Establishment and Verification of a Prediction Model for Identifying Pathologic Infections Based on the Clinical Characteristics of Epidermoid Cysts.

Background: To construct a prediction model based on the clinical characteristics of epidermoid cysts to identify pathologic infections, evaluate the diagnostic accuracy of the model, and conduct preliminary verification. Patients and Methods: We conducted a retrospective analysis of 314 patients diagnosed with epidermoid cysts that had been removed surgically. The clinical and pathologic data of all patients were collected. The patients were divided randomly into modeling group and verification group in a 75:25 ratio. In the modeling group, the multifactor logistic regression method was used to construct a prediction model for identifying epidermoid cyst pathologic infection, and the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic accuracy of the model, which was then validated in the verification group. Results: All 314 patients with epidermoid cysts were divided into non-infected group (183 cases) and infected group (131 cases) according to the pathologic results. Logistic regression analysis showed that the disease course, growth trend, redness, and texture of epidermoid cysts were independent factors affecting pathologic infection. The above four indicators were selected to construct the prediction model of epidermoid cyst pathologic infection. In the modeling group, the prediction model showed an area under the curve (AUC) of 0.898, with the sensitivity of 0.830, specificity of 0.890, positive likelihood ratio of 7.523, and negative likelihood ratio of 0.191. The AUC of the prediction model in the verification group was 0.919, which was not significantly different from that of the modeling group (p = 0.886). Conclusions: The prediction model based on the clinical characteristics of epidermoid cysts had good diagnostic accuracy and high specificity; it can be used to identify pathologic infections of epidermoid cysts.

Expression of CHL1 in Clear Cell Renal Cell Carcinoma and its Association With Prognosis.

As a member of the L1 family of neural cell molecules, close homologue of L1 (CHL1) has been proved to be downregulated in several human cancers. In the present study, we aimed to assess the expression and prognostic value of CHL1 in clear cell renal cell carcinoma (CCRCC). Immunohistochemistry was performed to detect the expression of CHL1 in tissue microarray chips. Then we compared specific clinicopathologic features in patients with different CHL1 expressions. The correlation between CHL1 expression and overall survival (OS) was evaluated by the Kaplan-Meier method and Cox regression analysis. We found that the expression of CHL1 was significantly lower in CCRCC tissues compared with adjacent normal tissues, which was correlated with TNM stage (P<0.001), Fuhrman grade (P=0.006), and LVI (P=0.004). The Kaplan-Meier survival analysis indicated that CCRCC patients with low CHL1 expression had a poorer OS rate than those with high CHL1 expression (P<0.001). Univariate and multivariate Cox regression analyses suggested that CHL1 was an independent and unfavorable prognostic factor for the OS rate of CCRCC patients. Collectively, low expression of CHL1 might predict poor OS rate of CCRCC.

Heterogeneous distribution of PD-L1 expression in the IASLC/ATS/ERS classification of lung adenocarcinoma.

BACKGROUND: PD-L1 expression in tumor cells can predict the efficacy of PD-1/PD-L1 inhibitors and prognosis in patients. However, the correlation between the PD-L1 expression and the novel lung adenocarcinoma classification are obscure. METHODS: 94 lung adenocarcinoma cases were reviewed in the Third Affiliated Hospital of Soochow University from January to December 2019. PD-L1 (DAKO 22C3) was used to test the PD-L1 expression in lung cancer tissue. RESULT: TPS was used to interpret the PD-L1 expression. The negative, low positive and high positive of PD-L1 were 52 cases (55.30%), 29 cases (30.90%) and 13 cases (13.80%). The subtype ratio of acinar, lepidic and solid in adenocarcinoma were correlation with the PD-L1 TPS (r = - 0.37, P < 0.001; r = - 0.22, P = 0.013; r = 0.68, P < 0.001). The results of χ2 test showed the PD-L1 expression had the significant difference with gender (P = 0.027), age (P = 0.018), smoking history (P = 0.021), lymph node metastasis (P = 0.001), TNM stage (P = 0.002), acinar structure (P = 0.017) and solid structure (P < 0.001). Multi-factor linear regression results suggested that solid structure, TNM stage and smoking history were associated with PD-L1 expression (P < 0.05). The solid structure showed more capability to PD-L1 expression (ß = 0.398). CONCLUSION: PD-L1 expression was heterogeneity in lung adenocarcinoma. The solid structure, TNM stage and smoking history were correlation to up-regulation of PD-L1 expression, and solid structure was the most importance factor.

Sponge particulates for biomedical applications: Biofunctionalization, multi-drug shielding, and theranostic applications.

Sponge particulates have attracted enormous attention in biomedical applications for superior properties, including large porosity, elastic deformation, capillary action, and three-dimensional (3D) reaction environment. Especially, the tiny porous structures make sponge particulates a promising platform for drug delivery, tissue engineering, anti-infection, and wound healing by providing abundant reservoirs of broad surface and internal network for cargo shielding and shuttling. To control the sponge-like morphology and improve the diversity of drug loading, some optimized preparation techniques of sponge particulates have been developed, contributing to the simplified preparation process and improved production reproducibility. Bio-functionalized strategies, including target modification, cell membrane camouflage, and hydrogel of sponge particulates have been applied to modulate the properties, improve the performance, and extend the applications. In this review, we highlight the unique physical properties and functions, current manufacturing techniques, and an overview of spongy particulates in biomedical applications, especially in inhibition of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectivity. Moreover, the current challenges and prospects of sponge particulates are discussed rationally, providing an insight into developing vibrant fields of sponge particulates-based biomedicine.

CD8+ T cells located in tertiary lymphoid structures are associated with improved prognosis in patients with gastric cancer.

The presence of tumor infiltrating lymphocytes (TILs) and tertiary lymphoid structures (TLSs) in tumor tissues are of great prognostic significance in several types of human cancer. The present study investigated the density of TILs and TLSs in gastric cancer (GC) tissues and their association with pathological parameters. Moreover, the clinical significance of follicular CD8+ cytotoxic T cells present within the germinal centers of the tumor-associated TLSs was investigated. Immunohistochemistry and H&E staining were used to examine the infiltration and distribution patterns of TILs, TLSs and germinal center (gc) CD8+ TILs in tumor tissues obtained from 63 patients with GC. The number of TILs, TLSs, combination of TILs and TLSs (TILs-TLSs) and gcCD8+ TILs were used to define tumoral immune parameters, and the prognostic value of these parameters was assessed. The analysis revealed that patients with GC with increased levels of TILs, TLSs, or gcCD8+ TILs exhibited improved overall survival. In addition, gcCD8+ TILs levels were significantly associated with patient age, histological grade and pTN stage. Increased levels of TILs-TLSs were positively associated with nerve invasion, tumor thrombus, nodal metastasis and histological grade. Multivariate Cox regression analysis revealed that TILs-TLSs and gcCD8+ TILs were independent prognostic factors. The data obtained in the present study demonstrated that high levels of tumoral immune parameters are important independent prognostic predictors for human GC. The results also suggested a possible role of gcCD8+ TILs in tumor immune surveillance.

Alarmins act both an immune and a disease alert / 中国免疫学杂志

Alarmins known as danger associated molecular patterns(DAMPs) are released into the extracellular endogenous bi-ological mediate by white blood cells and epithelial cells when body in a state of tissue injury and inflammation or physiological stress. Immunological and adaptive immune responses are activated and strengthened by chemotaxis and activation of antigen presenting cells(APC). They are closely associated with the disease development and outcome,and have important guiding significance for clinical diagnosis and treatment.

Research on risk control of hematodialysis equipment based on statistical data of failure / 中国医学装备

Objective:To investigate various risk factors that influence the safety of using hemodialysis equipment, and carry out risk control and reduce risk of using equipment through analyzed the statistical result of failure data of equipment.Methods:Based on all kinds of fault messages record in 2016, the failure data of 390 cases were carried out classified statistic analysis by using Microsoft Excel.Results: Through the statistic analysis of failure rate of 2016 year, there were four main factors were obtained. Aimed at the three higher percent factors that were equipment fault(85.1％), material(11.2％) and human reason(3.7％), respectively., the current management system of hemodialysis equipment was optimized and operation process was standardized from three aspects that included equipment management, material management, and the training and check for staff.Conclusion: Based on the analysis and research for the failure types of hemodialysis equipment purchased from different years, and the analysis of relevant reasons, the corresponding countermeasure of quality management is established, and the main body of responsibility is clarified, and the operative risk of hemodialysis equipment is effectively reduced.

Posterior approach vitrectomy treating penetrating ocular trauma with intraocular foreign body / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore the effect of early posterior approach vitrectomy in the treatment of penetrating ocular trauma with intraocular foreign body.METHODS: Totally 10 cases of penetrating ocular trauma with intraocular foreign bodies(IOFB) in the past two years were included.Emergency vitrectomy, intraocular foreign body removal and silicone oil tamponade were performed by the same surgeon.Antibiotics and steroids were given after surgeries.Retinal photocoagulation was done according to fundus conditions after surgeries.RESULTS: One patient combined with preoperation endophthalmitis and severely damaged retina failed to recover, eventually came to phthisis bulbi.Vitrectomy and IOFB removal were all successfully performed in the other patients.The postoperation follow-up time was 3-18mo.Two of the patients received secondary vitrectomy and silicone replacement surgeries due to recurrent retinal detachment.The remaining patients had no further bleeding with intraoclar pressure(IOP) 8-21mmHg.At the last follow-up, three of them gained best corrected visual acuity better than 0.1, two patients had visual acuity of 0.01 to 0.1 and four patients had poor visual acuity of light perception to FC/50cm because of macular damage.The patient with phthisis bulbi had no light perception.CONCLUSION: Early vitrectomy, foreign body removal and silicone oil tamponade is an effective treatment for patients with penetrating eyeball injury with IOFB.

Primary lymphoepithelioma-like carcinoma of salivary glands: a clinicopathological study of 21 cases.

Lymphoepithelioma-like carcinoma (LELC) of salivary glands is a rare kind tumor. In this study, the authors evaluated 21 patients with LELC of salivary glands who had long-term follow-up. Clinical characteristics, Epstein-Barr virus (EBV) infection, immunohistochemical features, oncoprotein expression, treatments, and outcomes were analyzed. All patients were Chinese. Their ages ranged from 20 to 73 years. All tumors showed the typical syncytial growth pattern of undifferentiated epithelial cells with a significant lymphocyte reaction. All of patients were found by in situ hybridization to have the EBV genome. All tumors showed positive immunostaining of AE1/AE3, CK5/6 and p63. Nearly all cases had bcl-2 oncoprotein expression, but the detection rate of p53, and c-erb B-2 expression was extremely low. LELC of salivary glands is a distinct entity of salivary cancer. LELC of salivary glands can receive multimodality treatment and has a better prognosis similar to that of nasopharyngeal carcinoma.

Effect of erythropoietin on signal transduction pathway in rat model of retinal detachment / 中华实验眼科杂志

BackgroundOur previous study showed that erythropoietin (EPO) protects the photoreceptor from apoptosis in retinal detachment(RD) rat,but its signal transduction pathway remains unknown.Objective The present study was to investigate the effects of EPO on signal transduction pathway in RD.MethodsTwentyfour albino clean Sprague-Dawley(SD) rats were randomly divided into 4 groups.5 μl PBS was injected into vitreous cavity of rats in RD+PBS group,and 400 ng EPO(5 μl) was used at the same way in RD+EPO group.Three days later,the rats were sacrificed and the retina was isolated in each group.The expression levels of Janus kinase 2 (JAK2),p-JAK2,Akt,p-Akt,extracellular regulated protein kinase-1/2 ( ERK-1/2 ),p-ERK-1/2,signal transducer and activator of transcription 5 ( STAT5 ),p-STAT5,nuclear factor-kB (NF-sB) and p-NF-kB were detected by Western blot assay.The administration of experimental animals followed the Standard of ARVO.ResultsThree days after RD,the expression levels of JAK2,Akt and ERK-1,ERK-2 in retinas among normal group,RD,RD+PBS,RD+EPO groups were statistically insignificant different ( F =0.298,P =0.826 ; F =0.681,P =0.588 ; F =0.978,P=0.450;F=1.115,P=0.399 ),but the levels of p-JAK2,p-Akt,p-Erk-1 and p-Erk-2 among these 4 groups were significant difference ( F=24.435,P =0.000; F=48.163,P =0.000;F =19.092,P =0.001; F =14.393,P=0.001 ),and those in RD+EPO group was significantly higher than that in RD and RD+PBS groups( P＜0.05 ).The expression levels of STAT5 and NF-kB among the 4 groups were no significantly differences (F =1.136,P=0.391 ;F=0.696,P=0.580),but after the phosphorylation of STAT5 and NF-kB,the differences was significant ( F =14.189,P =0.001 ; F =40.103,P =0.000 ).Those in RD,RD + PBS,RD + EPO groups did not increase either (P＞0.05).Although the levels of p-STAT5 and p-NF-kB in RD,RD+PBS,RD+EPO groups were significantly higher than those in normal control group( P＜0.05 ),the level of p-STAT5 in RD+EPO group was not significantly higher than that in RD and RD + PBS groups (P ＞ 0.05 ). Conclusions PI3K/Akt and MAPK/ERK-1/2 signal transduction pathways might participate in the protecting process of EPO to photoreceptor in RD rats.

Puerarin enhances superoxide dismutase activity and inhibits RAGE and VEGF expression in retinas of STZ-induced early diabetic rats

OBJECTIVE@#To investigate the effects of puerarin on the activity of superoxide dismutase (SOD), and expressions of advanced glycation end-product (AGE) receptor (RAGE) and vascular endothelial growth factor (VEGF) in retinas of streptozotocin (STZ)-induced early diabetic rats.@*METHODS@#Diabetic rat models were established by inducing diabetes via intra-peritoneal injection of STZ. Rats were randomly divided into normal (control), diabetic (DM), and DM+ puerarin groups. After intra-gastric administration of puerarin (500 mg/kg/day for 4 weeks), levels of SOD and malondialdehyde (MDA) were determined in serum and retina. mRNA and protein expression levels of RAGE and VEGF in retinas were determined by real-time polymerase chain reaction (RT-PCR) (mRNA) and Western blot analysis (protein levels).@*RESULTS@#There was significantly lower SOD activity and significantly higher MDA in serum and retinas of the DM group compared with the two other groups (P<0.05). After treatment with puerarin, SOD activity increased and MDA content decreased in this group (P<0.05). mRNA and protein expression levels of RAGE and VEGF in the DM group were significantly higher than those of the other groups (P<0.05), and decreased after puerarin treatment (P<0.05).@*CONCLUSIONS@#Puerarin is able to enhance SOD activity, and inhibit RAGE and VEGF expressions in retinas of STZ-induced early diabetic rats.

Effect of metoclopramide on capsule endoscopy examination: a randomized study / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the effect of metoclopramide on capsule endoscopy (CE) examination.</p><p><b>METHODS</b>Total 116 patients referred for CE were randomized into two groups with 58 patients in each group. In treatment group patients received 10 mg metoclopramide intramuscular injection after swallowing the capsule and in control group no metoclopramide was administered. The gastric transit time, small bowel transit time, complete endoscopy rate were observed in both groups.</p><p><b>RESULTS</b>The CE examination was completed in 51 patients of treatment group (87.9%) and 48 of control group (84.2%). Mean gastric transit time was (32.45 ± 29.63) min in treatment group and (45.81 ± 40.01)min in control group, there was significant difference between two groups (P<0.05). Mean small bowel transit time was (252.69 ± 113.29) min in treatment group and (258.75 ± 83.83) min in control group, there was no significant difference between two groups (P>0.05).</p><p><b>CONCLUSION</b>Metoclopramide may reduces gastric transit time, but not effect small bowel transit time,which suggests that it might increase the likelihood of complete small-bowel examination in patients undergoing capsule endoscopy.</p>

EGB761 on retinal light injury in rats / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Retinal light injury can lead to degeneration of the photoreceptor cell layer. It has been hypothesized that the mechanism for this process is the photochemical damage. Ginkgo balboa extract (Ginkgo biloba extract EGB761) EGB761 is a free radical scavenger. The purpose of this study was to investigate the possible effect of orally administered EGB761 on retinal light damage of mouse photoreceptor cells.</p><p><b>METHODS</b>Kunming mice were randomly chosen for the following groups containing 20 animals in each: control group, light damage group, saline control group, and drug treatment group. The drug treatment group and saline control group were given daily gavage of EGB761 (150 mg×kg(-1)×d(-1)) one week before light exposure. At 7, 14, and 30 days after light exposure, animals were sacrificed and eyes were examined by light microscopy, electron microscopy, and retinal histopathology using in situ detection of apoptotic cells.</p><p><b>RESULTS</b>In the light damage group after 7 days there was visible edema, and the outer nuclear layer appeared withered with deeply stained dead cells, leaving only a thin nuclear layer of 7 - 8 cells. After 14 days, the photoreceptor cell layer disappeared, leaving only the outer nuclear layer of 1 - 3 cells with an average thickness of (37.988 ± 1.207) µm. The average thickness of the retina was (126.32 ± 2.31) µm. In the drug treatment group, the photoreceptor cell layer and outer nuclear layer damage were significantly lower than the saline group (t = 21.993, P < 0.001), demonstrating that EGB761, especially at 14 days after light exposure, can reduce retinal light damage in mice.</p><p><b>CONCLUSION</b>Oral administration of EGB761 can partially inhibit apoptosis of photoreceptor cells, resulting in increased photoreceptor cell survival.</p>

Protection of endogenous erythropoietin on photoreceptor cells in retinal detachment and its mechanism / 中华实验眼科杂志

Background Erythropoietin (EPO) has a protective effect on retinal neurons in many retinal diseases,but regarding the effect of EPO on apoptosis of retinal photoreceptor cells in retinal detachment (RD) is uncompletely clear.Objective This study was to investigate the protective effect of endogenous EPO on photoreceptors in a rat model of RD and explore its possible mechanism.Methods Seventy-two Sprague- Dawley (SD) rats were randomly assigned to control group,RD group,RD+PBS group,RD+erythropoietin soluble receptor (EPOsR) 2, 20, 200ng groups with 12 rats for each group.1.4% hyaluronic acid was slowly injected into the subretinal space to induce RD in rats,and PBS or 2,20 or 200ng EPOsR was then injected into the vitreous space.On day 3 after RD,apoptotic photoreceptors were detected using transferase-mediated dUTP nickend labeling (TUNEL),and caspase-3 activity was assessed by Western-blot and immunofluorescence staining.On day 14 after RD,retinal histopathologic examination was carried out and outer nuclear layer (ONL) thickness was measured under the light microscope.The use of animals complied with the Statement of Association for Research in Vision and Ophthalmology. Results Apoptotic photoreceptors were seen in ONL of rats of the RD group.Apoptotic photoreceptors were gradually increased with the elevation of EPOsR dose in the vitreous cavity.Western blot and immunofluorescence consistently showed that the gray scale of caspase-3 activity was 0.15±0.04,0.49±0.03,0.50±0.07,0.63±0.03,0.69±0.04 and 0.83±0.04 in the normal group,RD group,RD +PBS group,RD+EPOsR 2,20,200ng groups respectively with statistically significant differences (F=76.016;P=0.000),and caspase-3 activity was considerably stronger in the RD+EPOsR 200ng group than the other groups (P＜0.01).On day 14 after RD,the ONL thicknesses in the normal control group,RD group,RD+PBS group,RD+EPOsR 2,20,200ng groups were (47.39±3.39)μm,(33.96±3.54)μm,(31.83±5.21)μm,(31.40±2.63)μm,(24.99±2.06)μm and (19.30±3.71)μm,showing significant differences among these groups (F=44.733,P=0.000).ONL thicknesses the groups treated with different doses of EPOsR were markedly thinner than that of the RD group and RD +PBS group (P＜0.01).Conclusion EPOsR induces apoptosis of retinal cells and enhances the activity of caspase-3 in a dose-dependent manner.Endogenous EPO can protect photoreceptors against anoxia-mediated damage in RD eyes through decreasing caspase-3 activity and inhibiting apoptosis.

The protective effects of erythropoietin/erythropoietin receptor system on optic nerve and retinal diseases / 中华实验眼科杂志

Erythropoietin(EPO) has an anti-apoptotic effect,and promotes the proliferation and differentiation of erythroid progenitor cells. Several studies have indicated that EPO can protect photoreceptor cells from the lightinduced retinal degeneration ;protect retinal neurons from ischemia-reperfusion injury and retinal ganglion cells after acute and chronic ocular hypertension; promote ganglion cell survival and axonal regeneration after optic nerve transaction; attenuate inflammation in multiple sclerosis optic neuritis; reduce the permeability of the retinal barrier and protect retinal neurons in diabetic retinopathy; enhance the stability of hypoxic retinal vessels in retinopathy of prematurity. Herein,we review the distribution of EPO and its receptor in retina,their expression in animal model of retinal diseases,and their effects and mechanisms in protection of retinal neurons and optic nerve.