Acoustic Radiation Force Impulse (ARFI) Elastography and Serological Markers in Assessment of Liver Fibrosis and Free Portal Pressure in Patients with Hepatitis B.

BACKGROUND The aim of this study was to investigate the feasibility of using acoustic radiation force impulse (ARFI) elastography, AST-to-platelet ratio index (APRI), and FIB-4 in assessing liver fibrosis and free portal pressure in patients with hepatitis B. MATERIAL AND METHODS We enrolled 126 patients with hepatitis B who underwent liver surgery at the General Surgery Department of the First Affiliated Hospital of Shihezi University Medical School from February 2013 to August 2015. Preoperatively, shear wave velocity (SWV) of the liver was measured with the Siemens S2000 ultrasound system to reflect liver stiffness. Serological markers were collected and fibrosis indices APRI and FIB-4 were calculated. Intraoperatively, liver tissues were harvested and free portal pressure (FPP) was measured. Postoperatively, fibrosis of liver tissues was pathologically staged. RESULTS The results of SWV, APRI, FIB-4, and FPP were all correlated with the degree of liver fibrosis (Spearman correlation coefficients: r=0.777, P<0.001; r=0.526, P<0.001; r=0.471, P<0.001; p<0.000; r=0.675, p<0.000). Receiver operating characteristic curve (ROC) analysis showed that the areas under the curve (AUC) of ARFI, APRI, and FIB-4 in diagnosing liver fibrosis were 0.830, 0.768, and 0.717, respectively, for stage F≥1; 0.861, 0.773, and 0.754, respectively, for stage F≥2; 0.941, 0.793, and 0.779, respectively, for stage F≥3; and 0.945, 0.783, and 0.754, respectively, for stage F=4. SWV, APRI, and FIB-4 were all correlated with FPP (Pearson correlation coefficients: 0.387, P<0.001; 0.446, P<0.001; 0.419, P<0.001). CONCLUSIONS ARFI, APRI, and FIB-4 can assess liver fibrosis in patients with hepatitis B when assessing the portal venous pressure. The difference in diagnostic efficacy between the 3 was not significant.

Stereoselective synthesis of epoxyisoprostanes: an organocatalytic and "pot-economy" approach.

An efficient and direct synthetic route to epoxyisoprostane EC methyl ester has been accomplished in 8 steps (10% overall yield) from readily available starting materials using a series of asymmetric organocatalytic reactions and one-pot operations.

Estimated human excretion rates of natural estrogens calculated from their concentrations in raw municipal wastewater and its application.

Natural estrogens are important endocrine disrupting compounds (EDCs), which may pose adverse effects on our environment. To avoid time-consuming sample preparation and chemical analysis, estimation of their concentrations in municipal wastewater based on their human urine/feces excretion rates has been generally adopted. However, the data of excretion rates available are very limited and show significant difference among countries. In the context of increasing reporting on the concentrations of natural estrogens in municipal wastewater around the world, this study presented a simple method to estimate their human excretion rates based on the concentrations of natural estrogens in raw sewage. The estimated human excretion rates of natural estrogens among ten countries were obtained, which totally covered over 33 million population. Among these, Brazilians had the largest excretion rates with estrone (E1) and 17ß-estradiol (E2) as 236.9 and 60 µg/day/P, respectively, while Iran had the lowest value of 2 µg/day/P for E1 and 0.5 µg/day/P for E2. The average estimated human excretion rates of E1, E2, and estriol (E3) are 17.3, 6.4, and 39.7 µg/day/P, respectively. When the estimated human excretion rates obtained were applied for prediction, the predicted results showed better accuracies than those based on human urinary/feces excretion rates. The method in this study is simple, cost-effective and time-saving, which may be widely applied.

Do we underestimate the concentration of estriol in raw municipal wastewater?

The main source of natural estrogens to municipal wastewater is human excretions via urine or feces, thus their concentrations in raw wastewater should show positive linear relationship with their human excretions. This study mainly focused on their concentration relationship in raw wastewater. Based on comparison between chemical analyses and predictions through human excretion rates, the observed concentrations of estriol (E 3) in municipal wastewater were found to be noticeably lower than the predicted values. The main cause for the disparity is that substantial conjugated E 3 also exists in raw wastewater. This work suggested that monitoring both E 3 and its conjugates is necessary to get more accurate E 3 removal performance of wastewater treatment plants (WWTPs).

[Analysis of relapse factors and risk assessment of adult acute lymphoblastic leukemia].

OBJECTIVE: To explore the risk factors of acute lymphoblastic leukemia (ALL) recurrence in adult patients and establish a prognosis index (PI) calculation model in order to improve the prevention strategy of ALL in adults. METHODS: 104 adult ALL patients from Blood Diseases Hospital & Chinese Academy of Medical Sciences between August 2008 and November 2011 were enrolled. COX proportional hazards regression stratified by Dummy variable was used to set up the prediction model; Kaplan-Meier method and Log-rank test were used to estimate and compare the survival. After calculated individual PI value, patients' expected survival should be estimated by groups. RESULTS: The overall median survival of adult ALL patients was 22.00 months (95% CI 17.00-27.00). COX regression analysis showed that chemotherapy group patients had a higher risk of recurrence than of ASCT group while setting treatment as the dummy variable (RR=2.052, 95%CI 0.877-4.799, P=0.007). Stratified Analysis showed that the risk factors of B-ALL recurrence in adult patients included HGB <100 g/L (RR=0.186, 95% CI 0.068-0.512, P=0.001), CNSL (RR=7.767,95% CI 2.951- 20.433, P=0.001), number of consolidation chemotherapy<3 (RR=0.445, 95% CI 0.211-0.940, P=0.034) and Ph chromosome positive (RR=2.771, 95% CI 1.353-5.674, P=0.005). Grouped by the PI value, the expected survival of each individual patient could be estimated as PI=0.58 base. CONCLUSION: HGB, CNSL, number of consolidation chemotherapy and Ph chromosome were independent risk factors of B-ALL recurrence in adult patients. PI value could predict the survival of adult ALL patients and provide reference for individual therapy and prognostic evaluation.

Ecotoxicity assessment of aged petroleum sludge using a suite of effects-based end points in earthworm Eisenia fetida.

Laboratory investigations were conducted to test the toxicity of aged petroleum sludge collected from Shengli Oil Field, the second largest oilfield in China, to earthworm Eisenia fetida. Various end points were measured in the earthworms, including mortality, growth, cocoon output, juvenile production, and avoidance behavioral response, to determine their comparative sensitivity for assessing harmful effects of petroleum-hydrocarbon-contaminated soil. The results showed that all these assays responded in a concentration-dependent manner, and two chronic end points, juvenile production and cocoon output, as well as avoidance behavioral response appeared to be sensitive end points for detecting toxicity of petroleum-hydrocarbon-contaminated soil. Comparatively, juvenile production exhibited similar sensitivity to avoidance behavior response, both of which were more sensitive than cocoon output, while mortality and adult growth were proposed as the least sensitive parameters. It was suggested that large amounts of petroleum sludge deposited in Shengli Oil Field may pose a potential threat to the local ecosystem, and the utility of multiple effects-based end points in earthworm E. fetida is useful to facilitate ecological risk assessments in hydrocarbon-contaminated sites.

[Assessment of serum free light chain of patients with multiple myeloma and clinical significance thereof].

OBJECTIVE: To determine the normal range, reference intervals and diagnostic ranges of serum free light chains (sFLC) and to evaluate the clinical significance of serum sFLC in diagnosis of multiple myeloma (MM). METHODS: Peripheral blood samples were collected from 63 healthy persons and 72 MM patients, including 35 cases of kappa-MM and 37 cases of lambda-MM. Immuno-turbidimetry and immunofixation electrophoresis (IFE) were used to detect the serum sFLC and monoclonal element of FLC. The specificity and sensitivity of sFLC were evaluated by comparing the results with those obtained by IFE. RESULTS: (1) The 95% reference interval for sFLC of the healthy persons was (9 - 29) mg/L, and that for sFLC-lambda was (15 - 34) mg/L. The diagnostic interval for sFLCkappa/lambda of the healthy persons was 0.59, and the 100% reference interval was 0.27 - 2.49. (2) The 95% reference intervals for sFLC-kappa and sFLC-lambda of the kappa-MM patients were (53 - 14 100) mg/L and (0 - 97) mg/L respectively, and those of the lambda-MM patients were (9 - 117) mg/L and (205 - 6875) mg/L respectively. The interval for sFLCkappa/lambda of the kappa-MM and lambda-MM patients were 10.27 and 0.005 respectively. (3) In the healthy persons sFLC-kappa and sFLC-lambda levels were positively correlated with age (P = 0.031 and P = 0.01), however, such correlation did not exist in the MM patients. No correlation between sFLCkappa/lambda and age was found in both the healthy persons and MM patients (both P > 0.05). (4) Detection and quantification of monoclonal FLC by nephelometry were more sensitive than IFE in serum samples from the patients with MM. CONCLUSION: The reference interval and diagnostic range of sFLC in Chinese have been obtained. Quantification of sFLC proves useful in the diagnosis and monitoring of patients with MM.