Rupture of a non sinus of Valsalva aneurysm during pregnancy: Case report and review of literatures.

Ruptured Sinus of Valsalva aneurysms during pregnancy is rare and presents a threat both to the mother and the fetus. We report a case of ruptured nonsinus of Valsalva aneurysms in a 26-year-old woman diagnosed at 32+4 weeks of gestation. A successful elective lower-segment cesarean section was conducted under general anesthesia. A successful surgical correction of the ruptured aneurysm under cardiopulmonary bypass (CPB) was performed with patch repair after 13 days. A multidisciplinary approach with respect to the pregnant patient's diagnosis, indications, and timing of surgery is necessary in ensuring the best possible outcomes for both the mother and the child.

Gland-sparing neck dissection: oncological and functional outcomes in oral cancer patients.

This study was performed to evaluate the subjective and objective functional outcomes of patients who had undergone submandibular gland-sparing neck dissection. All data were obtained from patients treated in a single hospital. Seventy-seven patients who had undergone complete submandibular gland sparing (CSGS) were included in the study. Cancer prognosis items were recorded. The subjective outcomes included patient self-evaluation of mouth dryness and the evaluation of the presence of saliva secretion following the application of digital pressure. Saliva scintigraphy served as the objective test. Self-reported xerostomia was compared between the CSGS patients and a control group of patients who had undergone unilateral submandibular gland removal (USGR; n = 74). In the CSGS group, local recurrence occurred in 3.8% of the 80 cancer sites, and neck recurrence occurred in 5.9% of neck dissection sites. Regarding the subjective measurements, 7.0% of the CSGS patients reported xerostomia and 91.9% demonstrated saliva secretion by digital pressure. Scintigraphy revealed actively secreting glands, with 42.9% of them showing normal gland function; none of the patients had severe xerostomia. The relative risk of dry mouth was significantly higher in the USGR patients than in the CSGS patients (P < 0.001). Submandibular gland sparing during neck dissection was found to result in satisfactory saliva secretion, with a relatively small risk of local or neck recurrence.

[Analysis of components of proteins from Echinococcus granulosus cyst fluid].

OBJECTIVE: To analyze the components of proteins from Echinococcus granulosus cyst fluid using the shotgun method, and to identify the active components with potential regulatory effects for immune dysregulation diseases. METHODS: The E. granulosus cyst fluid was collected aseptically from the hepatic cysts of patients with cystic echinococcosis, and characterized by liquid chromatography (LC) tandem mass spectrometry (MS/MS) following digestion with trypsin. The protein data were searched using the software MaxQuant version 1.6.1.0 and the cellular components, molecular functions, and biological processes of the identified proteins were analyzed using the Gene Ontology (GO) method. RESULTS: The E. granulosus cyst fluid separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) had a relative molecular mass of 25 to 70 kDa. LS-MS/MS analysis identified 37 proteins, including 32 known proteins and 5 unknown proteins. At least 4 proteins were preliminarily found to exhibit potential regulatory effects for immune dysregulation diseases, including antigen B, glutathione-S-transferase (GST), thioredoxin peroxidase (TPX) and malate dehydrogenase (MDH). GO enrichment analysis showed that the identified proteins had 149 molecular functions and were involved in 341 biological processes. CONCLUSIONS: E. granulosus cyst fluid has a variety of protein components, and four known proteins are preliminarily identified to be associated with immune dysregulation diseases.

Risk Factors for Maternal and Perinatal Complications during Pregnancy among Women with Tetralogy of Fallot.

BACKGROUND: Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease during pregnancy. Studies of risk factors are of great significance to maternal and fetal outcomes in patients with TOF. AIMS: To identify predictive risk factors for maternal and perinatal complications in women with TOF. SUBJECTS AND METHODS: 78 patients with TOF who delivered at Shanghai Obstetrical Cardiology Intensive Care Center between January 1993 and December 2017 were retrospective reviewed. A logistic regression model was used to identify risk factors for maternal and perinatal complications. RESULTS: There was no maternal death, five patients developed cardiac failure, sustained arrhythmias requiring treatments were recorded among 2 patients. Factors identified for maternal complications included previous cardiac events and oxygen saturation <90%. Oxygen saturation <90% was found to be independent predictor of maternal cardiac complications (RR = 21.455, 95%CI 2.186-210.572, P = 0.009). The perinatal survival rate was 87.18%, there were 52 term deliveries (66.67%). Perinatal poor outcomes include 9 therapeutic abortions (11.54%), 1 neonatal death (1.28%), 16 premature births (20.51%), 18 small for gestational age children (23.08%), 3 neonatal asphyxia (3.85%), and 3 neonatal cardiac malformations (3.85%). Factors identified for perinatal complications included without cardiac surgery, higher hemoglobin values, higher hematocrit values, oxygen saturation <90%, right ventricular hypertrophy, pulmonary stenosis, ventricular septal defect, and pulmonary hypertension. Oxygen saturation <90% was found to be independent predictor of perinatal complications (RR = 8.270, 95%CI 1.374-49.790, P = 0.021). CONCLUSIONS: Oxygen saturation <90% is associated with maternal and perinatal risks. Women with TOF whose oxygen saturation <90% are not recommended for pregnancy because of high maternal and perinatal complications.

[Role of the ES-62 protein derived from Acanthocheilonema viteae in regulation of immune dysregulation diseases: a review].

ES-62 is a phosphorylcholine-containing, 62 kDa glycoprotein derived from the excretory-secretory product of Acanthocheilonema viteae, which is effective for the prevention and treatment of immune dysregulation diseases through triggering activation of immune cells, such as dendritic cells, mononuclear macrophages and regulatory B cells and mediating immune responses. Recently, the role of the ES-62 protein in the management of allergic, autoimmune and metabolic diseases has been paid much attention. This review summarizes the regulatory role of the ES-62 protein in immune dysregulation diseases and the underlying mechanisms, so as to provide insights into future experimental studies.

Chitosan ducts fabricated by extrusion-based 3D printing for soft-tissue engineering.

Three kinds of methods based on extrusion and 3D printing and different acidic solutions (formic acid (FA), acetic acid (AA), glycolic acid (GA) and lactic acid (LA)) were applied for manufacturing the CS ducts. The tensile properties and preliminary cytotoxicity were measured for selecting the optimal ratio of CS slurry. The 3D printability of CS slurry was also studied. The tensile strength, Young's modulus, and fracture strain were tested for evaluating the degree of mechanical matching to soft-tissue. The optimal solvent to CS was 30 wt.% GA solution. The CS slurry possessing shear-thinning properties was suitable for 3D printing. The tensile strength, Young's modulus, and fracture strain of the CS rods were 10.98 ±â€¯0.61 MPa, 12.38 ±â€¯1.19 MPa, and 146.03 ±â€¯15.05 %, correspondingly. The CS ducts manufactured by 3D printing had an excellent mechanical matching to soft-tissue, outstanding biocompatibility and have great potential for soft-tissue restorations.

Informing a roadmap for cross-sectoral collaboration on portion size management as a national strategy to improve population nutrition - a Delphi study.

BACKGROUND: Addressing food portion sizes is a key untapped opportunity to help tackle obesity. This study sought to inform the agenda of a national movement involving diverse sectors to manage portion sizes in packaged foods, restaurants, cafeterias and prepared foods in grocery stores. METHODS: A Delphi study was conducted with representatives from public health, private-sector food companies and academia that formed a panel of experts (n = 32). Three iterative rounds of surveys were administered over 3 months. The surveys gathered opinions on psychological mindsets affecting portion size choice, eating habits, portion perception and distortion, passive overconsumption and challenges and advantages of this tool to improve population nutrition. The survey also inquired about visions for a future food environment. After every round, responses were analysed and questions narrowed to reach group consensus on specific items in the subsequent round. RESULTS: Although many experts fear that portion size interventions might be perceived as paternalistic, 91% of respondents agreed stealth interventions were preferable. Seventy-three per cent of experts believed that the most impactful portion size intervention was product reformulation while smaller packages were the most effective intervention according to only 28% of experts. The majority of the panel (59%) also believed that creating an artificial stopping point in packages was the best strategy to reduce food consumption. Finally, the study found that one of the most complex aspects of establishing a multi-sector collaboration for obesity prevention was to ascertain trust in the private sector's ability to balance profit versus social responsibility.[Corrections added on 21 March 2019, after first online publication: The percentage of experts who believed that small packages were the most effective intervention has been changed from "16%" to "28%".]. CONCLUSION: This study informs the agenda of a cross-sectoral, coordinated movement to tackle obesity through a combination of changing social norms, individual behaviours and industry practices around portion size. Although cross-sectoral collaboration for non-communicable disease prevention is encouraged by different organizations, strategic efforts to define a common agenda on portion size have been limited thus far. This research highlights important strategies in portion size interventions and steps needed for the success of such a movement, as part of a wider effort across sectors and stakeholders to halt and reverse obesity rates in the USA.

Transoral vertical ramus osteotomy fixed with Kirschner pins.

Transoral vertical ramus osteotomy (VRO) has been condemned because the condyle has the potential to sag, and because it needs lengthy maxillomandibular fixation. We have therefore introduced a simple method of fixation, and examined its effectiveness and complications. After the osteotomy, the proximal and distal segments are trimmed to adapt to each other. Four Kirschner (K) pins 0.9mm in diameter are inserted percutaneously from the proximal to the distal segment while the condyle is positioned in the glenoid fossa. This is followed by a brief period of maxillomandibular fixation. We have reviewed the records of 95 patients who had unilateral or bilateral vertical ramus osteotomy fixed with K pins, after which the mean (SD) period of fixation was 19 (11) days. Fixation failed in two patients because excursion of the jaw was either too heavy or too early. The fixations were redone. All other fixations remained stable, including the 20 dual-jaw procedures in which VRO preceded maxillary osteotomy. The mean (SD) maximal mouth opening at final follow-up was 44 (7) mm, and in only one patient was it less than 30mm. Numbness of the lip or chin developed in seven patients, five of whom had other anterior mandibular procedures. Four patients had discomfort on palpation of the site of the pins, and one required removal. The new method was effective, and resulted in few complications within its limitations.

Solid pseudopapillary neoplasm of pancreas in pregnancy treated with tumor enucleation: Case report and review of the literature.

Solid pseudopapillary neoplasm of pancreas (SPN) during pregnancy is rare and presents a threat both to the mother and the fetus. We report a case of SPN in a 26-year-old woman diagnosed at 21 weeks of gestation. Tumor enucleation was successfully performed by a general surgeon. A healthy female infant was delivered at 39 weeks and 5 days of gestation vaginally without complications. Our report provides an example that tumor enucleation of SPN during the second trimester could be successfully performed during pregnancy. A multidisciplinary approach with respect to the pregnant patient's diagnosis, indications, and timing of surgery is necessary in ensuring the best possible outcomes for both the mother and the child.

Obesity trend in the United States and economic intervention options to change it: A simulation study linking ecological epidemiology and system dynamics modeling.

OBJECTIVES: To study the country-level dynamics and influences between population weight status and socio-economic distribution (employment status and family income) in the US and to project the potential impacts of socio-economic-based intervention options on obesity prevalence. STUDY DESIGN: Ecological study and simulation. METHODS: Using the longitudinal data from the 2001-2011 Medical Expenditure Panel Survey (N = 88,453 adults), we built and calibrated a system dynamics model (SDM) capturing the feedback loops between body weight status and socio-economic status distribution and simulated the effects of employment- and income-based intervention options. RESULTS: The SDM-based simulation projected rising overweight/obesity prevalence in the US in the future. Improving people's income from lower to middle-income group would help control the rising prevalence, while only creating jobs for the unemployed did not show such effect. CONCLUSIONS: Improving people from low- to middle-income levels may be effective, instead of solely improving reemployment rate, in curbing the rising obesity trend in the US adult population. This study indicates the value of the SDM as a virtual laboratory to evaluate complex distributive phenomena of the interplay between population health and economy.

Investigation on the properties of borate bonding agents: Ti6Al4V-porcelain bonding, chemical durability and preliminary cytotoxicity.

The purpose of this study was to investigate the properties of the borate bonding agents (BBAS) including chemical durability, biocompatibility and bonding characteristics of porcelain to Ti6Al4V. The bond strength was performed by the three-point bending test. And the chemical durability and ion release of BBAS were tested by chemical soaking and inductively coupled plasma optical emission spectrometry (ICP-OES), respectively. Moreover, cytotoxicity was evaluated by cell viability assay and cell adhesion using human osteosarcoma cells (MG-63) and cell counter kit-8 (CCK-8) assay. To investigate the influences of composition and microstructure changes on all the properties mentioned above, the 11B and 27Al spectra and infrared spectra of BBAS were measured by solid-state nuclear magnetic resonance (SSNMR) and Fourier transform infrared spectroscopy (FTIR), respectively. Combined with all these properties of BBAS, the optimal addition proportion of Al2O3 into BBAS is 20 mol%. The relative contents of [BO3], [BO4], [AlO4], [AlO5] and [AlO6] have great influences on these properties of BBAS. BBAS, possessing excellent chemical durability, good biocompatibility and low ion release and being an effective way to improve the Ti6Al4V-porcelain bond strength, have significant clinical potentials in porcelain fused to metal restorations.

Applications of systems modelling in obesity research.

Obesity is a complex system problem involving a broad spectrum of policy, social, economic, cultural, environmental, behavioural, and biological factors and the complex interrelated, cross-sector, non-linear, dynamic relationships among them. Systems modelling is an innovative approach with the potential for advancing obesity research. This study examined the applications of systems modelling in obesity research published between 2000 and 2017, examined how the systems models were developed and used in obesity studies and discussed related gaps in current research. We focused on the applications of two main systems modelling approaches: system dynamics modelling and agent-based modelling. The past two decades have seen a growing body of systems modelling in obesity research. The research topics ranged from micro-level to macro-level energy-balance-related behaviours and policies (19 studies), population dynamics (five studies), policy effect simulations (eight studies), environmental (10 studies) and social influences (15 studies) and their effects on obesity rates. Overall, systems analysis in public health research is still in its early stages, with limitations linked to model validity, mixed findings and its actual use in guiding interventions. Challenges in theory and modelling practices need to be addressed to realize the full potential of systems modelling in future obesity research and interventions.

Effects of NGX6 expression on proliferation and invasion of nasopharyngeal carcinoma cells and survival of patients.

OBJECTIVE: To detect the expressions of nasopharyngeal carcinoma-associated gene 6 (NGX6) in nasopharyngeal carcinoma cells and tissues, and to investigate the effects of NGX6 on the proliferation and invasion of nasopharyngeal carcinoma cells and the survival of patients. PATIENTS AND METHODS: The human nasopharyngeal carcinoma cells (HONE1) and immortalized human nasopharyngeal epithelial cells (NP69) were selected and cultured. The mRNA and protein expression levels of NGX6 were detected via quantitative reverse transcription polymerase chain reaction (qRT-PCR) and Western blot. The expression of NGX6 in HONE1 was up-regulated using the gene transfection technique. Moreover, the effects of NGX6 on the proliferation and invasion capacities of HONE1 were observed via methyl thiazolyl tetrazolium (MTT) assay and Transwell assay. 50 biopsy tissue specimens of nasopharyngeal carcinoma and 20 non-neoplastic nasopharyngeal biopsy tissue specimens were collected, and the immunohistochemical method was used to detect the protein expression of NGX6 in tumor tissues of patients with esophageal carcinoma. Finally, the follow-up data of patients were recorded, Kaplan-Meier method was used for survival analysis, and the difference in survival rates was detected using the Log-rank test. RESULTS: The results of qRT-PCR and Western blot showed that the mRNA and protein expressions of NGX6 in HONE1 were significantly lower than those in nasopharyngeal carcinoma cells (NP69). After the overexpression of NGX6, the protein expression of NGX6 in HONE1 was significantly increased, but the proliferation and invasion capacities of HONE1 were significantly decreased. Besides, the immunohistochemical results revealed that the expression of NGX6 in tumor tissues of patients with nasopharyngeal carcinoma was significantly lower than that in normal tissues; the survival analysis showed that the level of NGX6 was positively correlated with the survival and prognosis of patients with nasopharyngeal carcinoma. CONCLUSIONS: NGX6 is lowly expressed in nasopharyngeal carcinoma, and it can inhibit the proliferation and invasion of nasopharyngeal carcinoma cells, whose expression is positively correlated with the survival and prognosis of patients with nasopharyngeal carcinoma.

Assessment of mismatch negativity and P300 response in patients with disorders of consciousness.

OBJECTIVE: To evaluate changes in mismatch negativity (MMN) and P300 response in vegetative state (VS) and minimally conscious state (MCS) patients before and after treatment, and their value for prediction of prognosis. PATIENTS AND METHODS: Event-related potentials (ERPs), performed on 11 patients classified as VS (n = 6) or MCS (n = 5), and five healthy participants (i.e., control group). We performed a six months telephone follow-up to monitor changes in consciousness recovery. RESULTS: Comparison of the three groups showed significantly higher MMN latency elicited by salient stimuli and P300 elicited by the subject's own name for the VS group, as well as significant difference in amplitudes of MMN elicited by frequent stimuli and P300 elicited by other first names for this group. The source of MMN and P300 responses was the frontal lobe for the control group, and temporal lobe for the VS and MCS groups. CONCLUSIONS: The sudden increase in MMN amplitude and latency shortening may indicate an improvement in the state of consciousness. Neurophysiological evaluations suggest that patients with vegetative state (VS) and minimally conscious state (MCS) may preserve patterns of higher-order cerebral processing similar to those observed in conscious patients.

[A preliminary study on the clinical characteristics of Parkinson's disease patients with restless legs syndrome].

Objective: To study the clinical characteristics of Parkinson's disease (PD) patients with restless legs syndrome (RLS). Methods: Ninety-nine PD patients and eighty-nine control group were included into this study and assessed for RLS by the question 6 of the non-motor symptoms questionnaire (NMSquest). The PD patients were divided into the RLS group and non RLS group, according to their answers to the NMSquest.The severity of motor symptoms, anxiety, depression and quality of life were evaluated according Unified Parkinson Disease Rating Scale (UPDRS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Parkinson' s Disease Quality Of Life Questionnaire(PDQ-39), respectively. Results: (1)18.2%(18/81)of the PD patients experienced RLS, the incidence was significantly higher than the general population (P<0.001). (2) The RLS patients were more often women (66.7% vs 33.3%, P=0.033 ). (3) The UPDRS-Ⅱ score(20±7, P=0.008), UPDRS-Ⅲ score(43±14, P=0.015), BDI score(23±13, P=0.002), BAI score(18±8, P=0.012), PDQ-39 score(75±26, P=0.000)in RLS group were significantly higher compared with non RLS group. (4) RLS showed no association with the course of the disease, the age, the PD onset age and levodopa dose equivalents. Conclusions: RLS more likely appears in PD patients, especially in women. The PD patients with RLS commonly suffer from serious motor symptom, low quality of life, anxiety and depression.

Morphokinetics of human blastocyst expansion in vitro.

Time-lapse imaging offers new tools to study dynamic processes of development such as blastocyst formation and expansion. This study quantitatively describes expansion in human blastocysts from donated oocytes. Measurements of hourly interval rate of changes in the blastocoel cross-sectional area revealed oscillatory pulses having 2-4 h periodicities. Two types of oscillations were distinguished. An E-Type ('expansion') had positive peak and positive or slightly negative trough interval rate of change values, and these characterized most of the expansion period. A C-type ('contraction') represented an infrequent but notable contraction of the blastocoel with loss of blastocoel fluid. These were reversible within 2-4 h in both groups and followed by further expansion. Therefore, oscillatory pulses are an intrinsic property of the trophectoderm. The zona seems to variably dampen the amplitude of these pulses. Expansion kinetics were compared between blastocysts with known positive (KID+) or negative (KID-) implantation outcomes. Regression analysis suggests that expansion may be relatively restricted in KID- embryos blastulating at relatively later times. These data extend observations in other mammalian systems and may provide information useful for clinical selection algorithms.

Evaluation to the effect of B2O3-La2O3-SrO-Na2O-Al2O3 bonding agent on Ti6Al4V-porcelain bonding.

Low-fusing bonding agents have been widely applied in Ti-ceramics restorations. As an important category, borate bonding agents have great potentials in increasing Ti-porcelain bonding. The purpose of this study is to evaluate the effect of borate bonding agent with addition of Na2O and Al2O3 on Ti6Al4V-porcelain bonding. The thermal properties of borate bonding agent, such as glass transition temperature (Tg) and crystallization peak temperature (Tp), were investigated to establish the sintering process. And the coefficient of thermal expansion (CTE) was to evaluate the matching effect of porcelain to Ti6Al4V. The bond strength was analyzed by the three point bending test. The microscopic morphology of the borate bonding agent surface after sintering, the interface of Ti-borate bonding agent-porcelain, and the fracture mode after porcelains fracture, were studied to assess the influence of borate bonding agent on Ti6Al4V-ceramics. With the addition of Na2O and Al2O3, the porcelain residues were observed increased indication on the Ti6Al4V surface after porcelain fracture and the bond strength was acquired the maximum (49.45MPa) in the bonding agent composition of 75.70B2O3-5.92La2O3-11.84SrO-4.67Na2O-1.87Al2O3. Those results suggest that borate bonding agent is an effective way to improve the Ti6Al4V-ceramics bond strength. And the addition of Na2O and Al2O3 strengthen this effect.

Knockdown of c-MET induced apoptosis in ABCB1-overexpressed multidrug-resistance cancer cell lines.

Inappropriate c-MET signaling in cancer can enhance tumor cell proliferation, survival, motility, and invasion. Inhibition of c-MET signaling induces apoptosis in a variety of cancers. It has also been recognized as a novel anticancer therapy approach. Furthermore, reports have also indicated that constitutive expression of P-glycoprotein (ABCB1) is involved in the HGF/c-MET-related pathway of multidrug resistance ABCB1-positive human hepatocellular carcinoma cell lines. We previously reported that elevated expression levels of PKCδ and AP-1 downstream genes, and HGF receptor (c-MET) and ABCB1, in the drug-resistant MES-SA/Dx5 cells. Moreover, leukemia cell lines overexpressing ABCB1 have also been shown to be more resistant to the tyrosine kinase inhibitor imatinib mesylate. These findings suggest that chemoresistant cancer cells may also develop a similar mechanism against chemotherapy agents. To circumvent clinical complications arising from drug resistance during cancer therapy, the present study was designed to investigate apoptosis induction in ABCB1-overexpressed cancer cells using c-MET-targeted RNA interference technology in vitro and in vivo. The results showed that cell viability decreased and apoptosis rate increased in c-MET shRNA-transfected HGF/c-MET pathway-positive MES-SA/Dx5 and MCF-7/ADR2 cell lines in a dose-dependent manner. In vivo reduction of tumor volume in mice harboring c-MET shRNA-knockdown MES-SA/Dx5 cells was clearly demonstrated. Our study demonstrated that downregulation of c-MET by shRNA-induced apoptosis in a multidrug resistance cell line.

Evaluation of wall correction factor of INER's air-kerma primary standard chamber and dose variation by source displacement for HDR ¹9²Ir brachytherapy.

The aim of the present study was to estimate the wall effect of the self-made spherical graphite-walled cavity chamber with the Monte Carlo method for establishing the air-kerma primary standard of high-dose-rate (HDR) ¹9²Ir brachytherapy sources at the Institute of Nuclear Energy Research (INER, Taiwan). The Monte Carlo method established in this paper was also employed to respectively simulate wall correction factors of the ¹9²Ir air-kerma standard chambers used at the National Institute of Standards and Technology (NIST, USA) and the National Physical Laboratory (NPL, UK) for comparisons and verification. The chamber wall correction calculation results will be incorporated into INER's HDR ¹9²Ir primary standard in the future. For the brachytherapy treatment in the esophagus or in the bronchi, the position of the isotope may have displacement in the cavity. Thus the delivered dose would differ from the prescribed dose in the treatment plan. We also tried assessing dose distribution due to the position displacement of HDR ¹9²Ir brachytherapy source in a phantom with a central cavity by the Monte Carlo method. The calculated results could offer a clinical reference for the brachytherapy within the human organs with cavity.