[Clinical characteristics of digestive system cancers metastatic to the heart].

Objective: To investigate the clinical features of patients with cardiac metastases from digestive system tumors. Methods: This retrospective study collected and analyzed the medical records of patients with cardiac metastases from digestive system tumors who received treatments in the Cancer Hospital, Chinese Academy of Medical Sciences between January 1999 and January 2021. Kaplan-Meier method was used for survival analysis. Results: A total of 19 patients were identified. The primary tumors were esophageal squamous cell carcinoma (n=7), gastric or gastroesophageal junction adenocarcinoma (n=6), hepatobiliary cancers (n=3) and colorectal cancers (n=3). 16 patients had pericardial metastases, 2 patients had right atrium metastases, and 1 patient had left ventricle metastasis. The most common symptom was dyspnea, which was present in 8 cases. 7 patients received locoregional treatment, while 11 patients underwent systemic therapies. The median overall survival from diagnosis of primary cancer was 31.4 months, and the median overall survival time from diagnosis of cardiac metastasis was 4.7 months. Conclusion: Cardiac metastasis from digestive system tumors is associated with low incidence and a poor prognosis. Systemic treatment remains the cornerstone of management, while novel anti-tumor drugs may improve therapeutic efficacy.

Untargeted lipidomics analysis in women with intrahepatic cholestasis of pregnancy: a cross-sectional study.

OBJECTIVE: To compare the plasma lipid profiles in women with normal pregnancies and those with mild or severe intrahepatic cholestasis of pregnancy (ICP). Our goal was to reveal lipidome-wide alterations in ICP and delve into the pathogenesis of ICP from a lipid metabolism perspective. DESIGN: Cross-sectional study, including women with normal pregnancies, women with mild ICP and women with severe ICP. SETTING: Gansu Provincial Hospital. POPULATION: Women with ICP were recruited from October 2019 to March 2020 in Gansu, China. METHODS: Untargeted lipidomics was used to analyse differentially expressed plasma lipids in controls, in women with mild ICP and in women with severe ICP (n = 30 per group). For lipidomics, liquid chromatography and Q-Exactive Plus Orbitrap mass spectrometry were performed. MAIN OUTCOME MEASURES: Differentially expressed lipids. RESULTS: Thirty-three lipids were differentially expressed in the severe and mild ICP groups, compared with the control group, and 20 of those were sphingolipids (ceramide, six species; sphingomyelin, 14 species). All differentially expressed sphingolipids in women with mild ICP were also differentially expressed in women with severe ICP; the fold change and significance of the differential expression were positively correlated with disease severity. CONCLUSIONS: We systematically characterized the lipidome-wide alterations in mild and severe ICP groups. The results indicated a link between ICP and disordered sphingolipid homeostasis. TWEETABLE ABSTRACT: Abnormal sphingolipid metabolism is involved in the pathogenesis of ICP.

Nomogram to predict survival of patients with advanced and metastatic pancreatic Cancer.

BACKGROUND: Nomograms are rarely employed to estimate the survival of patients with advanced and metastatic pancreatic cancer (PC). Herein, we developed a comprehensive approach to using a nomogram to predict survival probability in patients with advanced and metastatic PC. METHODS: A total of 323 patients with advanced and metastatic PC were identified from the Chinese People's Liberation Army (PLA) General Hospital. A baseline nomogram was constructed using baseline variables of 323 patients. Additionally, 233 patients, whose tumors showed initial responses to first-line chemotherapy, were enrolled in the chemotherapy response-based model. 128 patients and 108 patients with advanced and metastatic PC from January 2019 to April 2021 were selected for external validating baseline model and chemotherapy response-based model. The 1-year and 2-year survival probability was evaluated using multivariate COX regression models. The discrimination and calibration capacity of the nomograms were assessed using C-statistic and calibration plots. The predictive accuracy and net benefit of the nomograms were evaluated using ROC curve and DCA, respectively. RESULTS: In the baseline model, six variables (gender, KPS, baseline TB, baseline N, baseline WBC and baseline CA19-9) were used in the final model. In the chemotherapy response-based model, nine variables (KPS, gender, ascites, baseline N, baseline CA 19-9, baseline CEA, change in CA 19-9 level at week, change in CEA level at week and initial response to chemotherapy) were included in the final model. The C-statistics of the baseline nomogram and the chemotherapy response-based nomogram were 0.67 (95% CI, 0.62-0.71) and 0.74 (95% CI, 0.69-0.77), respectively. CONCLUSION: These nomograms were constructed to predict the survival probability of patients of advanced and metastatic PC. The baseline model and chemotherapy response-based model performed well in survival prediction.

[Analysis of pancreatic segmentation algorithm based on deep learning to improve pancreatic critical region segmentation ability on dual-phase CT].

Objective: To investigate the segmentation effects of the deep learning method on CT in the arterial phase and venous phase respectively by using subjective and objective evaluation system, and to investigate the factors that affect the difference between arterial phase and venous phase pancreas segmentation and the related factors affecting the venous pancreas segmentation. Method: A total of 218 cases of pancreatic CT scan data in the Department of Radiology of Peking Union Medical College Hospital from January to November 2019 were retrospectively collected. Each case contained images of arterial and venous phases, and the data were randomly divided into training set (139 cases), validation set (20 cases) and test set (59 cases) according to the ratio of the training and verification set to the test set of 7∶3. The two-stage global local progressive fusion network was trained on the training set, the model parameters of the optimal segmentation effect were found on the validation set, and the test set was predicted and the results were evaluated subjectively and objectively. The Likert 5-point scale was used for subjective evaluation based on the critical regions between pancreas and peripheral organs, while the Dice similarity coefficient (DSC) was used for objective evaluation. The paired t test or Wilcoxon paired rank test was used to compare the differences of subjective and objective scores of the arterial phase and venous phase. Results: For the critical regions of the pancreas at the duodenum, duodenal jejunal flexure, left adrenal gland, portal vein, superior mesenteric vein, splenic artery and splenic vein, the median number of subjective scores in arterial phase were 4(4, 5), 5(4, 5), 5(4, 5), 4(4, 5), 5(4, 5), 5(5, 5) and 4(3, 5)points respectively, the median number(first quartile, third quartile) of subjective scores in venous phase were 4(4, 4), 5(4, 5), 5(4, 5), 5(4, 5), 5(5, 5), 4(3, 4) and 5(5, 5) points respectively,there were statistically significant differences of the median number(first quartile, third quartile) of the subjective scores between the arterial and venous phase for the critical regions of the pancreas at the organs described above (all P<0.05). DSC in the venous phase was slightly higher than that in the arterial phase and the difference was not statistically significant (DSC: 0.932 vs 0.921, P=0.952). Subjective scores in venous phase of the pancreas and duodenal jejunum, stomach, and left adrenal gland with fat gaps were 4.64,4.68 and 4.63 points respectively, and those of the group without fat gaps were 4.56,4.62 and 4.56 points respectively, there were statistically significant differences of the subjective scores in venous phase of the groups with fat gaps or not between the pancreas and the organs described above (t=2.147, 2.112, 2.277, all P<0.05). Except the spleen, the density differences between the critical regions of the pancreas and other surrounding organs were statistically significant in arterial phase and venous phase segmentation (all P<0.05). Conclusion: Dual-phase CT was used to construct a deep learning automatic pancreas segmentation model, and the segmentation effect was evaluated subjectively and objectively. Subjective evaluation was helpful to improve the ability to segment the critical regions of the pancreas in the future.

[Early clinical effects of total knee arthroplasty with kinematic alignment assisted by patient-specific instrumentation].

Objective: To examine the clinical effects of the treatment of knee osteoarthritis patients with kinematic alignment technique of total knee replacement (KA-TKA) assisted by patient-specific instrumentation (PSI). Methods: The clinical data of 14 patients with knee osteoarthritis treated with unilateral KA-TKA assisted by PSI at Department of Orthopaedic Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University from May 2018 to August 2019 were analyzed retrospectively. There were 6 males and 8 females, aged 66.6 years (range: 56 to 79 years), 9 left knees and 5 right knees. The operation time, soft tissue release and extra varus or valgus osteotomy were recorded. The data of osteotomy blocks were measured and compared with the corresponding position of the prostheses. The hip knee ankle angle (HKA), the mechanical distal femoral lateral angle (mLDFA) and the proximal tibial medial angle (MPTA) were measured before and 3 months after the operation. The knee joint functional score (KS-F) , knee joint clinical score (KS-C) and the Western Ontario McMaster (WOMAC) Osteoarthritis Index were recorded and compared by paired t test or Wilcoxon non-parametric test. Results: The operation time was (81.8±16.9) minutes (range: 60 to 115 minutes), 2 cases were manually increased varus osteotomy by 2 mm and 1 patient received lateral retinaculum release. There was no extra medial or lateral soft tissue release. Intraoperative measurement of the resection showed that the femoral side mismatch was within 2 mm. The medial and lateral condyle, the medial and lateral posterior condyles were relatively overcut by 0.50 mm, 0.21 mm, 0.93 mm, and 0.71 mm, respectively. The tibial side mismatch was within 1.5 mm, the medial and lateral plateau were relatively undercut by 0.43 mm and 0.32 mm. HKA was corrected from (8.8±5.6) ° to (1.6±4.3) ° (t=20.723, P=0.000) .KS-C improved from 28.21±13.47 preoperative to 78.07±8.01 postoperative (t=-16.570, P=0.000); KS-F improved from 41.00±15.25 preoperative to 84.93±10.85 postoperative (t=-14.675, P=0.000).WOMAC Osteoarthritis Index decreased from 53.5 (25.75) (M(Q(R))) preoperative to 5.5 (5.25) postoperative (Z=-3.297, P=0.001) .No statistically significant difference was found in mLDFA and MPTA before and after surgery. No significant patellofemoral complication was recorded during follow-up time. Conclusions: PSI assisted TKA resection has high accuracy. KA-TKA aims to restore the native anatomy of the knee joint, only corrects the malalignment of lower extremities caused by articular cartilage wear, with less interference to soft tissues, easy to obtain satisfactory knee joint laxity and has a promising early clinical effect.

The role of mechanical stress in the formation of plantar melanoma: a retrospective analysis of 72 chinese patients with plantar melanomas and a meta-analysis.

BACKGROUND: Weightbearing areas of sole were reported to be significantly more vulnerable to melanoma than non-weightbearing areas. Few studies have investigated the role that mechanical stress plays in increasing the incidence of plantar melanoma (PM). OBJECTIVE: This study aims to investigate the potential role of mechanical stress in the formation of PM and evaluate the association of mechanical stress with certain pathological features of melanoma by using meta-analysis. METHODS: We analysed the distribution pattern of 72 PM lesions in Chinese patients and compared their incidence and demographic and clinicopathological features based on sites with different stress exposure. RESULTS: The most common region with a PM was the heel, followed by the forefoot, plantar aspect of the toes, lateral midfoot (LM) and arch. Both the heel and forefoot were significantly associated with a higher incidence of melanoma than the arch. A high density of lesions was observed in the posterior half of the heel and the lateral forefoot. Despite subtle differences in the contour maps of the density of lesions based on sex and age, different groups showed the same primary distribution tendency. The comparison between weightbearing and non-weightbearing areas revealed no significant difference in sex, age, lateralization, clinical pigmentation, Breslow depth or ulceration. However, the meta-analysis revealed that melanoma on weightbearing areas manifested as invasive melanoma at the time of diagnosis more frequently than cases on non-weightbearing areas (OR = 0.300 [95% CI, 0.092-0.977]; P = 0.046). CONCLUSION: Weightbearing areas indicating mechanical stress are correlated with a higher number of plantar melanoma compared with non-weightbearing areas and also show a tendency to be involved by invasive melanomas at the time of diagnosis more frequently than non-weightbearing areas.

Exposure to sodium salicylate disrupts VGLUT3 expression in cochlear inner hair cells and contributes to tinnitus.

To examine whether exposure to sodium salicylate disrupts expression of vesicular glutamate transporter 3 (VGLUT3) and whether the alteration in expression corresponds to increased risk for tinnitus. Rats were treated with saline (control) or sodium salicylate (treated) Rats were examined for tinnitus by monitoring gap-pre-pulse inhibition of the acoustic startle reflex (GPIAS). Auditory brainstem response (ABR) was applied to evaluate hearing function after treatment. Rats were sacrificed after injection to obtain the cochlea, cochlear nucleus (CN), and inferior colliculus (IC) for examination of VGLUT3 expression. No significant differences in hearing thresholds between groups were identified (p>0.05). Tinnitus in sodium salicylate-treated rats was confirmed by GPIAS. VGLUT3 encoded by solute carrier family 17 members 8 (SLC17a8) expression was significantly increased in inner hair cells (IHCs) of the cochlea in treated animals, compared with controls (p<0.01). No significant differences in VGLUT3 expression between groups were found for the cochlear nucleus (CN) or IC (p>0.05). Exposure to sodium salicylate may disrupt SLC17a8 expression in IHCs, leading to alterations that correspond to tinnitus in rats. However, the CN and IC are unaffected by exposure to sodium salicylate, suggesting that enhancement of VGLUT3 expression in IHCs may contribute to the pathogenesis of tinnitus.

[Microbiology analysis of periprothetic joint infection post total hip and knee arthroplasty of 9 centers in Beijing between 2014 and 2016].

Objective: To investigate the microbiological test, antibiotic sensitivity and surgical treatment of periprosthetic joint infection(PJI) cases in post total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients. Methods: A retrospective cross-sectional survey was conducted on 318 patients who underwent THA or TKA in 9 clinical centers in Beijing from January 2014 to December 2016.The data of microbiology, antibiotic sensitivity and surgical treatment were collected.The average age of patients was (62.3±13.1) years old (range: 21-86 years old), including 145 males and 173 females.The body mass index was (25.6±3.8) kg/m (2) (range: 15.6-38.1 kg/m(2)). Results: In total, 318 patients had microorganisms detected by periprosthetic tissue culture or synovial fluid culture, 209 cases (65.7%) had Gram-positive bacteria, 29 cases (9.1%) had Gram-negative bacteria, 10 cases (3.1%) had fungi, 3 cases (0.9%) had non-tuberculous mycobacteria, 72 cases (22.6%) were negative, 69 cases (21.7%) had methicillin-resistant bacteria. The antibiotic sensitivity results showed that the overall resistance rate of penicillin, cefuroxime, amoxicillin+clavulanic acid was 79.9%, 69.9%, and 68.1%, respectively; meropenem, vancomycin, and linezolid resistance rate was 0. For the treatment methods of hip and knee PJI, two-stage revision surgery acounted for 72.9% (108/148) and 64.1% (109/170), respectively. One-stage revision surgery accounted for 21.6% (32/148) and 7.6% (13/170), and open debridement surgery accounted for 4.7%(7/148) and 26.4% (45/170). Conclusions: Gram-positive bacteria was still the main pathogen of PJI.The methicillin-resistant bacteria and rare bacteria should be payed attention to. The Majority of hip and knee PJI cases were treated by two-stage revision surgery.

Structural exercise-based intervention for health problems in individuals with autism spectrum disorders: a pilot study.

OBJECTIVE: Exercise-based intervention promises to be more effective in a structured framework for individuals with autism spectrum disorders (ASD). The aim of this study was to observe changes in behavior of individuals with ASD by investigating their physical status after the structured exercise-based intervention. PATIENTS AND METHODS: The exercise intervention integrated an 8-week exercise program that included aerobic, resistive, and neuromuscular exercises. Body composition and the Autism Treatment Evaluation Checklist (ATEC) were evaluated to assess changes after the exercise-based intervention. RESULTS: After the exercise intervention, the fat mass of individuals with ASD were significantly reduced, and their behavior improved markedly. CONCLUSIONS: This pilot study demonstrated that individuals with ASD require long-term, structured exercise-based intervention, and that such exercise-based intervention is effective for improving their health.

A new perspective of the 2014/15 failed El Niño as seen from ocean salinity.

This study investigates the 2014/15 failed El Niño using salinity from an ocean general circulation model. The results indicate that subsurface processes were especially strong in the summer of 2014 and they led to positive sea surface salinity anomalies in the central equatorial Pacific. The positive sea surface salinity anomalies induced a westward displacement of the sea surface salinity front that represents the eastern boundary of the western Pacific warm pool, preventing the warm surface water from shifting eastward as seen in a typical El Niño event. In the meantime, more salty water was transported equatorward by a strengthening subtropical cell in the South Pacific. The enhanced subsurface processes in the central equatorial Pacific conveyed the salinity anomalies of subtropical origin to the sea surface and were largely responsible for the sea surface salinity variability but had less impacts on sea surface temperature during the 2014/15 failed El Niño, suggesting some potential advantage of ocean salinity in the El Niño-Southern Oscillation prediction.

Epidemiology and molecular characterization of Porcine teschovirus in Hunan, China.

Porcine teschoviruses (PTVs) have been shown to be widely distributed in pig populations. In this study, 261 faecal and 91 intestinal content samples collected from pigs at 29 farms in Hunan, China, were tested for the presence of PTV by reverse transcription-polymerase chain reaction (RT-PCR). An overall PTV-positivity rate of 19.03% was detected by RT-PCR, and a high PTV infection rate was circulating in asymptomatic fattening and nursery pigs. In total, 40 PTV isolates (PTV-HuNs) were obtained. Alignment of their coding sequences with those of other known PTVs revealed that the genomic sequence of the polyprotein contains 6,606-6,621 nucleotides, encoding a 2,202-2,207-amino acid sequence. Phylogenetic analyses based on the VP1 gene and capsid protein gene exhibited 13 main lineages corresponding to PTV serotypes 1-13, and seven PTV serotypes (PTV 2-6, 9, and 11) were identified in the isolates obtained in our study; this is the first report of PTV 5, 9 and 11 in China. Recombination analysis among the PTV-HuNs indicated that nine recombination events have occurred, including both inter- and intraserotype events. In addition, results demonstrated that only limited positive selection is acting on the global population of PTV isolates, and purifying selection is predominant. In conclusion, this study revealed a high infection rate of PTVs circulating in asymptomatic fattening and nursery pigs. The 40 PTV-HuNs showed high genetic diversity, and genetic analysis of all available PTV sequences revealed that strong purifying selection and recombination play important roles in the genetic diversity and evolution of the virus.

Bactericidal effect of Er:YAG laser combined with sodium hypochlorite irrigation against Enterococcus faecalis deep inside dentinal tubules in experimentally infected root canals.

This study evaluated the bactericidal effect of Er:YAG laser radiation combined with sodium hypochlorite (NaOCl) irrigation in the treatment of Enterococcus faecalis deep inside dentinal tubules. The Er:YAG laser was activated, respectively, at 0.3, 0.5 and 1.0 W for either 20 or 30 s; 52.5 g l(-1) NaOCl and normal saline were used for the control groups. Root canals before and after treatments were examined using scanning electron microscopy (SEM). Bacterial reductions both on the root canal walls and at 100, 200, 300, 400 and 500 µm inside the dentinal tubules were analysed using a one-way analysis of variance. SEM results showed that the Er:YAG laser combined with NaOCl disinfected the dentinal tubules from 200 to over 500 µm depth as irradiation power and time increased. This combination killed significantly more bacteria than both the negative control group at each level tested and the positive control group at 300, 400 and 500 µm inside the dentinal tubules. It reached 100% in all experimental groups, both on the root canal walls and at 100 and 200 µm inside the dentinal tubules. However, at 300, 400 and 500 µm inside the dentinal tubules, only the groups treated with 0.5 and 1.0 W for 30s exhibited no bacterial growth. Of the two groups in which no bacteria were detected at all tested depths, Er:YAG laser irradiation at 0.5 W for 30 s combined with NaOCl irrigation was preferable because of the lower emission power and shorter irradiation time, and may serve as a new option for effective root canal disinfection.

Phase-Lock Requirements in a Serial Array of Spin Transfer Nano-Oscillators.

The most promising approach to attain a narrow linewidth and a large output power simultaneously in spin torque oscillators is self-phase-locking of an array of oscillators. Two long range coupling mechanisms, magnetostatic interaction and self-induced current, are explored. Synchronization occurs with MR ratio ~ 14% and volume ~ 2.1 × 10(-5) µm(3) at room temperature for an experimental frequency dispersion, when only the self-induced microwave current is present. The dipole interaction decreases the MR ratio requirement when the elements are properly spaced.

Continuous critical current measurement of high-temperature superconductor tapes with magnetic substrates using magnetic-circuit method.

The critical current (I(c)) of high-temperature superconductor (HTS) tapes has to be examined not only for short samples, but also for the entire tape, because local weak points can possibly lead to the quenching of the whole HTS device. Some methods were reported for continuous I(c) measurement along the length of a HTS tape, but few of them were applicable to tapes with magnetic substrates represented by YBa2Cu3O(7-δ)(YBCO)-coated conductors based on Ni5W alloy substrate by rolling assisted bi-axially textured substrate process. We previously presented a contact-free method using magnetic circuits to measure I(c) continuously of long HTS tapes, namely the magnetic-circuit (MC) method. This method has been previously applied with high speed and resolution to measure I(c) of HTS tapes with non-magnetic substrates, due to its resistance to noise aroused by mechanical vibration. In this work, its ability to measure HTS tapes with magnetic substrates is demonstrated both theoretically and experimentally. A 100 m long commercial YBCO tape based on Ni5W alloy substrate was measured and regular I(c) fluctuations were discovered. The MC method can be a powerful tool for quality control of HTS tapes, especially for tapes with magnetic substrates.

Targeted cell reprogramming produces analgesic chromaffin-like cells from human mesenchymal stem cells.

Transplantation of allogeneic adrenal chromaffin cells demonstrated the promise of favorable outcomes for pain relief in patients. However, there is a very limited availability of suitable human adrenal gland tissues, genetically well-matched donors in particular, to serve as grafts. Xenogeneic materials, such as porcine and bovine adrenal chromaffin cells, present problems; for instance, immune rejection and possible pathogenic contamination are potential issues. To overcome these challenges, we have tested the novel approach of cell reprogramming to reprogram human bone marrow (BM)-derived mesenchymal stem cells (hMSCs) using cellular extracts of porcine chromaffin cells. We produced a new type of cell, chromaffin-like cells, generated from the reprogrammed hMSCs, which displayed a significant increase in expression of human preproenkephalin (hPPE), a precursor for enkephalin opioid peptides, compared to the inherent expression of hPPE in naive hMSCs. The resultant chromaffin-like cells not only expressed the key molecular markers of adrenal chromaffin cells, such as tyrosine hydroxylase (TH) and methionine enkephalin (Met-enkephalin), but also secreted opioid peptide Met-enkephalin in culture. In addition, intrathecal injection of chromaffin-like cells in rats produced significant analgesic effects without using immunosuppressants. These results suggest that analgesic chromaffin-like cells can be produced from an individual's own tissue-derived stem cells by targeted cell reprogramming and also that these chromaffin-like cells may serve as potential autografts for chronic pain management.