution by UV/Sodium Persulfate].

UV activated sodium persulfate was employed to remove triclosan (TCS) in aqueous solution. The effects of several factors such as UV wavelength,UV254 intensity,sodium persulfate dosage,pH value,and HA on TCS degradation were investigated. The second-order rate constants of free radicals (·OH, SO4·-) reacting with TCS and their contributions to TCS removal were determined,respectively. The dominant free radical was also identified. Furthermore, the TCS degradation efficiency in natural water by UV254/SPS and UV254/H2O2 was compared. Finally,the possible pathway and intermediate products of TCS degradation were analyzed with GC/MS. The results indicated that UV254 activated sodium persulfate could effectively remove TCS. The removal rate of TCS could reach 98.15% within 100s under the conditions of UV wavelength of 254 nm,UV intensity of 11.5µW·cm-2,sodium persulfate dosage of 1mmol·L-1,and TCS initial concentration of 275 µg·L-1. TCS degradation followed the pseudo-first-order kinetic model and the pseudo-first-order rate constant was determined to be 0.0392 s-1. Pseudo-first-order rate constant for TCS degradation increased with the increase of UV254 intensity(I)and sodium persulfate dosage within experiment ranges. The effect of UV wavelength on TCS removal was not notable. Neutral condition was detrimental to TCS degradation. TCS removal was inhibited in the presence of HA. The reaction rate constants for·OH and SO4·- reacting with TCS were 7.62×109 L·mol-1·s-1 and 9.86×109 L·mol-1·s-1,respectively. SO4·- was the dominant free radical and its contribution rate to TCS removal was 97.63% in UV254/SPS system. The K value of UV254/SPS was 4.13 times higher than that of UV254/H2O2 process,which demonstrated that UV254/SPS process could remove TCS more effectively than UV254/H2O2. The main intermediate products found were 2,4-DCP and phenol in the degradation process of TCS in Milli-Q water by UV254/SPS.

[Bronchial and pulmonary arterial sleeve resection and reconstruction in the treatment of central NSCLC].

OBJECTIVE: To evaluate the indications and surgical procedure of bronchial and pulmonary artery sleeve resection for patients with centrally located non-small cell lung cancer, and how to prevent complications. METHODS: From July 1989 to Aug 2000, 32 cases of central NSCLC were treated with bronchial and pulmonary arterial sleeve resection and reconstruction. The results were retrospectively analyzed. RESULTS: The complication rate was 25.0% (8/32), the mortality rate in 30-day postoperation was 6.3% (2/32), the overall 1-, 3- and 5-year survival rate was 82.8% (24/29), 50.0% (11/22) and 33.3% (4/12), respectively. CONCLUSION: Bronchial and pulmonary arterial sleeve resection and reconstruction in the treatment of patients with central NSCLC can not only maximize preservation of functional pulmonary parenchyma and improve patients, quality of life, but also provide an opportunity for those patients with poor pulmonary function to receive surgical resection of the tumor.

[Comparison of the characteristics in recurrence and metastasis between bronchioloalveolar carcinoma and other lung adenocarcinomas].

BACKGROUND & OBJECTIVE: The histological definition of bronchioloalveolar carcinoma (BAC) has been changed recently by the revised World Health Organization (WHO) classification. Although bronchioloalveolar carcinoma is a subtype of lung adenocarcinoma, its biological features are better than those of other lung adenocarcinomas. This study was to analyze differences in metastatic activity between bronchioloalveolar carcinoma and other lung adenocarcinomas. METHODS: The expression of E-Cadherin, Collagen IV, vascular endothelial growth factor receptor-2 (VEGFR-2), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in 28 specimens of stage I bronchioloalveolar carcinoma confirmed pathologically and 40 specimens of other stage I lung adenocarcinomas were detected by immunohistochemistry. Their correlations to tumor recurrence and metastasis were analyzed. RESULTS: The 5-year survival rate was significantly higher in ths patients with bronchioloalveolar carcinoma than in the patients with other lung adenocarcinomas (88.7% vs. 57.3%, P < 0.05). The intrathoracic recurrence rate was significantly higher and the extrathoracic metastasis rate was significantly lower in the patients with bronchioloalveolar carcinoma than in the patients with other lung adenocarcinomas (75% vs. 33.3%, 25% vs. 66.7%, P < 0.05). The positive rates of Collagen IV, E-Cadherin and TIMP-1 were significantly higher in bronchioloalveolar carcinoma than in other lung adenocarcinomas (78.6% vs. 42.5%, 78.6% vs. 40.0%, 67.5% vs. 42.9%, all P < 0.01). The positive rate of VEGFR-2 was significantly higher in other lung adenocarcinomas than in bronchioloalveolar carcinoma (85.7% vs. 77.5%, P < 0.05). There was no significant difference in the positive rate of MMP-9 between bronchioloalveolar carcinoma and other lung adenocarcinomas (85.0% vs. 78.6%, P = 0.494). CONCLUSION: As compared with other lung adenocarcinomas, stage I bronchioloalveolar carcinoma is less aggressive in clinical behavior and likely to develop intrathoracic recurrence, with less extrathoracic metastases and better prognosis.