The association between admission mean corpuscular volume and preoperative deep venous thrombosis in geriatrics hip fracture: a retrospective study.

OBJECTIVE: This study evaluated the association between admission MCV and preoperative deep vein thrombosis (DVT) in geriatric hip fractures. METHODS: Older adult patients with hip fractures were screened between January 2015 and September 2019. The demographic and clinical characteristics of the patients were collected at the largest trauma center in northwest China. MCV was measured at admission and converted into a categorical variable according to the quartile. Multivariate binary logistic regression and generalized additive model were used to identify the linear and nonlinear association between MCV and preoperative DVT. Analyses were performed using EmpowerStats and the R software. RESULTS: A total of 1840 patients who met the criteria were finally enrolled and divided into four groups according to their MCV levels. The mean MCV was 93.82 ± 6.49 (80.96 to 105.91 fL), and 587 patients (31.9%) were diagnosed with preoperative DVT. When MCV was a continuous variable, the incidence of preoperative DVT increased with mean corpuscular volume. In the fully adjusted model, admission MCV was positively correlated with the incidence of preoperative DVT (OR: 1.03; 95% CI: 1.01-1.05; P = 0.0013). After excluding the effect of other factors, each additional 1fL of MCV increased the prevalence of preoperative DVT by 1.03 times as a continuous variable. CONCLUSION: MCV was linearly associated with preoperative DVT in geriatric patients with hip fractures and could be considered a predictor of DVT risk. The MCV may contribute to risk assessment and preventing adverse outcomes in the elderly. STUDY REGISTRATION: This study is registered on the website of the Chinese Clinical Trial Registry (ChiCTR: ChiCTR2200057323).

Association between Neutrophil Levels on Admission and All-Cause Mortality in Geriatric Patients with Hip Fractures: A Prospective Cohort Study of 2,589 Patients.

Objective: To evaluate the association between neutrophil levels and all-cause mortality in geriatric hip fractures. Methods: Elderly patients with hip fractures were screened between January 2015 and September 2019. Demographic and clinical characteristics of the patients were collected. Linear and nonlinear multivariate Cox regression models were used to identify the association between neutrophil levels and mortality. Analyses were performed using Empower Stats and R software. Results: A total of 2,589 patients were included in this study. The mean follow-up period was 38.95 months. During the study period, 875 (33.80%) patients died due to various causes. Linear multivariate Cox regression models showed that neutrophil levels were associated with mortality after adjusting for confounding factors, when neutrophil concentration increased by 1∗109/L, the mortality risk increased by 3% (HR = 1.03, 95% CI: 1.00-1.06, and P=0210). Neutrophil concentration was used as a categorical variable; we only found statistically significant differences when neutrophil levels were high (HR = 1.27, 95% CI:1.05-1.52, and P=0.0122). In addition, the results are stable in P for trend and propensity score matching sensitivity analysis. Conclusions: Neutrophil levels are associated with mortality in geriatric hip fractures and could be considered a predictor of death risk in the long-term. This study is registered with the Chinese Clinical Trial Registry (ChiCTR) as number ChiCTR2200057323.

Development and validation of a nomogram to predict the risk of breast cancer-related lymphedema among Chinese breast cancer survivors.

PURPOSE: Breast cancer-related lymphedema (BCRL) is a major long-term complication for post-surgery breast cancer survivors. Although several risk factors have been identified, lifestyle characteristics have been neglected in previous studies. The aim of this study was to develop and validate a nomogram for estimating this population's risk of developing lymphedema, taking into consideration their demographic, clinical, and personal lifestyle behaviors. METHODS: In a cross-sectional study, we collected data from 775 post-operative breast cancer survivors who had attended a follow-up session in the recent 10 years (primary cohort). Lymphedema was assessed using the Norman telephone questionnaire, self-reported by patients. Multiple logistic regression was used to identify risk factors for lymphedema, including demographic, clinical, and lifestyle-related factors. A nomogram was constructed based on those factors and was validated using a separate group of 314 breast cancer patients (validation cohort). RESULTS: The factors independently associated with lymphedema were higher body mass index (BMI), modified radical mastectomy (MRM), postsurgical infection, chemotherapy, radiotherapy, exercise of the affected arm, and the active participation in physical activity (P<0.05). The area under the curve (AUC) values of the primary and the validation cohorts were 0.721 (95% confidence interval: 0.685-0.756) and 0.702 (95% confidence interval: 0.646-0.759), respectively. CONCLUSIONS: BCRL risk factors include MRM, radiotherapy, chemotherapy, and higher BMI, while the active physical activity behavior of patients appears to be a factor against lymphedema. The nomogram incorporating the patients' clinical and lifestyle factors might be useful for predicting lymphedema in breast cancer survivors.

Providing targeted psychological support to frontline nurses involved in the management of COVID-19: An action research.

AIM: To develop and implement a targeted psychological support scheme for frontline nurses involved in the management of coronavirus disease 2019 (COVID-19). BACKGROUND: Nurses play a vital role in managing the ongoing COVID-19 pandemic, while confronting enormous challenges and psychological problems. METHODS: Action research design was adopted to develop and provide a targeted psychological support scheme to 1,496 frontline nurses. Data regarding nurses' feedback were collected from WeChat group chat, letters and comments on theme lectures. Subsequently, qualitative content analysis was conducted using MAXQDA. RESULTS: A targeted psychological support scheme was formed via three action cycles according to nurses' needs. Frontline nurses received psychological assistance from a research team, which offered (1) a sense of belonging, (2) a sense of professional value and pride, and (3) a sense of being protected and confident. CONCLUSION: The researchers successfully provided targeted psychological support to nurses, and nurses were motivated and became more confident when their needs were addressed. IMPLICATIONS FOR NURSING MANAGEMENT: Nurses have various types of psychological needs, which could be addressed by targeted support. It is suggested that nurse managers should identify nurses' needs in real time and provide appropriate support through multidisciplinary collaboration to improve their confidence and enhance their resilience.

Extracellular vesicles enhance oxidative stress through P38/NF-kB pathway in ketamine-induced ulcerative cystitis.

Long-term abuse of ketamine causes ketamine-induced cystitis. The functional alterations of bladder epithelial cells in microenvironment during cystitis remain poorly understood. Here, we explored extracellular vesicles (EV) alteration in ketamine-induced toxicity. To simulate the high-concentration ketamine environment in vivo, we established an in vitro model of high ketamine using human uroepithelial cells (SV-HUC-1). Cell viability and proliferation were assessed to evaluate the effects of various concentrations (0, 0.25, 0.5, 1, 2, 4 and 8 mmol/L) of ketamine on SV-HUC-1 cells. The cell supernatant cultured at a concentration (0, 1, 2, 4 mmol/L) of ketamine was selected for EV extraction and identified. Subsequently, we assessed different groups (ketamine, ketamine plus EV blocker, EV, EV plus extracellular vesicles blocker) of oxidative stress and expression of inflammation. Last, luciferase reporter assay was performed to study the transcriptional regulation of EV on the NF-kB and P38 pathway. The results of our study suggested that treatment with 0, 1, 2 or 4 mmol/L ketamine altered the morphology and secretion capacity of extracellular vesicles. As the concentration of ketamine increased, the average particle size of EV decreased, but the crest size, particle concentration and EV protein increased. Moreover, after the addition of EV blocker, EV secreted at different concentrations were blocked outside the cell membrane, and the degree of oxidative stress decreased. Our study provided evidence that ketamine alters the secretion of EV by directly stimulating cells in inflammation microenvironment and EV play significant roles in intercellular signal communication and the formation of KIC.EV.

OTX1 exerts an oncogenic role and is negatively regulated by miR129-5p in laryngeal squamous cell carcinoma.

BACKGROUND: Orthodenticle homeobox 1 (OTX1) is a transcription factor that plays an important role in various human cancers. However, the function of OTX1 in laryngeal squamous cell carcinoma (LSCC) is largely unknown. We aimed to explore the roles of OTX1 in LSCC and its possible molecular mechanism. METHODS: The expression levels of OTX1 were assessed in LSCC cell lines and tissue samples. We further examined the effect of OTX1 on LSCC progression. The upstream regulator of OTX1 was identified using a computer algorithm and confirmed experimentally. RESULTS: OTX1 was highly expressed in 70.7% (70/99) of LSCC tissue samples. The OTX1 expression in LSCC was significantly correlated with lymph node metastasis. High OTX1 expression in patients with LSCC was correlated with poor prognosis. Knockdown of OTX1 inhibited proliferation, colony formation, migration and invasion in LSCC cells. Knockdown of OTX1 inhibited tumor growth in a xenograft mouse model. Mechanistically, OTX1 might act as a direct target of miR-129-5p. OTX1 enhanced tumorigenicity and tumor growth both in vitro and in vivo. CONCLUSIONS: Our findings support that OTX1 is an oncogene in LSCC tumorigenesis and progression. Furthermore, OTX1 is a direct target of miR-129-5p in LSCC cells. Taken together, OTX1 is a promising diagnostic and therapeutic marker for LSCC.

Association Between Plasma Homocysteine Levels and Subclinical Hypothyroidism in Adult Subjects: A Meta-Analysis.

Increased plasma homocysteine (Hcy) levels have been widely documented in patients with overt hypothyroidism; however, the significance of Hcy level changes in patients with subclinical hypothyroidism (SCH) remains controversial. The aim of this meta-analysis was to determine the Hcy status in patients with SCH compared with euthyroid subjects. We searched PubMed, Embase, and Cochrane Library databases prior to December 2019 to identify eligible studies and assessed the quality of selected studies using the Newcastle-Ottawa Quality Assessment Scale. Publication bias was evaluated by Begg's test and Egger's test. Meta-regression analysis was conducted to investigate the source of heterogeneity. A likely source of heterogeneity was the year of the study. All statistical analyses were performed with RevMan 5.3 and Stata 12.0 software. Our meta-analysis of twelve observational studies with 684 patients showed that those with SCH aged between 18 and 65 years old were associated with a slightly increased plasma Hcy level compared with euthyroid controls. The pooled result of the weighted mean difference (WMD) of increased tHcy levels was 1.16 µmol/l (95% CI: 0.51, 1.82; p=0.0005). The Hcy level in patients with SCH aged between 18 and 65 years old is significantly increased compared to euthyroid controls.

MiR-421 Is Overexpressed and Promotes Cell Proliferation in Non-Small Cell Lung Cancer.

BACKGROUND: Lung cancer is the main cause of cancer--related deaths worldwide, and the overall 5-year survival rate of non-small cell lung cancer (NSCLC) remained low. -MicroRNAs had been confirmed to be an important regulator in tumor progression, and they could serve as either tumor promoters or suppressors in NSCLC. OBJECTIVES: To identify the novel cancer-specific biomarkers for NSCLC patients, which may be useful to monitor tumor progression and improve NSCLC patients' survival. METHOD: The expression profile of miR-421 was analyzed in NSCLC samples using public datasets, including The Cancer Genome Atlas and GSE102286. The expression level of miR-421 was detected by reverse transcription-polymerase chain reaction. Cell proliferation and cell cycle were detected by Cell Counting Kit assay, flow cytometry assay, respectively. Kyoto Encyclopedia of Genes and Genomes analysis were applied to determine the biological roles of miR-421, based on the online DAVID system. Statistical comparisons between groups of normalized data were performed using t test or Mann-Whitney U test according to the test condition. RESULTS: In this study, we focused on exploring the roles of miR-421 in NSCLC prognosis and growth. The present study for the first time showed that miR-421 was overexpressed in NSCLC and associated with a shorter overall survival time of patients with NSCLC. Bioinformatics analysis revealed miR-421 was involved in transcription, cell cycle, and insulin signaling pathway regulation. Furthermore, a gain of function assay showed that overexpression of miR-421 could promote NSCLC cell proliferation and cell cycle progression. CONCLUSIONS: Our findings suggest that miR-421 might be a promising prognostic and therapeutic target for NSCLC.

Complete sequence of a tet(X4)-harboring IncX1 plasmid, pYY76-1-2, in Escherichia coli from a cattle sample in China.

Recently, a novel plasmid-mediated tigecycline resistance mechanism, Tet(X4), has raised a global antimicrobial resistance concern (1, 2).….

Heavy metal bioaccumulation and cation release by growing Bacillus cereus RC-1 under culture conditions.

In an effort to explore the detoxifying mechanisms of B. cereus RC-1 under heavy metal stress, the bioaccumulation by growing cells under varying range of pH, culture time and initial metal concentration were investigated from a perspective of cation release. The maximum removal efficiencies were 16.7%, 38.3%, 81.4% and 40.3% for Cu2+, Zn2+, Cd2+ and Pb2+, respectively, with initial concentrations of 10 mg/L at pH 7.0. In presence of Cu2+ or Zn2+, large quantities of cations were released into the medium in descending order of Na+>K+>Ca2+>Mg2+, while bioremoval of the two essential metals Cd2+ and Pb2+ was accompanied with cellular Na+ and Mg2+ uptake from the medium, respectively. The relative mean contributions of intracellular accumulation to the total removal were approximately 19.6% for Cu2+, 12.8% for Zn2+, 51.1% for Cd2+, and only 4.6% for Pb2+. Following exposure at high concentration, B. cereus RC-1 could keep intracellular Cd2+ concentrations constant, possibly by means of a Cd-efflux system whose activity coincided with uptake of Na+, and reduce intracellular Pb2+ concentration due to the effect of Mg2+ on limiting Pb2+ access to the cells. Cellular morphology, surface functional groups and intracellular trace elements were further investigated by SEM-EDX, TEM-EDX, FTIR and ICP-MS analysis. The phenomena that removal of Cd2+ and Pb2+ coincided with uptake of Na+ and Mg2+, respectively, inspires a novel research perspective towards the study of protective mechanism of bacterial cells against the toxicity of heavy metals.

Tin Oxide Crystals Exposed by Low-Energy {110} Facets for Enhanced Electrochemical Heavy Metal Ions Sensing: X-ray Absorption Fine Structure Experimental Combined with Density-Functional Theory Evidence.

Herein, we revealed that the electrochemical behaviors on the detection of heavy metal ions (HMIs) would largely rely on the exposed facets of SnO2 nanoparticles. Compared to the high-energy {221} facet, the low-energy {110} facet of SnO2 possessed better electrochemical performance. The adsorption/desorption tests, density-functional theory (DFT) calculations, and X-ray absorption fine structure (XAFS) studies showed that the lower barrier energy of surface diffusion on {110} facet was critical for the superior electrochemical property, which was favorable for the ions diffusion on the electrode, and further leading the enhanced electrochemical performance. Through the combination of experiments and theoretical calculations, a reliable interpretation of the mechanism for electroanalysis of HMIs with nanomaterials exposed by different crystal facets has been provided. Furthermore, it provides a deep insight into understanding the key factor to improve the electrochemical performance for HMIs detection, so as to design high-performance electrochemical sensors.

Pattern transitions of oil-water two-phase flow with low water content in rectangular horizontal pipes probed by terahertz spectrum.

The flow-pattern transition has been a challenging problem in two-phase flow system. We propose the terahertz time-domain spectroscopy (THz-TDS) to investigate the behavior underlying oil-water flow in rectangular horizontal pipes. The low water content (0.03-2.3%) in oil-water flow can be measured accurately and reliably from the relationship between THz peak amplitude and water volume fraction. In addition, we obtain the flow pattern transition boundaries in terms of flow rates. The critical flow rate Qc of the flow pattern transitions decreases from 0.32 m3 h to 0.18 m3 h when the corresponding water content increases from 0.03% to 2.3%. These properties render THz-TDS particularly powerful technology for investigating a horizontal oil-water two-phase flow system.

Preoperative neutrophil-to-lymphocyte ratio is an independent prognostic marker in patients with laryngeal squamous cell carcinoma.

BACKGROUND: Neutrophil-lymphocyte ratio (NLR) has been shown to be associated with prognosis in various solid tumors. This study aimed to evaluate the prognostic role of NLR in patients with laryngeal squamous cell carcinoma (LSCC). METHODS: A total of 141 LSCC patients were retrospectively reviewed. Patients' demographics were analyzed along with clinical and pathologic data. The optimal cutoff value of NLR was determined using receiver operating characteristic (ROC) curve analysis. The impact of the NLR and other potential prognostic factors on disease-free survival (DFS) and overall survival (OS) was assessed using the Kaplan-Meier method and multivariate Cox regression analysis. RESULTS: The optimal cutoff value of the NLR was 2.17. In the NLR ≤ 2.17 group, the 1-, 3-, and 5-year DFS rates were 88.2, 73.9 and 69.1 %, respectively, while in the NLR > 2.17 group, the DFS rates were 83.0, 54.6 and 49.2 %, respectively. Correspondingly, the 1-, 3-, and 5-year OS rates were 98.9, 85.1 and 77.4 % in the NLR ≤ 2.17 group and 97.9, 63.8 and 53.3 % in the NLR > 2.17 group, respectively. The multivariate Cox proportional hazard model analysis showed that NLR > 2.17 was a prognostic factor for both DFS [hazard ratio (HR) = 1.869; 95 % confidence interval (CI) 1.078-3.243; P = 0.026] and OS (HR =2.177; 95 % CI 1.208-3.924; P = 0.010). CONCLUSION: Our results showed that elevated preoperative NLR was an independent predictor of poor prognosis for patients with LSCC after surgical resection.

[Epidemiology, diagnosis and treatment of Middle East respiratory syndrome].

Middle East respiratory syndrome (MERS) has raised global public health concerns. The recent outbreak of MERS coronavirus (MERS-CoV) infection has led to 1 338 laboratory-confirmed cases in 26 countries worldwide as reported till 19 June, 2015. MERS-CoV may be considered a zoonotic virus that has crossed the species barrier to humans, but the pathogenesis and the routes of transmission are not completely understood. Most MERS-CoV cases reported thus far have a history of residence in or travel to the Middle East. Human-to-human transmission though was observed on some occasions in Korea, it is documented as non-sustainable event. The envelope spike glycoprotein on the surface of MERS-CoV which mediates receptor binding, membrane fusion and viral entry is thought to be involved in the mechanism of MERS-CoV.No specific and effective treatment for MERS-CoV is currently recommended, although supportive treatment has played an important role. Prophylactic strategies are necessary to prevent MERS-CoV infection.

The association between prealbumin concentration at admission and mortality in elderly patients with hip fractures: a cohort study.

Malnutrition is associated with complications and mortality in patients of hip fracture. Prealbumin may be more suitable than albumin to accurately predict the prognosis of hip fracture in elderly patients. We found that prealbumin concentration was nonlinearly associated with mortality in elderly patients with hip fracture, and an inflection point effect was observed. OBJECTIVE: To evaluate the association between prealbumin concentration at admission and mortality in elderly patients with hip fractures. METHODS: Elderly patients with hip fractures were screened between Jan 2015 and Sep 2019. Demographic and clinical characteristics of the patients were collected. Linear and nonlinear multivariate Cox regression models were used to identify the association between prealbumin concentration at admission and mortality. All analyses were performed using EmpowerStats and the R software. RESULTS: This cohort study included 2387 patients who met the study criteria. The mean follow-up was 37.64 months. The prealbumin concentration was 162.67 ± 43.2 mg/L. Multivariate Cox regression showed that prealbumin concentration was associated with mortality in geriatric patients with hip fracture (hazard ratio [HR] = 0.95, 95% confidence intervals [CI]: 0.93-0.97, P < 0.0001). In addition, an inflection point effect was observed in the nonlinear association. The inflection point was 162.2 mg/L. If it is less than this inflection point, then every 10 mg/L increase in prealbumin was associated with a 7% reduction in the risk of death (HR = 0.93, 95%CI: 0.90-0.96, P < 0.0001). When greater than the inflection point, there was no difference in the risk of death (HR = 0.99, 95%CI: 0.95-1.03, P = 0.5127). CONCLUSION: The prealbumin concentrations at admission were nonlinearly associated with long-term mortality in geriatric hip fractures, and 162.2 mg/L could be considered a prognostic factor of mortality risk.

Effect of Continuous Positive Airway Pressure on Incident Frailty in Elderly Patients with Obstructive Sleep Apnea: A Study Based on Propensity Score Matching.

Background: The concomitant rise in the prevalence of obstructive sleep apnea (OSA) and frailty among the elderly population has been linked to an increase in mortality rates. Despite continuous positive airway pressure (CPAP) being the gold standard treatment for OSA, its impact on incident frailty remains inadequately explored. Methods: In this cohort study, we analyzed data from 1290 patients diagnosed with OSA, aged 60 years and older. A subset of 71 patients who demonstrated high adherence to CPAP therapy were categorized as the CPAP group. Propensity score matching (PSM) was employed at a 1:4 ratio, matching for variables such as age, gender, body mass index (BMI), and sleep apnea-hypopnea index (AHI), to establish a non-CPAP group for comparison. The FRAIL scale was utilized to evaluate the frailty status of participants. Logistic regression analysis examined the relationship between CPAP therapy and incident frailty, as well as its individual components, in elderly patients with OSA. Results: During a median follow-up period of 52 months, incident frailty was observed in 70 patients (19.7%). Patients with OSA receiving CPAP therapy exhibited a lower incidence of frailty compared to those not receiving CPAP (11.26% vs 21.83%, P=0.045). In the multivariate model, CPAP therapy was significantly correlated with a reduced risk of incident frailty (OR = 0.36, 95% CI, 0.15-0.88; P = 0.025). Subcomponent analyses revealed that CPAP was associated with a lower risk of fatigue (OR=0.35, 95% CI, 0.19-0.63; P < 0.001), resistance (OR = 0.32, 95% CI, 0.14-0.74; P=0.008), and weight loss (OR = 0.38, 95% CI, 0.19-0.75; P = 0.007). Conclusion: CPAP therapy was associated with a reduced risk of incident frailty among elderly patients with OSA.

Circulating MicroRNAs as potential biomarkers for alcoholic steatohepatitis.

AIMS: To investigate serum miRNA profile in alcoholic steatohepatitis (ASH), evaluate its effect as non-invasive diagnostic tool and to study its targets' function. METHODS: Microarray and quantitative reverse transcription-polymerase chain reaction (qRT-PCR) were utilized to detect serum miRNAs pattern in a rat ASH model, followed by target prediction with bioinformatics calculation. The functions and pathways of miRNAs' targets were analysed using databases of Gene Ontology and KEGG. The association between dysregulated miRNAs and genes was assessed by MiR-Gene Network. Five top dysregulated miRNAs were also verified in humans. RESULTS: Eight up-regulated and three down-regulated serum miRNAs were selected as an accurate molecular signature in distinguishing ASH from control. For up-regulated miRNAs, 122 GO and 144 KEGG pathways were significantly enriched, including apoptosis, lipid metabolic process, PPAR signalling pathway. For down-regulated miRNAs, 86 GO and 104 KEGG pathways were enriched, including fatty acid metabolism and insulin signalling pathway. Besides, Ccdc117, Gcom1, Zmynd11 and Zfp423 were found at top list as under common regulation of maximum miRNAs. Moreover, miR-214 had the highest degree of 63 among all miRNAs, followed by miR-203 and miR-539. Similarly, Stat3 and Lyn showed the highest degree of 5 among all downstream targets. All significance analysis of microarrays (SAM) revealed that five top dysregulated miRNAs showed the same tendency in humans. CONCLUSION: We have reported a unique serum miRNA pattern for non-invasive diagnosis of ASH and provided data reservoir for miRNA and downstream targets exploration.

Association between Helicobacter Pylori infection and ulcerative colitis--a case control study from China.

AIMS: To investigate the association between H. pylori infection and UC prevalence in China. MATERIALS AND METHODS: Subjects were selected from patients admitted in Department of Gastroenterology for abdominal pain, hematochezia, diarrhea and other GI symptoms during 2009-2012. UC diagnosis was based on both colonoscopy and biopsy. H. pylori detection was based on (14)C urea breath test (UBT) and biopsy sample culture. Patients' demographic, anthropometric and serologic data were selected. H. pylori infection rate was compared between UC and control groups, followed by a subgroup analysis on the association between H. pylori infection and extent and severity degree of UC. RESULTS: Totally, 153 and 121 patients were selected and divided into UC and control groups. There were no significant differences in age, gender, BMI, hypertension and diabetes. However, smoking history was significantly lower while WBC and CRP levels were significantly higher in UC group. The H. pylori infection rate in UC group was 30.5%, significantly lower than that of 57.0% in control group. The H. pylori infection rate in UC of left colon and whole colon were 33,9% and 24.2% (p<0.05 between them), both significantly lower than that in control group. In addition, the H. pylori infection rates in mild, moderate and severe UC subgroups were 37.8%, 32.3% and 22.2% (p>0.05 among them), all of which were significantly lower than that in control group. CONCLUSION: We reported a significantly lower H. pylori infection rate in UC patients with different extent and severity degree, which provides evidence for bacteria involvement in UC pathogenesis and reminder clinicians to keep cautious in considering H. pylori eradication in UC patients.

Supracricoid partial laryngectomy cricohyoidoepiglottopexy (SCPL-CHEP) versus vertical partial laryngectomy for the treatment of glottic carcinoma.

The study aimed to compare the survival rate and functional outcome of supracricoid partial laryngectomy cricohyoidoepiglottopexy (SCPL-CHEP) and vertical partial laryngectomy (VPL) in the treatment of glottic carcinoma. Thirty-nine patients underwent SCPL-CHEP and 45 patients underwent VPL between 2002 and 2007. Post-operative clinical staging were performed according to the UICC staging criteria (2002). The primary endpoints were survival time and recurrence rate. The secondary endpoints were the laryngeal functions including pronunciation, swallowing, and respiration. Overall, the estimated mean survival time was 75.6 months. There was no significant difference in survival times between the two groups (P = 0.496). The SCPL-CHEP group had a significantly lower post-operative local recurrence rate than VPL group (2.6 vs. 17.8 %, P = 0.033). Significantly longer nasogastric tube removal (22 vs. 14 days, P < 0.001) and tracheostomy decannulation (38.5 vs. 15 days, P < 0.001) times in SCPL-CHEP group was observed with the VPL group, respectively. Significantly higher aspiration rates were observed at 3, 6, and 12 months in the SCPL-CHEP group compared with the VPL group (P < 0.001, P < 0.001, P < 0.05, respectively). Although the survival rate was not significantly different between the two groups, the local regional control rate and organ preservation in the supracricoid partial laryngectomy cricohyoidoepiglottopexy group was better than those observed in the vertical partial laryngectomy group.

Characterization of microbial community structure in a hybrid biofilm-activated sludge reactor for simultaneous nitrogen and phosphorus removal.

The microbial communities in a hybrid biofilm-activated sludge reactor (HY) for nitrogen and phosphorus removal were characterized by 16S rRNA-based clone libraries and phylogenetic analysis. The hybrid reactor removed over 90% of COD, 92% of total nitrogen (TN) and 95% of total phosphorus (TP) from the municipal wastewater, respectively. The mean removal rates of COD, TN, and TP in the conventional suspended activated sludge reactor were above 80%, 80% and 94%, respectively. Community structures were determined by phylogenetic analyses of six clone libraries (each nearly 100 clones). The dominant bacterial group with which clones were affiliated to the beta subclass of the Proteobacteria (31% to approximately 77%), following the Bacteroidetes group (10% to approximately 34%). In addition, several clone groups affiliated with unknown bacterial assemblages were identified in the clone libraries. Acinetobacter sp., which was thought to had played an important role in phosphate removal systems, was scarcely represented by clone sequences in both libraries. Differences in community structure were observed between the hybrid reactor and activated sludge reactors. Such differences may account for the differing wastewater treating capabilities of the two different systems.