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In this paper, the growth of finger-like droplets inside various polymer membrane embryos induced by non-solvent phase separation (NIPS) is studied in details by using a standardized optical microscopic observation method. The boundary conditions of the phase separation are well-defined by microfluidics technology. The growth of finger-like droplets and Marangoni convection inside them are tracked and recorded by high-speed camera of sharp resolutions. Effects of the geometry of the membrane embryos (thickness/shape/size), humidity of the atmosphere and the viscosity of the embryos on the growth of finger-like droplets are systematically studied. Except the qualitative observations that are consistent to previous relative reports, more quantitative data are provided in this paper. The diffusing speed of the interface of the developing large droplets is measured by template matching algorithm. Strikingly, the time-dependent diffusing speed of the developing large droplets shows a wave-like declining pattern, which indicates that fluctuating boundary conditions are surrounding the membrane embryos. The Reynolds number of the flow inside the developing large droplets is estimated at the order of 10−5, the magnitude of which is 2 order smaller than that of a swimming sperm. [Display omitted] • The traditional optical direct observation method is improved to study the growth of finger-like droplets. • Both quantitatively and qualitative data are provided to illustrate the growth dynamics of finger-like droplets. • Macro-flows (Marangoni convection) inside the developing large droplets are clearly observed and analyzed. [ABSTRACT FROM AUTHOR]

Objective: To evaluate whether excised parenchymal mass (EPM) during partial nephrectomy (PN) correlates with functional decline and can serve as a surrogate for functional outcomes.Materials and Methods: All 215 patients managed with PN for unifocal renal mass with necessary studies to determine EPM and percent glomerular filtration rate (GFR) and parenchymal mass preserved (both global and specific to the operated kidney) were analyzed. EPM was estimated from the pathologic specimen by subtracting the tumor mass from the specimen mass, with both calculated using the elliptical formula. Vascularized parenchymal mass preserved was measured from computed tomography scans obtained <2 months prior and 3-12 months after surgery. All functional analyses were required to be within the same time frames, and patients with a contralateral kidney were also required to have nuclear renal scans.Results: The median tumor size was 3.5 cm and the median R.E.N.A.L. was 7. Warm and cold ischemia were utilized in 123 and 92 patients, respectively (median ischemia time = 23 minutes). The median global GFR preserved was 89%, the median total parenchymal mass preserved was 93%, and the median estimated EPM was 16 cm3. Whereas percent parenchymal mass preserved correlated strongly with global and ipsilateral GFR preserved (both P < .001), EPM failed to correlate with functional outcomes on both univariable and multivariable analyses.Conclusion: Our data suggest that parenchymal mass preserved with standard PN by experienced surgeons associates strongly with function preserved, whereas EPM fails to correlate with functional outcomes. Further study of the functional impact of EPM in other circumstances will be required, such as enucleation or PN performed by less-experienced surgeons. [ABSTRACT FROM AUTHOR]

• A liver tumor segmentation network based on contextual information and parallel attention. • A novel hybrid dilated convolution and double dilated convolution for enlarging the receptive field of the network. • Contextual multi-scale attention block and dilated convolution block greatly contribute to segmentation performance. • The effectiveness of the proposed network is validated on two public datasets and one clinical dataset. Liver cancer is one of the leading causes of cancer death. Accurate and automatic liver tumor segmentation methods are urgent needs in clinical practice. Currently, Fully Convolutional Network and U-Net framework have achieved good results in medical image segmentation tasks, but there is still room for improvement. The traditional U-Net extracted a large number of low-level features, and the detailed features cannot be transmitted to deeper layers, resulting in poor segmentation ability. Therefore, this paper proposed a novel liver tumor segmentation network with contextual parallel attention and dilated convolution, called CPAD-Net. The proposed network applies a subsampled module, which has the same dimensionality reduction function as max-pooling without losing detailed features. CPAD-Net employs a contextual parallel attention module at skip connection. The module fuses contextual multi-scale features and extracts channel-spatial features in parallel. These features are concatenated with deep features to narrow the semantic gap and increase detailed information. Hybrid dilated convolution and double-dilated convolution are used in the encoding and decoding stages to expand the network receptive field. Dropout is added after each hybrid dilated convolution block to prevent overfitting. The efficacy of the proposed network is proved by widespread experimentation on two public datasets (LiTS2017 and 3Dircadb-01) and a clinical dataset from the Affiliated Hospital of Hebei University. The proposed network achieved Dice scores of 74.2%, 73.7% and 73.26%. The experimental results show that the proposed network outperforms most segmentation networks. [ABSTRACT FROM AUTHOR]

Background Acute ischemic injury in the operated kidney after partial nephrectomy (PN) is often masked by a functional contralateral kidney; however, there is no practical method to assess this and its prognostic significance has not been defined. Objective We propose a spectrum score to reflect the degree of ischemic insult in the ipsilateral kidney and study its relationship to subsequent functional recovery. Design, setting, and participants From 2007 to 2014, 243 patients with a functional contralateral kidney underwent PN with necessary studies for detailed analysis of function and parenchymal mass before and after surgery in the ipsilateral kidney. Based on split function and percent parenchymal mass preserved in the ipsilateral kidney, we determined: serum creatinine (SCr) ideal-peak : expected peak SCr presuming no ischemic injury; and SCr worstcase-peak : expected peak SCr presuming temporary complete nonfunction of the ipsilateral kidney. The acute ipsilateral renal dysfunction spectrum score was defined: (observed peak SCr – SCr ideal-peak )/(SCr worstcase-peak – SCr ideal-peak ). Subsequent functional recovery was defined: (percent function preserved)/(percent mass saved). Intervention PN. Outcome measurements and statistical analysis Factors associated with spectrum score and relationship between spectrum score and subsequent functional recovery were evaluated by linear regression. Results and limitations Median duration of warm ischemia ( n = 152) was 21 min (interquartile range [IQR] = 15–27) and hypothermia ( n = 91) 26 min (IQR = 23–30). Median parenchymal mass preservation was 83% (IQR = 74–91%). Warm ischemia and longer ischemia duration associated with higher spectrum score (both p < 0.05). Increased spectrum score (<25%, 25–50%, 50–75%, and >75% quartiles) had decreased functional recovery (98%, 94%, 90%, and 89%, respectively, p < 0.001). However, this trend was not observed in the hypothermia cohort. On multivariable analysis spectrum score and ischemia type significantly associated with functional recovery (both p < 0.01), while age and comorbidities failed to associate ( p = 0.3–0.7). Conclusions Acute ipsilateral renal dysfunction spectrum score unmasks the degree of ischemic insult in the operated kidney after PN and associates with functional recovery. While increased spectrum score associates with suboptimal recovery, even patients with a high spectrum score reached 89–90% recovery. Patient summary Acute functional decline after partial nephrectomy is difficult to evaluate in patients with two kidneys, but a proposed spectrum score can be used to evaluate this. Increased spectrum score reflects increased ischemia and may impact the functional recovery of the kidney. [ABSTRACT FROM AUTHOR]

Objective: To evaluate whether surgeons can predict the percent parenchymal mass that will be preserved by partial nephrectomy (PN) based on preoperative imaging, which could have potential utility for preoperative surgical planning and patient counseling. The proportion of preserved viable parenchyma following PN is the primary determinant of functional recovery. However, direct measurement of parenchymal volume preservation (VP) can be complex and time consuming.Materials and Methods: For patients managed with PN at our institution (2007-2014), we randomly selected 45 with a third in each of low, intermediate, or high R.E.N.A.L. complexity groups. All patients had recorded postoperative surgeon assessment of volume preservation (SAVP) and measured VP based on preoperative or postoperative computed tomography. Nine clinical providers predicted VP based solely on review of preoperative imaging while blinded to SAVP and measured VP. Clinical experience of the providers ranged from medical students to experienced urologic surgeons.Results: Median age was 66 years, median tumor size was 4.0 cm, and median R.E.N.A.L. was 8. Median measured VP was 81% (interquartile range of 74-89%). Preoperative prediction of VP correlated poorly with measured VP among the different surgeons (mean correlation coefficient, R = 0.34, range = 0.24-0.40). Surgeon experience provided minimal incremental improvement. Correlation between R.E.N.A.L. and measured VP was also marginal (R = 0.43). In contrast, correlation between postoperative SAVP and measured VP was much more robust (R = 0.75, P <.001).Conclusion: Preoperative prediction of VP and R.E.N.A.L. score correlated poorly with measured VP for patients managed with PN. In contrast, postoperative SAVP provided a relatively reliable estimate of VP, and should be considered an acceptable substitute in most clinical circumstances. [ABSTRACT FROM AUTHOR]

Background Acute increase of serum creatinine (SCr) after partial nephrectomy (PN) is primarily due to parenchymal mass reduction or ischemia; however, only ischemia can impact subsequent functional recovery. Objective We evaluate etiologies of acute kidney injury (AKI) after PN and their prognostic significance. Design, setting, and participants From 2007–2014, 83 solitary kidneys managed with PN had necessary studies for detailed analysis of function and parenchymal mass before/after surgery. AKI was classified by Risk/Injury/Failure/Loss/Endstage classification and defined by either standard criteria (comparison to preoperative SCr) or proposed criteria (comparison to projected postoperative SCr based on parenchymal mass reduction). Subsequent recovery was defined as percent function preserved/percent mass saved. Intervention PN. Outcome measurements and statistical analysis Predictive factors for AKI were evaluated by logistic regression. Relationship between AKI grade and subsequent functional recovery was assessed by linear regression. Results and limitations Median duration warm ischemia ( n = 39) was 20 min and hypothermia ( n = 44) was 29 min. Median parenchymal mass reduction was 11%. AKI occurred in 45 patients based on standard criteria and 38 based on proposed criteria, and reflected injury/failure (grade = 2/3) in 23 and 16 patients, respectively. On multivariable analysis, only ischemia time associated with AKI occurrence ( p = 0.016). Based on the proposed criteria, median recovery from ischemia was 99% in patients without AKI and 95%/90%/88% for patients with grades 1/2/3 AKI, respectively. The coefficient for association between AKI grade based on proposed criteria and subsequent functional recovery was -4.168 ( p = 0.018). Main limitation is limited patient cohort. Conclusions Parenchymal mass reduction and ischemia both contribute to acute changes in SCr after PN. Classification of AKI by proposed criteria significantly associates with subsequent functional recovery. However, more robust numbers will be needed to further assess the merits of the proposed criteria. While AKI is associated with suboptimal recovery, even patients with grade 2/3 AKI reached 88–90% of recovery expected. Patient summary Acute decline in function after partial nephrectomy associates with more prolonged ischemia time, and appears to impact subsequent functional recovery. However, most kidneys eventually recover strongly, even if their function is sluggish in the first few days after surgery. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the impact of extended warm ischemia on incidence of acute kidney injury (AKI) and ultimate functional recovery after partial nephrectomy (PN), incorporating rigorous control for loss of parenchymal mass, and embedded within comparison to cohorts of patients managed with hypothermia or limited warm ischemia.Materials and Methods: From 2007 to 2014, 277 patients managed with PN had appropriate studies to evaluate changes in function/mass specifically within the operated kidney. Recovery from ischemia was defined as %function saved/%parenchymal mass saved. AKI was based on global renal function and defined as a ≥1.5-fold increase in serum creatinine above the preoperative level.Results: Hypothermia was utilized in 112 patients (median = 27 minutes) and warm ischemia in 165 (median = 21 minutes). AKI strongly correlated with solitary kidney (P < .001) and duration (P < .001) but not type (P = .49) of ischemia. Median recovery from ischemia in the operated kidney was 100% (interquartile range [IQR] = 88%-109%) for cold ischemia, with 6 (5%) noted to have <80% recovery from ischemia. For the warm ischemia group, median recovery from ischemia was 91% (IQR = 82%-101%, P < .001 compared with hypothermia), and 34 (21%) had recovery from ischemia <80% (P < .001). For warm ischemia subgrouped by duration <25 minutes (n = 114), 25-35 minutes (n = 35), and >35 minutes (n = 16), median recovery from ischemia was 92% (IQR = 86%-100%), 90% (IQR = 78%-104%), and 91% (IQR = 80%-96%), respectively (P = .77).Conclusion: Our results suggest that AKI after PN correlates with duration but not with type of ischemia. However, subsequent recovery, which ultimately defines the new baseline glomerular filtration rate, is most reliable with hypothermia. However, most patients undergoing PN with warm ischemia still recover relatively strongly from ischemia, even if extended to 35-45 minutes. [ABSTRACT FROM AUTHOR]

Objective To compare freehand scripting and semiautomated renal parenchymal volume measurements on preoperative or postoperative computed tomography scans and assess relationships between parenchymal volume loss and functional changes within the operated kidney after partial nephrectomy (PN). Materials and Methods Fifty patients (16 solitary kidneys, 34 bilateral kidneys) with renal tumors managed by PN with necessary studies for analysis were included. Freehand scripting and semiautomated threshold-based analysis were performed before and 4-12 months after PN to obtain preoperative normal parenchymal volumes, projected residual parenchymal volumes, and actual postoperative volumes. Glomerular filtration rate was determined by the Modification of Diet in Renal Disease 2 equation along with nuclear renal scan to provide split function for patients with 2 kidneys. Limits of agreement and Bland-Altman analyses were performed. The relationship between the amount of vascularized parenchyma preserved and renal function saved was correlated for each measurement method using Pearson correlation. Results The semiautomated method yielded estimates that were higher than freehand scripting by a mean of 14 cm 3 for estimation of preoperative normal parenchymal volume, 21 cm 3 for projected residual parenchymal volume, and 9 cm 3 for actual postoperative parenchymal volume. For the semiautomated method, correlation between the amount of normal parenchyma preserved and renal function saved was 0.52 (95% confidence interval [CI], 0.28-0.69; P <.001), and for the scripting method, correlation was 0.60 (95% CI, 0.39-0.76; P <.001). Conclusion Semiautomated and freehand scripting measurements of parenchymal volumes were relatively consistent before and after PN, although the semiautomated approach tended to yield volumes that were approximately 5%-10% higher on average. Measurement of parenchymal volume changes by both approaches correlated significantly with functional changes after PN. [ABSTRACT FROM AUTHOR]

Objective Ischemia is a potential contributor to decline of function after partial nephrectomy (PN), although loss of parenchymal mass related to excision and reconstruction appears to be a more significant factor. However, loss of parenchymal mass could also be due to global effects of ischemia leading to parenchymal atrophy. In this study, we evaluated parenchymal volumes in regions away from the operated site to assess for atrophy. Materials and Methods A total of 164 patients undergoing PN for whom detailed analysis of function and parenchymal mass within the operated kidney could be performed were assessed for opposite pole volume (OPV) before and 4-12 months after surgery. Tumor location was required to be ≥2 cm away from the opposite polar line to exclude local effects related to excision or reconstruction. OPV was estimated by software analysis, and the ratio of the estimates (OPV ratio = postoperative OPV to preoperative OPV) was used to assess for atrophy. Results Patient demographics and tumor characteristics were representative of conventional PN populations, and warm ischemia (n = 101; median, 21 minutes) and cold ischemia (n = 63; median, 26 minutes) were applied by surgeon discretion. OPVs before and after PN were 63.2 and 62.5 cm 3 , respectively ( P = .76). The median OPV ratio was 0.99 suggesting that significant atrophy did not occur. OPV ratio was 0.99 for warm ischemia cases and 0.99 for cold ischemia cases ( P = .95). Conclusion Limited warm ischemia or hypothermia was not associated with significant parenchymal atrophy after PN, which suggests that parenchymal volume loss in this setting is primarily due to excision or reconstruction. [ABSTRACT FROM AUTHOR]

Objective: Parastomal hernia (PSH) is a common complication of ileal conduit diversion after radical cystectomy. Novel surgical techniques for preventing PSH formation are needed. We aimed to evaluate surgical technique of extraperitonealizing the ileal conduit (modified ileal conduit) for preventing PSH.Methods: A retrospective analysis of 375 consecutive patients who underwent ileal conduit after cystectomy at the Sun Yat-sen University Cancer Center between January 1, 2000 and June 31, 2019 was conducted. 214 patients had modified ileal conduit diversion and 161 patients conventional ileal conduit (Bricker) diversion. The demographic and clinicopathologic characteristics of patients in the 2 groups were compared using the t test and Chi square test. Univariable and multivariable Cox regression analyses were used to predict the risk of PSH formation.Results: The 2 groups were comparable in regard to all demographic and clinicopathologic variables. The incidence of PSH diagnosed by CT scan was 7.5% in the modified group and 21.1% in the conventional group (P < 0.001). High BMI and history of prior abdominal surgery was identified by univariable analysis as risk factors of PSH formation. Multivariable analyses revealed that technique of extraperitonealizing ileal conduit significantly reduced incidence of PSH in patients with or without risk factors of PSH formation (OR = 0.29, 95% CI 0.16-0.54, P < 0.001).Conclusions: Technique of extraperitonealizing ileal conduit appeared to be effective in reducing PSH formation after ileal conduit diversion. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: The objective of this study was to assess the clinical outcome after removal of a broken file from root canal by using ultrasonic techniques and to evaluate various factors that might influence the outcome. Methods: One hundred two patients with 102 teeth with a broken file in the root canal, treated between 2004 and 2008, were contacted for follow-up examination 12–68 months after treatment (median, 28 months). Outcome was assessed on the basis of clinical and radiographic criteria by calibrated examiners and dichotomized as healed or disease. The result was analyzed statistically by Pearson or Fisher exact test and multivariate logistic regression. Results: Of 66 teeth examined (64.7% recall), 81.8% were healed. Stepwise logistic regression analysis revealed that inadequate root canal filling was a statistically significant factor in predicting failure of successful healing. The cases with removal of broken files had a higher healing rate than those with broken files left in the root canal, but the difference was not statistically significant (P > .05). There was no significant difference in outcome related to presence or absence of perforation, although the rate of healing was greater in teeth without perforation. Other factors including age, sex, tooth type, apical status, position of segment, and type of restoration did not affect prognosis. Conclusions: Treatment outcome after the use of ultrasonics for removal of broken files was favorable. Adequate root filling has a more substantial impact on treatment outcome than the other factors. [Copyright &y& Elsevier]

Copper(II) diethyldithiocarbamate complex (CuET), the metabolite of disulfiram complexed with copper, is the component responsible for cancer treatment efficacy of disulfiram. But the hydrophobic property of CuET limits its use in vivo , and an appropriate drug delivery system needs to be developed. Ultrasmall melanin nanoparticle (M-Dot) with excellent biosafety and biocompatibility properties has been synthesized in our previous studies. Herein we prepared CuET loaded with M-Dots through hydrophobic interaction, which could enhance the water solubility significantly. After the administration of M-Dots-CuET in mice tumor models, the nanoparticles showed good tumor accumulation as evidenced by the enhanced photoacoustic signal in tumor regions. M-Dots-CuET also displayed excellent tumor inhibition capability, and the tumor growth inhibition value (TGI) was 45.1%. When combined with photothermal therapy, the TGI reached up to 78.6%. In summary, M-Dots-CuET provide a new potential strategy for cancer theranostics. The metabolite of disulfiram complexed with copper (CuET) was used as anticancer drug for tumor treatment. After being loaded to ultrasmall melanin nanoparticle (M-Dot), photoacoustic imaging could be used to monitor the accumulation of M-Dots-CuET in tumor regions. And in vivo studies showed excellent tumor proliferation inhibiting efficiency of M-Dots-CuET which combined chemotherapy and photothermal therapy strategy. [Display omitted] [ABSTRACT FROM AUTHOR]

Polycyclic aromatic hydrocarbons (PAHs) are contaminants of great concern owing to their persistence, toxicity, and bioaccumulation in aquatic environments. In this study, nanofiltration (NF) was used to investigate the removal of naphthalene (NAP) and phenanthrene (PHE) using three membranes of NF270, NF90, and DK. Subsequently, we examined the effects of coexisting organics on PAHs removal. Based on the results, DK was determined to be the optimal membrane for removing PAHs by comparing the membrane flux and pollutant rejection. The membrane flux reached 34.32 L/m2·h, and the NAP and PHE rejections were 92.21% and 97.85%, respectively, at transmembrane pressure (TMP) of 5 bar using DK. Coexisting organics decreased the membrane fluxes of NF270 and DK in the following order: protein > glucose > humic acid. The NAP and PHE rejections were obviously improved using NF270 in the following order: humic acid > protein > glucose. The PHE rejection was slightly improved using DK. A low concentration of organics could reduce the NAP rejection using DK; however, the NAP rejection could be restored at high concentrations of organics, except for humic acid. Coexisting organics could cause severe membrane fouling. The order of the effect of different coexisting organics on membrane fouling was protein > humic acid > glucose. The total investment and operating costs were about 1.47 and 0.187 million dollars, respectively, for treating PAHs solution using DK when the feed flow was 300 m3/d. [Display omitted] • PAHs could be effectively removed by DK membrane. • Coexisting organics decreased membrane flux with order of protein > glucose > humic acid. • PAHs removal using NF270 was improved with order of humic acid > protein > glucose. • Coexisting organics improved PHE removal slightly whereas reduced NAP removal by DK. • Membrane fouling was caused serious with order of protein > humic acid > glucose. [ABSTRACT FROM AUTHOR]

Objective: To compare the surgical precision for optimizing nephron-mass preservation of tumor enucleation (TE) vs standard partial nephrectomy (SPN), with primary focus on functional outcomes. TE is presumed to optimize preservation of parenchymal mass and function but this has not yet been rigorously studied and quantified.Materials and Methods: Robotic partial nephrectomy patients who had appropriate pre- and postoperative studies for analysis of parenchymal mass preservation specific to the operated kidney were included. Computed tomography or magnetic resonance imaging and estimated glomerular filtration rate were required to be <2 months prior and 4-12 months after surgery. Parenchymal mass preservation and surgical precision were estimated for each technique, with precision defined as actual postoperative parenchymal volume or predicted postoperative parenchymal volume, presuming loss of a 5 mm rim of parenchyma associated with tumor excision and reconstruction.Results: Analysis included 57 TE and 53 SPN. Median age, body mass index, and tumor size were comparable. Percent parenchymal mass preserved in the operated kidney with TE was 96% (interquartile range [IQR] = 90-100) vs 89% (IQR = 83-96) for SPN (P = .003). Precision of excision or reconstruction was 101% (IQR = 96-105) for TE vs 94% (IQR = 88-100) for SPN (P < .001). On multivariable analysis, only TE correlated with improved surgical precision (coefficient = 6.7, 95% confidence interval = 1.6-11.8, P = .01). Although preservation of global renal function also favored TE, the differences were marginal (96% vs 93%), and statistical significance was not observed (P = .2).Conclusion: Our analysis, which specifically focuses on the functional implications of TE, demonstrates that TE maximally spares normal parenchyma compared to SPN. Thus far, functional differences remain marginal and not statistically significant. Clinical significance of these findings in various clinical settings will require further investigation. [ABSTRACT FROM AUTHOR]

Many mechanisms contribute to the secondary injury cascades following traumatic spinal cord injury (SCI). However, most current treatment strategies only target one or a few elements in the injury cascades, and have been largely unsuccessful in clinical trials. Minocycline hydrochloride (MH) is a clinically available antibiotic and anti-inflammatory drug that has been shown to target a broad range of secondary injury mechanisms via its anti-inflammatory, anti-oxidant, and anti-apoptotic properties. However, MH is only neuroprotective at high concentrations. The inability to translate the high doses of MH used in experimental animals to tolerable doses in human patients limits its clinical efficacy. In addition, the duration of MH treatment is limited because long-term systemic administration of high doses of MH has been shown to cause liver toxicity and even death. We have developed a drug delivery system in the form of hydrogel loaded with polysaccharide-MH complexes self-assembled by metal ions for controlled release of MH. This drug delivery system can be injected into the intrathecal space for local delivery of MH with sufficient dose and duration, without causing any additional tissue damage. We show that local delivery of MH at a dose that is lower than the standard human dose (3 mg/kg) was more effective in reducing secondary injury and promoting locomotor functional recovery than systemic injection of MH with the highest dose and duration reported in experimental animal SCI (90–135 mg/kg). [ABSTRACT FROM AUTHOR]

Background Chronic kidney disease (CKD) can be associated with a higher risk of progression to end-stage renal disease and mortality, but the etiology of nephron loss may modify this. Previous studies suggested that CKD primarily due to surgical removal of nephrons (CKD-S) may be more stable and associated with better survival than CKD due to medical causes (CKD-M). Objective We addressed limitations of our previous work with comprehensive control for confounding factors, differentiation of non–renal cancer-related mortality, and longer follow-up for more discriminatory assessment of the impact of CKD-S. Design, setting, and participants From 1999 to 2008, 4299 patients underwent surgery for renal cancer at a single institution. The median follow-up was 9.4 yr (7.3–11.0). The new baseline glomerular filtration rate (GFR) was defined as the highest GFR between the nadir and 42 d after surgery. Three cohorts were retrospectively evaluated: no CKD (new baseline GFR >60 ml/min/1.73 m 2 ); CKD-S (new baseline GFR<60 but preoperative >60 ml/min/1.73 m 2 ); and CKD-M/S (new baseline and preoperative GFR both <60 ml/min/1.73 m 2 ). Cohort status was permanently set at 42 d after surgery. Intervention Renal surgery. Outcome measurements and statistical analysis Decline in renal function (50% reduction in GFR or dialysis), all-cause mortality, and non–renal cancer mortality were examined using a multivariable Cox proportional hazards model. Results and limitations CKD-M/S had a higher incidence of relevant comorbidities and the new baseline GFR was lower. On multivariable analysis (controlling for age, gender, race, diabetes, hypertension, and cardiac disease), CKD-M/S had higher rates of progressive decline in renal function, all-cause mortality, and non–renal cancer mortality when compared to CKD-S and no CKD (hazard ratio [HR] 1.69–2.33, all p < 0.05). All-cause mortality was modestly higher for CKD-S than for no CKD (HR 1.19, p = 0.030), but renal stability and non–renal cancer mortality were similar for these groups. New baseline GFR of <45 ml/min/1.73 m 2 significantly predicted adverse outcomes. The main limitation is the retrospective design. Conclusions CKD-S is more stable than CKD-M/S and has better survival, approximating that for no CKD. However, if the new baseline GFR is <45 ml/min/1.73 m 2 , the risks of functional decline and mortality increase. These findings may influence counseling for patients with localized renal cell carcinoma and higher oncologic potential when a normal contralateral kidney is present. Patient summary Survival is better for surgically induced chronic kidney disease (CKD) than for medically induced CKD, particularly if the postoperative glomerular filtration rate is ≥45 ml/min/1.73 m 2 . Patients with preexisting CKD are at risk of a significant decline in kidney function after surgery, and kidney-preserving treatment should be strongly considered in such cases. [ABSTRACT FROM AUTHOR]

Abstract: In this work, the cellular uptake, elimination and toxicity of CdSe/ZnS QDs in HepG2 cells were comprehensively studied using inductively coupled plasma mass spectrometry (ICP-MS), MTT assay, AO/EB staining, and glutathione level and gene expression analysis. ICP-MS analytical results showed that the uptake efficiency of CdSe QDs by HepG2 cells was lower than that of Cd(II) and Se(IV), and the uptake was dose- and time-dependent. The uptake amount was related to the physicochemical properties of QDs, and NH2-QDs with smaller size were more easily taken up by cells. In combination with various biochemical methodologies, a systematic and thorough quantitative analysis of the in vitro effects of CdSe/ZnS QDs with different coatings was conducted, along with that of Cd (II) and Se (IV). Although Cd(II) above 8.9 μM exhibited obvious toxicity to the cells, no obvious toxicity of four CdSe/ZnS QDs was observed within the tested concentration range (10–100 nM), most likely due to the protection of the ZnS shell and the PEG coating. From the molecular level's point of view, QDs at concentration of 100 nM exhibit obvious impact on the cells, such as increased gene expression (MT1A and CYP1A1), which was positively correlated with the intracellular concentration of QDs. [Copyright &y& Elsevier]

In recent years, oncolytic adenoviruses have shown some promise as a novel class of antitumor agents. However, their utility in targeting bone metastases is relatively less studied. We have examined whether the systemic therapy of oncolytic adenoviruses expressing the soluble form of transforming growth factor-β (TGFβ) receptor II fused with human immunoglobulin G1 can be developed for the treatment of established breast cancer bone metastases. MDA-MB-231-luc2 human breast cancer cells were injected in the left heart ventricle of nude mice to establish bone metastasis. Mice with hind limb tumors were administered (on days 8 and 11) oncolytic adenoviruses-Ad.sTβRFc or mhTERTAd.sTβRFc. Skeletal tumor growth was monitored weekly by bioluminescence imaging (BLI) and radiography. At the termination time on day 28, hind limb bones were analyzed for tumor burden, synchrotron micro-computed tomography, and osteoclast activation. Intravenous delivery of Ad.sTβRFc and mhTERTAd.sTβRFc induced significant inhibition of tumor growth, reduction of tumor burden, osteoclast activation, and increased animals' survival. Oncolytic adenoviruses were safer than dl309, a wild-type virus. A slight elevation of liver enzyme activity was observed after Ad.sTβRFc administration; this subsided with time. Based on these studies, we believe that Ad.sTβRFc and mhTERTAd.sTβRFc can be developed as a safe and effective approach for the treatment of established bone metastasis. [ABSTRACT FROM AUTHOR]