Diagnosis of pulmonary hemorrhagic leptospirosis complicated by invasive pulmonary aspergillosis complemented by metagenomic next-generation sequencing: a case report.

Background: Leptospirosis is a bacterial zoonosis with variable clinical manifestations. Pulmonary diffuse hemorrhagic leptospirosis often occurs rapidly and, when not promptly diagnosed and treated, it can be life-threatening. Aspergillus flavus is an opportunistic fungus that is commonly seen in immunosuppressed patients. Invasive pulmonary aspergillosis also progresses rapidly. This case study describes a patient with severe pneumonia caused by pulmonary hemorrhagic leptospirosis combined with invasive pulmonary aspergillosis. We have found almost no clinical reports to date on these two diseases occurring in the same patient. Case presentation: A 73-year-old male arrived at our hospital complaining of fever, general malaise, and hemoptysis that had lasted 4 days. The patient was initially diagnosed with severe pneumonia in the emergency department, but he did not respond well to empiric antibiotics. Subsequently, the patient's condition worsened and was transferred to the ICU ward after emergency tracheal intubation and invasive ventilator. In the ICU, antibacterial drugs were adjusted to treat bacteria and fungi extensively. Although the inflammatory indices decreased, the patient still had recurrent fever, and a series of etiological tests were negative. Finally, metagenomic next-generation sequencing (mNGS) of bronchial alveolar lavage fluid detected Leptospira interrogans and Aspergillus flavus. After targeted treatment with penicillin G and voriconazole, the patient's condition improved rapidly, and he was eventually transferred out of the ICU and recovered. Conclusion: Early recognition and diagnosis of leptospirosis is difficult, especially when a patient is co-infected with other pathogens. The use of mNGS to detect pathogens in bronchial alveolar lavage fluid is conducive to early diagnosis and treatment of the disease, and may significantly improve the prognosis in severe cases.

The combination of berberine and cinnamon polyphenol can improve glucose metabolism in T2DM rats through Bas-TGR5-GLP-1 / 药学学报

Berberine (BBR) is the main pharmacological active ingredient of Coptidis, which has hypoglycemic effect, but its clinical application is limited due to its poor oral bioavailability. Polyphenols, derived from cinnamon, are beneficial for type 2 diabetes mellitus (T2DM). The combination of both may have an additive effect. The aim of this study was to investigate the hypoglycemic effect and mechanism of combined medication in diabetic rats. The modeling rats were randomly divided into 5 groups (berberine group, cinnamon group, combined group, metformin group, diabetic control group) and normal control group. The animal experiments were approved by the Animal Ethics Committee (approval number: HMUIRB2022003). The subjects were given orally, and the control group was given equal volume solvent and body weight was measured weekly. Thirty days after administration, oral glucose tolerance test and insulin sensitivity test were performed, and fasting blood glucose (FBG), glycated serum protein (GSP), and serum insulin (INS) levels were detected; high-throughput sequencing technology was used to detect intestinal microbiota structure; real-time quantitative PCR (RT-qPCR) and Western blot were used to detect G protein-coupled receptor 5 (TGR5) and glucagon-like peptide-1 (GLP-1) expression levels. The results showed that, compared with the diabetic control group, the levels of FBG (P < 0.01) and GSP (P < 0.01) in the combined group were lower, and the insulin resistance was improved, which was better than that in the berberine group. Combined treatment increased the relative abundance of Bacteroides, Prevotella and Lactobacillus, reversed the decrease in Lactobacillus in the berberine alone induction group, and the combination of the two could promote the expression of TGR5 and GLP-1. In summary, the combined application of cinnamon and berberine can regulate glucose metabolism better than the application of berberine alone. Berberine combined with cinnamon can improve the function of pancreatic islet β cells in diabetes mellitus type 2 rats by changing the intestinal microbiota, increasing the expression of TGR5 and GLP-1 proteins, and thereby better regulating glucose metabolism.

Research on Impact Resistance of Aluminum Alloy New Rotating Thin-Walled Structures.

Honeycomb structures are widely used in the field of impact resistance and are constantly being developed and updated. In this paper, the design of three new aluminum alloy rotating thin-walled structures (NRTS) are examined. These structures combine common concave structures and rotating, rigid-body structures. The purpose of this study is to solve the problem of the poor energy absorption capacity of rotating, rigid-body structure due to small deformation and to provide a reference for honeycomb mechanism designs. The Young's modulus, the critical velocity, and the platform stress of the NRTS structure are derived from theoretical analysis. The dynamic response of the NRTS structure at different impact velocities is investigated using finite element simulation software. The results show that the rotating, thin-walled recessed honeycomb (RTRH) increases the plateau stress by 124% and 51% as compared to rotating, thin-walled square tubes (RTSTs) and the re-entrant hexagonal structure (RH), respectively; the rotating, thin-walled quadruple-arc honeycomb structure (RTQH) increases the SEA by 21% and 20% as compared to the RTST and RH, respectively; and the rotating thin-walled double-arc honeycomb structure (RTDH) increases the CEF by 54% and 51% as compared to the RTST and RH, respectively. During the study, it was demonstrated that NTRS also exhibits good energy absorption capacity. Then, the effect of rotation angle on the energy absorption performance was analyzed. The cell and wall thickness of the NTRS structure were optimized according to the gradient theory. It was proved that the gradient optimized structure has better energy absorption performance as compared to the uniform structure.

Predictive Significance of Claudin-3 for Epithelial Barrier Dysfunction in Chronic Rhinosinusitis With Nasal Polyps.

PURPOSE: The abnormal expression of tight junction (TJ) plays a vital role in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP). However, there is no appropriate tool to distinguish and diagnose epithelial barrier defects in clinical practice. This study aimed to evaluate the predictive value of claudin-3 for epithelial barrier dysfunction in CRSwNP. METHODS: In this study, TJ protein levels were evaluated by real-time quantitative polymerase chain reaction, immunofluorescent, and immunohistochemistry staining in control subjects and CRSwNP patients. The receiver operating characteristic (ROC) curve was created to assess the predictive value of TJ breakdown in clinical outcomes. In vitro, human nasal epithelial cells were cultured at the air-liquid interface to analyze the transepithelial electrical resistance (TER) level. RESULTS: The expression levels of occludin, tricellulin, claudin-3, and claudin-10 were decreased (all P < 0.05), and those of claudin-1 was increased (P < 0.05) in CRSwNP patients as compared to healthy subjects. Additionally, claudin-3 and occludin levels were negatively correlated with the computed tomography score in CRSwNP (all P < 0.05), and the ROC curve indicated that the claudin-3 level had the most predictive accuracy in evaluating epithelial barrier disruption (area under the curve = 0.791, P < 0.001). Finally, the time-series analysis showed the highest correlation coefficient between TER and claudin-3 (cross-correlation function = 0.75). CONCLUSION: In this study, we suggest that claudin-3 could be a valuable biomarker for predicting nasal epithelial barrier defects and disease severity in CRSwNP.

[Determination of eight cannabinoids in foods with enhanced matrix removal-lipid adsorbent by ultra performance liquid chromatography-tandem mass spectrometry].

A novel method was developed for the simultaneous determination of eight cannabinoids in six types of food matrices, including chocolate, fondant, biscuit, beverage, cookie and baijiu, using ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). The sample extraction and cleanup steps were optimized, and various purification methods were investigated to remove the oil matrix and glue in chocolate and fudge, respectively. Enhanced matrix removal-lipid adsorbent (EMR-Lipid) provided efficient, selective cleanup of the evaluated matrices. The sample was extracted using acetonitrile, followed by EMR-Lipid cleanup, and then dried using anhydrous sodium sulfate. The acetonitrile layer was concentrated by nitrogen to near-dry after 100 µL 10% glycerol in methanol was added to improve the recovery by reducing loss during concentration under the stream of nitrogen gas. Eight cannabinoids were separated using a Waters ACQUITY UPLC BEH Shield RP18 column (100 mm×3.0 mm, 1.7 µm). The responses of the cannabinoids in the positive and negative ionization modes were investigated and optimized, and the responses were superior in the negative ion mode compared to those in the positive ion mode. MS detection was performed in the multi-reaction monitoring (MRM) mode using an electrospray source in the negative ion mode. The cannabinoids were quantified using an external standard with matrix calibration curves to reduce the influences of the matrix effects on the quantitative results. The developed method was verified, and the conditions of sample pretreatment were also optimized. The calibration curves of tetrahydrocannabinol, cannabidivarin, tetrahydrocannabivarin, and cannabigerol and those of cannabidiol, cannabinol, cannabidiolic acid, and tetrahydrocannabinolic acid exhibited good linearities, with r>0.995, in the ranges of 2-200 and 0.4-40 ng/mL, respectively. The respective limits of detection (LODs, S/N=3) and quantification (LOQs, S/N=10) of tetrahydrocannabinol, cannabidivarin, tetrahydrocannabivarin, and cannabigerol were 4 and 10 µg/kg, and those of cannabidiol, cannabinol, cannabidiolic acid, and tetrahydrocannabinolic acid were 0.8 and 2 µg/kg. The average recoveries of the cannabinoids were 82.0%-114.9% under three spiked levels with corresponding relative standard deviations (RSDs) of <15% (n=6). EMR-Lipid provided efficient, selective cleanups of food matrices with good accuracy. The method is sensitive, rapid, accurate, simple to execute, and it is suitable for the determination of cannabinol compounds in typical food matrices.

[Effective constituents of essential oil from Gleditsiae Fructus Abnormalis and anti-cerebral ischemia/reperfusion injury mechanism: based on GC-MS, network pharmacology, and experimental verification].

Based on GC-MS and network pharmacology, the active constituents, potential targets, and mechanism of essential oil from Gleditsiae Fructus Abnormalis(EOGFA) against cerebral ischemia/reperfusion(I/R) injury were explored, and the effective constituents were verified by experiment. To be specific, GC-MS was used identify the constituents of the volatile oil. Secondly, the targets of the constituents and disease were predicted by network pharmacology, and the drug-constituent-target network was constructed, followed by Gene Ontology(GO) term enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment of the core targets. Molecular docking was performed to investigate the binding affinity between the active constituents and the targets. Finally, SD rats were used for experimental verification. The I/R injury model was established, and the neurological behavior score, infarct volume, and pathological morphology of brain tissue were measured in each group. The content of interleukin-1ß(IL-1ß), interleukin-6(IL-6), and tumor necrosis factor-alpha(TNF-α) was determined by enzyme-linked immunosorbent assay(ELISA), and the protein expression of vascular endothelial growth factor(VEGF) by Western blot. A total of 22 active constituents and 17 core targets were screened out. The core targets were involved in 56 GO terms and the major KEGG pathways of TNF signaling pathway, VEGF signaling pathway, and sphingolipid signaling pathway. Molecular docking showed that the active constituents had high affinity to the targets. The results of animal experiment suggested that EOGFA can alleviate the neurological impairment, decrease the cerebral infarct volume and the content of IL-1ß, IL-6 and TNF-α, and down-regulate the expression of VEGF. The experiment verified the part results of network pharmacology. This study reflects the multi-component, multi-target, and multi-pathway characteristics of EOGFA. The mechanism of its active constituents is related to TNF and VEGF pathways, which provides a new direction for in-depth research on and secondary development of Gleditsiae Fructus Abnormalis.

Effective constituents of essential oil from Gleditsiae Fructus Abnormalis and anti-cerebral ischemia/reperfusion injury mechanism: based on GC-MS, network pharmacology, and experimental verification / 中国中药杂志

Based on GC-MS and network pharmacology, the active constituents, potential targets, and mechanism of essential oil from Gleditsiae Fructus Abnormalis(EOGFA) against cerebral ischemia/reperfusion(I/R) injury were explored, and the effective constituents were verified by experiment. To be specific, GC-MS was used identify the constituents of the volatile oil. Secondly, the targets of the constituents and disease were predicted by network pharmacology, and the drug-constituent-target network was constructed, followed by Gene Ontology(GO) term enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment of the core targets. Molecular docking was performed to investigate the binding affinity between the active constituents and the targets. Finally, SD rats were used for experimental verification. The I/R injury model was established, and the neurological behavior score, infarct volume, and pathological morphology of brain tissue were measured in each group. The content of interleukin-1β(IL-1β), interleukin-6(IL-6), and tumor necrosis factor-alpha(TNF-α) was determined by enzyme-linked immunosorbent assay(ELISA), and the protein expression of vascular endothelial growth factor(VEGF) by Western blot. A total of 22 active constituents and 17 core targets were screened out. The core targets were involved in 56 GO terms and the major KEGG pathways of TNF signaling pathway, VEGF signaling pathway, and sphingolipid signaling pathway. Molecular docking showed that the active constituents had high affinity to the targets. The results of animal experiment suggested that EOGFA can alleviate the neurological impairment, decrease the cerebral infarct volume and the content of IL-1β, IL-6 and TNF-α, and down-regulate the expression of VEGF. The experiment verified the part results of network pharmacology. This study reflects the multi-component, multi-target, and multi-pathway characteristics of EOGFA. The mechanism of its active constituents is related to TNF and VEGF pathways, which provides a new direction for in-depth research on and secondary development of Gleditsiae Fructus Abnormalis.

Dual-modal polypeptide-containing contrast agents for magnetic resonance/fluorescence imaging.

Dual-modal magnetic resonance/fluorescent imaging (MRI/FI) attracts moreandmoreattentions in diagnosis of tumors. A corresponding dual-modal imaging agent with sufficient tumor sensitivity and specificity should be matched to improve imaging quality. Tripeptide (RGD) and pentapeptide (YIGSR) were selected as the tumor-targeting groups and attached to gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) and rhodamine B (RhB), and then make two novel polypeptide-based derivatives (RGD-Gd-DTPA-RhB and YIGSR-Gd-DTPA-RhB), respectively. These derivatives were further characterized and their properties, such as cell uptake, cell cytotoxicity, MRI and FI assay, were measured. YIGSR-Gd-DTPA-RhB and RGD-Gd-DTPA-RhB had high relaxivity, good tumor-targeting property, low cell cytotoxicity and good red FI in B16F10 melanoma cells. Moreover, YIGSR-Gd-DTPA-RhB and RGD-Gd-DTPA-RhB possessed high uptake to B16F10 melanoma, and then achieve highly enhanced FI and MRI of tumors in mice for a prolonged time. Therefore, YIGSR-Gd-DTPA-RhB and RGD-Gd-DTPA-RhB can be applied as the potential agents for tumor targeted MRI/FI in vivo.

[Adaptability of Broussonetia papyrifera to sewage sludge and its characteristics of nutrient and heavy metal uptake and accumulation]. / æž„æ ‘çš„æ±¡æ³¥é€‚åº”æ€§åŠå »åˆ†å’Œé‡é‡‘å±žå¸æ”¶ç´¯ç§¯ç‰¹å¾.

Broussonetia papyrifera, an important fast-growing economic tree species in China, has the advantages of strong adaptability, high-biomass, and high bioconcentration of heavy metals. Sewage sludge contains a great deal of nutrients and heavy metals. Planting B. papyrifera with sewage sludge can achieve the goals of sewage sludge remediation as well as resources production of B. papyrifera. A pot experiment was conducted to investigate growth, uptake and accumulation of nutrient and heavy metal in different organs (root, stem, leaf) of B. papyrifera, with treatments of control (lateritic red soil), 50% sewage sludge (mixed substrates of 50% sewage sludge and 50% lateritic red soil based on weight) and 100% sewage sludge. The comprehensive evaluation of capacity of uptake and accumulation was also carried out by principal component analysis and membership function. The results showed that B. papyrifera could grow normally in both 50% and 100% sewage sludge substrates, with higher plant height and biomass than that in the control, especially in 100% sewage sludge substrate. The quality index in 100% sewage sludge substrate (1.02) was 4.3 times and 2.4 times as that of the control and 50% sewage sludge substrate, respectively. The content of N in different organs and P in stem increased significantly in both 50% and 100% sewage sludge substrates. The content of K in stem and leaf was significantly decreased in 100% sewage sludge substrate, which were significant lower than that of control. The uptake of heavy metals such as Cu, Zn, Pb, Cd, Ni for B. papyrifera were mainly through roots. There was positive correlation between the content of heavy metals in root and sewage sludge ratio. The content of Pb and Cd in leaves were lower than the limit value of Hygienic Standard For Feeds (GB 13078-2017). The capacity for absorption and accumulation of Cd was better than that of other heavy metals. Compared with the control, rootretention rates of Zn, Pb and Cd significantly increased in both 50% and 100% sewage sludge substrates (57.8%-85.8%), while Cu and Ni significantly increased in 100% sewage sludge substrate (67.5% and 74.8%). Nutrient and heavy metal accumulations in total plant in both 50% and 100% sewage sludge substrates were significantly higher than that in the control, with 100% sewage sludge substrate being significantly higher than that in 50% sewage sludge substrate. Compared with 50% sewage sludge substrate, the increment rates of nutrient and heavy metal accumulations in different organs as well as total plants in 100% sewage sludge substrates were greatly increased. The rank of comprehensive evaluation scores of adaptability, element uptake and accumulation was in an order: 100% sewage sludge substrate (0.848) > 50% sewage sludge substrate (0.344) > control (0.080). With good adaptability to sewage sludge, B. papyrifera could grow normally in sewage sludge andeffectively absorb and fix nutrients and heavy metals. It is feasible to plant B. papyrifera into the sewage sludge for remediation of sewage sludge and resource production.

Communication obstacles between contracted family doctor team and the disabled / 中华全科医师杂志

Objective:To investigate the status quo of communication between contracted family doctor team and the disabled.Methods:Using convenience sampling, family doctor team members of 80 community health centers (CHCs) in Beijing were selected to participate in a questionnaire survey from April to June 2022. The questionnaire included the basic information of team members, the choice of communication methods and targets, the acquisition of communication knowledge and skills and so on.Results:A total of 365 team members participated in the survey. The most common type of disability was physical disability (78.08%,285/365). All participants met communication obstacles with disabled people in contracted health service, and hearing and speech disabilities were the most common (70.14%, 256/365). Only 13.42% (49/365) chose to directly communicate with the disabled themselves; 84.93% (310/365) used "increase the volume and slow down" method when communicating with the disabled, and 38.63% (141/365) chose "write and convey multiple messages at the same time". Most of participants (84.38%, 308/365) indicated the need for professional training in communication with persons with disabilities.Conclusion:There are communication obstacles between family doctor team members and the disabled during contracted services. More relevant professional training are urgently needed for contracted family doctor team to improve the abilities to communicate with the disabled.

A qualitative study on the feasibility of contracted nursing services for disabled persons / 中华全科医师杂志

Objective:To investigate the feasibility of contracted nursing services for disabled persons.Methods:A qualitative study on the feasibility of contracted nursing services for disabled persons was conducted from August 2020 to October 2020 with the phenomenological method. Community nurses were selected with the purpose of sampling method from Yuetan and Baizhifang Community Health Service Centers in Beijing Xicheng District for semi-constructed interviews, and 12 community nurses were finally interviewed according to the principle of information saturation. The research team took field notes, audio recordings and transcriptions of the interviews, coded to refine the themes, and fed back with the respondents to confirm the accuracy of the themes.Results:All the interviewed nurses thought that the contents of basic medical and public health required by the Guidance manual of contracted services of family doctors for disabled persons (the manual) including basic documentation, appointments, pre-diagnosis and post-diagnosis services, home care, rehabilitation nursing guidance, referral services and extended nursing services for the disabled and their families could be completed. All interviewees said that the manual had a guiding role in contracted services for disabled persons. Eight interviewed nurses believed that the manual involved referral services and rehabilitation care, but the technical guidance content did not meet the actual work needs and it should be supplemented and improved; 9 interviewees pointed out that there was a lack of communication with various types of disabled people in service practice, especially for those with vision, hearing, mental disabilities and disabled children; 7 interviewees said that it the free home care for the disabled was not sustainable. Conclusion:The contracted nursing services for disabled persons are feasible and the manual has a guiding role for the practice,and some contents need to be added in the manual to further improve service capacity for disabled people.

TNF-α and HMGB1: New Biomarkers of Acute Pulmonary Embolism.

OBJECTIVE: Inflammatory mediators have been implicated in the pathophysiology of acute pulmonary embolism (PE). However, the role of inflammatory mediator activation in the development of pulmonary embolism remains elusive. Here, we determined the reliability of the plasma levels of inflammatory markers tumor necrosis factor-alpha (TNF-α) and high mobility histone 1 (HMGB1) as diagnostic biomarkers of PE. METHODS: Eighty-seven patients with PE and ninety-two healthy adults were enrolled. Plasma levels of TNF-α and HMGB1 were measured before and after anticoagulation treatment using conventional commercialized ELISA. RESULTS: The mean concentrations of plasma TNF-α and HMGB1 in patients with PE before anticoagulation treatment were 3.36- and 2.54-fold higher than those in controls (p<0.0001), respectively. Similar results were obtained in patients with PE before anticoagulation treatment, in which plasma levels of TNF-α and HMGB1 were 3.99- and 1.99-fold higher (p<0.0001), respectively, than in PE patients after anticoagulation treatment. Among the two potential markers, TNF-α performed best in distinguishing patients with PE from controls. A significant positive correlation was found between the two markers' concentrations. CONCLUSIONS: These findings suggest that the plasma levels of TNF-α and HMGB1 may serve as potential biomarkers for PE.

Oxidative Stress Induced Osteocyte Apoptosis in Steroid-Induced Femoral Head Necrosis.

OBJECTIVE: To investigate the effect and mechanism of Glucocorticoids (GCs) induced oxidative stress and apoptosis on necrosis of the femoral head in patients and rats. METHODS: Eight patients with steroid-induced avascular necrosis of the femoral head (SINFH) and eight patients with developmental dysplasia of the hips (DDH) were enrolled in our study. In animal model, twenty male Sprague-Dawley rats were randomly divided into two groups (SINFH group and NS group). The SINFH model group received the methylprednisolone (MPS) injection, while control group was injected with normal saline (NS). MRI was used to confirm SINFH rat model was established successfully. Then, the rats were sacrificed 4 weeks later and femoral head samples were harvested. Histopathological staining was preformed to evaluate osteonecrosis. TUNEL staining was performed with 8-OHdG and DAPI immunofluorescence staining to evaluate oxidative injury and osteocyte apoptosis. Immunohistochemistry staining was used to detect Nox1, Nox2, and Nox4 protein expression. RESULTS: MRI showed signs of typical osteonecrosis of femoral head in SIHFH patients. Histopathological staining showed that the rate of empty lacunae in SINFH patients was significantly higher (56.88% ± 9.72% vs 19.92% ± 4.18%, T = -11.04, P < 0.001) than that in DDH patients. The immunofluorescence staining indicated that the TUNEL-positive cell and 8-OHdG-positve cell in SINFH patients were significantly higher (49.32% ± 12.95% vs 8.00% ± 2.11%, T = -7.04, P = 0.002, 54.6% ± 23.8% vs 9.75% ± 3.31%, T = -4.17, P = 0.003) compared to the DDH patients. The immunohistochemistry staining showed that the protein expression of NOX1, NOX2 and NOX4 in SINFH patients were significantly increased (64.50% ± 7.57% vs 37.58% ± 9.23%, T = -3.88, P = 0.018, 90.84% ± 2.93% vs 49.56% ± 16.47%, T = -5.46, P = 0.001, 85.46% ± 9.3% vs 40.69% ± 6.77%, T = -8.03, P = 0.001) compared to the DDH patients. In animal model, MRI showed signs of edema of femoral head in MPS group, which represents SINFH rat model was established successfully. Histological evaluation showed the rate of empty lacunae in MPS group was significantly higher (25.85% ± 4.68% vs 9.35% ± 1.99%, T = -7.96, P < 0.001) than that in NS group. The immunofluorescence staining indicated that the TUNEL-positive cell and 8-OHdG-positve cell (in MPS group were significantly increased (31.93% ± 1.01% vs 11.73% ± 1.16%, T = -32.26, P < 0.001, 47.59% ± 1.39% vs 22.07% ± 2.45%, T = -22.18, P < 0.001) compared to the NS group. The immunohistochemistry staining showed that the expression of NOX2 in MPS group was significantly increased (76.77% ± 8.34% vs 50.32% ± 10.84%, T = -4.74, P = 0.001) compare with NS group. CONCLUSION: Our findings indicated that GC-induced NOXs expression may be an important source of oxidative stress, which could lead to osteocyte apoptosis in the process of SINFH.

Heterogeneity and prognosis of programmed cell death-ligand 1 expression in the circulating tumor cells of non-small cell lung cancer.

Due to tumor heterogeneity, the consistency of programmed cell death-ligand 1 (PD-L1) expression between circulating tumor cells (CTCs) and tissue is controversial. This study aimed to establish a method for detecting CTC PD-L1 expression and exploring the impact of the same on the prognosis of lung cancer. In 32 patients with non-small cell lung cancer, lung cancer cells in the blood were enriched using CD326 immunomagnetic beads. Goat anti-mouse polyclonal CD326 antibody stained the epithelial lung cancer cells and anti-PD-L1 antibody was used to detect the expression of CTC PD-L1. The DAKO Link 48 automatic staining device detected the expression in lung cancer tissue. The consistency of PD-L1 expression was analyzed in lung cancer tissue and CTCs. The effect of plasma interferon gamma, tumor necrosis factor alpha, and interleukin-2 on PD-L1 expression and prognosis was analyzed. The number of CTCs detected in patients was 1-36, with a median of 2. There was no significant difference in PD-L1 expression fractions between CTCs and paired tumor tissue (p>0.05). The correlation coefficient was 0.20. Regardless of lung cancer tissue or CTCs, there was no statistically significant difference in the blood cytokine levels between the two groups with positive or negative PD-L1 expression (p>0.05). There was no correlation between CTCs and PD-L1 in 23 untreated patients. The expression of PD-L1 in CTCs and lung cancer tissue is heterogeneous and unaffected by the peripheral cytokines' levels. PD-L1 expression has no correlation between CTCs and tissues and is not related to prognosis.

[Expression and Clinical Significance of Serum MiR-370 and MiR-203 in Patients with Acute Myeloid Leukemia].

OBJECTIVE: To investigate the expression of microRNA-370 (miR-370) and microRNA-203 (miR-203) in the serum of patients with acute myeloid leukemia(AML), and to analyze its clinical diagnosis and prognostic significance. METHODS: 57 patients with acute myeloid leukemia were enrolled as experimental group, and 21 healthy people were enrolled as control group. The fasting venous blood of the personal in the two groups were collected. The expression of miR-370 and miR-203 of the personal in each groups were detected by real-time fluorescent quantitative PCR. The receiver operating characteristic (ROC) curve was plotted to detected the diagnostic values of serum miR-370, miR-203, and the Kaplan-Meier method was used to estimate the relationship between expression and overall survival of the patients. RESULTS: Compared with healthy controls, serum miR-370 expression was significantly decreased in AML patients(P<0.05), and serum miR-203 expression was also significantly decreased (P<0.05). ROC curve analysis showed that the expression of serum miR-370 and miR-203 could be used to distinguish acute myeloid leukemia and healthy people. The area under the ROC curve of miR-370 was 0.909, and the sensitivity and specificity were 91.46% and 100.00%, respectively. The area under the ROC curve of miR-203 was 0.895, and the sensitivity and specificity were 83.45% and 89.71%, respectively. Serum levels of miR-370 and miR-203 were closely related to overall survival in AML patients. CONCLUSION: The expression of miR-370 and miR-203 is decreased in the serum of patients with AML and may be a new markers for the diagnosis and prognosis of AML.

Effects of sewage sludge and other wastes application on the growth and element uptake of Jatropha curcas in abandoned rare-earth mine soil.

The wastes such as sewage sludge (SS) can be used to amend soil of abandoned rare-earth mine land (ARL). The energy plant Jatropha curcas could be used as a pioneer tree species in the ARL. In a pot experiment to address the responses of growth and element uptake of J. curcas, three treatments were established: adding SS to the soil of ARL (T1), adding SS and bagasse to the soil of ARL (T2), adding SS, bagasse and passivator to the soil of ARL (T3), with the untreated soil of the ARL as the control (CK). The results showed that compared with CK, T1 only significantly increased the plant height of J. curcas, T2 and T3 significantly increased the plant height, ground diameter and dry biomass of J. curcas, of which the total dry biomass increased by more than 184.7%. All the three treatments significantly increased the contents of N, P, K and Cu in J. curcas. T1 and T2 significantly increased the proportion of exchangeable Zn, Cd and Ni in the substrates, while T3 showed the opposite effects. T3 significantly decreased the migration factor (M) and mobility factor (MF) of Zn, Cd, Ni in the substrates, and significantly reduced the contents of Zn, Pb, Cd, Ni in J. curcas, with an inhibition rate of over 36.1%. The comprehensive evaluation of the membership function showed that the order of growth promotion effects on J. curcas was T2>T3>T1>CK, while the order of capacity of inhibiting J. curcas to accumulate Cu, Zn, Pb, Cd, Ni was T3>CK>T2>T1. The combined application of SS and bagasse significantly promoted the growth and element accumulation of J. curcas, and the addition of passivator significantly reduced heavy metals uptake without affecting the growth of J. curcas.

Atypical teratoid/rhabdoid tumor in adult: case series and an integrated survival analysis.

BACKGROUND: Atypical teratoid/rhabdoid tumor (AT/RT) is well documented in children but less so in adults because of its rarity. METHOD: We report a series of five cases, a literature review and quantitative analysis of the survival outcome of adult AT/RT patients. RESULTS: Seventy-four patients including our five cases (male: female = 16: 58) were evaluated, whose median age was 32.5 years (18-80 years). The commonest location was the sellar region. Median overall survival (OS) was 12.5 months (0.5-204.00 months). Chemotherapy was associated with OS (HR: 0.349, 95%CI: 0.176-0.694, p = 0.003), while other factors did not influence OS. From Kaplan-Meier analysis, surgery combining postoperative chemotherapy and radiotherapy was associated with better prognosis (Log Rank: χ2 = 14.662, p = 0.001). CONCLUSIONS: Adult AT/RT is commoner in females and tends to recur rapidly after surgical resection. Chemotherapy may provide a survival benefit. Surgery combined with postoperative chemotherapy and radiotherapy was associated with better prognosis for adult AT/RT patients, though the overall prognosis was still poor.

Endoscopic Partial Plantar Fasciotomy via 2 Medial Portals vs Mini-Open Procedure for Refractory Plantar Fasciitis.

BACKGROUND: The treatment of plantar fasciitis may require surgical intervention in patients with ineffective response to conservative treatment. There is a lack of evidence regarding the differences in clinical outcomes between the endoscopic and the mini-open procedures. The purpose of this study was to compare the clinical outcomes of the endoscopic partial plantar fasciotomy via 2 medial portals with mini-open partial plantar fasciotomy for treating refractory plantar fasciitis. METHODS: A retrospective analysis was carried out on 62 patients with refractory plantar fasciitis from January 2015 to July 2017. Thirty-three patients received endoscopic partial plantar fasciotomy, while the other 29 received mini-open procedure by patient preference. Two medial portals were used in the endoscopic group while single mini-medial method was used in the open group. All patients were followed up for 24 months. The pain visual analog scale (VAS), the American Orthopaedic Foot & Ankle Society (AOFAS) score, the calcaneodynia score (CS), and the 36-item Short Form Health Survey questionnaire (SF-36) were employed to evaluate the clinical outcomes of the 2 groups. RESULTS: There was increase in the functional scores (eg, VAS, AOFAS, CS, and SF-36) in both groups recorded at 3 months, 6 months, 1 year, and 2 years after surgery. The patients in the endoscopic group had better VAS, AOFAS, CS, and SF-36 scores at 3 months after the surgery compared with those of the open group. During the 6-month follow-up, although the 2 groups showed similar VAS and AOFAS, the CS and SF-36 scores of the endoscopic group were significantly higher than those of the open group. During the 1-year and 2-year follow-ups, the endoscopic group gained equivalent VAS, AOFAS, CS, and SF-36 scores compared with those of the open group. The recurrence rate was similar in both groups. Moreover, the patients in the endoscopic group achieved earlier recovery in comparison to those in the open group. CONCLUSION: For refractory plantar fasciitis, endoscopic partial plantar fasciotomy via 2 medial portals produced better short-term and equivalent long-term subjective outcomes than the mini-open surgery. LEVEL OF EVIDENCE: Level II, comparative study.

Expression and Clinical Significance of Serum MiR-370 and MiR-203 in Patients with Acute Myeloid Leukemia / 中国实验血液学杂志

OBJECTIVE@#To investigate the expression of microRNA-370 (miR-370) and microRNA-203 (miR-203) in the serum of patients with acute myeloid leukemia(AML), and to analyze its clinical diagnosis and prognostic significance.@*METHODS@#57 patients with acute myeloid leukemia were enrolled as experimental group, and 21 healthy people were enrolled as control group. The fasting venous blood of the personal in the two groups were collected. The expression of miR-370 and miR-203 of the personal in each groups were detected by real-time fluorescent quantitative PCR. The receiver operating characteristic (ROC) curve was plotted to detected the diagnostic values of serum miR-370, miR-203, and the Kaplan-Meier method was used to estimate the relationship between expression and overall survival of the patients.@*RESULTS@#Compared with healthy controls, serum miR-370 expression was significantly decreased in AML patients(P<0.05), and serum miR-203 expression was also significantly decreased (P<0.05). ROC curve analysis showed that the expression of serum miR-370 and miR-203 could be used to distinguish acute myeloid leukemia and healthy people. The area under the ROC curve of miR-370 was 0.909, and the sensitivity and specificity were 91.46% and 100.00%, respectively. The area under the ROC curve of miR-203 was 0.895, and the sensitivity and specificity were 83.45% and 89.71%, respectively. Serum levels of miR-370 and miR-203 were closely related to overall survival in AML patients.@*CONCLUSION@#The expression of miR-370 and miR-203 is decreased in the serum of patients with AML and may be a new markers for the diagnosis and prognosis of AML.

LncRNA CRNDE facilitates epigenetic suppression of CELF2 and LATS2 to promote proliferation, migration and chemoresistance in hepatocellular carcinoma.

Our study aimed to investigate the expression, functional significance, and related mechanism of long noncoding RNA CRNDE (colorectal neoplasia differentially expressed) in hepatocellular carcinoma (HCC) pathogenesis. The resulted revealed that CRNDE was significantly overexpressed in HCC tissues and cell lines, and was statistically correlated with poor clinical outcome. CRNDE knockdown markedly decreased HCC cell proliferation, migration, and chemoresistance. In addition, in vivo experiments confirmed the suppressive effect of CRNDE knockdown on HCC progression. Mechanically, CRNDE directly bound to EZH2 (enhancer of zeste homolog), SUZ12 (suppressor of zeste 12), SUV39H1, and mediated their inhibition of tumor suppressor genes, including CUGBP Elav-like family member 2 (CELF2) and large tumor suppressor 2 (LATS2). CELF2 exerted tumor suppressive effect in HCC and was involved in CRNDE-mediated oncogenic effect. In addition, the oncogenic effects of CRNDE on HCC proliferation, migration and tumorigenesis, as well as its inhibition of Hippo pathway were abolished by LATS2 overexpression. Together, our work demonstrated the importance of CRNDE in HCC progression and elucidated the underlying molecular mechanisms. These findings provided new insights into HCC pathogenesis and chemoresistance mediated by CRNDE.