[Marked improvement in rheumatoid lung nodules after treatment with tocilizumab combined with glucocorticoids and leflunomide: a case report and literature review].

Rheumatoid arthritis (RA), a chronic autoimmune disorder, is characterized by erosive inflammation of bone and cartilage, leading to progressive joint destruction. Pulmonary involvement occurs in approximately 60% of RA patients, manifests most commonly as interstitial lung disease and, less commonly, as rheumatoid lung nodules. Here, we report a 50-year-old woman, non-smoker, with recurrent cough and sputum of 7 years' duration, accompanied by a chest CT showing multiple cavitary nodules in both lungs. She had been treated empirically at several medical centers and was finally diagnosed with rheumatoid lung nodules. Marked improvement in rheumatoid lung nodules was observed after treatment with tocilizumab in combination with glucocorticoids and leflunomide. The aim of this study was to improve clinicians' understanding of rheumatoid lung nodules by analyzing the clinical features, diagnosis, and treatment of this case, and reviewing the relevant medical literature.

[Prognosis and related risk factors of acute respiratory distress syndrome in elder patients].

Objective: To study the risk factors associated with the hospital survival rate of elder patients with acute respiratory distress syndrome (ARDS) in Medical/Respiratory Intensive Care Units (MICUs/RICUs) by evaluating the prognosis, and therefore to provide insight into patient treatment strategy. Methods: Twenty MICUs/RICUs of 19 general hospitals in mainland China participated in the multicenter prospective cohort study carried out from Mar 1st, 2016 to Feb 28th, 2018. Patients who met the criteria of Berlin ARDS and older than 65 years were recruited. Baseline data, risk factors of ARDS, ventilator setup and prognosis data were collected from all patients. Univariant and multivariant regression analysis were conducted to analyze the factors associated with the prognosis. Results: 170 elder ARDS patients (age≥65 years) met the Berlin ARDS criteria, among whom 8.8% (15/170), 42.9% (73/170) and 48.2% (82/170) patients had mild, moderate and severe ARDS, respectively. The most common predisposing factor for elder ARDS was pneumonia, which was present in 134 patients (78.8%). 37.6% (64/170) patients were treated with noninvasive mechanical ventilation (NIV), but 43.8% (28/64) cases experienced treatment failure. 76.5% (130/170) patients were treated with invasive mechanical ventilation. All patients 80 years or older were given invasive mechanical ventilation. 51.8% (88/170) cases had complications of non-pulmonary organ failure. 61.8% (105/170) patients deceased during hospital stay. Multivariant logistic analysis showed that the independent risk factors for hospital survival rate in elder patients with ARDS were SOFA score (P=0.030, RR=0.725, 95% CI 0.543-0.969), oxygen index after 24 hours of ARDS diagnosis (P=0.030, RR=0.196, 95% CI 0.045-0.853), accumulated fluid balance within 7 days after diagnosis of ARDS (P=0.026, RR=1.000, 95% CI 1.000-1.000) and shock (P=0.034, RR=0.140, 95% CI 0.023-0.863). Conclusion: Among 20 ICUs, the high mortality rate of elder patients with ARDS was correlated with higher 24 hour SOFA score, lower 24 hour oxygen index after ARDS diagnosis, more positive fluid balance within 7 days and concomitant shock. The conservative fluid strategy within 7 days of ARDS diagnosis may benefit the elder ARDS patients.

The relationship between intestinal flora changes and osteoporosis in rats with inflammatory bowel disease and the improvement effect of probiotics.

OBJECTIVE: The aim of this study was to investigate the relationship between the changes in intestinal flora and the occurrence of osteoporosis in rats with inflammatory bowel disease and the improvement effect of probiotics. MATERIALS AND METHODS: A total of 100 Sprague Dawley (SD) model rats with colitis were selected as research objects. All rats were randomly divided into two groups, including: bowel disease group and osteoporosis group, with 50 rats in each group. Stool samples were collected from all rats, and Lactobacillus, Escherichia coli and Bifidobacteria were cultured and counted. The relationship between the occurrence of related osteoporosis and intestinal flora was analyzed as well. Thereafter, the rats in osteoporosis group were randomly divided into two subgroups, namely, control group (n=25) and observation group (n=25). Observation group was treated with probiotics by gastrogavage, while the control group was treated with the same volume of physiological saline. Next, the changes in serum osteoprotegerin (OPG), osteoprotegerin ligand [receptor activator of nuclear factor-kappa B ligand (RANKL)], procollagen type I carboxy-terminal propeptide (PICP), bone mineral density (BMD), bone alkaline phosphatase (BALP), tartrate-resistant acid phosphatase (TRACP), calcium concentration (Ca), and inflammatory cytokine levels were compared between the two groups after intervention. RESULTS: Osteoporosis group had significantly more Escherichia coli and notably fewer Lactobacillus and Bifidobacteria than bowel disease group (p<0.05). Pearson correlation analysis revealed that the occurrence of osteoporosis in rats with inflammatory bowel disease was negatively correlated with the count of Escherichia coli, whereas was positively related to the counts of Lactobacillus and Bifidobacteria (p<0.05). Moreover, the levels of serum OPG, PICP, TRACP, and Ca in observation group were remarkably higher than those in the control group (p<0.05). However, the levels of serum RANKL, BALP, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and interferon-gamma (INF-γ) were markedly lower than those in the control group (p<0.05). CONCLUSIONS: Osteoporosis in rats with inflammatory bowel disease has a negative association with the count of Escherichia coli, and a positive correlation with the counts of Lactobacillus and Bifidobacteria. In addition, treatment with probiotics can effectively alleviate osteoporosis symptoms in rats with inflammatory bowel disease by influencing the level of corresponding cytokines.

Sustained BMP-2 release and platelet rich fibrin synergistically promote tendon-bone healing after anterior cruciate ligament reconstruction in rat.

OBJECTIVE: Anterior cruciate ligament (ACL) injuries which cause knee disabilities remain a clinical challenge due to the compromised tendon-bone repair. Multiple strategies have been proposed to treat the tendon-bone injuries, and the combination of these therapies hold great potential to achieve synergistic effects. MATERIALS AND METHODS: We built PLGA-BMP-2 (bone morphogenetic protein 2) system and confirmed the sustained release of BMP-2 both in vitro and in vivo. We then applied different therapies to treat rat ACL reconstruction. We collected the tissue sample and analyzed the BMP-2 concentration both in serum and in injured sites. We tested the mRNA expression of genes that were related to inflammation, tissue repair and bone formation in damaged tissues. We also analyzed the protein levels of some genes associated with tendon formation and check the function of newly generated bone through biomechanical test. RESULTS: We found that, compared to monotherapies, simultaneous utilization of sustained BMP-2 release and platelet-rich fibrin (PRF) after anterior cruciate ligament reconstruction showed better therapeutic effects on tendon-bone healing in rat. This combined therapy efficiently enhanced the levels of growth factors that favor the angiogenesis and relieved the inflammatory responses in the injured sites. Of note, the combined therapy efficiently promoted the signals associated with bone formation and tendon regeneration. CONCLUSIONS: We demonstrated that the combined therapy with BMP-2 and PRF achieves synergistic effects on tendon-bone healing and holds great potential for the treatment of ACL reconstruction.

Enhancement of tendon-bone healing after rotator cuff injuries using combined therapy with mesenchymal stem cells and platelet rich plasma.

OBJECTIVE: The injuries of rotator cuff will cause the shoulder dysfunctions. Due to limited self-regeneration abilities of the tendon-bone part, rotator cuff injuries remain a clinical challenge. Previous studies have proposed many strategies for treating this disease. In this work, we aimed to combine different strategies to achieve better beneficial effects on tendon-bone repair. MATERIALS AND METHODS: We isolated mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) and tested the effects of PRP on the gene expression, cell death resistance, and osteogenic differentiation of MSCs. Then, we utilized multiple strategies to treat rotator cuff injuries. We evaluated the expression of genes that related to tissue repair, bone formation, and tendon regeneration. We also tested the biomechanical property of repair tissues. RESULTS: We found that the in-vitro co-culture with PRP endowed MSCs with enhanced production of growth factors, better osteogenic differentiation ability, and stronger ability to resist cell death. Next, we applied MSCs, PRP, and MSCs-PRP combined therapies in rat rotator cuff injury model to compare their therapeutic effects in vivo. Through biomechanical testing, we found that the combined therapy was most efficient to promote tissue regeneration and enhance the biomechanical property of the newly generated bone. CONCLUSIONS: The combined treatment induced strongest signals related to angiogenesis, bone formation, and tendon generation in-situ. We demonstrated that the combination of MSCs and PRP synergistically promotes tendon-bone healing and holds great promise for the treatment of rotator cuff injuries.

[Multi-center empirical study of virtual gastroscopy simulator in the examination of clinical practice skills of specialist physicians].

Objective: To study the role of virtual gastroscopy simulator in the examination of clinical practice skills of gastrointestinal specialists. Methods: A multi-center empirical study was carried out. In June 2018, ninety participants from three tertiary care teaching hospitals in China, including Zhongshan Hospital of Fudan University, Shanghai Tongji Hospital and Xiangya Hospital of Central South University, took part in the examination. Participants were selected as follows: 30 specialists without any experience of gastroscopy exams, 30 with basic knowledge (gastroscopy exams <500 cases) and 30 with good skill (gastroscopy exams ≥500 cases). These 90 students participated in this empirical study after theoretical study and simulator training. Among them, 50 (55.6%) were undergraduates, 25 (27.8%) masters, and 15 (16.7%) doctors; 42 (46.7%) were residents, 39 (43.3%) attending physicians, and 9 (10.0%) deputy chief physicians. The assessment was divided into two parts. The first part was to use the simulator (GI mentor II) for ballooning within 10 minutes, with a total score of 40 points. The second part was a complete gastroscopy exam on the simulator, including preparation before gastroscopy exam, gastroscopy exam, post - exam management and related knowledge quiz. The difficulty and discrimination of the assessment plan were evaluated by the extreme grouping method parameters (difficulty P definition: <0.3 was difficult, 0.3 to 0.7 was medium, ≥0.7 was easy; discrimination degree D definition: <0 was poor, 0 to 0.2 was medium, ≥0.2 was good), and by comparing the virtual gastroscopy assessment scores of different experience, academic, and professional title groups. The score analysis of the student group was expressed using the mastering rate (the average score divided by the total score). The data of the normal distribution was represented by (mean±SD) (range), and the data of the nonnormal distribution was represented by M (P25, P75). Kruskal-Wallis non-parametric test was used for comparison between groups. Results: The total score of 90 students was (82.9±10.9) (55.8 to 99.0), and the mastering rate was 82.9%. The overall difficulty of the first and the second parts were 0.78 and 0.76, respectively, and the difficulty level was easy. The overall discrimination of the first and the second parts were 0.70 and 0.67, respectively, and the discrimination was good. The stratified analysis was performed according to the professional title. The median score was 83.2 (75.5, 89.0) in the residents, 82.5 (71.7, 93.6) in the attending physicians, and 93.5 (88.5, 99.0) in the deputy chief physicians, and the difference was statistically significant (H=6.213, P=0.045). According to the stratification analysis of academic qualifications, the median score was 81.7 (73.0, 87.5) in participants with undergraduate degree, 91.0 (79.0, 95.0) in those with master degree and 88.0 (81.7, 93.5) in those with doctor degree, whose difference was statistically significant (H=9.233, P=0.010). The stratified analysis of the second part showed that the median scores of the "operational process" part of the low, medium and high basis group were 33.0 (30.5, 36.5), 34.0 (32.0, 36.0) and 37.0 (35.0, 37.5), respectively, whose difference was statistically significant (H=7.603, P=0.022). The median scores of the "operational process" section of the resident, attending physician, and deputy chief physician were 33.0 (30.5, 35.0) points, 36.0 (34.0, 37.5) points and 37.0 (37.0, 37.5) points, respectively, whose difference was statistically significant (H=18.563, P=0.001). Conclusions: The virtual gastroscopy simulator can reflect the true level of gastroscopy exam skills of the students. The examination questions are moderately difficult, and there is a good discrimination of the exam.

[Application of MDCT and post-processing in children with tracheal foreign body].

Objective:To explore the clinical value of MDCT and post-processing in children with suspected foreign body in trachea.Method:Two hundred patients with suspected tracheal foreign body were treated with 64-slice spiral CT (MDCT) and simulated endoscopic imaging,then compared with seen in bronchoscopy; Compare the results of MDCT and post-processing with the coincidence of intraoperative findings.Result:One hundred and eighty-four cases of positive children were examined by MDCT postprocessing technique and bronchoscopy,179 cases were obstructed by exogenous foreign body,5 cases were phlegm thrombosis (endogenous foreign body) obstruction; 16 cases of children with no foreign body diagnosed by MDCT post-processing technique were also examined by bronchoscopy. The results showed that there was a foreign body in 1 case,and the foreign body was located in the pharyngeal cleft (watermelon spermoderm),and the remaining 15 cases had no foreign body. MDCT and post-treatment techniques for children with tracheal foreign body diagnosis of 99.4% sensitivity,specificity of 75%.There was no significant difference in the detection rate of foreign body between the two techniques of MDCT and post-processing technique and bronchoscopy (P>0.05). Examed by MDCT and postprocessing,we can understand the specific location and size of foreign body,nature,shape preoperatively.Conclusion:Although MDCT and post-processing techniques can not be used to treat tracheal foreign bodies,but the diagnostic rate of bronchial foreign bodies is comparable to that of bronchoscopy. We could apply MDCT examination and post processing before the bronchoscopy,for foreign body inhalation history is not clear,or suspected airway foreign body. We can improve the level of diagnosis and treatment through guiding the operation of bronchoscopy focus.

[Changes and implications of esophageal function in patients with chronic cough induced by gastroesophageal reflux].

Objective: To explore the changes in the esophageal function and their association with the therapeutic outcome in patients with gastroesophageal reflux-induced chronic cough (GERC). Methods: One hundred thirty-five patients with definite GERC consecutively referred to our respiratory clinic were recruited into the study between January 2012 and August 2015.Cough was due to acid reflux in 81 patients and non-acid reflux in 54 patients, with the favorable response to the standard antireflux therapy in 88 patients and to the intensified antireflux treatment in 47 patients. The control groups included 26 patients with gastroesphageal reflux disease without cough and 22 healthy volunteers. All the subjects underwent an esophageal manometry from which the parameters were recorded, including the pressure, length and relaxation rate of lower esophageal sphincter, and the peristaltic contractive amplitude, wave velocity and contractive time of esophagus. The data were combined with the results of multi-channel intraluminal impedance combined with pH monitoring to analyze the changes of esophageal function in the patients with acid or non-acid GERC and their relation to the outcomes of antireflux therapy. Results: Compared with healthy volunteers, patients with GERC presented with a lower pressure [(11±5) mmHg vs (15±5) mmHg (1 mmHg=0.133 kPa), q=3.70, P=0.000], shorter overall length [(2.2±0.5) cm vs (3.0±1.0) cm, q=2.78, P=0.017] and similar relaxation rate of lower esophageal sphincter(q=1.14, P=0.258). Furthermore, they also showed a decrease in esophageal peristaltic contractive amplitude [(33±13) mmHg vs (45±11) mmHg, q=2.19, P=0.030] and wave velocity [(2.6±0.8) cm/s vs (3.4±0.6) cm/s, q=2.91, P=0.010] but an increase in esophageal contractive time of esophagus [(4.9±2.2) s vs (3.1±0.8) s, q=3.25, P=0.001] in addition to a linear negative correlation between esophageal peristaltic wave velocity and bolus clearance (r=-0.603, P=0.000). However, these parameters were not different between patients with GERC and gastroesophageal reflux disease without cough. The patients with GERC due to acid and non-acid reflux presented with a similar esophageal dysmotility but different variables reflecting the acidity of refluxates as indicated by multi-channel intraluminal impedance combined with pH monitoring. The esophageal peristaltic wave velocity was significantly lower in the patients with GERC responsive to the standard antireflux therapy than in those responsive to the intensified antireflux therapy [(2.2±0.6) cm/s vs (3.0±1.0) cm/s, t= 2.066, P= 0.041]. Conclusions: Esophageal dysfunction is present in patients with GERC. Its characteristics and severity are not associated with the types of gastroesophageal reflux inducing cough, but may predict the efficacy of medical antireflux therapy.

SERS detection of R6G based on a novel graphene oxide/silver nanoparticles/silicon pyramid arrays structure.

We present a novel surface-enhanced Raman scattering (SERS) substrate based on graphene oxide/silver nanoparticles/silicon pyramid arrays structure (GO/Ag/PSi). The SERS behaviors are discussed and compared by the detection of R6G. Based on the contrast experiments with PSi, GO/PSi, Ag/PSi and GO/AgA/PSi as SERS substrate, the perfect bio-compatibility, good homogeneity and chemical stability were confirmed. We also calculated the electric field distributions using Finite-difference time-domain (FDTD) analysis to further understand the GO/Ag/PSi structure as a perfect SERS platform. These experimental and theoretical results imply that the GO/Ag/PSi with regular pyramids array is expected to be an effective substrate for label-free sensitive SERS detections in areas of medicine, food safety and biotechnology.

Efficient removal of Cr(VI) from wastewater under sunlight by Fe(II)-doped TiO2 spherical shell.

Fe(II)-doped TiO2 spherical shell catalyst was synthesized by one-pot hydrothermal method. The photocatalytic removal of Cr(VI) from plating wastewater under sunlight of the catalyst was demonstrated. It was found that the removal effectiveness of about 99.99% for initial Cr(VI) concentration of 102.3 ppm and 99.01% for 153.4 ppm under 3h sunlight irradiation is realized. The Fe(II) ions serve not only as reducing agents for reducing the Cr(VI) to Cr(III) but also as an intermedium of a two-step reduction, in which the TiO2 photoreduces the Fe(II) ions to Fe atoms firstly, and then the Fe atoms reduce the Cr(VI) to Cr(III). The improved photocatalytic activity of the catalyst is considered due to the synergistic effect of a multi reducing process by Fe(II) doping. The extended optical response and effectively utilization of sunlight of the special spherical-shell-like morphology also contribute to the enhanced photocatalytic activity.

Primary structure similarity analysis of proteins sequences by a new graphical representation.

A new graphical description of the primary structure of protein sequences is introduced. First, a three-dimensional space discrete point set of a protein sequence is created based on the three main physicochemical properties of the amino acids. Secondly, a continuous cubic B-spline curve interpolating the amino acid points is constructed to represent the shape of the protein sequence. Then the geometric properties (curvature and torsion) of the continuous curve are extracted for the purpose of analyzing the similarity between protein sequences. Finally, an improved Canberra distance comparison is introduced for the similarity analysis of protein sequences with different lengths. Experimental results show that our method is effective for the similarity comparison of protein sequences.

Sapphire-based graphene saturable absorber for long-time working femtosecond lasers.

We report a long-time working femtosecond laser using metal-free sapphire-based graphene as a saturable absorber (SA). The sapphire-based graphene yielded excellent nonlinear saturable absorption properties and was demonstrated to be suitable as an SA for an ultrafast solid-state laser. Stable mode-locked pulses of 325 fs were obtained at a central wavelength of 1032 nm with a repetition rate of 66.3 MHz. At pump power of 8.23 W the average output power was 1.78 W and the highest pulse energy reached 26.8 nJ with a peak power of 72.6 kW. Our work opens up a facile route for making reliable graphene SA in the mode-locking technique and also displays an exciting prospect in making low-cost and ultrafast lasers.

The treatment of severe and multiple injuries in intensive care unit: report of 80 cases.

OBJECTIVE: To summarize our case load in managing severe and multiple injuries (SMI) in the Intensive Care Unit (ICU). PATIENTS AND METHODS: The clinical data of 80 SMI patients treated in our ICU from January 2009 to June 2013 were analyzed. RESULTS: Results of these 80 SMI patients, 60 (75%) were salvaged and 15 (18.75%) died. The causes of death included severe head injury (n=7), severe chest injury (n=3), destruction of injured abdominal organs (n=2), and multiple organ dysfunction syndrome (n=3). Five patients (7.50%) gave up treatment and were discharged upon their own requests. Early application of continuous renal replacement therapy (CRRT) and enteral nutrition (EN) improved outcomes. CONCLUSIONS: The key interventions during the ICU treatment of SMI include: adequate analgesia and appropriate sedation; timely management of hypoxemia; reasonable fluid resuscitation and CRRT.

Epithelial-mesenchymal transition markers expressed in circulating tumor cells in hepatocellular carcinoma patients with different stages of disease.

The presence of circulating tumor cells (CTCs) in peripheral blood is associated with metastasis and prognosis in hepatocellular carcinoma (HCC) patients. The epithelial-mesenchymal transition (EMT) has a pivotal role in tumor invasion and dissemination. To identify more sensitive biomarkers for evaluating metastasis and prognosis, we investigated the expression of EMT markers, including vimentin, twist, ZEB1, ZEB2, snail, slug and E-cadherin in CTCs, primary HCC tumors and adjacent non-tumoral liver tissues. After isolating viable CTCs from the peripheral blood of HCC patients using asialoglycoprotein receptors (ASGPRs), the CTCs were identified with immunofluorescence staining. CTCs were detected in the peripheral blood obtained from 46 of 60 (76.7%) HCC patients. Triple-immunofluorescence staining showed that twist and vimentin expression could be detected in CTCs obtained from 39 (84.8%) and 37 (80.4%) of the 46 patients, respectively. The expression of both twist and vimentin in CTCs was significantly correlated with portal vein tumor thrombus. Coexpression of twist and vimentin in CTCs could be detected in 32 (69.6%) of the 46 patients and was highly correlated with portal vein tumor thrombus, TNM classification and tumor size. Quantitative fluorescence western blot analysis revealed that the expression levels of E-cadherin, vimentin and twist in HCC tumors were significantly associated with the positivity of isolated CTCs (P=0.013, P=0.012, P=0.009, respectively). However, there was no significant difference in ZEB1, ZEB2, snail and slug expression levels in CTCs, primary HCC tumors and adjacent non-tumoral liver tissues across samples with regard to the clinicopathological parameters. Our results demonstrate that the EMT has a role in promoting the blood-borne dissemination of primary HCC cells, and the twist and vimentin expression levels in CTCs could serve as promising biomarkers for evaluating metastasis and prognosis in HCC patients.

Study of lipids, insulin metabolism, and paraoxonase-2-311 polymorphism in patients with different subtypes of Alzheimer's disease (translated version).

OBJECTIVE: To investigate the characteristics of blood lipids, insulin metabolism, and paraoxonase-2-311 (PON2-311) polymorphism among patients with Alzheimer's disease with different types of dementia. METHODS: A total of 84 patients with Alzheimer's disease, according to the National Institute of Neurological and Communicative Disorders and Stroke, and the Alzheimer's disease and Related Disorders Association clinical criteria for 'possible Alzheimer's disease', and with no family history of the condition, were enrolled. They were then categorised into 3 groups (senile dementia, presenile dementia, and mixed dementia) according to the diagnostic criteria of the Chinese Classification of Mental Disorders, third edition. Polymerase chain reaction-restriction fragment length polymorphism analysis was used to determine the presence of PON2-311 polymorphism. Serum cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, and fasting blood sugar were measured. Fasting plasma insulin was measured using chemiluminescence. The basal-state method was used to assess insulin resistance expressed as insulin sensitivity index. The cognitive rating scale of the Mini-Mental State Examination, Activities of Daily Living scale, and Hachinski Ischemic Scale were used to establish the clinical features and severity of cognitive impairment. Differences in PON2-311C/S polymorphism, serum insulin, blood glucose, blood lipids, and neuropsychological score were analysed. RESULTS: The serum triglyceride and cholesterol levels of the presenile dementia group were significantly higher than those of the senile and mixed dementia groups (p < 0.01). The high-density lipoprotein level of the senile dementia group was significantly higher than that of the mixed dementia group (p < 0.05). The serum insulin level of the presenile dementia group was significantly higher than that of the senile (p < 0.05) and mixed dementia groups (p < 0.01). There were no significant differences in distribution of the PON2-311 genotypes C/C, C/S, and S/S between the senile and mixed dementia groups, and no significant differences in C-allele and S-allele frequency between the 2 groups. CONCLUSIONS: The differences in serum triglycerides, cholesterol, high-density lipoprotein, and insulin levels between Alzheimer patients with senile, presenile, and mixed dementia found in this study suggest that patients with presenile dementia should monitor their lipid and insulin metabolism. No significant differences were found for PON2-311 genotypes or allele frequencies in patients with dementia due to Alzheimer's disease.

Facile synthesis of graphene on dielectric surfaces using a two-temperature reactor CVD system.

Direct deposition of graphene on a dielectric substrate is demonstrated using a chemical vapor deposition system with a two-temperature reactor. The two-temperature reactor is utilized to offer sufficient, well-proportioned floating Cu atoms and to provide a temperature gradient for facile synthesis of graphene on dielectric surfaces. The evaporated Cu atoms catalyze the reaction in the presented method. C atoms and Cu atoms respectively act as the nuclei for forming graphene film in the low-temperature zone and the zones close to the high-temperature zones. A uniform and high-quality graphene film is formed in an atmosphere of sufficient and well-proportioned floating Cu atoms. Raman spectroscopy, scanning electron microscopy and atomic force microscopy confirm the presence of uniform and high-quality graphene.

Ag-decorated TiO2 nanograss for 3D SERS-active substrate with visible light self-cleaning and reactivation.

The production of SERS-active substrates which are uniform, sensitive, reproducibile and durable still remains an important issue. Here, we report a strategy for the fabrication of a large-area Ag-decorated TiO2 nanograss SERS-active substrate by a simple solvothermal approach combined with Ag evaporation. The nanograss consists of dense rutile TiO2 nanorods of about 5 nm in diameter and the decorated Ag nanoparticles are an average of 8 nm in diameter. The Ag protrusions and gaps between them contribute to three dimensional SERS "hot spots" which can be modulated by simply controlling the Ag evaporating parameters. The Ag-decorated TiO2 substrate is highly efficient in detecting rhodamine 6G (R6G) and 4-aminothiophenol (4-ATP) molecules and has good homogeneity. An obvious red shift and even high enhancement of b2 vibration mode were observed in detecting 4-ATP due to the effective charge transfer from the Ag atoms to sulfur atoms. The Ag-decorated TiO2 substrate can be easily self-cleaned and reactivated by visible light irradiation without obvious degeneration of SERS signals. Our results demonstrate that the Ag-decorated TiO2 substrate with high and homogeneous SERS activity has potential feasibility as a sensitive SERS probe.

Molecular cloning of a new wheat calreticulin gene TaCRT1 and expression analysis in plant defense responses and abiotic stress resistance.

Calreticulin proteins play essential roles in regulating various metabolic processes and in molecular signal transduction in animals and plants. Using homologous PCR, we screened a cDNA library of the wheat resistance gene Yr5 from a near-isogenic line in the susceptible common wheat variety Taichung 29, which was inoculated with an incompatible race CYR32 of Puccinia striiformis. We isolated a novel full-length cDNA encoding calreticulin protein, which we named TaCRT1. Sequence analyses indicated that TaCRT1 contains an open reading frame of 1287 bp in length; it was deduced to encode 428 amino acids. Clustering analysis showed that TaCRT1 belongs to group III of the calreticulin protein family. Semi-quantitative RT-PCR was used to analyze expression profiles of the isolated gene under biotic and abiotic stresses. Expression of TaCRT1 was suppressed by exogenous application of phytohormones, such as abscisic acid and methyl jasmonate, and by dehydration; but it was induced by CYR32 infection and cold treatment. Based on the expression patterns, we propose that TaCRT1 participates in regulatory processes involved in defense responses and stress resistance in wheat.

Recyclable magnetic photocatalysts of Fe2+/TiO2 hierarchical architecture with effective removal of Cr(VI) under UV light from water.

We report the synthesis and photocatalytic removal of Cr(VI) from water of hierarchical micro/nanostructured Fe(2+)/TiO(2) tubes. The TiO(2) tubes fabricated by a facile solvothermal approach show a three-level hierarchical architecture assembled from dense nanosheets nearly vertically standing on the surface of TiO(2) microtube. The nanosheets with a thickness of about 20 nm are composed of numerous TiO(2) nanocrystals with size in the range of 15-20 nm. Ferrous ions are doped into the hierarchical architecture by a reduction route. The Fe(2+)/TiO(2) catalyst demonstrates an effective removal of Cr(VI) from water under UV light and the removal effectiveness reaches 99.3% at the initial Cr(VI) concentration of 10 mg L(-1). The ferrous ion in the catalyst serves not as the photo-electron trap but as an intermedium of a two-step reduction. The TiO(2) photoreduces the Fe(2+) ions to Fe atoms firstly, then the Fe atoms reduce the Cr(VI) to Cr(III), and the later is removed by adsorption. The hierarchical architecture of the catalyst serves as a reactor for the photocatalytic reaction of Cr(VI) ions and an effective absorbent for the removal of Cr(III) ions. The catalyst can be easily magnetically separated from the wastewater after photocatalytic reaction and recycled after acid treatment.

The association of metabolic syndrome with reflux esophagitis: a case-control study.

BACKGROUND: Obesity has been associated with reflux esophagitis. However, the association of metabolic syndrome with reflux esophagitis remains unknown. METHODS: A case-control study of 372 subjects undergoing upper endoscopy during health checkups was conducted (182 patients with reflux esophagitis vs 190 age and gender-matched controls). We further measured their height, weight, waist circumference, hip circumference, blood pressure, triglyceride, high-density lipoprotein, and fasting blood glucose. Multivariable linear regression analysis was used to identify the independent risk factors associated with the presence of reflux esophagitis. KEY RESULTS: Reflux esophagitis cases showed higher mean waist circumference (81.37 ± 0.68 vs 79.36 ± 0.70, P < 0.05), waist hip ratio (0.86 ± 0.01 vs 0.84 ± 0.01, P < 0.05) and fasting blood glucose (5.59 ± 0.10 vs 5.32 ± 0.08, P < 0.05) than those in controls. When adjusted for gender and age, multivariate analysis demonstrated that there was a positive dose-response relationship between reflux esophagitis and waist hip ratio (men: OR 3.41, 95% CI 1.52-7.62, women: OR 3.37, 95% CI 1.61-7.06), triglyceride (OR 2.07, 95% CI 1.12-3.82), fasting blood glucose (OR 1.81, 95% CI 1.12-2.94), and metabolic syndrome (OR 2.01, 95% CI 1.15-3.50), there was an inverse dose-response relationship between reflux esophagitis and high-density lipoprotein for men (OR 0.36, 95% CI 0.15-0.85). CONCLUSIONS & INFERENCES: High waist hip ratio, triglyceride, fasting blood glucose, and metabolic syndrome were associated with increased risk factors for reflux esophagitis while high high-density lipoprotein for men correlated with a reduced risk of reflux esophagitis.