A Cost-Effective and Sensitive Method for the Determination of Lincomycin in Foods of Animal Origin Using High-Performance Liquid Chromatography.

BACKGROUND: Lincomycin (LIN) is extensively used for treating diseases in livestock and promoting growth in food animal farming, and it is frequently found in both the environment and in food products. Currently, most of the methods for detecting lincomycin either lack sensitivity and precision or require the use of costly equipment such as mass spectrometers. RESULT: In this study, we developed a reliable high-performance liquid chromatography-ultraviolet detection (HPLC-UVD) method and used it to detect LIN residue in 11 types of matrices (pig liver and muscle; chicken kidney and liver; cow fat, liver and milk; goat muscle, liver and milk; and eggs) for the first time. The tissue homogenates and liquid samples were extracted via liquid-liquid extraction, and subsequently purified and enriched via sorbent and solid phase extraction (SPE). After nitrogen drying, the products were derivatized with p-toluene sulfonyl isocyanic acid (PTSI) (100 µL) for 30 min at room temperature. Finally, the derivatized products were analyzed by HPLC at 227 nm. Under the optimized conditions, the method displayed impressive performance and demonstrated its reliability and practicability, with a limit of detection (LOD) and quantification (LOQ) of LIN in each matrix of 25-40 µg/kg and 40-60 µg/kg, respectively. The recovery ranged from 71.11% to 98.30%. CONCLUSIONS: The results showed that this method had great selectivity, high sensitivity, satisfactory recovery and cost-effectiveness-fulfilling the criteria in drug residue and actual detection requirements-and proved to have broad applicability in the field of detecting LIN in animal-derived foods.

[Efficacy of Decitabine Combined with Preexcitation Regimen in Treatment of Newly Diagnosed AML Patients Who Did not Respond to Initial Standard Induction Chemotherapy].

OBJECTIVE: To investigate the efficacy of decitabine combined with preexcitation regimen in the treatment of newly diagnosed acute myeloid leukemia (AML) patients who have not been relieved by the first standard induction chemotherapy and its influence on the relative content of regulatory T lymphocytes (Tregs). METHODS: The clinical data of 102 newly diagnosed AML patients (except acute promyelocytic leukemia) who did not relieve after initial standard induction chemotherapy in Shaanxi Provincial People's Hospital from March 2013 to March 2019 were retrospectively analyzed. Fifty-one patients who accepted pre-excitation regimen were divided into regular group, while another 51 patients treated with decitabine combined with pre-excitation regimen were divided into combination group. The efficacy, incidence of toxic and side effects, Core Scale of Quality of Life (QLQ-C30) score before and after treatment, T lymphocyte subsets (CD3+, CD4+, CD4+/CD8+, Tregs) and 3-year overall survival (OS) rate were compared between the two groups. RESULTS: The total effective rate of combination group was 80.39%, which was significantly higher than 62.75% of regular group (P < 0.05). After treatment, the QLQ-C30 score of combination group was 60.27±6.96, which was significantly lower than 65.73±7.96 of regular group (P < 0.001). There was no statistical difference in the incidence of toxic and side effects between the two groups (P >0.05). After treatment, the levels of CD3+, CD4+, CD4+/CD8+ in the combination group were higher than those in the regular group (all P < 0.001), while Treg was lower (P < 0.001). The 3-year OS rate in the combination group was 72.55%, which was significantly higher than 52.94% in the regular group (P < 0.001). CONCLUSION: Decitabine combined with preexcitation regimen has a significant effect on AML patients who have not been alleviated by standard induction chemotherapy in the first course of treatment. It can reduce anti-tumor immune suppression and improve immune function by regulating the relative content of Tregs, thus prolongs survival time and improves life quality of patients without increasing adverse reactions.

Synergism with Shikimic Acid Restores ß-Lactam Antibiotic Activity against Methicillin-Resistant Staphylococcus aureus.

Methicillin-resistant Staphylococcus aureus (MRSA) has evolved into a dangerous pathogen resistant to beta-lactam antibiotics (BLAs) and has become a worrisome superbug. In this study, a strategy in which shikimic acid (SA), which has anti-inflammatory and antibacterial activity, is combined with BLAs to restart BLA activity was proposed for MRSA treatment. The synergistic effects of oxacillin combined with SA against oxacillin resistance in vitro and in vivo were investigated. The excellent synergistic effect of the oxacillin and SA combination was confirmed by performing the checkerboard assay, time-killing assay, live/dead bacterial cell viability assay, and assessing protein leakage. SEM showed that the cells in the control group had a regular, smooth, and intact surface. In contrast, oxacillin and SA or the combination treatment group exhibited different degrees of surface collapse. q-PCR indicated that the combination treatment group significantly inhibited the expression of the mecA gene. In vivo, we showed that the combination treatment increased the survival rate and decreased the bacterial load in mice. These results suggest that the combination of oxacillin with SA is considered an effective treatment option for MRSA, and the combination of SA with oxacillin in the treatment of MRSA is a novel strategy.

CSAP-UNet: Convolution and self-attention paralleling network for medical image segmentation with edge enhancement.

Convolution operation is performed within a local window of the input image. Therefore, convolutional neural network (CNN) is skilled in obtaining local information. Meanwhile, the self-attention (SA) mechanism extracts features by calculating the correlation between tokens from all positions in the image, which has advantage in obtaining global information. Therefore, the two modules can complement each other to improve feature extraction ability. An effective fusion method is a problem worthy of further study. In this paper, we propose a CNN and SA paralleling network CSAP-UNet with U-Net as backbone. The encoder consists of two parallel branches of CNN and Transformer to extract the feature from the input image, which takes into account both the global dependencies and the local information. Because medical images come from certain frequency bands within the spectrum, their color channels are not as uniform as natural images. Meanwhile, medical segmentation pays more attention to lesion regions in the image. Attention fusion module (AFM) integrates channel attention and spatial attention in series to fuse the output features of the two branches. The medical image segmentation task is essentially to locate the boundary of the object in the image. The boundary enhancement module (BEM) is designed in the shallow layer of the proposed network to focus more specifically on pixel-level edge details. Experimental results on three public datasets validate that CSAP-UNet outperforms state-of-the-art networks, particularly on the ISIC 2017 dataset. The cross-dataset evaluation on Kvasir and CVC-ClinicDB shows that CSAP-UNet has strong generalization ability. Ablation experiments also indicate the effectiveness of the designed modules. The code for training and test is available at https://github.com/zhouzhou1201/CSAP-UNet.git.

Endoplasmic reticulum stress contributes to pyroptosis through NF-κB/NLRP3 pathway in diabetic nephropathy.

AIMS: Diabetic nephropathy (DN) is known as a major microvascular complication in type 1 diabetes. Endoplasmic reticulum (ER) stress and pyroptosis play a critical role in the pathological process of DN, but their mechanism in DN has been litter attention. MAIN METHODS: Here, we firstly used large mammal beagles as DN model for 120 d to explored the mechanism of endoplasmic reticulum stress-mediated pyroptosis in DN. Meanwhile, 4-Phenylbutytic acid (4-PBA) and BYA 11-7082 were added in the MDCK (Madin-Daby canine kidney) cells by high glucose (HG) treatment. ER stress and pyroptosis related factors expression levels were analyzed by immunohistochemistry, immunofluorescence, western blotting, and quantitative real-time PCR assay. KEY FINDINGS: We identified that glomeruli atrophy, renal capsules were increased, and renal tubules thickened in diabetes. Masson and PAS staining resulted showed that the collagen fibers and glycogen were accumulated in kidney. Meanwhile, the ER stress and pyroptosis-related factors were significantly activated in vitro. Importantly, 4-PBA significantly inhibited the ER stress, which also alleviated the HG-induced pyroptosis in MDCK cells. Furthermore, BYA 11-7082 could reduce the expression levels of NLRP3 and GSDMD genes and proteins. SIGNIFICANCE: These data provide evidence for ER stress contributes to pyroptosis through NF-κΒ/ΝLRP3 pathway in canine type 1 diabetic nephropathy.

circSTRN3 aggravates sepsis-induced acute kidney injury by regulating miR-578/ toll like receptor 4 axis.

Sepsis is a systemic inflammatory response caused by infection, and severe sepsis is commonly associated with the development of acute kidney injury (AKI). Accumulating evidence has revealed the implication of circular RNAs in AKI. In this study, we explored the potential engagement and the underlying mechanism of hsa_circ_010157 (circSTRN3) in sepsis-induced AKI. CircSTRN3 levels in HK2 cells and serum samples of patients were determined by RT-PCR. The protein levels of TLR4 (Toll Like Receptor 4), bax (Bcl-2-associated X protein), cleaved caspase 3 and bcl-2 (B-cell lymphoma-2) were detected by Western blotting (WB), and the levels of proinflammatory cytokines were detected by ELISA. The molecular interactions between mir-578/TLR4 and circSTRN3/miR-578 were analyzed by dual luciferase reporter assay as well as RNA pull-down experiment. Lipopolysaccharide (LPS) treated HK2 cells were used as an in vitro model to investigate the functional interaction of circSTRN3/miR-578/TLR4 axis. We found that the expression level of circSTRN3 in patients with sepsis-induced AKI and LPS-induced HK2 cells was higher. Silencing cicrSTRN3 alleviated LPS-induced cell proliferation, and suppressed the inflammatory response and apoptosis in LPS-treated HK2 cells. In contrast, the overexpression of circSTRN3 aggravated the cellular damages induced by LPS treatment. CircSTRN3 targeted miR-578/TLR4 axis to influence the damage effect induced by LPS. miR-578 inhibitor or TLR4 overexpression impaired the rescue effect of circSTRN3 knockdown. These results indicate that circSTRN3 upregulation in sepsis-induced AKI modulates miR-578/TLR4 axis to promote the pathogenesis of AKI, which could serve as future therapeutic targets for AKI treatment.

Low-concentration iron promotes Klebsiella pneumoniae biofilm formation by suppressing succinic acid.

BACKGROUND: Klebsiella pneumoniae is widely distributed in water and plays a major role in both human and poultry infections. Many K. pneumoniae strains form biofilms on various surfaces, enhancing their pathogenicity and resistance to antibiotics. The water supply pipeline of chicken farms has become a hotbed for the growth of K pneumoniae biofilm because of its humid environment, and because the chicken drinking water pipeline is thin, it is easily blocked by the biofilm, and the diffused cells can cause repeated and persistent infections. Iron is vital to the growth of microorganisms and the formation of biofilms. Therefore, the aim of this study was to examine the effects of iron on K. pneumoniae biofilm formation and any associated metabolic changes to provide a rationale for reducing the formation of biofilms. RESULTS: Biofilm formation was enhanced to the greatest extent by the presence of 0.16 mM FeCl2, producing a denser structure under electron microscopy. The number of biofilm-forming and planktonic bacteria did not change, but protein and polysaccharide concentrations in the bacterial extracellular polymeric substances (EPS) were significantly increased by iron supplementation. To clarify this mechanism, intracellular metabolomic analysis was carried out, showing that the differential, down-regulated metabolites included succinic acid. The addition of 1.7 mM succinic acid counteracted the biofilm-forming effect of iron, with no bactericidal side effects. CONCLUSION: This study demonstrates the importance of succinic acid and iron in K. pneumoniae biofilms, and provides insight into the formation of K. pneumoniae biofilms and direction for the development of new antibacterial agents.

Withaferin A inhibits cell proliferation of U266B1 and IM-9 human myeloma cells by inducing intrinsic apoptosis.

Withaferin A, a withanolide obtained from Withania somnifera exhibits remarkable pharmacological properties. Withaferin A has been reported to exert cytotoxic effects against human multiple myeloma cells. Nevertheless, the in-depth understanding of the withaferin A induced antiproliferative effects against human myeloma cells is still unclear. The results showed that withaferin A inhibited the viability of six different myeloma cells with a lowest IC50 of 9 µM against the U266B1 and IM-9 cell lines. Withaferin A inhibited the viability and colony formation of the U266B1 and IM-9 cells in a dose and time-dependent manner. The DAPI and annexin V/PI staining assays revealed that withaferin A exerts anticancer effects against the human myeloma cells via induction of apoptosis. The induction of apoptosis in U266B1 and IM-9 cells was associated with upregulation of Bax and cytochrome c, downregulation of Bcl-2 and activation of PARP, caspase-3 and capase-9 cleavage. Additionally, withaferin A triggered the production of ROS in human myeloma cells indicative of ROS mediated apoptosis in human myeloma cells. The treatment of the U266B1 and IM-9 with ascorbic acid (antioxidant) could prevent the withaferin A mediated ROS production and the withaferin A induced antiproliferative effects. Collectively, the results show that withaferin A inhibits human myeloma cell proliferation via ROS mediated intrinsic apoptosis.

DACT3 has a tumor-inhibiting role in acute myeloid leukemia via the suppression of Wnt/ß-catenin signaling by DVL2.

Dapper antagonist of catenin-3 (DACT3) is a new tumor-related protein associated with a diverse set of tumors. However, whether DACT3 plays a role in acute myeloid leukemia (AML) is not fully understood. Our findings showed low DACT3 level in AML tissue, which was corrected with shorter survival rates. Upregulation of DACT3 effectively repressed cellular proliferation, and promoted cell cycle arrest and apoptosis of AML cells. Upregulation of DACT3 decreased levels of Dishevelled2 (DVL2), phospho-glycogen synthase kinase-3ß (GSK-3ß), and active ß-catenin, which collectively suppressed Wnt/ß-catenin-mediated transcriptional activity. Overexpression of DVL2 reversed DACT3-mediated suppression of Wnt/ß-catenin pathway. Reactivation of Wnt/ß-catenin abrogated DACT3-upregulation-evoked tumor-suppression in AML cells. Overexpression of DACT3 impeded the formation and growth of AML-derived xenograft tumor. Collectively, our work reveals a tumor-suppressive role of DACT3, a protein that negatively adjusts Wnt/ß-catenin pathway via downregulation of DVL2 in AML.

Investigating Young Employee Stressors in Contemporary Society Based on User-Generated Contents.

Understanding stressors is an effective measure to decrease employee stress and improve employee mental health. The extant literature mainly focuses on a singular stressor among various aspects of their work or life. In addition, the extant literature generally uses questionnaires or interviews to obtain data. Data obtained in such ways are often subjective and lack authenticity. We propose a novel machine-human hybrid approach to conduct qualitative content analysis of user-generated online content to explore the stressors of young employees in contemporary society. The user-generated online contents were collected from a famous Q&A platform in China and we adopted natural language processing and deep learning technology to discover knowledge. Our results identified three kinds of new stressors, that is, affection from leaders, affection from the social circle, and the gap between dream and reality. These new identified stressors were due to the lack of social security and regulation, frequent occurrences of social media fearmongering, and subjective cognitive bias, respectively. In light of our findings, we offer valuable practical insights and policy recommendations to relieve stress and improve mental health of young employees. The primary contributions of our work are two-fold, as follows. First, we propose a novel approach to explore the stressors of young employees in contemporary society, which is applicable not only in China, but also in other countries and regions. Second, we expand the scope of job demands-resources (JD-R) theory, which is an important framework for the classification of employee stressors.

MicroRNA-365 induces apoptosis and inhibits invasion of human myeloma cells by targeting homeobox A9 (HOXA9).

The aberrant micro-RNA (miR) expression has been reported to play a vital role in proliferation and tumorigenesis and of several human cancers. MicroRNA-365 (miR-365) has been shown to exhibit tumor-suppressive or oncogenic role in several human cancers. Nonetheless, little is known about its growth regulatory role in human multiple myeloma. The present study characterized the regulatory control exercised by miR-365 in multiple myeloma. The results showed significant (P < 0.05) upregulation of miR-365 in myeloma tissues and cell lines. Overexpression of miR-365 significantly (P < 0.05) suppressed the proliferation and inhibition of miR-365 promoted the proliferation of the human myeloma cells. The tumor-suppressive effects of miR-365 were found to be the result of apoptosis in the IM-9 myeloma cells. The miR-365 overexpression also suppressed the invasion of the IM-9 myeloma cells. The homeobox gene, HOXA9 was identified as the molecular regulatory target of miR-365 in human myeloma. The overexpression of miR-365 was shown to cause suppression of HOXA9. The silencing of HOXA9 could also suppress the growth of the IM-9 myeloma cells while as the overexpression of HOXA9 could abolish the tumor-suppressive effects of miR-365. The in vivo study revealed that miR-365 inhibits the growth of the xenografted tumors. Nonetheless, the inhibition of miR-365 promotes the growth of the xenografted tumors. To sum up, the current study suggests the tumor-suppressive effects of miR-365 in human myeloma and highlights the applicability of miR-365 as vital therapeutic target against this fatal malignancy.

A special acute care surgery model for dealing with dilemmas involved in emergency department in China.

There was a fast growth in the number and the formation of emergency department (ED) visits in China during the twenty-first century. As a result, engaging special medical model will be essential to decompressing the ED visits. To do this, it will be important to understand which specific aspects to focus interventions on for the greatest impact. To characterize the emergency surgery patients who were seen and discharged from ED. Retrospective cohort study of hospitalized emergency surgery patients currently under the care from specialists presenting to an urban, university affiliated hospital between 01 January 2018 and 1 January 2019. This study will highlight some of the controversies and challenges and key lessons learned. During the study period there were 231,229 ED visits; 4100 of these patients were admitted for Acute care surgery (ACS) service. Multivariate analysis identified age ≧ 65 (p = 0.023; odds ratio, OR = 2.66), ACS model (p = 0.000, OR = 0.18), ICU stay (p = 0.000, OR = 118.73) as factors associated with in-hospital mortality. There was a increase in length of stay between young and elderly postoperative patients when stratifying patients by age (11.67 ± 9.48 vs 13.95 ± 9.11 p < 0.05). ED overcrowding is not just an ED problem. ED overcrowding is a systems problem requiring a systematic facility-wide multidisciplinary response. Continuous and high-quality surveillance data across China are needed to estimate the acute care surgery model which used to deal with ED overcrowding.

Study on the mechanism of synthetic (Ce,La)CO3F sulfuric acid acidification and NH3-SCR loaded with Mn and Fe.

A hydrothermal method was used to synthesise (Ce,La)CO3F grain simulated minerals, in accordance with the Ce-La ratio of bastnaesite in the mineralogy of the Bayan Ebo process. The NH3-SCR catalytic activity of the synthesised (Ce,La)CO3F was improved by loading transition metals Mn and Fe and sulphuric acid acidification treatments. The activity test results showed that the catalysts which were simultaneously acidified with sulphuric acid and loaded with transition metals Mn and Fe had a NO x conversion of 92% at 250 °C. XRD, SEM, XPS and in situ Fourier transform infrared spectroscopy (FTIR) were used to investigate the physical phase structure, surface morphology, reaction performance and mechanism of the catalysts, to provide theoretical guidance for the specific reaction path of cerium fluorocarbon ore in the NH3-SCR reaction. The results showed that the introduction of transition metals and sulphuric acid greatly increases the proportion of adsorbed oxygen (Oα) and facilitates the adsorption of NH3 and NO. The catalyst surface metal sulphate and metal oxide species act as the main active components on the catalyst surface to promoted the reaction, and cracks and pores appear on the surface to facilitate the adsorption of reactive gases. The reaction mechanism of the SO4 2--Mn-Fe/(Ce,La)CO3F catalyst, and characterisation of the adsorption and conversion behaviour of the reactive species on the catalyst surface, were investigated by Fourier transform infrared spectroscopy (FTIR). The results showed that the catalyst follows the E-R and L-H mechanisms throughout the reaction, with the E-R mechanism being the main reaction. The reaction species were NH4 +/NH3 species in the adsorbed state and NO. The NH3(ad) species on the Lewis acidic site is the main NH3(g) adsorbed species for the reaction, bonded to Ce4+ in the carrier (Ce,La)CO3F to participate in the acid cycle reaction, and undergo a redox reaction on the catalyst surface to produce N2 and H2O. The SO4 2- present on the catalyst surface can also act as an acidic site for the adsorption of NH3. The above results indicated the excellent performance of the SO4 2--Mn-Fe/(Ce,La)CO3F catalyst, which provided a theoretical basis for the high value utilization of bastnaesite.

Glycyrrhizin, an HMGB1 inhibitor, Suppresses Interleukin-1ß-Induced Inflammatory Responses in Chondrocytes from Patients with Osteoarthritis.

BACKGROUND: High mobility group box 1 (HMGB1) is increased in osteoarthritis (OA) tissue and chondrocytes stimulated with interleukin-1ß (IL-1ß). Suppression of HMGB1 expression is correlated with reduced inflammatory responses induced by IL-1ß. This study aimed to investigate how inhibition of HMGB1 by glycyrrhizin might affect inflammatory responses and viability of OA patient-derived chondrocytes treated with IL-1ß. DESIGN: The amounts of HMGB1 in the cartilage tissue and synovial fluid in patients with OA were assessed by Western blot and enzyme-linked immunosorbent assay (ELISA). Chondrocytes were extracted from OA patients and maintained in culture. The impact of glycyrrhizin on IL-1ß-induced cell toxicity and inflammatory mediators and cytokines, including prostaglandin E2 (PGE2), nitric oxide (NO), proinflammatory cytokines, and metalloproteases (MMPs), were assessed by ELISA, Western blot, quantitative real-time polymerase chain reaction, and the Griess reagent assay. RESULTS: We confirmed that HMGB1 was significantly upregulated in specimens acquired from patients with OA. HMGB1 inhibition by glycyrrhizin improved cell viability of chondrocytes treated with IL-1ß. Glycyrrhizin suppressed IL-1ß-induced upregulation of HMGB1 and inflammatory mediators and cytokines, including PGE2, NO, proinflammatory cytokines, and MMPs. CONCLUSION: Our results indicate that glycyrrhizin may be a potential therapy for OA patients and these promising findings warrant further study for clinical application.

Scutellarin circumvents chemoresistance, promotes apoptosis, and represses tumor growth by HDAC/miR-34a-mediated down-modulation of Akt/mTOR and NF-κB-orchestrated signaling pathways in multiple myeloma.

Multiple myeloma (MM) is a neoplastic dyscrasia of monoclonal immunoglobulin-secreting plasma cells culminating in multi-organ dysfunction. In this study, we sought to investigate whether scutellarin (STN), a flavonoid, could reduce MM progression, mitigate chemoresistance of MM cells to bortezomib (BTB), and cause MM cell apoptosis in a xenograft mouse model of MM. Epigenetic signalling plays a main role in the modulation of various pathways involved in multiple myeloma progression. At the outset, mechanistic analyses of the MM pathways indicated that key epigenetic molecules including HDAC1/3 and miR-34a were up-modulated and down-modulated respectively, in the MM mice. Besides, the downstream signalling analysis of miR-34a depicted that the c-Met/AKT/mTOR pathway was activated in the MM mice. We also investigated the expression of NF-κB, one of the major chemoresistance inducers in cancer treatment, in the MM mice. As anticipated, the tumor-bearing mice expressed more NF-κB along with elevated anti-apoptotic Bcl-xL protein, as well as reduced pro-apoptotic Bim protein. On the other hand, STN+BTB co-treatment effectively combated the MM tumor progression, and STN circumvented the MM tumor resistance to BTB and provoked apoptotic cell death in MM. Based on our study data, we deduce that STN, in combination with BTB, appears to be a reliable tumoricidal strategy.

SOX12 promotes the growth of multiple myeloma cells by enhancing Wnt/ß-catenin signaling.

SRY-related high-mobility-group box 12 (SOX12) has currently emerged as a key cancer-related protein in multiple human cancer types. However, little is known about the relevance of SOX12 in multiple myeloma (MM). The current study aimed to investigate the potential role of SOX12 in MM. Our results demonstrated that SOX12 expression was markedly elevated in MM cell lines. A series of cellular assays demonstrated that SOX12 knockdown significantly reduced the proliferation and colony formation, and upregulated cell apoptosis of MM cells. By contrast, SOX12 overexpression promoted the proliferation, colony formation and decreased the apoptosis of MM cells, results that reveal its oncogenic effects. SOX12 regulated ß-catenin expression and TCF/LEF transcriptional activity. Moreover, the SOX12-knockdown-mediated antitumor effect in MM cells was significantly reversed by transfecting a ß-catenin expression vector. Notably, SOX12 inhibition retarded tumor growth in vivo of a MM-derived mouse xenograft model. In conclusion, our results suggest a potential oncogenic function for SOX12 in MM. Our findings reveal that SOX12 knockdown inhibits the growth of MM cells by downregulating the Wnt/ß-catenin signaling pathway, results that imply SOX12 may represent a novel therapeutic target for MM treatment.

Estimating a Sleep Apnea Hypopnea Index Based on the ERB Correlation Dimension of Snore Sounds.

This paper proposes a new perspective of analyzing non-linear acoustic characteristics of the snore sounds. According to the ERB (Equivalent Rectangular Bandwidth) scale used in psychoacoustics, the ERB correlation dimension (ECD) of the snore sound was computed to feature different severity levels of sleep apnea hypopnea syndrome (SAHS). For the training group of 93 subjects, snore episodes were manually segmented and the ECD parameters of the snores were extracted, which established the gaussian mixture models (GMM). The nocturnal snore sound of the testing group of another 120 subjects was tested to detect SAHS snores, thus estimating the apnea hypopnea index (AHI), which is called AHIECD. Compared to the AHIPSG value of the gold standard polysomnography (PSG) diagnosis, the estimated AHIECD achieved an accuracy of 87.5% in diagnosis the SAHS severity levels. The results suggest that the ECD vectors can be effective parameters for screening SAHS.

Clinicopathologic characteristics of mixed epithelial/mesenchymal metaplastic breast carcinoma (carcinosarcoma): a meta-analysis of Chinese patients.

Breast carcinosarcoma is a rare and aggressive subtype of metaplastic breast cancer. Data focusing on breast carcinosarcoma is limited. The purposes of this study are to describe the clinicopathological features of breast carcinosarcoma and to evaluate post-surgical outcomes. MATERIAL AND METHODS: All case reports about breast carcinosarcoma in China were collected from eligible papers published in Chinese core periodicals between 1990 and 2015 with key words of breast carcinosarcoma, breast cancer, carcinosarcoma, or metaplastic carcinoma. The survival rates, clinical behaviour, and pathological characteristics were analysed. RESULTS: The mean age of the cohort of 215 patients was 53 years (range, 25-82 years). The tumour size ranged from 2.5 cm to 18 cm. The incidence of pathologically confirmed lymph node metastases was 30.81%. The epithelial component in a tumour may be composed of invasive ductal carcinoma (84.21%), squamous cell carcinoma (7.89%), lipid-rich carcinoma (6.58%), or adenocarcinoma (1.31%). Mesenchymal components may contain different elements ranging from fibrosarcoma (63.16%) to chondrosarcoma (19.73%), osteosarcoma (9.21%), liposarcoma (3.95%), or leiomyosarcoma (3.95%). The five-year survival of the breast carcinosarcoma in 149 patients is 62.6% (CI: 54.9%~0.703%). CONCLUSIONS: Breast carcinosarcoma is a rare subtype of metaplastic breast cancer. It is characterised by large tumour size, higher rates of axillary nodal involvement, higher rates of both local and distant recurrence, and is difficult to diagnose with preoperative core needle biopsies. Adjuvant treatment after surgical operation may improve the five-year OS of patients with breast carcinosarcoma.

Challenges faced by acute care surgeons in China.

The aim of this article is to describe briefly about Chinese ACS surgeons' work status. It is an undeniable fact that the analysis of ED and ACS resources shows negative tendencies and high work overload, resulting in low patient safety and quality of care. And, there was a substantial shortage of surgeons in the subspecialty. So, a set of strategic measures and state policies should be prioritized.