[Risk factors of pain after CT-guided preoperative localization of pulmonary nodules with four-hook needle].

Objective: To identify the risk factors of pain after CT-guided preoperative localization of pulmonary nodules with 4-hook needle. Methods: The clinical data of 212 patients, who underwent CT-guided preoperative localization of single pulmonary nodule with 4-hook needle in Nanjing Drum Tower Hospital affiliated to Nanjing University Medical School from September 2021 to February 2022 were retrospectively analyzed. All patients, including 83 males and 129 females with an age of (54±12) years, were divided into mild pain group (n=163) and moderate-severe pain group (n=49) according to numeric rating scale (NRS) for assessment of pain intensity. The gender, age, body mass index, smoking history, American Society of Anesthesiologists physical status (ASA), nodule location, nodule size, nodule distance from pleura, needle tip distance from pleura, localization-related complications (pneumothorax, pulmonary hemorrhage) and NRS for assessment of pain intensity after pulmonary nodules localization were collected and compared between the two groups. Univariate analysis and multivariate binary logistic regression analysis were performed to identify the risk factors of moderate-severe pain after CT-guided preoperative localization of pulmonary nodules with 4-hook needle. Results: The success rate of preoperative localization was 100%. The rates of pneumothorax and pulmonary hemorrhage were 22.6% and 17.0%, respectively. Univariate analysis showed that there was no significant difference in gender, age, body mass index, smoking history, ASA physical status, nodule location, nodule size, nodule distance from pleura and localization-related complications (pneumothorax, pulmonary hemorrhage) between the two groups (P>0.05), while needle tip distance from pleura of moderate-severe pain group was significantly less than that of mild pain group [7(6, 11) mm vs 15(12, 19) mm, P<0.001]. Multivariate binary logistic regression analysis showed that needle tip distance from pleura was the only risk factor for moderate-severe pain (OR=0.645, 95%CI: 0.562-0.739, P<0.001). According to receiver operating characteristic (ROC) curve analysis, when the cut-off value of needle tip distance from pleura was 9.5 mm, the sensitivity was 69.4%(34/49), the specificity was 90.2%(147/163), and the area under the curve (AUC) was 0.878 (95%CI: 0.820-0.935, P<0.001). Conclusions: Needle tip distance from pleura was the independent risk factor of moderate-severe pain after CT-guided preoperative localization of pulmonary nodules with 4-hook needle. The less needle tip distance from pleura is, the higher risk of moderate-severe pain occurs.

Dietary calcium levels regulate calcium transporter gene expression levels in the small intestine of broiler chickens.

1. This study investigated the effect of dietary calcium (Ca) levels on growth performance, bone development and Ca transporter gene expression levels in the small intestine of broiler chickens.2. On the day of hatch, 350, Ross 308 male broilers were randomly allotted to one of five treatments with five replicate pens each and 14 birds per pen. Dietary Ca levels in feed were 5.0, 7.0, 9.0, 11.0 and 13.0 g/kg, in which 9.0 g/kg was in the control diet. All diets contained 4.5 g/kg non-phytate phosphorus (NPP).3. The increase in dietary Ca levels from 5.0 to 13.0 g/kg did not affect the growth performance of 1- to 18-day-old broilers (P > 0.05).4. Increasing the Ca levels linearly increased the ash weight and the contents of ash, Ca and phosphorus (P) in the tibia of broilers at 18 days of age (P < 0.05). The contents of ash, Ca and P in broilers fed with 9.0 g/kg Ca were higher than those in birds fed with 5.0 g/kg Ca (P < 0.05).5. Increasing the Ca levels linearly decreased mRNA expression levels of the Ca-binding protein 28-kDa (CaBP-D28k), plasma membrane Ca-transporting ATPase 1b (PMCAlb), sodium (Na)/Ca exchanger 1 (NCX1), nuclear vitamin D receptor (nVDR) and membrane vitamin D receptor (mVDR) in the duodenum of broilers at 18 d of age (P < 0.05). Similar results were seen in the jejunum and ileum. Broilers fed 9.0-13.0 g/kg Ca in feed had lower mRNA expression levels of CaBP-D28k and PMCAlb in the small intestine than birds fed 5.0 g/kg Ca in feed (P < 0.05).6. The data indicated that low levels of dietary Ca stimulated its transporter gene transcription and promoted absorption, but high levels of Ca inhibited transporter gene expression and prevented excessive absorption in the small intestine of broiler chickens.

[Advances in the role of extracellular histones in the inflammatory process of liver injury].

Histones are important structural proteins of chromatin in the nucleus, which can regulate gene transcription, and can be released from the nucleus to the outside of the cell under injury and inflammatory stimulations, thereby causing cytotoxicity and immune stimulation, and aggravating tissue damage. Extracellular histones are involved in the occurrence and development of many diseases, including sepsis, autoimmune diseases, liver injury, and acute lung injury. Therefore, its application not only can be used as a body's biomarker of inflammation, but also it is expected to become a molecular target for the treatment of diseases. This article reviews the role of extracellular histones in the inflammatory process of liver injury.

Prevention of neonatal ventilator-associated pneumonia through oral care with the combined use of colostrum and sodium bicarbonate.

OBJECTIVE: This study aims to investigate the effect of oral care via the combined use of colostrum and sodium bicarbonate on the prevention of neonatal ventilator-associated pneumonia (VAP). PATIENTS AND METHODS: In accordance with the inclusion and exclusion criteria, 120 infant patients who were hospitalized in the neonatal intensive care unit (NICU) from January to October of 2019 were selected and randomly divided into three groups (40 cases in each group), namely, colostrum combined with sodium bicarbonate nursing (experimental group), colostrum (control group I), and sodium bicarbonate (control group II) groups. The primary outcomes measured included incidence rates of VAP and oral infection, positive rate of pathogenic bacteria after sputum culture, mechanical ventilation time, and length of stay (LOS). RESULTS: The incidence rates of VAP and oral infection and the positive rate of pathogenic bacteria after sputum culture of the experimental group, which were 6.67%, 10.00%, and 10.00%, respectively, were significantly different from those of control groups I and II (p < 0.05). The mechanical ventilation time of the experimental group was 156.07 ± 26.67 h, which was shortened by 9.79% and 9.43% compared with those of control groups I and II, respectively. The LOS of the experimental group was 17.6 ± 1.96 days, which was shortened by 17.74% and 17.50% compared with those of control groups I and II, respectively. The differences were statistically significant (p< 0.05). CONCLUSIONS: Oral care through the combined use of colostrum and sodium bicarbonate can lower the VAP incidence rate of infant patients and shorten their mechanical ventilation time and LOS.

Effects of simulation training on COVID-19 control ability and psychological states of nurses in a children's hospital.

OBJECTIVE: This study aims to discuss the effects of simulation training on improving the pre-examination, triage, prevention, and control of coronavirus disease 2019 (COVID-19), explain the psychological states of pre-examination and triage staff in general hospitals during the COVID-19 epidemic, and analyze relevant influencing factors. This study may serve as a reference of psychological consultation services to medical staff. SUBJECTS AND METHODS: This study included 60 nurses assigned in the pre-examination department, fever clinics, and isolation wards of a general hospital from January 26th to February 1st, 2020. Before assuming the posts, the nurses received simulation training on the clinical reception of suspected patients with COVID-19. Operation skills of the nurses before and after the training were assessed. RESULTS: The percent of passing significantly increased from 65% before the training to 98.33% after training (p<0.05). Training also significantly relieved the anxiety and depression of the nurses (p<0.05). CONCLUSIONS: Scenario-simulation training can increase the emergency abilities of pediatric nurses in the prevention and control of the COVID-19 epidemic and relieve the anxiety of nurses.

Protective effect of magnesium sulfate on cranial nerves in preeclampsia rats through NF-κB/ICAM-1 pathway.

OBJECTIVE: The aim of this study was to investigate the protective effect of magnesium sulfate (MgSO4) on the cranial nerves of preeclampsia (PE) rats through the nuclear factor-κB (NF-κB)/intercellular adhesion molecule-1 (ICAM-1) pathway. MATERIALS AND METHODS: A total of 30 pregnant rats were randomly divided into three groups, including control group, model group, and treatment group, with 10 rats in each group. Systolic blood pressure was measured at 13 d, 15 d, and 19 d. The apoptosis level in brain tissues was detected via Western blotting and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay. Protein expression of genes was detected using immunohistochemical staining. Moreover, the messenger ribonucleic acid (mRNA) expressions of NF-κB and ICAM-1 in brain tissues were determined through Reverse Transcription-Polymerase Chain Reaction (RT-PCR). RESULTS: Systolic blood pressure exhibited significant differences among the three groups at 15 d and 19 d of gestational age (p<0.05). At 15 d of gestational age, systolic blood pressure was significantly higher in model group than that of control group (p<0.05). However, it was slightly lower in treatment group than model group (p<0.05). At 19 d of gestational age, systolic blood pressure was significantly higher in model group than control group (p<0.05). However, it decreased remarkably in treatment group when compared with model group (p<0.05). In treatment group, systolic blood pressure at 19 d was significantly lower than that at 15 d (p<0.05). Subsequent Western blotting revealed that the protein expression of B-cell lymphoma-2 (Bcl-2) in brain tissues decreased evidently, whereas the expression of Bcl-2 associated X protein (Bax) increased significantly in model group compared with control group, showing statistically significant differences (p<0.01). The protein expression of Bcl-2 in brain tissues increased significantly, while the expression of Bax declined remarkably in treatment group compared with model group (p<0.01). The number of apoptotic cells in model group and treatment group increased significantly compared with that in control group, with the largest in model group (p<0.05). However, it remarkably declined in treatment group compared with model group (p<0.05). These results suggested that MgSO4 treatment could significantly reduce neuronal apoptosis in PE rats. According to the results of immunohistochemistry, the protein expressions of NF-κB and ICAM-1 in brain tissues were significantly higher in model group and treatment group than those in control group (p<0.05). However, they were significantly lower in treatment group than model group (p<0.05). RT-PCR results manifested that the mRNA expressions of NF-κB and ICAM-1 in brain tissues exhibited evident differences among the three groups (p<0.05). Model group and treatment group showed significantly up-regulated mRNA expressions of NF-κB and ICAM-1 in brain tissues compared with control group (p<0.05). The highest mRNA expression was observed in model group. However, treatment group exhibited remarkably decreased mRNA expressions of NF-κB and ICAM-1 in brain tissues compared with model group (p<0.05). CONCLUSIONS: MgSO4 exerts a protective effect on cranial nerves of PE rats by inhibiting the NF-κB/ICAM-1 signaling pathway.

Overexpression of miR-146a inhibits the apoptosis of hippocampal neurons of rats with cerebral hemorrhage by regulating autophagy.

In this study, to investigate the effect of overexpression of miR-146a on autophagy of hippocampal neurons in rats with intracerebral hemorrhage (ICH), 72 Sprague-Dawley rats were randomly divided into the sham, ICH, miR-146a agomir, and miR-146a agomir control groups. The ICH model was constructed by injection of collagenase VII. The apoptosis of hippocampal neurons was measured by TUNEL assay. The levels of LC3 and Beclin 1 were analyzed by immunohistochemistry. Mitochondrial autophagy was examined by transmission electron microscopy. The levels of LC3A, LC3B, Beclin 1, Bax, Bcl-2, and cleaved caspase 3 were examined by Western blot. Western blot was also used to evaluate the expression of nuclear factor κB signaling pathway-related factors. To examine the effect of autophagy inhibitor (3-methyladenine (3-MA)) on miR-146a-regulated apoptotic protein expression, 30 rats were further divided into the sham, ICH, miR-146a agomir, 3-MA, and miR-146a + 3-MA groups. The levels of Bax, Bcl-2, and cleaved caspase 3 were examined by Western blot. Compared with the sham group, the nerve function scores, brain water content, the percentage of apoptotic cells, and the expression levels of LC3, Beclin 1, Bax, cleaved caspase 3, and p-P65 in the hippocampus of rats in the ICH group were all significantly increased (p < 0.05), whereas the expression levels of miR-146a, Bcl-2, and p-IκBα were markedly decreased (p < 0.05). Mitochondrial autophagy was also evident. Furthermore, compared with the ICH group, the results of the abovementioned tests in the miR-146a agomir group were reversed. The overexpression of miR-146a inhibited the autophagy of hippocampal neurons in rats with ICH.

The protective effect of lidocaine on lipopolysaccharide-induced acute lung injury in rats through NF-κB and p38 MAPK signaling pathway and excessive inflammatory responses.

OBJECTIVE: Acute lung injury is a severe disease with a high rate of mortality, leading to more important illness. We aimed at exploring the protective role and potential mechanisms of lidocaine on lipopolysaccharide (LPS)-induced acute lung injury (ALI). MATERIALS AND METHODS: Sprague Dawley (SD) rats were randomly assigned to control group receiving 0.9% saline solution, LPS group treated with 4 mg/kg LPS i.p., LPS + lidocaine(treated with 4 mg/kg LPS i.p. followed by giving 1 mg/kg, 3 mg/kg, 5 mg/kg of lidocaine i.v.). Lung specimens and the bronchoalveolar lavage fluid (BALF) were collected for histopathological examination and biochemical analyze 12 h after LPS induction. The cytokines expression of TNF-α, IL-6 and MCP-1 was measured by ELISA. In addition, the malondialdehyde (MDA) content, the activities of total antioxidant capacity (T-AOC) and superoxide dismutase (SOD) in lung tissues were also detected using ELISA. The protein expressions of p38, p-p38, p65, p-p65 and IκB were analyzed by Western blot. RESULTS: The results indicated that after lidocaine treatment was able to decrease significantly wet-to-dry (W/D) ratio and ameliorate the histopathologic damage. Additionally, total protein content and the number of leukocytes in BALF significantly decreased. ELISA result indicated that the levels of TNF-α, IL-6 and MCP-1 in BALF were markedly suppressed. Meanwhile, the activities of T-AOC and SOD in lung tissues significantly increased, while the content of MDA significantly decreased after treatment with lidocaine. Moreover, Western blot suggested that lidocaine inhibited phosphorylation of NF-κB p65 and p38 MAPK. CONCLUSIONS: Therefore, lidocaine could ameliorate the LPS-induced lung injury via NF-κB/p38 MAPK signaling and excessive inflammatory responses, providing a potential for becoming the anti-inflammatory agent against lung injury.

Effects of sevoflurane post-conditioning in cerebral ischemia-reperfusion injury via TLR4/NF-κB pathway in rats.

OBJECTIVE: The aim of the study was to investigate the anti-inflammatory effect of sevoflurane post-conditioning on cerebral ischemia-reperfusion injury in rats. MATERIALS AND METHODS: Thirty Sprague Dawley (SD) rats were randomly divided into 3 groups: sham operation group (Sham), ischemia/reperfusion injury (I/R) group and sevoflurane post-conditioning group (Se). Hematoxylin-eosin (HE) staining was used to observe the inflammatory response in the brain tissue. The levels of TNF-α, IL-1ß, IL-6 in serum were measured by ELISA. The mRNA and protein expression of TLR4 and NF-κB p65 were detected by RT-PCR and Western blot in the brain tissue. RESULTS: The post-conditioning of sevoflurane decreased the level of inflammatory reaction in ischemic-reperfusion rat cerebral infarction area and reduced the levels of pro-inflammatory cytokines such as TNF-α, IL-1ß, IL-6 in rats with ischemia-reperfusion injury. In addition, after treatment with sevoflurane, the mRNA and protein expression of TLR4 and NF-κBp65 in TLR4/NF-κB pathway was inhibited. CONCLUSIONS: Sevoflurane post-conditioning can decrease the inflammatory reaction in cerebral infarct area induced by cerebral ischemia-reperfusion injury in rats. The neuroprotective effect mechanism of sevoflurane may be related to TLR4/NF-κB signaling pathway.

Age, phosphorus, and 25-hydroxycholecalciferol regulate mRNA expression of vitamin D receptor and sodium-phosphate cotransporter in the small intestine of broiler chickens.

Four experiments were conducted in this study. Experiment 1 was carried out to examine mRNA expressions of nuclear vitamin D receptor (nVDR), membrane vitamin D receptor (mVDR), and type IIb sodium-phosphate cotransporter (NaPi-IIb) in the small intestine of broiler chickens. Experiments 2, 3, and 4 were implemented to evaluate effects of age, non-phytate phosphorus (NPP), and 25-hydroxycholecalciferol (25-OH-D3) on mRNA expressions of nVDR, mVDR, and NaPi-IIb in the duodenum of chickens. Results showed that mRNA expression levels of nVDR and NaPi-IIb were highest in the duodenum of 21-day-old broilers, lower in the jejunum, and lowest in the ileum. By contrast, no differences in mRNA expression levels of mVDR were detected among the duodenum, jejunum, and ileum. Age quadratically affected mRNA expressions of nVDR, mVDR, and NaPi-IIb in the duodenum and 25-hydroxylase in the liver of 7- to 42-day-old broilers, with the highest levels observed at 21 d of age. By contrast, age linearly decreased mRNA expression level of 1α-hydroxylase in kidneys. Dietary NPP levels quadratically affected mRNA expression levels of nVDR and mVDR in the duodenum and 25-hydroxylase in the liver of 21-day-old broilers. The highest mRNA expression levels of nVDR and mVDR and lowest mRNA level of 25-hydroxylase were observed at 0.55% NPP. mRNA expression level of NaPi-IIb linearly declined when dietary NPP levels increased from 0.25 to 0.65%. Addition of 12.5 µg/kg of 25-OH-D3 increased mRNA expression level of 1α-hydroxylase in kidneys and those of nVDR, mVDR, and NaPi-IIb in the duodenum of broilers compared with birds fed the diet without 25-OH-D3. These data indicate that mRNA expressions of nVDR and NaPi-IIb are highest in the duodenum, and the greatest mRNA levels of nVDR, mVDR, and NaPi-IIb are observed at 21 d of age. Dietary NPP levels quadratically increase mRNA expressions of nVDR and mVDR but linearly decrease NaPi-IIb mRNA level. 25-OH-D3 up-regulates the above gene transcription.

Cisplatin plus norcantharidin alter the expression of TGF-ß1/Smads signaling pathway in hepatocellular carcinoma.

PURPOSE: To investigate the effects of cisplatin plus norcantharidin on transforming growth factor (TGF)-ß1/Smads signaling pathway in hepatocellular carcinoma cells. METHODS: Hepatocellular carcinoma cells (Hep3B) were divided into four groups: control group, cisplatin 2.0 µg/ml group, norcantharidin 10 µg/ml group, and cisplatin 2.0 µg/ml plus norcantharidin 10 µg/ml group. All cells were incubated for 24 hours. Cells proliferation was assessed using cell counting kit-8. Relative mRNA expression of TGF-ß1, Smad4 and Smad7 were assessed by quantitative RT-PCR. Protein expression of TGF-ß1 and Smad4 were investigated by western blotting. RESULTS: Cisplatin, norcantharidin and cisplatin plus norcantharidin significantly inhibited the proliferation of cells, significantly attenuated both the mRNA and protein expression of TGF-ß1 and Smad7, and significantly up-regulated the mRNA and protein expression of Smad4 in Hep3B (all p < 0.05), and cisplatin plus norcantharidin exhibited powerful effects than cisplatin and norcantharidin. CONCLUSIONS: Cisplatin, norcantharidin and cisplatin plus norcantharidin can significantly alter the expression of TGF-ß1/Smads signaling pathway and inhibit the proliferation of Hep3B cells. Cisplatin plus norcantharidin exhibited powerful effects than cisplatin and norcantharidin (Fig. 4, Ref. 23).

Glutathione S-transferase A1 - a sensitive marker of alcoholic injury on primary hepatocytes.

The primary hepatocytes were extracted and purified from mice through improved Seglen two-step perfusion method. Ethanol-induced injury hepatocytes model in mice was used to investigate the importance of glutathione S-transferase A1 (GSTA1) in hepatocytes injury by comparison with other indicators, such as alanine aminotransferase, aspartate aminotransferase, malondialdehyde, glutathione and superoxide dismutase. The release of GSTA1 was demonstrated to be an earlier and more sensitive indicator of hepatocytes injury than other indicators. Significant increases in GSTA1 were detected at 2 h after ethanol exposure, while other indicators were undetected at this time. A markedly difference in other indicators were observed at 6 and 8 h. The release of GSTA1 was significantly increased at a concentration of 50 mmol/L ethanol, the lowest exposure concentration than that in other indicators. In contrast, other indicators release was not statistically significant until concentrations of 75 mmol/L and 100 mmol/L ethanol. These results suggest that GSTA1 can be detected at the early stage of low concentration ethanol exposure and that GSTA1 is more sensitive and reliable marker in ethanol-induced hepatic injury.

Impact of point-of-care diagnostics on maternal outcomes in HIV-infected women: systematic review and meta-analysis protocol.

INTRODUCTION: Studies indicate substandard diagnostic care, delayed and missed diagnosis as some of the contributing factors to maternal mortality. The clinical impact of point-of-care (POC) diagnostics has been shown in the monitoring and treatment of a variety of infectious diseases, including HIV/AIDS and tuberculosis. The objective of this systematic review is to investigate the impact of POC diagnostics on maternal outcomes for HIV-infected women. METHODS: We will conduct a systematic review to evaluate the impact of POC diagnostics for improving desired healthcare outcomes for HIV-infected women. The search strategy will involve electronic databases including: Cochrane Infectious Disease Group Specialised Register; Cochrane Central Register of Control Trials, published in The Cochrane Library; PubMed; EBSCOhost and LILACS. The studies will be mapped in 2 stages: stage 1 will map studies descriptively by focus and method; stage 2 will involve additional inclusion criteria, quality assessment and data extraction undertaken by 2 reviewers in parallel. Evidence will be synthesised using relevant systematic research tools: meta-analysis and subgroup analysis will be conducted using RevMan and Stata 13 will be used for meta-regressions. We will follow recommendations described in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and the Cochrane Handbook for Intervention Reviews. ETHICS AND DISSEMINATION: We anticipate finding a large number of studies on POC diagnostic interventions on maternal outcomes in HIV-infected women, which, once summarised, will be useful to guide future diagnostic interventions. The protocol for the systematic review has been registered in PROSPERO. The study will be disseminated electronically and in print. It will also be presented to conferences related to HIV/AIDS, POC diagnostics and maternal health. TRIAL REGISTRATION NUMBER: PROSPERO CRD42014015439.

Estimation of the standardized ileal digestible lysine requirement for primiparous pregnant sows.

This experiment was conducted to determine the optimal standardized ileal digestible lysine (SID Lys) level in diets fed to primiparous sows during gestation. A total of 150 (Landrace × Large White) crossbred gilts (weighing 149.9 ± 3.1 kg) were fed gestation diets (12.55 MJ of ME/kg) containing SID Lys levels of 0.43, 0.52, 0.60, 0.70 or 0.80% respectively. Gilts were fed 2.0 kg/day from day 1 to 80 and 3.0 kg/day from day 80 to 110 of gestation respectively. Gilts were allocated to treatments based on their body weight on the day of breeding. Weight gain from day 80 to 110 increased with increasing dietary SID Lys levels (p = 0.044). Fitted broken-line (p = 0.031) and quadratic plot (p = 0.047) analysis of body weight gain indicated that the optimal SID Lys level for primiparous sows was 0.70 and 0.69% respectively. During gestation, neither backfat thickness nor loin eye area was affected by dietary SID Lys level. Increasing dietary Lys had no effect on the litter size at birth or pigs born alive per litter. Litter weight at birth was not affected by dietary SID Lys level. The litter weight variation at birth quadratically decreased with increasing dietary SID Lys (p = 0.021) and was minimized at 0.70% dietary SID Lys. Gilts fed the 0.70% SID Lys diet had the highest dry matter (p = 0.031) and protein (p = 0.044) content in colostrum. On day 110 of gestation, gilts fed the 0.70% SID Lys diet tended to have the highest serum prolactin (p = 0.085) and serum insulin (p = 0.074) levels. The data demonstrate that the optimal dietary SID Lys was 0.70% for pregnant gilts, which is similar to the recommendation of 0.69% that was estimated by the NRC (2012).

Cereblon binding molecules in multiple myeloma.

Immunomodulation is an established treatment strategy in multiple myeloma with thalidomide and its derivatives lenalidomide and pomalidomide as its FDA approved representatives. Just recently the method of action of these cereblon binding molecules was deciphered and results from large phase 3 trials confirmed the backbone function of this drug family in various combination therapies. This review details the to-date knowledge concerning mechanism of IMiD action, clinical applications and plausible escape mechanisms in which cells may become resistant/refractory to cereblon binding molecule based treatment.

Longitudinal analysis of 25 sequential sample-pairs using a custom multiple myeloma mutation sequencing panel (M(3)P).

Recent advances in genomic sequencing technologies now allow results from deep next-generation sequencing to be obtained within clinically meaningful timeframes, making this an attractive approach to better guide personalized treatment strategies. No multiple myeloma-specific gene panel has been established so far; we therefore designed a 47-gene-targeting gene panel, containing 39 genes known to be mutated in ≥3 % of multiple myeloma cases and eight genes in pathways therapeutically targeted in multiple myeloma (MM). We performed targeted sequencing on tumor/germline DNA of 25 MM patients in which we also had a sequential sample post treatment. Mutation analysis revealed KRAS as the most commonly mutated gene (36 % in each time point), followed by NRAS (20 and 16 %), TP53 (16 and 16 %), DIS3 (16 and 16 %), FAM46C (12 and 16 %), and SP140 (12 and 12 %). We successfully tracked clonal evolution and identified mutation acquisition and/or loss in FAM46C, FAT1, KRAS, NRAS, SPEN, PRDM1, NEB, and TP53 as well as two mutations in XBP1, a gene associated with bortezomib resistance. Thus, we present the first longitudinal analysis of a MM-specific targeted sequencing gene panel that can be used for individual tumor characterization and for tracking clonal evolution over time.

Prediction of digestible and metabolizable energy content of rice bran fed to growing pigs.

Two experiments were conducted to determine the digestible energy (DE) and metabolizable energy (ME) content of 19 rice bran samples and to develop prediction equations for DE and ME based on their chemical composition. The 19 rice bran samples came from different rice varieties, processing methods and regions. The basal diet was formulated using corn and soybean meal (74.43% corn and 22.91% soybean meal and 2.66% vitamins and minerals). The 19 experimental diets based on a mixture of corn, soybean meal and 29.2% of each source of rice bran, respectively. In Exp. 1, 108 growing barrows (32.1±4.2 kg) were allotted to 1 of 18 treatments according to a completely randomized design with 6 pigs per treatment. The treatment 1 was the control group which was fed with basal diet. The treatments 2 to 18 were fed with experimental diets. In Exp. 2, two additional rice bran samples were measured to verify the prediction equations developed in Exp. 1. A control diet and two rice bran diets were fed to 18 growing barrows (34.6±3.5 kg). The control and experimental diets formulations were the same as diets in Exp. 1. The results showed that the DE ranged from 14.48 to 16.85 (mean 15.84) MJ/kg of dry matter while the ME ranged from 12.49 to 15.84 (mean 14.31) MJ/kg of dry matter. The predicted values of DE and ME of the two additional samples in Exp. 2 were very close to the measured values.

A Randomised Controlled Trial to Evaluate the Effectiveness of Intrathecal Bupivacaine Combined with Different Adjuvants (Fentanyl, Clonidine and Dexmedetomidine) in Caesarean Section.

PURPOSE: The purpose of this study was to evaluate comparatively, in women undergoing caesarean section under spinal anesthesia, the effectiveness of hyperbaric bupivacaine combined with 3 different adjuvants (fentanyl, clonidine, and dexmedtomidine) on quality of blockade and maternal and neonatal repercussions. METHOD: 84 patients undergoing elective surgeries under spinal anesthesia were randomized into 4 groups of 21 each, gB, gBF, gBC and gBD. Patients in groups gb, gBF, gBC and gBD were given bupivacaine alone, bupivacaine plus fentanyl (15.0 µg), bupivacaine plus fentanyl plus clonidine (75 µg), and bupivacaine plus dexmedetomidine (10 µg), respectively. Hemodynamic parameters evaluated were the onset and level of sensory block, perioperative analgesia, degree and recovery time of motor block, duration of analgesia, sedation, and maternal-foetal repercussions. RESULTS: The onset of blockade was significantly faster in groups with adjuvants clonidine and dexmedetomidine compared with gB and gBF. Patients in Groups gB and gBF reported pain during the perioperative period. Duration of analgesia was significantly higher in Group gBD and was comparable to gBC and time to motor block recovery was significantly higher in Group gBD. Sedation was significant in Group gBD and gBC. CONCLUSION: Addition of dexmedetomidine and clonidine as adjuvants to hyperbaric bupivacaine provided adequate anesthesia and postoperative analgesia compared to fentanyl adjuvant without causing any significant side effects.

Effects of Adding Super Dose Phytase to the Phosphorus-deficient Diets of Young Pigs on Growth Performance, Bone Quality, Minerals and Amino Acids Digestibilities.

Two experiments were conducted to evaluate the efficacy of feeding an Escherichia coli (E. coli) derived phytase to pigs fed P deficient, corn-soybean meal diets. In Exp. 1, one hundred and twenty crossbred piglets (9.53±0.84 kg) were allocated to one of five treatments which consisted of four low P diets (0.61% Ca, 0.46% total P and 0.24% non-phytate P) supplemented with 0, 500, 1,000, or 20,000 FTU/kg E. coli phytase as well as a positive control formulated to be adequate in all nutrients (0.77% Ca, 0.62% total P and 0.42% non-phytate P). The treatments were applied to six pens with four pigs per pen for 28 days. In Exp. 2, ten crossbred pigs (19.66±1.16 kg) fitted with ileal T-cannula were used in a nutrient balance study. The pigs were assigned to treatments similar to those used in Exp. 1 in a doubly replicated 5×4 incomplete Latin square design (5 diets with 4 periods). Each period consisted of a 5-d adjustment period followed by a 3-d total collection of feces and urine and then a 2-d collection of ileal digesta. Supplementation with phytase linearly increased (p<0.05) weight gain, feed intake, feed efficiency, bone breaking strength and fat-free dry and ash bone weight. There were linear increases (p<0.01) in the apparent ileal digestibility (AID) of DM, GE, CP, Ca, total P, inositol hexaphosphate (IP6) and some AA with increasing dose of E. coli phytase. Pigs fed 20,000 FTU/kg had a greater (p<0.05) AID of IP6 (80% vs 59% or 64%, respectively) than pigs fed diets with 500 or 1,000 FTU/kg phytase. There were linear increases (p<0.05) in the total tract digestibility of Ca, total P, Na, K, Mg, and Zn as well as in the retention of Mg and Zn with increased phytase dose. The retention and utilization of Cu, and the total tract digestibility of CP and Cu quadratic increased (p<0.05) with increased phytase dose. In conclusion, supplementation of 500 FTU of phytase/kg and above effectively hydrolyzed phytate in low-P corn-soybean diets for pigs. In addition, a super dose of phytase (20,000 FTU/kg) hydrolyzed most of the IP6 and consequently further improved mineral use, protein utilization and performance.

Anti-CD11c antibody, Efalizumab attenuate ventilator-induced lung injury.

BACKGROUND: The pathophysiology of ventilator-induced lung injury (VILI) involves multiple mechanisms including inflammation and inflammatory cells infiltration. The anti-CD11c monoclonal antibody, Efalizumab has been demonstrated to inhibit the T cell activation, migration and adhesion to keratinocytes. MATERIALS AND METHODS: In this study, we induced lung injury with mechanical ventilation in male Sprague-Dawley rats, the rats were divided into four groups: lung-protective ventilation (LV), injurious ventilation (HV), HV+human IgG control and HV+ Efalizumab groups. Then we detected the lung tissue wet/dry ratio, and the activity of myeloperoxidase (MPO) was determined. The concentration of protein, TNF-a, IL-6, IL-1b and MIP-2 in the BALF were detected by ELISA. The expression ICAM-1 was measured by Realtime PCR. RESULTS: Compared with the human IgG control treated group, the treatment of Efalizumab attenuate the ventilator-induced lung injury, including the wet/dry ratio and the activity of myeloperoxidase (MPO), meanwhile, the level of pro-inflammatory cytokines, such as TNF-a, IL-6, IL-1b and MIP-2 were decreased in the BALF of Efalizumab-treated group rats compared with the human IgG-treated control group. In addition, the histopathological index of ventilator-induced lung injury was improved after efalizumab treatment, that also reduced the recruitment of inflammatory cells into the lung, such as neutrophils. CONCLUSIONS: Our data suggested that Efalizumab could protect rat from ventilator-induced lung injury and improve the survival time through the inhibition of intrapulmonary inflammatory response.