Percutaneous microwave ablation versus sclerotherapy for large hepatic hemangioma: a multi-center cohort study.

OBJECTIVE: The study aimed to compare the effectiveness and safety of ultrasound-guided microwave ablation (MWA) and percutaneous sclerotherapy (PS) for the treatment of large hepatic hemangioma (LHH). METHODS: This retrospective study included 96 patients who underwent MWA (n = 54) and PS (n = 42) as first-line treatment for LHH in three tertiary hospitals from January 2016 to December 2021. Primary outcomes were technique efficacy rate (volume reduction rate [VRR] > 50% at 12 months), symptom relief rate at 12 months and local tumor progression (LTP). Secondary outcomes included procedure time, major complications, treatment sessions, cost and one-, two-, three-year VRR. RESULTS: During a median follow-up of 36 months, the MWA group showed a higher technique efficacy rate (100% vs. 90.4%, p = .018) and symptom relief rate (100% vs. 80%, p = .123) than the PS group. The MWA group had fewer treatment sessions, higher one-, two- and three-year VRR, lower LTP rate (all p < .05), longer procedure time and higher treatment costs than the PS group (both p < .001). MWA shared a comparable major complications rate (1.8% vs. 2.4%, p = .432) with PS. After multivariate analysis, the lesion's heterogeneity and maximum diameter >8.1 cm were independent risk factors for LTP (all p < .05). In the PS group, lesions with a cumulative dose of bleomycin > 0.115 mg/cm3 had a lower risk of LTP (p = .006). CONCLUSIONS: Both MWA and PS treatments for large hepatic hemangioma are safe and effective, with MWA being superior in terms of efficacy.

Prediction model of no-response before the first transarterial chemoembolization for hepatocellular carcinoma: TACF score.

Previous clinic models for patients with hepatocellular carcinoma (HCC) receiving transarterial chemoembolization (TACE) mainly focused on the overall survival, whereas a simple-to-use tool for predicting the response to the first TACE and the management of risk classification before TACE are lacking. Our aim was to develop a scoring system calculated manually for these patients. A total of 437 patients with hepatocellular carcinoma (HCC) who underwent TACE treatment were carefully selected for analysis. They were then randomly divided into two groups: a training group comprising 350 patients and a validation group comprising 77 patients. Furthermore, 45 HCC patients who had recently undergone TACE treatment been included in the study to validate the model's efficacy and applicability. The factors selected for the predictive model were comprehensively based on the results of the LASSO, univariate and multivariate logistic regression analyses. The discrimination, calibration ability and clinic utility of models were evaluated in both the training and validation groups. A prediction model incorporated 3 objective imaging characteristics and 2 indicators of liver function. The model showed good discrimination, with AUROCs of 0.735, 0.706 and 0.884 and in the training group and validation groups, and good calibration. The model classified the patients into three groups based on the calculated score, including low risk, median risk and high-risk groups, with rates of no response to TACE of 26.3%, 40.2% and 76.8%, respectively. We derived and validated a model for predicting the response of patients with HCC before receiving the first TACE that had adequate performance and utility. This model may be a useful and layered management tool for patients with HCC undergoing TACE.

Establishment of a Scale for Predicting Early Hematoma Enlargement of Spontaneous Intracerebral Hemorrhage Based on Non-Contrast CT Signs.

AIM: To optimize the Spontaneous intracerebral hemorrhage (sICH) early hematoma expansion prediction scoring table to adopt appropriate clinical treatment plans and improve the prognosis of sICH patients. MATERIAL AND METHODS: A total of 150 patients with sICH were enrolled, and 44 had early hematoma expansion. According to the selection and exclusion criteria, the study subjects were screened, their NCCT characteristic signs and clinical data were analyzed statistically. The established prediction score was applied to the follow-up study cohort to conduct a pilot study, and the t-test and ROC curve were used to evaluate its predictive ability. RESULTS: Statistical analysis found that initial hematoma volume, GCS score, and NCCT special signs were independent risk factors for early hematoma expansion after sICH (p < 0.05). Thus, a score table was established. Subjects with ≥10 were divided into high-risk group, 6-8 comprised the medium-risk group, and ≤4 were divided into low-risk group. Among 17 patients with acute sICH, 7 developed early hematoma enlargement. The prediction accuracy was 92.41% in the low-risk group, 98.06% in the medium-risk group, and 84.61% in the high-risk group. CONCLUSION: This optimized prediction score table based on the special signs of NCCT shows the high prediction accuracy of sICH early hematoma.

Genomic Analysis of Amphioxus Reveals a Wide Range of Fragments Homologous to Viral Sequences.

Amphioxus species are considered living fossils and are important in the evolutionary study of chordates and vertebrates. To explore viral homologous sequences, a high-quality annotated genome of the Beihai amphioxus (Branchiostoma belcheri beihai) was examined using virus sequence queries. In this study, 347 homologous fragments (HFs) of viruses were identified in the genome of B. belcheri beihai, of which most were observed on 21 genome assembly scaffolds. HFs were preferentially located within protein-coding genes, particularly in their CDS regions and promoters. A range of amphioxus genes with a high frequency of HFs is proposed, including histone-related genes that are homologous to the Histone or Histone H2B domains of viruses. Together, this comprehensive analysis of viral HFs provides insights into the neglected role of viral integration in the evolution of amphioxus.

Mapping of lymph node dissection determined by the epicenter location and tumor extension for esophagogastric junction carcinoma.

Backgrounds: Previous studies identified the extent of lymph node dissection for esophagogastric junction (EGJ) carcinoma based on the metastatic incidence. The study aimed to determine the optimal extent and priority of lymphadenectomy based on the therapeutic efficacy from each station. Methods: The studies on the lymph node metastasis (LNM) and therapeutic efficacy index (EI) for EGJ carcinomas were identified until April 2022. The obligatory stations with the LNM rates over 5% and therapeutic EI exceeding 2% should be routinely resected for D2 dissection, whereas the optional stations with EI between 0.5% and 2% should be resected for D3 dissection in selective cases. Results: The survey yielded 16 eligible articles including 6,350 patients with EGJ carcinoma. The metastatic rates exceeded 5% at no. 1, 2, 3, 7, 9, 11p, and 110 stations and were less than 5% in abdominal no. 4sa~6, 8a, 10, 11d, 12a, and 16a2/b1 and mediastinal no. 105~112 stations. Consequently, obligatory stations with EI over 2% were largely determined by the epicenter location and located at the upper perigastric, lower mediastinal, and suprapancreatic zones, corresponding to those with rates of LNM over 5%. Consistent with the LNM rates less than 5%, the optional stations with EI between 0.5% and 2% were largely dependent on the degree of tumor extension toward the lower perigastric, splenic hilar (grecurvature), para-aortic (less curvature of the cardia), and middle or upper mediastinal zones. Conclusions: The obligatory stations can be resected as an "envelope-like" wrap by transhiatal proximal gastrectomy with lower esophagectomy, whereas the optional stations for dissection are indicated by the tumor extension. The extended gastrectomy is required for the lower perigastric in the stomach-predominant tumor with gastric involvement exceeding 5.0 cm, para-aortic dissection in the less curvature-predominant tumor and splenic hilar dissection in the grecurvature-predominant tumor whereas transthoracic subtotal esophagectomy is required for complete mediastinal dissection and adequate negative margin in the esophagus-predominant tumor with esophageal invasion exceeding 3.0 cm.

Maternal Thyroid Function and Birth Weight in Twins.

CONTEXT: Thyroid hormones are associated with birth weight in singleton pregnancy. Twin pregnancies need more thyroid hormones to maintain the normal growth and development of the fetuses compared with single pregnancy. OBJECTIVE: We aimed to investigate the association of thyroid hormones and birth weight in twins. METHODS: This was a retrospective cohort study in a Chinese population. Pregnant women who received regular antenatal health care and delivered live-born twins from 2014 to 2019 were included (n = 1626). Linear mixed model with restricted cubic splines and logistic regression models were used to estimate the association of thyroid hormones with birth weight and birth weight discordance in twins. RESULTS: We observed that both thyrotropin (TSH) and free thyroxine (FT4) were not associated with birth weight in twins overall, while when stratifying on fetal sex or chorionicity, there were nonlinear association between FT4 levels and birth weight in boys (Pnonlinear < .001) and in dichorionic (DC) twins (Pnonlinear = 0.03). Women with levels of FT4 lower than the 10th percentile had a higher risk of birth weight discordance in their offspring than women with normal FT4 levels (range, 2.5 to 97.5 percentiles) (odds ratio = 1.58; 95% CI, 1.05-2.33). CONCLUSION: Our study suggests there was an association of FT4, but not TSH, with birth weight and birth weight discordance varied by sex and chorionicity. These findings could have implications for obstetricians to be aware of the importance of FT4 levels in preventing birth weight discordance in twin pregnancy.

A pan-cancer analysis reveals role of clusterin (CLU) in carcinogenesis and prognosis of human tumors.

Clusterin (CLU) is a chaperone-like protein that has been demonstrated to have a direct relationship with cancer occurrence, progression, or metastasis. Clusterin was downregulated in tumor tissues using three datasets of tongue squamous carcinoma from the Gene Expression Omnibus. We further retrieved datasets from The Cancer Genome Atlas and Gene Expression Omnibus to thoroughly investigate the carcinogenic consequences of Clusterin. Our findings revealed that decreased Clusterin expression in malignancies was associated with a worse overall survival prognosis in individuals with multiple tumors; Clusterin gene deep deletions were found in almost all malignancies and were connected to most cancer patient's prognosis, Clusterin DNA methylation level was dependent on tumor type, Clusterin expression was also linked to the invasion of cancer-associated CD8+ T-cells and fibroblasts in numerous cancer forms. Moreover, pathway enrichment analysis revealed that Clusterin primarily regulates biological processes such as cholesterol metabolism, phospholipid binding, and protein-lipid complex formation. Overall, our pan-cancer research suggests that Clusterin expression levels are linked to tumor carcinogenesis and prognosis, which contributes to understanding the probable mechanism of Clusterin in tumorigenesis as well as its clinical prognostic significance.

Response of gut microbiota to serum metabolome changes in intrahepatic cholestasis of pregnant patients.

BACKGROUND: Intrahepatic cholestasis in pregnancy (ICP) is the most common liver disease during pregnancy, and its exact etiology and course of progression are still poorly understood. AIM: To investigate the link between the gut microbiota and serum metabolome in ICP patients. METHODS: In this study, a total of 30 patients were recruited, including 15 patients with ICP (disease group) and 15 healthy pregnant patients (healthy group). The serum nontarget metabolomes from both groups were determined. Amplification of the 16S rRNA V3-V4 region was performed using fecal samples from the disease and healthy groups. By comparing the differences in the microbiota and metabolite compositions between the two groups, the relationship between the gut microbiota and serum metabolites was also investigated. RESULTS: The Kyoto Encyclopedia of Genes and Genomes analysis results showed that the primary bile acid biosynthesis, bile secretion and taurine and hypotaurine metabolism pathways were enriched in the ICP patients compared with the healthy controls. In addition, some pathways related to protein metabolism were also enriched in the ICP patients. The principal coordination analysis results showed that there was a distinct difference in the gut microbiota composition (beta diversity) between the ICP patients and healthy controls. At the phylum level, we observed that the relative abundance of Firmicutes was higher in the healthy group, while Bacteroidetes were enriched in the disease group. At the genus level, most of the bacteria depleted in ICP are able to produce short-chain fatty acids (e.g., Faecalibacterium, Blautia and Eubacterium hallii), while the bacteria enriched in ICP are associated with bile acid metabolism (e.g., Parabacteroides and Bilophila). Our results also showed that specific genera were associated with the serum metabolome. CONCLUSION: Our study showed that the serum metabolome was altered in ICP patients compared to healthy controls, with significant differences in the bile, taurine and hypotaurine metabolite pathways. Alterations in the metabolization of these pathways may lead to disturbances in the gut microbiota, which may further affect the course of progression of ICP.

Echogenicity Changes in Brainstem Raphe Detected by Transcranial Parenchymal Sonography and Clinical Characteristics in Parkinson's Disease.

Background: Decreased brainstem raphe (BR) echogenicity detected by transcranial parenchymal sonography (TCS) is associated with depression in psychiatric and neurologic diseases. However, previous studies focusing on the relationship between motor and non-motor symptoms and echogenicity changes in BR in patients with PD yielded controversial results. Objectives: To investigate the relationship between echogenicity changes in BR detected by TCS and motor and a series of non-motor symptoms in patients with PD. Methods: Consecutive PD patients were recruited from the Second Affiliated Hospital of Soochow University. Demographic information and Motor and non-motor symptoms for all subjects were collected. TCS was used to detect the echogenicity changes in BR in PD patients. Results: One hundred and thirty-five consecutive patients with PD were enrolled in the study. The BR abnormal rate was significantly higher in PD patients with anxiety (p = 0.003) or depression (p = 0.022) than patients without. Spearman correlation analyses showed that Hamilton Rating Scale for Depression(HRSD) (r = 0.274, p = 0.002) and Parkinson's Disease Questionnaire 39-item(PDQ-39) (r = 0.208, p = 0.034) scores were positively correlated with abnormal BR echogenicity. Multivariate logistic regression analyses showed that HRSD and HAMA scores were associated with BR hypoechogenicity, the corresponding odds ratios (confidence intervals) were 1.07 (95% CI, 1.01-1.13) and 1.10(1.01-1.18), respectively. However, the PDQ-39 score was not associated with BR hypoechogenicity. Conclusion: The abnormal reduction in BR echogenicity detected by TCS is associated with depression and anxiety, but not motor symptoms in PD patients.

Prepregnancy Overweight and Obesity Are Associated with an Increased Risk of Preterm Birth in Chinese Women.

INTRODUCTION: The association between obesity before pregnancy and preterm birth varies with age and ethnicity. OBJECTIVE: To study the association between early body mass index (BMI) and risk of preterm birth in Chinese women. METHODS: This was a hospital-based retrospective cohort study including 36,596 Chinese women who gave birth to a live singleton infant from 2015 to 2018. Women were classified as underweight (BMI <18.5), normal weight (BMI 18.5 to <23), overweight (BMI 23 to <27.5), or obese (BMI ≥27.5) according to the most recent criteria for Asian women. Multivariate log-binomial regression models were used to estimate the relative risks (RRs) and 95% confidence intervals (95% CIs) for preterm birth among different groups. RESULTS: Compared to women with normal weight, women with overweight or obesity before pregnancy had an increased risk of preterm birth; the RRs and 95% CIs were 1.22 (95% CI: 1.08-1.37) and 1.30 (95% CI: 1.01-1.69), respectively. The greatest risk of extremely preterm birth was observed in obese women. The estimators were robust when considering the maternal age and rate of gestational weight gain (GWG) during pregnancy. CONCLUSIONS: Women with overweight and obesity had an increased risk of preterm birth regardless of GWG in early pregnancy. Our study suggests that it is beneficial to lose weight before conception for both overweight and obese women who plan to become pregnant.

Regulation of nonylphenol-induced reproductive toxicity in mouse spermatogonia cells by miR-361-3p.

Nonylphenol (NP) is an environmental chemical that affects apoptosis and male infertility. In our study, we found that a high concentration of NP could down-regulate the expression of microRNA-361-3p (miR-361-3p) in the murine GC-1 spermatogonia cell line and in vivo in murine spermatogonia. Additionally, one direct target of this miR, the 3' untranslated region of Killin (Klln) mRNA, was identified. Klln encodes a transcription factor that directly regulates the expression of Tp73 (transcriptionally active p73), whose encoded protein can up-regulate the expression of Puma (p53 upregulated modulator of apoptosis). Thus, our investigation revealed that the expression of Klln, Tp73, and Puma increased upon NP-dependent down-regulation of miR-361-3p, which eventually leads to apoptosis of spermatogonia.

Design, synthesis and evaluation of novel tacrine-multialkoxybenzene hybrids as multi-targeted compounds against Alzheimer's disease.

A series of benzoates (or phenylacetates or cinnamates) - tacrine hybrids (7a-o) were designed, synthesized and evaluated as multi-potent anti-Alzheimer drug candidates. The screening results showed that most of them exhibited a significant ability to inhibit ChEs, certain selectivity for AChE over BuChE and strong potency inhibitory of self-induced ß-amyloid (Aß) aggregation. All IC50 values of biological activity were at the nanomolar range. Especially, compound 7c displayed the greatest ability to inhibit AChE with an IC50 value of 5.63 nM and the highest selectivity with ratio of BuChE/AChE value of 64.6. Moreover, it also exhibited a potent inhibitory of Aß aggregation with an IC50 value of 51.81 nM. A Lineweaver-Burk plot and molecular modeling study showed that compound 7c targeted both the CAS and PAS of ChEs. A structure-activity relationship analysis suggested that the electron density of aromatic ring which was linked with tacrine through acetyl group played a significant role in determining the inhibitory activity.

Dynamic changes of flavonoids in Actinidia valvata leaves at different growing stages measured by HPLC-MS/MS.

Flavonoids are a large group of phenolic secondary metabolites havinga wide range of biochemical and pharmacological effects. Quantitative analysis of flavonoid profiles in the genus Actinidia, which has not been intensively conducted, is useful to a better understanding of the pattern and distribution of flavonoids. In the present work, a liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS) method was developed to profile the flavonoids, which was then used to determine the dynamic change of 17 biologically active flavonoids in the leaves of Actinidia valvata at the main growing stages, including glucuronides and acylated di- and triglycosides of flavonoids. The contents of flavonoid triglycosides were significantly higher than other flavonoids. The highest concentrations of kaemperol glycosides were observed in June, while other flavonoids showed highest concentrations in October. On the other hand, the contents of four isorhamnetin glycosides were increased sharply in September to October. The flavonoid profiles seem to be related to temperature, UV-B, and water deficit. Further studies are required to examine the functions of flavonoids in the Actinidia valvata and the underlying molecular mechanisms of actions.

Evaluation of the micro-shear bond strength of four adhesive systems to dentin with and without adhesive area limitation.

The purpose of this study was to evaluate the bonding ability of four representative dentin-adhesive systems by applying the micro-shear bond strength (µ-SBS) test method and to evaluate the influence of adhesive area limitation on the bond strength. Two different adhesive application methods were used in the µ-SBS test (with and without adhesives area limitation), and four representative adhesive systems were used in this study. Each dentin surface was treated with one of the four representative adhesive systems, and with twenty samples per group (n=20), each of the four groups underwent a µ-SBS test. The results showed that the bond strength was significantly influenced by the adhesive application method (p<0.05), the adhesive type (p<0.05) and the interaction between the two factors (p<0.05). With regard to the four representative dentin-adhesive systems, 3-E&R has a much better bond quality compared to the other adhesive systems. Furthermore, the micro-shear bond strength test method of restricting the area of both the adhesive and the resin is more reliable for evaluating the bonding property of adhesives to dentin, and it is also adequate for comparing the different adhesives systems.

[Effect of SiO2-ZrO2slurry coating on surface performance of zirconia ceramic].

OBJECTIVE: To evaluate the effect of SiO2-ZrO2slurry coating on surface performance of zirconia ceramic. METHODS: Seventy pre-sintered zirconia discs were randomly divided into seven groups with 10 discs per group. Sample discs in each group received one of the following seven different surface treatments, namely, sintered (group AS), sand blasting after sintered (group SB), coated with slurry of mole ratio of SiO2to ZrO22:1 (group 2SiO2-1ZrO2), coated with slurry of mole ratio of SiO2to ZrO21:1 (group 1SiO2-1ZrO2), coated with slurry of mole ratio of SiO2to ZrO21:2 (group 1SiO2-2ZrO2), coated with slurry of mole ratio of SiO2to ZrO21:3 (group 1SiO2-3ZrO2), coated with slurry of mole ratio of SiO2to ZrO21:4 (group 1SiO2-4ZrO2). Profilometer, X-ray diffractometer (XRD), energy dispersive spectrometer, scanning electron microscopy (SEM) were used to analyze surface performance. RESULTS: The surface roughness of the discs in group AS was lower than those in the other groups [(0.33 ± 0.03) µm] (P < 0.05), there was no statistically significant difference (P > 0.05) among group 2SiO2-1ZrO2[(3.85 ± 0.38) µm], group 1SiO2-1ZrO2[(3.78 ± 0.56) µm] and group 1SiO2-2ZrO2[(4.06 ± 0.48) µm], and no difference (P > 0.05) was observed between group 1SiO2-3ZrO2[(1.02 ± 0.09) µm] and group 1SiO2-4ZrO2[(1.53 ± 0.23) µm] either. However, surface roughness in all coating groups was higher than those in group SB [(0.86 ± 0.05) µm] (P < 0.05). According to the XRD pattern, group AS and all coating groups consisted of 100% tetragonal airconia and monoclinic zirconia was detected at surface of group SB. Contents of surface silicon of coating groups increased significantly, however, no silicon was detected at sample surface of group AS and group SB. SEM showed that zirconia grains of coating exposed since part of silicon was etched by hydrofluoric acid, a three-dimensional network of intergrain nano-spaces was created. CONCLUSIONS: SiO2-ZrO2slurry coating could make surface of zirconia rough and increase Si content without creating monoclinic zirconia.

An integrated expanded bed adsorption process for lactoferrin and immunoglobulin G purification from crude sweet whey.

An integrated expanded bed adsorption process was developed in this study to purify lactoferrin and immunoglobulin G (IgG) from crude sweet whey. The process used two sequential expanded beds packed with a cationic exchanger (Fastline SP) and a mixed-mode resin (Streamline Direct CST-1), respectively. Lactoferrin was isolated in the first expanded bed packed with Fastline SP, and the flow through was loaded into the second expanded bed packed with Streamline Direct CST-1 to separate IgG. Three integration strategies were compared to improve the separation efficiency, especially for the purification of IgG in the second expanded bed. The purities of IgG obtained from these three strategies were 91.9%, 83.8% and 92.4%, and the recoveries were 14.3%, 63.7% and 29.7%, respectively. By efficient integration of the two expanded beds, lactoferrin and IgG were successfully recovered from crude sweet whey with high purities and reasonable recoveries. Moreover, the stream flowed out of the integrated process was collected and separated by ultrafiltration to produce whey protein concentrate. Therefore, sweet whey resource could be fully utilized. The results demonstrated that it is possible to purify multiple proteins from untreated crude resource with a rationally designed expanded bed adsorption process.

Polydatin: a review of pharmacology and pharmacokinetics.

CONTEXT: Polydatin, also named piceid (3,4',5-trihydroxystilbene-3-ß-d-glucoside, PD), is a monocrystalline compound isolated from Polygonum cuspidatum Sieb. et Zucc. (Polygonaceae), but is also detected in grape, peanut, hop cones, red wines, hop pellets, cocoa-containing products, chocolate products and many daily diets. There are numerous investigations reported of PD in the past 22 years, but they are usually scattered across various publications, which may block further research and clinical use of PD. OBJECTIVE: The article summarizes and evaluates the published scientific information of PD pharmacological effects and pharmacokinetics since 1990. MATERIALS AND METHODS: The information from 98 cases included in this review was compiled using major databases such as MEDLINE, Elsevier, Springer, PubMed, Scholar and CNKI. RESULTS: Numerous pharmacological investigations of PD mainly focus on cardiovascular effects, neuroprotection, anti-inflammatory and immunoregulatory effects, anti-oxidation, anti-tumor, liver and lung protection, etc. CONCLUSION: A great number of pharmacological and pharmacokinetic investigations in the past 22 years have demonstrated that PD has favorable therapeutic properties, indicating its potential as an effective material. However, further research is needed to explore its molecular mechanisms of action and definitive target proteins.

Genome shuffling improves thermotolerance and glutamic acid production of Corynebacteria glutamicum.

Genome shuffling was used to improve the thermotolerance of L: -glutamic acid-producing strain Corynebacteria glutamicum. Five strains with subtle improvements in high temperature tolerance and productivity were selected by ultraviolet irradiation and diethyl sulfate mutagenesis. An improved strain (F343) was obtained by three rounds of genome shuffling of the five strains as mentioned above. The cell density of F343 was four times higher than that of ancestor strains after 24 h of cultivation at 44°C, and importantly, the yield of L: -glutamic acid was increased by 1.8-times comparing with that of the ancestor strain at 38°C in a 5-L fermentor. With glucose supplement and two-stage pH control, the L: -glutamate acid concentration of F343 reached 119 g/L after fermentation for 30 h. The genetic diversity between F343 and its ancestors was also evaluated by amplified fragment length polymorphism analysis. Results suggest that the phenotypes for both thermotolerance and L: -glutamic acid production in F343 were evolved.