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Objectives: In addition to its blood-sparing effects, intraoperative cell salvage may reduce lung injury following cardiac surgery by removing cytokines, neutrophilic proteases and lipids that are present in cardiotomy suction blood. To test this hypothesis, we performed serial measurements of biomarkers of the integrity of the alveolar-capillary membrane, leucocyte activation and general inflammation. We assessed lung injury clinically by the duration of postoperative mechanical ventilation and the alveolar arterial oxygen gradient., Methods: Serial measurements of systemic plasma concentrations of interleukin-6 (IL-6), myeloperoxidase, elastase, surfactant protein D (SP-D), Clara cell 16 kD protein (CC16) and soluble receptor for advanced glycation endproducts (sRAGEs) were performed on blood samples from 195 patients who underwent cardiac surgery with the use of a cell salvage (CS) device (CS, n = 99) or without (CONTROL, n = 96)., Results: Postoperative mechanical ventilation time was shorter in the CS group than in the CONTROL group [10 (8-15) vs 12 (9-18) h, respectively, P = 0.047]. The postoperative alveolar arterial oxygen gradient, however, was not different between groups. After surgery, the lung injury biomarkers CC16 and sRAGEs were lower in the CS group than in the CONTROL group. Biomarkers of systemic inflammation (IL-6, myeloperoxidase and elastase) were also lower in the CS group. Finally, mechanical ventilation time correlated with CC16 plasma concentrations., Conclusions: The intraoperative use of a cell salvage device resulted in less lung injury in patients after cardiac surgery as assessed by lower concentrations of lung injury markers and shorter mechanical ventilation times., (© The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Purpose: During orthodontic treatment, the incisors in patients with Class II division 1 and division 2 malocclusion showed different clinical features, which determine the different ways to move the teeth to the suitable position. This study analyzed the morphology of alveolar bone around upper central incisor with cone-beam CT (CBCT)., Methods: The sample consisted of 20 normal malocclusion and 40 patients with Class II malocclusion （division 1 20 cases and division 2 20 cases）. CBCT images before orthodontic treatment were reconstructed by INVIVO 5.0 image processing software. Paired t test was used for statistical analysis with SPSS 19.0 software package., Results: At the upper central incisors, the alveolar thickness between normal malocclusion and Class II division 1 and division 2 malocclusion had significant difference except the palate thickness between normal malocclusion and Class II division 2 malocclusion (P<0.05)., Conclusions: Orthodontist should consider the relationship between the teeth position and alveolar bone shape comprehensively, choose the correct plan in order to avoid root desorption, alveolar bone loss, fenestration and other adverse reactions.

The magnetic quadrupole structure formation during the interaction of two ultrashort high power laser pulses with a collisionless plasma is demonstrated with 2.5-dimensional particle-in-cell simulations. The subsequent expansion of the quadrupole is accompanied by magnetic-field annihilation in the ultrarelativistic regime, when the magnetic field cannot be sustained by the plasma current. This results in a dominant contribution of the displacement current exciting a strong large scale electric field. This field leads to the conversion of magnetic energy into kinetic energy of accelerated electrons inside the thin current sheet.

Hepatocellular adenoma (HCA) is a benign hepatocyte-derived tumor commonly seen in reproductive-aged women with long-term use of oral contraceptives (OCs) in European and North American countries. Accordingly, HCA is currently classified into four molecular subtypes as adopted by the World Health Organization. The present study was firstly to characterize and determine the genetic alterations and clinicopathological features of the largest series of HCAs in China. We reviewed 189 patients with HCA who underwent hepatectomies at our liver center from January 1984 to January 2012, among which 36 HCAs were randomly selected for the sequencing of HNF1α, β-catenin and gp130 genes, and 60 HCAs were randomly selected for detecting microsatellite instability (MSI). Compared with Western studies, our data showed distinctive findings including male (69.8%) and overweight/obese (50.3%) predominance. Only 3.5% of female patients had a documented history of OCs use for 2-4 years. All 36 sequenced HCAs showed HNF1α mutations (72% missense, 28% synonymous), 2 hotspot polymorphisms of HNF1α (I27L: rs1169288 and S487N: rs2464196) were seen in 17 (47%) and 10 (27.8%) cases, respectively, and a novel single nucleotide polymorphism site (rs1169304) in intron 9 of HNF1α was detected in 32 (88%) cases, but no β-catenin or gp130 gene mutation was detected, and no nuclear β-catenin staining was detected by immunohistochemistry. The frequency of MSI was 75% for D12S1398 (HNF1α inactivated pathway) and 78.5% for D6S1064 (HIPPO signaling pathway) in 34 overweight/obese patients with HCA. Our results firstly indicate that patients with HCA in China frequently occur in male overweigh and obese adult population, lack an association with OCs use and exhibit unique genetic alterations. Taken together, these observations suggest that alternative pathogenetic pathways involve in HCA tumorigenesis in Chinese patients., (Copyright © 2015 Elsevier GmbH. All rights reserved.)

Aims: Hepatic carcinosarcoma (HCS) is an aggressive tumor for which a consensus regarding the clonal origin has not yet been reached. The aim of the study was to identify the origin of the hepatocellular carcinoma (HCC) and sarcoma components in HCS., Methods: We chose microsatellite technique containing loss of heterozygosity (LOH) and microsatellite instability (MSI) on three HCS patients who underwent curative resection confirmed by pathological examination. Tumors were firstly analyzed for Hep Par 1, CK18, CD10, CD117, SMA and vimentin expression by immunohistochemistry. LOH and MSI were then investigated. The incidence rate of LOH/MSI in all nine MS was calculated as the fractional allelic loss (FAL) index, which was internationally recognized standard. A FAL<30% was representative of a monoclonal origin and a FAL≥30% indicated a polyclonal origin., Results: All patients were positive for HBsAg. Microscopic examination showed HCS containing two different cell types: a fibrosarcoma component with spindle cells and an HCC population of cells with a trabecular pattern. In the HCC tumor portions, Hep Par 1, CK18, CD10 were expressed while vimentin was not. In contrast, the spindle cell populations were positive for vimentin and negative for Hep Par 1, CK18, CD10. The highest frequencies of LOH and MSI were at the D16S505 (2/3; 66.7%), D17S831 (2/3; 66.7%) and D17S938 MS (2/3; 66.7%). The FALs for the three cases of HCS were 50% (4/8), 55.6% (5/9) and 33.3% (3/9), suggesting a polyclonal origin., Conclusions: Immunohistochemistry and analysis of LOH and MSI strongly demonstrated that the three HCS samples were consistent with a polyclonal origin for all three cases., (Copyright © 2015 Elsevier GmbH. All rights reserved.)

Purpose: To analyze the clinical effect of extraction correction of patients with maxillary protrusion by using Damon high torque appliances., Methods: Forty patients with extraction of four first premolars due to orthodontic treatment were selected. They had protrusion of maxilla and were randomly divided into two groups. Both arches of Damon group were treated with Damon high torque appliances and MBT group were corrected with traditional MBT straight wire appliance; patients in two groups received sliding mechanics for adduction of upper anterior teeth. Cephalometric radiophotographs were analyzed before（T0）and after adduction of upper anterior teeth（T1）. The difference between the two groups was analyzed with SPSS15.0 software package., Results: The upper incisors showed a more retruded position in the two groups at T1,although they showed a similar amount in both groups. The backward movement of upper lip was 2.31mm in Damon group, which was significantly less than that of 2.81mm in MBT group(P<0.05). No significant difference in the first molar mesialization was detected between Damon group(2.33 mm) and MBT group(2.36mm) (P>0.05). For anterior teeth retraction, nasolabial angle (NLA) in MBT and Damon group were 107.44°and 106.33°, increase of NLA in MBT group was 9.17°,which was significantly larger than that of 7.22°in Damon group (P<0.05). U1-MxP in MBT and Damon were 110.61°and 114.11°. U1-MxP decreased 12.06°in MBT group, while significant change was deteced in Damon group of 7.61°(P<0.05)., Conclusions: Application of Damon high torque appliances in extraction treatment of maxillary protrusion patients yielded better control of the labial crown torque of anterior teeth, and avoided excessive lingual inclination of anterior teeth compared with MBT in adduction of upper anterior teeth.

β-Arrestins and β-arrestin2 are important adaptor proteins and signal transduction proteins that are mainly involved in the desensitization and internalization of G-protein-coupled receptors. Fibrosis is characterized by accumulation of excess extracellular matrix (ECM) molecules caused by chronic tissue injury. If highly progressive, the fibrotic process leads to organ malfunction and, eventually, death. The incurable lung fibrosis, renal fibrosis and liver fibrosis are among the most common fibrotic diseases. Recent studies show that β-arrestins can activate signaling cascades independent of G-protein activation and scaffold many intracellular signaling networks by diverse types of signaling pathways, including the Hedgehog, Wnt, Notch and transforming growth factor-β pathways, as well as downstream kinases such as MAPK and PI3K. These signaling pathways are involved in the pathological process of fibrosis and fibrotic diseases. This β-arrestin-mediated regulation not only affects cell growth and apoptosis, but also the deposition of ECM, activation of inflammatory response and development of fibrotic diseases. In this review, we survey the involvement of β-arrestins in various signaling pathways and highlight different aspects of their regulation of fibrosis. We also discuss the important roles of β-arrestins in the process of fibrotic diseases by regulating the inflammation and deposit of ECM. It is becoming more evident that targeting β-arrestins may offer therapeutic potential for the treatment of fibrotic diseases.

5-FU is a common first-line chemotherapeutic drug for the treatment of hepatocellular carcinoma. However the development of acquired resistance to 5-FU confines its clinical usages. Although this phenomenon has been the subject of intense investigation, the exact mechanism of acquired resistance to 5-FU remains elusive. Here, we report that over-expression of GRP78 contributes to acquired resistance to 5-FU in HCC by up-regulating the c-Src/LSF/TS axis. Moreover, we found that the resistance to 5-FU conferred by GRP78 is mediated by its ATPase domain. The ATPase domain differentially increased the expression of LSF, TS and promoted the phosphorylation of ERK and Akt. We further identified that GRP78 interacts physically with c-Src through its ATPase domain and promotes the phosphorylation of c-Src, which in turn increases the expression of LSF in the nucleus. Together, GRP78 confers the resistance to 5-FU by up-regulating the c-Src/LSF/TS axis via its ATPase domain.

Hashimoto's Thyroiditis (HT) is the most common cause of hypothyroidism in areas of the world where iodine levels are sufficient. However, the pathogenesis of HT has not been completely elucidated. The first functional human TSHβ splice variant was supposed to be involved in the pathology of Hashimoto's thyroiditis. The question remains as to which kind of intrathyroid cells expresses functional TSHβ splice variant and whether there are expression variations of functional TSHβ splice variant in the injured thyroid of patient with HT. For the answer to this question, immune-injured thyroids were obtained from 30 patients with HT. Localization study of functional TSHβ splice variant in injured thyroid was done by immunofluorescence double staining. Transcription and translation level of functional TSHβ splice variant were detected by using qRT-PCR and semi-quantitative immunohistochemistry method, respectively. The correlation between expression level of functional TSHβ splice variant and degree of thyroid follicles damage was assessed. It was firstly identified that functional TSHβ splice variant was predominately expressed by plasma cells infiltrated around follicles and germinal center in injured thyroid of patient with HT. Of particular interest, the TSHβ splice variant was expressed at significantly higher levels in the thyroid tissues of patients with HT than that in the normal thyroid tissues, furthermore, expression level of TSHβ splice variant was positive related with the degree of follicles damage in thyroid of patient with HT. These findings defined the immune-derived functional TSHβ splice variant that resided in the thyroid of patient with HT, which exerted the unique effects on the pathogenesis of HT, meanwhile, we considered these findings to have significant implications for understanding immune-endocrine interactions in a number of ways., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Objective: Most publications describe cathepsin B and L as tumor and metastasis factors. These proteases also play a very important role in aging process. The aim of this study was to evaluate the serum level of cathepsin B and L with aging and their association with matrix metalloproteinase 2 (MMP2), which was reported to associate with age-related diseases., Methods: This research was conducted using blood samples provided by healthy people (n=90, 63 men and 27 women). Subjects were subdivided into groups with respect to age: young (about 18-30 years old, n=30), middle age (about 36-50 years old, n=30), and aged (above 56 years old, n=30). Altered serum level of cathepsin B, cathepsin L, and MMP2 with aging was studied by enzyme-linked immunosorbent assay (ELISA) and Western blotting using discriminative antibodies specific for each factor., Results: ELISA and Western blotting revealed that the serum level of cathepsin L and MMP2, but not cathepsin B significantly decreased in aged group compared with young group. Cathepsin L positively correlates with MMP2 among the whole healthy people (r(2)=0.869, p<0.0001)., Conclusion: The serum level of cathepsin L decreased with age, while cathepsin B remained no significant difference between young and aged individuals. In addition, cathepsin L positively correlates with MMP2., Practice: The cathepsin L may be used as a monitoring index in age-related diseases., Implications: In addition to cathepsin B, cathepsin L may be also involved in the aging process., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

A variable-displacement pump controlled pitch system is proposed to mitigate generator power and flap-wise load fluctuations for wind turbines. The pitch system mainly consists of a variable-displacement hydraulic pump, a fixed-displacement hydraulic motor and a gear set. The hydraulic motor can be accurately regulated by controlling the pump displacement and fluid flows to change the pitch angle through the gear set. The detailed mathematical representation and dynamic characteristics of the proposed pitch system are thoroughly analyzed. An adaptive sliding mode pump displacement controller and a back-stepping stroke piston controller are designed for the proposed pitch system such that the resulting pitch angle tracks its desired value regardless of external disturbances and uncertainties. The effectiveness and control efficiency of the proposed pitch system and controllers have been verified by using realistic dataset of a 750 kW research wind turbine., (Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.)

Objective: This study aimed to describe the imaging features of adenoid cystic carcinoma (ACC) of the breast using multimode imaging., Materials and Methods: The findings from mammography, sonography, magnetic resonance imaging, or digital breast tomosynthesis in 11 patients with histopathologically confirmed ACC of the breast were reviewed. The imaging criteria included location, shape, size, number, margin, calcification, attenuation, echo and/or signal intensity, internal mass enhancement pattern, and dynamic-enhancement characteristics., Results: On mammography (n = 9), ACC demonstrated as an irregular or lobulated mass with indistinct or spiculated margins. Sonographically (n = 11), ACCs appeared as a hypoechoic solid or heterogeneous mass with minimum vascularity on color Doppler examination. With regard to magnetic resonance imaging (n = 9), 2 of the largest masses had an extensive high T2-weighted imaging (T2WI) signal and hypointense internal septations, which demonstrated delayed enhancement. Dynamic enhancement illustrated washout kinetics. The 7 smaller masses appeared isointense on T2WI, and their internal septations were unenhanced. Among them, 5 demonstrated plateau kinetics and 2 demonstrated persistent kinetics., Conclusions: Although ACC is a rare event in the breast, we believe that the following signs may suggest the diagnosis of this entity: a well-defined border, extensive high T2WI signals, and internal septations that demonstrate delayed enhancement in larger lesions.

Purpose: To provide some references of using micro-implant anchorage in clinical orthodontic treatment, the thickness of buccal bone of mandible of different vertical facial type in adults with cone-beam CT (CBCT) were measured., Methods: Initial 3-dimensional images of 45 adult patients (15 men, 30 women)were reoriented by using a standardized protocol, and divided into 3 groups by angle of mandibular plane (G1: high angle, 15 patients; G2: average angle, 15 patients; G3: low angle, 15 patients). After signing the informed consent form, three measurement points were defined at 4, 6, and 8mm from the alveolar crest in each measurement area. Statistical analysis was performed with SPSS11.0 software package., Results: The thickness of buccal bone in mandible was thinner in G1 than in G2, and was thinnest in G3. The cortical bone thickness was thickest at the 8 mm level and thinnest at the 4mm level., Conclusions: The study suggested that the cortical bone thickness at 4mm level from the alveolar crest was safe for implantation. It is more stable when the distance of implants was more away from the alveolar crest. Patients with low mandibular plane angle should use self-tapping micro-implant anchorage. Supported by Nantong Science and Technology Fund (HS2013033).

Aims: To evaluate the potential association of anemia with micro- and macrovascular complications in Chinese patient with type 2 diabetes mellitus (T2DM)., Methods: A total of 1997 patients with T2DM were included in this cross-sectional study. Patients were defined as anemic, if hemoglobin (Hb) levels were < 13 g/dL in males and < 12 g/dL in females. Data on demographics, anthropometric parameters, and co-morbidities were extracted for each patient., Results: Twenty two percent of T2DM patients (439/1997) had anemia, and those patients with higher rates of micro- and macrovascular complications had higher rates of anemia. Univariate logistic regression analysis showed that anemia was a risk factor of microvascular complications (OR = 1.83, 95% CI: 1.45 - 2.31; P < 0.001) and macrovascular complications (OR = 2.10, 95% CI: 1.63 - 2.71; P < 0.001). After adjusting for conventional risk factors, anemia remained positively associated with microvascular complications (OR = 1.52, 95% CI: 1.17 - 1.99), but lost its association with macrovascular complications (OR = 1.01, 95% CI: 0.73 - 1.41). Anemia was also independently associated with diabetic retinopathy, nephropathy, and peripheral neuropathy., Conclusions: These findings suggest that anemia was related to both micro- and macrovascular complications in Chinese patients with T2DM, but was only an independent risk factor of microvascular complications. Assessment of Hb levels in T2DM patients may help to prevent subsequent diabetic micro- and macrovascular complications.

Background: Platinum chemotherapy has a role in the treatment of metastatic triple-negative breast cancer but its full potential has probably not yet been reached. We assessed whether a cisplatin plus gemcitabine regimen was non-inferior to or superior to paclitaxel plus gemcitabine as first-line therapy for patients with metastatic triple-negative breast cancer., Methods: For this open-label, randomised, phase 3, hybrid-designed trial undertaken at 12 institutions or hospitals in China, we included Chinese patients aged 18-70 years with previously untreated, histologically confirmed metastatic triple-negative breast cancer, and an ECOG performance status of 0-1. These patients were randomly assigned (1:1) to receive either cisplatin plus gemcitabine (cisplatin 75 mg/m(2) on day 1 and gemcitabine 1250 mg/m(2) on days 1 and 8) or paclitaxel plus gemcitabine (paclitaxel 175 mg/m(2) on day 1 and gemcitabine 1250 mg/m(2) on days 1 and 8) given intravenously every 3 weeks for a maximum of eight cycles. Randomisation was done centrally via an interactive web response system using block randomisation with a size of eight, with no stratification factors. Patients and investigator were aware of group assignments. The primary endpoint was progression-free survival and analyses were based on all patients who received at least one dose of assigned treatment. The margin used to establish non-inferiority was 1·2. If non-inferiority of cisplatin plus gemcitabine compared with paclitaxel plus gemcitabine was achieved, we would then test for superiority. The trial is registered with ClinicalTrials.gov, number NCT01287624., Findings: From Jan 14, 2011, to Nov 14, 2013, 240 patients were assessed for eligibility and randomly assigned to treatment (120 in the cisplatin plus gemcitabine group and 120 in the paclitaxel plus gemcitabine group). 236 patients received at least one dose of assigned chemotherapy and were included in the modified intention-to-treat analysis (118 per group). After a median follow-up of 16·3 months (IQR 14·4-26·8) in the cisplatin plus gemcitabine group and 15·9 months (10·7-25·4) in the paclitaxel plus gemcitabine group, the hazard ratio for progression-free survival was 0·692 (95% CI 0·523-0·915; pnon-inferiority<0·0001, psuperiority=0·009, thus cisplatin plus gemcitabine was both non-inferior to and superior to paclitaxel plus gemcitabine. Median progression-free survival was 7·73 months (95% CI 6·16-9·30) in the cisplatin plus gemcitabine group and 6·47 months (5·76-7·18) in the paclitaxel plus gemcitabine group. Grade 3 or 4 adverse events that differed significantly between the two groups included nausea (eight [7%] vs one [<1%]), vomiting (13 [11%] vs one [<1%]), musculoskeletal pain (none vs ten [8%]), anaemia (39 [33%] vs six [5%]), and thrombocytopenia (38 [32%] vs three [3%]), for the cisplatin plus gemcitabine compared with the paclitaxel plus gemcitabine groups, respectively. In addition, patients in the cisplatin plus gemcitabine group had significantly fewer events of grade 1-4 alopecia (12 [10%] vs 42 [36%]) and peripheral neuropathy (27 [23%] vs 60 [51%]), but more grade 1-4 anorexia (33 [28%] vs 10 [8%]), constipation (29 [25%] vs 11 [9%]), hypomagnesaemia (27 [23%] vs five [4%]), and hypokalaemia (10 [8%] vs two [2%]). Serious drug-related adverse events were seen in three patients in the paclitaxel plus gemcitabine group (interstitial pneumonia, anaphylaxis, and severe neutropenia) and four in the cisplatin plus gemcitabine group (pathological bone fracture, thrombocytopenia with subcutaneous haemorrhage, severe anaemia, and cardiogenic syncope). There were no treatment-related deaths., Interpretation: Cisplatin plus gemcitabine could be an alternative or even the preferred first-line chemotherapy strategy for patients with metastatic triple-negative breast cancer., Funding: Shanghai Natural Science Foundation., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

We investigate the optical absorption and scattering properties of underwater media pertinent to our underwater free space quantum key distribution (QKD) channel model. With the vector radiative transfer theory and Monte Carlo method, we obtain the attenuation of photons, the fidelity of the scattered photons, the quantum bit error rate, and the sifted key generation rate of underwater quantum communication. It can be observed from our simulations that the most secure single photon underwater free space QKD is feasible in the clearest ocean water.

This study aimed to investigate the therapeutic effects of craniocervical decompression with duraplasty and cerebellar tonsillectomy for the treatment of Chiari malformation-I with syringomyelia (CM I-SM). From January 2005 to December 2011, 127 patients with CM I-SM underwent craniocervical decompression with duraplasty and cerebellar tonsillectomy and the therapeutic effects of these surgeries were evaluated using Tator scores. No patient in this study died or showed disease deterioration after the surgery. Re-examination by magnetic resonance imaging (MRI) showed that the cisterna magna was obviously larger after the operation in all but one patient. Moreover, syringomyelia (SM) was reduced in 76 patients. CM I-SM symptoms disappeared or decreased in 112 patients after following discharge. Follow-up was conducted in 84 of the patients and 79 of these patients exhibited improved symptoms. A second MRI re-examination showed that the cisterna magna was successfully constructed in 44 patients; 42 of these patients showed further eliminated or obviously reduced SM. Craniocervical decompression with duraplasty and cerebellar tonsillectomy achieved favorable therapeutic effects. Thus, craniocervical decompression with duraplasty and cerebellar tonsillectomy is a rational surgical approach with beneficial clinical effects. The proposed approach may have useful applications in the treatment of CM I-SM.

A consistent theoretical model that can be applied in a wide range of densities and temperatures is necessary for understanding the variation of a material's properties during compression and heating. Taking argon as an example, we show that the combination of self-consistent fluid variational theory and linear response theory is a promising route for studying warm dense matter. Following this route, the compositions, equations of state, and transport properties of argon plasma are calculated in a wide range of densities (0.001-20 g/cm(3)) and temperatures (5-100 kK). The obtained equations of state and electrical conductivities are found in good agreement with available experimental data. The plasma phase transition of argon is observed at temperatures below 30 kK and density about 2-6g/cm(3). The minimum density for the metallization of argon is found to be about 5.8 g/cm(3), occurring at 30-40 kK. The effects of many-particle correlations and dynamic screening on the electrical conductivity are also discussed through the effective potentials.

Objectives: To evaluate if pulsatile cardiopulmonary bypass (CPB) has any protective influence on renal function in elderly patients undergoing aortic valve replacement (AVR)., Methods: Forty-six patients (≥ 75 years old) with aortic valve stenosis underwent AVR with either pulsatile perfusion (PP) or non-pulsatile perfusion (NP) during CPB. Haemodynamic efficacy of the blood pump during either type of perfusion was described in terms of the energy equivalent pressure and the surplus haemodynamic energy. Urine samples were collected before surgery, at sternum closure, and at 2 and 18 h of intensive care unit stay to detect acute kidney injury markers. Perioperative urine levels of N-acetyl-β-D-glucosaminidase (NAG), kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin (NGAL) were assessed together with plasma creatinine, creatinine clearance (CCr) and 24-h haemodynamic monitoring. Normally distributed continuous variables were described as mean ± standard deviation and non-normally distributed data were presented as the median [25th-75th percentiles]., Results: PP was characterized by a significantly higher amount of surplus haemodynamic energy transferred to the patients (P < 0.001), with lower mean systemic vascular resistance during CPB (P = 0.020) and during 18 h postoperatively (group-P = 0.018). No difference was found between pre- and postoperative CCr in the PP group (71 ± 23 vs 60 ± 35 ml/min, P = 0.27), while its statistically significant perioperative decrement was observed in the NP group (67 ± 24 vs 45 ± 15 ml/min, P < 0.001). The PP group showed significantly lower urinary levels of NAG at 18 h postoperatively (P = 0.008), and NGAL at sternum closure (P = 0.010), 2 h (P < 0.001) and 18 h (P = 0.015) postoperatively., Conclusions: Short-term PP in elderly patients showed higher safety for renal physiology than NP, resulting in better maintenance of glomerular filtration and lower renal tissue injury., (© The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Compound 1, a triterpenoid saponin from Ardisia gigantifolia Stapf showing potential anti-tumour activity, was hydrolysed into two deglycosyl derivatives (2 and 3) by Alternaria alternata AS 3.6872. Both these derivatives are new compounds. Their structures were elucidated on the basis of 1D, 2D NMR, HR-ESI-MS and optical rotation spectral data. Compounds 1-3 were evaluated for their cytotoxicity against human hepatocellular carcinoma and normal liver cells by Cell Counting Kit 8 colorimetric assay.

Background: Cell-saving devices (CS) are frequently used in cardiac surgery to reduce transfusion requirements, but convincing evidence from randomized clinical trials is missing. Filtration of salvaged blood in combination with the CS is widely used to improve the quality of retransfused blood, but there are no data to justify this approach., Methods: To determine the contribution of CS and filters on transfusion requirements, we performed a multicenter factorial randomized clinical trial in two academic and four nonacademic hospitals. Patients undergoing elective coronary, valve, or combined surgical procedures were included. The primary end point was the number of allogeneic blood products transfused in each group during hospital admission., Results: From 738 included patients, 716 patients completed the study (CS+filter, 175; CS, 189; filter, 175; neither CS nor filter, 177). There was no significant effect of CS or filter on the total number of blood products (fraction [95% confidence interval]: CS, 0.96 [0.79, 1.18]; filter, 1.17 [0.96, 1.43]). Use of a CS significantly reduced red blood cell transfusions within 24 hours (0.75 [0.61,0.92]), but not during hospital stay (0.86 [0.71, 1.05]). Use of a CS was significantly associated with increased transfusions of fresh frozen plasma (1.39 [1.04, 1.86]), but not with platelets (1.25 [0.93, 1.68]). Use of a CS significantly reduced the percentage of patients who received any transfusion (odds ratio [95% confidence interval]: 0.67 [0.49, 0.91]), whereas filters did not (0.92 [0.68, 1.25])., Conclusions: Use of a CS, with or without a filter, does not reduce the total number of allogeneic blood products, but reduces the percentage of patients who need blood products during cardiac surgery., (Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Compound 1, a triterpenoid saponin from Ardisia gigantifolia Stapf. showing potential anti-tumor activity, was transformed into three derivatives (2-4) by Aspergillus avenaceus 3.4454. Among them, compounds 2 and 3 are new compounds. Their structures were elucidated on the basis of 1D NMR, 2D NMR, HR-ESI-MS, and optical rotation data. Compounds 1-3 were evaluated for their cytotoxicity against human hepatocellular carcinoma and normal liver cells by cell counting kit 8 colorimetric assay. Compound 3 displayed better cytotoxicity against Bel-7402 and HepG2 cell lines and much weaker cytotoxicity against normal liver L02 cell than that of positive control (epirubicin hydrochloride).

Objective: To explore the relationship between the expression of EIIIA+ fibronectin in incised wound of rat's skin and injury time., Methods: The wounding model was established by cutting the dorsal skin of 48 adult SD rats. The rats were sacrificed at the pre-set injury time as immediately, 0.5 h, 1 h, 2 h, 3 h, 4 h, 6 h, and 8 h. The skin samples were taken at the margin of wound. The expression of the EIIIA? fibronectin was detected by immunohistochemistry and Western blotting and the relationship be- tween its expression and injury time was observed. Results The expression of EIIIA+ fibronectin was not observed immediately. The basal cell of skin began to show positive expression 0.5 h after injury. With the extension of injury time, positive staining became stronger. The value of relative optical density was gradually increased with prolonged injury time by the Western blotting analysis., Conclusion: The expression of EIIIA+ fibronectin could be used for estimation of injury time in the early stage of skin injury.

Supercritical fluids have intriguing behaviors at extreme pressure and temperature conditions, prompting the need for thermodynamic properties of supercritical fluid xenon (SCF) under shock compression. Double-shock experimental data on SCF xenon in the 140 GPa pressure range were directly measured by means of a multi-channel pyrometer and a Doppler-pins-system. It entered the so-called warm dense region. We found that the shock compressed SCF Xe had higher dynamic compression and higher number density than that of liquid Xe at same shock pressure. The larger compressibility of SCF Xe in our experiments could be explained that the increase of electronic excitations and ionizations leaded to a large drop of thermal pressure and a softening of Hugoniot. The high pressure phase diagram of xenon was depicted with the aid of the degeneracy, coupling parameter, and current available experiments on the pressure-temperature plane.

Purpose: Cardiopulmonary bypass is still a major cause of lung injury and delay in pulmonary recovery after cardiac surgery. Although it has been shown that pulsatile flow induced by intra-aortic balloon pumping is beneficial for preserving lung function, it is not clear if the same beneficial effect can be accomplished with pulsatile flow generated in the extracorporeal circuit. Therefore, we investigated the effect of pulsatile flow, produced by a centrifugal pump, on lung function in elderly patients., Methods: Serial measurements of lung biomarkers Clara cell 16 kD protein, surfactant protein D, and elastase were performed on blood samples from 37 elderly patients (≥75 years) who underwent elective aortic valve replacement surgery with CPB, either with pulsatile perfusion or continuous perfusion. Pulmonary function was assessed by postoperative ventilation time, the arterial blood oxygenation (PaO2/FiO2), the alveolar-arterial oxygen gradient (Aa-O2 gradient) and the pulmonary vascular resistance indexed by body surface area (PVRi)., Results: There was no difference in lung function between both groups, as assessed by the postoperative ventilation time, the PaO2/FiO2 ratio, and the Aa-O2 gradient. The PVRi, however, was significantly lower in the pulsatile perfusion group 15 mins after the administration of protamine (p<0.05). The plasma concentrations of the lung biomarkers increased during surgery and peaked at 1 h ICU, there were however no differences between groups., Conclusions: Pulsatile flow does not seem beneficial to postoperative lung function in elderly patients. Moreover, pulsatile flow does not affect lung function on a subclinical level as assessed by lung biomarkers.

Study Design: This is a retrospective, clinical, and radiologic study of posterior reduction and fusion of the C1 arch in the treatment of unstable Jefferson fractures., Objective: The aim of the study was to describe a new motion-preserving surgical technique in the treatment of unstable Jefferson fracture., Summary of Background Data: The management of unstable Jefferson fractures remains controversial. The majority of C1 fractures can be effectively treated nonoperatively with external immobilization unless there is an injury to the transverse atlantal ligament (TAL). Conservative treatment usually involves immobilization for a long time in Halo vest, whereas surgical intervention generally involves C1-C2 fusion, eliminating the range of motion of the upper cervical spine. We propose a novel method for the treatment of unstable Jefferson fractures without restricting the range of motion., Methods: A retrospective review of 12 patients with unstable C1 fractures between April 2008 and October 2011 was performed. They were treated by inserting bilateral posterior C1 pedicle screws or lateral mass screws interconnected by a transversal rod to achieve internal fixation. There were 8 men and 4 women, with an average age of 35.6 years (range, 20-60 y). Presenting symptoms included neck pain, stiffness, and decreased range of motion but none had neurological injury. Seven patients had bilateral posterior arch fractures associated with unilateral anterior arch fractures (posterior 3/4 Jefferson fracture, Landells type II), and 5 had unilateral anterior and posterior arch fractures (half-ring Jefferson fracture, Landells type II). Seven patients had intact TAL, and 5 patients had fractures and avulsion of the attachment of TAL (Dickman type II)., Results: A total of 24 screws were inserted. Five cases had screws placed in the lateral mass: 3 because of posterior arch breakage, and 2 because the height of the posterior arch at the entry point was <4 mm. The remaining 7 cases had pedicle screw fixation. One patient had venous plexus injury during exposure of lower margin of the posterior arch; however, successful hemostasis was achieved with Gelfoam. Postoperative x-ray and computed tomography scan showed partial breach of the transverse foramen caused by a screw in 1 case, and breach of the inner cortex of the pedicle caused by screw displacement in 1 case; however, no spinal cord injury or vertebral artery injury was found. The remaining screws were in good position. Patients were followed up for 6-40 months (average, 22 mo). All cases had recovery of range of motion of the cervical spine to the preinjury level by 3-6 months after surgery, with resolution of pain. At 6 months follow-up, plain radiographs and computed tomography scans revealed satisfactory cervical alignment, no implant failure, and satisfactory bony fusion of the fractures; no C1-C2 instability was observed on the flexion-extension radiographs., Conclusions: C1 posterior limited construct is a valid technique and a feasible method for treating unstable Jefferson fractures, which allows preservation of the function of the craniocervical junction, without significant morbidity.

Objective: To study MRI diagnosis of ovarian fibrothecomas., Methods: MRI appearances of 27 ovarian fibrothecomas 26 female patients confirmed by surgical pathology were retrospectively reviewed and correlated with clinical and histological findings., Results: Most patients were post-menopausal females 73.1% (19/26) of cases. 38.5% (10/26) of patients showed an elevated serum carbohydrate antigen 125 (CA-125) level (>35 U ml(-1)). On MR T2 weighted imaging, 3 distinct features were revealed. (1) Homogeneous hypointense masses in 25.9% (7/27) cases. (2) Heterogeneous tumours with mostly isointense and few patchy hyperintense areas in 51.9% (14/27) cases. (3) Heterogeneous tumours with predominantly hyperintense and few isointense parts in 22.2% (6/27) cases. On T1 weighted imaging, all the fibrothecomas turned out to be homogeneous masses except six cystic degeneration cases. After contrast, 70.4% (19/27) tumours showed homogeneous mild enhancement in all phases. Beyond the tumours, endometrial abnormality and uterus enlargement were found in 38.5% (10/26) and 15.4% (4/26) patients, respectively. Ascites were seen in 53.8% (14/26) patients. There was a statistically significant difference among the 3 T2 weighted image features (F = 7.024; p = 0.003) in terms of the size of fibrothecomas. The cystic tumours also had the tendency to show the ascite condition (p = 0.002) as well as elevated serum CA-125 levels (p = 0.014). Vimentin was positively stained in 10 (76.9%) of 13 cases who underwent the immunohistochemical analysis., Conclusion: MRI has the superiority to show the distinct appearances of tumours as well as their functional features according to oestrogenic effect., Advances in Knowledge: This study describes the unique features of fibrothecomas on MRI on a relatively large series of patients with tumours and the indirect oestrogenic effect findings.

A series of new upconversion nanoparticles have been functionalised with tumour-targeting molecules and metal chelates, prepared following standard peptidic and thiol chemistry. The targeting strategy has been delivered via the αvβ3 integrin, which is a heterodimeric cell surface receptor that is up-regulated in a variety of cancers, such as melanoma and breast cancer. The well-known DOTA (1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid) motif allows coordination to the radionuclide (68)Ga. Radiolabelling experiments were optimised under relatively mild conditions, and are rare amongst nanoparticulate materials. In vivo application of these probes in mouse tumour models revealed their potential as specific cancer contrast agents for PET imaging.

Amyloid deposits consist of protein fibrils and amorphous material, and this deposition is related to oxidative stress. Previously, we demonstrated the presence of high-density lipoproteins and/or lipids in amyloid deposits of familial amyloid polyneuropathy patients. In this study, the presence of myeloperoxidase (MPO) in amyloid deposits was demonstrated using immunohistochemical staining. In contrast, normal surrounding tissues were consistently negative for MPO. Nitrotyrosine was present in amyloid deposits after being exposed to the MPO/H2O2/NO(-) system by immunohistochemical staining, and the oxide mediated modification of serum transthyretin (TTR) was observed upon exposure to the MPO/H2O2 system using two-dimensional gel electrophoresis and TTR Western blotting. This observation revealed that the TTR amyloid deposits and serum TTR were oxidized by the MPO/H2O2/NO(-) system. Nitric oxide-mediated modification of TTR may play a role in amyloidogenesis in vivo.

An eight‑base pair (bp) deletion in the Pou4f3 gene in hair cells is associated with DFNA15, a hereditary form of hearing loss. To explore the pathological mechanisms underlying the development of DFNA15, the effect of the mutation in Pou4f3 on the activity of the myosin VI (Myo6) promoter, was investigated. The upstream regulatory sequence of Myo6 (2625 bp), consisting of an 1899 bp upstream sequence and a 727 bp intron 1 sequence, was amplified using polymerase chain reaction and subcloned into the pGL3‑Basic vector expressing firefly luciferase. For verification of inserted fragments, plasmids were subjected to restriction analysis and then sequenced. HEK293T human embryonic kidney cells were transiently transfected with renilla luciferase‑thymidine kinase vectors expressing Renilla luciferase and the Myo6 promoter‑driven firefly luciferase expressing vectors along with pIRES2‑enhanced green fluorescent protein (EGFP)‑Pou4f3 (expressing wild‑type Pou4f3) or pIRES2‑EGFP‑Pou4f3 (expressing the truncation mutant of Pou4f3). The relative luciferase activities were measured to determine the activity of the Myo6 promoter. The Myo6 promoter activity was not affected by co‑expression of wild‑type Pou4f3, as indicated by the comparable relative luciferase activities in the presence of the pIRES2‑EGFP‑Pou4f3 and the empty control vectors. However, co‑expression of mutated Pou4f3 significantly inhibited the activity of the Myo6 promoter to almost half of that of the control (P<0.001). The data suggests that mutated Pou4f3 has a negative role in the promoter activity of Myo6, and by extension, the expression of myosin VI, and this may be an underlying mechanism of DFNA15 hearing loss.

In contrast to the single shock compression state that can be obtained directly via experimental measurements, the multi-shock compression states, however, have to be calculated with the aid of theoretical models. In order to determine experimentally the multiple shock states, a diagnostic approach with the Doppler pins system (DPS) and the pyrometer was used to probe multiple shocks in dense argon plasmas. Plasma was generated by a shock reverberation technique. The shock was produced using the flyer plate impact accelerated up to ∼6.1 km/s by a two-stage light gas gun and introduced into the plenum argon gas sample, which was pre-compressed from the environmental pressure to about 20 MPa. The time-resolved optical radiation histories were determined using a multi-wavelength channel optical transience radiance pyrometer. Simultaneously, the particle velocity profiles of the LiF window was measured with multi-DPS. The states of multi-shock compression argon plasma were determined from the measured shock velocities combining the particle velocity profiles. We performed the experiments on dense argon plasmas to determine the principal Hugonoit up to 21 GPa, the re-shock pressure up to 73 GPa, and the maximum measure pressure of the fourth shock up to 158 GPa. The results are used to validate the existing self-consistent variational theory model in the partial ionization region and create new theoretical models.

Objective: To study the curative effect of postural reduction with instrumental reduction in treatment of flexion-distraction thoracolumbar fractures., Methods: A retrospective study was performed on 43 patients with single thoracolumbar flexion-distraction fractures admitted from August 2009 to August 2011, included 28 males and 15 females with an average age of 44 years old (34 to 56 years old). All patients were treated with postural reduction with instrumental reduction. The kyphosis (Cobb angle) recovery of injured vertebral height and complication were analyzed. The visual analogue scale(VAS) and com-plications were followed up and recorded., Results: There was no difference in recovery of injured vertebral posterior height among preoperative, 1 week and 1 year after operation (P > 0.05). There were significantly difference in kyphosis (Cobb angle) and recovery of injured vertebral anterior height between preoperative and postoperative at 1 week (P < 0.05). There was no difference in kyphosis (Cobb angle) and recovery of injured vertebral anterior height between 1 week and 1 year after operation (P > 0.05). VAS significantly improved from preoperative (7.2 +/- 1.2) to (0.8 +/- 0.7) at 1 year after operation (t = 18.47, P < 0.001)., Conclusion: Postural reduction with instrumental reduction is effective for thoracolumbar flexion-distraction fractures and it is beneficial to the recovery of vertebral height and saggital alignment.

Objective: To find a more appropriate alternative to D-dimer cutoff value for the diagnosis of deep vein thrombosis (DVT) in cancer patients., Methods: A total of 711 cancer patients with symptoms suspicious of DVT were included in the study. D-dimer levels were assessed using ELISA. All patients were subjected to imaging procedures., Results: Among 711 patients with cancer, 466 (65.5%) were females and 245 (34.5%) were males, with an average age of 57.3 ± 13.23 years. The mean age in the DVT group was significantly higher than in the non-DVT group (P<0.05). The D-dimer levels of the DVT group were significantly higher than those of the non-DVT group (P<0.05). The incidence rate of DVT varied significantly according to cancer type (P<0.05). Increasing age and lung cancer were significantly correlated with D-dimer levels (P<0.05), and a one-year increase in age was associated with a 14.28 ng/ml increase in the D-dimer value. The optimal cutoff point for D-dimer was found to be 981 ng/ml, with a sensitivity of 86.4%, specificity of 79.4%, and accuracy of 82.6%. If the D-dimer cutoff point was set to 981 ng/ml, the specificity would increase from 61.8% to 85.5% without loss of sensitivity in patients aged 40 years or younger. In patients aged more than 40 years, the new cutoff almost doubled the specificity with slightly reduced sensitivity., Conclusion: In cancer patients, a new cutoff value of 981 ng/ml effectively improved the exclusion of DVT, especially for patients aged more than 40 years.

Objective: Our aim was to investigate clinical and laboratory characteristics of osteoarthritic patients who had amyloid deposition in their knee joints., Methods: Synovial membranes were obtained from 36 patients with knee osteoarthritis (OA) who underwent joint replacement surgery. From this sample, the diagnosis of amyloid was determined by Congo red staining, which demonstrated apple-green birefringence under a polarized microscope. All synovial membranes were immunohistochemically characterized for the expressions of amyloid immunoglobulin light chain (AL-κ and AL-λ), serum amyloid-A (SAA), amyloidogenic transthyretin (ATTR), and amyloidogenic β2-microglobulin (Aβ2M). Matrix-assisted laser desorption-ionizaton/time of flight mass spectrometry (MALDI-TOF MS) was used to analyze transthyretin (TTR) isoforms in the serum of each patient., Results: Nine cases (25%) were found to be amyloid-positive. Immunohistochemically, eight cases (88.9%) had ATTR deposition, and one sample (11.1%) was shown to be AL-κ-positive. MALDI-TOF MS identified that the TTR in the serum of the patients was unmodified wild-type TTR, TTR-Cys-S-S-Cys, and TTR-Cys-S-S-CysGly. The age at surgery and the disease duration were significantly higher in the ATTR-positive group than in the ATTR-negative group. Knee score and function score were significantly lower in the ATTR-positive group than in the ATTR-negative group., Conclusions: Amyloid deposition in synovial membranes of OA patients was found to be ATTR and AL-κ. TTR in the serum of the patients was unmodified wild-type TTR together with two isoforms. The high age at surgery, long disease duration, and a deteriorated knee function were associated with ATTR amyloid deposition in the osteoarthritic knee joints.

Objective: To identify factors affecting xenograft growth of epithelial ovarian cancer (EOC) cells in nude mice and to detect characteristic mutations occurring in the xenografts following serial passage., Materials and Methods: A total of 64 human EOCs were subcutaneously inoculated in Balb/c nude mice in order to obtain a series of xenografts. Whole-exome sequencing was analyzed with Agilent SureSelect targeted enrichment capture system and Illumina Solexa Hiseq 2000 sequencing platform. Mutations were confirmed by comparison against the reference genome build 37.3., Results: The tumor take rate was 50% (32/64). TP53 mutation was detected in nine often Type II tumors. BRAF and CTNNB1 were not mutated in any of the samples, and PTEN mutation occurred in only one sample. The present data indicate that advanced stage serous EOCs and early stage non-serous EOCs were easy to grow in nude mice, and xenografts maintained the characteristic mutations., Conclusions: Advanced stage serous EOCs and early stage non-serous EOCs were easy to grow in nude mice, and xenografts maintained the characteristic mutations. Xenografts in nude mice are useful in vivo models for the study of human EOCs.

Recent in vitro studies have shown that guided waves can characterize bone properties. However, for clinical applications to be viable, the soft-tissue layer should be considered. This study examined the effect of soft tissue on guided waves using a bovine bone plate over a water half-space and overlaid by a 4-mm gelatin-based soft-tissue mimic. The data (with and without soft tissue) clearly show a high-frequency, fast-propagating wave packet and a low-frequency, delayed phase group. The presence of soft tissue attenuates the signals significantly and increases mode density and number as predicted by theory. The data retain higher frequency content than the bone-plate data at large offsets. Using theoretical dispersion curves, the guided modes can be identified with mode 1 (similar to the A0 Lamb mode) minimally affected by the addition of soft tissue. There is infiltration of high-frequency, late-arriving energy within the low-velocity guided-wave regime. Results of travel-time calculation suggest that P-wave and PP-reflections/multiples within the soft tissue may be responsible for the high-frequency oscillations., (Copyright © 2013 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

Glioblastoma multiforme (GBM) is the most common and malignant form of primary brain tumors in human. Small molecular magnetic resonance imaging (MRI) contrast agents are used for GBM diagnosis. However, conventional contrast agents have several limitations, such as low T1 relaxivity, short circulation half lives and absence of tumor targeting. Herein, we develop an upconversion nanoprobe labeled with Gd(3+) -DOTA and RGD (UCNP-Gd-RGD) for dual-modality imaging of glioblastoma. The preparation of UCNP-Gd-RGD starts with amine-functional upconversion nanoparticle core, followed by PEGylation, Gd(3+) DOTA conjugation and RGD labeling. The obtained UCNP-Gd-RGD has improved colloidal stability and reduced cytotoxicity compared with the UCNP core counterpart. Meanwhile, UCNP-Gd-RGD shows strong upconversion luminescence in deep-red region and three times enhancement of T1 relaxivity over Gd(3+) DOTA. Due to the recognition between UCNP-Gd-RGD and integrin αv β3 receptors, the nanoprobe specifically binds to U87MG cells, as evidenced by confocal microscopy and quantified by ICP-MS. Furthermore, UCNP-Gd-RGD demonstrates a preferential retention in subcutaneous U87MG tumor xenograft as shown in both in vivo upconversion fluorescence/MR imaging studies and ex vivo analysis. UCNP-Gd-RGD, conjugated with numerous RGD peptide and T1 contrast enhancing molecules, is promising for MR imaging of glioblastoma and delineating the tumor boundary before surgery. In addition, NIR-to-red upconversion characteristic of UCNP-Gd-RGD facilitates its potential intra-operative use for fluorescence-guided tumor resection., (Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Objective: To evaluate the clinicopathological features and prognosis of primary hepatic lymphoma (PHL)., Methods: Thirty-five patients with PHL who underwent surgical resection and were confirmed by pathology in our hospital from 1982 to 2012 were re-evaluated for clinicopathological data, including their symptoms, radiological features, recurrence interval, histopathological properties and prognosis., Results: Of the 35 patients, 25 were men (71.4%) and 10 were women (28.6%), with an average age of 52.6 years old (range, 17-79 years). Presented symptoms were epigastric phymatosis, abdominal pain and low-grade fever. In the present study, 21 (60.0%) patients were positive for HBsAg, 1(2.9%) patient was positive for anti-HCV, 3 patients were positive for AFP, 12 patients and 2 patients were complicated by cirrhosis and hepatocellular carcinoma, respectively. Pathologically, 35 PHL were classified into 19 DLBCL (54.3%), 13 T cell-lymphoma (37.1%), and 3 MALT lymphoma (8.6%). Patients with DCBCL showed better postoperative survival than patients with T cell-lymphoma (31.7 ± 3.2) months vs. (22.9 ± 2.2) months (P < 0.05)., Conclusions: Hepatitis B virus (HBV) infection may contribute to the pathogenesis of Chinese patients with PHL. Surgical resection followed by comprehensive therapy is the first-line option for PHL. The prognosis of patients with PHL is associated with PHL subtypes.

Background & Aims: To investigate diagnostic and prognostic values of sulfite oxidase (SUOX) in patients with hepatocellular carcinoma (HCC) who underwent curative resection., Methods: We investigated immunohistochemically the expression dynamics of SUOX, aldo-ketoreductase family 1 member B10 (AKR1B10) and CD34 at different stages of HCC. The differential diagnostic performance of three markers or their combinations in high-grade dysplastic nodules (HGDNs) and well-differentiated small HCC (WD-sHCC) were investigated by logistic regression models and validated in an independent testing set. Overall survival (OS) and time to recurrence (TTR) were evaluated in 300 patients with HCC as the testing cohort, and validated in 198 patients with HCC., Results: SUOX was decreased and AKR1B10 and CD34 were increased with the stepwise progression of hepatocarcinogenesis. For differential diagnosis of WD-sHCC from HGDNs, the sensitivity and specificity of the SUOX+AKR1B10+CD34 combination for WD-sHCC detection were 93.8% and 95.2%, respectively, and overall accuracy was much higher than any of the three individual markers and two marker combinations. In addition, SUOX, but not AKR1B10 and CD34, was an independent prognostic factor for OS and TTR, and showed better correlation with OS and TTR if combined with serum α-fetoprotein (AFP) for both the testing and validation cohorts., Conclusions: SUOX+AKR1B10+CD34 combination could make a substantial contribution to hepatic immunopathological diagnosis to distinguish WD-sHCC from HGDNs. Meanwhile, SUOX combined with serum AFP may predict postoperative outcome and tumor recurrence risk., (Copyright © 2013 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.)

Gold nanoparticles have been widely explored as cancer therapeutics and diagnostic agents in recent years. With their unique subcellular size and good biocompatibility, gold nanoparticles are a promising drug delivery vehicle. In this study, folic acid-coated gold nanoparticles conjugated with fluorophore FITC through amine terminated poly(ethylene glycol) were prepared and confocal microscopy together with bright-field differential interference contrast imaging data showed that folic acid-coated gold nanoparticles accumulated mainly in cytoplasm of primary human fibroblasts, without causing any observable cytotoxicity upon exposure for 48 hours. Through the further development of a drug delivery system that conjugates doxorubicin onto the surface of gold nanoparticles with a poly(ethylene glycol) spacer via an SMCC linker, we demonstrated that multidrug resistance in cancer cells can be significantly overcome by a combination of highly efficient cellular entry and enhanced cytotoxicity of Au-SMCC-DOX nanoconjugates, as revealed both by confocal microscopy imaging and cytotoxicity assay. The prepared Au-SMCC-DOX nanoconjugates demonstrated enhanced drug accumulation and retention in multidrug resistant hepG2-R cancer cells when it was compared with free doxorubicin, with a cytoplasm accumulation profile. The results indicated that gold nanoparticles are a kind of promising drug delivery vehicle with good biocompatibility and suitable for further applications in drug delivery for improved chemotherapy, especially for overcoming multidrug resistance.

Aim: To investigate the metabolic profiles of xenograft pancreatic cancer before and after radiotherapy by high-resolution magic angle spinning proton magnetic resonance spectroscopy (HRMAS (1)H NMR) combined with principal components analysis (PCA) and evaluate the radiotherapeutic effect., Methods: The nude mouse xenograft model of human pancreatic cancer was established by injecting human pancreatic cancer cell SW1990 subcutaneously into the nude mice. When the tumors volume reached 800 mm(3), the mice received various radiation doses. Two weeks later, tumor tissue sections were prepared for running the NMR measurements. (1)H NMR and PCA were used to determine the changes in the metabolic profiles of tumor tissues after radiotherapy. Metabolic profiles of normal pancreas, pancreatic tumor tissues, and radiation- treated pancreatic tumor tissues were compared., Results: Compared with (1)H NMR spectra of the normal nude mouse pancreas, the levels of choline, taurine, alanine, isoleucine, leucine, valine, lactate, and glutamic acid of the pancreatic cancer group were increased, whereas an opposite trend for phosphocholine, glycerophosphocholine, and betaine was observed. The ratio of phosphocholine to creatine, and glycerophosphocholine to creatine showed noticeable decrease in the pancreatic cancer group. After further evaluation of the tissue metabolic profile after treatment with three different radiation doses, no significant change in metabolites was observed in the (1)H NMR spectra, while the inhibition of tumor growth was in proportion to the radiation doses. However, PCA results showed that the levels of choline and betaine were decreased with the increased radiation dose, and conversely, the level of acetic acid was dramatically increased., Conclusion: The combined methods were demonstrated to have the potential for allowing early diagnosis and assessment of pancreatic cancer response to radiotherapy.

Objectives: To investigate the serum levels and modifications of transthyretin (TTR) in patients with rheumatoid arthritis (RA) by mass spectrometry, and the potential role of TTR in early RA., Methods: Serum samples were collected from early RA (ERA), middle and late RA (LRA), osteoarthritis (OA) patients, and healthy controls (HC). Levels of TTR were measured by ELISA, and serum TTR was further detected by Western blot. A subsequent MALDI-TOF-MS was performed to analyse the modified TTR., Results: Serum TTR levels in ERA (502.46±108.15 mg/l) was significantly higher than that of healthy controls (424.98±117.63 mg/l) (p<0.05). TTR levels in LRA was higher than that of HC but without statistical significance (p>0.05), and no statistical significance between OA (363.90±105.21mg/l) and HC (p>0.05). Two protein bands were identified corresponding to monomer and dimmer TTR by western blot. The proportion of TTR monomer was similar in each group. However, the proportion of TTR dimer in RA was lower than that in HC, which was decreased more in LRA (p<0.05). By MALDI-TOF-MS, four major peaks were observed in sera corresponding to native TTR (13749.86±1.48 m/z), Sul-TTR (13829.63±2.76 m/z), Cys-TTR (13870.70±2.70 m/z), and Cysgly-TTR (13927±5.77 m/z). The proportion of modified TTR varied with different disease stages., Conclusions: TTR levels in sera of patients with early RA were significantly increased. Four modified TTR were identified by MALDI-TOF-MS, and the proportion of modified TTR varied with different disease stages. Thus serum TTR could be considered as a potential serological marker for early diagnosis of RA.

Previous data have shown that the type II cGMP‑dependent protein kinase (PKG II) inhibits the EGF‑induced MAPK signaling pathway. In order to thoroughly investigate PKG, it is necessary to elucidate the function of another type of PKG, PKG I. The aim of this study was to investigate the possible inhibitory effect of PKG II and PKG I activity on the basic fibroblast growth factor (bFGF)‑induced proliferation and migration of U251 human glioma cells and the possible underlying mechanisms. U251 cells were infected with adenoviral constructs encoding cDNA of PKG I (Ad‑PKG I) or PKG II (Ad‑PKG II) to increase the expression levels of PKG I or PKG II and then treated with 8‑Br‑cGMP and 8‑pCPT‑cGMP, respectively, to activate the enzyme. An MTT assay was used to detect the proliferation of the U251 cells. The migration of the U251 cells was analyzed using a Transwell migration assay. Western blot analysis was used to detect the phosphorylation/activation of the fibroblast growth factor receptor (FGFR), MEK and ERK and the nuclear distribution of p-ERK. The results showed that bFGF treatment increased the proliferation and migration of U251 cells, accompanied by increased phosphorylation of FGFR, MEK and ERK. Furthermore, the nuclear distribution of p-ERK increased following bFGF treatment. Increasing the activity of PKG II through infection with Ad-PKG II and stimulation with 8-pCPT-cGMP significantly attenuated the aforementioned effects of the bFGF treatment, while increased PKG I activity did not inhibit the effects of bFGF treatment. These data suggest that increased PKG II activity attenuates bFGF‑induced proliferation and migration by inhibiting the MAPK/ERK signaling pathway, whereas PKG I does not.

Object: The aims of this study were to evaluate a large series of posterior C-1 lateral mass screws (LMSs) to determine accuracy based on CT scanning findings and to assess the perioperative complication rate related to errant screw placement., Methods: Accuracy of screw placement was evaluated using postoperative CT scans obtained in 196 patients with atlantoaxial instability. Radiographic analysis included measurement of preoperative and postoperative CT scans to evaluate relevant anatomy and classify accuracy of instrumentation placement. Screws were graded using the following definitions: Type I, screw threads completely within the bone (ideal); Type II, less than half the diameter of the screw violates the surrounding cortex (safe); and Type III, clear violation of transverse foramen or spinal canal (unacceptable)., Results: A total of 390 C-1 LMSs were placed, but 32 screws (8.2%) were excluded from accuracy measurements because of a lack of postoperative CT scans; patients in these cases were still included in the assessment of potential clinical complications based on clinical records. Of the 358 evaluable screws with postoperative CT scanning, 85.5% of screws (Type I) were rated as being in the ideal position, 11.7% of screws (Type II) were rated as occupying a safe position, and 10 screws (2.8%) were unacceptable (Type III). Overall, 97.2% of screws were rated Type I or II. Of the 10 screws that were unacceptable on postoperative CT scans, there were no known associated neurological or vertebral artery (VA) injuries. Seven unacceptable screws erred medially into the spinal canal, and 2 patients underwent revision surgery for medial screws. In 2 patients, unilateral C-1 LMSs penetrated the C-1 anterior cortex by approximately 4 mm. Neither patient with anterior C-1 penetration had evidence of internal carotid artery or hypoglossal nerve injury. Computed tomography scanning showed partial entry of C-1 LMSs into the VA foramen of C-1 in 10 cases; no occlusion, associated aneurysm, or fistula of the VA was found. Two patients complained of postoperative occipital neuralgia. This was transient in one patient and resolved by 2 months after surgery. The second patient developed persistent neuralgia, which remained 2 years after surgery, necessitating referral to the pain service., Conclusions: The technique for freehand C-1 LMS fixation appears to be safe and effective without intraoperative fluoroscopy guidance. Preoperative planning and determination of the ideal screw insertion point, the ideal trajectory, and screw length are the most important considerations. In addition, fewer malpositioned screws were inserted as the study progressed, suggesting a learning curve to the technique.

A series of new visible and near-infrared (NIR) luminescent lanthanide-hydroxybenz[de]anthracen derivatives (Ln(HBAN)(3)(H(2)O)(2)(NO(3))(3), Ln(HBAN)(3)phen(NO(3))(3)) were synthesized (HBAN-6-hydroxybenz[de]anthracen-7-one, Ln=Eu, Yb, Nd). Further, chemically bonded lanthanide hybrids of functionalized mesoporous silica (SBA-15) are prepared using HBAN-functionalized alkoxysilane (HBAN-Si) as linker, which is named as Ln(HBAN-SBA-15)(3)(NO(3))(3), Ln(HBAN-SBA-15)(3)phen(NO(3))(3) (Ln=Eu, Yb, Nd), respectively. The physical characterization and especially the photoluminescence properties for these hybrids are performed. SAXRD and BET of them revealed that all of these hybrid materials have uniformity in the mesostructure. Worth noting here is that the excitation spectra of these hybrid materials are extended to visible light region (439-535 nm). Upon ligand-mediated excitation with the ultraviolet and visible light, the visible luminescence for europium hybrids and NIR luminescence for Yb(3+) and Nd(3+) hybrids are obtained., (Copyright © 2012 Elsevier Inc. All rights reserved.)

A minimized perfusion circuit (MPC) has proven to be superior to the conventional circulatory perfusion bypass (CCPB) as it reduces the blood-material interaction and hemodilution. Until now not much is known about impact these different perfusion systems have on the brain. The objective of this study is to determine carnosinase and brain-type fatty binding protein (BFABP) activity as novel specific biomarkers for ischemic brain tissue damage and how their activity differs during and after MPC and CCPB as well as to compare the inflammatory response of both perfusion systems. In a prospective pilot study, 28 patients undergoing coronary artery bypass grafting were randomly divided into an MPC group (n = 14) and a CCPB group (n = 14). Blood samples were taken before, during, and after operation until the fifth postoperative day. The brain biomarker carnosinase was determined by measuring the rate of histidine production from the substrate homocarnosine, whereas BFABP and interleukin-6 were determined by enzyme-linked immunosorbent assay (ELISA). C-reactive protein (CRP) and endothelin-1 were determined by enzyme immunoassay. The mean serum carnosinase activity was significantly higher in MPC (0.57 ± 0.34 nM histidine/mL/min) as compared with the CCPB group (0.36 ± 0.13 nM histidine/mL/min) at the end of operation (P = 0.02). The BFABP did not show any difference between the two groups in the immediate postoperative period until the second postoperative day. From that time point onward, it showed a steep increase in the CCPB group (581.3 ± 157.11 pg/mL) as compared with the concentrations in the MPC group (384.6 ± 39 pg/mL) (P = 0.04). The inflammation markers interleukin-6 and CRP showed a similar pattern in both groups without significant difference. In contrast, the leukocyte count on operation day and endothelin-1 on the first postoperative day were significantly higher in the CCPB group (P = 0.01, P = 0.03, respectively). MPC showed a significant higher and stable serum carnosinase activity during extracorporeal circulation as compared with the CCPB due to less hemodilution and a better preserved oxygen capacity. As a consequence, the antioxidant stress during MPC is limited as compared with CCPB, which means less brain tissue damage reflected by a lower BFABP release. Except endothelin-1 and leukocyte count, the inflammatory response of the MPC and CCPB was equal., (© 2012, Copyright the Authors. Artificial Organs © 2012, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.)

Background: Despite continuous improvements in materials and perfusion techniques, cardiac surgery still causes lung injury and a delay of pulmonary recovery. Currently, there is no gold standard for quantifying cardiac surgery induced lung injury and dysfunction. Adding objective measures, such as plasma biomarkers, could be of great use here. In this study the utility of lung epithelium specific proteins as biomarkers for lung dysfunction was evaluated., Methods: Serial measurements of plasma concentrations of Clara cell 16 kD (CC16) protein, Surfactant protein D (SP-D), Elastase and Myeloperoxidase were performed on blood samples from 40 patients who underwent coronary artery bypass grafting with cardiopulmonary bypass (CABG, n = 20) or without cardiopulmonary bypass (OPCAB, n = 20)., Results: The increase of SP-D and CC16 between pre-operative concentrations and concentrations at the end of cardiopulmonary bypass, correlated with the Aa-O2 gradient at 1 hour on the ICU (Rs = 0.409, p = .016 and Rs = 0.343, p = .043, respectively).Furthermore, SP-D and CC16 were higher in CABG than in OPCAB at the end of surgery [8.96 vs. 4.91 ng/mL, p = .042 and 92 vs. 113%, p = .007, respectively]. After 24 h both biomarkers returned to their baseline values., Conclusions: Our results show that increases in plasma of SP-D and CC16 correlate with clinical lung injury after coronary artery bypass surgery. Therefore, lung epithelium specific proteins seem to be a useful biomarker for measuring lung injury in the setting of cardiac surgery.

Background: Ion beam has been used in cancer treatment, and has a unique preferable feature to deposit its main energy inside a human body so that cancer cell could be killed by the ion beam. However, conventional ion accelerator tends to be huge in its size and its cost. In this paper a future intense-laser ion accelerator is proposed to make the ion accelerator compact., Subjects and Methods: An intense femtosecond pulsed laser was employed to accelerate ions. The issues in the laser ion accelerator include the energy efficiency from the laser to the ions, the ion beam collimation, the ion energy spectrum control, the ion beam bunching and the ion particle energy control. In the study particle computer simulations were performed to solve the issues, and each component was designed to control the ion beam quality., Results: When an intense laser illuminates a target, electrons in the target are accelerated and leave from the target; temporarily a strong electric field is formed between the high-energy electrons and the target ions, and the target ions are accelerated. The energy efficiency from the laser to ions was improved by using a solid target with a fine sub-wavelength structure or by a near-critical density gas plasma. The ion beam collimation was realized by holes behind the solid target. The control of the ion energy spectrum and the ion particle energy, and the ion beam bunching were successfully realized by a multi-stage laser-target interaction., Conclusions: The present study proposed a novel concept for a future compact laser ion accelerator, based on each component study required to control the ion beam quality and parameters.