[Analysis of the therapeutic effect of aspiration thrombectomy for early carotid stent thrombosis].

Objective: To investigate the clinical characteristics and the efficacy of thrombus aspiration in patients with early intrastent thrombosis (EST) following carotid artery stenting (CAS). Methods: This study is a retrospective case series, collecting clinical data of five patients who developed EST after CAS in the Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University from January 2021 to September 2023.All patients were male, with an age of (64.0±11.9) years (range:48 to 77 years), accounting for 2.0% (5/244) of CAS procedures during the same period.Among them, three patients did not receive standard dual antiplatelet therapy before the procedure, and one had an inadequate ADP inhibition rate (45.6%).Four patients received XACT carotid stents, while one received a Wallstent carotid stent.All five patients showed significant residual stenosis ranging from 43% to 55% after CAS.Emergency thrombus aspiration was performed in all cases, and data regarding perioperative conditions, vascular patency, and clinical outcomes were collected. Results: The interval between CAS and the occurrence of EST ranged from 3 hours to 14 days.The main clinical symptoms included sudden onset of consciousness disorders and contralateral limb weakness.None of the patients received preoperative intravenous thrombolysis, and thrombus aspiration was performed during the procedure to restore vascular patency.Four cases underwent balloon angioplasty during the procedure, and two cases utilized overlapping stents.Two patients experienced intraoperative embolization of thrombus to the C2 segment.In one case, the embolized thrombus was retrieved using an intracranial thrombectomy stent, while in another case, it was aspirated using a guiding catheter.Postoperatively, all patients had a thrombolysis in cerebral infarction grade of 3, and symptoms improved in four cases.One patient showed no improvement in symptoms, and MRI revealed extensive new infarction in the right frontal and insular regions, adjacent to the right lateral ventricle.Regular follow-up examinations after discharge did not reveal restenosis or embolism within the stent.The follow-up period ranged from 7.6 to 21.2 months, with modified Rankin scale scores of 0 to 1 point in four cases and 2 points in one case, indicating good recovery in all patients. Conclusions: Acute intrastent thrombosis is a rare complication after carotid artery stenting.The combined use of percutaneous thrombus aspiration and endovascular techniques, such as balloon angioplasty and stent overlapping, can rapidly restore vessel patency with favorable outcomes.However, further large-scale clinical studies are needed to confirm the effectiveness of these treatments for acute intrastent thrombosis.

The Diagnostic Value of Serum ST8SIA6-AS1 as Biomarker in Hepatocellular Carcinoma.

BACKGROUND: Long noncoding RNA (lncRNA) is a promising serum biomarker in cancer diagnosis. However, literature on the diagnostic value of the lncRNA for hepatocellular carcinoma (HCC) is scant. METHODS: The expression of ST8SIA6-AS1 in serum and HCC cell lines was detected by real-time PCR (RT-PCR). We then analyzed the relationship between clinicopathological characteristics and serum ST8SIA6-AS1 expression. In addition, we performed the receiver operating characteristic (ROC) curve and area under curve (AUC) analyses to determine the diagnostic ability of serum ST8SIA6-AS1. RESULTS: Our data demonstrated an up-regulation of ST8SIA6-AS1 in 77 HCC patients and HCC cell lines. Besides, clinicopathological analysis revealed that ST8SIA6-AS1 corresponds with tumor stages and metastasis, thus might be used for monitoring the HCC progress. Importantly, the ROC analysis demonstrated that ST8SIA6-AS1 yields a superior diagnostic ability. Compared with α-fetoprotein (AFP) alone, a combination of ST8SIA6-AS1 and AFP may achieve more reliable diagnostic results. CONCLUSIONS: Together, our results demonstrate that serum ST8SIA6-AS1 is a promising serum diagnostic bio-marker for HCC.

SLEEP-GOAL: A multicenter success criteria outcome study on 302 obstructive sleep apnoea (OSA) patients.

OBJECTIVE: To demonstrate SLEEP-GOAL as a more holistic and comprehensive success criterion for Obstructive Sleep Apnoea (OSA) treatment. METHODS: A prospective 7-country clinical trial of 302 OSA patients, who met the selection criteria, and underwent nose, palate and/or tongue surgery. Pre- and post-operative data were recorded and analysed based on both the Sher criteria (apnoea hypopnea index, AHI reduction 50% and <20) and the SLEEP-GOAL. RESULTS: There were 229 males and 73 females, mean age of 42.4±17.3 years, mean BMI 27.9±4.2. The mean VAS score improved from 7.7±1.4 to 2.5±1.7 (p<0.05), mean Epworth score (ESS) improved from 12.2±4.6 to 4.9±2.8 (p<0.05), mean body mass index (BMI) decreased from 27.9±4.2 to 26.1±3.7 (p>0.05), gross weight decreased from 81.9±14.3kg to 76.6±13.3kg. The mean AHI decreased 33.4±18.9 to 14.6±11.0 (p<0.05), mean lowest oxygen saturation (LSAT) improved 79.4±9.2% to 86.9±5.9% (p<0.05), and mean duration of oxygen <90% decreased from 32.6±8.9 minutes to 7.3±2.1 minutes (p<0.05). The overall success rate (302 patients) based on the Sher criteria was 66.2%. Crosstabulation of respective major/minor criteria fulfilment, based on fulfilment of two major and two minor or better, the success rate (based on SLEEP-GOAL) was 69.8%. Based solely on the Sher criteria, 63 patients who had significant blood pressure reduction, 29 patients who had BMI reduction and 66 patients who had clinically significant decrease in duration of oxygen <90% would have been misclassified as "failures". CONCLUSION: AHI as a single parameter is unreliable. Assessing true success outcomes of OSA treatment, requires comprehensive and holistic parameters, reflecting true end-organ injury/function; the SLEEP-GOAL meets these requirements.

Proton pump inhibitors and risk of hip fracture: a meta-analysis of observational studies.

We performed a meta-analysis of relevant studies to quantify the magnitude of the association between proton pump inhibitors (PPIs) and risk of hip fracture. Patients with PPIs had a greater risk of hip fracture than those without PPI therapy (RR 1.20, 95% CI 1.14-1.28, p < 0.0001). These results could be taken into consideration with caution, and patients should also be concerned about the inappropriate use of PPIs. INTRODUCTION: Proton pump inhibitors (PPIs) are generally considered as first-line medicine with great safety profile, commonly prescribed for gastroesophageal reflux disease (GERD) and peptic ulcer disease. However, several epidemiological studies documented that long-term use of PPIs may be associated with an increased risk of hip fracture. Although, the optimal magnitude of the hip fracture risk is still undetermined. We, therefore, performed a meta-analysis of relevant studies to quantify the magnitude of the association between PPIs and risk of hip fracture. METHODS: We collected relevant articles using MEDLINE, EMBASE, Google Scholar, and Web of Science from January 1, 1990, to March 31, 2018. We included only the large (n ≥ 500) observational studies with a follow-up duration of at least one year in which the hip fracture patients were identified by a standard procedure. Two of the authors extracted data from each included study independently according to a standardized protocol. RESULTS: A total of 24 observational studies with 2,103,800 participants (319,568 hip fracture patients) met all the eligibility criteria. Patients with PPIs had a greater risk of hip fracture than those without PPI therapy (RR 1.20, 95% CI 1.14-1.28, p < 0.0001). An increased association was also observed in both low and medium doses of PPI taken and hip fracture risk (RR 1.17, 95% CI 1.05-1.29, p = 0.002; RR 1.28, 95% CI 1.14-1.44, p < 0.0001), but it appeared to be even greater among the patients with higher dose (RR 1.30, 95% CI 1.20-1.40, p < 0.0001). Moreover, the overall pooled risk ratios were 1.20 (95% CI 1.15-1.25, p < 0.0001) and 1.24 (95% CI 1.10-1.40, p < 0.0001) for the patients with short- and long-term PPI therapy, respectively, compared with PPI non-users. CONCLUSION: Our results suggest that PPI use is significantly associated with an increased risk of hip fracture development, which is not observed in H2RA exposure. Physicians should, therefore, exercise caution when considering a long-term PPI treatment to their patients who already have an elevated risk of hip fracture. In addition, patients should be concerned about the inappropriate use of PPIs; if necessary, then, they should continue to receive it with a clear indication.

Effects of triethylene glycol dimethacrylate and hydroxyethyl methacrylate on macrophage polarization.

AIM: To evaluate the effects of hydrophilic dental resin monomers, triethylene glycol dimethacrylate (TEGDMA) and hydroxyethyl methacrylate (HEMA), on the polarization of a human monocyte cell line (THP-1). METHODOLOGY: THP-1 cells were treated with resin monomers at noncytotoxic concentrations for 48 h and were analysed for CD86 and CD206 expressions using flow cytometry. The cells were stimulated for polarization in the presence of resin monomers (co-treatment) or after treatment with monomers (pre-treatment). CD86 and CD206 mRNA in co-treated cells was evaluated using quantitative real-time polymerase chain reaction. The release of TNF-α and TGF-ß by pre-treated and co-treated cells was assessed using enzyme-linked immunosorbent assay. Morphological changes of macrophages during polarization were observed using bright-field microscopy. One-way analysis of variance was used for statistical analysis. RESULTS: TEGDMA (1 mmol L-1 ) and HEMA (2 mmol L-1 ) did not induce CD86 and CD206 expressions in THP-1 cells but rather inhibited their expressions in the co-treated cells. The inhibitory effects also appeared at the transcription level. However, the expression of surface markers was not affected by pre-treatment with resin monomers. The release of TNF-α and TGF-ß by M1- and M2-stimulated cells, respectively, was suppressed by co-treatment (P < 0.05). Microscopic studies revealed that co-treatment with resin monomers suppressed polarization-associated morphological changes such as cell volume increase. CONCLUSIONS: TEGDMA and HEMA inhibited macrophage polarization to both M1 and M2 at the transcription level, and the inhibitory effects disappeared upon the removal of resin monomers from the cell culture.

Newborn hearing screening in prematurity: fate of screening failures and auditory maturation.

OBJECTIVES: The purpose of this study was to identify delayed auditory maturation and the fate of premature infants who failed the newborn hearing screening (NHS) in neonatal intensive care unit. MATERIALS AND METHODS: A total of 1375 neonates underwent NHS using the transient evoked otoacoustic emission (TEOAE) in a tertiary hospital between 2007 and 2010 according to the Joint Committee on Infant Hearing guidelines. In addition, a structured telephone survey was given to caregivers of infants who were lost to follow-up NHS. Auditory steady-state response (ASSR) threshold and the threshold change in diagnostic test failures were analysed. RESULT: Among the 1375 NICU babies, 344 (25.0%) babies, 111 (9.7%) babies and 64 (4.6%) babies failed to pass the first TEOAE, second TEOAE and diagnostic ASSR, respectively. However, at the age of about 5 years, 12 (0.9%) infants showed permanent hearing loss (PHL). The ASSR threshold improved from 69.0 ± 19.7 dB to 52.9 ± 21.6 dB in <4 months (P < 0.001). Premature infants of <29 weeks of gestational age at birth showed higher referral (P = 0.003) rate at the first OAE test compared to the others, and the difference continued until the last follow-up. The odds ratio for the initial ASSR threshold >67.5 dB for PHL was 9.00 (95% confidence interval, 1.7-46.7). CONCLUSION: Most of first TEOAE screening failures (91.3%) showed normal hearing and speech development. Hearing levels in premature infants can improve over time, particularly in neonates with initial ASSR threshold <67.5 dB.

[Expression of FoxM1 and BCRP in invasive breast carcinoma of no special type and its prognosis significance].

Objective: To investigate the relationship between expression of FoxM1 and BCRP in invasive breast carcinoma of no special type (IBC-NST) tissues and the clinical pathological characteristics and prognosis of the patients. Methods: Seventy-eight cases of IBC-NST with excision were included. The expression of FoxM1 and BCRP was assessed by immunohistochemistry and its relationship with the clinical pathological characteristics and prognosis was evaluated. Results: FoxM1 was expressed in 71.8%(56/78) of IBC-NST, and the expression was related to tumor diameter, TNM staging, ER, PR and HER2. BCRP was expressed in 53.8% (42/78) of IBC-NST, and the expression was related to age, tumor diameter, lymph node metastasis, ER and HER2. Kaplan-Meier survival analysis showed the survival time was related to tumor diameter, TNM staging, lymph node metastasis and the expression of FoxM1, BCRP, ER, PR and HER2. Cox multivariate analysis showed that TNM staging, FoxM1, BCRP, HER2 were determinants of patient survival time. Conclusions: The expression of FoxM1 is associated with tumor diameter, TNM staging, ER, PR and HER2 while BCRP is associated with age, tumor diameter, lymph node metastasis, ER and HER2. Both FoxM1 and BCRP have prognostic significance in IBC-NST patients.

Effectiveness of anatomic criteria for predicting parotid tumour location.

OBJECTIVE: We evaluated the accuracy, positive predictive value (PPV), negative predictive value (NPV), specificity and sensitivity of eight anatomic landmarks to differentiate parotid deep lobe tumours from superficial lobe tumours: the lateral margin of the retromandibular vein (RMV), a straight line from the facial nerve trunk (FN trunk) to the mandibular ramus (FN line), a straight line from the FN trunk to the RMV (tRMV), a straight line from the FN trunk to the lateral margin of the masseter (tMasseter), a straight line from the ipsilateral vertebral posterior end to the RMV (U-line), an arc with a radius of 8.5 mm centred on the mandibular ramus (Conn's arc), a straight line from the lateral surface of the masseter muscle to the lateral margin of the RMV (rMasseter) and an angle from the FN line, tumour and the lateral margin of the masseter muscle (FTM angle). METHODS: A total of 181 patients with a parotid gland tumour who underwent parotidectomy at a tertiary hospital were identified retrospectively from May 2005 to May 2013. Pre-operative computed tomography and intraoperative findings were compared to evaluate each landmark. RESULTS: rMasseter (accuracy: 85.5%, PPV: 90.0%, NPV: 85.12%, specificity: 98.1%, sensitivity: 22.2%) and tMasseter (accuracy: 86.3%, PPV: 80.0%, NPV: 87.1%, specificity: 97.1%, sensitivity: 44.4%) showed superior results as diagnostic criteria. CONCLUSION: rMasseter and tMasseter were useful as anatomic landmarks to differentiate a parotid deep lobe tumour from a superficial lobe tumour.

[Effect of bufalin on proliferation and apoptosis through ERK/RSK2 pathway in human esophageal carcinoma cell line xenografts in nude mice].

OBJECTIVE: To investigate the effect of bufalin on proliferation and apoptosis through ERK/RSK2 pathway in esophageal squamous cell carcinoma xenografts in nude mice. METHODS: The subcutaneous xenograft model of esophageal cancer ECA109 cells in nude mice was established. The mice were divided into the model group, low-dose bufalin group, medium-dose bufalin group, high-dose bufalin group, PD98059 group and combination group to evaluate the effect of bufalin on the xenografts. The morphology of xenografts was observed by microscopy. The cell apoptosis index of xenografts was detected by TUNEL assay. The expression of ERK and RSK2 mRNA of human ECA109 cell transplantation tumor in nude mice was examined by real-time quantitative PCR. The protein levels of ERK, p-ERK, RSK2, p-RSK2, GSK3ß, p-GSK3ß, Bad and p-Bad in the xenografts were examined by Western blot and Immunohistochemistry. RESULTS: The tumor size of nude mice in the model group, low-dose bufalin group (BL), medium -dose bufalin group (BM), high-dose bufalin group (BH), PD98059 group and combined therapy group (BP) was (1.758±0.181) cm(3,) (1.680±0.150) cm(3,) (1.285±0.134) cm(3,) (0.873±0.095) cm(3,) (0.815±0.108) cm(3) and (0.530±0.104) cm(3,) respectively. Histological examination showed that the xenografts of each group had varying degrees of necrosis, and the most extensive necrosis was observed in the BP group. The TUNEL assay showed that the cell apoptosis index of xenografts in the model, BL, BM, BH, PD98059 and BP groups was (6.0±0.6)%, (11.0±0.7)%, (19.1±0.9)%, (25.1±1.4)%, (20.0±1.2)% and (17.1±0.7)%, respectively, which is highest in the BH group. The real-time quantitative PCR results showed that the ΔCT values of ERK mRNA in the model, BL, BM, BH, PD98059 and BP groups were 0.270±0.084, 0.293±0.081, 0.596±0.224, 0.857±0.183, 0.868±0.187 and 1.313±0.282, respectively. The ΔCT values of RSK2 mRNA in the model, BL, BM, BH, PD98059 and BP groups were 0.340±0.062, 0.337±0.071, 0.642±0.226, 0.915±0.170, 0.923±0.176 and 1.413±0.269, respectively. The relative expression of ERK and RSK2 mRNA was gradually decreased. Western blot and immunohistochemistry results showed that the protein levels of ERK, RSK2 and Bad in each group were not significantly different (P>0.05). The protein levels of p-ERK in the model, BL, BM, BH, PD98059 and BP groups were 0.721±0.094, 0.695±0.095, 0.555±0.080, 0.388±0.052, 0.341±0.060, 0.235± 0.056, respectively. The median immunoreactivity scores of p-ERK in each group were 8, 8, 6, 4, 5 and 3. The protein levels of p-RSK2 in the model, BL, BM, BH, PD98059 and BP groups were 0.613±0.085, 0.612±0.084, 0.427±0.089, 0.305±0.056, 0.258±0.051, 0.158±0.058, respectively. The median immunoreactivity scores of p-RSK in each group were 8, 8, 5, 3, 3 and 1. The protein level of GSK3ß in the model, BL, BM, BH, PD98059 and BP groups were increased gradually, while the protein level of p-GSK3ß and p-Bad were decreased gradually. CONCLUSIONS: Bufalin exerts significant inhibitory effect on the esophageal squamous cell carcinoma xenogragts in nude mice. Bufalin may suppress the growth of xenogragts in nude mice by down-regulating the level of ERK and RSK2 phosphorylation, inhibit the proliferation of xenogragts via inactivating GSK3ß and promote apoptosis through down-regulation of p-Bad.

[Association of the expression of leptin and leptin receptor with bone metastasis in pulmonary adenocarcinoma].

Objective: To explore the association of expression of leptin and leptin receptor (LR) with bone metastasis of pulmonary adenocarcinoma. Methods: One hundred and sixteen pulmonary adenocarcinoma patients who had complete clinicopathological data and definite pathological diagnosis in our hospital from January 2008 to January 2010 were selected. They were divided into the metastasis (n= 58) and non-metastasis (control, n=58) groups. The expressions of leptin and LR were identified by immunohistochemistry. The differences between expressions of leptin and LR in primary pulmonary adenocarcinoma tissues and metastasis, and between the groups with and without bone metastasis were analyzed. We also analyzed the correlation of leptin and LR expressed in primary adenocarcinoma and bone metastatic tissues, and the relationship between their expression levels and bone metastasis free survival (BMFS). Results: Among 58 patients of the metastasis group, the cases of high, moderate and low expressions of leptin were 36, 15 and 7, respectively, and the cases of high, moderate and low expressions of LR were 32, 17 and 9, respectively. Among the 58 patients of control group, the cases of high, moderate and low expressions of leptin were 19, 24 and 15, respectively, and those of LR were 17, 16 and 25, respectively. The expressions of leptin and LR in primary pulmonary adenocarcinoma tissues of metastasis group were significantly different from those of the control group (P=0.006, P=0.002, respectively). The expressions of leptin and LR in primary pulmonary adenocarcinoma tissues of the bone metastasis group were also significantly different from those of the non-bone metastasis group (P=0.029, P=0.032, respectively). The high/moderate expression rates of leptin and LR in the bone-metastatic tissues reached 91.4% (32/35) and 88.6% (31/35), respectively. The results showed that the expressions of leptin and LR in primary pulmonary adenocarcinoma tissues were positively related with their expressions in bone metastatic tissue (r = 0.612). The median bone metastasis free survival (BMFS) of the bone metastasis groups with high, moderate and low expressions of leptin were 14, 21 and 47 months, respectively, and the median BMFS of high, moderate and low expressions of LR in the bone metastasis group were 13, 19 and 27 months, respectively. The expressions of leptin and LR in pulmonary adenocarcinoma were significantly associated with BMFS (P<0.001, P=0.006, respectively). Conclusions: The expressions of leptin and LR are significantly up-regulated in primary pulmonary adenocarcinoma tissues and bone metastatic tissues, and are negatively correlated with BMFS. These two molecules may be used as effective predictors of bone metastasis in pulmonary adenocarcinoma.

Genetic polymorphisms in the prostaglandin pathway genes and risk of head and neck cancer.

OBJECTIVE: Previous studies examining the association between genetic variations in prostaglandin pathway and risk of head and neck cancer (HNC) have only included polymorphisms in the PTGS2 (COX2) gene. This study investigated the association between genetic polymorphisms of six prostaglandin pathway genes (PGDS, PTGDS, PTGES, PTGIS, PTGS1 and PTGS2), and risk of HNC. METHODS: Interviews regarding the consumption of alcohol, betel quid, and cigarette were conducted with 222 HNC cases and 214 controls. Genotyping was performed for 48 tag and functional single-nucleotide polymorphisms (SNPs). RESULTS: Two tag SNPs of PTGIS showed a significant association with HNC risk [rs522962: log-additive odds ratio (OR) = 1.42, 95% confidence interval (CI): 1.01-1.99 and dominant OR = 1.58, 95% CI: 1.02-2.47; rs6125671: log-additive OR = 1.49, 95% CI: 1.08-2.05 and dominant OR = 1.96, 95% CI: 1.16-3.32]. In addition, a region in PTGIS tagged by rs927068 and rs6019902 was significantly associated with risk of HNC (global P = 0.007). Finally, several SNPs interacted with betel quid and cigarette to influence the risk of HNC. CONCLUSIONS: Genetic variations in prostaglandin pathway genes are associated with risk of HNC and may modify the relationship between use of betel quid or cigarette and development of HNC.

Preliminary study of the clonal characteristics of the TCR BV subfamilies in T cells in the peripheral blood from patients with uveitis.

The aim of this study was to investigate the characteristics and polymorphisms of the T-cell receptor BV complementarity-determining region 3 (TCR BV CDR3) gene in peripheral blood mononuclear cells (PBMCs) from patients with uveitis to provide an experimental basis for studying the pathogenesis of this disease. RT-PCR amplification of 26 subfamilies of the TCR BV CDR3 gene and immune spectratyping analysis were used to study the pedigree drift of TCR BV CDR3 in PBMCs from the uveitis patients. The following results were obtained: 1) the vast majority of the TCR BV CDR3 spectra in PBMCs in 5 healthy subjects fit the normal (or Gaussian) distribution. The distributions of the TCR BV CDR3 spectra in 4 patients with uveitis were non-normal and showed an abnormal peak including a widowed peak trend, a partial peak, and an irregular abnormal peak. 2) In the 26 TCR BV subfamilies, the abnormal peak frequency was different in the various subfamilies. The BV2 and BV17 (both 3/4) subfamilies had higher frequencies of the non-normally distributed abnormal peak. The BV5.2, BV6, BV15, and BV18 subfamilies showed no abnormal peaks. 3) TCR BV2 and BV17 yielded an abnormal peak in 3 HLA-B27-negative patients; however, no such abnormalities were detected in HLA-B27-positive patients. The abnormal expression of some TCR BV subfamilies in PBMCs from patients with uveitis may be associated with the immune pathogenesis of the disease. Our study provides the basis for further investigations into the pathogenesis of uveitis.

[Propensity score matching analysis of the short-term efficacy of Kamikawa versus double- tract reconstruction in laparoscopic proximal gastric cancer surgery].

Objective: To compare the short-term efficacy of Kamikawa anastomosis and double-tract reconstruction (DTR) after proximal gastrectomy. Methods: This was a propensity score matched, retrospective, cohort study. Inclusion criteria comprised age 20-70 years, diagnosis of gastric cancer by pathological examination of preoperative endoscopic biopsies, tumor diameter ≤4 cm, and location in the upper 1/3 of the stomach (including the gastroesophageal junction), and TNM stage IA, IB, or IIA. The study cohort comprised 73 patients who had undergone laparoscopic proximal gastric cancer radical surgery in the Department of Gastroenterology, Tangdu Hospital, Air Force Medical University between June 2020 and February 2023, 19 of whom were in the Kamikawa group and 54 in the DTR group. After using R language to match the baseline characteristics of patients in a ratio of 1:2, there were 17 patients in the Kamikawa group and 34 in the DTR group. Surgery-related conditions, postoperative quality of life, and postoperative complications were compared between the two groups. Results: After propensity score matching, there were no statistically significant differences in baseline data between the two groups (P>0.05). Compared with the DTR group, the Kamikawa group had longer operative times (321.5±15.7 minutes vs. 296.8±26.1 minutes, t=32.056, P<0.001), longer anastomosis times (93.0±6.8 minutes vs. 45.3±7.7 minutes, t=56.303, P<0.001), and less bleeding (76 [54~103] mL vs.112 [82~148) mL, Z=71.536, P<0.001); these differences are statistically significant. There were no statistically significant differences between the two groups in tumor size, time to first postoperative passage of gas, postoperative hospital stay, number of lymph nodes removed, duration of lymph node dissection, or total hospitalization cost (all P>0.05). The median follow-up time was 6.1 ± 1.8 months. As to postoperative quality of life, the Kamikawa group had a lower rate of upper gastrointestinal contrast reflux than did the DTR group (0 vs. 29.4% [10/34], χ2=6.220, P=0.013); this difference is statistically significant. However, differences between the two groups in quality of life score on follow-up of 3 months and 6 months on the Gastroesophageal Reflux Disease (GERD) scale were not statistically significant (all P>0.05). The incidence of postoperative complications was 2/17 in the Kamikawa group, which is significantly lower than the 41.2% (14/34) in the DTR group (χ2=4.554, P=0.033). Conclusion: Kamikawa anastomosis and DTR are equally safe and effective procedures for reconstructing the digestive tract after proximal gastric surgery. Although Kamikawa anastomosis takes slightly longer and places higher demands on the surgical team, it is more effective at preventing postoperative reflux.

First Report of Colletotrichum chlorophyti Infecting Soybean Seed in Arkansas, United States.

Colletotrichum chlorophyti was first reported in the United States in 2009 on soybean petioles (Glycine max [L.] Merr.) collected from Alabama, Illinois, and Mississippi (4). This species has not been reported to infect seed, unlike other Colletotrichum spp. (2). From the 2012 growing season, soybean seeds obtained from the National Agricultural Statistics Service representing 151 seed lots from growers' fields in 11 states were assayed by plating them on acidified potato dextrose agar (APDA). Before plating, seeds were surface disinfected by sequential immersion in 50% ethanol for 30 s, 20% commercial bleach for 1 min, two 1 min rinses in sterile distilled water, and kept at 25°C in the dark for 1 week. Infected seeds from one seed lot from Arkansas produced colonies similar to Colletotrichum spp. This seed lot was visually examined and divided into asymptomatic or discolored symptomatic seeds. Because of the limited number of seeds in the seed lot, 20 seeds that asymptomatic and 40 seeds that appeared symptomatic were assayed on APDA as previously described. Asymptomatic seeds did not produce any dark fungal colonies. Among the symptomatic seeds, five appeared to have flecked light gray seed coats with some larger grayish to black and irregular spots where cracks were sometimes formed, and they developed small black fungal masses or became entirely dark on the surface. Five fungal isolates were obtained from these infected seeds. On APDA, the isolates initially produced white to pink smooth-margined colonies, turned black with age, produced no aerial growth, and filled a 9 cm diameter petri dish within 10 days. DNA of one isolate was extracted for PCR and sequencing of the ITS region with ITS1 and ITS4 primers (3). From the BLAST analysis, the sequence was 100% identical to C. chlorophyti isolates, IMI 103806, and CBS 142.79 (Accession Nos. GU227894 and GU227895, respectively). To test for pathogenicity, the fungus was sub-cultured on APDA and eight APDA discs (4 mm diameter) were set into 50 ml potato dextrose broth inside a 250-ml flask and shook at a speed of 100 rpm at room temperature (24 ± 1°C) for 10 days. The mycelium was then weighed, fragmented with a blender, and resuspended in sterile distilled water to a final concentration of ~40 mg/ml. The mycelial suspension was sprayed on soybean seedlings of cv. Williams 82 (two plants/pot) at growth stage V1 to V2 until runoff. The inoculated plants were kept in a moist chamber (>90% relative humidity) for 48 h at 24 ± 1°C in the dark, and then transferred to normal plant growing conditions. At 5 days post-inoculation (dpi), the leaves showed typical symptoms caused by C. chlorophyti, including necrosis on the edge of young leaves and petioles, formation of irregular dark brown lesions, and leaves became scrolled (4). Setose acervuli, curved conidia with tapered ends (21.4 ± 1.1 × 3.8 ± 0.3 µm), and chlamydospores were found on the detached symptomatic leaves after 12 dpi. No perithecia formed. The morphology matched the description of C. chlorophyti (1,4). To our knowledge, this is the first report of C. chlorophyti in Arkansas and the first time that this species has been reported infecting seed of any plant. References: (1) S. Chandra and R. N. Tandon. Curr. Sci. 34:565, 1965. (2) G. L. Hartman et al. Page 13 in: Compendium of Soybean Diseases, APS Press, St. Paul, MN, 1999. (3) T. J. White et al. Page 315 in: PCR Protocols. A Guide to Methods and Applications. Academic Press, San Diego, CA, 1990. (4) H.-C. Yang et al. Plant Dis. 96:1699, 2012.

First Report of Colletotrichum chlorophyti Causing Soybean Anthracnose.

Anthracnose of soybean [Glycine max (L.) Merr.] is caused by several Colletotrichum spp. (4). Petiole samples were collected from Alabama, Mississippi, and Illinois in 2009. Diseased tissues suspected of being caused by Colletotrichum were cut into 1- to 2-cm lengths, surface-disinfested, and placed on water agar. Pure cultures obtained by picking single spores from sporulating acervuli on tissue or hyphal tips on agar were transferred to acidic potato dextrose agar (APDA) at 24 ±1°C under 12-h cool-white fluorescent lighting. Isolates were grouped by morphological characteristics. One group consisting of six isolates (four from IL and one each from AL and MS) did not morphologically match any reported Colletotrichum spp. causing soybean anthracnose but matched the description of C. chlorophyti S. Chandra & Tandon (1,2). On APDA, colonies were initially pink, turning black after several days with smooth margins and no aerial mycelium. Conidial masses were light salmon in color. Conidia ranged from 15.5 to 21.3 µm long (mean 18.0 µm) × 2.5 to 4.3 wide (mean 3.3 µm) (n = 200). They were curved with tapered ends and a truncated base, aseptate, and hyaline. Chlamydospores were dark brown, clustered or chained together, and 5 to 12 µm wide (n = 30). Setae were straight, dark brown, and septate. Appressoria and perithecia were absent. Soybean plants (cv. Williams 82) at the V2 to V3 stage were atomized with a suspension of fragmented mycelia (40 mg/ml) using one isolate from IL. Plants were kept moist (>90% relative humidity) for 48 h in the dark, then transferred to normal growing conditions. Three days post-inoculation, younger trifoliolate leaf margins and intra- and interveinal lesions were necrotic surrounded by slight chlorosis. Isolations were obtained from symptomatic leaves and confirmed as C. chlorophyti by morphological characteristics. Further comparisons were completed with one isolate (IL1A or BPI 884117) by PCR and BLAST sequencing analyses of the partial ITS rDNA region, actin, ß-tubulin, GAPDH, and histone H3 genes (2) (GenBank Accession Nos. JX126475, JX126476, JX126477, JX126478, and JX126479, respectively). The results showed high identity of all the five sequences to two C. chlorophyti isolates, IMI 103806 and CBS 142.79 (Accession Nos. GU227894/GU227895 in ITS = 100%, GU227992/GU227993 in actin = 99%, GU228188/GU228189 in ß-tubulin = 99%, GU228286/GU228287 in GAPDH = 99% and 96%, respectively, and GU228090/GU228091 in histone H3 = 99%). Soybean anthracnose, commonly caused by C. truncatum, has curved and truncated conidia that are longer than C. chlorophyti. In addition, the two are distinguished by chlamydospores and lack of appressoria in C. chlorophyti combined with differences in multigene sequence analysis. Isolates of C. chlorophyti were reported to infect Chlorophytum sp. (Liliaceae) in India and Stylosanthes hamate in Australia (3). To our knowledge, there are no previous reports of this species in the United States or of it infecting soybean worldwide (3). This report describes C. chlorophyti as a novel incitant of soybean anthracnose. References: (1) S. Chandra and R. N. Tandon. Curr. Sci. 34:565, 1965. (2) U. Damm et al. Fungal Divers. 39:45, 2009. (3) D. F. Farr and A. Y. Rossman. Fungal Databases, Systematic Mycology and Microbiology Laboratory, ARS, USDA. Retrieved from http://nt.ars-grin.gov/fungaldatabases/ , May 21, 2012. (4) G. L. Hartman et al. Compendium of Soybean Diseases, APS Press, St. Paul, MN. pp. 13, 1999.

The expression of cytokeratin and apoptosis-related molecules in echinococcosis related liver injury.

The study aimed to investigate the expression of cytokeratin and apoptosis-related molecules in the livers of two types of hepatic echinococcosis mice models and to preliminarily explore the relationship between the expression of cytokeratin and apoptosis in echinococcosis related liver injury. We established a mouse model infected by Echinococcus granulosus and Echinococcus multilocularis and observed the expression of cytokeratin and apoptosis related proteins in the two types of hepatic echinococcosis tissues during different stages by immunohistochemical staining. A co-culture model was established using normal hepatocytes and different concentrations of E. granulosus and E. multilocularis protoscoleces. Cell Counting Kit-8 was used to detect cell proliferation, flow cytometry was used to detect hepatocyte apoptosis, and western blot was used to quantify cytokeratin and apoptosis-related proteins, such as caspase3, caspase9, Bcl-2, and Bax. Surgical specimens were obtained from patients with hepatic echinococcosis to analyze the expressions of cytokeratin, caspase3, caspase9, Bcl-2, and Bax by western blot. The expressions of cytokeratin and caspase3 were analyzed by immunohistochemistry. The qRT-PCR method was used to determine the expression of CK8 and CK18 in the liver tissues. In vivo experiments showed that compared to that in the control group, the cytokeratin and caspase3 proteins in the liver tissues of the two types of hepatic echinococcosis were strongly expressed around the lesions of liver echinococcosis; there was a difference between cytokeratin expression of the two different echinococcosis parasites in the liver. Echinococcus granulosus and Echinococcus multilocularis in the co-culture model in vitro could promote the expression of CK, caspase3, caspase9, and Bax protein, decrease the expression of Bcl-2, promote hepatocyte apoptosis, and inhibit cell proliferation; in clinical samples, we found that compared with that in the normal tissues, the expression of cytokeratin, caspase3, caspase9, and Bax in echinococcus tissues was high, but that in Bcl-2 was low. Furthermore, the expression of CK8 and CK18 mRNA were higher in echinococcus tissues than that in the normal tissues and immunohistochemistry analysis also showed that cytokeratin and caspase3 levels were higher in echinococcus tissues than that in the normal tissues. The expression of cytokeratin and apoptosis-related molecules, reflecting liver damage, is high in the liver and is caused due to hepatic echinococcosis. This study provides the first evidence of cytokeratin could be useful for evaluating liver tissue damage caused by echinococcus infection.

Growth and properties of Zn(1-x)CdxO and Zn(1-x)CdxO/ZnO core/shell nanoparticles.

Octylamine capped Zn(1-x)CdxO alloys and Zn(1-x)CdxO/ZnO core/shell nanoparticles have been grown by the thermal decomposing of zinc and cadmium cupferronates in organic solvents. Zn(1-x)CdxO alloys incorprated with different concentration of Cd have been grown by quickly injecting of their precursors at 200 degrees C. Zn(1-x)CdxO/ZnO core/shell nanoparticles are performed by slowly injecting of shell precursors at 180 degrees C. The prepared nanoparticles are characterized by X-ray diffraction, absorption spectrometer, Mirco-Raman spectrometer and transmission electron microscopy. The band gap of ZnCdO alloys shrinks linearly and the crystal lattice expands with an increase of Cd concentration. The growth of ZnO shells on ZnCdO cores enhances the core luminescence dramatically and results in a red shift in the absorption and emission of Zn(1-x)CdxO cores.

Growth and properties of ZnO/Zn(1-x)MgxO core/shell nanoparticles.

ZnO/Zn(0.9)Mg(0.1)O core/shell nanoparticles have been grown by employing metal cupferronate complex as precursors in organic solvents. ZnO cores are grown by quickly injecting their precursor at 250 degrees C while the shells are performed by slowly injecting their precursors at different temperatures. The grown nanoparticles are characterized by X-ray diffraction, photoluminescence microscopy, and transmission electron microscopy. The effects of the shell growth temperatures and precursor injecting rate are studied. Zn(0.9)Mg(0.1)O shells can epitaxially grow on ZnO cores when the shell growth temperature is lowered to 200 degrees C and the shell precursor is supplied slowly at a rate of 0.1 mmol/h. Increaseing shell supply rate or shell growth temperature results in homogenous growth of Zn(0.9)Mg(0.1)O nanoparticles. The shell growth can dramatically enhance core emission and cause a red shift on the core band edge emission.

Effects of Inflammatory Disease on Clinical Progression and Treatment of Ischiogluteal Bursitis: A Retrospective Observational Study.

INTRODUCTION: The symptoms of Ischiogluteal Bursitis (IGB) are often nonspecific and atypical, and its diagnosis is more challenging. Moreover, it is difficult to predict cases of chronic progression or poor treatment response. Therefore, the aim of this study was to investigate the clinical course of IGB patients and identify factors that are predictive of failure of conservative treatment. MATERIALS AND METHODS: Our study consisted of IGB patients diagnosed between 2010 March and 2016 December who had been followed-up for at least one year. Structured questionnaires and medical records were reviewed to analyse demographic characteristics, lifestyle patterns, blood tests, and imaging studies. We categorized the cases into two groups based on the response to conservative treatment and the need for surgical intervention. RESULTS: The most common initial chief symptoms were buttock pains in 24 patients (37.5%). Physical examinations showed the tenderness of ischial tuberosity area in 59 (92.2%) patients, but no specific findings were confirmed in 5 patients (7.8%). 51 patients (79.7%) responded well to the conservative management, 11 patients (17.2%) needed injection, and 2 patients (3.1%) had surgical treatment performed due to continuous recurrence. There was no difference in demographic and blood lab data between the two groups. However, the incidence of inflammatory diseases (response group: 10.3% vs non-response group: 66.7%, p=0.004) was significantly different between the two groups. CONCLUSION: The diagnosis of IGB can be missed due to variations in clinical symptoms, and cautions should be exercised in patients with inflammatory diseases as conservative treatment is less effective in them, leading to chronic progression of IGB.