Stop Ischemic Event to the Brain: Screening Risk Factors of Cerebrovascular Stenosis in Coronary Artery Disease Patients.

OBJECTIVES: In this study, we investigated the difference in risk factors between the 2 diseases, aiming to further clarify who needs to do ischemic cerebrovascular disease (ICVD)-related screening among coronary artery disease (CAD) patients. METHODS: Clinical data of 326 patients with first-episode CAD from June 1, 2017, to July 31, 2020, in the Chinese PLA General Hospital were retrospectively reviewed. Outcomes, including clinical features and laboratory examination, were taken. Features related to ICVD including the extension of intracranial arterial (internal carotid artery intracranial segment, middle cerebral artery M1 segment, anterior cerebral A1 segment, vertebrobasilar artery intracranial segment, posterior cerebral artery P1 segment) and carotid arterial (internal carotid artery extracranial segment, common carotid artery, subclavian artery) stenosis were detected. Risk factors for the occurrence of ICVD in patients with CAD were analyzed. RESULTS: Among patients with the onset of CAD, in comparison of the nonstenosis and stenosis of intracranial artery subgroups, there were statistical differences in the onset age, hypertension, and duration of hypertension as well as the biochemical indicators, including high-density lipoprotein and glycosylated hemoglobin. In addition, statistical differences were detected in the onset age as well as the biochemical indicators, including glycosylated hemoglobin and blood glucose serum protein, along with the difference in the degree of cardiovascular stenosis. CONCLUSIONS: The onset age of CAD was shown to serve as a vital risk factor for ICVD. The primary prevention of ICVD in patients with CAD should lay more emphasis on the management of hypertension and diabetes.

Effect of access to the integrated treatment model for patients with multiple severe injuries in the Chinese population.

AIMS: The aim of this study was to enhance the effectiveness of an integrated treatment model for patients with severe multiple injuries in China. METHODS: In this study, we conducted a retrospective analysis of data from 110 patients with multiple severe injuries. These patients were divided into two groups based on the treatment model they received. The first group, called the MDTM group, received the integrated treatment model, which involved a multidisciplinary team-based approach. The second group, designated the TSM group, received the traditional specialist-based treatment model. The primary outcome measure was the survival rate of patients after treatment. Secondary outcomes included the time spent on hospital emergency treatment, the length of hospital stay, the mortality rate, and family satisfaction. RESULTS: The survival rate of patients after treatment in the MDTM group (83.93%) was significantly greater than that in the TSM group (70.37%). Consequently, the mortality of patients after treatment in the MDTM group (16.07%) was significantly lower than that in the TSM group (29.63%). Furthermore, the MDTM group demonstrated significantly shorter durations of rescue efforts and shorter hospital stays. Additionally, family satisfaction was significantly greater in the MDTM group. CONCLUSION: The integrated treatment model shows potential for optimizing outcomes for patients with multiple severe injuries and generating higher levels of family satisfaction. This model holds practical applicability in the context of China and may help alleviate the strained relationship between physicians and patients.

[Pulse pressure loss after extracorporeal cardiopulmonary resuscitation is an independent predictor of ECMO weaning failure].

OBJECTIVE: To analyze the predictors of successful weaning off extracorporeal membrane oxygenation (ECMO) after extracorporeal cardiopulmonary resuscitation (ECPR). METHODS: The clinical data of 56 patients with cardiac arrest who underwent ECPR in Hunan Provincial People's Hospital (the First Affiliated Hospital of Hunan Normal University) from July 2018 to September 2022 were retrospectively analyzed. According to whether ECMO was successfully weaning off, patients were divided into the successful weaning off group and the failed weaning off group. The basic data, duration of conventional cardiopulmonary resuscitation (CCPR, the time from cardiopulmonary resuscitation to ECMO), duration of ECMO, pulse pressure loss, complications, and the use of distal perfusion tube and intra-aortic balloon pump (IABP) were compared between the two groups. Univariate and multivariate Logistic regression analyses were performed to identify the risk factors for weaning failure of ECMO. RESULTS: Twenty-three patients (41.07%) were successfully weaned from ECMO. Compared with the successful weaning off group, patients in the failed weaning off group were older (years old: 46.7±15.6 vs. 37.8±16.8, P < 0.05), higher incidence of pulse pressure loss and ECMO complications [81.8% (27/33) vs. 21.7% (5/23), 84.8% (28/33) vs. 39.1% (9/23), both P < 0.01], and longer CCPR time (minutes: 72.3±19.5 vs. 54.4±24.6, P < 0.01), shorter duration of ECMO support (hours: 87.3±81.1 vs. 147.7±50.8, P < 0.01), and worse improvement in arterial blood pH and lactic acid (Lac) levels after ECPR support [pH: 7.1±0.1 vs. 7.3±0.1, Lac (mmol/L): 12.6±2.4 vs. 8.9±2.1, both P < 0.01]. There were no significant differences in the utilization rate of distal perfusion tube and IABP between the two groups. Univariate Logistic regression analysis showed that the factors affecting the weaning off ECMO of ECPR patients were pulse pressure loss, ECMO complications, arterial blood pH and Lac after installation [pulse pressure loss: odds ratio (OR) = 3.37, 95% confidence interval (95%CI) was 1.39-8.17, P = 0.007; ECMO complications: OR = 2.88, 95%CI was 1.11-7.45, P = 0.030; pH after installation: OR = 0.01, 95%CI was 0.00-0.16, P = 0.002; Lac after installation: OR = 1.21, 95%CI was 1.06-1.37, P = 0.003]. After adjusting for the effects of age, gender, ECMO complications, arterial blood pH and Lac after installation, and CCPR time, showed that pulse pressure loss was an independent predictor of weaning failure in ECPR patients (OR = 1.27, 95%CI was 1.01-1.61, P = 0.049). CONCLUSIONS: Early loss of pulse pressure after ECPR is an independent predictor of failed weaning off ECMO in ECPR patients. Strengthening hemodynamic monitoring and management after ECPR is very important for the successful weaning off ECMO in ECPR.

Co-production of spirosiloxane and biochar adsorbent from wheat straw by a low-cost and environment-friendly method.

To enhance the value of wheat straw derivatives, wheat straw ash (WSA) was used as a reactant for the first time to synthesize spirocyclic alkoxysilane, an important organosilicon raw material, using an energy-saving and environmentally friendly non-carbon thermal reduction method. After spirocyclic alkoxysilane extraction, the biochar in the wheat straw ash prepared an adsorbent for Cu2+. The maximum copper ion adsorption capacity (Qm) of silica-depleted wheat straw ash (SDWSA) was 31.431nullmg/g, far exceeding those of WSA and similar biomass adsorbents. The effects of the pH, adsorbent dose, and contact time on the adsorption behaviour of the SDWSA for Cu2+ adsorption were systematically investigated. The adsorption mechanism of Cu2+ by the SDWSA was investigated using the Langmuir, Freundlich, pseudo-first-order kinetic, pseudo-second-order kinetic, and Weber and Morris models by combining the preliminary experimental data and characterization results. The adsorption isotherm and Langmuir equation matched perfectly. The Weber and Morris model can describe the mass-transfer mechanism of Cu2+ adsorption by SDWSA. Both film and intraparticle diffusion are rapid control steps. Compared to WSA, SDWSA has a larger specific surface area and a higher content of oxygen-containing functional groups. A large specific surface area provides more adsorption sites. Oxygen-containing functional groups react with Cu2+ through electrostatic interactions, surface complexation, and ion exchange, which are the possible adsorption mechanisms for SDWSA. These methods improve the added value of wheat straw derivatives and promote wheat straw ash recovery and centralized treatment. This makes it possible to use the thermal energy of wheat straw and facilitates the treatment of exhaust gases and carbon capture.

Daily point-of-care ultrasound-assessment of central venous catheter-related thrombosis in critically ill patients: a prospective multicenter study.

PURPOSE: Central venous catheter (CVC)-related thrombosis (CRT) is a known complication in critically ill patients. However, its clinical significance remains unclear. The objective of the study was to evaluate the occurrence and evolution of CRT from CVC insertion to removal. METHODS: A prospective multicenter study was conducted in 28 intensive care units (ICUs). Duplex ultrasound was performed daily from CVC insertion until at least 3 days after CVC removal or before patient discharge from the ICU to detect CRT and to follow its progression. CRT diameter and length were measured and diameter > 7 mm was considered extensive. RESULTS: The study included 1262 patients. The incidence of CRT was 16.9% (95% confidence interval 14.8-18.9%). CRT was most commonly found in the internal jugular vein. The median time from CVC insertion to CRT onset was 4 (2-7) days, and 12% of CRTs occurred on the first day and 82% within 7 days of CVC insertion. CRT diameters > 5 mm and > 7 mm were found in 48% and 30% of thromboses. Over a 7-day follow-up, CRT diameter remained stable when the CVC was in place, whereas it gradually decreased after CVC removal. The ICU length of stay was longer in patients with CRT than in those without CRT, and the mortality was not different. CONCLUSION: CRT is a frequent complication. It can occur as soon as the CVC is placed and mostly during the first week following catheterization. Half of the thromboses are small but one-third are extensive. They are often non-progressive and may be resolved after CVC removal.

A Comparative Study of the Etiology of Intracranial Vertebral Artery Dissection and Carotid Artery Dissection.

BACKGROUND: Both extrinsic (trauma or violent movement) and intrinsic (structural abnormality, atherosclerosis, or hemodynamic instability) factors may result in arterial dissection. The role of these factors in the origin or progression of dissection remains unclear. This study aimed to characterize the clinical features, radiologic features, and outcomes of intracranial vertebral artery dissection compared with carotid artery dissection and to determine the major causative factors. METHODS: Consecutive patients with craniocervical dissection (n=127) were retrospectively analyzed. Patients with intracranial vertebral artery dissection (n=77) and those with carotid artery dissection (n=35) were compared with respect to patient age, sex, cerebrovascular risk factors, laboratory indices, and radiologic features. RESULTS: Intracranial vertebral artery dissection was the most common craniocervical arterial dissection in our cohort (n=77, 60.6%). Body mass index in the intracranial vertebral artery dissection group was significantly greater than that in carotid artery dissection group. Clinical manifestations of intracranial vertebral artery dissection included ischemic stroke (37.7%), dizziness or vertigo (39.0%), and headache or neck pain (44.2%). Two patients had a definite history of trauma. The frontal and lateral tortuosity ratios of the vertebral basilar artery were significantly greater while the vertex angle was smaller in the intracranial vertebral artery dissection group compared with carotid artery dissection group. A positive correlation between the tortuosity ratios and subarachnoid hemorrhage and a significant inverse correlation between the tortuosity ratios and lipid parameters (high-density lipoprotein; apolipoprotein A1) were identified. CONCLUSIONS: Intrinsic causes may play a more important role in the development of intracranial vertebral artery dissection than carotid artery dissection.

Molecular mechanism analysis of m6A modification-related lncRNA-miRNA-mRNA network in regulating autophagy in acute pancreatitis.

This study aims to explore the molecular mechanism of N6-methyladenosine (m6A) modification-related long noncoding RNA (lncRNA)-microRNA (miRNA)-messenger RNA (mRNA) network in regulating autophagy and affecting the occurrence and development of acute pancreatitis (AP). RNA-seq datasets related to AP were obtained from Gene Expression Omnibus (GEO) database and merged after batch effect removal. lncRNAs significantly related to m6A in AP, namely candidate lncRNA, were screened by correlation analysis and differential expression analysis. In addition, candidate autophagy genes were screened through the multiple databases. Furthermore, the key pathways for autophagy to play a role in AP were determined by functional enrichment analysis. Finally, we predicted the miRNAs binding to genes and lncRNAs through TargetScan, miRDB and DIANA TOOLS databases and constructed two types of lncRNA-miRNA-mRNA regulatory networks mediated by upregulated and downregulated lncRNAs in AP. Nine lncRNAs related to m6A were differentially expressed in AP, and 21 candidate autophagy genes were obtained. Phosphoinositide 3-kinase (PI3K)-Akt signaling pathway and Forkhead box O (FoxO) signaling pathway might be the key pathways for autophagy to play a role in AP. Finally, we constructed a lncRNA-miRNA-mRNA regulatory network. An upregulated lncRNA competitively binds to 13 miRNAs to regulate 6 autophagy genes, and a lncRNA-miRNA-mRNA regulatory network in which 2 downregulated lncRNAs competitively bind to 7 miRNAs to regulate 2 autophagy genes. m6A modification-related lncRNA Pvt1, lncRNA Meg3 and lncRNA AW112010 may mediate the lncRNA-miRNA-mRNA network, thereby regulating autophagy to affect the development of AP.

The Pharmacokinetics/Pharmacodynamics and Neurotoxicity of Tigecycline Intraventricular Injection for the Treatment of Extensively Drug-Resistant Acinetobacter baumannii Intracranial Infection.

Objective: This study aimed to provide feasible suggestions for intraventricular injection of tigecycline to treat intractable Acinetobacter baumannii intracranial infections by studying its pharmacokinetics/pharmacodynamics and neurotoxicity. Methods: A simple and reliable two-dimensional high-performance liquid chromatography (2D-HPLC) method was used to determine tigecycline concentration. The pharmacokinetics (PK) of tigecycline in cerebrospinal fluid (CSF) was investigated by performing therapeutic drug monitoring (TDM). The pharmacodynamics (PD) of tigecycline was evaluated by its minimum inhibitory concentration (MIC) against XDR A. baumannii. CCK8 assay was used to evaluate the cytotoxicity of different concentrations of tigecycline effect on PC12 cells, and apoptosis assay was analyzed by flow cytometry. Results: Tigecycline retention time in 2D-HPLC was 7.636 min. The lower limit of quantitation (LLOQ) was 0.1mg/L, which met the requirements of concentration determination for TDM. The MIC50 and MIC90 values of tigecycline for A. baumannii were 2 and 4 mg/L, respectively. After a dose of 5mg tigecycline, Cmax in CSF was 37.894 mg/L which was high above the MIC values. The t 1/2 of tigecycline was estimated to be 2.73 hours. Tigecycline significantly decreased cell viability as assessed and induced apoptosis of the PC12 cell. The IC50 value of PC12 cells treated with tigecycline was about 51.35 mg/L. Conclusion: Intraventricular injection of tigecycline is a promising method for treating XDR A. baumannii intracranial infection. Since a high concentration of tigecycline in CSF may have potential neurotoxicity, and the t 1/2 was short, giving small doses of less than 5 mg at least twice a day may be safer and more effective. Intraventricular injection of tigecycline must be selected cautiously and best carried out under TDM.

Biodiversity promotes ecosystem functioning despite environmental change.

Three decades of research have demonstrated that biodiversity can promote the functioning of ecosystems. Yet, it is unclear whether the positive effects of biodiversity on ecosystem functioning will persist under various types of global environmental change drivers. We conducted a meta-analysis of 46 factorial experiments manipulating both species richness and the environment to test how global change drivers (i.e. warming, drought, nutrient addition or CO2 enrichment) modulated the effect of biodiversity on multiple ecosystem functions across three taxonomic groups (microbes, phytoplankton and plants). We found that biodiversity increased ecosystem functioning in both ambient and manipulated environments, but often not to the same degree. In particular, biodiversity effects on ecosystem functioning were larger in stressful environments induced by global change drivers, indicating that high-diversity communities were more resistant to environmental change. Using a subset of studies, we also found that the positive effects of biodiversity were mainly driven by interspecific complementarity and that these effects increased over time in both ambient and manipulated environments. Our findings support biodiversity conservation as a key strategy for sustainable ecosystem management in the face of global environmental change.

Bmal1 Regulates the Redox Rhythm of HSPB1, and Homooxidized HSPB1 Attenuates the Oxidative Stress Injury of Cardiomyocytes.

Oxidative stress is the main cause of acute myocardial infarction (AMI), which is related to the disorder of the regulation of Bmal1 on the redox state. HSPB1 form homologous-oxidized HSPB1 (homooxidized HSPB1) to resist oxidative damage via S-thiolated modification. However, it is still unclarified whether there is an interaction between the circadian clock and HSPB1 in myocardial injury. A total of 118 AMI patients admitted and treated in our hospital from Sep. 2019 to Sep. 2020 were selected to detect the plasma HSPB1 expression and the redox state. We divided the AMI patients into three subgroups: morning-onset AMI (5 : 00 am to 8 : 00 am; Am-subgroup, n = 38), noon-onset AMI (12 : 00 pm to 15 : 00; Pm-subgroup, n = 45), and night-onset AMI (20 : 00 pm to 23 : 00 pm; Eve-subgroup, n = 35) according to the circadian rhythm of onset. The Am-subgroup had remarkably higher cardiac troponin I (cTnI), creatine kinase MB (CK-MB), and B-type natriuretic peptide (BNP) but lower left ventricular ejection fraction (LVEF) than the Pm-subgroup and Eve-subgroup. Patients complicated with cardiogenic shock were significantly higher in the Am-subgroup than in the other two groups. The homooxidized HSPB1 in plasma markedly decreased in the Am-subgroup. The HSPB1C141S mutant accelerated H9c2 cell apoptosis, increased reactive oxygen species (ROS), and decreased reduced-glutathione (GSH) and the ratio of reduced-GSH and GSSG during oxidative stress. Importantly, we found that the redox state of HSPB1 was consistent with the oscillatory rhythm of Bmal1 expression in normal C57B/L mice. The circadian rhythm disorder contributed to decrease Bmal1 and homooxidized HSPB1 in cardiomyocytes of C57BL/6 mice. In addition, Bmal1 and homooxidized HSPB1 decreased in neonatal rat cardiomyocytes exposed to H2O2. Knockdown of Bmal1 led to significant attenuation in homooxidized HSPB1 expression, whereas overexpression of Bmal1 increased homooxidized HSPB1 expression in response to H2O2. Our findings indicated that the homooxidized HSPB1 reduced probably the AMI patients' risk of shock and target organ damage, which was associated with Bmal1 regulating the redox state of HSPB1.

[Quality Control Test of Transcranial MRI-guided Focused Ultrasound Treatment System before Surgery].

OBJECTIVE: To investigate the pre-treatment preventive maintenance and quality control procedure of MRI system and transcranial MRI-guided focused ultrasound (TcMRgFUS) treatment system by monitoring quality control of these two systems. METHODS: The general performance index and image quality control index of MRI system, as well as the quality assurance program of TcMRgFUS EXABLATE 4000 system were tested and recorded. RESULTS: The general performance index and image quality control index of MRI system met requirements. CONCLUSIONS: Through system detection, the system performance could be monitored, ensuring the accuracy and safety of surgery.

Development of unenhanced CT-based imaging signature for BAP1 mutation status prediction in malignant pleural mesothelioma: Consideration of 2D and 3D segmentation.

OBJECTIVES: We aimed to explore the feasibility of 2D and 3D radiomics signature based on the unenhanced computed tomography (CT) images to predict BRCA1-associated protein 1 (BAP1) gene mutation status for malignant pleural mesothelioma (MPM) patients. MATERIALS AND METHODS: 74 patients with MPM were retrospectively enrolled (22 mutant BAP1, 52 wild-type BAP1 demonstrated by Sanger sequencing). The radiomic features were extracted respectively from the 2D and 3D segmentation of unenhanced pre-treatment CT images, and the dataset was randomly divided into training (n = 51) and test (n = 23) sets for radiomics model development and internal validation. The synthetic minority over-sampling technique (SMOTE) was used for data balancing in the training set. 2D or 3D features were sequentially selected by ICC > 0.8, correlation analysis (cut-value 0.7), univariate analysis or univariate logistic regression (LR), which were involved into multivariate LR for LR model construction. Following the comparison of the 2D and 3D models by the ROC analysis and Delong test for AUC, the calibration and clinical utility of 2D and 3D models were evaluated. RESULTS: 3D radiomic features showed better ICCs compared with 2D in both intra- (P < 0.001) and inter-observer (P < 0.001) analysis. 3D radiomic model based on selected features developed from a balanced training dataset presented a favorable predictive performance with AUC of 0.786 and 0.768 in the training and test sets, respectively. The predictive performance of 3D model was superior to 2D model (1 feature) both in the training (AUC 0.786 vs. 0.683, P = 0.036) and the test (AUC 0.768 vs.0.652, P = 0.441) set. The calibration curve and decision curves also indicate a better BAP1 prediction performance and clinical benefit for 3D model than that of 2D model. CONCLUSION: The developed unenhanced CT-based 3D radiomics signature is potential as a noninvasive marker for predicting BAP1 mutation status.

Investigating Optimal Echo Times for Quantitative Susceptibility Mapping of Basal Ganglia Nuclei in the Healthy Brain.

BACKGROUND: Quantitative susceptibility mapping (QSM) technique had been used to measure the magnetic susceptibility of brain tissue in clinical practice. However, QSM presented echo-time (TE) dependence, and an appropriate number of echo-times (nTEs) for QSM became more important to obtain the reliable susceptibility value. OBJECTIVE: The aim of the study was to explore the optimal nTEs for quantitative susceptibility mapping (QSM) measurements of basal ganglia nuclei in the healthy brain. METHODS: 3D multi-echo enhanced gradient recalled echo T2 star weighted angiography (ESWAN) sequence was acquired on a 3.0T MR scanner for QSM analysis. Regions of interests (ROIs) were drawn along the margin of the head of the caudate nucleus (HCN), putamen (Pu) and globus pallidus (GP). The mean susceptibility value and standard deviation of the ROIs were derived from the pixels within each region. RESULTS: CV analysis demonstrated that TE6, TE8 and TE14 ESWAN sequences presented consistent lower CV value (< 1) for QSM measure of HCN, Pu and GP. ANOVA identified that susceptibility value showed no significant difference between TE6 and TE8 in HCN, Pu and GP (P > 0.05). ICC analysis demonstrated that the susceptibility value of TE6-TE8 had the highest ICC value as compared with TE6-TE14 and TE8-TE14 in HCN, Pu and GP. Combined with the timeefficiency of MRI scanning, TE6 sequence could not only provide the reliable QSM measurement but also short imaging time. CONCLUSION: The current study identified that the optimal nTEs of ESWAN were 6 TEs (2.9ms ~ 80.9ms) for QSM measurement of basal ganglia nuclei in the healthy brain.

Functional changes of the lateral pterygoid muscle in patients with temporomandibular disorders: a pilot magnetic resonance images texture study.

BACKGROUND: Texture features were the intrinsic properties of the human tissues and could efficiently detect the subtle functional changes of involved tissue. The pathologic changes of the lateral pterygoid muscle (LPM) were significantly correlated with the temporomandibular disc displacement. However, the occult functional changes of LPM could not be detected by the naked eye on the medical images. The current study was aimed to evaluate the functional changes of the LPM in the patients with temporomandibular disorders (TMDs) using texture analysis. METHODS: Twenty-nine patients with TMD were performed with magnetic resonance (MR) imaging on a 3.0T MR scanner, who were consecutively recruited from the TMD clinic of Hainan Hospital of Chinese People's Liberation Army General Hospital from February 2019 to September 2019. The patients were classified into three groups according to the disc displacement: disc without displacement (DWoD), disc displacement with reduction (DDWR) and disc displacement without reduction (DDWoR). The gray-level co-occurrence matrix method was applied with the texture analysis of LPM on the axial T2-weighted imaging. The texture features included angular second moment, contrast, correlation, inverse different moment, and entropy. One-way analysis of variance was used for grouped comparisons and receiver operating characteristics (ROC) curve analysis was applied to evaluate the diagnostic efficacy of the texture parameters. RESULTS: Texture contrast of LPM presented significantly lower in DDWoR (46.30 [35.03, 94.48]) than that in DWoD (123.85 [105.06, 143.23]; test statistic = 23.05; P < 0.001). Texture entropy of LPM showed significant differences among DWoD (7.62 ±â€Š0.33), DDWR (6.76 ±â€Š0.35), and DDWoR (6.46 ±â€Š0.39) (PDWoD-DDWR < 0.001, PDWoD-DDWoR < 0.001, and PDDWR-DDWoR = 0.014). Area under the ROC curve (AUC) demonstrated that texture entropy had an excellent diagnostic accuracy for DWoD-DDWR (AUC = 0.96) and DWoD-DDWoR (AUC = 0.98). CONCLUSION: The texture contrast and entropy could identify the altered functional status of LPM in patients with TMD and could be considered as the effective imaging biomarker to evaluate the functional changes of LPM in TMD.

Early Systemic Inflammatory Response Syndrome Duration Predicts Infected Pancreatic Necrosis.

BACKGROUND AND PURPOSE: Systemic inflammatory response syndrome (SIRS) was considered to play an important role in the progress of acute pancreatitis, but its specific relation with infected pancreatic necrosis remains largely unclear. We aimed to investigate the correlation between SIRS duration and infected pancreatic necrosis, and its application in prediction of infected pancreatic necrosis. METHODS: A prospective observational cohort study of 2130 patients with acute pancreatitis from 2012 to 2017. The SIRS duration at the first week was registered daily, and demographic, radiology, and all clinical laboratory data were prospectively collected and retrospectively reviewed. RESULTS: A significant upward tendency of infected pancreatic necrosis incidence was observed with increased SIRS duration. In multivariate logistic regression, SIRS duration (odds ratio, 1.305; 95% CI, 1.161-1.468) was independently associated with infected pancreatic necrosis. ROC analysis demonstrated that the areas under curves of SIRS duration for predicting persistent multi-organ failure, pancreatic infection, and mortality were 0.97 (95% CI, 0.96-0.98), 0.92 (95% CI, 0.91-0.94), and 0.86 (95% CI, 0.83-0.90), respectively, which were comparable to, or even greater than, the area under curves of APACHE II and CT severity index scores. CONCLUSIONS: Early SIRS duration was strongly associated with infected pancreatic necrosis and could serve as an easy bedside indicator to predict pancreatic infection.

GC-MS based metabolomics strategy to distinguish three types of acute pancreatitis.

Acute pancreatitis (AP) is a progressive systemic inflammatory response with high morbidity and high mortality, which is mainly caused by alcohol, bulimia, gallstones and hyperlipidemia. The early diagnosis of different types of AP and further explore potential pathophysiological mechanism of each type of AP is beneficial for optimized treatment strategies and better patient's care. In this study, a metabolomics approach based on gas chromatography-mass spectrometry (GC-MS), and random forests algorithm was established to distinguish biliary acute pancreatitis (BAP), Hyperlipidemia acute pancreatitis (HLAP), and alcoholic acute pancreatitis (AAP), from healthy controls. The classification accuracies for BAP, HLAP, and AAP patients compared with healthy control, were 0.886, 0.906 and 0.857, respectively, by using 5-fold cross-validation method. And some special metabolites for each type of AP were discovered, such as l-Lactic acid, (R)-3-Hydroxybutyric acid, Phosphoric acid, Glycine, Erythronic acid, l-Phenylalanine, d-Galactose, l-Tyrosine, Arachidonic acid, Glycerol 1-hexadecanoate. Furthermore, associations between these metabolites with the metabolism of amino acids, fatty acids were identified. Our studies have illuminated the biomarkers and physiological mechanism of disease in a clinical setting, which suggested that metabolomics is a valuable tool for identifying the molecular mechanisms that are involved in the etiology of BAP, AAP, HLAP and thus novel therapeutic targets.

Role of TXNDC5 in tumorigenesis of colorectal cancer cells: In vivo and in vitro evidence.

Thioredoxin domain­containing 5 (TXNDC5) is reportedly overexpressed in colorectal cancer (CRC) and is therefore considered an oncogene. However, the role of TXNDC5 in CRC tumorigenesis remains unclear. The present study aimed to explore the role of TXNDC5 in CRC tumorigenesis in vitro and in vivo under hypoxic and normoxic conditions. Analyses of patient tissue samples revealed a positive association between the expression of hypoxia­inducible factor­1α (HIF­1α) or TXNDC5 and the TNM stage of CRC. In addition, a positive correlation between the expression levels of HIF­1α and TXNDC5 was observed in CRC tissues. Furthermore, culturing RKO and HCT­116 human CRC cell lines under hypoxic conditions significantly increased the expression levels of HIF­1α and TXNDC5, whereas knockdown of HIF­1α abolished the hypoxia­induced expression of TXNDC5. Knockdown of TXNDC5 significantly decreased cell proliferation and colony formation, and incre-ased apoptosis of both cell lines. Furthermore, knockdown of TXNDC5 markedly increased hypoxia­induced reactive oxygen species (ROS) generation, and the expression of hypoxia­induced endoplasmic reticulum stress (ER) markers (CCAAT­enhancer­binding protein homologous protein, glucose­regulated protein 78 and activating transcription factor 4) and apoptotic markers (B­cell lymphoma 2­associated X protein and cleaved caspase­8). In addition, the expression levels of TXNDC5 were significantly increased in tumor tissues compared with in adenoma and normal tissues in a mouse model of CRC tumorigenesis. In conclusion, the in vivo data demonstrated that TXNDC5 is overexpressed in CRC tissues, and this overexpression may be associated with unfavorable clinicopathological features. The in vitro data indicated that hypoxia may induce TXNDC5 expression via upregulating HIF­1α; this effect promoted CRC cell proliferation and survival under hypoxic conditions, likely via inhibiting hypoxia­induced ROS/ER stress signaling. These findings suggested that TXNDC5 functions as an important stress survival factor to maintain tumorigenesis of CRC cells under hypoxia by regulating hypoxia­induced ROS/ER stress signaling. The present study provided novel insights into the role of TXNDC5 in the tumorigenesis of CRC.

Adsorption of methyl orange dye onto biochar adsorbent prepared from chicken manure.

In this work, the biochar adsorbent carboxymethyl cellulose (CMC), was prepared from the pyrolysis (600 °C, 120 min) of chicken manure for the removal of methyl orange (MO) from aqueous solution, and its physicochemical properties were characterized by scanning electron microscopy (SEM) and Fourier transform infrared spectra (FTIR). The experimental parameters including agitation speed, initial solution pH, biochar dosage and contact time on the adsorption properties of MO from aqueous solution onto CMC were investigated in batch experiments. The kinetic adsorption of different initial concentration could be accurately described by the pseudo-second-order model and the overall rate process was apparently influenced by external mass transfer and intra-particle diffusion. Furthermore, the Langmuir isotherm model showed a better fit with equilibrium data (R2 > 0.99), with the maximum adsorption capacity of 39.47 mg·g-1 at 25 °C. Moreover, the thermodynamic parameters indicated that the adsorption of MO onto CMC was a spontaneous and endothermic process. The results of this study indicated that CMC could be used as a promising biomass adsorbent material for aqueous solutions containing MO.

Preparation and Characterization of Highly Ordered Mercapto-Modified Bridged Silsesquioxane for Removing Ammonia-Nitrogen from Water.

In acidic conditions, mesoporous molecular sieves SBA-15 and SBA-15-SH were synthesized. Structural characterization was carried out by powder X-ray diffraction (XRD), Fourier Transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), transmission electron microscopy (TEM), 13C CP MAS-NMR, 29Si CP MAS-NMR and nitrogen adsorption⁻desorption (BET). The results showed that in SBA-15-SH, the direct synthesis method made the absorption peak intensity weaker than that of SBA-15, while the post-grafted peak intensity did not change. Their spectra were different due to the C-H stretching bands of Si-O-Si and propyl groups. But their structure was still evenly distributed and was still hexangular mesoporous structure. Their pore size increased, and the H-SBA-15-SH had larger pore size. The adsorption of ammonia-nitrogen by molecular sieve was affected by the relative pressure and the concentration of ammonia-nitrogen, in which the adsorption capacity of G-SBA-15-SH was the largest and the adsorption capacity of SBA-15 was the smallest.

Leukoencephalopathy with calcifications and cysts: A case report.

RATIONALE: Leukoencephalopathy with calcifications and cysts (LCC) is an uncommon entity characterized by edematous leukoencephalopathy, cerebral calcifications, and parenchymal cysts. Due to its rarity, the clinical, radiological, and histopathological features have yet to be well elucidated. PATIENT CONCERNS: The first case is a 35-year-old female who was asymptomatic. A giant intracranial cyst was incidentally detected radiologically, and it was slowly growing in the recent 10 years. The second case is a 20-year-old female who presented with a 1-month history of headache. Brain computed tomography showed multiple asymmetric calcifications in the bilateral basal ganglia and white matter. Magnetic resonance imaging revealed a cyst in the right parietal lobe. DIAGNOSES: They were diagnosed with LCC. INTERVENTIONS AND OUTCOMES: The first patient underwent surgical resection of the intracranial cyst, and the second patient received a stereotactic biopsy. The patients performed well postoperatively. LESSONS: LCC can be found at any age. A young age seems to be associated with severer symptoms. The clinical manifestations can be variable and aggressive. The potential pathogenic basis still needs further research.