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Manganese superoxide dismutase (MnSOD/SOD2) is an essential mitochondrial enzyme that detoxifies superoxide radicals generated during oxidative respiration. MnSOD/SOD2 lysine 68 acetylation (K68-Ac) is an important post-translational modification (PTM) that regulates enzymatic activity, responding to nutrient status or oxidative stress, and elevated levels have been associated with human illness. To determine the in vivo role of MnSOD-K68 in the heart, we used a whole-body non-acetylation mimic mutant (MnSOD K68R ) knock-in mouse. These mice exhibited several cardiovascular phenotypes, including lower blood pressure, decreased ejection fraction, and importantly, dilated cardiomyopathy, as evidenced by echocardiography at four months of age. In addition, both mouse embryo fibroblasts (MEFs) and cardiovascular tissue from MnSOD K68R/K68R mice exhibited an increase in cellular senescence. Finally, MnSOD K68R/K68R mouse hearts also showed an increase in lipid peroxidation. We conclude that constitutively active MnSOD detoxification activity, lacking the normal switch between non-acetylated and acetylated forms, dysregulates mitochondrial physiology during development, leading to dilated cardiomyopathy., Competing Interests: Declaration of competing interests All authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: The combination of magnetic compression anastomosis (MCA) and endoscopy has been used to treat biliary stricture after liver transplantation. However, its use for the treatment of complex biliary obstruction after major abdominal trauma has not been reported. This case report describes the successful use of MCA for the treatment of biliary obstruction resulting from major abdominal trauma., Case Summary: A 23-year-old man underwent major abdominal surgery (repair of liver rupture, right half colon resection, and ileostomy) following a car accident one year ago. The abdominal drainage tube, positioned at the Winslow foramen, was draining approximately 600-800 mL of bile per day. During the two endoscopic retrograde cholangiopancreatography procedures, the guide wire was unable to enter the common bile duct, which prevented placement of a biliary stent. MCA combined with endoscopy was used to successfully achieve magnetic anastomosis of the peritoneal sinus tract and duodenum, and then a choledochoduodenal stent was placed. Finally, the external biliary drainage tube was removed. The patient achieved internal biliary drainage leading to the removal of the external biliary drainage tube, which improved the quality of life., Conclusion: Magnetic compression technique can be used for the treatment of complex biliary obstruction with minimal operative trauma., Competing Interests: Conflict-of-interest statement: All the authors declare that they have no conflict of interest to disclose., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background: The treatment of postoperative anastomotic stenosis after excision of rectal cancer is challenging. Endoscopic balloon dilation and radial incision are not effective in all patients. We present a new endoscopy-assisted magnetic compression technique (MCT) for the treatment of rectal anastomotic stenosis. We successfully applied this MCT to a patient who developed an anastomotic stricture after radical resection of rectal cancer., Case Summary: A 50-year-old man had undergone laparoscopic radical rectal cancer surgery at a local hospital 5 months ago. A colonoscopy performed 2 months ago indicated that the rectal anastomosis was narrow due to which ileostomy closure could not be performed. The patient came to the Magnetic Surgery Clinic of the First Affiliated Hospital of Xi'an Jiaotong University after learning that we had successfully treated patients with colorectal stenosis using MCT. We performed endoscopy-assisted magnetic compression surgery for rectal stenosis. The magnets were removed 16 d later. A follow-up colonoscopy performed after 4 months showed good anastomotic patency, following which, ileostomy closure surgery was performed., Conclusion: MCT is a simple, non-invasive technique for the treatment of anastomotic stricture after radical resection of rectal cancer. The technique can be widely used in clinical settings., Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background: The treatment of postoperative anastomotic stenosis (AS) after resection of colorectal cancer is challenging. Endoscopic balloon dilation is used to treat stenosis in such cases, but some patients do not show improvement even after multiple balloon dilations. Magnetic compression technique (MCT) has been used for gastrointestinal anastomosis, but its use for the treatment of postoperative AS after colorectal cancer surgery has rarely been reported., Case Summary: We report a 72-year-old man who underwent radical resection of colorectal cancer and ileostomy one year ago. An ileostomy closure was prepared six months ago, but colonoscopy revealed a narrowing of the rectal anastomosis. Endoscopic balloon dilation was performed three times, but colonoscopy showed no significant improvement in stenosis. The AS was successfully treated using MCT., Conclusion: MCT is a minimally invasive method that can be used for the treatment of postoperative AS after colorectal cancer surgery., Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

A ketogenic diet (KD) is a high-fat, low-carbohydrate diet that leads to the generation of ketones. While KDs improve certain health conditions and are popular for weight loss, detrimental effects have also been reported. Here, we show mice on two different KDs and, at different ages, induce cellular senescence in multiple organs, including the heart and kidney. This effect is mediated through adenosine monophosphate-activated protein kinase (AMPK) and inactivation of mouse double minute 2 (MDM2) by caspase-2, leading to p53 accumulation and p21 induction. This was established using p53 and caspase-2 knockout mice and inhibitors to AMPK, p21, and caspase-2. In addition, senescence-associated secretory phenotype biomarkers were elevated in serum from mice on a KD and in plasma samples from patients on a KD clinical trial. Cellular senescence was eliminated by a senolytic and prevented by an intermittent KD. These results have important clinical implications, suggesting that the effects of a KD are contextual and likely require individual optimization.

Background: Endoscopic balloon dilation is a minimally invasive treatment for colorectal stenosis. Magnetic compression anastomosis can be applied against gastrointestinal anastomosis. When combined with endoscopy, it offers a unique approach to the recanalization of colorectal stenosis., Case Summary: We have reported here the case of a 53-year-old female patient who underwent a descending colostomy due to sigmoid obstruction. Postoperative fistula restoration was not possible in her due to sigmoid stenosis. Accordingly, endoscopic-assisted magnetic compression anastomosis for sigmoid stenosis was performed, and the sigmoid stenosis was recanalized 15 d after the surgery. Subsequently, a reduction colostomy was successfully performed after 10 d., Conclusion: This case report proposes a novel minimally invasive treatment approach for colorectal stenosis., Competing Interests: Conflict-of-interest statement: All the authors declare that they have no conflict of interest to disclose., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background: Biliary adenomas that occur in the extrahepatic biliary tree are rare. It is difficult to distinguish it from cholangiocarcinoma or cholangiolithiasis by various imaging examinations, and it is very easy to be misdiagnosed., Aim: To evaluate the cumulative experiences including clinical characteristics and treatments of nine patients diagnosed with extrahepatic biliary adenoma admitted to the First Affiliated Hospital of Xi'an Jiaotong University from 2016 to 2022., Methods: A total of nine patients were included in our study. The laboratory examinations, disease diagnosis, therapy and pathological characteristics, and follow-up of every patient were evaluated., Results: Our cohort consisted of six females and three males with an average diagnosis age of 65.1 years (range 46-87). Six extrahepatic biliary adenomas were located in the common bile ducts and three in the hepatic duct. On initial presentation, all of the patients have symptom of biliary origin, including obstructive jaundice (4/9, 44.4%), abdominal pain (6/9, 66.7%), and fever (3/9, 33.3%). Preoperative imaging examination considered bile duct carcinoma in 6 cases and bile duct calculi in 3 cases. All the patients received surgical treatment and were confirmed by pathology as biliary adenoma. The symptoms improved significantly in all 9 patients after surgery. Seven of nine patients recovered well at follow-up without tumor recurrence. One patient died 2 mo after the surgery due to heart failure. One patient developed jaundice again 8 mo after surgery, underwent endoscopic retrograde cholangiopancreatography and biliary stent placement., Conclusion: Benign extrahepatic biliary tumors are rare and difficult to diagnosis preoperatively. Intraoperative choledochoscopy and timely biopsy may offer great advantages., Competing Interests: Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

Colorectal cancer has the second highest incidence of malignant tumors and is the fourth leading cause of cancer deaths in China. Early diagnosis and treatment of colorectal cancer will lead to an improvement in the 5-year survival rate, which will reduce medical costs. The current diagnostic methods for early colorectal cancer include excreta, blood, endoscopy, and computer-aided endoscopy. In this paper, research on image analysis and prediction of colorectal cancer lesions based on deep learning is reviewed with the goal of providing a reference for the early diagnosis of colorectal cancer lesions by combining computer technology, 3D modeling, 5G remote technology, endoscopic robot technology, and surgical navigation technology. The findings will supplement the research and provide insights to improve the cure rate and reduce the mortality of colorectal cancer., Competing Interests: Conflict-of-interest statement: The authors declare that there are no conflicts of interest regarding the publication of this paper., (©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.)

Apoptosis is a cellular defense mechanism used for the elimination of host cells infected by viruses. Viruses have evolved corresponding inhibitors of apoptosis genes to promote their replication. Anti-apoptosis-related genes, involved in baculovirus proliferation, have been proposed but it is unclear whether these genes can be manipulated in gene therapy. We constructed a transgenic silkworm, using the CRISPR/Cas9 system to knock out the BmNPV inhibitor of apoptosis 2 (iap2). The sequencing results showed that all the sequences could edit the target site of BmNPV iap2 gene. There were no differences in economic traits and growth tests between the BmNPV iap2 knockout strain transgenic silkworm lines and the control groups. However, the mortality rate was significantly reduced, the median lethal dose (LD50) was about 100 times higher than the control group, and the onset time was prolonged by 1-2 days after knocking out BmNPV iap2. In addition, the expression levels of apoptotic-related genes Bmiap2, BmICE and BmDreed were significantly affected and the activity of caspase 9 was increased after BmNPV iap2 being edited in transgenic silkworm. These results demonstrated that gene editing BmNPV iap2 could significantly inhibit BmNPV replication and proliferation. This approach provides a new strategy for antiviral research., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: Compared to traditional open surgery, laparoscopic surgery has become a standard approach for colorectal cancer due to its great superiorities including less postoperative pain, a shorter hospital stay, and better quality of life. In 2007, Whiteford et al reported the first natural orifice trans-anal endoscopic surgery (NOTES) sigmoidectomy using transanal endoscopic microsurgery. To date, all cases of NOTES colorectal resection have included a hybrid laparoscopic approach with the use of established rigid platforms., Aim: To introduce a novel technique of peroral external traction-assisted transanal NOTES rectosigmoidectomy followed by intracorporeal colorectal end-to-end anastomosis by using only currently available and flexible endoscopic instrumentation in a live porcine model., Methods: Three female pigs weighing 25-30 kg underwent NOTES rectosigmoid resection. After preoperative work-up and bowel preparation, general anesthesia combined with endotracheal intubation was achieved. One dual-channel therapeutic endoscope was used. Carbon dioxide insufflation was performed during the operation. The procedure of trans-anal NOTES rectosigmoidectomy included the following eight steps: (1) The rectosigmoid colon was tattooed with India ink by submucosal injection; (2) Creation of gastrostomy by directed submucosal tunneling; (3) Peroral external traction using endoloop ligation; (4) Creation of rectostomy on the anterior rectal wall by directed 3 cm submucosal tunneling; (5) Peroral external traction-assisted dissection of the left side of the colon; (6) Trans-anal rectosigmoid specimen transection, where an anvil was inserted into the proximal segment after purse-string suturing; (7) Intracorporeal colorectal end-to-end anastomosis using a circular stapler by a single stapling technique; and (8) Closure of gastrostomy using endoscopic clips. All animals were euthanized immediately after the procedure, abdominal exploration was performed, and the air-under-water leak test was carried out., Results: The procedure was completed in all three animals, with the operation time ranging from 193 min to 259 min. Neither major intraoperative complications nor hemodynamic instability occurred during the operation. The length of the resected specimen ranged from 7 cm to 13 cm. With the assistance of a trans-umbilical rigid grasper, intracorporeal colorectal, tension-free, end-to-end anastomosis was achieved in the three animals., Conclusion: Peroral traction-assisted transanal NOTES rectosigmoidectomy followed by intracorporeal colorectal end-to-end anastomosis is technically feasible and reproducible in an animal model and is worthy of further improvements., Competing Interests: Conflict-of-interest statement: To the best of our knowledge, no conflict of interest exists., (©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)

Ser/Thr protein phosphatase 2A (PP2A) is one of the type 2 protein phosphatases, which is required for many intracellular physiological processes and pathogen infection. However, the function of PP2A is unclear in silkworm, Bombyx mori. Here, we cloned and identified BmPP2A, a PP2A gene from B. mori, which has two HEAT domains and a high similarity to PP2A from other organisms. Our results showed that BmPP2A is localized in the cytoplasm and highly expressed in silkworm epidermis and midgut, and that Bombyx mori nucleopolyhedrovirus (BmNPV) infection induces down-regulation of BmPP2A expression. Furthermore, up-regulation of BmPP2A via overexpression significantly inhibited BmNPV multiplication. In contrast, down-regulation of BmPP2A via RNA interference and okadaic acid (a PP2A inhibitor) treatment allowed robust BmNPV replication. This is the first report of PP2A having an antiviral effect in silkworm and provides insights into the function of BmPP2A, a potential anti-BmNPV mechanism, and a possible target for the breeding of silkworm-resistant strains., (© 2019 Institute of Zoology, Chinese Academy of Sciences.)

Purpose: The goal of this study was to investigate x-ray beam profiles at various water depths to characterize the two-dimensional x-ray dose distribution, allowing for off-axis and out-of-field radiation dose estimation for a wide range of x-ray beam spectra commonly encountered in fluoroscopically guided interventional procedures., Methods: A Siemens Artis interventional fluoroscope was operated in a service mode to generate a continuous x-ray beam at fixed x-ray beam spectra, defined by their kVp and the thickness of additional copper filtration. A PTW scanning water tank with a diode detector was used to measure the x-ray beam profiles at several depths in water at various fields of view and x-ray beam spectra, both parallel and perpendicular to the anode-cathode axis direction., Results: X-ray beam profiles, including out-of-field tails, were characterized for a wide range of beam qualities. The anode heel effect was pronounced even at depth, resulting in large dose variations across the x-ray field; this effect was even more definite at large fields of view, at higher kVps, and in the absence of additional copper filtration., Conclusions: This study investigated and characterized 2D radiation dose deposition in water from x-ray beam spectra commonly used by modern fluoroscopes in interventional procedures. This knowledge can be applied to manual dosimetry calculations or can be used to refine the accuracy of automated dose mapping tools or Monte Carlo simulations of the radiation dose to soft tissue within the x-ray field and to tissue adjacent to the primary beam. Additionally, this study illustrates a substantial reduction of the anode heel effect by using moderate amounts of additional copper filtration to harden the x-ray beam spectrum., (© 2019 American Association of Physicists in Medicine.)

Objective: To investigate the effect of micro ribonucleic acid (miR)-34a regulating silent information regulator 1 (SIRT1) on myocardial infarction (MI) rats., Materials and Methods: A total of 30 male, 8-week-old rats were divided into three groups, including: sham group (M group), MI group and MI + miR-34a treatment group (miR group). Tissue morphology in the MI region was observed via hematoxylin-eosin (HE) staining. Myocardial apoptosis in the three groups was detected via terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay. Furthermore, the protein levels of SIRT1, B-cell lymphoma-2 (Bcl-2) and Bcl-2 associated X protein (Bax) in myocardial cells were detected via Western blotting., Results: Compared with M group, left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) increased significantly in MI group and miR group (p<0.05), while left ventricular ejection fraction (LVEF) and fractional shortening (FS) decreased obviously (p<0.05). The results of HE staining showed that the inflammatory infiltration of myocardial cells and intercellular collagen fibers significantly increased, and the neuronal damage was remarkably aggravated in MI group and miR group when compared with M group (p<0.05). Compared with MI group, myocardial necrosis, inflammatory cell infiltration and intercellular collagen fibers all increased significantly in miR group (p<0.05). Moreover, the results of TUNEL assay revealed that myocardial apoptosis rate in MI group [(21.35±3.12)%] was remarkably higher than that of M group [(9.53±1.17)%]. Meanwhile, it was significantly higher in miR group [(42.38±3.44)%)] than that of MI group, displaying statistically significant differences (p<0.05). The number of apoptotic cells increased obviously in MI group when compared with M group, while it decreased significantly in MI group when compared with miR group (p<0.05). Besides, the protein levels of SIRT1 and Bcl-2 in myocardial tissues in miR group were remarkably lower than those of M group and MI group (p<0.05). Furthermore, the protein level of Bax in miR group was higher than that of M group and MI group, and there were statistically significant differences (p<0.05)., Conclusions: Overexpression of miR-34a inhibits the activity of SIRT1, thereby promoting the apoptosis of MI.

A traditional immobilized pH gradient (IPG) has a high stability for isoelectric focusing (IEF) but suffers from time-consuming rehydration, focusing and staining-imaging as well as complex performance. To address these issues, an IEF system with an array of 24 IPG columns (10 mm × 600 μm × 50 μm) and dynamic scanning imaging (DSI) was firstly designed for protein focusing. Moreover, two IPG columns (pH 4-9 and pH 6.7-7.7 of 10 mm in length) were firstly synthesized for IEF. A series of experiments were carried out based on the IEF array. In contrast to a traditional IPG IEF with more than 10 h rehydration, 5-14 h IEF and ca 10 h stain-imaging, the IEF array had the following merits: 25 min rehydration for sample loading, 4 min IEF, and 2 min dynamics scanning of 24 columns, well addressing the issues of traditional IEF. Furthermore, the IEF array had fair sensitivity (LOD of 60 ng), good recovery (95%), and high stability (1.02% RSD for intra-day and 2.16% for inter-day). Finally, the developed array was successfully used for separation and determination of HbA 1c (a key biomarker for diabetes diagnosis) in blood samples. All these results indicated the applicability of the developed IEF array to diabetes diagnosis., (Copyright © 2019. Published by Elsevier B.V.)

Background: Quality of life (QoL) is an important indicator for evaluating therapeutic outcomes and mortality in renal transplant recipients, but there is scarce information regarding QoL, adherence behavior, social support and their relationships. This study assessed these factors among renal transplant recipients., Methods: Using a descriptive, correlational, cross-sectional design, this study included a convenience sample of 253 kidney transplant recipients. Structured questionnaires were used to collect data., Results: The scores on QoL domains (except the social functioning domain [P = .909]) were lower in our recipients than in the general Chinese population norm (P = .0000001). Time since transplantation (P = .041) and education (P = .013) were factors affecting QoL scores. The mean total adherence behavior score was 60.64 ± 7.71. Occupation and time since transplantation affected the total adherence behavior score. There was an alarming percentage of nonadherence in our transplant recipients (27.5%-72.3%). The mean total social support score was 40.76 ± 9.51. The total social support score (P = .0000087) was lower than the general Chinese population norm. Occupation (P = .0000087) education (P = .010), marital status (P = .013), payment method (P = .028) and monthly income (P = .007) affected the total social support score; there were significant relationships between physical health, psychological health, adherence behavior (r = .145, P = .022; r = .153, P = .016), and social support (r = .211, P = .001; r = .301, P = .000)., Conclusions: The findings demonstrate somewhat deficient QoL among renal transplant recipients compared with the general population. Social support, adherence behavior, time since transplantation and education significantly influenced QoL for our recipients, and social support had the most significant influence on adherence behavior and QoL., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Objective: The objective of this study was to compare reader accuracy detecting lesions near hardware in a CT phantom model at different radiation exposures using an advanced metal artifact reduction (MAR) algorithm and standard filtered back projection (FBP) techniques and to determine if radiation exposure could be decreased using MAR without compromising lesion detectability., Materials and Methods: A CT phantom manufactured with spherical lesions of various sizes (10-20 mm) and attenuations (20-50 HU) embedded around cobalt-chromium spheres attached to titanium rods, simulating an arthroplasty, was scanned on a single CT scanner (FLASH, Siemens Healthcare) at 140 kVp and 0.6-mm collimation using clinical-dose (300 Quality Reference mAs [Siemens Healthcare]), low-dose (150 Quality Reference mAs), and high-dose (600 Quality Reference mAs) protocols. Images reconstructed with iterative MAR, advanced modeled iterative reconstruction (ADMIRE), and FBP with identical parameters were anonymized and independently reviewed by three radiologists. Accuracies for detecting lesions, measured as AUC, sensitivity, and specificity, were compared., Results: Accuracy using MAR was significantly higher than that using FBP at all exposures (p values ranged from < 0.001 to 0.021). Sensitivity was also higher for MAR than for FBP at all exposures. Specificity was very high for both reconstruction techniques at all exposures with no significant differences. Accuracy of low-dose MAR was higher than and not inferior to standard-dose and high-dose FBP. MAR was significantly more sensitive than FBP in detecting smaller lesions (p = 0.021) and lesions near high streak artifact (p < 0.001)., Conclusion: MAR improves reader accuracy to detect lesions near hardware and allows significant reductions in radiation exposure without compromising accuracy compared with FBP in a CT phantom model.

Background: We analyzed the effect of comprehensive care on the patients who received minimally invasive percutaneous nephrolithotomy (MPCNL)., Methods: Patients hospitalized from 2013-2014 in Zhumadian Central Hospital (n=124) were enrolled and divided into two groups on random basis. The control group was treated with routine nursing model while the observation group was given comprehensive care additionally. The surgery time, degree of comfort, complications and successful cases, hospitalization time, sleep quality, nursing satisfaction and changes of systolic pressure, pulse and respiratory at different time were observed and analyzed., Results: The surgery time of the control group was significantly longer than that of observation group ( P <0.05). The observation group felt more comfortable and showed more significant successful cases than the control group. Moreover, the hospitalization time were significantly reduced in observation group when compared with control group ( P <0.05). The sleep quality of the observation group was significantly better than that of the control group ( P <0.05). Before anesthesia, diastolic blood pressure, systolic blood pressure, pulse and respiration were not significantly different between the two groups. The diastolic blood pressure, systolic blood pressure, pulse and respiration after anesthesia, intraoperative 30 min, postoperative 30 min and other moments were significantly different. The incidence of complications in the control group was significantly higher than that in the observation group. The nursing satisfaction of the observation group was significantly higher than that of the control group., Conclusion: The comprehensive care on the patients undergoing MPCNL was effective, and it can dramatically shorten surgery time, improve the success rate, improve the sleep quality of patients, keep life sign stable and minimize the complications., Competing Interests: Conflict of Interests The authors declare that there is no conflict of interest.

The purpose of this study was to extend the concept of weighted CT dose index ([Formula: see text]) to the elliptical phantoms. Based on the published body dimension data, eight body aspect ratios were chosen between 1 (perfectly circular) and 1.72 (extremely elliptical). For each aspect ratio, two elliptical cylinders were created digitally to represent adult and pediatric bodies. Their cross-sectional areas were identical to the standard 32- and 16-cm CTDI phantoms. For each phantom, [Formula: see text] at center and periphery were simulated for tube voltages between 70 and 140 kVp using a validated Monte Carlo program. The simulations also provided the average dose over the cross-sectional area, [Formula: see text]. Values of [Formula: see text] and [Formula: see text] allowed linear systems of equations to be established, from which central and peripheral weighting coefficients were solved. Regardless of phantom shape, only two weighting coefficients were needed: [Formula: see text] for the central [Formula: see text] and [Formula: see text] for the average of the four peripheral [Formula: see text]'s. Over the full range of aspect ratios, [Formula: see text] increased linearly from 0.37 to 0.46, whereas [Formula: see text] decreased linearly from 0.63 to 0.54, allowing the concept of [Formula: see text] to be readily extended to the elliptical phantoms. When cross-sectional area (hence volume) was kept constant, all phantoms had the same [Formula: see text] regardless of shape.

In Monte Carlo simulation of CT dose, many input parameters are required (e.g. bowtie filter properties and scan start/end location). Our goal was to examine the uncertainties in patient dose when input parameters were inaccurate. Using a validated Monte Carlo program, organ dose from a chest CT scan was simulated for an average-size female phantom using a reference set of input parameter values (treated as the truth). Additional simulations were performed in which errors were purposely introduced into the input parameter values. The effects on four dose quantities were analyzed: organ dose (mGy/mAs), effective dose (mSv/mAs), CTDI vol -normalized organ dose (unitless), and DLP-normalized effective dose (mSv/mGy · cm). At 120 kVp, when spectral half value layer deviated from its true value by  ±1.0 mm Al, the four dose quantities had errors of 18%, 7%, 14% and 2%, respectively. None of the dose quantities were affected significantly by errors in photon path length through the graphite section of the bowtie filter; path length error as large as 5 mm produced dose errors of  ⩽2%. In contrast, error of this magnitude in the aluminum section produced dose errors of  ⩽14%. At a total collimation of 38.4 mm, when radiation beam width deviated from its true value by  ±  3 mm, dose errors were  ⩽7%. Errors in tube starting angle had little impact on effective dose (errors  ⩽  1%); however, they produced organ dose errors as high as 66%. When the assumed scan length was longer by 4 cm than the truth, organ dose errors were up to 137%. The corresponding error was 24% for effective dose, but only 3% for DLP-normalized effective dose. Lastly, when the scan isocenter deviated from the patient's anatomical center by 5 cm, organ and effective dose errors were up 18% and 8%, respectively.

Research on molecular mechanisms that viruses use to regulate the host apparatus is important in virus infection control and antiviral therapy exploration. Our previous research showed that the Bombyx mori nucleopolyhedrovirus (BmNPV) LEF-11 localized to dense regions of the cell nucleus and is required for viral DNA replication. Herein, we examined the mechanism of LEF-11 on BmNPV multiplication and demonstrated that baculovirus LEF-11 interacts with Bombyx mori ATAD3A and HSPD1 (HSP60) protein. Furthermore, we showed that LEF-11 has the ability to induce and up-regulate the expression of ATAD3A and HSPD1, phenomena that were both reversed upon knockdown of lef-11. Our findings showed that ATAD3A and HSPD1 were necessary and contributed to BmNPV multiplication in Bombyx mori cells. Moreover, ATAD3A was found to directly interact with HSPD1. Interestingly, ATAD3A was required for the expression of HSPD1, while the knockdown of HSPD1 had no obvious effect on the expression level of ATAD3A. Taken together, the data presented in the current study demonstrated that baculovirus LEF-11 hijacks the host ATPase family members, ATAD3A and HSPD1, efficiently promote the multiplication of the virus. This study furthers our understanding of how baculovirus modulates energy metabolism of the host and provides a new insight into the molecular mechanisms of antiviral research.

Purpose: In this investigation, we sought to characterize X-ray beam qualities and quantitate percent depth dose (PDD) curves for fluoroscopic X-ray beams incorporating added copper (Cu) filtration, such as those commonly used in fluoroscopically guided interventions (FGI). The intended application of this research is for dosimetry in soft tissue from FGI procedures using these data., Methods: All measurements in this study were acquired on a Siemens (Erlangen, Germany) Artis zeego fluoroscope. X-ray beam characteristics of first half-value layer (HVL), second HVL, homogeneity coefficients (HCs), backscatter factors (BSFs) and kVp accuracy and precision were determined to characterize the X-ray beams used for the PDD measurements. A scanning water tank was used to measure PDD curves for 60, 80, 100, and 120 kVp X-ray beams with Cu filtration thicknesses of 0.0, 0.1, 0.3, 0.6, and 0.9 mm at 11 cm, 22 cm, and 42 cm nominal fields of view, in water depths of 0 to 150 mm., Results: X-ray beam characteristics of first HVLs and HCs differed from previous published research of fluoroscopic X-ray beam qualities without Cu filtration. PDDs for 60, 80, 100, and 120 kVp with 0 mm of Cu filtration were comparable to previous published research, accounting for differences in fluoroscopes, geometric orientation, type of ionization chamber, X-ray beam quality, and the water tank used for data collection. PDDs and X-ray beam characteristics for beam qualities with Cu filtration are presented, which have not been previously reported., Conclusions: The data sets of X-ray beam characteristics and PDDs presented in this study can be used to estimate organ or soft tissue doses at depth involving similar beam qualities or to compare with mathematical models., (© 2017 American Association of Physicists in Medicine.)

Aim: To introduce natural orifice transgastric endoscopic surgery (NOTES) tube ileostomy using pelvis-directed submucosal tunneling endoscopic gastrostomy and endoscopic tube ileostomy., Methods: Six live pigs (three each in the non-survival and survival groups) were used. A double-channeled therapeutic endoscope was introduced perorally into the stomach. A gastrostomy was made using a 2-cm transversal mucosal incision following the creation of a 5-cm longitudinal pelvis-directed submucosal tunnel. The pneumoperitoneum was established via the endoscope. In the initial three operations of the series, a laparoscope was transumbilically inserted for guiding the tunnel direction, intraperitoneal spatial orientation and distal ileum identification. Endoscopic tube ileostomy was conducted by adopting an introducer method and using a Percutaneous Endoscopic Gastrostomy Catheter Kit equipped with the Loop Fixture. The distal tip of the 15 Fr catheter was placed toward the proximal limb of the ileum to optimize intestinal content drainage. Finally, the tunnel entrance of the gastrostomy was closed using nylon endoloops with the aid of a twin grasper. The gross and histopathological integrity of gastrostomy closure and the abdominal wall-ileum stoma tract formation were assessed 1 wk after the operation., Results: Transgastric endoscopic tube ileostomy was successful in all six pigs, without major bleeding. The mean operating time was 71 min (range: 60-110 min). There were no intraoperative complications or hemodynamic instability. The post-mortem, which was conducted 1-wk postoperatively, showed complete healing of the gastrostomy and adequate stoma tract formation of ileostomy., Conclusion: Transgastric endoscopic tube ileostomy is technically feasible and reproducible in an animal model, and this technique is worthy of further improvement., Competing Interests: Conflict-of-interest statement: To the best of our knowledge, no conflict of interest exists.

Objective: The purpose of this study was to compare iterative metal artifact reduction (iMAR), a new single-energy metal artifact reduction technique, with filtered back projection (FBP) in terms of attenuation values, qualitative image quality, and streak artifacts near shoulder and hip arthroplasties and observer ability with these techniques to detect pathologic lesions near an arthroplasty in a phantom model., Materials and Methods: Preoperative and postoperative CT scans of 40 shoulder and 21 hip arthroplasties were reviewed. All postoperative scans were obtained using the same technique (140 kVp, 300 quality reference mAs, 128 × 0.6 mm detector collimation) on one of three CT scanners and reconstructed with FBP and iMAR. The attenuation differences in bones and soft tissues between preoperative and postoperative scans at the same location were compared; image quality and streak artifact for both reconstructions were qualitatively graded by two blinded readers. Observer ability and confidence to detect lesions near an arthroplasty in a phantom model were graded., Results: For both readers, iMAR had more accurate attenuation values (p < 0.001), qualitatively better image quality (p < 0.001), and less streak artifact (p < 0.001) in all locations near arthroplasties compared with FBP. Both readers detected more lesions (p ≤ 0.04) with higher confidence (p ≤ 0.01) with iMAR than with FBP in the phantom model., Conclusion: The iMAR technique provided more accurate attenuation values, better image quality, and less streak artifact near hip and shoulder arthroplasties than FBP; iMAR also increased observer ability and confidence to detect pathologic lesions near arthroplasties in a phantom model.

Although current antiviral strategies can inhibit baculovirus infection and decrease viral DNA replication to a certain extent, novel tools are required for specific and accurate elimination of baculovirus genomes from infected insects. Using the newly developed clustered regularly interspaced short palindromic repeats/associated protein 9 nuclease (CRISPR/Cas9) technology, we disrupted a viral genome in infected insect cells in vitro as a defense against viral infection. We optimized the CRISPR/Cas9 system to edit foreign and viral genome in insect cells. Using Bombyx mori nucleopolyhedrovirus (BmNPV) as a model, we found that the CRISPR/Cas9 system was capable of cleaving the replication key factor ie-1 in BmNPV thus effectively inhibiting virus proliferation. Furthermore, we constructed a virus-inducible CRISPR/Cas9 editing system, which minimized the probability of off-target effects and was rapidly activated after viral infection. This is the first report describing the application of the CRISPR/Cas9 system in insect antiviral research. Establishment of a highly efficient virus-inducible CRISPR/Cas9 system in insect cells provides insights to produce virus-resistant transgenic strains for future., (Copyright © 2016 Elsevier B.V. All rights reserved.)

The multiplexing transmission has always been a focus of attention for communication technology. In this paper, the radiation characteristics of circular microstrip patch antenna was firstly analyzed based on cavity model theory, and then spiral beams carrying orbital angular momentum (OAM) were generated, using elliptical microstrip patch antenna, with a single feed probe instead of a standard circular patch with two feedpoints. Moreover, by combining the proposed elliptic microstrip patch antenna with Universal Software Radio Peripheral (USRP), a wireless OAM transmission system was established and the real-time transmission of text, image and video in a real channel environment was realized. Since the wireless OAM transmission has the advantage of good safety and high spectrum utilization efficiency, this work has theoretical significance and potential application.

The first goal of this study was to investigate the accuracy of the displayed reference plane air kerma (Ka,r) or air kerma-area product (Pk,a) over a broad spectrum of X-ray beam qualities on clinically used interventional fluoroscopes incorporating air kerma-area product meters (KAP meters) to measure X-ray output. The second goal was to investigate the accuracy of a correction coefficient (CC) determined at a single beam quality and applied to the measured Ka,r over a broad spectrum of beam qualities. Eleven state-of-the-art interventional fluoroscopes were evaluated, consisting of eight Siemens Artis zee and Artis Q systems and three Philips Allura FD systems. A separate calibrated 60 cc ionization chamber (external chamber) was used to determine the accuracy of the KAP meter over a broad range of clinically used beam qualities. For typical adult beam qualities, applying a single CC deter-mined at 100 kVp with copper (Cu) in the beam resulted in a deviation of < 5% due to beam quality variation. This result indicates that applying a CC determined using The American Association of Physicists in Medicine Task Group 190 protocol or a similar protocol provides very good accuracy as compared to the allowed ± 35% deviation of the KAP meter in this limited beam quality range. For interventional fluoroscopes dedicated to or routinely used to perform pediatric interventions, using a CC established with a low kVp (~ 55-60 kVp) and large amount of Cu filtration (~ 0.6-0.9 mm) may result in greater accuracy as compared to using the 100 kVp values. KAP meter responses indicate that fluoroscope vendors are likely normalizing or otherwise influencing the KAP meter output data. Although this may provide improved accuracy in some instances, there is the potential for large discrete errors to occur, and these errors may be difficult to identify.

Modern fluoroscopes used for image-based guidance in interventional procedures are complex X-ray machines, with advanced image acquisition and processing systems capable of automatically controlling numerous parameters based on defined protocol settings. This study evaluated and compared approaches to technique factor modulation and air kerma rates in response to simulated patient thickness variations for four state-of-the-art and one previous-generation interventional fluoroscopes. A polymethyl methacrylate (PMMA) phantom was used as a tissue surrogate for the purposes of determining fluoroscopic reference plane air kerma rates, kVp, mA, and variable copper filter thickness over a wide range of simulated tissue thicknesses. Data were acquired for each fluoroscopic and acquisition dose curve within each vendor's default abdomen or body imaging protocol. The data obtained indicated vendor- and model-specific variations in the approach to technique factor modulation and reference plane air kerma rates across a range of tissue thicknesses. However, in the imaging protocol evaluated, all of the state-of-the-art systems had relatively low air kerma rates in the fluoroscopic low-dose imaging mode as compared to the previous-generation unit. Each of the newest-generation systems also employ Cu filtration within the selected protocol in the acquisition mode of imaging; this is a substantial benefit, reducing the skin entrance dose to the patient in the highest dose-rate mode of fluoroscope operation. Some vendors have also enhanced the radiation output capabilities of their fluoroscopes which, under specific conditions, may be beneficial; however, these increased output capabilities also have the potential to lead to unnecessarily high dose rates. Understanding how fluoroscopic technique factors are modulated provides insight into the vendor-specific image acquisition approach and may provide opportunities to optimize the imaging protocols for clinical practice.

Purpose: In CT imaging, a desirable quality assurance dose quantity should account for the dose variability across scan parameters and scanner models. Recently, AAPM Task Group 111 proposed to use equilibrium dose-pitch product (Dˆeq), in place of CT dose index (CTDI100), for scan modes involving table translation. The purpose of this work is to investigate whether this new concept better accounts for the tube voltage (kVp) dependence of organ dose than the conventional CTDI100., Methods: Three extended cardiac-torso patient models were included in this study. They represented normal-weight, overweight, and obese patients with abdomen-pelvis diameters ranging between 23 and 36 cm and body mass indices ranging between 20 and 42. A Monte Carlo program developed and validated for a 128-slice CT system was used to simulate organ dose for abdomen-pelvis scans at five tube voltages (70, 80, 100, 120, 140 kVp) with a pitch of 0.8 and a collimation of 38.4 mm. The same Monte Carlo program was also used to obtain CTDI100 and Dˆeq as well as their volume-averaged values, CTDIvol and Dˆeq,vol., Results: With other scan parameters kept constant, organ dose itself depended strongly on kVp. For the normal-weight patient model, the coefficient of variation (COV) across the five kVp values ranged between 72% and 75% for nine organs (liver, spleen, stomach, pancreas, kidneys, colon, small intestine, bladder, and ovaries) fully encompassed by the primary radiation beam. The COV generally increased with increasing patient size, ranging between 72%-77% and 76%-81% for the overweight and obese patient models, respectively. One-way analysis of variance for the effect of kVp was highly significant for all patient models (p<2×10(-26)). When organ dose was normalized by CTDIvol, the COV across kVps reduced to 5%-11%, 6%-15%, 12%-22% for the normal-weight, overweight, and obese patients, respectively. The effect of kVp was still highly significant (p=0.0001-0.004). When organ dose was normalized by Dˆeq,vol, the COV further reduced to 1%-8%, 3%-11%, 9%-19%, respectively. The effect of kVp was still significant for the obese patient model (p=0.004), but no longer significant for the normal-weight and overweight patient models (p=0.4 and 0.09, respectively). Finally, if organ dose conversion factors obtained at 120 kVp were used to approximate the values at 70 and 80 kVp, the resulting errors in the estimated organ dose were significantly reduced when the conversion factors were based on Dˆeq,vol instead of CTDIvol., Conclusions: In adult abdomen-pelvis CT, equilibrium dose-pitch product better accounts for the kVp dependence of organ dose than CTDI100.

Objective: The purposes of this study were to determine the differences in estimated volumetric CT dose index (CTDIvol) obtained from the topogram before abdominal and pelvic MDCT in adult and pediatric patients using a scan type-based algorithm for selecting kilovoltage (CARE kV) and a fixed and a weight-based Quality Reference mAs for selecting tube (gmAs) current-exposure time product, in comparison with standard protocols, and to determine the bias and variability of estimated CTDIvol vis-à-vis actual CTDIvol using the standard protocols., Materials and Methods: During a 14-month period, 312 adult and pediatric patients referred for abdominal and pelvic MDCT were included in the study. For all patients, the estimated CTDIvol based on the topogram was recorded: protocol A, CARE kV on and 210 gmAs; protocol B, CARE kV on and 1 gmAs times patient weight (in pounds); and protocol C (standard protocol), CARE kV off, 120 kVp, and 1 gmAs times patient weight (in pounds). For the pediatric patients, estimated CTDIvol for the standard protocol D was calculated with 120 kVp and 150 gmAs. All patients were scanned with the standard protocols, and the actual CTDIvol was recorded. Linear regression models compared the CTDIvol of the three protocols in adults and the fourth for children. The estimated and actual CTDIvol were compared using a t test., Results: Protocol B yielded the lowest estimated CTDIvol (mean, 13.2 mGy for adults and 3.5 mGy for pediatric patients). The estimated CTDIvol overestimated the actual CTDIvol by, on average, 1.07 mGy for adults and 0.3 mGy for children., Conclusion: CARE kV appears to reduce estimated CTDIvol vis-à-vis standard protocols only when a weight-based gmAs is used. Prescan estimated CTDIvol calculations appear to generally overestimate actual CTDIvol.

Objective: To analyze the effects of hyaluronidase and hirudoid treatment on drug extravasation in neonates., Methods: The medical records of 13 neonates with drug extravasation treated with hyaluronidase and hirudoid between August 1(st), 2010 and May 1(st), 2012 were analyzed retrospectively. The treatment procedure for drug extravasation adhered to the protocol in neonatal department. The information including age, sex, weight, diagnosis, size of affected area, site of extravasation and treatment was collected. Findings : The extravasation injuries alleviated and the symptoms improved after treatment, no adverse drug effects were reported with use of hyaluronidase and hirudoid., Conclusion: The treatment appeared to be beneficial in the management of extravasations of various medications in neonates and may be useful in reducing the severity of cutaneous toxicosis. However, further studies with large samples are still needed to assess the effectiveness and safety of hyaluronidase and hirudoid.

Objective: To study the role of hypoxia-inducible factor 1 alpha (HIF1alpha) on knee cartilage degeneration,and to explore the effects and mechanisms of Chinese herbal compound Yiqi Huayu prescription on HIF-1alpha gene knockout mice on knee cartilage degeneration., Methods: The 4-month and 6-month HIF-1alpha gene knock out mice were obtained by interbreeding, and divided into HIF-1alpha +/+ 4-month mice group,HIF-1alpha -/- 4-month mice group,HIF-1alpha +/+ 6-month mice group and HIF-1alpha -/- 6-month mice group, 3 mice in each group. And then the 2-month-old HIF-1alpha gene knock out mice were randomly divided into Yiqi Huayu prescription group and physiological saline group. There were 6 mice in each group. After 2 months' drug administration, the knee joint of mice was collected, and the Mankin score were evaluated; Safranine-fast green staining, HE Staining, and immunohistochemistry analysis for VEGF, Col X, Col II, MMP-13 and Sox-9 were performed erespectively., Results: (1) Compared to the results in the HIF-1alpha+/+ mice groups, the HIF-1alpha-/- mice developed aging related cartilage loss and bony tissue appearance, cartilage defects increased,and cells reduced. In HIF-1alpha-/-4-month mice and 6-month mice group, the expresion of Col II and Sox9 decreased, and the expression of Col X, MMP-13 and VEGF increased. (2) Compared to the physiological saline group, the ossification and defect of knee joint cartilage reduced of mice in the Yiqi Huayu prescription group, the cartilage cell distribution was more uniform, and the total number of cells increased. The expression of type II collagen and Sox9 protein increased, expression of Col X, MMP-13 and VEGF protein decreased of mice in the Yiqi Huayu prescription group., Conclusion: The knee cartilage degenerates in the HIF-1alpha cKO mice, and the degeneration increased with age adding. The Yiqi Huayu prescription can delay the degeneration of knee cartilage of HIF-1alpha cKO mice.

Osteoarthritis is one of the most common diseases seen in clinical practice. Cartilage survives in the hypoxic microenvironment. Hypoxia-inducible factor-1α (HIF-1α) is a key nuclear transcription factor which mediates the hypoxic response of cells. HIF-1α gene is an important regulator for the adaptation of articular cartilage to the hypoxic environment. It is important for formation of articular cartilage, energy metabolism and matrix synthesis. If the HIF-1α gene is knocked out, the cartilage can not maintain their normal morphology and function, which may lead to cartilage degeneration, and result in diseases such as osteoarthritis. Chinese herbal medicines can regulate the expression of HIF-1α gene and supply a therapy method for osteoarthritis. In this paper, the authors review the situation of the correlation between HIF-1α and osteoarthritis cartilage degeneration examined in recent years.

The concept of the coevolutionary arms race holds a central position in our understanding of pathogen-host interactions. Here we identify the molecular mechanisms and follow the stepwise progression of an arms race in a natural system. We show how the evolution and function of the HopZ family of type III secreted effector proteins carried by the plant pathogen Pseudomonas syringae are influenced by a coevolutionary arms race between pathogen and host. We surveyed 96 isolates of P. syringae and identified three homologs (HopZ1, HopZ2, and HopZ3) distributed among approximately 45% of the strains. All alleles were sequenced and their expression was confirmed. Evolutionary analyses determined that the diverse HopZ1 homologs are ancestral to P. syringae, and have diverged via pathoadaptive mutational changes into three functional and two degenerate forms, while HopZ2 and HopZ3 have been brought into P. syringae via horizontal transfer from other ecologically similar bacteria. A PAML selection analysis revealed that the C terminus of HopZ1 is under strong positive selection. Despite the extensive genetic variation observed in this family, all three homologs have cysteine-protease activity, although their substrate specificity may vary. The introduction of the ancestral hopZ1 allele into strains harboring alternate alleles results in a resistance protein-mediated defense response in their respective hosts, which is not observed with the endogenous allele. These data indicate that the P. syringae HopZ family has undergone allelic diversification via both pathoadaptive mutational changes and horizontal transfer in response to selection imposed by the host defense system. This genetic diversity permits the pathogen to avoid host defenses while still maintaining a virulence-associated protease, thereby allowing it to thrive on its current host, while simultaneously impacting its host range., Competing Interests: Competing interests. The authors have declared that no competing interests exist.