[Relationship between bioelectrical impedance analysis-derived fluid status and nutritional indicators and the prognosis in patients undergoing maintenance hemodialysis].

Objective: To explore the relationship between bioelectrical impedance analysis (BIA)-derived fluid status and nutritional indicators and the prognosis in patients undergoing maintenance hemodialysis (MHD). Methods: A retrospective cohort study was conducted. The clinical data of MHD patients in Jiangsu Province Hospital between January 2014 and December 2016 were analyzed. BIA data of healthy volunteers in Gulou District, Nanjing City, collected between April and October 2022, were used to determine the cut-off value of body cell mass index (BCMI). Referring to previous research, using 0.15 as the cut-off value for the ratio of overhydration and extracellular water (OH/ECW). The data were transformed into binary variables based on these cut-off values to categorize patients into different groups. Kaplan-Meier analysis was used to plot survival curves, and the Cox proportional hazards model was performed to analyze risk factors for all-cause mortality. Results: A total of 706 MHD patients (407 males and 299 females) were included, aged (54±15) years. MHD patients were classified into four groups based on whether BCMI was<5.4 kg/m2 and OH/ECW was≥0.15, which included non-overhydration and non-malnutrition group, overhydration group, malnutrition group, and overhydration and malnutrition group, with 269, 186, 151, and 100 patients, respectively. During a median follow-up of [M(Q1, Q3)] 33 (26, 37) months, 162 patients died. Kaplan-Meier analysis showed that the median survival periods of the four groups were 52 months (95%CI: 41-54 months), 46 months (95%CI: 44-49 months), 37 months (95%CI: 34-40 months), and 34 months (95%CI: 30-38 months), respectively, with a statistically significant difference (P<0.001). The 1-year survival rates were 95.5%, 93.5%, 92.1%, and 88.0% (P<0.001), respectively, and the 2-year mortality rates were 92.6%, 87.1%, 83.4%, and 77.0% (P<0.001), respectively. Multivariate Cox regression analysis showed that compared with non-overhydration and non-malnutrition group, the risk of all-cause mortality increased by 1.18 times in the malnutrition group (HR=2.18, 95%CI: 1.29-3.71, P=0.004), and by 1.59 times in the overhydration and malnutrition group (HR=2.59, 95%CI: 1.48-4.54, P=0.001). Conclusions: BIA-derived fluid status and nutritional indicators are associated with the prognosis of MHD patients. Compared with patients without fluid overload and malnutrition, patients with malnutrition and fluid overload have an increased risk of all-cause mortality.

[Association between sarcopenia and abdominal aortic calcification in maintenance hemodialysis patients].

Objective: To investigate the relationship between sarcopenia and abdominal aortic calcification (AAC) in maintenance hemodialysis (MHD) patients. Methods: A cross-sectional study was conducted. MHD patients who underwent regular dialysis between January 2021 and January 2022 at hemodialysis center in Jiangdu People's Hospital Affiliated to Yangzhou University were enrolled. The incidence of sarcopenia in these patients was examined by measuring handgrip strength, gait speed and appendicular skeletal muscle mass index (ASMI) using bioelectrical impedance analysis. AAC score was measured by a lateral lumbar spinal radiograph. The general information of the patients was collected and the blood biochemical indexes were detected. These patients were divided into non-calcification group (n=104) and calcification group (n=127) according to the score of AAC. Multivariate logistic regression was used to analyze the related factors of AAC. Results: A total of 231 MHD patients (134 males and 97 females) were enrolled in the study, with the mean age of (57.1±11.4) years. Among 231 hemodialysis patients, the incidence of sarcopenia and AAC were 46.3% (107 cases) and 55.0% (127 cases), respectively. The age [(60.2±11.1) vs (53.4±12.2) years, P<0.001] and dialysis vintage [86 (46, 135) vs 57 (27, 109) months, P=0.005] in calcification group were longer than these in the non-calcification group. The level of 25(OH)D3 [17.7 (13.5, 24.3) vs 20.5 (15.1, 28.1) µg/L, P=0.008] and gait speed [(0.88±0.23) vs (1.01±0.20) m/s, P=0.024], handgrip strength [(17.9±9.1) vs (20.7±9.9) kg, P=0.013], ASMI [(6.65±2.24) vs (7.83±2.46) kg/m2, P<0.001] were lower. While, AAC score [12 (9, 19) vs 0 (0, 3), P<0.001] and the incidence of sarcopenia [58.3% (74/127) vs 31.7% (33/104), P<0.001] were higher in the calcification group than these in the non-calcification group. Multivariate logistic regression analysis indicated that sarcopenia (OR=1.928, 95%CI: 1.302-2.855, P=0.001), decrease of 25(OH)D3 level (OR=0.969, 95%CI: 0.940-1.000, P=0.047), age (OR=1.043, 95%CI: 1.015-1.072, P=0.002), and dialysis vintage (OR=1.009, 95%CI: 1.004-1.015, P=0.001) were related factors of AAC. Conclusions: Sarcopenia is associated with AAC in MHD patients. In clinical practice, attention should be paid to sarcopenia in MHD patients.

[Treatment of postprandial discomfort syndrome in the elderly: a multi-centered prospective randomized controlled clinical study].

Objective: To evaluate the efficacy and safety of Oryz-Aspergillus enzyme and pancreatin tablets (Combizym(®)) in the treatment of postprandial distress syndrome (PDS) in the elderly, compared with gastrointestinal motility drugs. Methods: A prospective randomized controlled trial was designed and registered in the China Clinical Trials Registry (ChiCTR-IPR-16008185). The elderly patients with PDS were randomly divided into three groups, including Mosapride group with Mosapride citrate tablets 5 mg 3 times per day for 2 weeks; Combizym(®) group with Combizym tablets 244 mg 3 times per day for 2 weeks; combined treatment group with both drugs and same doses for 2 weeks. The modified Nepean dyspepsia index (NDSI) score, discomfort intensity score and PDS score were calculated on patients before treatment, at the end of first and second week of treatment, as well as 4 weeks after treatment finished, respectively. Adverse effects were evaluated. Results: A total of 323 patients from 16 tertiary hospitals in China were enrolled in this study. Among them, 105 patients were in Mosapride group, 109 in Combizym(®) group and 109 in combined treatment group. There were 148 males (45.8%) and 175 females (54.2%) with median age 71.4±9.0 years (60-100 years). Baseline characteristics of three groups were comparable. After treatment, the NDSI scores in three groups all decreased significantly (P<0.001), while they were similar between groups (P>0.05). The discomfort intensity score and PDS score in three groups showed a significant reduction after treatment (P<0.001), especially in the combined treatment group. Compared with Mosapride group, the scores in Combizym(®) group decreased significantly after one or two weeks [discomfort intensity score: after one week, 4.0(2.5, 8.0) vs. 6.0(3.0, 10.0); after two weeks, 3.0(0.0, 5.0) vs. 4.0(2.0, 6.0); all P<0.05. PDS score: after one week, 6.0(3.0, 9.0) vs. 7.0(3.5, 10.5); after two weeks, 3.0(0.0, 5.0) vs. 4.0(2.0, 7.0); all P<0.05]. The efficacy rate in all patients after first week of treatment was over 15.0%. The efficacy rates after two weeks were 55.2%, 68.8% and 73.4% in Mosapride group, Combizym(®) group and combined treatment group, respectively. After two week treatment, the efficacy rates in Combizym(®) group (P=0.041) and combined group (P=0.006) were higher than that of Mosapride group. The recurrence rate of Mosapride group was 9.5%, which was significantly higher than that of Combizym(®) group (1.8%, P<0.05) and combined treatment group (1.8%, P<0.05). There were no serious adverse effects in the three groups. Conclusions: The efficacy of Oryz-Aspergillus enzyme and pancreatin tablets is comparable with that of Mosapride in elderly PDS patients, with fewer adverse effects and low recurrence rate. Combination regimen indicates better efficacy than that of Oryz-Aspergillus enzyme and pancreatin tablets or Mosapride alone.

Probing weak localization in chemical vapor deposition graphene wide constriction using scanning gate microscopy.

Low-temperature scanning gate microscopy (LT-SGM) studies of graphene allow one to obtain important spatial information regarding coherent transport such as weak localization (WL) and universal conductance fluctuations. Although fascinating LT-SGM results on pristine graphene prepared by mechanical exfoliation have been reported in the literature, there appears to be a dearth of LT-SGM results on chemical vapor deposition (CVD)-grown graphene whose large scale and flexible substrate transferability make it an ideal candidate for coherent electronic applications. To this end, we have performed LT-SGM studies on CVD-grown graphene wide constriction (0.8 µm), which can be readily prepared by cost-effective optical lithography fully compatible with those in wafer foundry, in the WL regime. We find that the movable local gate can sensitively modulate the total conductance of the CVD graphene constriction possibly due to the intrinsic grain boundaries and merged domains, a great advantage for applications in coherent electronics. Moreover, such a conductance modulation by LT-SGM provides an additional, approximately magnetic-field-independent probe for studying coherent transport such as WL in graphene and spatial conductance variation.

Effects of simulated weightlessness on cellular morphology and biological characteristics of cell lines SGC-7901 and HFE-145.

We investigated the effects of simulated weightlessness on cellular morphology, proliferation, cell cycle, and apoptosis of the human gastric carcinoma cell line SGC-7901 and the human gastric normal cell line HFE-145. A rotating clinostat was used to simulate weightlessness. The Image-Pro4.5 image analysis system was used for morphometric analysis. Proliferating cell nuclear antigen expression was examined by immunohistochemical staining. Changes in the cell cycle were examined using a cytometer. Apoptosis was measured using the terminal dUTP nick-end labeling (TUNEL) method. When subjected to simulated weightlessness, the cellular morphology of SGC-7901 cells was changed at 12, 24, 48, and 72 h, cell conversion from the G1 to S phase was blocked, proliferation was inhibited at 48 and 72 h, and the apoptosis index was increased at 72 h. The same changes were observed for HFE-145 cells at 12 h when subjected to simulated weightlessness, but no significant changes were found afterward compared with controls. SGC-7901 cells change their cellular morphology and biological characteristics during clinostat-simulated weightlessness at 72 h, but HFE-145 cells only change at 12 h and adapt to simulated weightlessness after that point.

Characteristics of young rural Chinese suicides: a psychological autopsy study.

BACKGROUND: Patterns of suicide rates in China differ in many ways from those in the West. This study aimed to identify the risk factors characteristic for young rural Chinese suicides. METHOD: This was a case-control psychological autopsy (PA) study. The samples were suicides and living controls (both aged 15-34 years) from 16 rural counties of China. We interviewed two informants for each suicide and each control with pretested and validated instruments to estimate psychosocial, psychiatric and other risk factors for suicides. RESULTS: The prevalence of mental disorders was higher among the young Chinese who died by suicide than among the living controls, but was lower than among suicides in the West. Marriage was not a protecting factor for suicide among young rural Chinese women, and never-married women who were involved in relationships were about three times more likely to commit suicide than single women who were unattached. Religion/religiosity was not a protecting factor in Chinese suicide, as it tended to be stronger for suicides than for controls. Impulsivity was significantly higher for suicides than for controls. Psychological strain, resulting from conflicting social values between communist gender equalitarianism and Confucian gender discrimination, was associated significantly with suicide in young rural Chinese women, even after accounting for the role of psychiatric illness. CONCLUSIONS: Risk factors for suicide in rural China are different from those in the West. Psychological strain plays a role in suicide. Suicide prevention programs in China should incorporate culture-specific considerations.

Evidence for spin-dependent energy transport in a superconductor.

In ferromagnetic materials, spin up and down electrons can carry different heat currents. This spin-dependent energy excitation mode ('spin energy mode') occurs only when spin up and down energy distribution functions are different. In superconductors, heat is carried by quasiparticle excitations and the spin energy mode can be excited by spin-polarised current injection. In the presence of a finite Zeeman magnetic field, the spin energy mode surprisingly leads to a charge imbalance (different numbers of hole- and electron-like quasiparticles) at the superconducting gap edge. By performing spin-resolved spectroscopy of the out-of-equilibrium quasiparticle populations in a mescoscopic superconductor, we reveal that their distribution functions are non-Fermi-Dirac. In addition, our spectroscopic technique allows us to observe a charge imbalance, localised in energy to the gap edge and thus unambiguously identify the spin energy mode. Our results agree well with theory and shed light on energy transport in superconducting spintronics.

Conformation changes of albumin and lysozyme on electrospun TiO2 nanofibers and its effects on MSC behaviors.

Protein adsorption plays a key role in bone repair and regeneration by affecting cell behavior. In this study, TiO2 nanofibers (TiO2 NFs) with different structures, including anatase TiO2 nanofibers (A-NFs), anatase TiO2 nanofibers with beads (B-NFs), anatase-rutile TiO2 nanofibers (AR-NFs) and rutile TiO2 nanofibers (R-NFs), were prepared by electrospinning method. Bovine serum albumin (BSA) and lysozyme (LYZ) were used to explore the adsorption behaviors of TiO2 NFs and then the effects of materials with protein on bone marrow mesenchymal stem cells (MSCs) were studied. Pure titanium metal (PT) was used as control. The results displayed that the adsorption amounts of BSA on samples were B-NFs > AR-NFs > A-NFs ≈ R-NFs > PT, and that for LYZ were B-NFs > AR-NFs > R-NFs > A-NFs > PT. The conformation of proteins changed remarkably when they were adsorbed on meterials. Soaking the TiO2 NFs with and without protein into SBF revealed that the BSA and LYZ on B-NFs, A-NFs and AR-NFs could accelerate the HA deposition on its surface, but it had no promoting effect on HA deposition on B-NFs. MTT and PCR tests showed that the BSA and LYZ adsorbed on materials could promote the proliferation and osteogenic differentiation of MSCs to different degrees due to their different adsorption amount and conformation changes on different TiO2 NFs. The current work demonstrated that the surface properties and crystal structure of TiO2 NFs could influence the adsorption behavior and conformational change of BSA and LYZ, and then further regulate MSCs biological behavior.

[Efficacy and safety of eltrombopag in aplastic anemia: A multi-center survey in China].

Objective: To evaluate the safety and efficacy of eltrombopag combined with immunosuppressive therapy in patients with aplastic anemia (AA) in China. Methods: We investigated and analyzed the clinical data of AA patients from 14 hematological treatment centers who were treated with oral eltrombopag for at least 3 mon. Results: We enrolled 56 AA patients, including 19 treatment-naïve patients and 37 IST-refractory patients. The median administration period for eltrombopag was 7 (3-31) months, and the median maximum stable dosage was 75 mg/d (50-150 mg/d) . The 3-month hematological response (HR) rate was 60%, and the complete response (CR) rate was 30% in 10 SAA patients who were treated with first-line eltrombopag and standard IST (ATG+CsA) . Eight of 9 eltrombopag and CsA ± androgen first-line treated SAA patients responded (8/9, 89%) and 4 (44%) gave CR. The overall HR and CR rates were 79% and 52.6%, respectively, among these 19 patients by the end of the follow-up period. Of the 19 AA patients who were refractory to CsA ± androgen, 11 achieved HR (57.9%) at 3 mon, and the best HR rate was 44% in standard IST (ATG+CsA) refractory 18 patients after eltrombopag treatment. Fifty-one percent of the patients experienced mild or moderate adverse events, and gastrointestinal discomfort was the most common adverse effect reported by the study subjects. Conclusion: Adding Eltrombopag in first-line IST can accelerate the acquisition and improve the quality of hematological responses in AA patients. AA with relatively more residual hematopoietic cells may be well treated with eltrombopag and non-ATG IST. Eltrombopag can be used as salvage therapy for CsA±androgen refractory patients. Eltrombopag was generally safe and well tolerated by AA patients in China.

Assessment of toxicity potential of metallic elements in discarded electronics: a case study of mobile phones in China.

The electronic waste (e-waste) is increasingly flooding Asia, especially China. E-waste could precipitate a growing volume of toxic input to the local environment if it was not handed properly. This makes the evaluation of environmental impact from electronics an essentially important task for the life cycle assessment (LCA) and the end-of-life management of electronic products. This study presented a quantitative investigation on the environmental performance of typical electronics. Two types of disposed mobile phones (MPs), as a representative of consumer electronics, were evaluated in terms of toxicity potential indicator (TPI) with an assumption of worst-case scenario. It is found that the composition and the percentages of constituents in MPs are similar. More than 20 metallic elements make up 35 wt.%-40 wt.% of the total weight, of which 12 elements are identified to be highly hazardous and 12 are less harmful. With the TPI technique, the environmental performance of Pb is attributed to be 20.8 mg(-1). The total TPIs of metallic elements in the old and new type MP is 255,403 and 127,639 units, respectively, which is equivalent to the effect of releasing 6.14 and 12.28 g Pb into the environment. The average TPI of the old and new type MP is 4.1 and 4.5 mg(-1), respectively, which suggests a similar eco-efficiency per unit mass. The new model of MP is more eco-effective than the old one, which is not due to a reduction in the type of hazardous elements, but rather due to a significant miniaturization of the package with less weight. A single MP can have a considerable toxicity to the environment as referred to Pb, which suggests a major concern for the environmental impact of the total e-waste with a huge quantity and a heavy mass in China.

Oxidative stress, apoptosis and abnormal expression of apoptotic protein and gene and cell cycle arrest in the cecal tonsil of broilers induces by dietary methionine deficiency.

Methionine (Met) is often called the first limiting amino acid in birds. Broilers have high requirement for Met, so they are at high risk of Met deficiency. The aims of the present research is to study the effects of Met deficiency on the histomorphological changes, antioxidant functions, apoptosis and cell cycle in the cecum tonsil of broilers. A batch of 120 one-day-old Cobb broilers in total are divided into two groups and fed on a Met deficiency diet or a control diet for six weeks, followed by analysis using the methods of experimental pathology, biochemical method, immunohistochemical method, ELISA, FCM, Tunel assay, and qRT-PCR. Results showed that the cecal tonsils were impaired, and the SOD, CAT and GSH-Px activity, the ability to suppression on the hydroxy radicals, and the content of GSH reduced in Met deficiency group comparing to the control group. In contrast, the MDA content is higher in Met deficiency group. As measured by immunohistochemical method, ELISA, Tunel, FCM and qRT-PCR, increased proportion of apoptotic cells, abnormal content or expression of apoptotic proteins, as well as cell cycle arrest were observed. In conclusion, dietary Met deficiency imposes a severe impact on the cecal tonsils, mainly in the forms of histological injury, cell cycle arrest, oxidative stress, and increased cellular apoptosis. The oxidative stress leads to cellular apoptosis and then induces the injury of the cecum tonsils. The local intestinal mucosal immune system would finally be injured by the oxidative stress and apoptosis in the intestine.

Effects of simvastatin on lung injury induced by ischaemia-reperfusion of the hind limbs in rats.

We investigated whether simvastatin reduces lung injury caused by ischaemia-reperfusion of the hind limbs in rats. The control group underwent dissection of bilateral femoral arteries; another group (I/R group) underwent ischaemia of bilateral hind limbs for 2 h followed by 3 h reperfusion; and two other groups were pretreated with 5 or 10 mg/kg per day simvastatin for 3 days and then underwent ischaemia-reperfusion. The control and I/R group rats received placebo (water) instead of simvastatin. The lungs of the I/R rats showed marked histopathological changes compared with the other groups. Lung tissue myeloperoxidase, malondialdehyde, neutrophil count and lung injury scores in both simvastatin groups were significantly lower than in the I/R group; 10 mg/kg per day simvastatin significantly reduced lung water content although 5 mg/kg per day did not. Expression of haem oxygenase-1 (HO-1) protein in lung tissue was significantly greater in the simvastatin groups than in the I/R group. Simvastatin protects against lung injury associated with lower extremity ischaemia-reperfusion by reduction of neutrophil aggregation and oxidative damage, and upregulation of HO-1 expression in the injured lung.

Synergistic effects of fibronectin and bone morphogenetic protein on the bioactivity of titanium metal.

To improve the biological properties of bioactive titanium metal, recombinant human bone morphogenetic protein 2(rhBMP-2) and fibronectin (Fn) were adsorbed on its surface solely or contiguously to modify the anodic oxidized titanium (AO-Ti), acid-alkali-treated titanium (AA-Ti), and polished titanium (P-Ti). It is found that the different bioactive titanium surface structures had great influence on protein adsorption. The adsorption amounts of BMP adsorbed solely and Fn/BMP adsorbed contiguously were AA-Ti > P-Ti > AO-Ti, and that for Fn adsorbed solely was AA-Ti ≈ P-Ti > AO-Ti. The conformation of proteins was changed remarkably after the adsorption. For BMP, the α-helix decreased on AA-Ti and stabilized on P-Ti and AO-Ti. For Fn, the ß-sheet on PT-Ti and AA-Ti increased significantly. For Fn/BMP, the percentage of ß-sheet on AA-Ti increased, and that of α-helix on all samples was stable. MSCs showed greater adhesion and spreading on Fn/BMP groups. MTT and Elisa tests showed that the synergistic effects of proteins made the cells proliferate and differentiate faster. It indicated both the surface structure and the synergistic effects of proteins could influence the biological properties of titanium metals. It provides research foundation for improving the biological properties of bioactive titanium metals by simultaneous application of several proteins. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 2485-2498, 2017.

[Significance of the combined detection of routine blood test, serum iron and hemoglobin electrophoresis in screening thalassemia in non- high incidence area].

Objective: To evaluate the role of combined detections of routine blood test, serum iron and hemoglobin electrophoresis in screening thalassemia in non- high incidence area. Methods: Peripheral blood and serum samples of 1 000 outpatients from the department of hematology and the department of gynecology and obstetrics were obtained. Common mutations of thalassemia were detected by using GAP- PCR and reverse dot blotting, and Sanger sequencing was performed to discover rare mutations of α- and ß- thalassemia. Routine blood test, serum iron and hemoglobin electrophoresis were also performed for every patient. Results: Among 1 000 samples, 225(22.5%)are detected as α-thalassemia, 403(40.3%)ß-thalassemia and 15(1.5%)composite thalassemia. Among 225 α-thalassemia patients, 28 were silent, 138 were intermedia, and 59 were HbH disease. Of 403 ß-thalassemia, 390 were carriers, 7 were double heterozygote, and 6 were homozygote. In all samples, there were 357 patients detected with no common mutations, 38 patients had higher result values for both MCV and MCH and none detected with thalassemia gene. There were 48 patients who had higher serum iron but normal or lower MCV, 42 of them(87.5%)had thalassemia gene. Furthermore, 38 patients showed abnormal hemoglobin electrophoresis, 35 of them were HbH disease, while the other 3 were HbF- related thalassemia. Five patients showed abnormal hemoglobin electrophoresis, lower MCV and MCH, as well as higher serum iron, had no frequent mutation but rare ones. Conclusion: Patients with higher MCV and MCH can mostly be excluded to have thalassemia, while higher serum iron represents thalassemia possibility and can provide a preliminary indication of thalassemia type, and last but not least abnormal hemoglobin electrophoresis indicates the disease. It is recommended to further carry out sequencing of rare mutations for those who had abnormal results in the combined screening, and detected with no frequent mutation. Combination of these three examinations can improve the detection efficiency of patients with thalassemia.

Long-term outcomes of HLA-haploidentical stem cell transplantation based on an FBCA conditioning regimen compared with those of HLA-identical sibling stem cell transplantation for haematologic malignancies.

A comparison was conducted of 213 patients with haematologic malignancies who underwent HLA-identical sibling (n=108) or HLA-haploidentical (n=105) haematopoietic cell transplantation (haplo-HCT) at our centre. The conditioning regimen included fludarabine, busulphan, cyclophosphamide and antilymphocyte globulin (ATG) (FBCA). The total dose of ATG differed between identical and haploidentical groups (3.75 mg/kg versus 12.5 mg/kg). The cumulative incidences of grade II-IV acute GvHD in the identical and haploidentical groups were 20.4% and 21.9% (P=0.73), and 2-year cumulative incidences of chronic GvHD were 36.4% and 24.1% (P=0.17), respectively. The 3-year probabilities of non-relapse mortality for identical and haploidentical groups were 20.5% and 34.9% (P=0.048), and for relapse were 22.2% and 21.0% (P=0.85), respectively. The 3-year overall survivals in the identical and haploidentical groups were 62.6% and 52.6% (P=0.054), whereas the 3-year disease-free survivals were 54.7% and 43.1% (P=0.14), respectively. In the multivariate analysis, patients in the high-risk group exhibited reduced survival, and the higher dose of mononuclear or CD34+ cells resulted in an increase in the likelihood of survival. In conclusion, haplo-HCT based on an FBCA conditioning regimen could achieve nearly comparable outcomes to HLA-identical sibling HCT.