Diagnostic Value of ER, PR, FR and HER-2-Targeted Molecular Probes for Magnetic Resonance Imaging in Patients with Breast Cancer.

BACKGROUND/AIMS: Smart molecular probes are required in the application of Magnetic resonance imaging (MRI) for biochemical and clinical research. This study aims to investigate the diagnostic values of estrogen receptor (ER), progesterone receptor (PR), folate receptor (FR) and human epidermal growth factor receptor 2 (HER-2)-targeted molecular probes in the MRI diagnosis of breast cancer. METHODS: Initially, a total of 508 female breast cancer patients were selected for breast cancer subtype classification by immunohistochemistry. Subsequently, the tumor size, lymph node metastasis, and histological grade of different breast cancer subtypes were compared. Molecular probes of Ab-ER-USPIO, Ab-PR-USPIO, Ab-FR-USPIO and Ab-HER-2-USPIO were constructed and screened. The specific binding of molecular probes to breast cancer cells was detected both in vitro and in vivo by Prussian blue staining and MRI using T1 and T2 weighted images. Finally, in vivo toxicity of Ab-HER-2-USPIO was analyzed using hematoxylin and eosin staining. RESULTS: We identified the following subtypes of breast cancer: Luminal A (ER-positive, FR-positive, HER-2-negative), Luminal B (ER-positive, FR-positive, HER-2-positive), HER-2 overexpression (ER-negative, FR-negative, HER-2-positive), and triple-negative breast cancer (ER-negative, FR-negative, HER-2-negative). Featuring favorable in vitro biocompatibility and low in vivo toxicity, Ab-HER-2-USPIO can specifically bind to breast cancer cells BT47 and SKBR3, thus enhancing the quality of T1 weighted MRI images. CONCLUSION: The results indicate that HER-2-targeted MRI molecular probes may be used in the clinical diagnosis of breast cancer and facilitate the development of promising strategies for breast cancer treatments.

Prognostic Values of Platelet Distribution Width and Platelet Distribution Width-to-Platelet Ratio in Severe Burns.

BACKGROUND: Platelet distribution width (PDW) and PDW-to-platelet ratio (PPR) have been proven to be good prognostic indicators for many diseases. However, their prognostic values in severe burns have not been reported. OBJECTIVE: To investigate the early time course of PDW and PPR in severe burn patients and investigate their prognostic values. METHODS: This is a 16-year, single-center retrospective study of 590 severe burn patients. The complete blood count parameters on day 1, day 3, and day 7 postburn, including PDW and PPR, were collected. Receiver operating characteristic curves (ROC) analysis, multiple logistic regression analysis and Kaplan-Meier survival analysis were performed to evaluate the prognostic values of PDW and PPR in severe burn patients. RESULTS: According to 120-day follow-up records, 96 patients were nonsurvivors and 494 patients were survivors. ROC and area under the curve (AUC) analysis showed that, for predicting 120-day prognosis, the AUC of PDW (0.782) and PPR (0.816) on day 3 was the highest, followed by the AUC of PDW (0.764) and PPR (0.750) on day 7. The ROC-AUC of PPR (0.816) on day 3 was very close to that of the ABSI score (0.818). Multiple logistic regression analysis showed that the PDW (P = 0.033 and P = 0.009) and PPR (P = 0.052 and P = 0.046) on day 3 and day 7 were all significantly independently positively associated with 120-day mortality. Kaplan-Meier survival analysis showed that high PDW and PPR were both significantly associated with a high 120-day mortality rate on day 3 and day 7. CONCLUSION: PDW and PPR on day 3 and day 7 were independent risk factors for 120-day mortality in severe burn patients. These objective and readily available prognostic indicators may be more clinically favored.

Differences by age in the obesity paradox in severe burns.

BACKGROUND: Many studies show a "obesity paradox", which seems to protect against death. Whether an obesity paradox space is present in severe burn patients remains a matter of great debate. Most research on the obesity paradox of burn injuries is classified by body mass index (BMI) rather than by age. OBJECTIVE: To investigate whether the obesity paradox exists in severe burn patients stratified by age. METHODS: Retrospective analysis was performed on 490 patients with severe burns who were ≥ 18 years of age and were admitted to Fujian Medical University Union Hospital from January 2005 to December 2020. Demographic and clinical characteristics were collected, including age, BMI, total body surface area (TBSA), presence of inhalation injury, abbreviated burn severity index (ABSI) score, diabetes comorbidities, hypertension comorbidities, and in-hospital mortality. The patients were divided into the younger group (18 ≤ age<65 years) and the older group (age ≥ 65 years). The important variables of the two groups were compared. The predictive value of BMI stratified by age on in-hospital mortality was evaluated by binary logistic regression analysis and the Cochran's and Mantel-Haenszel statistics. RESULTS: A total of 490 patients were selected for this study, and were divided into the younger group (413) and the elderly group (77) according to their ages. In the younger group, logistic regression analyses indicated that high BMI remained significantly and independently associated with decreased in-hospital mortality (P = 0.021). That is, in-hospital mortality decreased by 17.8% when BMI increased by 1 kg/m2. In the older group, BMI was not associated with in-hospital mortality (P = 0.808). In the younger group, the results of Pearson's chi-square test was less than 0.05, indicating a correlation between BMI and prognosis. In the older group, the conclusion was contrary with, no correlation between BMI and prognosis. If the confounding factors of age were not considered, this results in no correlation between BMI and prognosis. In the younger group, the survival/death ratio of patients with overweight and obesity was 2.078 times that of patients with normal weight. CONCLUSION: In this study of patients with severe burns, overweight and obesity had protective effect on burn injury in the younger group (18 ≤ age<65 years), but not in the older group (age ≥ 65 years). Investigating the obesity paradox in burn patients needs to consider age differences. However, multicentre clinical trials are needed to verify the results.

Glutamine relieves the hypermetabolic response and reduces organ damage in severe burn patients: A multicenter, randomized controlled clinical trial.

BACKGROUND: Severe burns can cause a hypermetabolic response and organ damage. Glutamine is a conditionally essential amino acid with various pharmacological effects. In this study, whether glutamine could alleviate the hypermetabolic response and maintain organ function after burn injury was analyzed. METHODS: A multicenter, randomized, single-blind, parallel controlled trial was conducted to evaluate the efficacy of glutamine in decreasing hypermetabolism after burn injury. Physiological and biochemical indexes, such as vital signs, metabolic hormones, metabolic rate, and organ damage, were recorded on the 7th and 14th days after treatment. RESULTS: In total, 55 adult burn patients with a total burn surface area (TBSA) of 30-70% were included in this study and randomly divided into the burn control (B, 28 patients) and burn+glutamine (B+G, 27 patients) groups. Except for the glutamine administration, the groups did not differ in the other treatments and nutrition supplements. The levels of diamine oxidase (DAO), lactulose/mannitol (L/M), ß2-microglobulin, lactate dehydrogenase (LDH), hydroxybutyrate dehydrogenase (HBD) and cardiac troponin l (cTnl) in the B+G group were significantly lower than those in the B group (p < 0.05 or 0.01). The levels of resting energy expenditure (REE), serum catecholamines, glucagon, lactate and Homeostasis model assessment (HOMA) in the B+G group were significantly lower than those in the B group (p < 0.05 or 0.01). No significant difference was found in the length of hospitalization or the mortality rate between the two groups (p > 0.05). CONCLUSIONS: Glutamine moderately alleviates the hypermetabolic response and reduces organ damage after severe burns. Therefore, the early application of glutamine, which is effective and safe, should be used as an active intervention as early as possible.

Analytical Solution for Chloride Diffusivity of Concrete with Aggregate Shape Effect.

In view of the key role of chloride diffusivity in evaluating concrete durability, it is very important to determine this parameter accurately by an effective approach. This paper establishes an analytical solution for chloride diffusivity of concrete that can consider the aggregate shape. In this approach, the aggregate shape is simulated as an ellipse and the equivalent model is applied to calculate the chloride diffusivity of equivalent aggregate composed of interface transition zone (ITZ) and aggregate. With resort to this model, at the meso scale, the concrete can be reduced from the original three-phase composition to the two-phase one (i.e., equivalent aggregates and cement paste). Based on the mesostructure of concrete that consisted of randomly dispersed equivalent elliptical aggregates and cement paste, the generalized Maxwell's approach is formed to determine the chloride diffusivity of concrete. The corresponding chloride diffusion test is conducted and the thickness of ITZ is reasonably determined as 0.04 mm by SEM test. By comparing with the experimental data, the accuracy of the analytical solution is confirmed. Finally, the impact of aggregate shape on chloride diffusivity is discussed. The analytical results show that the chloride diffusivity has a reduction with the increase of aggregate content or decrease of aspect ratio.

Effects of intestinal trefoil factor on intestinal mucus barrier in burned mice.

Severe burns might cause intense inflammatory response and tissue ischemia and hypoxia, and these effects result in intestinal mucosal barrier damage. In this study, we evaluated the effects of recombinant human intestinal trefoil factor (rhITF) on the intestinal mucus barrier after burn injury. The results showed that rhITF could improve the intestinal mucosal damage index, decrease diamine oxidase (DAO) activity, reduce intestinal damage, and thereby alleviate intestinal mucous permeability. Severe burns were associated with subsequent decreases in the mucus thickness and the levels of hexose, and mucin, and rhITF administration might partially reverse these changes. Additional experiments showed that supplementation with rhITF markedly increased the mitochondrial respiratory control rate (RCR) and phosphorus-oxygen ratio (P/O) in intestinal tissue. Moreover, rhITF improved the intestinal mucosal blood flow (IMBF) and the levels of oxygen extraction (Oext), nitric oxide (NO) and ATP. These results suggest that ITF can improve the blood perfusion of the intestinal mucosa after severe burns, promote the transport of glutamine in the intestinal mucosa, improve the energy metabolism of goblet cells, stimulate goblet cell differentiation and maturation, promote the synthesis and secretion of intestinal mucus, and maintain the barrier function of intestinal mucus.

Experimental Investigation and Analytical Modeling of Chloride Diffusivity of Fly Ash Concrete.

Owing to its importance in the assessment of reinforced concrete structures, it is essential to determine the chloride diffusivity of fly ash concrete. This paper presents an investigation into the diffusion characteristics of chloride ions in fly ash concrete. Through experiment, the relationship between chloride diffusivity and curing age up to 1800 days is measured and the effects of curing age, water/binder ratio, aggregate volume fraction, and fly ash content (i.e., percentage of total cementitious material by mass) on chloride diffusivity are evaluated. It is found that the chloride diffusivity decreases with the increase of curing age, aggregate volume fraction, and fly ash content, but increases with the increase of water/binder ratio. In analytical modeling, an equivalent aggregate model is constructed and the equivalent interfacial transition zone (ITZ) thickness is derived analytically. With the equivalent aggregate model, three-phase fly ash concrete reduces to a two-phase composite material. By extending the Maxwell method, the chloride diffusivity of fly ash concrete is formulated. Finally, the validity of the analytical method is verified by experimental results.

A Three-Dimensional Random Walk Algorithm for Estimating the Chloride Diffusivity of Concrete.

The chloride diffusivity of concrete is an important parameter for assessing the long-term durability of coastal concrete structures. The purpose of this paper is to present a three-dimensional random walk algorithm (RWA) for estimating the chloride diffusivity of concrete. By analyzing the size distribution of aggregates, the equivalent interfacial transition zone (ITZ) thickness is derived in an analytical manner. Each aggregate is combined with the surrounding ITZ to construct an equivalent aggregate model (EAM) and the chloride diffusivity is formulated. It is found that the equivalent ITZ thickness decreases with the increase of practical ITZ thickness and aggregate volume fraction. The aggregate gradation influences the equivalent ITZ thickness to a certain extent. The relative chloride diffusivity of the equivalent aggregate is almost directly and inversely proportional to the equivalent ITZ thickness and the aggregate radius, respectively. The numerical results show that, when the EAM is adopted, the computational time is greatly reduced. With the EAM, concrete can be modeled as a two-phase material and the chloride diffusivity is estimated by applying the RWA. It is shown that, with the increase of mean square displacement and number of Brownian particles, the average chloride diffusivity of concrete approaches a stable value. Finally, through comparison with experimental data, the validation of the RWA is preliminarily verified.

SARS-CoV-2 turned positive in a discharged patient with COVID-19 arouses concern regarding the present standards for discharge.

An outbreak of coronavirus disease (COVID-19) in Wuhan, China caused by SARS-CoV-2 has led to a serious epidemic in China and other countries, resulting in worldwide concern. With active efforts of prevention and control, more and more patients are being discharged. However, how to manage these patients normatively is still challenging. This paper reports an asymptomatic discharged patient with COVID-19 who retested positive for SARS-CoV-2, which arouses concern regarding the present discharge standards of COVID-19.

[Epidemiological investigation on an outbreak of amoebic dysentery in Jiangshan City of Zhejiang Province].

The investigation was carried out from 15 May to 10 June 2006 among diarrhea patients of two schools and periphery residents in Hecun Town, Jiangshan City. Stool samples were examined for Entamoeba histolytica. Water samples were taken for microbial analysis. 31 cases with E. histolytica were found,with 74.2% (23 cases) of students and preschool children. 9 cases were found in Liuyi kindergarten and 8 cases in Hecun central primary school with a prevalence of 7.4% and 0.65%, respectively. Among 594 asymptomatic close contactors, 9 cases (1.5%) were carriers of cysts. Of the 31 cases, 22 were found with no habit of handwashing before eating or after defecation, and 14 cases had a close contact to the patients. No amoebic cysts or trophozoites were found from 12 water samples collected from schools or patient's houses, but the Escherichia coli level exceeded the national standard in 7 samples.

Effective Medium Method for Chloride Diffusion Coefficient of Mature Fly Ash Cement Paste.

The chloride diffusion coefficient of concrete plays an essential role in the durability assessment and design of concrete structures built in chloride-laden environments. The purpose of this paper is to present an effective medium method (EMM) for evaluating the chloride diffusion coefficient of mature fly ash cement paste. In this method, a numerical method is used to estimate the degrees of hydration of cement and fly ash. Fly ash cement paste is then modeled as a two-phase composite material, composed of a solid phase and a pore space. By introducing the percolation theory, the EMM is modified to derive the chloride diffusion coefficient of fly ash cement paste in an analytical manner. To verify the EMM, a chloride diffusion test of fly ash cement paste at a curing age of up to 540 days is conducted. It is shown that, within a reasonable fly ash content, a larger fly ash content and/or curing age results in a smaller chloride diffusion coefficient. The chloride diffusion coefficient decreases with a decreasing water/binder ratio. Finally, the validity of the EMM is verified with experimental results.

[Investigation into the controlled release behavior of gemcitabine-loaded nanovesicles].

OBJECTIVE: To prepare gemcitabine-loaded nanovesicles and to observe its morphology, structure, particle size, and drug-release performance in vitro. METHODS: Diemulsion technique was used to prepare nanovesicles as carrier from amphiphilic block copolymer of poly (ethylene glycol)-block-poly (D, L-lactide), and gemcitabine was used as the model drug. The morphology of vesicles was determined by scanning electron microscope (SEM) and transmission electron microscope (TEM), and its drug loading (DL), encapsulation ratio (ER), and drug-release curve in vitro were detected by UV-Vis-NIR Spectrophotometer. RESULTS: The Gemcitabine-loaded nanovesicles is a kind of hollow nanosphere with the mean size of 200.6 nm, DL of 4.14% and ER of 20.54%. The nanovesicles showed its excellent controlled-release characteristic in the experiment of drug release in vitro. CONCLUSION: The nanovesicles prepared from PEG-PDLLA can be served as one of carriers for Gemcitabine with good performance of drug controlled-release. It will provide a reliable experimental base for the further researches in vivo.

Preparation, physicochemical characterization and cytotoxicity in vitro of gemcitabine-loaded PEG-PDLLA nanovesicles.

AIM: To investigate the preparation, physicochemical characterization and cytotoxicity in vitro of Gemcitabine-loaded poly(ethylene glycol)-block-poly(D,L-lactide) (PEG-PDLLA) nanovesicles. METHODS: The nanovesicle carriers were prepared from the amphiphilic block copolymer of PEG-PDLLA by a double emulsion technique, and gemcitabine was used as the model drug. The morphology of the nanovesicles was determined by scanning and transmission electron microscopy, and the drug content, drug entrapment and drug-release curve in vitro were detected by UV-Vis-NIR spectrophotometry. Cytotoxicity in the human pancreatic cancer cell line SW1990 was tested by 3-(4,5-dimethyl) ethiazole (MTT) assay. RESULTS: The gemcitabine-loaded nanovesicles were hollow nanospheres with a mean size of 200.6 nm, drug loading of 4.14% and drug embedding ratio of 20.54%. The nanovesicles showed excellent controlled release that was characterized by a fast initial release during the first 72 h, followed by a slower and continuous release. The MTT assay demonstrated that gemcitabine-loaded nanovesicles exhibited dose-dependent and time-delayed cytotoxicity in the human pancreatic cancer cell line SW1990. CONCLUSION: Gemcitabine-loaded PEG-PDLLA nanovesicles prepared by a double emulsion technique exhibited good performance for controlled drug release, and had similar cytotoxic activity to free gemcitabine.

[Comparison of biological phosphorus removal between different systems using O2, NO3(-) and NO2(-) as electron acceptors].

By parallel operation of three phosphorus removal systems (SBR) using different electron acceptors of O2, NO3(-) and NO2(-), process characteristics and inherent competition mechanism of microorganisms were discussed. Although NO2(-) had no direct inhibition on anoxic phosphorus uptake after the DPAO cultivation, system performance was still much lower than that with NO3(-) as electron acceptor. And it ultimately resulted from the washout of the group of DPAO (DPAO5) that lacked the ability to denitrify NO2(-) and the enhanced GAO growth in the system. Being the efficient electron acceptor, NO3(-) or O2 supplying SBRs removed phosphorus smoothly and comparatively, in viewpoint of stiochoimetry and constitution of functional bacteria. In all three test systems, mass of GAO was present to exhaust limited organics with PAO population. Moreover, total PAO could be divided into 6 distinct groups, i.e., PO, PN, Pn, PNn, PON and PONn, based on the abilities of utilizing different electron acceptors. And facultative PAO of PON and PONn were found as the main contributors for the phosphorus removal. The higher ratio they accounted in sludge, the more capacity the system possessed to remove phosphorus, i.e., SBR0 > SBRn5 > SBRn3.

[Efficacy of antiviral treatment on intrahepatic HBV DNA and histology in HBeAg -positive chronic hepatitis B patients].

OBJECTIVE: To evaluate the effect of antiviral agents on intrahepatic HBV DNA and histology in HBeAg-positive chronic hepatitis B patients. METHODS: Thirty-five patients were treated with lamivudine, 16 with interferon alfa (INF-alpha), 24 with sequential Lamivudine and INF-alpha. The total duration of therapy was 12 months. Intrahepatic HBV DNA was measured quantitatively by real-time polymerase chain reaction. RESULTS: There was significant change in all parameters of the groups of patients at the end of treatment (P < 0.05). The patients treated with sequential treatment had slightly higher HBeAg seroconversion rate (38.1%) than that of the other patients (P=0.1352). The baseline levels of intrahepatic HBV DNA in the patients with HBeAg seroconversion or undetectable serum HBV DNA were significantly lower than that of the other patients (P < 0.05). CONCLUSION: Antiviral agents could effectively inhibit intrahepatic HBV DNA and improve hepatic histology. The patients with low baseline intrahepatic HBV DNA level may achieve better antiviral efficacy. Sequential treatment might produce high HBeAg seroconversion rate.