bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of total bilirubin and indirect bilirubin content with metabolic syndrome among Kazakhs in Xinjiang
Authors: Hao Hao , Guo Heng , Ma Ru-lin , Yan Yi-zhong , Hu Yun-hua , Ma Jiao-long , Zhang Xiang-hui , Wang Xin-ping , Wang Kui , Mu La-ti , Song Yan-peng , Zhang Jing-yu , He Jia , Guo Shuxia
Published: June 2020

Background: Some studies have shown that a high level of bilirubin is a protective factor against metabolic syndrome (MS), while a high level of transaminase is a risk factor for MS. However, the existing results are inconsistent and few cohort studies have been published. Methods: Using an ambispective cohort study, 565 Kazakhs from Xinjiang, China were selected as the study subjects. The baseline serum bilirubin and transaminase levels of the subjects were divided into quartiles and the relationship between these values and the incidence of MS was analyzed. The definition of MS was based on the Joint Interim Statement (JIS) diagnostic criteria. Results: The average follow-up time for the subjects was 5.72 years. The cumulative incidence of MS was 36.11% (204 of the 565 subjects), and the incidence density was 63.10/1000 person-years. Multivariate Cox regression analysis showed that the levels of total bilirubin (TBIL) and indirect bilirubin (IBIL) were negatively correlated with the occurrence of MS, Compared to the lowest quartile level (Q1), the hazard ratios of MS the TBIL levels at the Q2-Q4 quartiles were: 0.47 (0.31-0.71), 0.53 (0.35-0.79), and 0.48 (0.32-0.72), respectively, while IBIL levels at the Q2-Q4 quartiles showed an MS hazard ratio of 0.48 (0.32-0.72), 0.54(0.36-0.81), and 0.52 (0.35-0.77), respectively, all at a 95% confidence level. However, no relationship was found between transaminase levels and the incidence of MS. Conclusion: Serum TBIL and IBIL levels were negatively correlated with the incidence of MS in a Kazakh population in China.
The thermochemical non-equilibrium scale effects of the high enthalpy nozzle
Authors: Shen Junmou , Lu Hongbo , Li Ruiqu , Chen Xing , Ma Handong
Published: June 2020

The high enthalpy nozzle converts the high enthalpy stagnation gas into the hypervelocity free flow. The flow region of the high enthalpy nozzle consists of three parts: an equilibrium region upstream of the throat, a non-equilibrium region near the throat, and a frozen region downstream of the throat. Here we propose to consider the thermochemical non-equilibrium scale effects in the high enthalpy nozzle. With numerical solving axisymmetric compressible Navier-Stokes equations coupling with Park’s two-temperature model, the fully non-equilibrium solution is employed throughout the entire nozzle. Calculations are performed at different stagnation conditions with the different absolute scales and expansion ratio. The results of this study contain twofold. Firstly, as the absolute scale and expansion ratio increase, the freezing position is delayed, and the flow approaches equilibrium. Secondly, the vibrational temperature and Mach number decrease with the increase in the nozzle scale and expansion ratio，while the speed of sound, static pressure, and translational temperature increase as the nozzle scale and expansion ratio increase.
Residual stress variation in SiCf/SiC composite during heat treatment and its effects on mechanical behavior
Authors: Chen Xiaowu , Cheng Guofeng , Zhang Junmin , Guo Feiyu , Zhou Haijun , Liao Chunjin , Wang Hongda , Zhang Xiangyu , Dong Shaoming
Published: June 2020

Residual stress originated from thermal expansion mismatch determines the mechanical properties of ceramic matrix composites (CMCs). Here, continuous SiC fiber reinforced SiC matrix (SiCf/SiC) composites were fabricated by nano-infiltration and transient eutectic-phase (NITE) method, and the residual stress of the composites was investigated using high-temperature Raman spectrometer. With temperature increasing from room temperature to 1400℃, the residual stresses of the matrix and the fiber decrease from 1.29 GPa to 0.62 GPa and from 0.84 GPa to 0.55 GPa in compression respectively, while that of the interphase decreases from 0.16 GPa to 0.10 GPa in tension. The variation of residual stress shows little effect in the tensile strength of the composites, while causes a slight decrease in the tensile strain. The suppression of fiber/matrix debonding and fiber pulling-out caused by the residual stress reduction in the interphase is responsible for the decreasing tensile strain. This work can open up new alternatives for residual stress analysis in CMCs.
Population structure and geographic segregation of Cryptosporidium parvum IId subtypes in cattle in China
Authors: Zhang Zhenjie , Hu Suhui , Zhao Wentao , Guo Yaqiong , Li Na , Zheng Zezhong , Zhang Longxian , Kvac Martin , Xiao Lihua , Feng Yaoyu
Published: June 2020

Background: Cryptosporidium parvum is a zoonotic pathogen worldwide. Extensive genetic diversity and complex population structures exist in C. parvum in different geographic regions and hosts. Unlike the IIa subtype family, which is responsible for most zoonotic C. parvum infections in industrialized countries, IId is identified as the dominant subtype family in farm animals, rodents, and humans in China. Thus far, the population genetic characteristics of IId subtypes in calves in China are not clear.Methods: In the present study, 46 C. parvum isolates from dairy and beef cattle in six provinces and regions, China were characterized using sequence analysis of eight genetic loci, including msc6-7, rpgr, msc6-5, dz-hrgp, chom3t, hsp70, mucin1, and gp60. They belonged to three IId subtypes in the gp60 gene, including IIdA20G1 (n = 17), IIdA19G1 (n = 24) and IIdA15G1 (n = 5). The data generated were analyzed for population genetic structures of C. parvum using DnaSP and LIAN, and subpopulation structures using STRUCTURE, RAxML, Arlequin, GENALEX and Network.Results: Seventeen multilocus genotypes were identified. The results of linkage disequilibrium analysis indicated the presence of an epidemic genetic structure in the C. parvum IId population. When isolates of various geographical areas were treated as individual subpopulations, maximum likelihood inference of phylogeny, pairwise genetic distance analysis, sub-structure analysis, principal component analysis and network analysis all provided evidence for geographic segregation of subpopulations in Heilongjiang, Hebei, and Xinjiang. In contrast, isolates from Guangdong, Shanghai, and Jiangsu were genetically like each other.Conclusions: Data from the multilocus analysis have revealed a much higher genetic diversity of C. parvum than gp60 sequence analysis. Despite an epidemic population structure, there is apparent geographic segregation in C. parvum subpopulations within China.
Aesthetic evaluation of the labiolingual position of maxillary lateral incisors by orthodontists and laypersons
Authors: Jiang Xue , Cao Zhiwei , Yao Yang , Zhao Zhihe , Liao Wen
Published: June 2020

BackgroundsThe maxillary anterior teeth play a crucial role in smile aesthetics. As for maxillary lateral incisors, most studies concentrated on its size, incisor edge level, inclination, et al. However, the aesthetic effect of lateral incisor movement in spatial position has not been studied yet. Therefore, the purpose of this study was to explore the influence of labiolingual position of maxillary lateral incisors on the aesthetic perception of orthodontists and laypersons and different gender groups.MethodsA photograph of a male's smile was selected. iOrtho7.0 software (Time Angel, Wuxi, China) was used to edit the three dimensional (3D) dental models. By referring to the 3D models, the photograph was digitally processed to create seven images with different labiolingual positions of the maxillary lateral incisors in 0.5 mm increments (+ indicates labial movement and -indicates lingual movement). Eighty-six orthodontists and one hundred sixty-one laypersons were asked to evaluate images using a visual analog scale. Data were analyzed by Student t-test and One-way analysis of variance with post hoc test.ResultsThere was no significant difference between the perception of males and females (P > 0.05). Orthodontists assigned lower scores to all images than laypersons. +1.5 mm was considered as the least attractive smile by orthodontists while + 1.5 mm and − 1.5 mm were regarded as the least attractive ones by laypersons. 0 mm was rated the most attractive by all judges (P < 0.05). Between the 0 mm and − 0.5 mm, laypersons observed the difference but orthodontists did not.ConclusionsThe labiolingual position of maxillary lateral incisors does affect the perception of smile esthetics. Although orthodontists gave lower score to each image than laypersons.
Understanding the Regulatory Mechanisms of Endometrial Cells on Activities of Endometrial Mesenchymal Stem-Like Cells During Menstruation
Authors: Xu Shan , Chan Rachel W.S. , Li Tianqi , Ng Ernest H.Y. , Yeung William S.B.
Published: June 2020

Background: The identification of endometrial stem/progenitor cells in a high turnover rate tissue suggests that a well-orchestrated underlying network controls the behaviour of these stem cells. The thickness of the endometrium can grow from 0.5 – 1 mm to 5 – 7 mm within a week indicating the need of stem cells for self-renewal and differentiation during this period. The cyclical regeneration of the endometrium suggests specific signals can activate the stem cells during or shortly after menstruation. Methods: Endometrial mesenchymal stem-like cells (eMSCs) were cocultured with endometrial epithelial or stromal cells from different phases of the menstrual cycle, the clonogenicity and the phenotypic expression of eMSC markers (CD140b and CD146) were assessed. The functional role of WNT/β-catenin signalling on eMSC was determined by Western blot analysis, immunofluorecent staining, flow cytometry, quantitative real-time PCR and small interfering RNA. The cytokine levels in the conditioned medium of epithelial or stromal cells cocultured with eMSCs was evaluated by enzyme-linked immunosorbent assays. Results: Coculture of endometrial cells (epithelial or stromal) from the menstrual phase enhanced the clonogenicity and self-renewal activities of eMSCs. Such phenomenon was not observed in niche cells from the proliferative phase. Coculture with endometrial cells from the menstrual phase confirmed an increase in expression of active β-catenin in the eMSCs. Treatment with IWP-2, a WNT inhibitor suppressed the observed effects. Anti-R-spondin-1 antibody reduced the stimulatory action of endometrial niche cells on WNT/β-catenin activation in the T-cell factor/lymphoid enhancer-binding factor luciferase reporter assay. Moreover, the mRNA level and protein immunoreactivities of leucine-rich repeat-containing G-protein coupled receptor 5 were higher in eMSCs than unfractionated stromal cells. Conditioned media of endometrial niche cells cocultured with eMSCs contained increased levels of C-X-C motif ligand 1 (CXCL1), CXCL5 and interleukin 6. Treatment with these cytokines increased the clonogenic activity and phenotypic expression of eMSCs. Conclusions: Our findings indicate a role of WNT/β-catenin signalling in regulating activities of endometrial stem/progenitor cells during menstruation. Certain cytokines at menstruation can stimulate the proliferation and self-renewal activities of eMSCs. Understanding the mechanism in the regulation of eMSCs may contribute to treatments of endometrial proliferative disorders such as Asherman’s Syndrome.
Thymosin alpha-1 Protected T Cells from Excessive Activation in Severe COVID-19
Authors: Yu Kuai , Wu Yongjian , He Jingjing , Liu Xuefei , Wei Bo , Wen Wen , Wen Xiaofeng , Xu Wenxiong , Dong Xingjun , Yan Yue , Li Shuo , Liao Shuangye , Gao Chenqi , Zhong Bei , Jiang Yongliang , Li Min , Bian Chaochao , Li Xiang , Li You , Liu Haiping , Chen Xiangqi , Zhao Qingyu , Xia Xiaojun , Liang Juanran , Zou Bin , Lin Bingliang , Xie Baosong , Wei Lai , Zuo Zhixiang , Zhou Haibo , Huang Xi , Zhou Penghui
Published: June 2020

Two typical features of uncontrolled inflammation, cytokine storm and lymphopenia, are associated with the severity of coronavirus disease 2019 (COVID-19), demonstrating that both innate and adaptive immune responses are involved in the development of this disease. Recent studies have explored the contribution of innate immune cells to the pathogenesis of the infection. However, the impact of adaptive immunity on this disease remains unknown. In order to clarify the role of adaptive immune response in COVID-19, we characterized the phenotypes of lymphocytes in PBMCs from patients at different disease stages using single-cell RNA sequencing (scRNA-seq) technology. Dynamics of the effector cell levels in lymphocytes revealed a distinct feature of adaptive immunity in severely affected patients, the coincidence of impaired cellular and enhanced humoral immune responses, suggesting that dysregulated adaptive immune responses advanced severe COVID-19. Excessive activation and exhaustion were observed in CD8 T effector cells, which might contribute to the lymphopenia. Interestingly, expression of Prothymosin alpha (PTMA), the proprotein of Tα1, was significantly increased in a group of CD8 T memory stem cells, but not in excessively activated T cells. We further showed that Tα1 significantly promoted the proliferation of activated T cells in vitro and relieved the lymphopenia in COVID-19 patients. Our data suggest that protection of T cells from excessive activation might be critical for the prevention of severe COVID-19.
Decreased miR- 31 Suppress Cell Migration and Proliferation By Targeting Syncytin-1 in Pancreatic Carcinoma
Authors: Yang Jing , Luo Judong , Wang Feng , Cheng Zhiwen , Han Xia , Liu Changmin , Wang Zhenbo
Published: June 2020

Background: Pancreatic cancer(PC) is seriously harmful to human health, and the pathogenesis is not clear. The present study aimed to explore the functional role of syncytin-1 in PC.Methods: Syncytin-1 and miR-31 expression was analyzed by qRT-PCR and Western blot analysis in both human PC cell lines and tissuse. The prognostic significance of syncytin-1 was investigated using the immunohistochemistry(IHC) and Kaplan-Meier survival. The CCK-8 assay and transwell assays were used to determine the role of syncytin-1 and miR-31 in cell proliferation, migration and invasion. Luciferase reporter assays was used to identify possible miRNA targets in tumorigenesis.Results: The results showed that the syncytin-1 level was significantly decreased in PC cell lines and tissues than normal(P < 0.05), while miR-31 was markedly higher than normal(P < 0.05), and low expression of syncytin-1 have a poor prognosis than high expression(P < 0.05). Overexpression of syncytin-1 significantly reduced the PC cell proliferation and invasion ability in PANC-1 and BxPC-3 cells(P < 0.05), and miR-31showed contrary results. The Dual-Luciferase reporter gene assay demonstrated that miR-31 binded directly to 3’UTR of syncytin-1 and resulting in the inhibition of syncytin-1. The overexpression of miR-31 promoted migration and proliferation of PC cells through down-regulating the expression of syncytin-1.Conclusion: We verified that syncytin-1 can inhibit proliferation and invasion of PC cell lines by targeting miR-31.
Oral health status of Lisu 12-year-old children in the Yunnan province of China: a cross-sectional study
Authors: Chen Kitty Jieyi , Li Yuexiao , Xu Biao , Liu Juan , Li Yanhong , Zhang Shinan , Chu Chun Hung
Published: June 2020

Background
Lisu is an ethnic minority group living in Yunnan, a province in Southwest China. This study investigated the oral health status among 12-year-old Lisu children in Yunnan.
Method:
A multistage sampling method was adopted to recruit 12-year-old Lisu children from primary schools. A self-administrated questionnaire was distributed to the children to collect their sociodemographic background information and oral health-related behaviours. Two calibrated dentists performed the oral examinations in the primary schools. They examined dental caries, gingivitis and dental fluorosis using the diagnosis criteria recommended by the World Health Organization. A Chi-square test, the Mann-Whitney U test, zero-inflated negative binomial (ZINB) regression and multivariate logistic regression were used for statistical analysis.
Results
A total of 512 Lisu children were invited, and 482 children (48% boys) participated in the study (response rate: 94%). The caries prevalence was 35% and caries experience in mean (SD) DMFT scores was 0.63 (0.10). The mean (SD) DT score was 0.60 (1.10), consisting 95% of the mean DMFT scores. Gingivitis was found on 426 children (88%), while no dental fluorosis was observed. Results of ZINB model indicated sex and sugary-snacking habits were related to the dental caries experience (p < 0.05). The prevalence rate of gingivitis was associated with the mother’s education level, the child’s monthly-pocket money and daily toothbrushing frequency (p < 0.05).
Conclusion
Dental caries and gingivitis were prevalent among 12-year-old Lisu children in the Yunnan province in China, and most of the decayed teeth were unrestored. Dental fluorosis was not observed in the children.
Analysis of clinical characteristics, nucleic acid detection and prognosis of 72 cases of common type Corona Virus Disease 2019(COVID-19) pneumonia in Hubei Province,China
Authors: Liao Jiangrong , Lou Yueyan , Lu Shuoyan , Xian Xueyun , Wu Xiulin , Zhao Daiwei , Luo Zhuwen , Wu Xueling
Published: June 2020

Background: To describe the clinical characteristics and the time of nucleic acid turning negative in patients with common type Corona Virus Disease 2019(COVID-19) pneumonia and analyze the treatment time and prognostic factors.Methods: It’s a retrospective analysis of 72 cases of common type COVID-19 pneumonia diagnosed by nucleic acid test and Computed tomography (CT).Results: The average time of nucleic acid test turning negative is 17.37±9.29 days, and the average treatment time was 23.74±8.06 days. There was no influence of Blood leukocyte count, Neutrophil count, lymphocyte count, C-reactive protein (CRP), glutamic-pyruvic transaminase (ALT), glutamic oxalacetic transaminase (AST), creatinine, D-dimer on the prognosis of the patients, whether univariate or multivariate logistic regression analysis. By χ2 test of the drugs and prognosis, we found that oseltamivir may have an impact on the prognosis of patients (P<0.05), while other drugs have no significant impact on the prognosis of patients. Through the correlation analysis, we found that age, the admission temperature, leukocyte count, neutrophil count, CRP were positively correlated with the treatment time of the patients (both P<0.05). Leukocyte count and neutrophil count were positively correlated with the time of nucleic acid test turning negative (both P<0.05).Conclusions: Age, the admission temperature, leukocyte count, neutrophil count, CRP were positively correlated with the treatment time of the patients. Leukocyte count and neutrophil count were positively correlated with the time of nucleic acid test turning negative. Oseltamivir may have an impact on the prognosis of patients, but the detailed role needs further study.
Mucosal healing is not associated with better outcome during seven years of follow-up in pediatric patients with Crohn's disease
Authors: Melek Jan , Štanclová Markéta , Dědek Petr , Štichhauer Radek , Koudelka Jaroslav , Douda Tomáš , Tachecí Ilja , Douda Ladislav , Vaňásek Tomáš , Pozler Oldřich , Bureš Jan
Published: June 2020

Background
Mucosal healing (MH) has become a perspective treatment target in patients with Crohn’s disease (CD). Data about the impact of MH on long-term outcome in pediatric patients are still scarce.
Methods
76 pediatric patients with CD were evaluated retrospectively (2000–2015) in a tertiary care center. Based on MH achievement, they were divided into two groups (MH, n = 17 and No MH, n = 59). The primary endpoint was to assess the association of MH and the need for CD-related hospitalizations or surgery in pediatric patients with CD.
Results
The number of hospitalized patients was 24% in the MH group and 42% in the No MH group, P = 0.26. The total number of CD-related hospitalizations was not significant between the MH group and the No MH group (5 vs. 41, P = 0.15). The time to the first hospitalization was 24 months in MH and 21 months in No MH, p > 0.99. 24% patients in the MH group and 39% patients in the No MH group underwent CD-related operation, P = 0.39. Time to the first operation was 43 months for MH and 19 months for the No MH group, P = 0.13. The follow-up period was 91 months in the MH group and 80 months in the No MH group, P = 0.74. The use of infliximab was positively associated with MH, P = 0.002.
Conclusions
MH was not associated with fewer CD-related hospitalizations or operations in pediatric patients with CD during seven years of follow-up.
Changes of serum zinc-α2-glycoprotein level and analysis of its related factors in gestational diabetes mellitus:a cross-sectional study
Authors: Feng Caiying , You Jie , Chen Guixia , Su Hongli , Zhang Li , Cui Lingling , Li Zhonglei , Huang Guoling , Xu Dongmei
Published: June 2020

Background

Previous studies have discovered that zinc-α2-glycoprotein is related to insulin resistance and lipid metabolism. The aim of the study is to explore the change of serum zinc-α2-glycoprotein(ZAG) and its related factors in gestational diabetes mellitus(GDM).
Methods

Eighty newly diagnosed GDM patients were enrolled in study group, and 80 normal pregnant women were selected as control group. The differences of baseline data between the two groups were compared, and the change of serum ZAG level and its relationship with related indexes was analyzed.
Results

Compared to control group, the level of serum ZAG in the study group decreased [(43.94 ± 14.51)mg/L vs. (62.57 ± 19.05)mg/L, P < 0.001]. Pearson correlation (or Spearman correlation) analysis showed that serum ZAG level was negatively correlated with FPG, FINS, HOMA-IR and TG (P < 0.05) and positively correlated with HDL(P < 0.05). Multiple linear regression showed that HDL, FINS, HOMA-IR were independent factors of serum ZAG(P < 0.001).
Conclusion

The level of serum ZAG in patients with gestational diabetes mellitus decreased, and HDL, FINS and HOMA-IR are the influencing factors in study group.
Trial registration:

The study registered in the Chinese Clinical Trial Registry(Chi CTR2000028811).
Analysis of combined indicators for risk of osteoporotic hip fractures in elderly women
Authors: Zhao Jinhui , Shi Huipeng , Jiang Dajun , Wang Lingtian , Chen Shengbao , Jia Weitao
Published: June 2020

Background
Hip fractures in the elderly population has become a global issue due to its high morbidity and mortality. Although an increasing number of researchers are devoting attention to identify risk factors in attempts to reduce the incidence of hip fractures in the elderly, only few studies have investigated combined indicators in elderly hip fractures. The objective of the present study was to compare the accuracy of combined independent risk factors in assessing the risk of hip fractures in elderly women.
Methods
Ninety elderly females who sustained hip fractures and 110 female outpatients who fulfilled the inclusion criteria were included in our cross-sectional study. Bone mineral density (BMD), Beta-carboxy terminal telopeptide(β-CTX), N-terminal/mid region (N-MID), and 25(OH)D levels were analyzed. A novel evaluation model was established to evaluate combined indicators in assessing hip fractures in elderly women.
Results
Compared with the control group, taller height, higher levels of β-CTX, and lower levels of total hip BMD, femoral neck BMD, and 25(OH)D were found in the facture group. After adjustment for confounding factors, logistic regression analysis revealed that 25(OH)D, femoral neck BMD and height remained risk factors for hip fractures in elderly women. Then a model including independent risk factors was established. DeLong test showed the area under the ROC(AUC) of 25(OH)D was significantly greater than that for femoral neck BMD (p < 0.01) and height (p < 0.01). AUC of model including 25(OH)D and height was significantly greater than that of other combinations (p < 0.01).
Conclusion
25(OH)D, femoral neck BMD and height were associated with the occurrence of hip fractures in elderly women even after adjustment for confounding factors, and model including 25(OH)D and height could provide better associated power than other combinations in the assessment of elderly hip fractures. β-CTX and N-MID were not independent risk factors for hip fractures in elderly women.
Finite element analysis of a new internal fixation implant for Pauwels type III femoral neck fractures
Authors: Fan Zhirong , Su Haitao , Lin Zhou , Huang Huida , Zhou Junde , Peng Jiajie , Hong Weiwu , Jiang Tao , Liu Zitao
Published: June 2020

Background

The optimal treatment strategy for Pauwels type III femoral neck fractures remains controversial. A new internal fixation femoral neck system (FNS) for the treatment of femoral neck fractures was developed, and we compared the mechanical efficiency of the internal fixation FNS with that of two cannulated screw configurations for the treatment of Pauwels type III femoral neck fractures.
Method:

In this study, we constructed models of Pauwels type III femoral neck fractures with angles of 50°, 60°, and 70°. Moreover, a fixation model with the FNS and two fixation models with cannulated screws were developed. Under two axial loads, 1400 N and 2100 N, the von Mises stress distributions, maximum von Mises stress, and displacements of the femur and internal fixation components were measured for each fracture group.
Result

The maximum von Mises stress of internal fixation in the three models was mostly located near the fracture line, and the femoral head region closest to the femoral calcar experienced the maximum amount of stress. As the Pauwels angle and axial loads increased, the stress and displacement of the proximal femoral head and internal fixation component increased in each group. Compared with cannulated screw configurations, the internal fixation FNS showed lower values of peak stress at the femoral head and smaller displacements of the femur and internal implant in the treatment of Pauwels type III femoral neck fractures with Pauwels angles of 50°, 60°, and 70°.
Conclusion

The newly developed internal fixation FNS provided improved biomechanical stability for the treatment of Pauwels type III femoral neck fractures, which indicated that the internal fixation FNS may be a new option for the treatment of vertical femoral neck fractures.
Perioperative Evolution of Sodium Levels in Cirrhotic Patients Undergoing Liver Transplantation: An Observational, Prospective Study
Authors: zamberg ido , Maillard Julien , Tomala Simon , Assouline Benjamin , Keli-Barcelos Gleicy , Aldenkortt Florence , Mavrakanas Thomas , Andres Axel , Schiffer Eduardo
Published: June 2020

Background & Aims: Hyponatremia is an important predictor of early death among cirrhotic patients in the orthotopic liver transplantation (OLT) waiting list. Evidence exists that prioritizing OLT waiting list according to the MELD score combined with plasma sodium concentration might prevent pretransplantation death. However, the evolution of plasma sodium concentrations during the perioperative period of OLT is not well known. We aimed to describe the evolution of perioperative sodium concentration during OLT and its relation to perioperative neurohormonal responses.Methods: Twenty-seven consecutive cirrhotic patients who underwent OLT were prospectively included in the study over a period of 27 months. We studied the evolution of plasma sodium levels, the hemodynamics, the neurohormonal response and other biological markers during the perioperative period of OLT.Results: All patients with a hyponatremia before OLT were in the Child C group. None of the patients had acute or chronic renal impairment. Interestingly, in patients with hyponatremia, plasmatic sodium reached normal levels as soon as the injured livers were removed during surgery and the plasma sodium concentration remained within normal ranges 1 day, 7 days, as well as 6 months after surgery.Conclusions: Further investigation of rapid correction and stabilization of sodium levels after OLT, as observed in our study, would be of interest in order to fully understand the mecanisms involved in cirrhosis related hyponatremia, its prognostic value and clinical implications.
Impact of Body Mass Index on the Mortality of Critically Ill Patients Admitted to the Intensive Care Unit: An Observational Study
Authors: Mahmoodpoor Ata , Karrubi Fahimeh , Hosseini Mohammad-Salar , Iranpour Afshin , Sanaie Sarvin
Published: June 2020

Background: Obesity, a wide-ranging disorder all around the world, is associated with significant morbidity and mortality in the general population. Regarding the present controversies, this study aims to evaluate the possible association of body mass index (BMI) and mortality in patients admitted to intensive care units.Methods: During this cross-sectional study, all patients admitted to the intensive care unit of two university affiliated hospitals in northwest of Iran from November 2017 to March 2019 were enrolled. The demographic characteristics of patients, length of stay in the intensive care unit and hospital, organ failure, mortality, duration of mechanical ventilation and vasopressor-therapy, type of nutrition, the occurrence of nosocomial infection, type of admission (medical, surgical, trauma) were recorded for all patients. According to the WHO classification of BMI, patients were divided into the six groups, and the data were analyzed accordingly.Results: Of the 502 patients studied, 267 were male (53.2%) and 235 were female (46.8%). The highest mortality rate was observed among the obesity class II patients (35 < BMI < 40) with 28.6%, while the lowest rate was observed in the normal-weight patients (18.5 < BMI < 25) with 3.9%. The highest length of hospital stay was seen in patients with BMI > 30 with 12 days of hospitalizations. APACHE II and waist circumference had a statistically significant relationship with the mortality rate of patients (P-value < 0.001).Conclusion: The current study showed that BMI could be related to mortality, regardless of waist circumference and APACHE II score. However, considering waist circumference and APACHE II score as confounding factors, BMI does not have a significant effect on mortality and only affect the morbidity of patients.
Prognostic implications of CDC45 expression in hepatocellular carcinoma
Authors: Yang Chen , Xie Shufang , Wu Yi , Ru Guoqing , He Xianglei , Pan Hongyin , Wang Shibing , Tong Xiangmin
Published: June 2020

Background

The outcomes of hepatocellular carcinoma (HCC) remain poor despite dramatic improvements in treatment, and novel prognostic biomarkers are urgently needed to ameliorate the situation. Cell division cycle protein 45 (CDC45) plays a key role in DNA replication, which is considered to be involved in tumorigenesis and has become a new prognostic marker. This study investigated CDC45 expression in tumour tissues and defined its prognostic value in HCC patients.
Methods

Differential transcriptional and proteomic expression profiles were obtained and validated using multiple datasets. We then used immunohistochemistry (IHC) staining to examine the expression of CDC45 in tumour tissue specimens and compare them with adjacent normal tissue specimens using a constructed tissue microarray (TMA) and analysed the relationship of clinical features and prognosis in HCC patients. Functional enrichment analyses were used to describe significantly involved hallmark pathways of differentially expressed genes (DEGs).
Results

Contrary to the transcriptome expression level in the database, our results showed that the proteome expression of CDC45 in was evidently downregulated in HCC compared with normal adjacent tissues (P < 0.0001). Although we did not find any differences in terms of vascular invasion, Edmondson grade, lymphatic infiltration, or metastasis between patients with high and low CDC45 expression in our limited number of HCC samples, low expression of CDC45 was significantly correlated with aggressive characteristics, including microvascular invasion (P = 0.046). In addition, a multivariate analysis indicated that CDC45 expression (P = 0.035) was an independent prognostic factor for the overall survival (OS) rate of patients with HCC. Furthermore, patients with low CDC45 expression levels were significantly correlated with inferior OS rates than patients with high CDC45 expression levels (P < 0.05). Functional annotations indicated that CDC45 is involved in the most significant pathways, including the cell cycle, DNA replication, drug metabolism − cytochrome P450, metabolism of xenobiotics by cytochrome P450, and chemical carcinogenesis pathways.
Conclusions

Our findings showed that a low protein level of CDC45 was associated with a poor prognosis in HCC patients, indicating that CDC45 might be a novel prognostic marker and help identify new therapeutic targets for HCC.
WITHDRAWN: Positron Emission Tomographic imaging of tumor cell death using Zirconium-89-labeled APOMAB® Following Cisplatin Chemotherapy in Lung and Ovarian Cancer Xenograft Models
Authors: Liapis Vasilios , Tieu William , Wittwer Nicole , Gargett Tessa , Evdokiou Andreas , Takhar Prab , Rudd Stacey E. , Donnelly Paul S. , Brown Michael P. , Staudacher Alexander H.
Published: June 2020

Purpose. There are no currently approved non-invasive methods for detecting tumor treatment responses within the first few days of treatment. The monoclonal antibody, DAB4, or its chimeric derivative, chDAB4 (APOMAB®), targets the Lupus-associated or Sjögren Syndrome-B antigen (La/SSB). La/SSB is over-expressed in malignancy and is selectively targeted by chDAB4 in cancer cells dying after DNA-damaging treatment. Therefore, chDAB4 is a unique diagnostic tool that specifically detects dead cancer cells and could be used to distinguish between chemotherapy responsive and non-responsive patients. In this study, we performed preclinical validation studies using whole-body Positron-Emission Tomography (PET) to examine tumor and normal tissue uptake of 89Zr-labeled chDAB4 in lung or ovarian tumor-bearing mice, which were left untreated or given cisplatin chemotherapy.Methods. The binding of chDAB4 and its conjugates to dead cisplatin-treated human lung and ovarian cancer cells was assessed in vitro as well as its Fc-dependent effector functions. Mice bearing xenografts of H460 lung cancer or A2780 ovarian cancer cells were untreated or given cisplatin chemotherapy followed 24 hours later by 89Zr-labeled chDAB4. Post-cisplatin tumor responses were monitored using bioluminescence imaging and caliper measurements and 89Zr-labeled chDAB4 tumor uptake was measured using an Albira SI PET imager and PMOD analysis software. On completion of experiments, organs were dissected and biodistribution of 89Zr-labeled chDAB4 was measured using a Hidex gamma-counter.Results. The chDAB4 antibody bound only to dead A2780 and H460 cells, and its binding increased with cisplatin treatment in vitro. The chDAB4 antibody did not exhibit Fc-dependent effector functions. Chemotherapy significantly increased uptake of 89Zr-labeled chDAB4 in tumors but not in normal tissues for each tumor model. The greatest differences in average uptake of 89Zr-labeled chDAB4 in subcutaneous tumors were observed 3 days post-cisplatin chemotherapy compared to untreated mice, and before tumor shrinkage was evident.Conclusion. After administration of cisplatin chemotherapy, tumor xenograft uptake of 89Zr-labeled chDAB4 was detected in vivo by PET imaging. Given that the chDAB4 mAb lacked effector activity and that malignant rather than normal tissues were targeted after chemotherapy, these results support clinical development of chDAB4 as both a predictive marker of chemotherapy response and a theranostic imaging agent, which may guide subsequent delivery of chDAB4-directed antibody drug or radio-conjugate anticancer therapies.
Outpatient vs. Inpatient Hip Arthroplasty: A Matched Case-Control Study on 90-Day Complication Rate and 2-Year Patient Reported Outcomes
Authors: Rosinsky Philip J. , Chen Sarah L. , Yelton Mitchell J. , Lall Ajay C. , Maldonado David R. , Shapira Jacob , Meghpara Mitchell B , Domb Benjamin G
Published: June 2020

Background
The transition to outpatient-based surgery is a major development occurring in recent years in the field of total hip arthroplasty (THA). The effect of this transition on patient reported outcomes (PROs) is still not well established. The purpose of the current study was to compare patients undergoing inpatient THA (iTHA) to patients undergoing outpatient THA (oTHA) regarding (1) perioperative variables including: surgical time, blood loss, and length of stay (2) 90-day complication rates and unplanned emergency room or office visits (3) 2-year PROs including: modified Harris hip score (mHHS), Harris hip score (HHS), forgotten joint score (FJS), pain, and satisfaction, as well as quality of live measures.
Methods
The XXX registry was analyzed for patients undergoing THA between July 2014 and April 2016. The first 100 patients undergoing oTHA were selected and matched to 100 patients undergoing iTHA via propensity matching based on the following variables: age, sex, body mass index (BMI), Charlson comorbidity index (CCI), and smoking status. The primary outcomes were PROs at two years post-operatively. The secondary outcomes were perioperative surgical variables, 90-day complication rates, and unplanned emergency and clinic visits.
Results
After exclusions, 91 patients remained in each group and were compared. The oTHA group showed improved 2-year PROs with regard to mHHS (91.5 vs. 86.2; P = 0.02), HHS (92.3 vs. 87.4; P = 0.02), and pain (1.0 vs. 1.5; P = 0.04). The oTHA group had an average length of stay of 6.8 hours compared to 43.2 hours for the iTHA group (P < 0.001). There were no significant differences between the groups regarding readmissions, emergency room visits, and unplanned clinic visits. Complications and revision rates were similar in both groups.
Conclusion
In appropriately selected patients, oTHA can achieve improved postoperative 2-year PROs compared to iTHA. We found no differences regarding postoperative short-term complications or two-year revision rates, and no differences in unplanned office visits or readmissions.
Correlation between percutaneous transthoracic needle biopsy and recurrence in stage I lung cancer: a systematic review and meta-analysis
Authors: Li Haichao , Chen Rong , Zhao Jian
Published: June 2020

Objective To systematically evaluate the correlation between percutaneous transthoracic needle biopsy (PTNB) and recurrence in stage I lung cancer. Methods The databases of PubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and China Biology Medicine disc were retrieved to collect relevant literatures about the correlation between percutaneous transthoracic needle biopsy(PTNB) and recurrence in stage I lung cancer. The retrieval time was limited from the time of their database establishment to April 30/2020.Screened the literature, extracted the data and assessed the quality of studies included. Then the meta-analysis was performed by using Stata l6.0 software. Results A total of 8 cohort studies involving 2760 lung cancer patients were included. The results of meta-analysis showed that PTNB did not increase the risk of total recurrence and pleural recurrence in the patients with stage I lung cancer.The result of subgroup analysis is according to the tumor location. For stage I lung cancer, PTNB will increase the risk of pleural recurrence in patients with sub-pleural lesions but not in those without sub-pleural lesions. Conclusion To stage I lung cancer, PTNB is not associated with the total recurrence and pleural recurrence but PTNB will increase the risk of pleural recurrence in patients with sub-pleural lesions.
Case Report of Diaphragmatic Hernia with Small Hernia Sac Orifice
Authors: Wang Yun-jin , Chen Liu , Zhou Chao-ming , zhang zhengmian
Published: June 2020

Background：Congenital diaphragmatic hernia(CDH) is an embryonic stage in which the abdominal organs enter the thoracic cavity under the action of pressure difference between the thoracic and abdominal cavity, resulting in pulmonary hypoplasia due to the dysplasia of the diaphragm and the failure to heal the posterolateral pleura and peritoneum during the development of the diaphragm.Case presentation: A 7-month-old girl was admitted to hospital with the chief complaint of repeated vomiting for 1 day. Diagnosis was established by chest and abdominal radiographs and computerized tomography(CT). During the operation, it was found that there were many contents of intrathoracic hernia, and the hernia sac orifice was small. It was difficult to return them by thoracoscopy,then they were transferred to laparoscopic-assisted content return of diaphragmatic hernia.The patient had a good postoperative result.Conclusion: This is a very rare case of Congenital diaphragmatic hernia with small hernia sac orifice, and it emphasizes the significance of preoperative computerized tomography.
Improvement of Thick Coal Seam Gas Drainage Efficiency Using Highly Pressurized Multi-Discharge CO2 Gas Fracturing Technique
Authors: Lu Tingkan , Kaijage Dickson , Li Dongyin , Yang Xuelin
Published: June 2020

Thick coal seam fracture stimulations were carried out to improve pre gas drainage efficiency using the highly pressurized multi-discharge carbon dioxide gas fracturing technique. The paper presents research results obtained from field work and numerical simulation. The field data demonstrates that the multi-discharge fracturing technique can effectively enhance thick coal seam permeability, so as to improve thick coal seam gas drainage efficiency. On the other hand, regardless of numbers of discharge set used, the effective gas drainage radius remains unchanged, which is inconsistent with the traditional coal seam fracture stimulation, so the causes are discussed in detail. Numerical simulation indicates that the technique provides two basic functions in improving efficiency of coal seam gas drainage: 1) improving coal seam permeability and 2) forming gas pressure gradient of coal seam. The former creates fracture network of coal seam, and the latter, as a driving force, drives coal seam gas from a fracturing borehole to the drainage boreholes through the network developed.
Primary or interval debulking surgery for stage IV ovarian cancer patients: experience from a ten-year case series
Authors: Deng Qiuling , Feng Zheng , Wen Hao , Ju Xingzhu , Chen Xiaojun , Bi Rui , Wu Xiaohua
Published: June 2020

Background

Whether patients with stage IV ovarian cancer can benefit from neoadjuvant chemotherapy (NACT) is unclear. The main aim was to compare the survival outcomes of primary debulking surgery (PDS) versus NACT followed by interval debulking surgery (IDS) in stage IV ovarian cancer patients.
Methods

This study retrospectively analyzed 190 consecutive patients with stage IV ovarian cancer who underwent either PDS or NACT + IDS between June 2003 and June 2013 at Fudan University Shanghai Cancer Center. Progression free survival (PFS) and overall survival (OS) were analyzed with Kaplan-Meier method. Multivariable cox proportional hazard models tested for associations of potential explanatory variables with survival.
Results

A total of 111 patients underwent PDS and 79 patients received NACT + IDS. More NACT patients had stage IVB disease compared with PDS patients (p = 0.001). Additionally, a higher rate of complete resection (45.6% vs 21.6%, p < 0.001) was achieved in NACT patients compared to those with PDS. There was no significant difference of platinum sensitivity between the two groups (p = 0.998). The median PFS for PDS and NACT groups were 14 (95%CI, 12–16) and 16 (95%CI, 13–17) months, respectively (p = 0.744). The median OS were 40 (95%CI, 31–49) and 53(95% CI, 41–65) months for PDS and NACT groups, respectively (p = 0.094). In addition, NACT was more beneficial than PDS in patients with extra-abdominal lymph node metastases (median OS (95%CI) = 37 (24–50) vs 60 (41–79) months, p = 0.006).
Conclusions

There were no significant survival differences between PDS and NACT groups for stage IV ovarian cancer patients. However, NACT had survival benefit in patients with extra-abdominal lymph node metastases.
Clinical Investigations External Validation of Multimodal Termination of Resuscitation Rules for Out-of-hospital Cardiac Arrest Patients in the Covid-19 Era
Authors: Jung Haewon , Lee Mijin , Cho Jae Wan , Lee Sang Hun , Lee Suk Hee , Mun You Ho , Chung Han-sol , Kim Yang Hun , Kim Gyun Moo , Park Sin-youl , Jeon Jae Cheon , Kim Changho
Published: June 2020

Background:Futile resuscitation for out-of-hospital cardiac arrest (OHCA) patients in the COVID-19 era can lead to risk of disease transmission and unnecessary transport. Various existing basic or advanced life support (BLS or ALS) rules for termination of resuscitation (TOR)have been derived and validated in North America and Asian countries. This study aimed to evaluate the external validation of these rules in predicting the survival outcomes of OHCA patients in the COVID-19 era.Methods: A multicenter observational study was performed using the WinCOVID-19 Daegu registry data collected from 18 February to 31March 2020. The outcomes of each rule were compared to the actual patient survival outcomes. The sensitivity, specificity, false positive ratio (FPR), and positive predictive value (PPV) of each TOR rule were evaluated. Results: Of the 184 OHCA patients, 170 patients,who showed cardiac arrest of presumed cardiac etiology, were enrolled. TOR was recommended for 122 patientsbased on the international BLS-TOR rule, which showed 85% specificity, 74% sensitivity, 0.8% FPR, and 99% PPV for predicting unfavorable survival outcomes. When the traditional BLS-TOR rules and KoCARC TOR rule II were applied to our registry, one patient met the TOR criteria but survived at hospital discharge. With regard to the FPR (upper limit of 95% confidence interval<5%) and PPV (>99%) criteria, only the KoCARCTOR rule I, which included a combination ofthree factors including not being witnessed by emergency medical technicians, presenting with an asystole at the scene, and not experiencing prehospital shock delivery or ROSC, was found to be superiorto all other TOR rules. Conclusion: Among the previous nine BLS and ALS TOR rules, KoCARCTOR rule I was most suitable for predicting poor survival outcomes and showed improved diagnostic performance. Further research on variations in resources and treatment protocols among facilities, regions, and cultures will be useful in determining the feasibility of TOR rules for COVID-19 patients worldwide.Trial registration: Not applicable