Discovery of New Isotopes

Using the fusion-evaporation reaction ^{106}Cd(^{58}Ni,4n)^{160}Os and the gas-filled recoil separator SHANS, two new isotopes _{76}^{160}Os and _{74}^{156}W have been identified. The α decay of ^{160}Os, measured with an α-particle energy of 7080(26) keV and a half-life of 201_{-37}^{+58} µs, is assigned to originate from the ground state. The daughter nucleus ^{156}W is a ß^{+} emitter with a half-life of 291_{-61}^{+86} ms. The newly measured α-decay data allow us to derive α-decay reduced widths (δ^{2}) for the N=84 isotones up to osmium (Z=76), which are found to decrease with increasing atomic number above Z=68. The reduction of δ^{2} is interpreted as evidence for the strengthening of the N=82 shell closure toward the proton drip line, supported by the increase of the neutron-shell gaps predicted in theoretical models.

[Healing effect of photodynamic therapy on extraction sockets of periodontally compromised teeth: a randomized, controlled, superiority clinical trial].

Objective: To evaluate the effects of photodynamic therapy (PDT) in extraction sockets of periodontally compromised molars on soft tissue healing, postoperative pain, bone density and bone height changes. Methods: This study is a single-center, single-blind, randomized controlled superiority clinical trial. Thirty-eight periodontally compromised molars requiring extraction in patients attending the Department of Periodontology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, from December 2022 to September 2023 were included, and randomly assigned to PDT group and control group. The control group received routine debridement after extraction, while PDT group received routine debridement followed by PDT. The bucco-lingual and mesio-distal wound distances at 7 and 14 d after extraction were measured, and then the wound closure rates were calculated. Evaluating the soft tissue healing indexes at 7 and 14 d after extraction. The visual analogue scale was used to assess the pain level at 6 h, 1 d, 2 d, and 3 d after tooth extraction. Apical radiographs were taken immediately and 2 months after extraction in order to compare the changes of the bone density and height. Results: The wound closure rate at 1 week was (78.08±5.45)% in PDT group and (71.03±6.82)% in control group, with significant differences (P<0.01). The wound closure rate at 2 weeks in PDT group [(85.88±3.84) %] was significantly higher than that in the control group [(81.66±3.79) %] (P<0.01), but did not reach the superiority value of the superiority test (superiority value=10%, 95%CI at 1 week: 3.00%-11.12%, 95%CI at 2 weeks: 1.71%-6.73%). The soft tissue healing index of PDT group at 1 week was significantly better than the control group (P<0.05), but there was no significant difference between the two groups at 2 weeks (P>0.05). There was no significant difference between the two groups in terms of postoperative pain at 6 h, 1 d, 2 d and 3 d as well as in bone density and height changes at 2 months after tooth extraction (P>0.05). Conclusions: PDT could promote soft tissues healing to some extent, but did not provide additional assistance in the healing of extraction sockets of periodontally compromised teeth. PDT did not show benefits on postoperative pain, changes of the bone density and bone height after tooth extraction.

Dietary supplementation of proteases on growth performance, nutrient digestibility, blood characteristics and gut microbiota of growing pigs fed sorghum-based diets.

Low-tannin sorghum is an excellent energy source in pig diets. However, sorghum contains several anti-nutritional factors that may have negative effects on nutrient digestibility. The impacts of proteases on growth performance, nutrient digestibility, blood parameters, and gut microbiota of growing pigs fed sorghum-based diets were studied in this study. Ninety-six pigs (20.66 ± 0.65 kg BW) were allocated into three groups (eight pens/group, four pigs/pen): (1) CON (control diet, sorghum-based diet included 66.98% sorghum), (2) PRO1 (CON + 200 mg/kg proteases), (3) PRO2 (CON + 400 mg/kg proteases) for 28 d. No differences were observed in growth performance and apparent total tract digestibility (ATTD) of nutrients between CON and PRO1 groups. Pigs fed PRO2 diet had increased (P < 0.05) BW on d 21 and 28, and increased (P < 0.05) average daily gain during d 14-21 and the overall period compared with pigs fed CON diet. In addition, pigs fed PRO2 diet had improved (P < 0.05) ATTD of gross energy, CP, and DM compared with pigs fed CON and PRO1 diets. Pigs fed PRO2 diet had lower (P < 0.05) plasma globulin (GLB) level and higher (P < 0.05) plasma glucose, albumin (ALB) and immunoglobulin G levels, and ALB/GLB ratio than pigs fed CON and PRO1 diets. Furthermore, pigs fed PRO2 diet had decreased (P < 0.05) the relative abundance of Acidobacteriota at the phylum level and increased (P < 0.05) the relative abundance of Prevotella_9 at the genus level. The linear discriminant analysis effect size analysis also showed that pigs fed PRO2 diet had significantly enriched short-chain fatty acid-producing bacteria, such as Subdoligranulum and Parabacteroides. In conclusion, protease supplementation at 400 mg/kg improved the growth performance of growing pigs fed sorghum-based diets, which may be attributed to the improvement of nutrient digestibility, host metabolism, immune status and associated with the altered gut microbiota profiles.

[A phase I study of subcutaneous envafolimab (KN035) monotherapy in Chinese patients with advanced solid tumors].

Objective: To evaluate the safety and antitumor activity of envafolimab monotherapy in Chinese patients with advanced solid tumors. Methods: This open-label, multicenter phase I trial included dose escalation and dose expansion phases. In the dose escalation phase, patients received subcutaneous 0.1, 0.3, 1.0, 2.5, 5.0 or 10.0 mg/kg envafolimab once weekly (QW) following a modified "3+ 3" design. The dose expansion phase was performed in the 2.5 mg/kg and 5.0 mg/kg (QW) dose cohorts. Results: At November 25, 2019, a total of 287 patients received envafolimab treatment. During the dose escalation phase, no dose-limiting toxicities (DLT) was observed. In all dose cohorts, drug-related treatment-emergent adverse events (TEAEs) for all grades occurred in 75.3% of patients, and grade 3 or 4 occurred in 20.6% of patients. The incidence of immune-related adverse reactions (irAE) was 24.0% for all grades, the most common irAEs (≥2%) included hypothyroidism, hyperthyroidism, immune-associated hepatitis and rash. The incidence of injection site reactions was low (3.8%), all of which were grades 1-2. Among the 216 efficacy evaluable patients, the objective response rate (ORR) and disease control rate (DCR) were 11.6% and 43.1%, respectively. Median duration of response was 49.1 weeks (95% CI: 24.0, 49.3). Pharmacokinetic (PK) exposure to envafolimab is proportional to dose and median time to maximum plasma concentration is 72-120 hours based on the PK results from the dose escalation phase of the study. Conclusion: Subcutaneous envafolimab has a favorable safety and promising preliminary anti-tumor activity in Chinese patients with advanced solid tumors.

Effects of dietary methionine supplementation from different sources on growth performance and meat quality of barrows and gilts.

Methionine is indispensable for growth and meat formation in pigs. However, it is still unclear that increasing dietary sulphur-containing amino acid (SAA) levels using different methionine sources affects the growth performance and meat quality of barrows and gilts. To investigate this, 144 pigs (half barrows and half gilts) were fed the control (100% SAA, CON), DL-Methionine (125% SAA, DL-Met)-supplemented, or OH-Methionine (125% SAA, OH-Met)-supplemented diets during the 11-110 kg period. The results showed that plasma methionine levels varied among treatments during the experimental phase, with increased plasma methionine levels observed following increased SAA consumption during the 25-45 kg period. In contrast, pigs fed the DL-Met diet had lower plasma methionine levels than those fed the CON diet (95-110 kg). Additionally, gilts fed the DL-Met or OH-Met diets showed decreased drip loss in longissimus lumborum muscle (LM) compared to CON-fed gilts. OH-Met-fed gilts had higher pH45min values than those fed the CON or DL-Met diets, whereas OH-Met-fed barrows had higher L45min values than those fed the CON or DL-Met diets. Moreover, increased consumption of SAA, regardless of the methionine source, tended to decrease the shear force of the LM in pigs. In conclusion, this study indicates that increasing dietary levels of SAA (+25%) appeared to improve the meat quality of gilts by decreasing drip loss and increasing meat tenderness.

[Transanal drainage tube for prevention of anastomotic leak after anterior resection for rectal cancer: a meta-analysis].

Objective: To assess the effectiveness of transanal drainage tube (TDT) in reducing the incidence of anastomotic leak following anterior resection in patients with rectal cancer. Methods: We conducted a systematic search for relevant studies published from inception to October 2022 across multiple databases, including PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP. Meta-analysis was performed using Review Manager 5.4 software. The primary outcomes included total incidence of anastomotic leak, grade B and C anastomotic leak rates, reoperation rate, anastomotic bleeding rate, and overall complication rate. Results: Three randomized controlled trials involving 1115 patients (559 patients in the TDT group and 556 in the non-TDT group) were included. Meta-analysis showed that the total incidences of anastomotic leak and of grade B anastomotic leak were 5.5% (31/559) and 4.5% (25/559), respectively, in the TDT group and 7.9% (44/556) and 3.8% (21/556), respectively, in the non-TDT group. These differences are not statistically significant (P=0.120, P=0.560, respectively). Compared with the non-TDT group, the TDT group had a lower incidence of grade C anastomotic leak (1.6% [7/559] vs. 4.5% [25/556]) and reoperation rate (0.9% [5/559] vs. 4.3% [24/556]), but a higher incidence of anastomotic bleeding (8.2% [23/279] vs. 3.6% [10/276]). These differences were statistically significant (P=0.003, P=0.001, P=0.030, respectively). The overall complication rate was 26.5%(74/279) in the TDT group and 27.2% (75/276) in the non-TDT group. These differences are not statistically significant (P=0.860). Conclusions: TDT did not significantly reduce the total incidence of anastomotic leak but may have potential clinical benefits in preventing grade C anastomotic leak. Notably, placement of TDT may increase the anastomotic bleeding rate.

Assessing surgical risk calculators on hernia repair candidates with cirrhosis.

PURPOSE: Several risk calculators have been developed and deployed to help surgeons estimate the mortality risk that comes with performing hernia repair surgery on patient with severe liver disease. This study seeks to evaluate the accuracy of these risk calculators on patients with cirrhosis and identify the most suitable population of patient to use these calculators on. METHODS: The American College of Surgeons National Surgery Quality Improvement Program (NSQIP) 2013-2021 datasets were queried for patients who underwent hernia repair surgery. Mayo Clinic's "Post-operative Mortality Risk in Patients with Cirrhosis" risk calculator, Model for End-Stage Liver Disease (MELD) calculator, NSQIP's Surgical Risk Calculator, and a surgical 5-item modified frailty index were assessed to determine whether they accurately predict mortality following abdominal hernia repair. RESULTS: In total, 1368 patients met inclusion criteria. Receiver operating characteristic (ROC) curve analysis of the 4 mortality risk calculators resulted in the following: NSQIP Surgical Risk Calculator = 0.803 (p < 0.001); "Post-operative Mortality Risk in Patients with Cirrhosis" with an etiology of "Alcoholic or Cholestatic" yielded an AUC = 0.722 (p < 0.001); MELD score yielded an AUC = 0.709 (p < 0.001); and the modified 5-item frailty index yielded an AUC = 0.583 (p = 0.04). CONCLUSION: The NSQIP Surgical Risk Calculator more accurately predicts 30-day mortality in patients with ascites undergoing hernia repair. However, if the patient is missing one of the 21 input variables required by this calculator, Mayo Clinic's 30-day mortality calculator should be consulted before the more widely used MELD score.

Identification and Verification of the Ability of Cdk5 to Phosphorylate Deubiquitinating Enzyme BRCC3 In Vitro.

It is known that the expression of the deubiquitinating enzyme BRCA1-BRCA2-containing complex subunit 3 (BRCC3) and cyclin-dependent protein kinase 5 (Cdk5) is increased in Parkinson's disease (both are involved in neuroinflammatory response). However, the regulatory mechanism of Cdk5 on the post-translational modification of BRCC3 remains unclear. Here we studied whether Cdk5 phosphorylates BRCC3. Phosphorylation of BRCC3 by Cdk5 was predicted by GPS 5.0 software. His-BRCC3 plasmid was constructed by cloning the BRCC3 gene into pGEX-6P-1 vector, and then His-BRCC3 fusion protein was induced with isopropyl ß-d-1-thiogalactopyranoside and purified using His-Tag affinity chromatography purification agarose. Phosphorylation of BRCC3 fusion protein by Cdk5 in vitro was detected by mass spectrometry and Western blotting. The results showed that multiple phosphorylation sites were predicted by GPS 5.0, and the His-BRCC3 fusion protein was successfully induced and purified. In vitro kinase assay, Western blotting, and mass spectrometry showed that Cdk5 can phosphorylate BRCC3. It has been demonstrated that protein kinase Cdk5 can phosphorylate the deubiquitinating enzyme BRCC3 in vitro, which provides new data for further study on the mechanism of neurodegeneration.

[Study on epidemiological status of e-cigarette use among adolescent in Zhejiang province, China].

Objective: To describe the prevalence of e-cigarette use among adolescent in Zhejiang province, and to analyze its distribution of different genders and school types to provide evidence for controlling the use of e-cigarette among adolescent. Methods: A total of 7 663 students from 60 middle schools through stratified multi-stage cluster sampling methods from Zhejiang province were surveyed by using questionnaire. Indicators as tried to use e-cigarette rate, current e-cigarette using rate, and other indicators were collected. All data were weighted by age proportions of adolescent in Zhejiang. Results: The prevalence of tried to use and current using e-cigarettes among middle school students were 6.99% and 1.45%, respectively; and there were 4.19% juniors who were susceptibility to future e-cigarette use. The rate of tied to use e-cigarette, current using e-cigarette and susceptibility to future e-cigarette use were higher in boys than in girls. The rate of current using e-cigarette was 2.07% for rural and 0.48% for urban. Technical secondary school students had the highest rate of tried to use e-cigarette and susceptibility to future e-cigarette use (13.53%, 6.91%). Junior school students (2.96%) had the lowest level of susceptibility to future tobacco use. The rate of tried e-cigarette use and current e-cigarette use and susceptibility to future e-cigarette use were higher in the group of "One of students' parents was smoker" (8.63%, 2.19%, 5.23%). The highest rate of current smoking was found in the group of "Weekly allowance more than 50 Yuan" (10.02%, 2.54%, 6.29%). Compared to technical secondary school students, senior school student (OR=0.57) and junior school students (OR=0.45) were less likely to try to use e-cigarette. Students whose weekly allowance were less than 20 Yuan were less likely to try to use e-cigarette (OR=0.49). Students who were boys (OR=5.44) and one of their parents was smoker (OR=1.59) were more likely to try to use e-cigarette. Conclusions: There were middle school students with tried e-cigarette use and current e-cigarette use, especially in technical secondary schools. The prevalence of e-cigarette using among middle school students increased with age. It is important to further spread of e-cigarette knowledge widely and deeply, and reduce the susceptible population of adolescents using e-cigarettes.

[A retrospective safety study on screening of the samples in the clinical biobank of Beijing Hospital].

To investigate whether the laboratory specimens preserved in Beijing Hospital Biobank during a specific period had been contaminated by SARS-Cov-2 through a cross-sectional study, and to establish a retrospective biobank safety screening system. Laboratory specimens were collected from the Department of Respiratory and Critical Care Medicine and the Fever Clinic of Beijing Hospital from November 1, 2019 to January 22, 2020, nucleic acid and serological antibody testing were performed for SARS-CoV-2 in these specimens (including 79 serum, 20 urine, 42 feces and 21 bronchoalveolar lavage fluid specimens). The safety of the stored samples during this period was defined by negative and positive results. Both the nucleic acid test and serological antibody test showed negative for SARS-CoV-2, indicating that these specimens were safely stored in the biobank. High-risk specimens collected in our hospital during the early stage of the COVID-19 outbreak are free of SARS-CoV-2, and a safety screening strategy for the clinical biobank is established to ensure the biosafety of these samples.

[Establishment of model to predict lateral neck recurrence of central lymph node metastasis in papillary thyroid carcinoma].

Objective: To explore the risk factors for lateral neck recurrence of central lymph node metastasis (CLMN) in papillary thyroid cancer (PTC), and to construct a model to predict the recurrence. Methods: The records of 245 consecutive PTC patients with CLMN underwent surgical treatment from 1996 to 2009 in our department were retrospectively reviewed. The threshold value of CLNM number is determined by ROC curve. The risk factors for lateral neck recurrence were determined by using Cox regression model. The identified risk factors were incorporated into a nomogram model to predict the risk of lateral neck recurrence. Results: A total of 245 patients were enrolled in the study, among them, 32 cases occurred lateral neck lymph node recurrence and 4 cases were dead of thyroid carcinoma. Multivariate analysis revealed that primary tumor size, extrathyroidal extension, the number of metastatic CLNM >3 were independent risk factors of lateral neck recurrence (P<0.05), lateral neck recurrence was a risk factor of disease-free survival(P<0.05). The nomogram model of predicting the lateral neck recurrence was further established based on the above 3 independent risk factors, the area under the receiver operating characteristic (ROC) curve of which was 0.790. Conclusions: The nomogram model based on the independent risk factors of LN recurrence can be helpful to screen the papillary thyroid carcinoma patients with high risk of lateral neck recurrence, and provide more guidance for clinical treatment.

[Protective effect of vitamin D in mice with acute liver failure].

Objective: To explore the protective effect of vitamin D in acute liver failure through a mouse model. Methods: Acute liver failure was induced by combining D-galactosamine (D-GalN) lipopolysaccharide (LPS) to observe the effect of long-term vitamin D deficiency on liver injury and inflammatory signals in a mouse model. Acute liver failure was induced by thioacetamide (TAA) to observe the effect of vitamin D deficiency on the survival rate, and further high-dose of vitamin D supplementation protective effect was determined in a mouse model. Liver function was evaluated by measuring serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and liver inflammation by hematoxylin-eosin staining. The expressions of tumor necrosis factor (TNF-α), interleukin (IL) -1ß, NOD-like receptor family, pyrin domain containing 3 (NLRP-3), chemokines (CCL2, CXCL1 and CXCL2), etc. in liver tissues were detected by RT-qPCR. The quantitation of macrophages in liver tissue was detected by immunohistochemistry. The comparison between groups were performed by t-test. The survival curve was analyzed by log-rank (Mantel-Cox) test. Results: Long-term vitamin D deficiency had increased acute liver failure sensitivity in mice, which was manifested by increased blood cell extravasation, massive necrosis of parenchymal cells, up-regulation of TNF-α, IL-1ß, and NLRP-3 mRNA expression (P < 0.05), and increased macrophages quantitation (P < 0.05) in liver tissues. At the same time, vitamin D deficiency had increased the mice mortality rate because of liver injury (P < 0.01). On the contrary, pre-administration of high dose of vitamin D (100 IU/g) had significantly reduced liver injury, inhibited ALT and AST rise (P < 0.01), alleviated liver necrosis, and down-regulated the mRNA expression of inflammatory factors in liver tissues (P < 0.05). Conclusion: Mouse model shows that long-term vitamin D deficiency can aggravate drug-induced acute liver failure and reduce survival rates. Furthermore, high-dose of vitamin D has a certain hepatoprotective effect, which can significantly improve liver necrosis condition and inhibit inflammation. Therefore, adequate vitamin D can retain liver physiological balance to resist liver injury.

[Prediction and investigation of the potential risk factors for the upper mediastinal metastasis of papillary thyroid carcinoma].

Objective: To predict and investigate the potential risk factors for the upper mediastinal metastasis of papillary thyroid carcinoma (PTC). Methods: This study was a prospective cohort study. The admission criteria were patients with untreated thyroid cancer diagnosed in Cancer Hospital, Chinese Academy of Medical Sciences from December 2013 to December 2015, and positive lymph node (cN1, including cN1a and cN1b) was diagnosed by ultrasound. All patients underwent neck to thorax enhanced Computed Tomography (CT) examination preoperatively. All patients with suspected upper mediastinal lymph node metastasis experienced suspicious regional dissection, and those who had not undergone surgery and whose postoperative pathology was non-papillary thyroid carcinoma were excluded. Kaplan-Meier method was selected for survival analysis and all the factors were analyzed by multivariate Logistic regression. Results: Of the 248 patients, 54 were prompted by postoperative pathology for upper mediastinal lymph node metastasis, 86 cases were phase T1, 94 cases were phase T2, 17 cases were phase T3 and 51 cases were phase T4, 21 cases were N1a phase and 227cases were N1b phase. There was a statistically significant difference in the T-phase and N-phase between the upper mediastinal lymph node metastasis group and no upper mediastinal lymph node metastasis group(P<0.05). Univariate analysis showed that among the preoperative relevant factors, ultrasound tumor length> 2 cm, ultrasound tumor bilaterally, CT double neck lymph node metastasis, increased thyroglobulin (Tg), and increased anti-thyroglobulin antibody (ATG) were all risk factors for upper mediastinal lymph node metastasis(all P<0.05). Among the postoperative factors, bilateral tumor, double neck lymph node metastasis, tumor invasion of the recurrent laryngeal nerve, trachea, esophagus or larynx, T3 staging, T4 staging, total number of metastatic lymph nodes>10, the number of metastatic lymph nodes in level Ⅵ>3 and >6, the proportion of metastatic lymph nodes in level Ⅵ>1/2, the number of metastatic lymph nodes in level Ⅳ> 5 and metastatic proportion >1/3 are risk factors for metastasis of upper mediastinal lymph node(all P<0.05). Multivariate analysis showed that CT indicated double neck lymph node metastasis, increased Tg, increased ATG, the proportion of metastatic lymph nodes in level Ⅵ >1/2, and in level Ⅳ>1/3 are independent risk factors for upper mediastinum lymph node metastasis(all P<0.05). The 5-year recurrence-free survival rates of the upper mediastinal lymph node metastasis group and the no upper mediastinal lymph node metastasis group were 92.3% and 94.8% respectively, and the difference was not statistically significant(P=0.307). Conclusions: For preoperative ultrasound considering the presence of lymph node metastases, enhanced neck to thorax CT should be performed routinely. When bilateral cervical lymph node metastasis is determined by CT, or endocrine tests suggest abnormally increased antibodies, attention should be paid to the upper mediastinal lymph nodes metastasis. In the course of neck dissection, if more lymph node metastases in level Ⅵ and level Ⅳ were detected, surgeons should be vigilant of the upper mediastinal metastasis. The prognosis of patients underwent complete mediastinal dissection is not significantly different from that of patients without mediastinal metastasis.

Nrf2 mediates the neuroprotective effect of isoflurane preconditioning in cortical neuron injury induced by oxygen-glucose deprivation.

OBJECTIVE: To investigate how nuclear factor-E2-related factor 2 (Nrf2) involved in the protective effect of isoflurane (Iso) preconditioning in oxygen glucose deprivation (OGD)-induced cortical neuron injury. METHODS: Primary mouse cortical neurons were divided into Control, ML385 (an Nrf2 inhibitor), Iso, Iso + ML385, OGD, ML385 + OGD, Iso + OGD, and Iso + ML385 + OGD groups. Lactate dehydrogenase activity (LDH) release and oxidative stress indexes were quantified. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was used to detect cell viability, Annexin V-FITC/propidium iodide (PI) staining to measure cell apoptosis, dichloro-dihydro-fluorescein diacetate (DCFH-DA) method to test reactive oxygen species (ROS), and quantitative reverse-transcription polymerase chain reaction (qRT-PCR) and Western blotting to evaluate genes and protein expression. RESULTS: Iso preconditioning reduced LDH release and inhibited cell cytotoxicity in OGD-induced cortical neurons, which was abolished by ML385. Iso preconditioning increased the Nrf2 nuclear translocation in cortical neurons. Meanwhile, Iso decreased the OGD-induced apoptosis with the down-regulations of Bax and Caspase-3 and the up-regulation of Bcl-2, which was reversed by ML385. OGD enhanced the level of ROS and malondialdehyde (MDA) in cortical neurons, but reduced the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), which were aggravated in ML385 + OGD group and mitigated in Iso + OGD group. No observable difference was found between OGD group and Iso + ML385 + OGD group regarding apoptosis-related proteins and oxidative stress-related indexes. CONCLUSION: Iso preconditioning up-regulated Nrf2 level to play its protective role in OGD-induced mouse cortical neuron injury.

Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China.

BACKGROUND: Cancer patients are regarded as a highly vulnerable group in the current Coronavirus Disease 2019 (COVID-19) pandemic. To date, the clinical characteristics of COVID-19-infected cancer patients remain largely unknown. PATIENTS AND METHODS: In this retrospective cohort study, we included cancer patients with laboratory-confirmed COVID-19 from three designated hospitals in Wuhan, China. Clinical data were collected from medical records from 13 January 2020 to 26 February 2020. Univariate and multivariate analyses were carried out to assess the risk factors associated with severe events defined as a condition requiring admission to an intensive care unit, the use of mechanical ventilation, or death. RESULTS: A total of 28 COVID-19-infected cancer patients were included; 17 (60.7%) patients were male. Median (interquartile range) age was 65.0 (56.0-70.0) years. Lung cancer was the most frequent cancer type (n = 7; 25.0%). Eight (28.6%) patients were suspected to have hospital-associated transmission. The following clinical features were shown in our cohort: fever (n = 23, 82.1%), dry cough (n = 22, 81%), and dyspnoea (n = 14, 50.0%), along with lymphopaenia (n = 23, 82.1%), high level of high-sensitivity C-reactive protein (n = 23, 82.1%), anaemia (n = 21, 75.0%), and hypoproteinaemia (n = 25, 89.3%). The common chest computed tomography (CT) findings were ground-glass opacity (n = 21, 75.0%) and patchy consolidation (n = 13, 46.3%). A total of 15 (53.6%) patients had severe events and the mortality rate was 28.6%. If the last antitumour treatment was within 14 days, it significantly increased the risk of developing severe events [hazard ratio (HR) = 4.079, 95% confidence interval (CI) 1.086-15.322, P = 0.037]. Furthermore, patchy consolidation on CT on admission was associated with a higher risk of developing severe events (HR = 5.438, 95% CI 1.498-19.748, P = 0.010). CONCLUSIONS: Cancer patients show deteriorating conditions and poor outcomes from the COVID-19 infection. It is recommended that cancer patients receiving antitumour treatments should have vigorous screening for COVID-19 infection and should avoid treatments causing immunosuppression or have their dosages decreased in case of COVID-19 coinfection.

[Correlation analysis between Dx-pH monitoring and proton pump inhibitor test in the diagnosis of laryngopharyngeal reflux disease].

Objective: The consistency of 24-hour oropharyngeal Dx-pH monitoring and proton pump inhibitor(PPI) test in the diagnosis of laryngopharyngeal reflux disease (LPRD) was investigated. Methods: Sixty patients with laryngopharyngeal reflux (LPR) related symptoms who had never received PPI treatment were assessed by reflux symptom index (RSI) and reflux finding score (RFS) between October 2017 and October 2018, including 28 males and 38 females, aged from 16 to 72 years, with a medium age of 38 years. Prior to treatment, all patients were evaluated with 24 hours oropharyngeal Dx-pH monitoring(Restech). After empiric therapy with PPI twice-daily for 8 weeks, the efficacy was evaluated according to posttreatment RSI score.The data was analysed with Kruskal-Wallis test, Student Newman Keuls test and consistency check. Results: (1)Among all 60 patients,13 patients (21.7%) had pathologic Ryan score and all resulted responsive to PPI;27 patients (45.0%) with a negative Ryan score were unresponsive to PPI; 20 patients (33.3%) despite a negative Ryan score resulted responsive to PPI therapy. Considering responsiveness to PPI therapy as the gold standard for the diagnosis of LPRD, the sensitivity, specificity, positive predictive value and negative predictive value of Ryan score were 39.4%, 100%, 100% and 57.4% respectively. The Kappa value was 0.369 (P<0.01). (2)Among 34 patients (56.7%) with positive Dx-pH results (24-hour oropharyngeal acid reflux events≥ 3 times), 29 patients were positive and 5 patients were negative in PPI test. Among 26 patients with negative Dx-pH results (24-hour oropharyngeal acid reflux events<3 times), 4 patients were positive and 22 patients were negative in PPI test. Considering responsiveness to PPI therapy as the gold standard for the diagnosis of LPRD, the sensitivity, specificity, positive predictive value and negative predictive value of 24-hour oropharyngeal acid reflux events were 87.9%, 81.5%, 85.3% and 84.6% respectively. The Kappa value was 0.696(P<0.01). Conclusions: There is a positive correlation between 24-hour oropharyngeal Dx-pH monitoring positive results (24-hour oropharyngeal acid reflux events≥3 times) and PPI test in the diagnosis of LPRD. The 24-hour oropharyngeal Dx-pH monitoring can be a promising tool for the diagnosis of suspected LPRD patients, and more sensitive and accurate Dx-pH diagnostic index will be required in the clinic.

[Correlation between serum bilirubin and cardiovascular autonomic neuropathy in patients with type 2 diabetes].

Objective: To investigate the correlation between serum bilirubin and cardiovascular autonomic neuropathy (CAN) in type 2 diabetes mellitus patients. Methods: A total of 369 patients with type 2 diabetes mellitus who were hospitalized at the Department of Endocrinology, Nanjing Jinling Hospital from April 2017 to October 2018 were enrolled, including 226 males and 143 females, with an average age of (54.6±12.1) years. According to cardiovascular reflex tests (CARTs), all the patients were divided into Non CAN group(149 patients without CAN) and CAN group (220 patients complicated with CAN). The difference of serum bilirubin levels between the two groups was compared. The differences of CARTs and the incidence of CAN were compared by tertiles of serum bilirubin levels. The binary logistic regression was used to analyze the risk factors for diabetic cardiovascular autonomic neuropathy. Results: The serum total bilirubin [(9.28±2.74) µmol/L vs (11.08±2.98) µmol/L, P<0.001], direct bilirubin [(3.17±1.20) µmol/L vs (3.71±1.24) µmol/L, P<0.001] and indirect bilirubin levels [(6.11±1.89) µmol/L vs (7.37±2.10) µmol/L, P<0.001] in CAN group were significantly lower than that in Non CAN group. With the increase of serum bilirubin, the incidence of CAN decreased (P<0.01). Multivariate Logistic regression analysis showed that serum total bilirubin (OR=0.819, 95%CI: 0.744-0.901, P<0.001), direct bilirubin (OR=0.739, 95%CI: 0.601-0.908, P=0.004) and indirect bilirubin (OR=0.749, 95%CI: 0.653-0.860, P<0.001) were inversely correlated with the incidence of CAN. Conclusions: Within the physiological range, lower level of serum bilirubin is inversely correlated with the incidence of CAN. It is noteworthy to screen diabetic cardiovascular autonomic neuropathy in patients with type 2 diabetes mellitus who had a lower serum bilirubin level.

Application of Nonlinear Optical Microscopic Imaging Technology for Quality Assessment of Donor Kidneys.

BACKGROUND: Nonlinear optical microscopic (NLOM) imaging technique shows its high resolution imaging features in histocytology. The purpose of this study was to investigate NLOM imaging technique as a useful tool for a donor kidney quality assessment. MATERIALS AND METHODS: Eighty-three pretransplant kidney biopsies from adult donors were analyzed retrospectively. Each specimen was paraffin-embedded and sectioned into 2 consecutive 5-µm thick sections. One section was stained with Masson trichrome, and the other was left unstained for NLOM imaging using second harmonic generation combined with two-photon excited fluorescence (SHG/TPEF). The pretransplant kidney quality was assessed by an experienced pathologist using the Remuzzi scoring system, which characterizes renal tissue morphology into 4 aspects: tubular atrophy, interstitial fibrosis, glomerulosclerosis, and vascular injury. The K coefficient was used to measure the consistency of the Remuzzi scores between conventional Masson trichrome stained images and SHG/TPEF images. RESULTS: NLOM imaging technology can capture high-resolution tissue images from unstained renal tissue, is easy to operate, and shortens time-consuming histological processing procedures. No significant differences (P > .05) were found between the Remuzzi scores of the SHG/TPEF images and the Masson trichrome stained images. The high κ coefficients (0.804-0.895) showed a good consistency between these 2 techniques. CONCLUSION: The NLOM technique is suitable for renal tissue imaging and could potentially be used for routine pretransplant kidney evaluation in clinical settings.

Prognostic value of long non-coding RNA HOST2 expression and its tumor-promotive function in human osteosarcoma.

OBJECTIVE: Aberrant expression of long noncoding RNA (lncRNA) is associated with carcinogenesis of various tumors. The aim of current study was to explore the clinical significance and biological function of long non-coding RNA HOST2 (lnc-HOST2) in patients with osteosarcoma. PATIENTS AND METHODS: The expression of lnc-HOST2 was detected by quantitative Real-time PCR (qRT-PCR) in 163 osteosarcoma specimens and matched the normal tissues. The significance of lnc-HOST2 as a prognostic factor as well as its relationship with survival was determined. The effects of lnc-HOST2 expression on the biological behavior of osteosarcoma cells were investigated by MTT and flow cytometry. qRT-PCR and Western blot were used to evaluate the mRNA and protein expression of apoptosis-related factors. RESULTS: The expression levels of lnc-HOST2 in osteosarcoma tissues were significantly higher than those in corresponding noncancerous bone tissues (p < 0.01). Statistical assay indicated that the expression level of lnc-HOST2 was positively correlated with tumor stage (p = 0.003) and distant metastasis (p = 0.000). Furthermore, Kaplan-Meier analysis suggested that patients with high lnc-HOST2 showed poorer overall survival than those with low lnc-HOST2 (p = 0.000). The univariate and multivariate analysis further revealed that lnc-HOST2 expression was an independent prognostic factor for overall survival. Then, functionally, down-regulation of lnc-HOST2 suppressed proliferation and induced cell apoptosis in osteosarcoma cells. Notably, we confirmed that up-regulation of lnc-HOST2 led to Bcl-2 downregulation and Bax upregulation in osteosarcoma cells. CONCLUSIONS: We provided the first evidence that lnc-HOST2 may serve as a novel prognostic marker in osteosarcoma. Further, targeting lnc-HOST2 may represent an attractive target therapy for osteosarcoma.