CT-based decision tree model for predicting EGFR mutation status in synchronous multiple primary lung cancers.

Background: The current study aimed to construct a computed tomography (CT)-based decision tree algorithm (DTA) model to predict the epidermal growth factor receptor (EGFR) mutation status in synchronous multiple primary lung cancers (SMPLCs). Methods: The demographic and CT findings of 85 patients with molecular profiling for surgically resected SMPLCs were reviewed retrospectively. Least absolute shrinkage and selection operator (LASSO) regression was used to select the potential predictors of EGFR mutation, and a CT-DTA model was developed. Multivariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed to assess the performance of this CT-DTA model. Results: The CT-DTA model was applied to predict the EGFR mutant that had ten binary split, of which eight parameters to accurately categorize the lesions as follows: the presence of bubble-like vacuole sign (19.4% importance in the development of the model), presence of air bronchogram sign (17.4% importance), smoking status (15.7% importance), types of the lesions (14.8% importance), histology (12.6% importance), presence of pleural indentation sign (7.6% importance), gender (6.9% importance), and presence of lobulation sign (5.6% importance). The ROC analysis achieved an area under the curve (AUC) of 0.854. Multivariate logistic regression analysis demonstrated that this CT-DTA model was an independent predictor of EGFR mutation (P<0.001). Conclusions: CT-DTA model is a simple tool to predict the status of EGFR mutation in SMPLC patients and could be considered for treatment decision-making.

On-demand plerixafor added to high-dose cyclophosphamide and pegylated recombinant human granulocyte colony-stimulating factor in the mobilization of patients with multiple myeloma: a treatment with high effectiveness, convenient, and affordable cost.

Objective: The combination of high-dose cyclophosphamide (HD-Cy) (3g/m2) plus granulocyte colony-stimulating factor (G-CSF) and on-demand plerixafor (PXF) has been considered an effective mobilization regimen of patients with multiple myeloma(MM). However, the daily multi-injection regimen of G-CSF poses challenges. This study delves into the efficiency and cost implications of a novel approach, using HD-Cy alongside pegylated G-CSF (PEG G-CSF) and on-demand PXF. Unlike G-CSF, which necessitates daily injections, the half-life of PEG G-CSF extended allows for a single injection. Methods: A retrospective analysis was conducted on 350 MM patients, which were categorized based on their mobilization regimens: Cy+PEG G-CSF+/-PXF (n=66), Cy+PEG G-CSF (n=91), Cy+ G-CSF (n=169), and G-CSF+PXF (n=24). Results: Mobilization with Cy+PEG G-CSF+/-PXF(8.79)yielded a notably higher median CD34+ cell count compared to the other regimens: Cy+PEG G-CSF(4.96), Cy+G-CSF (4.65), and G-CSF+PXF (2.99) (P<0.001). The percentage of patients who achieved >6×106/kg CD34+ cells was significantly higher in the Cy+PEG G-CSF+/-PXF group (77.3%) than in the other mobilization regimens: Cy+PEG G-CSF (41.8%), Cy+ G-CSF (37.3%), and G-CSF+PXF (8.3%) (P<0.001). From a cost perspective, the Cy+PEG G-CSF+/-PXF approach was more economical than the G-CSF+PXF strategy but was marginally costlier than the other two methods. A multivariate assessment highlighted that the combination of Cy+PEG G-CSF with on-demand PXF had a superior potential to achieve the desired harvest (6×106/kg) compared to the Cy+PEG G-CSF protocol without PXF. The incremental cost-effectiveness ratio for each 1% increase in the probability of achieving a successful optimal harvest was $ 97.02 per patient. The incidence of neutropenic fever was 3.0% in the Cy+PEG G-CSF+/-PXF group. Conclusion: The combination of on-demand PXF with HD-Cy and PEG G-CSF offers a cost-effective approach with a high mobilization success rate, manageable side effects, and the convenience of fewer injections. It stands as a promising mobilization strategy for MM patients.

Impact of social class on health: The mediating role of health self-management.

BACKGROUND: Studies have explored the relationship between social class and health for decades. However, the underlying mechanism between the two remains not fully understood. This study aimed to explore whether health self-management had a mediating role between social class and health under the framework of Socio-cultural Self Model. METHODS: 663 adults, randomly sampled from six communities in Southwest China, completed the survey for this study. Social class was assessed using individuals' income, education, occupation. Health self-management was assessed through evaluation of the health self-management behavior, health self-management cognition, health self-management environment. Physical health and mental health were measured by the Chinese version of Short-Form (36-item) Health Survey, which contains Physical Functioning, Role-Physical, Role-Emotional, Vitality, Mental Health, Social Function, Bodily Pain and General Health. Pearson's correlation was used to examine the associations between major variables. Mediation analyses were performed to explore the mediating role of health self-management. RESULTS: Social class positively predicted self-rated health. The lower the social class, the lower the self-reported physical and mental health. Health self-management partially mediated the relationship between social class and self-rated health. That is, the health self-management ability of the lower class, such as access to healthy and nutritious food and evaluate their own health status, is worse than that of the higher class, which leads to physical and mental health inequality between the high and the low classes. CONCLUSION: Health self-management mediated the relationship between social class and health. Promoting health self-management abilities are conducive to improving both physical and mental health.

Exploring the Safety, Effectiveness, and Cost-Effectiveness of a Chinese Patent Medicine (Fufang E'jiao Syrup) for Alleviating Cancer-Related Fatigue: A Protocol for a Randomized, Double-Blinded, Placebo-Controlled, Multicenter Trial.

OBJECTIVE: To provide higher level evidence on the benefits of a Chinese patent medicine (CPM) (Fufang E'jiao Syrup, FFEJS) for alleviating cancer-related fatigue (CRF), this article describes a protocol for a randomized controlled trial. METHODS/DESIGN: We designed a double-blind, placebo-controlled stratified permuted block randomization clinical trial on CRF among 3 types of cancer in China. Participants will be equally allocated to FFEJS group or placebo group according to the randomization sequence and the hospitals they were enrolled at. Each patient will receive 20 ml of either the study formula FFEJS or a placebo formula, 3 times a day for 6 weeks. The follow-up period will be another 4 weeks for safety evaluation. The primary outcome is the difference in improvement of fatigue as measured with the Revised Piper Fatigue Scale-Chinese Version (RPFS-CV). Secondary outcomes include change in fatigue (measured by routine blood panel and hormones in peripheral blood) and QoL (measured by Edmonton symptom assessment scale and Functional Assessment of Cancer Therapy). Patient safety will be measured by liver, renal or cardiac damage, and the risk of FFEJS having a tumor promotion and progression effect will be monitored throughout this study. Cost-effectiveness will also be evaluated mainly by incremental cost per each quality-adjusted life year gained. DISCUSSION: This article describes the study design of a CPM for CRF in patients with advanced cancer through exploring the effectiveness, safety, and cost-effectiveness of FFEJS. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04147312. Registered on 1 Sep 2019.

Use of low-value pediatric services in the Military Health System.

BACKGROUND: Low-value care (LVC) is understudied in pediatric populations and in the Military Health System (MHS). This cross-sectional study applies previously developed measures of pediatric LVC diagnostic tests, procedures, and treatments to children receiving care within the direct and purchased care environments of the MHS. METHODS: We queried the MHS Data Repository (MDR) to identify children (n = 1,111,534) who received one or more of 20 previously described types of LVC in fiscal year 2015. We calculated the proportion of eligible children and all children who received the service at least once during fiscal year 2015. Among children eligible for each measure, we used logistic regressions to calculate the adjusted odds ratios (AOR) for receiving LVC at least once during fiscal year 2015 in direct versus purchased care. RESULTS: All 20 measures of pediatric LVC were found in the MDR. Of the 1,111,534 eligible children identified, 15.41% received at least one LVC service, and the two most common procedures were cough and cold medications in children under 6 years and acid blockers for infants with uncomplicated gastroesophageal reflux. Eighteen of the 20 measures of pediatric LVC were eligible for comparison across care environments: 6 were significantly more likely to be delivered in direct care and 10 were significantly more likely to be delivered in purchased care. The greatest differences between direct and purchased care were seen in respiratory syncytial virus testing in children with bronchiolitis (AOR = 21.01, 95% CI = 12.23-36.10) and blood tests in children with simple febrile seizure (AOR = 24.44, 95% CI = 5.49-108.82). A notably greater difference of inappropriate antibiotic prescribing was seen in purchased versus direct care. CONCLUSIONS: Significant differences existed between provision of LVC services in direct and purchased care, unlike previous studies showing little difference between publicly and privately insured children. In fiscal year 2015, 1 in 7 children received one of 20 types of LVC. These proportions are higher than prior estimates from privately and publicly insured children, suggesting the particular need to focus on decreasing wasteful care in the MHS. Collectively, these studies demonstrate the high prevalence of LVC in children and the necessity of reducing potentially harmful care in this vulnerable population.

Plasma circulating tumor DNA assessment reveals KMT2D as a potential poor prognostic factor in extranodal NK/T-cell lymphoma.

BACKGROUND: The early detection of tumors upon initial diagnosis or during routine surveillance is important for improving survival outcomes. Here, we investigated the feasibility and clinical significance of circulating tumor DNA (ctDNA) detection for Extranodal NK/T-cell lymphoma, nasal type (ENTKL). METHODS: The plasma ctDNA assessment was based on blood specimens collected from 65 newly diagnosed patients with ENKTL in the hematology medical center of Xinqiao Hospital. Longitudinal samples collected under chemotherapy were also included. The gene mutation spectrum of ENKTL was analyzed via next generation sequencing. RESULTS: We found that the most frequently mutated genes were KMT2D (23.1%), APC (12.3%), ATM (10.8%), ASXL3 (9.2%), JAK3 (9.2%), SETD2 (9.2%), TP53 (9.2%) and NOTCH1 (7.7%). The mutation allele frequencies of ATM and JAK3 were significantly correlated with the disease stage, and mutated KMT2D, ASXL3 and JAK3 were positively correlated with the metabolic tumor burden of the patients. Compared with the tumor tissue, ctDNA profiling showed good concordance (93.75%). Serial ctDNA analysis showed that treatment with chemotherapy could decrease the number and mutation allele frequencies of the genes. Compared with PET/CT, ctDNA has more advantages in tracking residual disease in patients. In addition, patients with mutated KMT2D had higher expression compared with those with wild type, and mutated KMT2D predicted poor prognosis. CONCLUSION: Our results unveil the mutation spectrum of ENKTL patients' plasma, which can be used to monitor the disease status of the patients exactly, and KMT2D is the most frequently mutated gene with prognosis prediction value. The application of ctDNA sequencing can provide precision treatment strategies for patients. TRIAL REGISTRATION: This study is registered with chictr.org (ChiCTR1800014813, registered 7 February, 2018-Retrospectively registered).

Application of cell-based biological bioassays for health risk assessment of PM2.5 exposure in three megacities, China.

The determination of PM2.5-induced biological response is essential for understanding the adverse health risk associated with PM2.5 exposure. In this study, we conducted cell-based bioassays to measure the toxic effects of PM2.5 exposure, including cytotoxicity, oxidative stress, genotoxicity and inflammatory response. The concentration-response relationship was analyzed by benchmark dose (BMD) modeling and the BMDL10 was used to estimate the biological potency of PM2.5 exposure. PM2.5 samples were collected from three typical megacities of China (Beijing, BJ; Wuhan, WH; Guangzhou, GZ) in typical seasons (winter and summer). The total PM, water-soluble fractions (WSF), and organic extracts (OE) were prepared and subjected to examination of toxic effects. The biological potencies for cytotoxicity, oxidative stress and genotoxicity were generally higher in winter samples, while the inflammatory potency of PM2.5 was higher in summer samples. The relative health risk (RHR) was determined by integration of the biological potencies and the cumulative exposure level, and the ranks of RHR were BJ-W > WH-W > BJ-S > WH-S > GZ-W > GZ-S. Notably, we note that different PM2.5 compositions were associated with distinct biological effects, and the health effects distribution of PM2.5 varied in regions and seasons. These findings demonstrate that the approach of integrated cell-based bioassays could be used for the evaluation of health effects of PM2.5 exposure.

The development of a cell-based model for the assessment of carcinogenic potential upon long-term PM2.5 exposure.

To assess the carcinogenic potential of PM2.5 exposure, we developed a cell-based experimental protocol to examine the cell transformation activity of PM2.5 samples from different regions in China. The seasonal ambient PM2.5 samples were collected from three megacities, Beijing (BJ), Wuhan (WH), and Guangzhou (GZ), from November 2016 to October 2017. The mean concentrations of PM2.5 were much higher in the winter season (BJ: 109.64 µg/m3, WH: 79.99 µg/m3, GZ: 49.99 µg/m3) than that in summer season (BJ: 42.40 µg/m3, WH: 25.82 µg/m3, GZ: 19.82 µg/m3). The organic extracts (OE) of PM2.5 samples from combined summer (S) (June, July, August) or winter (W) (November, December, January) seasons were subjected to characterization of chemical components. We treated human bronchial epithelial (HBE) cells expressing CYP1A1 (HBE-1A1) with PM2.5 samples at doses ranging from 0 to 100 µg/mL (0, 1.563, 3.125, 6.25, 12.5, 25, 50, 100 µg/mL) and determined the phenotype of malignant cell transformation. A dose-response relationship was analyzed by benchmark dose (BMD) modeling, and the potential were indicated by BMDL10. The order of the carcinogenic risk of seasonal PM2.5 samples from high to low was BJ-W, WH-W, GZ-W, WH-S, BJ-S, and GZ-S. Notably, we found that the alteration in the lung cancer-related biomarkers, KRAS, PTEN, p53, c-Myc, PCNA, pAKT/AKT, and pERK/ERK was congruent with the activity of cell transformation and the content of specific components of polycyclic aromatic hydrocarbon (PAHs) bound to PM2.5. Taken together, we have successfully developed a cell-based alternative model for the evaluation of potent carcinogenicity upon long-term PM2.5 exposure.

Assessment of Molecular Subtypes in Thyrotoxic Periodic Paralysis and Graves Disease Among Chinese Han Adults: A Population-Based Genome-Wide Association Study.

Importance: Thyrotoxic periodic paralysis (TPP) is a potentially lethal complication of hyperthyroidism. However, only 1 specific susceptibility locus for TPP has been identified. Additional genetic determinants should be detected so that a prediction model can be constructed. Objective: To investigate the genetic architecture of TPP and distinguish TPP from Graves disease cohorts. Design, Setting, and Participants: This population-based case-control study used a 2-stage genome-wide association study to investigate the risk loci of TPP and weighted genetic risk score to construct a TPP prediction model with data from a Chinese Han population recruited in hospitals in China from March 2003 to December 2015. The analysis was conducted from November 2014 to August 2016. Main Outcomes and Measures: Loci specifically associated with TPP risk and those shared with Graves disease and prediction model of joint effects of TPP-specific loci. Results: A total of 537 patients with TPP (mean [SD] age, 35 [11] years; 458 male) 1519 patients with Graves disease and no history of TPP (mean [SD] age, 38 [13] years; 366 male), and 3249 healthy participants (mean [SD] age, 46 [10] years; 1648 male) were recruited from the Han population by hospitals throughout China. Two new TPP-specific susceptibility loci were identified: DCHS2 on 4q31.3 (rs1352714: odds ratio [OR], 1.58; 95% CI, 1.35-1.85; P = 1.24 × 10-8) and C11orf67 on 11q14.1 (rs2186564: OR, 1.50; 95% CI, 1.29-1.74; P = 2.80 × 10-7). One previously reported specific locus was confirmed on 17q24.3 near KCNJ2 (rs312729: OR, 2.08; 95% CI, 1.83-2.38; P = 8.02 × 10-29). Meanwhile, 2 risk loci (MHC and Xq21.1) were shared by Graves disease and TPP. After 2 years of treatment, the ratio of persistent thyrotropin receptor antibody positivity was higher in patients with TPP than in patients with Graves disease and no history of TPP (OR, 3.82; 95% CI, 2.04-7.16; P = 7.05 × 10-6). The prediction model using a weighted genetic risk score and 11 candidate TPP-specific single-nucleotide polymorphisms had an area under the curve of 0.80. Conclusions and Relevance: These findings provide evidence that TPP is a novel molecular subtype of Graves disease. The newly identified loci, along with other previously reported loci, demonstrate the growing complexity of the heritable contribution to TPP pathogenesis. A complete genetic architecture will be helpful to understand the pathophysiology of TPP, and a useful prediction model could prevent the onset of TPP.

Characterization of PM2.5-bound phthalic acid esters (PAEs) at regional background site in northern China: Long-range transport and risk assessment.

Eleven major phthalic acid esters (PAEs) congeners were analyzed for PM2.5 samples collected at Mount Tai, a high elevation mountain site in northern China from June to August 2015. The results showed that the average concentration of PAEs in PM2.5 was 19.48ngm-3, and bis(2-Ethylhexyl) phthalate (DEHP), dibutyl phthalate (DBP) and diisobutyl phthalate (DIBP) were the predominant species in particle-phase, whereas diethyl phthalate (DEP) and dimethyl phthalate (DMP) were the prevailing PAEs in gas-phase. PAE concentrations decreased at the beginning of cloud/fog events, while they increased after the cloud/fog events since the liquid-phase PAEs could be absorbed by solid-phase PAEs. Potential source contribution function (PSCF) analysis and principal component analysis (PCA) revealed that the highest PSCF value of air masses were mainly sourced from southwest of Mount Tai and multiple sources contributed to PAEs. A Monte Carlo simulation was applied to estimate the incremental lifetime cancer risks (ILCR) from inhalation exposure on the basis of DEHP concentrations. The estimated values of ILCR for the general population were lower than the U.S. Environmental Protection Agency threshold, which is 10-6. However, since the local population was exposed to various local emission sources, the actual health risk is undervalued.

Bio-production of Baccatin III, an Important Precursor of Paclitaxel by a Cost-Effective Approach.

Natural production of anti-cancer drug taxol from Taxus has proved to be environmentally unsustainable and economically unfeasible. Currently, bioengineering the biosynthetic pathway of taxol is an attractive alternative production approach. 10-deacetylbaccatin III-10-O-acetyl transferase (DBAT) was previously characterized as an acyltransferase, using 10-deacetylbaccatin III (10-DAB) and acetyl CoA as natural substrates, to form baccatin III in the taxol biosynthesis. Here, we report that other than the natural acetyl CoA (Ac-CoA) substrate, DBAT can also utilize vinyl acetate (VA), which is commercially available at very low cost, acylate quickly and irreversibly, as acetyl donor in the acyl transfer reaction to produce baccatin III. Furthermore, mutants were prepared via a semi-rational design in this work. A double mutant, I43S/D390R was constructed to combine the positive effects of the different single mutations on catalytic activity, and its catalytic efficiency towards 10-DAB and VA was successfully improved by 3.30-fold, compared to that of wild-type DBAT, while 2.99-fold higher than the catalytic efficiency of WT DBAT towards 10-DAB and Ac-CoA. These findings can provide a promising economically and environmentally friendly method for exploring novel acyl donors to engineer natural product pathways.

A Nursing Pain Assessment and Record Information System: Design and Application in the Oncology Department.

Pain is an unpleasant sensory and emotional feeling accompanying existing, impending, or potential tissue damage. Valid pain assessment and standardized pain documentation are important in oncology pain management; however, they are still deficient. Thus, we developed a pain assessment and record information system for nurses in the oncology department and implemented a questionnaire survey to evaluate users' acceptance of the system. The pain assessment system focused on usability and efficiency to provide a modified workflow that was safe, less time-consuming, patient centered, enjoyable, and efficient. The pain assessment and record chart types in the system enabled greater standardization of pain assessments and records. The application of the system greatly improved the efficiency of nursing in the oncology department, guiding nurses in an accurate and comprehensive patient pain assessment and contributing significantly to further improvement in pain care standards and care decisions. Nurses and doctors surveyed reported a high degree of satisfaction with factors such as saving time and improving the capacity of pain control, suggesting that the system enhanced the quality of pain management. Through this system, we can promote pain management, improving care quality for patients.

A novel process for obtaining pinosylvin using combinatorial bioengineering in Escherichia coli.

Pinosylvin as a bioactive stilbene is of great interest for food supplements and pharmaceuticals development. In comparison to conventional extraction of pinosylvin from plant sources, biosynthesis engineering of microbial cell factories is a sustainable and flexible alternative method. Current synthetic strategies often require expensive phenylpropanoic precursor and inducer, which are not available for large-scale fermentation process. In this study, three bioengineering strategies were described to the development of a simple and economical process for pinosylvin biosynthesis in Escherichia coli. Firstly, we evaluated different construct environments to give a highly efficient constitutive system for enzymes of pinosylvin pathway expression: 4-coumarate: coenzyme A ligase (4CL) and stilbene synthase (STS). Secondly, malonyl coenzyme A (malonyl-CoA) is a key precursor of pinosylvin bioproduction and at low level in E. coli cell. Thus clustered regularly interspaced short palindromic repeats interference (CRISPRi) was explored to inactivate malonyl-CoA consumption pathway to increase its availability. The resulting pinosylvin content in engineered E. coli was obtained a 1.9-fold increase depending on the repression of fabD (encoding malonyl-CoA-ACP transacylase) gene. Eventually, a phenylalanine over-producing E. coli consisting phenylalanine ammonia lyase was introduced to produce the precursor of pinosylvin, trans-cinnamic acid, the crude extraction of cultural medium was used as supplementation for pinosylvin bioproduction. Using these combinatorial processes, 47.49 mg/L pinosylvin was produced from glycerol.

Assessment of renal allograft function early after transplantation with isotropic resolution diffusion tensor imaging.

OBJECTIVES: To investigate the value of diffusion tensor imaging (DTI) and tractography in renal allografts at the early stage after kidney transplantation. METHODS: This study was approved by the institutional ethical review committee, and written informed consent was obtained. A total of 54 renal allograft recipients 2-3 weeks after transplantation and 26 age-matched healthy volunteers underwent renal DTI with a 3.0-T magnetic resonance imaging (MRI) system. Recipients were divided into three groups according to the estimated glomerular filtration rate (eGFR). Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) of the cortex and medulla were measured and compared among the groups. Whole-kidney tractography was performed. Correlation of eGFR with diffusion parameters was evaluated. RESULTS: In allografts with stable function, the medullary ADC was higher and the cortical FA was lower (p < 0.001) than in healthy kidneys. The cortical ADC, medullary ADC and FA decreased as the allograft function declined, and with a positive correlation with eGFR (p < 0.001); cortical FA did not. Tractography demonstrated a decrease of tract density in impaired functional allografts. CONCLUSIONS: Renal DTI produces reliable results to assess renal allograft function at the early stage after transplantation. KEY POINTS: • DTI and tractography can evaluate renal allograft function at an early stage • Medullary FA, cortical and medullary ADC can effectively evaluate allograft function • Medullary FA, cortical and medullary ADC are correlated with eGFR in renal allografts • Medullary ADC increased and cortical FA decreased in stable allografts compared to control subjects • Medullary FA, cortical and medullary ADC decreased and allograft function declined.

[Transportation and risk assessment of heavy metal pollution in water-soil from the Riparian Zone of Daye Lake, China].

Each 20 water samples and soil samples (0-10 cm, 10-20 cm) were collected from the riparian zone of Daye Lake in dry season during March 2013. Heavy metals (Cu, Ph, Cd, Zn) have been detected by flame atomic absorption spectrometric (FAAS). The results showed that the average concentrations of Cu, Pb, Cd, Zn in the water were 7.14, 25.94, 15.72 and 37.58 microg x L(-1), respectively. The concentration of Cu was higher than the five degree of the surface water environment quality standard. The average concentrations of Cu, Pb, Cd, Zn in soil(0-10 cm) were 108.38, 53.92, 3.55, 139.26 mg x kg(-1) in soil (10-20 cm) were 93.00, 51.72, 2.08, 171.00 mg x kg(-1), respectively. The Cd concentrations were higher than the three grade value of the national soil environment quality standard. The transportation of Pb from soil to water was relatively stable, and Zn was greatly influenced by soil property and the surrounding environment from soil to water. The transformation of heavy metal in west riparian zone was higher than that of east riparian zone. The potential environmental risk was relatively high. Cu, Pb, Cd, Zn were dominated by residue fraction of the modified BCR sequential extraction method. The overall migration order of heavy metal element was: Pb > Cu > Cd > Zn. There were stronger transformation and higher environmental pollution risk of Cu, Pb. The index of assessment and potential ecological risk coefficient indicated that heavy metal pollution in soil (0-10 cm) was higher than the soil (10-20 cm), Cd was particularly serious.

The integrated quality assessment of Chinese commercial dry red wine based on a method of online HPLC-DAD-CL combined with HPLC-ESI-MS.

AIM: To apply an integrated quality assessment strategy to investigate the quality of multiple Chinese commercial dry red wine samples. METHOD: A comprehensive method was developed by combining a high performance liquid chromatography-diode array detector-chemiluminescence (HPLC-DAD-CL) online hyphenated system with an HPLC-ESI-MS technique. RESULTS: Chromatographic and H2O2-scavenging active fingerprints of thirteen batches of different, commercially available Chinese dry red wine samples were obtained and analyzed. Twenty-five compounds, including eighteen antioxidants were identified and evaluated. The dominant and characteristic antioxidants in the samples were identified. The relationships between antioxidant potency and the cultivated variety of grape, producing area, cellaring period, and trade mark are also discussed. CONCLUSION: The results provide the feasibility for an integrated quality assessment strategy to be efficiently and objectively used in quality (especially antioxidant activity) assessment and identification of dry red wine.

Assessment of biological characteristics of adipose tissue-derived stem cells co-labeled with Molday ION Rhodamine B™ and green fluorescent protein in vitro.

The current study aimed to investigate adipose tissue-derived stem cells (ADSCs) in vivo by multimodality imaging following implantation for cellular therapy. The biological characteristics of ADSCs co-labeled with Molday ION Rhodamine B™ (MIRB) and green fluorescent protein (GFP) were studied in vitro. Following rat ADSC isolation and culture, a combined labeling strategy for ADSCs based on genetic modification of the reporter gene GFP with lentiviral vector expression enhancement and physical MIRB labeling was performed. Cell viability, proliferation, membrane-bound antigens and multiple differentiation ability were compared between the labeled and unlabeled ADSCs. The ADSCs were successfully labeled with GFP and MIRB, showing various fluorescent colors for marker identification. The fluorescence emitted by the GFP protein was sustained and exhibited stable expression, while MIRB fluorescence decreased with time. Compared with the unlabeled ADSCs, no significant differences were detected in cell viability, proliferation, membrane-bound antigens and multiple differentiation ability in the co-labeled samples (P>0.05). No significant effects on the biophysical properties of ADSCs were observed following co-labeling with lentiviral vectors encoding the gene for emerald green fluorescent protein and MIRB. The ADSCs were able to be efficiently tracked in vitro and in vivo by multimodality imaging thus, the co-labeling approach provides a novel strategy for therapeutic gene studies.

[Subjective and objective clinical outcome assessment on chronic rhinosinusitis following endoscopic sinus surgery].

OBJECTIVE: To assess the subjective and objective outcomes of chronic rhinosinusitis (CRS) following endoscopic sinus surgery (ESS) and establish an assessment system of outcome with ease of application clinically. METHODS: A prospective cohort study was conducted to survey and assess the outcomes of 120 consecutive CRS patients undergoing endoscopic sinus surgery at 12 months after operation. The subjective and objective measures comprised symptom by visual analog scale (VAS), health-related quality of life by medical outcome study short-form 36-items (SF-36) and sino-nasal outcome test-20 (SNOT-20) scales, endoscopic appearance, mucociliary function, and histological findings. The differences of subjective and objective assessments before and after operation were compared by t-test and Chi-Square test and the correlations between the parameters above were analyzed by Spearman correlation analysis. RESULTS: At 12 months after operation, the patients' total scores by VAS, SF-36 and SNOT-20 scales improved significantly beyond the preoperative survey (P < 0.01); there were 85.96%, 77.19% and 83.33% patients with the scores respectively superior to that of preoperation, of which 72.28% subjects benefited simultaneously from these parameters; and a significant correlation was observed among them before and after operation (P < 0.01) where SNOT-20 showed a more compatibility than the other two. At 12 months after operation, the patients' total scores of endoscopic appearance, mucociliary function, and histological findings significantly improved beyond the preoperative evaluation (P < 0.05); there were 86.84% , 86.81% and 75.57% patients with the scores respectively superior to that of preoperation, of which 71.85% subjects benefited simultaneously from these parameters; and a significant correlation was observed among them before and after operation (P < 0.05) where endoscopic appearance showed a more compatibility than the other two. At 12 months after operation, 74.56% patients showed an accordant improving or worsening outcome evaluated by SNOT-20 and endoscopic appearance, while 25.44% ones represented inverse endings, of which patients with comorbidity of nasal polyps more easily demonstrated this tendency significantly (P < 0.05). No significant correlation existed between the scores of SNOT-20 and endoscopic appearances both in preoperation and in postoperation (P > 0.05), but the total scores of the anterior 10-item, excluding the posterior 10-item, of SNOT-20 inventory was found significantly correlated with the quantitative appearances on nasal endoscopy throughout (0.18 < or = 0.42, P < 0.05). CONCLUSIONS: Administration of ESS can effectively improve the outcomes of CRS patients including symptom, health-related quality of life, endoscopic appearance, mucociliary function, and histological findings. A subjectively and objectively measured assessment system with tenseness, trustiness, reasonableness, and effectiveness and with ease of application clinically is established on the basis of SNOT-20 and endoscopic appearance evaluation for outcome research.

[Factors associated with diagnostic delay for patients with smear-positive pulmonary tuberculosis in rural Hunan, China].

OBJECTIVE: To explore the influences of socio-economic, health services, cultural beliefs, and symptoms on health seeking behavior of tuberculosis patients attending county tuberculosis dispensaries in rural Hunan province of China. METHODS: A cross-sectional descriptive survey was conducted in 4 counties randomly stratified by economic status from 122 counties, Hunan, China. After informed consent, a consecutive sample of patients, aged 15 years and older, with smear-positive pulmonary tuberculosis were interviewed and completed a pre-tested questionnaire. RESULTS: A total of 318 patients with smear-positive pulmonary tuberculosis were interviewed. The median of patient delay, health system delay and total delay were 30, 24 and 65 days, respectively. Logistic regression shows that factors significantly contributed to patient delay were haemoptysis, far distance to health institute, seeking folk therapy, and lower per capita income. Factors significantly associated with health system delay were female, lower level of education, prior health education on tuberculosis, seeking folk therapy and stigma associated with tuberculosis. CONCLUSION: In order to reduce diagnostic delay, integrated measures including extensive training of medical staff in non-tuberculosis health facilities, decentralization of services and more specific and effective health education on tuberculosis should be taken.