Prevalence and Risk Factors of Acute Pulmonary Embolism in Patients with Lung Cancer Surgery.

Acute pulmonary embolism (PE) is one of the serious complications with high mortality after thoracic surgery. The authors aimed to determine the prevalence of PE events and evaluate additional risk factors for PE in patients with lung cancer surgery. Patients underwent lung cancer resections during January 2012 to July 2015 and had 30-day postoperative follow-up were included. Those with incomplete or miscoded data were excluded. The number of postoperative PE events was recorded retrospectively. Analyses were used to evaluate risk factors of PE during the hospitalization. The authors reviewed 11,474 patients who underwent surgery for lung cancer. The overall 30-day incidence of PE after thoracic surgery at their institution was 0.53%. The 30-day PE incidence without chemical prophylaxis was 0.57% (55/9,726) and the mortality rate was 10%. Multivariate analyses revealed that age over 66 (odds ratio [OR]: 1.09, 95% confidence interval [CI]: 1.05-1.12, p < 0.001), more extensive surgery than lobectomy (OR: 2.34, 95% CI: 1.28-4.25, p = 0.006) and stage IV of lung cancer (OR: 4.22, 95% CI: 1.50-11.9, p = 0.007) were associated with an increased risk of PE. Using these additional risk factors, based on readily available clinical characteristics, can help to risk-stratify patients and warrant extended chemical prophylaxis for patients to reduce the incidence of acute PE.

Pathogenic role of glycan-specific IgG antibodies in IgA nephropathy.

BACKGROUND: Accumulating evidences proved the important roles of circulating IgA1-containing immune complexes (cIgA1) in IgA nephropathy (IgAN). Galactose-deficient IgA1 (Gd-IgA1) and glycan-specific IgG antibody have been identified as major components in cIgA1. Before, Gd-IgA1 was reported as a vital factor in IgAN, partly via of its pathogenic role to induce mesangial cells activation. However, we still lack direct evidences to clarify the biological effect of glycan-specific IgG antibody in IgAN. METHODS: In the present study, we enrolled 35 IgAN patients and 17 age- and sex-matched healthy controls. Using uniform aberrant glycosylated IgA1 molecules, and IgG from different individuals, we in vitro prepared IgG-ddIgA1 complexes, and compared the biological differences among these immune complexes regarding their proliferative and inflammatory effects on mesangial cells. RESULTS: IgG-ddIgA1 complexes from both patients with IgA nephropathy (IgAN-IgG-dd-IgA1) and healthy controls (HC-IgG-dd-IgA1) could induce the proliferation of mesangial cells and up-regulate expression of MCP-1, IL-6 and CXCL1. The levels of mesangial cells proliferation induced by IgAN-IgG-dd-IgA1 were significantly higher than those induced by HC-IgG-dd-IgA1 (1.10 ± 0.05 vs. 1.03 ± 0.03; p < 0.001). However, the levels of secreted MCP-1, IL-6 and CXCL1 from mesangial cells challenged by IgAN-IgG-dd-IgA1 and HC-IgG-dd-IgA1 were comparable. CONCLUSIONS: We found that glycan-specific IgG antibodies derived from patients with IgAN had the biological effect to induce mesangial cells proliferation. Moreover, in the present study we also established a method for in vitro preparation of pathogenic IgG-ddIgA1 complexes, which could be applied in future studies exploring IgAN pathogenesis.

Diagnostic value of single-source dual-energy spectral computed tomography for papillary thyroid microcarcinomas.

BACKGROUND: Ultrasound (US) and computed tomography (CT) are common diagnostic imaging methods for detecting and diagnosing papillary thyroid microcarcinoma (PTMC). However, single-source dual-energy spectral computed tomography (spectral CT) reduces beam hardening artefacts and optimizes contrast, which may add value in detecting PTMC. OBJECTIVE: To investigate values of applying single-source dual-energy spectral CT for diagnosing PTMCs, in comparison with high frequency ultrasound and conventional polychromatic images. METHODS: Thirty-one patients with suspected PTMC underwent contrast-enhanced dual-energy spectral CT. The images were analyzed by two experienced radiologists. Noise and contrast-noise-ratio (CNR) were compared between conventional CT and spectral CT. Ultrasonography was also performed by an experienced radiologist with a 7 to 12-MHz linear array transducer. Detection and diagnostic sensitivity were determined and compared. RESULTS: Forty-six pathologically-confirmed PTMC lesions were detected in 31 patients. Spectral CT had lower noise and higher CNR than conventional CT (P < 0.05). US detected more tumors (45/46 [97.8%] than conventional CT images (40/46 [87.0%]) or spectral CT images (44/46 [95.7%]). Among them, 30 (65.2%), 36 (78.3%), and 40 (87.0%) lesions were diagnosed correctly by conventional CT, spectral CT and US, respectively. Spectral CT had higher sensitivity than conventional CT (P = 0.031). However, there was no significant difference between spectral CT and US diagnostic sensitivities (P = 0.125). CONCLUSION: Single-source dual-energy spectral CT was superior to conventional polychromatic images and similar to high frequency ultrasound in detecting and diagnosing for PTMCs. CT had advantages in detecting level VI and VII lymph nodes. Spectral CT and US provided good results for PTMC, and aid preoperative diagnosis.

MicroRNA 182 inhibits CD4+CD25+Foxp3+ Treg differentiation in experimental autoimmune encephalomyelitis.

MicroRNA 182 has been found to have a distinct contribution in the clonal expansion of activated- and functioning of specialized-helper T cells. In this study we knocked down microRNA 182 in vivo and induced experimental autoimmune encephalomyelitis (EAE) to determine the influences of microRNA 182 in the Treg cells functional specialization through Foxo1 dependent pathway in the peripheral lymphoid organs. Down-regulation of microRNA 182 significantly increased the proportions of Foxp3+ T cells in the peripheral lymph nodes and spleen. In vivo study verified a positive correlation between microRNA 182 levels and symptom severity of EAE, and a negative correlation between microRNA 182 and the transcriptional factor Foxp3. In vitro polarization study also confirmed the contribution of Foxo1 in microRNA 182 mediated down-regulation of Foxp3+ T cells. Together, our results provide evidence that during the development of EAE, microRNA 182 repressed Treg cells differentiation through the Foxo1 dependent pathway.

[Clinical features of systemic lupus erythematosus with pulmonary pleural lesion in children].

OBJECTIVE: To investigate the clinical features of systemic lupus erythematosus (SLE) with pulmonary pleural lesion in children. METHODS: One hundred and thirty three child patients with SLE admitted from 2001 to 2010 were enrolled in the study. The clinical data, chest X-ray findings and laboratory examination were retrospectively reviewed. Cases with infectious pulmonary pleural lesion were excluded. RESULTS: According to chest X-ray findings pleural pulmonary lesions were involved in 45 out of 133 cases with SLE (33.83 %); however, only 30 cases (66.67 %) had positive respiratory manifestations. Respiratory features included cough and/or sputum (55.56 %), dyspnea and chest pain (15.56 % and 11.11 %), and only 28.89 % case with pleural pulmonary lesions had rales. Chest X-ray findings included pleural effusion/pleurisy (32 cases, 71.11%), bronchial pneumonia (21 cases, 46.67%) or interstitial pulmonary disease (13 cases, 28.89%). Compared to children without pulmonary pleural lesion, children with pulmonary pleural lesion had higher incidence of leukopenia, lower C3 or antibody dsDNA (+) (all P<0.05). There was no difference in abnormality of erythrocyte sedimentation rate (ESR), CRP, IgG,IgA,IgM, thrombocytopenia, antibody ANA(+), anti-SSA(+), anti-SSB(+) or anti-Sm(+) between children with or without pulmonary pleural lesion (P>0.05). CONCLUSION: High incidence of pulmonary pleura lesions are present in children with SLE, however, clinical manifestations are lack of specificity or even no respiratory manifestation. Chest X-ray or HRCT scan are necessary in all cases with SLE. Children with leukopenia, lower C3 or antibody dsDNA (+) are more likely to have pulmonary pleural lesion.

Graphene/SnS2 van der Waals Photodetector with High Photoresponsivity and High Photodetectivity for Broadband 365-2240 nm Detection.

The fabrication of graphene/SnS2 van der Waals photodetectors and their photoelectrical properties are systematically investigated. It was found that a dry transferred graphene/SnS2 van der Waals heterostructure had a broadband sensing range from ultraviolet (365 nm) to near-infrared (2.24 µm) and respective improved responsivities and photodetectivities of 7.7 × 103 A/W and 8.9 × 1013 jones at 470 nm and 2 A/W and 1.8 × 1010 jones at 1064 nm. Moreover, positive and negative photoconductance effects were observed when the photodetectors were illuminated by photon sources with energies greater and smaller than the bandgap of SnS2, respectively. The photoresponsivity (R) versus incident power density (P) follows the empirical law R ∝ Pinß, with ß > -1 for positive photoconductance effects and ß < -1 for negative photoconductance effects. On the basis of the Fowler-Nordheim tunneling model and a Poisson and drift-diffusion simulation, we show quantitatively that the barrier height and barrier width of the heterostructure photodetector could be controlled by a laser and an external electrical field through a photogating effect generated by carriers trapped at the interface, which could be used to tune the separation and transport of photogenerated carriers. Our results may be useful for the design of high performance van der Waals heterojunction photodetectors.

Study of the dimension change after grafting of bone from the outer mandibular table to different maxillofacial recipient sites.

BACKGROUND: The object of this study was to investigate the dimension change after bone of the outer mandibular table had been grafted to different facial recipient sites. METHODS: Six cases of hemifacial skeleton dysplasia had accepted therapeutics of onlay bone grafting at both mandibular angle and infraorbital regions of the affected side. Grafted bones had been harvested from the outer mandibular table of the uninjured side. For each patient, computed tomography scans were taken of immediate postoperative and 6 months postoperative results. By a technique based on 3-dimensional spiral computed tomography separated reconstruction and registration, grafted bones both at mandibular angle and infraorbital regions were independent. Volume of the grafted bone was measured, and 3-dimensional analysis was done. RESULTS: At 6 months after the operation, the volume of the bone that had been grafted to the infraorbital region had a reduction rate of 11.2% ± 2.3%, and for the bone that had been grafted to the mandibular angle region, the volumetric reduction rate was 20.8% ± 7.2%. The difference of grafted bone resorption rate between the 2 recipient areas has statistical significance (<0.05). Three-dimensional analysis of grafted bones shows that the resorption took place mainly at the length-breadth direction and decreased thickness was less. Of the bone that had been grafted to the mandibular angle area, resorption mainly occurred at the inferior and posterior border of mandible. CONCLUSIONS: As an autogenous bone graft resource for reparation and reconstruction of maxillofacial bone deformity, the outer mandibular table has a different rate of resorption after it had been onlay grafted to various maxillofacial recipient sites, and the difference of the local mechanical environment maybe an influencing factor. Quantization of bone resorption rate could better guide the clinical use of outer mandibular table as an onlay bone graft resource.

[CT features of ovarian Brenner tumor and a report of 9 cases].

OBJECTIVE: In order to improve the preoperative diagnostic accuracy, the computed tomographic (CT) features of ovarian Brenner tumor were described and analyzed. METHODS: CT image and clinical data of nine patients with pathologically confirmed Brenner tumor were collected and analyzed retrospectively. There were 8 benign lesions and 1 borderline lesion. RESULTS: All lesions in the nine cases were unilateral, round, lobulated or irregular in shape and well defined, in a mean diameter of 7.8 cm. Among the nine cases, 5 were benign tumors with uniform structure, 3 were benign tumors accompanied with other pathological components, and 1 was borderline tumor. On the CT images, the 5 uniform benign lesions showed to be solid tumor of low density (lower than that of muscle) or with small cyst inside, two of the 5 lesions had calcification, and other 2 lesions showed slightly heterogeneous enhancement after enhanced scanning. The 3 benign Brenner tumors accompanied with other pathological structures were solid-cystic or cystic, with a clear demarcation of solid and cystic components. The density of solid parts was lower than that of muscle, and slight enhancement, and one of them had calcification. The one borderline tumor was a heterogeneous solid one and its density was higher than that of muscle, with a large proportion of low density and large calcification, and moderately enhanced after enhancing. None of the 9 cases had metastasis or effusion. CONCLUSION: Ovarian Brenner tumors are usually unilateral and often accompanied with other type of tumor components. When a tumor is of uniform component, the CT imaging often shows a homogeneous solid tumor with homogeneous or heterogeneous density. When a tumor is accompanied with other tumor components, it may be solid-cystic or cystic and has partial calcification. After enhancing, a benign Brenner tumor is slightly enhanced, while the borderline one is moderately/highly enhanced.

Computed tomography features of enlarged tonsils as a first symptom of non-Hodgkin's lymphoma.

BACKGROUND AND OBJECTIVE: The tonsils are the most commonly involved primary part of non Hodgkin's lymphoma (NHL) of the head and neck, which usually happens in the Waldeyer's ring. Our study describes the features of computed tomography on enlarged tonsils as a first symptom of NHL and the characteristics of the involved cervical lymph nodes. METHODS: A retrospective review was performed on 130 patients with primary extranodal lymphomas of the head and neck over 16 years. Of them 22 untreated patients showed tonsil lesions as a first symptom. RESULTS: Bilateral enlarged tonsils were involved in 13 patients, and unilateral lesions were in 9 patients. The lesions in 20 patients appeared mass like, while 2 patients had diffuse thickening. There were 8 patients with simultaneous invasion of the nasopharynx, soft palate, and epiglottis. Of the 19 patients that underwent enhanced CT scans, 15 patients demonstrated slight homogeneous enhancement, 4 with crannied or a patch of low density, and 1 with ring like enhancement. All 22 patients appeared to have cervical lymph nodes involvement. The upper groups of cervical lymph nodes were involved bilaterally in 13 patients, unilaterally in 9 patients. The middle groups were involved bilaterally in 7 patients, unilaterally in 10 patients. The lower groups were involved bilaterally in 2 patients, and unilaterally in 5 patients. After contrast administration, lymph nodes showed homogeneous density and slight enhancement in 11 patients, heterogeneous enhancement with necrosis and cystic changes in 6 patients, and ring like enhancement in 2 patients. CONCLUSIONS: Bilateral involvement, homogeneous density, and slight enhancement are characteristics of tonsil involvement of non Hodgkin's lymphoma. Bilateral upper groups of cervical lymph nodes are the most frequently involved lymph nodes, which are often shown with homogeneous density and slight enhancement.

Clinical and microbiological characteristics of patients with biliary disease.

BACKGROUND: Biliary diseases are common digestive system disorders which may combine with biliary tract infection such as cholecystitis or cholangitis. Thus, rapid identification of the bacteria and their antibiotic susceptibility profiles are crucial for reducing the mortality of patients with biliary tract infection. AIM: To identify bacterial species and antibiotic susceptibility for antibacterial therapy and analyze bile cultivation risk factors for increasing detection rates. METHODS: This retrospective study was conducted from July 2008 to July 2017. In total, 1339 bile samples which were collected during therapeutic endoscopic retrograde cholangiopan-creatography or percutaneous transhepatic cholangiodrainage or other biliary surgeries or biliary drainage were obtained to characterize pathogen spectra, antibiotic susceptibility, and clinical features. Clinical data including age, sex, comorbidities, clinical symptoms, protopathies, and history of biliary tract diseases and surgeries were collated from hospital medical records. Species identification and initial drug susceptibility were further identified by biochemical characterization using the VITEK 2 Compact test. RESULTS: Positive microbiological findings were observed in 738 samples. The most frequently encountered strains were gram-negative bacteria (74.94%), including Escherichia coli (37.78%), Pseudomonas aeruginosa (8.96%), and Klebsiella pneumoniae (10.29%). Bile bacteria were largely sensitive to carbapenems, piperacillin/tazobactam, and gentamicin. Gram-negative strains had low susceptibility to ceftriaxone, quinolones and ampicillin. Almost the same micro-organisms were present in patients with malignant and benign diseases. The number of samples with Klebsiella pneumoniae in the bile culture were significantly different between patients with malignant and benign diseases (55 vs 30; P = 0.019). Age (P < 0.001), fever (P < 0.001), history of biliary tract diseases and surgeries (both P < 0.001), benign disease (P = 0.002), and the comorbidity chronic renal insufficiency (P = 0.007) affected the positive rates of the bile samples. CONCLUSION: Gram-negative bacteria were the most commonly isolated biliary bacteria. We determined the major factors associated with positive detection rates. Microbiological analysis of bile samples allowed accurate antibiotic treatments.

Correlation analysis between metabolic tumor burden measured by positron emission tomography/computed tomography and the 2015 World Health Organization classification of lung adenocarcinoma, with a risk prediction model of tumor spread through air spaces.

BACKGROUND: Tumor spread through air spaces (STAS) is an important pattern of invasion and impacts the frequency and location of recurrence. The objective was to assess the correlation between metabolic tumor burden of positron emission tomography/computed tomography (PET/CT) and 2015 World Health Organization (WHO) classification of lung adenocarcinoma, and to establish a risk prediction model of STAS. METHODS: We reviewed 127 consecutive patients. The SUVmax, SUVmean, SUVpeak, MTV, TLG, diameter, and CTV were measured. All risk factors were analyzed by multivariate logistic regression analysis; regression coefficients and odds ratios were calculated for independent risk factors. A STAS risk prediction model was created using the regression coefficients to determine the predictive probability (PP). RESULTS: The nodule types and SUV were significantly correlated with 2015 WHO pathological categories (P<0.001). Most of (83.3%) the lepidic predominant adenocarcinoma (LPA) appeared as non-solid or part-solid nodules with the lowest SUV (P<0.05). There was a significant difference in STAS distribution among different nodule types (P=0.000). STAS was significantly correlated with SUVmax (P=0.000), SUVmean (P=0.000), SUVpeak (P=0.000), TLG (P=0.001), and diameter (P=0.044). The risk prediction model of STAS was established. The PP of STAS and the incidence of STAS were analyzed using the ROC curve (AUC =0.759, P=0.000). The sensitivity, specificity, and accuracy of the predictive model for STAS were 47.1%, 88.6%, and 71.1%, respectively. CONCLUSIONS: The LPA appeared as non-solid nodule with low SUV without STAS has a good prognosis. SUV and TLG are valuable predictive indices in the prediction of STAS. The predictive model developed in predicting the incidence of STAS has good specificity and accuracy.

Diagnostic accuracy of single-source dual-energy computed tomography and ultrasonography for detection of lateral cervical lymph node metastases of papillary thyroid carcinoma.

BACKGROUND: Dual-energy computed tomography (DECT) imaging can generate iodine-based material decomposition (MD) images and spectral HU curve. This study aimed to investigate the diagnostic accuracy of single-source dual-energy CT (DECT) and ultrasonography (US) for detecting lateral cervical lymph node metastases of papillary thyroid carcinoma (PTC). METHODS: Thirty patients with PTC were enrolled in the study and underwent DECT and US examination before thyroidectomy and cervical lymph node dissection. The spectral parameters included iodine concentration (IC), normalized iodine concentration (NIC) and slope (λHU) of lymph nodes. The CT morphological parameters included maximal short diameter, shape, margin, calcification and cystic degeneration of lymph nodes. The US morphological parameters included maximal short diameter, calcification and cystic degeneration of lymph nodes. The diagnostic value of every single spectral parameter, combined gemstone spectral image (GSI) parameters, CT morphological parameters and US morphological parameters between metastatic and non-metastatic lymph nodes were statistically compared. Receiver operating characteristic (ROC) curves, sensitivity, and specificity were used to determine the diagnostic value. RESULTS: Ninety-nine lymph nodes from thirty patients were pathologically confirmed. Among them, 70 (70.7%) were metastatic. For single GSI parameters, ROC analysis showed that the area under the curve (AUC) for IC was the highest (AUC =0.937) but the difference was not statistically significant when compared with NIC or slope (λHU) (P>0.05). The optimal diagnostic threshold for IC was 2.56 mg/mL, with a sensitivity, specificity and accuracy of 87.1%, 93.1%, and 88.9%, respectively. The AUC for combined GSI parameter (AUC =0.942) was higher compared with the US morphological parameters (AUC =0.771, P<0.001), with a sensitivity, specificity, and accuracy of 92.9%, 86.2%, and 90.9%, respectively. However AUC did not differ significantly among combined GSI parameters, combined CT morphological parameters and a single application for spectral CT parameters IC (P>0.05). CONCLUSIONS: Combined GSI parameters showed better diagnostic accuracy in lateral cervical lymph node metastasis of PTC compared with that of combined US morphological parameters. IC alone showed excellent diagnostic stability and could be performed easily.

TREM-1 Contributes to Inflammation in IgA Nephropathy.

BACKGROUND: Circulating IgA1-containing immune complexes (cIgA1) were shown to play important roles in IgA nephropathy (IgAN). They could induce the release of multiple inflammatory factors, including MCP-1 and IL-6, and elevated urinary inflammatory factors were also reported in patients with IgAN, which suggested that inflammation is a major contributor to kidney injury in IgAN. After the previous identification of the upregulated release of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) by mesangial cells under cIgA1 challenge using cytokine array, in the present study, we further explored the role of TREM-1, an amplifier of inflammation, in cIgA1-induced kidney injury. METHODS: In total, 35 patients with IgAN and 17 healthy controls were enrolled. The cIgA1 was isolated from plasma and used to treat cultured mesangial cells. The mRNA expression of TREM-1 as well as levels of sTREM-1, MCP-1, and IL-6 in the mesangial cell supernatant and urine samples were detected. RESULTS: We found that cIgA1 from patients with IgAN could significantly upregulate the expression of TREM-1 in mesangial cells compared to healthy controls. The levels of ΔsTREM-1 were positively correlated with MCP-1 levels in the mesangial supernatant. Similarly, higher urinary levels of sTREM-1 were also observed in patients with IgAN compared to healthy controls. Moreover, IgAN patients with detectable urinary sTREM-1 presented with severe clinical and pathological manifestations, including higher IgA and lower eGFR levels, compared to patients whose urinary sTREM-1 levels were below the limit of quantification. CONCLUSION: Our present study suggested that TREM-1 in cIgA1 induced inflammatory kidney injury in IgAN.

Binding of ferulic acid to cytochrome c enhances stability of the protein at physiological pH and inhibits cytochrome c-induced apoptosis.

Ferulic acid (FA) is one of the most effective components of a traditional Chinese medicine, angelica, and cytochrome c plays a vital role in apoptosis. Here we report the application of fluorescence spectroscopy, isothermal titration calorimetry (ITC), differential scanning calorimetry (DSC), and circular dichroism (CD) to investigate the mechanism for the interaction of bovine heart cytochrome c with FA and the effect of the binding on native state stability of the protein at physiological pH. Fluorescence spectroscopic studies together with ITC measurements indicate that FA binds to cytochrome c with moderate affinity and quenches the intrinsic fluorescence of the protein in a static way. ITC experiments show that the interaction of cytochrome c with FA is driven by a moderately favorable entropy increase in combination with a less favorable enthalpy decrease for the first binding site of the protein. The melting temperature of cytochrome c in the presence of FA measured by DSC and CD increases 4.0 and 5.0 degrees C, respectively, compared with that in the absence of FA. Taken together, these results indicate that FA binds to and stabilizes cytochrome c at physiological pH. Furthermore, binding of FA to cytochrome c inhibits cytochrome c-induce apoptosis of human hepatoma cell line SMMC-7721. Our data provide insight into the mechanism of drug-protein interactions, and will be helpful to the understanding of the mechanism for FA-inhibited and cytochrome c-induced apoptosis.

Prognostic value of metabolic variables of [18F]FDG PET/CT in surgically resected stage I lung adenocarcinoma.

The objective of this study was to assess the prognostic value of metabolic tumor burden measured by positron emission tomography/computed tomography (PET/CT) in patients with stage I lung adenocarcinoma.We reviewed 127 consecutive patients with pathologically proven stage I lung adenocarcinoma who underwent pretreatment [18F]FDG PET/CT scans in our hospital from 2005 June to 2012 June. The maximum, mean, and peak standardized uptake value (SUVmax, SUVmean, and SUVpeak), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and computed tomography volume (CTV) were measured. The Kaplan-Meier and Cox proportional hazards model were used with age, gender, TNM stage, clinical stage, histological grade, nodule type, tumor size, and metabolic parameters to predict progression-free survival (PFS). The cut-off point was determined through receiver-operating characteristic curve.In univariate analysis, the histological grade, nodule type, diameter (cut-off value of 2.0 cm), CTV (6.56 cm), SUVmax (3.25 g/mL), SUVmean (1.58 g/mL), SUVpeak (1.84 g/mL), MTV (4.80 cm), and TLG (10.40) were significantly associated with PFS (all P value < .05). Patients with poorly differentiated adenocarcinoma, solid nodule type, large size, and high metabolic tumor burden were associated with poor prognosis. In multivariate analysis, only histological grade was independent prognostic factors for progression with a P value of .005 (RR, 0.355; 95% CI, 0.173-0.728). Among 5 PET/CT metabolic parameters, only MTV was independent prognostic factors for progression with a P value of .031 (RR, 1.118; 95% CI, 1.010-1.237).Histological grade was an independent predictor for progression in patients with stage I lung adenocarcinoma. Among 5 PET/CT metabolic parameters, only MTV was an independent predictor for progression.

Comparison of different automated lesion delineation methods for metabolic tumor volume of 18F-FDG PET/CT in patients with stage I lung adenocarcinoma.

The aim of the study was to investigate the suitable segmentation method in small, low uptake and heterogeneous nodules of stage I lung adenocarcinoma.133 stage I lung adenocarcinoma patients with F-FDG PET/CT scans were enrolled in this retrospective study. All lesions were divided into different groups according to nodule density, nodule size, and the maximum standard uptake value (SUVmax) level. Four different PET segmentation methods were performed, including percentage threshold of SUVmax (T42% and T42% × RC), gradient-based threshold (adaptive iterative algorithm, AT-AIA), and background-related threshold (adaptive thresholding at 40% SUVmax, AT40%) approaches. The MTVs were evaluated and compared with CT volume (CTV). Percentage volume error (%VE) compared to CTV was calculated and the correlations between MTVs and CTV were analyzed.AT-AIA had the highest accuracy in large, high uptake, and solid nodules (72.5%, 72.4%, and 65.6%, respectively). AT40% had the highest accuracy in small, low uptake and nonsolid nodules (56.6%, 56.1%, and 62.6%, respectively). In part-solid nodules, the accuracy of AT-AIA (60.0%) and AT40% (56.7%) were higher than that of T42% and T42% × RC. The MTV of AT-AIA was in excellent correlation with the CTV in solid nodules (R = 0.831, P < .001) and in high uptake nodules (R = 0.830, P < .001). The MTV of AT40% was in good correlation with the CTV in nonsolid nodules (R = 0.686, P = .003) and in part-solid nodules (R = 0.731, P < .001).AT40% showed best performance in small, low uptake, nonsolid and part-solid lesions. AT-AIA was suitable for large, high uptake, and solid lesions.

Proteomic profiling of rat bone marrow mesenchymal stem cells induced by 5-azacytidine.

Mesenchymal stem cells (MSCs) can differentiate into different types of cells and thus have tremendous potential for cell therapy and tissue engineering. 5-Azacytidine (5-aza), a DNA demethylation reagent, has been reported to induce MSCs to differentiate into cardiomyocytes in vitro. To determine a global effect of 5-aza on MSCs, we investigated the protein expressions of rat MSCs with two-dimensional gel electrophoresis (2-DE). We have generated a proteome reference map of rat MSCs, and have successfully identified 34 proteins with MALDI-TOF-MS analysis. Nine proteins showed distinct regulation in MSCs after 5-aza treatment. The proteins regulated by 5-aza included cytoskeletal proteins, cadmium-binding proteins, and metabolic proteins, etc. These proteins have been reported to be involved in cell proliferation and differentiation through different signaling pathways, and the molecular mechanism of MSCs differentiation is discussed at the proteome level.

Effect of 5-azacytidine on the protein expression of porcine bone marrow mesenchymal stem cells in vitro.

Bone marrow-derived mesenchymal stem cells (MSCs) are pluripotent stem cells that show a vital potential in the clinical application for cell transplantation. In the present paper, proteomic techniques were used to approach the protein profiles associated with porcine bone marrow MSCs and investigate the regulation of MSC proteins on the effect of 5-azacytidine (5-aza). Over 1,700 protein species were separated from MSCs according to gel analysis. Compared with the expression profiling of control MSCs, there were 11 protein spots up-regulated and 26 down-regulated in the protein pattern of 5-aza-treated cells. A total of 21 proteins were successfully identified by MALDI-TOF-MS analysis, among which some interesting proteins, such as alpha B-crystallin, annexin A2, and stathmin 1, had been reported to involve in cell proliferation and differentiation through different signaling pathways. Our data should be useful for the future study of MSC differentiation and apoptosis.

Measures of Urinary Protein and Albumin in the Prediction of Progression of IgA Nephropathy.

BACKGROUND AND OBJECTIVES: Proteinuria is an independent predictor for IgA nephropathy (IgAN) progression. Urine albumin-to-creatinine ratio (ACR), protein-to-creatinine ratio, and 24-hour urine protein excretion (UPE) are widely used for proteinuria evaluation in clinical practice. Here, we evaluated the association of these measurements with clinical and histologic findings of IgAN and explored which was the best predictor of IgAN prognosis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Patients with IgAN were followed up for ≥12 months, were diagnosed between 2003 and 2012, and had urine samples available (438 patients). Spot urine ACR, protein-to-creatinine ratio, and 24-hour UPE at the time of renal biopsy were measured on a Hitachi Automatic Biochemical Analyzer 7180 (Hitachi, Yokohama, Japan). RESULTS: In our patients, ACR, protein-to-creatinine ratio, and 24-hour UPE were highly correlated (correlation coefficients: 0.71-0.87). They showed good relationships with acknowledged markers reflecting IgAN severity, including eGFR, hypertension, and the biopsy parameter (Oxford severity of tubular atrophy/interstitial fibrosis parameter). However, only ACR presented with positive association with the Oxford segmental glomerulosclerosis/adhesion parameter and extracapillary proliferation lesions. The follow-up time was 37.0 (22.0-58.0) months, with the last follow-up on April 18, 2014. In total, 124 patients reached the composite end point (30% eGFR decline, ESRD, or death). In univariate survival analysis, ACR consistently had better performance than protein-to-creatinine ratio and 24-hour UPE as represented by higher area under the curve using time-dependent survival analysis. When adjusted for well known risk factors for IgAN progression, ACR was most significantly associated with the composite end point (hazard ratio, 1.56 per 1-SD change of standard normalized square root-transformed ACR; 95% confidence interval, 1.29 to 1.89; P<0.001). Compared with protein-to-creatinine ratio and 24-hour UPE, addition of ACR to traditional risk factors resulted in more improvement in the predictive ability of IgAN progression (c statistic: ACR=0.70; protein-to-creatinine ratio =0.68; 24-hour UPE =0.69; Akaike information criterion: ACR=1217.85; protein-to-creatinine ratio =1229.28; 24-hour UPE =1234.96; P<0.001). CONCLUSIONS: In IgAN, ACR, protein-to-creatinine ratio, and 24-hour UPE had comparable association with severe clinical and histologic findings. Compared with protein-to-creatinine ratio and 24-hour UPE, ACR showed slightly better performance in predicting IgAN progression.

Over-expressed genes detected by suppression subtractive hybridization in carcinoma derived from transformed 16HBE cells induced by BPDE.

OBJECTIVE: To screen the over differentially expressed genes in carcinoma induced by BPDE-transformed 16HBE cells (16HBE-C cells). METHODS: The suppression subtractive hybridization (SSH) method was performed to profile differentially expressed genes between 16HBE-C cells and 16HBE cells. The cDNA fragments of differentially expressed genes were inserted into TA cloning vector and transformed competent E. coli strain. Positive clones were randomly picked up and identified by the colony PCR method. Dot blot was used to test the same source with the tester. The differentially expressed cDNA fragments were sequenced and compared with known genes and EST database in Genbank. RESULTS: Eight known genes were over-expressed in 16HBE-C cells including eukaryotic translation elongation factor 1 alpha 1, HIF-1 responsive RTP801, ribosomal protein L10 (RPL10), ribosomal protein S29 (RPS29), mitochondrion related genes, and laminin receptor 1. Three differentially expressed cDNA fragments could not be matched to the known genes but to the EST database. CONCLUSION: The SSH method can detect differentially expressed genes between 16HBE-C and 16HBE cells. BPDE-induced carcinogenesis may be related to alteration of at least eight known genes and three unknown genes. These expression data provide a clue to further cloning novel genes and studying functions in BPDE-induced carcinoma.