Single-cell transcriptomics reveals the heterogeneity of the decidual endothelial cells that participate in labor onset.

OBJECTIVE: To investigate the heterogeneity of decidual endothelial cells and their changes during delivery. PATIENTS AND METHODS: Single-cell RNA sequencing was used to characterize the transcriptomes of decidual endothelial cells before and after the onset of labor. RESULTS: Decidual endothelial cells (9748 cells) were divided into five subgroups with different functions according to differences in the transcriptome. The functions of cluster 5 were enriched in vascular development and response to growth factors. After the onset of labor, the activities of each cluster were different, including the interleukin 17 pathway and regulation of ERK1 and ERK2 cascade. The downregulated genes were related to scavenger receptor (cluster 5), which may reflect the process of endothelial activation. In terms of genetic changes, cluster 5 may be more actively involved in labor than the other clusters. CONCLUSIONS: Peripartum decidual endothelial cells are heterogeneous and participate in labor to varying degrees. One of the five subtypes of endothelial cells may be more actively involved in labor onset. Our findings may enable the assessment of decidual endothelial cells and labor onset.

Soft granular particles sheared at a controlled volume: rate-dependent dynamics and the solid-fluid transition.

We study the responses of fluid-immersed soft hydrogel spheres that are sheared under controlled volume fractions. Slippery, deformable particles along with the density-matched interstitial fluid are sandwiched between two opposing rough cones, allowing studies for a wide range of volume fraction φ both above and below the jamming of granular suspension. We utilize sudden cessations of shearing, accompanied by refraction-matched internal imaging, to supplement the conventional flow-curve measurements. At sufficiently high volume fractions, the settling of particles after the cessations exhibits a continuous yet distinct transition over the change of the shear rate. Such changes back out the qualitative difference in the state of flowing prior to the cessations: the quasi-static yielding of a tightly packed network, as opposed to the rapid sliding of particles mediated by the interstitial fluid whose dynamics depends on the driving rate. In addition, we determine the solid-fluid transition using two independent methods: the extrapolation of stress residues and the estimated yield stress from high values of φ, and the settling of particles upon shear cessations as φ goes across the transition. We also verify the power law on values of characteristic stress with respect to the distance from jamming φ - φc, with an exponent close to 2. These results demonstrate a multitude of relaxation timescales behind the dynamics of soft particles, and raise questions on how we extend the existing paradigms of the flow of a densely packed system when the softness is actively involved.

[Establishment of clinical features and prognostic scoring model in early-stage hepatitis B-related acute-on-chronic liver failure].

Objective: To explore the clinical characteristics and establish a corresponding prognostic scoring model in patients with early-stage clinical features of hepatitis B-induced acute-on-chronic liver failure (HBV-ACLF). Methods: Clinical characteristics of 725 cases with hepatitis B-related acute-on-chronic hepatic dysfunction (HBV-ACHD) were retrospectively analyzed using Chinese group on the study of severe hepatitis B (COSSH). The independent risk factors associated with 90-day prognosis to establish a prognostic scoring model was analyzed by multivariate Cox regression, and was validated by 500 internal and 390 external HBV-ACHD patients. Results: Among 725 cases with HBV-ACHD, 76.8% were male, 96.8% had cirrhosis base,66.5% had complications of ascites, 4.1% had coagulation failure in respect to organ failure, and 9.2% had 90-day mortality rate. Multivariate Cox regression analysis showed that TBil, WBC and ALP were the best predictors of 90-day mortality rate in HBV-ACHD patients. The established scoring model was COSS-HACHADs = 0.75 × ln(WBC) + 0.57 × ln(TBil)-0.94 × ln(ALP) +10. The area under the receiver operating characteristic curve (AUROC) of subjects was significantly higher than MELD, MELD-Na, CTP and CLIF-C ADs(P < 0.05). An analysis of 500 and 390 cases of internal random selection group and external group had similar verified results. Conclusion: HBV-ACHD patients are a group of people with decompensated cirrhosis combined with small number of organ failure, and the 90-day mortality rate is 9.2%. COSSH-ACHDs have a higher predictive effect on HBV-ACHD patients' 90-day prognosis, and thus provide evidence-based medicine for early clinical diagnosis and treatment.

[Observation of the therapeutic and characteristic effects of terlipressin on refractory cirrhotic ascites].

Objective: To observe the therapeutic effect of terlipressin on refractory ascites (RA) in cirrhosis, and its role and impact on acute kidney injury (AKI). Methods: A non-randomized controlled clinical trial data of 111 hospitalized cases of liver cirrhosis accompanied with RA was collected from Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Zhongshan Hospital of Hubei Province, The First Affiliated Hospital of Zhengzhou University, The First Affiliated Hospital of Medical School of Zhejiang University, and People's Hospital of Pudong New Area of Shanghai between March 2015 and March 2017. 26 cases of conventional treatment group (control group) were divided into two subgroups: RA without AKI (RA-NAKI) and RA with AKI (RA-AKI), and each subgroup consisted 13 cases. Patients with bacterial infection were treated with diuretics, albumin supplementation and antibiotics. 85 cases were presented in terlipressin combined treatment group, of which 27 cases were of RA-NAKI and 58 cases were of RA-AKI. Control group was injected terlipressin 1mg of intravenous drip or static push (once q6 h ~ 12 h) for more than 5 days. The treatment duration lasted for 2 weeks with 4 weeks of follow-up. Body weight, 24-hour urine volume, abdominal circumference, mean arterial pressure (MAP), liver and kidney function, anterior hepatic ascites, deepest point of ascites, and ultrasonographic detection of ascites in supine position before treatment, one and two weeks after treatment and 4 weeks after follow-up were compared. Count data were tested by χ (2). Samples of four groups at baseline were compared. One-way analysis of variance was used for normal distribution data and Kruskal-Wallis H test for non-normal distribution data. Repeated measures analysis of variance was used to compare the difference in efficacy between different time points before and after treatment in the group. The LSD method of one-way ANOVA was used to compare the two groups. A t-test of independent samples was used to compare the efficacy of different time series between the two groups. Mann-Whitney rank- sum test was used to compare the data of non-normal distribution between the two groups. Results: (1) Baseline data were compared among 4 subgroups of terlipressin RA-NAKI and control RA-AKI. Control group age was higher than that of terlipressin group, and the serum creatinine (SCr) of the RA-AKI group was higher than RA-NAKI group, and there was no significant difference in the rest of the baseline data and the combined medication (P > 0.05). (2) An intra-group comparison between control and trelipressin before and after treatment showed that all patients had lower body mass, abdominal circumference and deepest ascites, and higher serum albumin (P < 0.05). 24-hour urine volume and MAP was significantly increased in the terlipressin group, while the pre-ascites, SCr and child Turcotte Pugh (CTP) scores were decreased. Body weight, abdominal circumference, pre-ascites, and deepest ascites of the terlipressin group were decreased, while MAP was increased during the treatment and follow-up periods. The differences were statistically significant when compared with the control group at the same time (P < 0.05). There was a statistically significant difference in the increase of 24-h urine volume in the terlipressin group compared with the control group (P < 0.05). The decrease in SCr and CTP in the terlipressin group after 2 weeks of treatment and 4 weeks of follow-up was statistically significant compared with the control group (P < 0.05). (3) Among the two subgroups of RA-AKI and RA-NAKI in the terlipressin group, the baseline SCr value of the former was higher than that of the latter. After treatment, the body weight, abdominal circumference, pre-ascites, deepest ascites and CTP scores were decreased. In the RA-AKI group, 24-hour urine volume, MAP, SCr and serum albumin concentration were significantly increased. The difference between the two subgroups before and after treatment was compared, and the body weight of RA-AKI group at 1, 2 weeks of treatment and 4 weeks of follow-up was significantly lower than RA-NAKI group, which were (- 2.3 ± 0.2 vs. - 1.5 ± 0.2) kg, (- 4.1 ± 0.2 vs. - 2.6 ± 0.2) kg, (- 4.2 ± 0.3 vs. - 2.4 ± 0.3) kg, respectively. RA-NAKI group urine volume was significantly increased at 2 weeks of treatment and 4 weeks of follow-up, which was (468 ± 42 vs. 110 ± 131) ml, (272 ± 34 ml vs. 11 ± 112) ml, respectively. SCr reduction (18.3 ± 4.7 vs. 0.9 ± 2.4) µmol/l at 4 weeks of follow-up was apparent in RA-NAKI group, and the difference was statistically significant (P < 0.05). Conclusion: Addition of terlipressin to conventional treatment may significantly increase MAP, 24-h urine volume, improve renal function and promote ascites resolution in patients with refractory cirrhotic ascites. Moreover, its combination effect is more obvious in AKI patients, and adverse reactions are mild.

Screw head plugs increase the fatigue strength of stainless steel, but not of titanium, locking plates.

OBJECTIVES: Screw plugs have been reported to increase the fatigue strength of stainless steel locking plates. The objective of this study was to examine and compare this effect between stainless steel and titanium locking plates. METHODS: Custom-designed locking plates with identical structures were fabricated from stainless steel and a titanium alloy. Three types of plates were compared: type I unplugged plates; type II plugged plates with a 4 Nm torque; and type III plugged plates with a 12 Nm torque. The stiffness, yield strength, and fatigue strength of the plates were investigated through a four-point bending test. Failure analyses were performed subsequently. RESULTS: For stainless steel, type II and type III plates had significantly higher fatigue strength than type I plates. For titanium, there were no significant differences between the fatigue strengths of the three types of plates. Failure analyses showed local plastic deformations at the threads of screw plugs in type II and type III stainless steel plates but not in titanium plates. CONCLUSION: The screw plugs could increase the fatigue strength of stainless steel plates but not of titanium plates. Therefore, leaving screw holes open around fracture sites is recommended in titanium plates.Cite this article: L-W. Hung, C-K. Chao, J-R. Huang, J. Lin. Screw head plugs increase the fatigue strength of stainless steel, but not of titanium, locking plates. Bone Joint Res 2018;7:629-635. DOI: 10.1302/2046-3758.712.BJR-2018-0083.R1.

New microsatellites revealed strong gene flow among populations of a new outbreak pest, Athetis lepigone (Möschler).

Athetis lepigone (Möschler) (Lepidoptera: Noctuidae) is a new outbreak pest in China. Consequently, it is unclear whether the emergence and spread of the outbreak of this pest are triggered by rapid in situ population size increases in each outbreak area, or by immigrants from a potential source area in China. In order to explore the outbreak process of this pest through a population genetics approach, we developed ten novel polymorphic expressed sequence tags (EST)-derived microsatellites. These new microsatellites had moderately high levels of polymorphism in the tested population. The number of alleles per locus ranged from 3 to 19, with an average of 8.6, and the expected heterozygosity ranged from 0.269 to 0.783. A preliminary population genetic analysis using these new microsatellites revealed a lack of population genetic structure in natural populations of A. lepigone. The estimates of recent migration rate revealed strong gene flow among populations. In conclusion, our study developed the first set of EST-microsatellite markers and shed a new light on the population genetic structure of this pest in China.

[Changes and perspectives of non-biological artificial liver treatment].

Liver failure is a common clinical syndrome of serious liver diseases with a high mortality rate. Artificial liver support system can significantly reduce the mortality rate of patients with liver failure and is widely used in clinical practice. Due to the shortage of blood resource, the increase in blood-borne diseases, increased demands for liver transplantation, and the change in treatment concepts, single non-biological artificial liver treatment is often unable to satisfy clinical needs, and it is urgent to develop new therapeutic paradigms of non-bioartificial liver. This article reviews the changes and perspectives of non-biological artificial liver in the treatment of liver failure.

[Research advances in diagnosis and treatment of liver failure in 2016].

Liver failure has various clinical types, a complex pathogenesis, and rapid disease progression, as well as a high mortality rate. Liver failure caused by hepatitis B virus infection is the most common type in China with severe conditions, various complications, and a mortality rate as high as 40%-90%. Invasive fungal disease secondary to acute-on-chronic liver failure can affect patients' prognosis and increase mortality rate. This article introduces the research advances in hepatitis B-related liver failure, artificial liver, and invasive fungal disease secondary to acute-on-chronic liver failure in 2016.

Short granular chain under vibration: Spontaneous switching of states.

We study experimentally a short chain of N(≤8) loosely connected spheres bouncing against a horizontal surface that vibrates sinusoidally at intensity Γ. Distinct states are identified: a base state of uniform bouncing in-sync with the substrate prevails at low values of Γ, whereas increasing Γ can induce transitions to two excited states with appreciable storage of energy around one or both ends of the chain. We find that, in a transitional window of Γ, the chain can even switch spontaneously among states, resolving the mystery why different modes of motion can be initiated at the same position in our previous work along a gradient of vibration [Phys. Rev. Lett. 112, 058001 (2014)]. Preliminary interpretations on the parametric dependences and the optimal frequency window for seeing these transitions are offered, based on the microscopic and statistical evidence in our experiments up to date.

[Current status and perspectives of artificial liver for treatment of acute-on-chronic liver failure].

This article briefly introduces the mechanisms and characteristics of several new artificial liver therapies, the advantages and disadvantages of different sites for placement of the drainage tube, and commonly used anticoagulation methods, as well as the prevention and treatment of common complications of the artificial liver support system. The future direction of development of artificial liver includes new regimens for "individualized treatment" based on patients' conditions, combination of non-biological artificial liver and biological active ingredients, and development of efficient and perfected hybrid bioartificial liver, which can further improve the therapeutic outcome of liver failure.

Vortex-induced morphology on a two-fluid interface and the transitions.

We investigate experimentally the steady flows in a cylinder containing two immiscible liquids, with the primary fluid being driven by the upper boundary rotating at constant speeds. The system exhibits interesting interplays between the flow fields and the morphology of the interface, with evidence showing that the remarkable flattop structure is a consequence of the vortex breakdown discovered decades ago, and that the deformability of the interface also feedbacks positively to the development of the vortices. Monitoring the topological structure of the flow fields defines the base states and transitions behind the morphology, whereas our survey over different aspect ratios also reveals rich phenomena of surface instabilities accompanying these steady states.

Theory of myelin coiling.

A new model is proposed to explain coiling of myelins composed of fluid bilayers. This model allows the constituent bilayer cylinders of a myelin to be non-coaxial and the bilayer lateral tension to vary from bilayer to bilayer. The calculations show that a myelin would bend or coil to lower its free energy when the bilayer lateral tension is sufficiently large. From a mechanical point of view, the proposed coiling mechanism is analogous to the classical Euler buckling of a thin elastic rod under axial compression. The analysis of a simple two-bilayer case suggests that a bilayer lateral tension of about 1 dyne/cm can easily induce coiling of myelins of typical lipid bilayers. This model signifies the importance of bilayer lateral tension in determining the morphology of myelinic structures.

Confined multilamellae prefer cylindrical morphology. A theory of myelin formation.

By evaporating a drop of lipid dispersion we generate the myelin morphology often seen in dissolving surfactant powders. We explain these puzzling nonequilibrium structures using a geometric argument: the bilayer repeat spacing increases and thus the repulsion between bilayers decreases when a multilamellar disk is converted into a myelin without gain or loss of material and with number of bilayers unchanged. Sufficient reduction in bilayer repulsion can compensate for the cost in curvature energy, leading to a net stability of the myelin structure. A numerical estimate predicts the degree of dehydration required to favor myelin structures over flat lamellae.

Effects of artificial liver support system on patients with acute or chronic liver failure.

AIMS: Acute on chronic liver failure (AoCLF) is associated with a high mortality rate. Artificial liver support system (ALSS) is useful to bridge patients with liver failure to liver transplantation or to regenerate their own livers. The aims of this prospective study were to investigate the effects of ALSS on clinical manifestations, liver function, and 30-day survival to probe the factors related to mortality in patients with AoCLF. METHODS: In this study, 338 enrolled patients with AoCLF who received ALSS treatment for 1 to 8 sessions, were compared with 312 patients treated with conventional medications. RESULTS: Clinical manifestations and liver functions were significantly improved, namely, decreased levels of serum transaminases, total bilirubin, and bile acid, as well as increased levels of serum albumin following ALSS treatment. The 30-day survival rates of the patients who received ALSS versus controls were 47.9% versus 34.6%, respectively (P = .01). The MELD score and the stage of hepatic encephalopathy were highly associated with mortality (P < .001), but the sessions of ALSS showed a positive relation to the 30-day survival (P < .05). CONCLUSIONS: ALSS appears to be efficacious and safe for the treatment of patients with AoCLF. Both model for end-stage liver disease (MELD) score and hepatic encephalopathy are useful to predict the mortality of patients.

[A study of artemether combined with primaquine in the treatment of falciparum malaria].

OBJECTIVE: To evaluate the efficacy and side effects of artemether combined with primaquine in the treatment of falciparum malaria. METHODS: Randomization and comparison methods were used in 121 falciparum malaria cases in the Republic of Central Africa. Sixty-one cases were treated with artemether combined with primaquine (Group A used artemether orally, Group B used artemether intramuscularly). And 60 cases received single artemether (Group C used artemether orally, Group D used artemether intramuscularly) were taken as control. RESULTS: In Group A and B the mean fever clearance time were 47.6 +/- 15.7 and 36.9 +/- 10.7 hours, clinical cure rates 84.4% and 100%, relapse rates 6.3% and 3.4%, respectively. In Group C and D the mean fever clearance time were 48.2 +/- 18.4 and 42.2 +/- 9.5 hours, clinical cure rates 90.1% and 96.3%, relapse rates 21.2% and 18.5%, respectively. Side effects in cases of all groups were mild. CONCLUSION: Artemether combined with primaquine and single artemether(via both routes) showed good therapeutic effects in falciparum malaria cases, while artemether combined with primaquine was more effective than single artemether in reducing relapes rate of malaria.

Phase-stepped speckle shearing interferometer by source wavelength modulation.

Phase stepping by wavelength modulation of the optical source is demonstrated in a path-length unbalanced shearing interferometer. A magnification difference, which accompanies the path-length imbalance in the interferometer, introduces an unwanted radial shear, which is shown to be compensated by inclusion of a block of high-refractive-index material in the longer interferometer arm. The block also increases the phase shift obtained for a given wavelength change. The phase-stepping technique is demonstrated with a three-step algorithm to measure out-of-plane strain on a f lat metal plate.

Progestin stimulates the biosynthesis of fibronectin and accumulation of fibronectin mRNA in human endometrial stromal cells.

Fibronectin is a major component of decidual basement membrane. In the present study, we have investigated the effect of progestin on the synthesis and secretion of fibronectin in human endometrial stromal cells. Stromal cells were isolated during the menstrual cycle and cultured in RPMI-1640 with 2% fetal calf serum supplemented with progesterone or medroxyprogesterone acetate (MPA) in a long-term culture system. Indirect immunofluorescent staining showed that fibronectin was uniformly distributed in the intracellular and extracellular regions of stromal cells treated with MPA for 14 days. The biosynthesis and secretion of this protein and the accumulation of cellular fibronectin mRNA were studied after various culture periods. Cells were pulse-labelled with [35S]methionine to determine the amount of newly synthesized fibronectin secreted into the culture medium. A monoclonal antibody (Mab) identified human fibronectin on SDS-polyacrylamide gel electrophoresis (SDS-PAGE), showing a predominant band (Mr 230-250 kDa) which migrated with authentic fibronectin run in parallel. In six endometrial specimens, the amount of radioactivity incorporated as [35S]fibronectin was increased by progestin. Maximal stimulation occurred after 6 days treatment with MPA. Culture beyond 16 days reduced the rate of synthesis and secretion to 40% of the maximum. The effect of progestin was dose dependent with 0.02, 0.2 and 1 microM progesterone, producing 2.0, 3.8 and 11-fold increases respectively, over the control. Medroxyprogesterone acetate was more effective than progesterone, the maximal response (10-fold increase) being achieved at 0.02 microM MPA.(ABSTRACT TRUNCATED AT 250 WORDS)

Fluorescence changes of 7-chloro-4-nitrobenzo-2-oxa-1,3-diazole bound to thiol groups of gizzard myosin.

The fluorescence intensity of gizzard myosin that incorporated about 2 mol of 7-chloro-4-nitrobenzo-2-oxa-1,3-diazole (NBD-C1) at 0.6 M KC1 was quenched at low concentrations of MgATP or in the presence of F-actin. The observed quenching was reduced at high MgATP concentrations. The half maximal change in quenched fluorescence was shifted from 7.5 microM to 25 microM MgATP for NBD-myosin at 0.15 M KC1. The fluorescent label NBD-C1 can be used to detect changes in the conformation of gizzard myosin.