Noninvasive quantitative analysis of ceramide in skin of healthy Chinese population.

OBJECTIVE: The objective of this study was to make noninvasive quantitative analysis of ceramide (CER) in skin of healthy Chinese population by high performance liquid chromatography tandem mass spectrometry. METHODS: Seven healthy subjects were selected and the stratified skin samples were available using cyanoacrylate adhesion method. High performance liquid chromatography tandem mass spectrometry, use ceramide Subclass Standard C42H85NO3 Quantification of the 12 corresponding ceramide subclass in the epidermis on the 7 skin samples, which cannot get all the standard of ceramides subclass since the stratum corneum ceramide is complex and diverse. Data were collected and analyzed using full-flow lipid analysis software (LipidSearch). RESULTS: All the seven skin samples contained 12 subclasses of ceramide and the samples were quantitated with ceramide C42H85NO3 standard. The average contents were 33.63, 27.59, 108.57, 220.75, 149.20, 43.06, and 22.78 µg/mL, respectively. CONCLUSION: Ceramide is an important lipid in the epidermis and is closely related to the skin barrier function. There are 12 subtypes of ceramide detected in the skin of Chinese healthy people, and there is a difference in the concentration between individuals. The difference may be associated with the skin barrier condition, and may also be related to the unavoidable error in the process of sampling, treatment, and detection.

[A research of omics-based biological aging clocks and their applications].

Aging, a process of functional decline with the increase of chronological age, is a major risk factor for chronic diseases. Aging shows significant individual differences, which is influenced by both genetic and environmental factors. Accurate measurement of physiological age helps identify individuals with accelerated aging and those at high risk for chronic diseases and mortality, which would promote individual health management and precision medicine for healthy aging. In this paper, we summarize the omics-based aging clocks and discuss their current and future applications.

Flexible and individualized treatment to achieve sustained viral response for recurrent hepatitis C in liver transplant recipients.

Hepatitis C recurrence after liver transplantation is universal and is a major cause of long-term graft failure. Improving the effectiveness of recurrent hepatitis C treatment is extremely important. We studied 35 anti-hepatitis C virus (HCV)-positive patients who underwent liver transplantation. Among the 35 patients, 25 patients had recurrent hepatitis C and received antiviral treatment. HCV RNA load after liver transplantation was increased by 3.68-fold. The antiviral treatment regimen comprised pegylated-interferon (180 µg) every 2 weeks and ribavirin at a dose of 200-400 mg every day. The treatment duration was flexible and individualized, and depended on viral response to treatment. The dosage of tacrolimus was decreased gradually to minimize immunocompromise. Median (interquartile) serum level of tacrolimus was 6.9 (6-8.9) ng/mL at initiation of treatment and 3.8 (3.6-5) ng/mL at the end of treatment. One patient (4.0%) was withdrawn from the study, and three patients (12%) died of infection during treatment. At end of treatment, 18 of 25 patients (72%) were negative for serum HCV RNA. After an additional 6 months following the end of treatment, 16 of the 25 patients (64%) had sustained viral response (SVR) and only two patients had HCV relapse. The 1-year, 3-year and 5-year survival rates were 91.4%, 84.5% and 84.5% for all patients and 88.0%, 82.8% and 82.8% for the 25 patients who received antiviral therapy. In conclusion, recurrent HCV infection is an important issue in liver transplantation. The flexible regimen of antiviral therapy and individualized immunosuppressive agents that was applied in this study achieved a SVR rate of 64%.

Evaluation of methanogenic treatment of TMAH (tetra-methyl ammonium hydroxide) in a full-scale TFT-LCD wastewater treatment process.

This study evaluated TMAH biodegradation under methanogenic conditions. Under methanogenic conditions, a sludge from a full-scale UASB treating TFT-LCD wastewater was able to degrade 2,000 mg/L of TMAH within 10 h and attained a specific degradation rate of 19.2 mgTMAH/gVSS-h. Furthermore, several chemicals including some surfactants, DMSO, and sulfate were examined for their potential inhibitory effects on TMAH biodegradation under methanogenic conditions. The results indicated that surfactant S1 (up to 2%) and DMSO (up to 1,000 mg/L) presented negligible inhibitory effects on TMAH degradation, while surfactant S2 (0.2-1%) might inhibit methanogenic reaction without any TMAH degradation for 3-5 h. At sulfate concentrations higher than 300 mg/L, a complete inhibition of methanogenic reaction and TMAH biodegradation was observed. Results from cloning and sequencing of archaeal 16S rRNA gene fragments showed that Methanosarcina barkeri and Methanosarcina mazei were the dominant methanogens in the UASB treating TMAH-containing TFT-LCD wastewater.

[Influence of comprehensive incubational measures on the perioperative treatment of extensively burned patients who underwent escharectomy and skin grafting].

Objective: To explore the influence of standardized and comprehensive incubational measures on perioperative treatment of extensively burned patients who underwent escharectomy and skin grafting. Methods: From January 2017 to November 2018, 50 patients with extensive burn who underwent escharectomy and skin grafting in the First Affiliated Hospital of Air Force Medical University and met the inclusion criteria of this study, were recruited in this retrospective cohort study. According to the incubational measures at that time, 20 patients (14 males and 6 females, aged (33.5±5.2) years) who received routine incubation during the perioperative period from January to October 2017 were set as routine incubation group, and 30 patients (23 males and 7 females, aged (35.8±1.4) years) who received standardized comprehensive incubational measures during the perioperative period from November 2017 to November 2018 were set as comprehensive incubation group. Their body temperature was controlled mainly in 4 stages: preoperative preparation and transfer from intensive care unit (ICU) to operating room, preoperative preparation in operating room, intraoperative operating room management, as well as postoperative transfer from operating room to ICU. The initial body temperature in operating room and intraoperative hypothermia duration, intraoperative blood loss, postoperative recovery time, postoperative chill, blister, and ulcer, and wound healing rate on post operation day (POD) 10 were recorded and calculated. Data were statistically analyzed with two independent samples t test and chi-square test. Results: (1) The initial body temperature in operating room of patients in comprehensive incubation group was (36.3±0.4) ℃, which was significantly higher than (35.6±0.4)℃ in routine incubation group, t=6.658, P<0.01; the intraoperative duration of hypothermia was (205±38) min, which was significantly shorter than (234±42) min in routine incubation group, t=2.564, P<0.05. (2) The intraoperative blood loss of patients in comprehensive incubation group was (323±114) mL, which was significantly less than (490±162) mL in routine incubation group, t=4.272, P<0.01; the postoperative recovery time was (36±8) min, which was significantly shorter than (49±17) min in routine incubation group, t=3.229, P<0.01. (3) The incidence of postoperative chill of patients in comprehensive incubation group was significantly lower than that in routine incubation group (χ(2)=28.626, P<0.01). The incidences of postoperative blister and ulcer of patients between the 2 groups were close. (4) On POD 10, the wound healing rate of patients in comprehensive incubation group was (78.08±0.06)%, which was significantly higher than (71.03±0.08)% in routine incubation group, t=3.694, P<0.01. Conclusions: The standardized and comprehensive incubational measures can effectively improve the initial body temperature of patients entering the operating room, shorten the intraoperative duration of hypothermia, reduce the amount of blood loss and postoperative complications, as well as shorten the postoperative recovery time, thus improve the wound healing rate.

Microbial ecology and performance of ammonia oxidizing bacteria (AOB) in biological processes treating petrochemical wastewater with high strength of ammonia: effect of Na(2)CO(3) addition.

This study evaluated nitrification performance and microbial ecology of AOB in a full-scale biological process, powder activated carbon treatment (PACT), and a pilot-scale biological process, moving bed biofilm reactor (MBBR), treating wastewater collected from a petrochemical industry park. The petrochemical influent wastewater characteristics showed a relative low carbon to nitrogen ratio around 1 with average COD and ammonia concentrations of 310 mg/L and 325 mg-N/L, respectively. The average nitrification efficiency of the full-scale PACT process was around 11% during this study. For the pilot-scale MBBR, the average nitrification efficiency was 24% during the Run I operation mode, which provided a slightly better performance in nitrification than that of the PACT process. During the Run II operation, the pH control mode was switched from addition of NaOH to Na(2)CO(3), leading to a significant improvement in nitrification efficiency of 51%. In addition to a dramatic change in nitrification performance, the microbial ecology of AOB, monitored with the terminal restriction fragment length polymorphism (T-RFLP) molecular methodology, was found to be different between Runs I and II. The amoA-based TRFLP results indicated that Nitrosomonas europaea lineage was the dominant AOB population during Run I operation, while Nitrosospira-like AOB was dominant during Run II operation. To confirm the effects of Na(2)CO(3) addition on the nitrification performance and AOB microbial ecology observed in the MBBR process, batch experiments were conducted. The results suggest that addition of Na(2)CO(3) as a pH control strategy can improve nitrification performance and also influence AOB microbial ecology as well. Although the exact mechanisms are not clear at this time, the results showing the effects of adding different buffering chemicals such as NaOH or Na(2)CO(3) on AOB populations have never been demonstrated until this study.

[Exploring of a prognostic long non-coding RNA signature of hepatocellular carcinoma by using public database].

Objective: To explore an effective long non-coding RNA (lncRNA) signature in predicting the prognosis of hepatocellular carcinoma through the analysis on RNA sequencing data of hepatocellular carcinoma patients and peritumoral tissues in the Cancer Genome Atlas (TCGA) database. Methods: The clinical characteristics and RNA sequencing data of 377 hepatocellular carcinoma patients were obtained from TCGA database by the end of February 2018. Then, differentially expressed lncRNAs between 50 pairs of tumor and peritumoral tissues were explored using student's t-test. Next, a lncRNA signature was established through LASSO Cox regression analysis. All the patients were divided into four groups (

Microbial ecology and performance of nitrifying bacteria in an aerobic membrane bioreactor treating thin-film transistor liquid crystal display wastewater.

This study was conducted to evaluate the long-term performance of an aerobic membrane bioreactor (MBR), treating TFT-LCD wastewater containing dimethyl sulphoxide (DMSO), monoethanolamine (MEA) and tetra-methyl ammonium hydroxide (TMAH), which are recognized as slow-biodegradable organic compounds containing nitrogen and can release significant amount of ammonia during biodegradation. Moreover, many studies have reported that certain organic compounds can potentially inhibit nitrification of AOB, but limited information is available regarding the effects of TFT-LCD wastewater compounds on nitrification performance and microbial ecology of nitrifying bacteria. In general, the aerobic MBR achieved satisfactory conversion efficiency for DMSO, MEA, TMAH, and ammonia, except that a sudden inhibition on MEA degradation was observed for a transition period when the influent feed switched from synthetic to real TFT-LCD wastewater. Furthermore, the terminal restriction fragment length polymorphism (T-RFLP) methodology was applied to monitor the microbial ecology of nitrifying bacteria in the aerobic MBR. The results suggested that Nm. marina or Nm. cummunis were the dominant AOB population in the aerobic MBR fed with synthetic TFT-LCD wastewater, while Nitrosospira became dominant in the aerobic MBR fed with real TFT-LCD wastewater. For the NOB population, both Nitrobacter and Nitrospira were present during this study. Finally, the results of batch experiments, which were conducted to evaluate the effects of DMSO, MEA, and TMAH on nitrification activity, indicated that MEA and TMAH became inhibitory to nitrifying bacteria at concentrations of 250 and 50 mg/L, respectively, while DMSO did not at concentrations up to 100 mg/L.

Evaluation of performance and microbial ecology of sequencing batch reactor and membrane bioreactor treating thin-film transistor liquid crystal display wastewater.

In Taiwan, a substantial amount of thin-film transistor liquid crystal display (TFT-LCD) wastewater is produced daily due to an increasing production of the opto-electronic industry in recent years. The main components of TFT-LCD wastewater include dimethyl sulphoxide (DMSO), monoethanolamine (MEA), and tetra-methyl ammonium hydroxide (TMAH), which are recognized as non-or slow-biodegradable organic compounds and limited information is available regarding their biological treatablility. This study was conducted to evaluate the long-term performance of two bioreactors, anaerobic-aerobic (A/O) sequencing batch reactor (SBR) and aerobic membrane bioreactor (MBR), treating synthetic TFT-LCD wastewater containing DMSO, MEA, and TMAH with different loadings. For the A/O SBR, the influent wastewater was composed of 800 mg MEA/L, 430 mg DMSO/L, and 90 mg TMAH/L, respectively. After reaching steady-state, SBR was able to achieve more than 99% degradation efficiencies for the three compounds examined. For the case of aerobic MBR, the influent wastewater was composed of 550 mg MEA/L, 270 mg DMSO/L, and 330 mg TMAH/L, respectively, and degradation efficiencies for the three compounds achieved more than 99%. Although both different reactors shared similar and satisfactory degradation efficiencies for DMSO, MEA, and TMAH, the microbial ecology of these two reactors, as elucidated with molecular methods, was apparently different. The 16S rDNA-based cloning/sequencing results indicated that the dominant sequences retrieved from the aerobic MBR, including Hyphomicrobium denitrificans, Hyphomicrobium zavarzinii, Rhodobacter sp., and Methyloversatilis universalis, showed a clear linkage to their physiological properties of DMSO and TMAH degradation. On the other hand, Zoogloea sp., Chlorobium chlorochromatii, Agricultural soil bacterium, and Flavosolibacter ginsengiterrae were proliferated in the A/O SBR Run1, while Thiobacillus sp., Nitrosomonas sp., Thauera aromatica and Azoarcus sp. became dominant in Run2. Furthermore, the sequences retrieved from different reactors were used to establish the terminal restriction fragment length polymorphism (TRFLP) fingerprint methodology for monitoring the dynamics of dominant degrading bacteria in the aerobic MBR treating TFT-LCD wastewater.

Practice of breastfeeding and factors that affect breastfeeding in Hong Kong.

OBJECTIVES: To describe the patterns of and factors affecting breastfeeding and to find out any significant relationship between breastfeeding and health of the child. DESIGN: Cohort study. SETTING: Postnatal ward of the Prince of Wales Hospital. PARTICIPANTS: A total of 243 infants born in 1998 to 2001 at the hospital. Each infant was followed up for 3 years. Home visits were carried out at 3, 15, 24, and 36 months of age by medical students from the Chinese University of Hong Kong. A questionnaire was completed at each visit. Independent sample t-tests and Pearson Chi squared tests were used. RESULTS: Of the 243 subjects, 213 provided data on the method of infant feeding. There were 66.7% of mothers initiating breastfeeding, with a median duration of 1 month. Only 13.4% met the World Health Organization's recommendations on breastfeeding. Breastfeeding was found to have a statistically significant relationship with (i) the infant's birth order and (ii) the mother's and father's education level. During follow-up, 44.6% of the infants were hospitalised but there was no significant relationship between breastfeeding and number of hospitalisations. CONCLUSIONS: The current breastfeeding rate in Hong Kong falls below expectations when compared with other developed nations. To raise this rate, more support is needed for families with parents having a lower education level or more than two children, as they are the least likely to breastfeed. This might be achieved by encouraging antenatal class attendance, counselling of husbands, and more support for breastfeeding from doctors.

Extrapancreatic pseudoaneurysm after pancreas transplantation.

Pseudoaneurysms after pancreatic transplantation are an infrequent event. Repair usually involves removal of the transplant. We describe a patient with a pseudoaneurysm associated with pancreatic transplantation. The pseudoaneurysm originated from the external iliac artery distal to the donor Y-graft anastomosis. Diagnosis was made by duplex ultrasound. Surgical repair was effected through a retroperitoneal incision enabling vascular control. The patient has done well postoperatively, and with 1-year follow-up, continues to have normal renal and pancreatic allograft function.

Effect of donor-disseminated intravascular coagulation in liver transplantation.

It is not known whether disseminated intravascular coagulation, present in a large percentage of organ donors, affects patient outcome after liver transplantation. We reviewed our first 55 liver transplantations and identified 10 donors with disseminated intravascular coagulation. We compared the perioperative courses of the 10 recipients of these transplanted livers with those of 10 matched controls whose donors did not have disseminated intravascular coagulation. Disseminated intravascular coagulation recipients did not require more blood products during or after surgery; their hepatic enzyme levels and prothrombin times after surgery were not statistically significantly higher than those of the controls. There was no difference in hospital stay, number of episodes of rejection, retransplantations, or deaths. The presence of disseminated intravascular coagulation in donors did not adversely affect graft function or patient outcome and should not be a sole criterion for rejecting a liver for transplantation.

[Embolization of an arteriovenous fistula in the posterior fossa: report of a case].

We report a case of posterior fossa arteriovenous fistula with a possible arterial aneurysm. The patient was a 15-year-old female. She was transferred to us because of a sudden onset of dyspnea, severe headaches, and loss of consciousness. The CT scan found an abnormal vascular lesion in the posterior fossa. Calcification was noted in the wall of the largest abnormal vascular structure. The angiogram showed a focal aneurysmal dilatation of the hemispheric branch of the right posterior inferior cerebellar artery, followed by an arteriovenous fistula, which drained to the right transverse sinus. Embolization was performed by implanting a detachable balloon into the proximal end of the aneurysm. These abnormal vascular structures disappeared completely on the angiogram after the embolization. CT scan one week after embolization showed increased density in these abnormal vascular structures, with no enhancement after contrast, indicating thrombosis or the formation of a blood clot in their lumen. The CT half a year after embolization showed reduction in size and a low density change in the largest vascular structure with calcification in the wall. All other abnormal vascular structures disappeared. An angiogram half a year after the embolization confirmed no recurrence of the aneurysm or arteriovenous fistula.

Effects of volatile fatty acids on a thermophilic anaerobic hydrogen fermentation process degrading peptone.

Hydrogen fermentation using glucose as a single substrate caused abrupt pH drops and the gradual losses of hydrogen producers, which in turn led to system failure. In this study the use of a proteinaceous substrate, peptone, avoided the abrupt pH drops in the reactive system and allowed for further exploration of volatile fatty acids (VFAs) and pH effects on the hydrogen fermentation process. Our results showed that: (1) during the hydrogen fermentation tests, the abrupt pH drops were avoided thus system stability increased due to the production of ammonia from the peptone fermented, (2) pH control was not necessary and the addition of acetate to the process had little effect on the hydrogen fermentation process, (3) at the extreme pHs the addition of acetate either lengthened the lag phase (pH < or = 6) or slowed the hydrogen production rate (pH > or = 8), and both situations were not desired, and (4) high VFA content in the system sped up the consumption of hydrogen gas. Results of this study suggested that the hydrogen fermentation using the protein-containing substances as substrate was beneficial in maintaining the system pH. As long as the pH was maintained around 6-8, system inhibition due to VFAs accumulation was minimized. Thus, the optimal operation of a hydrogen fermentation process would be achievable via the control of substrate composition at a certain carbohydrate-to-protein ratio.

Effects of substrate components on hydrogen fermentation of multiple substrates.

As is well known, carbohydrate is the most appropriate organic material for hydrogen fermentation, and its hydrogen yield is significantly larger than that of protein. The fermentation of protein began with hydrogen production followed by hydrogen consumption, which helps overall hydrogen recovery. Both carbohydrate and protein are basic components of organic material, and yet carbohydrate is known to be a better substrate than protein in terms of hydrogen yield during hydrogen fermentation. This study used multiple substrates containing different ratios of glucose and peptone as multiple substrates to investigate the roles played by carbohydrate and protein in hydrogen fermentation. The experimental results demonstrated that suitable ratios of glucose and peptone improved the growth of hydrogen producing bacteria. Additionally, a maximum hydrogen yield of 6.4 mmole-H2/g-COD was obtained from the multiple substrate containing 40% peptone and 60% glucose. Most of the produced hydrogen came from fermentation of glucose, not peptone. During hydrogen fermentation, the pH dropped by 1.0 and 1.9 units in 80% and 20% of peptone content in the substrate. Ammonia produced due to peptone degradation neutralized the acids produced from hydrogen fermentation.

Study of a three-stage fluidized bed process treating acrylic synthetic-fiber manufacturing wastewater containing high-strength nitrogenous compounds.

Polyacrylonitrile (PAN) is one of the major synthetic fibers commonly used in the mass production of clothing. The chemical synthesis of PAN is carried out by polymerization of the acrylonitrile (AN) monomers with co-monomers such as vinyl acetate, methyl acrylate and cyclohexyl acrylate. Using water quality analysis of the PAN wastewater, high concentration of organic nitrogen was found and the TKN/COD ratios achieved were 0.15-0.26, indicating the complicated biodegradation characteristics for the PAN wastewater. In order to enhance biodegradation of nitrogenous compounds in PAN wastewater, a combined three-stage process of thermophilic anaerobic/anoxic denitrification/aerobic nitrification fluidized bed reactors was employed. The results indicated that the concentration of effluent in the three-stage process of OD and organic nitrogen was 175 mg/L and 13 mg/L, respectively. Furthermore, molecular biotechnology was applied to study the microbial population in the thermophilic anaerobic fluidized bed reactor. From the results of denaturing gradient gel electrophoresis, the diversity of PAN-degrading bacteria would change in different volumetric loading. Furthermore, the bacteria communities in the thermophilic anaerobic fluidized bed reactor were also studied by fluorescence in situ hybridization and confocal laser scanning microscopy. Alpha and delta-Proteobacteria were dominant in the bacteria population, and some high G+C content bacteria and Clostridium could be characterized in this system.

Liver transplantation: perspectives after 250 liver transplants at the Ochsner Clinic.

At the Ochsner Clinic we recently performed our 250th liver transplant. Reaching this milestone has led us to reflect back on the history of liver transplant, both at our own institution and nationally, noting the many achievements and improvements in liver transplantation during the relatively brief history of this therapeutic modality. Furthermore, there are a number of issues both medical and political which will likely be affecting how liver transplantation is performed in the future.

[Direct observation of the tympanic cavity by the superfine fiberscope].

As a clinical test, direct observation of the middle ear should be ideally performed without any surgical intervention such as myringotomy. This paper reports a newly invented superfine fiberscope which makes it possible to insert through the eustachian tube, and direct views of the middle ear structures on normal subjects and patients. The patients were of a small cholesteatoma and traumatic dislocation of the ossicular chain. All of them were tested with local anesthesia in outpatient clinic. This superfine fiberscope was of great value in observing of middle ear structures as a diagnostic instruments, as that no surgical intervention was necessary in the procedure.