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Acute cellular rejection (ACR) is a prevalent postoperative complication following liver transplantation (LT), exhibiting an increasing incidence of morbidity and mortality. However, the molecular mechanisms of ACR following LT remain unclear. To explore the genetic pathogenesis and identify biomarkers of ACR following LT, three relevant Gene Expression Omnibus (GEO) datasets consisting of data on ACR or non-ACR patients after LT were comprehensively investigated by computational analysis. A total of 349 upregulated and 260 downregulated differentially expressed genes (DEGs) and eight hub genes ( ISG15, HELZ2, HNRNPK, TIAL1, SKIV2L2, PABPC1, SIRT1, and PPARA ) were identified. Notably, HNRNPK , TIAL1 , and PABPC1 exhibited the highest predictive potential for ACR with AUCs of 0.706, 0.798, and 0.801, respectively. KEGG analysis of hub genes revealed that ACR following LT was predominately associated with ferroptosis, protein processing in the endoplasmic reticulum, complement and coagulation pathways, and RIG-I/NOD/Toll-like receptor signaling pathway. According to the immune cell infiltration analysis, γδT cells, NK cells, Tregs, and M1/M2-like macrophages had the highest levels of infiltration. Compared to SIRT1, ISG15 was positively correlated with γδT cells and M1-like macrophages but negatively correlated with NK cells, CD4 + memory T cells, and Tregs. In conclusion, this study identified eight hub genes and their potential pathways, as well as the immune cells involved in ACR following LT with the greatest levels of infiltration. These findings provide a new direction for future research on the underlying mechanism of ACR following LT., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Chun-Qiang Dong reports financial support was provided by The First Affiliated Hospital of 10.13039/501100011827Guangxi Medical University. Song-Qing He reports financial support was provided by The First Affiliated Hospital of 10.13039/501100011827Guangxi Medical University. Chun-Qiang Dong reports a relationship with The First Affiliated Hospital of 10.13039/501100011827Guangxi Medical University that includes: funding grants. Song-Qing He reports a relationship with The First Affiliated Hospital of 10.13039/501100011827Guangxi Medical University that includes: funding grants. No other conflicts of interest. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: We aim to investigate the prevalence, patterns, risk factors, and outcomes of peritoneal metastases (PM) after curative laparoscopic hepatectomy (LH) for hepatocellular carcinoma (HCC)., Methods: A multicenter cohort of 2,138 HCC patients who underwent curative LH from August 2010 to December 2016 from seven hospitals in China was retrospectively analyzed. The incidence of PM following LH was evaluated and compared with that in open hepatectomy (OH) after 1:1 propensity score matching (PSM)., Results: PM prevalence was 5.1% (15/295) in the early period [2010-2013], 2.6% (47/1,843) in the later period [2014-2016], and 2.9% (62/2,138) in all LH patients, which was similar to 4.0% (59/1,490) in the OH patients. The recurrence patterns, timing, and treatment did not significantly vary between the LH and OH patients (P>0.05). Multivariate logistic regression revealed that tumor diameter >5 cm, non-anatomical resection, presence of microvascular invasion, and lesions <2 cm from major blood vessels were independent risk factors of PM after LH. Of the 62 cases with PM, 26 (41.9%) had PM only, 34 (54.9%) had intrahepatic recurrence (IHR) and PM, and 2 (3.2%) had synchronous extraperitoneal metastases (EPM). Patients with resectable PM had a 5-year overall survival (OS) of 65.0% compared to 9.0% for unresectable PM (P=0.001)., Conclusions: The prevalence, patterns and independent risk factors of PM were identified for HCC patients after LH. LH was not associated with increased incidence of PM in HCC patients for experienced surgeons. Surgical re-excision of PM was associated with prolonged survival., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://hbsn.amegroups.com/article/view/10.21037/hbsn-22-506/coif). The authors have no conflicts of interest to declare., (2024 Hepatobiliary Surgery and Nutrition. All rights reserved.)

Myocardial infarction refers to the ischemic necrosis of myocardium, characterized by a sharp reduction or interruption of blood flow in the coronary arteries due to the coronary artery occlusion, resulting in severe and prolonged ischemia in the corresponding myocardium and ultimately leading to ischemic necrosis of the myocardium. Given its high risk, it is considered as one of the most serious health threats today. In current clinical practice, multiple approaches have been explored to diminish myocardial oxygen consumption and alleviate symptoms, but notable success remains elusive. Accumulated clinical evidence has showed that the implantation of mesenchymal stem cell for treating myocardial infarction is both effective and safe. Nevertheless, there persists controversy and variability regarding the standardizing MSC transplantation protocols, optimizing dosage, and determining the most effective routes of administration. Addressing these remaining issues will pave the way of integration of MSCs as a feasible mainstream cardiac treatment.

Background: Nonalcoholic fatty liver disease (NAFLD) has become the leading cause of cirrhosis and other chronic liver diseases (COCLDs)., Aim: To conduct a comprehensive and comparable updated analysis of the global, regional, and national burden of COCLDs due to NAFLD in 204 countries and territories from 1990 and 2019 by age, sex, and sociodemographic index., Methods: Data on COCLDs due to NAFLD were collected from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. Numbers and age-standardized prevalence, death, and disability-adjusted life years (DALYs) were estimated through a systematic analysis of modelled data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. The estimated annual percentage change was used to determine the burden trend., Results: In 2019, the global age-standardized prevalence rate of COCLDs due to NAFLD was 15022.90 per 100000 population [95% uncertainty interval (UI): 13493.19-16764.24], which increased by 24.51% (22.63% to 26.08%) from 1990, with an estimated annual percentage change of 0.78 (95% confidence interval: 0.74-0.82). In the same year, however, the age-standardized death rate and age-standardized DALYs per 100000 population were 1.66 (95%UI: 1.20-2.17) and 43.69 (95%UI: 31.28-58.38), respectively. North Africa and the Middle East had the highest prevalence rates of COCLDs due to NAFLD. The death rate increased with age up to the 95+ age group for both sexes. Males had higher numbers of prevalence, death rate, and DALYs than females across all age groups before the 65-69 age group. The sociodemographic index was negatively correlated with the age-standardized DALYs., Conclusion: Globally, the age-standardized prevalence rate has increased during the past three decades. However, the age-standardized death rate and age-standardized DALYs decreased. There is geographical variation in the burden of COCLDs due to NAFLD. It is strongly recommended to improve the data quality of COCLDs due to NAFLD across all countries and regions to facilitate better monitoring of the burden of COCLDs due to NAFLD., Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

Purpose: This study aimed to explore the survival significance of surgery and age on the prognosis of patients with primary trachea malignancies., Methods: The entire cohort of 637 patients with primary malignant trachea tumors was used to perform the main analyses. The data of those patients were from a public database. Overall survival (OS) curves were drawn by the Kaplan-Meier method and compared by the Log-rank test. The univariable and multivariable Cox regression analyses calculated the hazard ratio (HR) and 95% confidence interval (CI) for overall mortality. The propensity-score matching analysis was used to reduce the selection bias., Results: Age, surgery, histological type, N classification, M classification, marital status, and tumor grading were identified as independent prognostic factors after eliminating confounding factors. The results of the Kaplan-Meier method revealed that patients with age < 65 had a survival advantage over those with age ≥ 65 (HR = 1.908, 95% CI 1.549-2.348, P < 0.001). The 5-year OS rates were 28% and 8% in the group with age < 65 and age ≥ 65, respectively (P < 0.001). Cases with surgery had better survival over patients without surgery (HR = 0.372, 95% CI 0.265-0.522, P < 0.001). Compared with patients who did not undergo operations, patients with surgery had a higher median survival time (20 vs. 174 months). For patients with surgery, young age was considered a survival-promoting factor (HR 2.484; 95% CI 1.238-4.983, P = 0.010)., Conclusion: We suggested that age and surgery were the independent prognostic factors in patients with primary malignant trachea tumors. Besides, age serves as an essential indicator for evaluating the prognosis of postoperative patients., (© 2023. The Author(s).)

Objective: Intrauterine growth restriction followed by postnatal catch-up growth (CG-IUGR) increases the risk of insulin resistance-related diseases. Low-density lipoprotein receptor-related protein 6 (LRP6) plays a substantial role in glucose metabolism. However, whether LRP6 is involved in the insulin resistance of CG-IUGR is unclear. This study aimed to explore the role of LRP6 in insulin signaling in response to CG-IUGR., Methods: The CG-IUGR rat model was established via a maternal gestational nutritional restriction followed by postnatal litter size reduction. The mRNA and protein expression of the components in the insulin pathway, LRP6/β-catenin and mammalian target of rapamycin (mTOR)/S6 kinase (S6K) signaling, was determined. Liver tissues were immunostained for the expression of LRP6 and β-catenin. LRP6 was overexpressed or silenced in primary hepatocytes to explore its role in insulin signaling., Results: Compared with the control rats, CG-IUGR rats showed higher homeostasis model assessment for insulin resistance (HOMA-IR) index and fasting insulin level, decreased insulin signaling, reduced mTOR/S6K/ insulin receptor substrate-1 (IRS-1) serine307 activity, and decreased LRP6/β-catenin in the liver tissue. The knockdown of LRP6 in hepatocytes from appropriate-for-gestational-age (AGA) rats led to reductions in insulin receptor (IR) signaling and mTOR/S6K/IRS-1 serine307 activity. In contrast, LRP6 overexpression in hepatocytes of CG-IUGR rats resulted in elevated IR signaling and mTOR/S6K/IRS-1 serine307 activity., Conclusion: LRP6 regulated the insulin signaling in the CG-IUGR rats via two distinct pathways, IR and mTOR-S6K signaling. LRP6 may be a potential therapeutic target for insulin resistance in CG-IUGR individuals., (© 2023. Huazhong University of Science and Technology.)

Background: Acute histoplasmosis is a rare fungal disease in China. This study is aimed to summarize the clinical characteristics of the first large-scale outbreak of imported acute histoplasmosis in Chinese, so as to provide suggestions for clinical diagnosis and treatment., Methods: We collected the symptoms, signs, laboratory examination and imaging data of 10 patients in so far the biggest outbreak of imported acute histoplasmosis in immunocompetent Chinese. Their clinical characteristics and time-varying cytokine/chemokine levels were analyzed, and rank correlation analysis between these markers was utilized to show their condition., Results: The 10 patients of imported acute histoplasmosis were working without any respiratory protection in an abandoned mine tunnel in Guyana. The most common symptoms were fever and cough. Their chest CT imaging showed multiple nodular shadows in lungs. Laboratory examination showed that at admission the CRP, PCT, LDH, CysC, G-test, β2-MG were all increased in at least 9 patients, and the CD4/CD8 was decreased to < 1 in all patients. Most cytokines/chemokines (other than IL-4, IL-12, INF-α, TNF-α) varied widely with patients and time, but their overall trend is higher at admission and decreasing gradually during hospitalization, especially for the IL-6, IL-8, IL-10 and IFN-γ. The LDH, CysC, G-test, β2-MG, N/L, IL-6, IL-8, IL-10, IFN-γ, IL-27 are in positive associations to both CRP and PCT., Conclusions: The diagnosis of acute histoplasmosis needs a comprehensive analysis of epidemiological history, clinical symptoms and signs, and results of imaging, laboratory, microbiological and pathological examinations. Although none of the CRP, PCT, G-test, N/L, LDH, CysC, β2-MG, IL-6, IL-8, IL-10, IFN-γ shows specificity in the diagnosis of acute histoplasmosis, there is possibility that the above factors might help in the inflammation and prognosis estimation. However, more studies and further investigation are still required for the verification., (© 2022. The Author(s).)

Objective: To compare the effect of moxibustion combined with basic treatment and simple basic treatment on the clinical symptoms, renal function and hypercoagulable state in patients with idiopathic membranous nephropathy (IMN) of low to medium risk with spleen-kidney deficiency and blood stasis., Methods: A total of 60 patients with IMN of low to medium risk with spleen-kidney deficiency and blood stasis were randomized into an observation group (30 cases, 2 cases dropped off) and a control group (30 cases, 1 case dropped off). In the control group, the conventional basic treatment of anti-hypertension, regulating blood lipid and anti-coagulation was adopted. On the basis of the control group, moxibustion was applied at Shenshu (BL 23), Pishu (BL 20), Guanyuan (CV 4), Zusanli (ST 36) and Sanyinjiao (SP 6) in the observation group, once a day, 5 days a week continuously with 2 day interval. The treatment of 6 months was required in the both groups. Before treatment and 3 and 6 months into treatment, the total TCM syndrome score, the renal function indexes (24-hour urinary protein quantity [UTP], albumin [ALB], urea nitrogen [BUN] and creatinine [Scr]), the blood coagulation indexes (fibrinogen [FIB], D-Dimer [D-D], p-selection and von Willebrand factor [vWF]), total cholesterol (TC) and triacylglycerol (TG) levels were observed, and the therapeutic efficacy was evaluated on 3 and 6 months into treatment in the two groups., Results: The effective rates of 3 and 6 months into treatment were 78.6% (22/28) and 89.3% (25/28) in the observation group, which were higher than 62.1% (18/29) and 75.9% (22/29) in the control group respectively ( P <0.05). On 3 and 6 months into treatment, the total TCM syndrome scores were decreased compared before treatment in the both groups ( P <0.05), and those in the observation group were lower than the control group ( P <0.05). On 3 months into treatment, the levels of UTP, FIB, D-D, P-selection and vWF were decreased ( P <0.05), the level of ALB was increased ( P <0.05) compared before treatment in the observation group; the levels of UTP and FIB were decreased compared before treatment in the control group ( P <0.05); the level of ALB in the observation group was higher than that in the control group ( P <0.05), the levels of FIB and vWF in the observation group were lower than those in the control group ( P <0.05). On 6 months into treatment, the levels of UTP, FIB, D-D, P-selection, vWF, TC and TG were decreased ( P <0.05), the levels of ALB were increased ( P <0.05) compared before treatment in the both groups ( P <0.05); the levels of UTP, FIB, D-D, P-selection, vWF, TC and TG in the observation group were lower than those in the control group, the level of ALB in the observation group was higher than that in the control group ( P <0.05)., Conclusion: Moxibustion combined with basic treatment can effectively improve the clinical symptoms, renal function and renal microcirculation in patients with idiopathic membranous nephropathy of low to medium risk with spleen-kidney deficiency and blood stasis, the therapeutic effect is superior to the simple basic treatment.

Background: Robot-assisted and laparoscopic surgery are the most minimally invasive surgical approaches for the removal of liver lesions. Minor hepatectomy is a common surgical procedure. In this study, we evaluated the advantages and disadvantages of robot-assisted vs laparoscopic minor hepatectomy (LMH)., Methods: A systematic literature search was performed in PubMed, Embase, and the Cochrane Library to identify comparative studies on robot-assisted vs. laparoscopicminor hepatectomy up to February, 2020. The odds ratios (OR) and mean differences with 95% confidence intervals were calculated using the fixed-effects model or random-effects model., Results: A total of 12 studies involving 751 patients were included in the meta-analysis. Among them, 297 patients were in the robot-assisted minor hepatectomy (RMH) group and 454 patients were in the LMH group. There were no significant differences in intraoperative blood loss (P = .43), transfusion rates (P = .14), length of hospital stay (P > .64), conversion rate (P = .62), R0 resection rate (P = .56), complications (P = .92), or mortaliy (P = .37) between the 2 groups. However, the RMH group was associated with a longer operative time (P = .0003), and higher cost (P < .00001) compared to the LMH group. No significant differences in overall survival or disease free survival between the 2 groups were observed. In the subgroup analysis of left lateral sectionectomies, RMH was still associated with a longer operative time, but no other differences in clinical outcomes were observed., Conclusions: Although RMH is associated with longer operation times and higher costs, it exhibits the same safety and effectiveness as LMH. Prospective randomized controlled clinical trials should now be considered to obtain better evidence for clinical consensus., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Hepatic ischemia/reperfusion injury (IRI) is a result of the ischemic cascade and may occur in the settings of liver trauma, resection and transplantation. Components of the complement system have been indicated to be mediators of hepatic IRI and regulators of liver regeneration. As such, their potential to mediate both beneficial and harmful effects render them key targets for therapy. In the present study, the mechanisms of complement mediating hepatic IRI were discussed with a focus on the different functions of complement in hepatic injury and liver recovery, and an explanation for this apparent paradox is provided, i.e. that the complement products C3a and C5a have an important role in liver damage; however, C3a and C5a are also necessary for liver regeneration. Furthermore, situated at the end of the complement activation cascade, the membrane attack complex is crucial in hepatic IRI and inhibiting the complex with a site-targeted murine complement inhibitor, complement receptor 2-CD59, may improve liver regeneration after partial hepatectomy, even when hepatectomy is combined with ischemia and reperfusion., (Copyright: © Hu et al.)

Objective: To investigate the clinical efficacy of vertebral body stent (VBS) system and percutanous kyphoplasty (PKP) combined with zoledronic acid for the treatment of severely osteoporotic compression vertebral fractures (OVCFs)., Methods: The clinical data of 48 patients with osteoporotic thoracolumbar fractures treated from December 2017 to December 2018 were retrospectively analyzed, including 13 males and 35 females, aged 55 to 92 years old with an average (71.2±10.5) years. All patients were treated with VBS system PKP surgery, and zoledronic acid injection was used for anti-osteoporosis treatment after operation. The VAS scores ODI, the height of diseasedvertebral lost were compared before operation, 3 d and half a year after operation, and whether there was re-fracture of diseased or adjacent vertevrae after operation was observed., Results: Before operation, 3 d and half a year after operation, VAS scores were 7.60±0.12, 3.00±0.46, 1.20±0.23, ODI were(82.00±0.32)%, (30.00±1.50) %, (18.00±0.16) %, the height of diseased vertebral lost were (12.00±0.43) mm, (3.00± 0.15) mm, (3.60±0.51) mm respectively. Postoperative VAS score, ODI, the height of diseased vertebral lost were obviously improved ( P <0.05), and there was no significant difference between 3 d and half a year after operation ( P >0.05). All the 48 patients were followed up with an average time of (6.6±0.5) months. All the incisions healed at grade A after operation, and no re-fracture of diseased vertebrae or adjacent vertebrae was found at the final follow-up., Conclusion: VBS system and PKP combined with zoledronic acid in the treatment of OVCFs not only may effectively relieve the pain in the thoracolumbar back, improve the mobility of the thoracolumbar, but also can restore the height of the vertebral body to the maximum extent, and prevent the re-fracture of the affected vertebrae and adjacent vertebrae, which is worthy to spread in clinic.

Objective: To investigate the effect of corticosteroid on hospital mortality, hospital length of stay, and time of viral clearance in patients with severe and critical COVID-19., Patients and Methods: Patients with severe and critical COVID-19 who had been discharged or expired were enrolled in this study. Patients were divided into corticosteroid group and non-corticosteroid group according to the systemic corticosteroid use or not. Clinical data were collected, and hospital mortality, hospital length of stay, time of viral clearance, time of mechanical ventilation, and duration from illness onset to symptom resolution were compared between the two groups., Results: A total of 72 inpatients who were diagnosed with severe and critical COVID-19 were enrolled, in which 47 patients were divided into corticosteroid group and 25 were involved as the non-corticosteroid group. Baseline characteristics were generally similar between the two groups. Four (5.6%) patients died during hospitalization, and 68 (94.4%) were discharged. Among survivors, the mean duration time from admission to discharge was 19.5d (SD 7.05 d). The mean time of viral clearance among survivors was 17.5d (SD 7.67 d), with a maximum of 37 d, and a minimum of 5 d. Hospital mortality (4.3% vs. 8.0%), length of hospital stay (18.7d vs. 21.0d), and time of viral clearance (16.1d vs. 19.4d) had no significant difference between two groups (p>0.05). The duration of symptoms suffering was shorter in the corticosteroid group than non-corticosteroid group, with statistically significant difference (p<0.05)., Conclusions: Corticosteroid therapy in patients with severe COVID-19 cannot reduce the hospital mortality, and is not associated with delayed viral clearance, but it could relieve the inflammatory storm and improve clinical symptoms in brief. Patients with severe COVID-19 could benefit from low-dose corticosteroid treatment.

Premise: The distribution and performance of bryophyte species vary with vertical gradients, as a result of changes in environmental factors, especially light. However, the morphological and physiological drivers of bryophyte distribution along forest vertical gradients are poorly understood., Methods: For 18 species of mosses and liverworts distributed among three vertical microhabitats (ground, tree trunk, and branch, variance in 28 morphological and photosynthetic functional traits was comparatively analyzed among the microhabitats and bryophyte life-forms in a subtropical cloud forest in Ailao Mountain, Yunnan, southwestern China. Principal component analysis (PCA) was used to summarize trait differences among bryophyte species., Results: In contrast to trunk and ground dwellers, branch dwellers tended to reduce light interception (smaller leaf and cell sizes, lower chlorophyll content), protect against damage from intense irradiation (higher ratios of carotenoids to chlorophyll), raise light energy use (higher photosynthetic capacity), and cope with lower environmental moisture (pendant life-forms, thicker cell walls). The PCA showed that ecological strategies of bryophytes in response to levels of irradiation were specialized in branch dwellers, although those of ground and trunk dwellers were less distinct., Conclusions: Environmental filtering shaped the combination of functional traits and the spatial distribution of bryophytes along the vertical gradients. Bryophyte species from the upper canopy of cloud forests show narrow variation in functional traits in high-light intensity, whereas species in the lower vertical strata associated with low-light intensity used contrasting, but more diverse ecological strategies., (© 2020 Botanical Society of America.)

Background: Hepatocellular carcinoma (HCC) is a common malignant gastrointestinal tumor. There are currently few clinical diagnostic and prognostic markers for HCC. LncRNA cancer susceptibility candidate 9 (CASC9) is a long-chain non-coding RNA discovered in recent years, and previous studies have found that lncRNA CASC9 participates in the occurrence and development of HCC, but its clinical value remains unclear., Aim: To determine the expression of lncRNA CASC9 in HCC and its diagnostic and prognostic value., Methods: Data on CASC9 expression in patients with HCC were collected from the Cancer Genome Atlas (TCGA) database to analyze the relationship between CASC9 and patient survival. A total of 80 HCC patients treated in The First Affiliated Hospital of Guangxi Medical University from May 2012 to January 2014 were enrolled in the patient group, and 50 healthy subjects were enrolled in the control group during the same period. CASC9 expression in the two groups was determined using quantitative real-time polymerase chain reaction, and its diagnostic and prognostic value was analyzed based on the CASC9 data and pathological data in these HCC patients. The relationship between CASC9 and patient survival was assessed during the 5-year follow-up period., Results: Analysis of data from TCGA database revealed that control samples showed significantly lower CASC9 expression than carcinoma tissue samples ( P < 0.001); the low CASC9 expression group had a higher survival rate than the high CASC9 expression group ( P = 0.011), and the patient group showed significantly increased expression of serum CASC9, with the area under the curve (AUC) of 0.933. CASC9 expression was related to tumor size, combined hepatitis, tumor, node, metastasis (TNM) staging, lymph node metastasis, differentiation and alpha fetoprotein, and the high CASC9 expression group showed lower 1-year, 3-year and 5-year survival rates than the low CASC9 expression group (all a P < 0.05). Multivariate Cox regression analysis revealed that TNM staging, lymph node metastasis, differentiation, alpha fetoprotein and CASC9 were independent factors affecting the prognosis of patients. Stage I+II patients with lymph node metastasis, low differentiation, and alpha fetoprotein > 200 ng/mL had a poor 5-year survival rate., Conclusion: High CASC9 expression is beneficial in the prognosis of HCC patients. CASC9 is expected to be a potential diagnostic and prognostic indicator of HCC., Competing Interests: Conflict-of-interest statement: The authors declare no conflict of interest., (©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.)

Objective: To investigate the clinical and imaging characteristics of acute histoplasmosis. Methods: The clinical and imaging data of 10 patients with acute histoplasmosis were studied. Their clinical and imaging characteristics were analyzed. All the patients returned from a South American republic in April 2019 and were treated at the Chongqing public health medical treatment center. Results: All the 10 patients were male, aged 30-56 years old, with an average age of 43.8 years old. Four of them were engaged in soil clearing, 2 in gas cutting, 2 in moving tools, and 2 in inspection. The disease in all the 10 patients was caused by inhaling a large amount of bacteria-bearing dust in a short time, with an incubation period of 9-13 days, and the main clinical manifestations were fever, insomnia, dizziness, headache, cough, poor appetite, rash and diarrhea. One patient's head CT showed extensive thickening and increased density of bilateral frontotemporal, parietal and occipital meninges, while the other 9 patients showed no obvious abnormalities. Chest CT findings were as follows: (1) Multiple nodular shadow: the chest CT findings of 4 patients were miliary nodular shadow with diffuse distribution in both lungs. Most of the nodules were less than 5 mm in diameter and distributed evenly or unevenly. CT findings of 6 cases showed scattered nodular shadows in both lungs, with diameters ranging from 2 to 15 mm, and obvious distribution in subpleural and inferior lobes of both lungs. (2) Consolidation shadow: in 2 cases, the size of the shadow was uneven and the density increased, mainly distributed in the subpleura and the lower lobe of both lungs. (3) Ground glass density shadow: mainly distributed around nodules, halo signs can be seen around some nodules. (4) Mediastinum and/or hilar lymph nodes were enlarged. (5) Pleural effusion: a small amount of pleural effusion was found in 4 cases. (6) Pericardial effusion in 3 cases. Abdominal CT showed splenomegaly in 8 cases and hepatomegaly in 1 case. Conclusions: Acute histoplasmosis has no specificity in clinical manifestations. However, there are still some features in CT manifestations, including multiple nodules in both lungs accompanied by halo, enlarged liver, spleen and mediastinal lymph nodes, and multiple serous cavity effusions.

Chlorophyll content in lichens is routinely used as an accurate indicator of lichen vigor, interspecific differences, and the effect of site-related environmental parameters. Traditional methods of chlorophyll extraction are destructive, time-consuming, expensive, and inoperable, especially when measuring large quantities of chlorophyll. However, non-destructive methods of measurement using portable chlorophyll meters are rarely used for lichens. Considering the characteristics of lichens such as rough blade surface and absence of chlorophyll b in cyanolichens, we compared the non-destructive methods with traditional methods and evaluated their applicability in studying lichen pigment content. Two instruments, SPAD-502 and CCM-300, were used to measure the pigment content of seven foliose lichen species. These pigment readings were compared with those determined using the dimethyl sulphoxide (DMSO) extraction method. Significant correlations were observed between SPAD/CCM values and pigments (chlorophyll and total carotenoids) extracted from chlorolichens, especially species with a smooth surface. The CCM-300 was more accurate in detecting the pigment content of foliose chlorolichens. However, both instruments showed certain limitations in the determination of pigment content in cyanolichens, especially gelatinous species. For example, CCM-300 often failed to give specific values for some cyanolichen samples, and both instruments showed low measurement accuracy for cyanolichens. Based on the high correlation observed between chlorophyll meter readings and pigments extracted from chlorolichens, equations obtained in this study enabled accurate prediction of pigment content in these lichens.

Background: There are no unanimous reports on different layouts and classifications of multi-hole secundum atrial septal defects (MHASD) and subsequent standardized occlusion techniques. The MHASD can be isolated or cribriform with variable inter-defects distance. In this retrospective study, experience-based classification and two approaches-based occlusion results are presented., Methods: We retrospectively collected and analyzed data of 150 MHASD patients from 1320 patients who underwent atrial septal defect occlusion in our institute. The MHASD patients were categorized into 4 types; type A, B, C and D and occluded under exclusive transesophageal echocardiographic guidance. According to different types, 122 patients were occluded using peratrial approach and 28 patients via percutaneous approach. In type A, single device implantation is performed to occlude the large hole and squeeze the small one. For type B single or double-device deployment was performed depending on an inter-defects distance. In type C and D, a patent foramen-ovale (PF) device was selectively positioned to the central defect to occlude the central defect and cover the peripheral ones. In peratrial approach, 8 patients underwent inter-defects septal puncture technique to achieve single-device occlusion. The intracardiac manipulation time, procedural time, double device deployment, redeployment rate, residual shunt, and proportions were analyzed between (and within peratrial technique) two techniques., Results: Successful occlusion was achieved in all 150 patients. Single device occlusion was applied in 78/84 type A and 22/37 type B patients (p < 0.05). Double device occlusion was more applicable to type B than A patients (p < 0.01). Sixteen of 21 type C and all type D patients used PF device for a satisfactory occlusion. Redeployment of the device occurred frequently in type B patients than A (p < 0.01). The intracardiac manipulation time and procedural time were shorter in type A than B (p < 0.05). The intracardiac manipulation time was also shortened in type A peratrial than type A percutaneous group (p < 0.05). Complete occlusion rate for all patients at discharge was 70% and rose to 82% at 1 year follow up., Conclusions: The diverse layouts and classification of MHASDs can help to choose different techniques and proper devices of different kinds to achieve better occlusion results.

Cholangiocarcinoma (CCA) is a severe malignancy usually producing a poor prognosis and high mortality rate. MicroRNAs (miRNAs) have been reported in association with CCA; however, the role miR-329 plays in the CCA condition still remains unclear. Therefore, this study was conducted to explore the underlying mechanism of which miR-329 is influencing the progression of CCA. This work studied the differential analysis of the expression chips of CCA obtained from the Gene Expression Omnibus database. Next, to determine both the expression and role of pituitary tumor transforming gene-1 (PTTG1) in CCA, the miRNAs regulating PTTG1 were predicted. In the CCA cells that had been intervened with miR-329 upregulation or inhibition, along with PTTG1 silencing, expression of miR-329, PTTG1, p-p38/p38, p-ERK5/ERK5, proliferating cell nuclear antigen (PCNA), Cyclin D1, Bcl-2-associated X protein (Bax), B-cell CLL/lymphoma 2 (Bcl-2), and caspase-3 were determined. The effects of both miR-329 and PTTG1 on cell proliferation, cell-cycle distribution, and apoptosis were also assayed. The miR-329 was likely to affect the CCA development through regulation of the PTTG1-mediated mitogen-activated protein kinase (MAPK) signaling pathway. The miR-329 targeted PTTG1, leading to inactivation of the MAPK signaling pathway. Upregulation of miR-329 and silencing of PTTG1 inhibited the CCA cell proliferation, induced cell-cycle arrest, and subsequently promoted apoptosis with elevations in Bax, cleaved caspase-3, and total caspase-3, but showed declines in PCNA, Cyclin D1, and Bcl-2. Moreover, miR-329 was also found to suppress the tumor growth by downregulation of PTTG1. To summarize, miR-329 inhibited the expression of PTTG1 to inactivate the MAPK signaling pathway, thus suppressing the CCA progression, thereby providing a therapeutic basis for the CCA treatment., (© 2018 Wiley Periodicals, Inc.)

The complement system is a key component of the body's immune system. When abnormally activated, this system can induce inflammation and damage to normal tissues and participate in the development and progression of a variety of diseases. In the past, many scholars believed that alcoholic liver disease (ALD) is induced by the stress of ethanol on liver cells, including oxidative stress and dysfunction of mitochondria and protease bodies, causing hepatocyte injury and apoptosis. Recent studies have shown that complement activation is also involved in the genesis and development of ALD. This review focuses on the roles of complement activation in ALD and of therapeutic intervention in complement-activation pathways. We intend to provide new ideas on the diagnosis and treatment of ALD., Competing Interests: Conflict-of-interest statement: All authors have no conflicts of interest to report.

Background: The current approaches of transcatheter closure of mitral paravalvular leak (MPVL) have different drawbacks. The challenges come from transseptal puncture, accessing the MPVL site, and the absence of dedicated delivery systems. This study introduces a novel peratrial approach for device closure of different locations of MPVLs using a probe-assisted delivery system under three-dimensional transesophageal echocardiography., Methods: A 4.0-cm minithoracotomy incision was made in the fourth right interspaces. The right atrium and the interatrial septum were punctured and dilated, followed by a guidewire passing through the septum. A specially designed J-shaped bendable hollow probe was advanced into the left atrium. The steerable probe was adjusted to cross the MPVL and introduced a stiff guidewire into the left ventricle. A 7F short delivery sheath was advanced over the wire through the MPVL into the left ventricle. A proper-sized muscular septal occluder was then selected and deployed., Results: Transesophageal echocardiography revealed complete occlusion in 7 of 8 patients after a follow-up of 6 months to 4 years. Mild residual paravalvular regurgitation occurred in an early patient. In 2 patients with a crescent-shaped MPVL, two guidewires were advanced into the left ventricle across the leak, and double devices were deployed sequentially. All patients' symptoms improved by at least one New York Heart Association functional class., Conclusions: The peratrial technique can access and close MPVLs at different locations through a right minithoracotomy approach. This technique has the advantages of easy transseptal puncture, easy access to the MPVL site, and no exposure to radiation., (Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Pigment epithelium-derived factor (PEDF) is a pleiotropic gene with anti-inflammatory, antioxidant and anti-angiogenic properties. However, recent reports about the effects of PEDF on cardiomyocytes are controversial, and it is not known whether and how PEDF acts to inhibit hypoxic or ischemic endothelial injury in the heart. In the present study, adult Sprague-Dawley rat models of acute myocardial infarction (AMI) were surgically established. PEDF-small interfering RNA (siRNA)-lentivirus (PEDF-RNAi-LV) or PEDF-LV was delivered into the myocardium along the infarct border to knockdown or overexpress PEDF, respectively. Vascular permeability, cardiomyocyte apoptosis, myocardial infarct size and animal cardiac function were analyzed. We also evaluated PEDF's effect on the suppression of the endothelial permeability and cardiomyocyte apoptosis under hypoxia in vitro. The results indicated that PEDF significantly suppressed the vascular permeability and inhibited hypoxia-induced endothelial permeability through PPARγ-dependent tight junction (TJ) production. PEDF protected cardiomyocytes against ischemia or hypoxia-induced cell apoptosis both in vivo and in vitro via preventing the activation of caspase-3. We also found that PEDF significantly reduced myocardial infarct size and enhanced cardiac function in rats with AMI. These data suggest that PEDF could protect cardiac function from ischemic injury, at least by means of reducing vascular permeability, cardiomyocyte apoptosis and myocardial infarct size.

p-Type surface conductivity is a uniquely important property of hydrogen-terminated diamond surfaces. In this work, we report similar surface-dominated electrical properties in silicon nanowires (SiNWs). Significantly, we demonstrate tunable and reversible transition of p(+)-p-i-n-n(+) conductance in nominally intrinsic SiNWs via changing surface conditions, in sharp contrast to the only p-type conduction observed on diamond surfaces. On the basis of Si band energies and the electrochemical potentials of the ambient (pH value)-determined adsorbed aqueous layer, we propose an electron-transfer-dominated surface doping model, which can satisfactorily explain both diamond and silicon surface conductivity. The totality of our observations suggests that nanomaterials can be described as a core-shell structure due to their large surface-to-volume ratio. Consequently, controlling the surface or shell in the core-shell model represents a universal way to tune the properties of nanostructures, such as via surface-transfer doping, and is crucial for the development of nanostructure-based devices.

A facile hydrothermal method was adopted to in situ grow ZnO nanowire pyramidal bundle arrays on zinc substrates at low growth temperature without the assistance of catalysts and templates. The bundle arrays were shown to form by sticking of nanowires at their tips. Field electron emission characterization of nanowires bundle arrays revealed a very low turn-on electric field of about 2.3 V/microm and a threshold electric field (corresponding to the field electron emission current density of 10 mA/cm2) of 6.8 V/microm, which are comparable to those observed in carbon nanotube arrays. The bundle arrays also show pronounced long-term field electron emission stability at a high current density. In addition, the formation mechanism of the pyramidal bundled arrays and the origin of the peculiar field electron emission properties were discussed.

Selenium nanowires with a diameter of about 70 nm and a growth direction along [001] were fabricated via a facile solution method. Photoconductive properties of Se wires were systematically characterized via photodetectors made of single Se nanowire. The photodetectors exhibited a high light on-off current ratio (Ilight/ Idark) of 450, and a fast light response speed of millisecond rise/fall time with excellent stability and reproducibility. It was also observed that the response time strongly depend on the intensity of the illumination light: the rise time and fall time for a typical photodetector is 0.68/1.85, 0.53/1.70, 0.54/1.65, 0.51/1.59, and 0.49/1.58 ms for light intensity of 0.18, 0.26, 0.43, 0.96, and 1.89 mW/cm2, respectively, and the relationship between the light intensity and the photocurrent can be fitted by using a simple power law. The diameters of the nanowire were found to have a significant influence on the response speed with smaller Se nanowires showing higher response speed. Finally, the mechanisms of photoconduction and factors affecting the performance of the photodetectors were elucidated.

Single- and few-layer graphene sheets with sizes up to 0.1 mm were fabricated by simply quenching hot graphite in an ammonium hydrogen carbonate aqueous solution. The identity and thickness of graphene sheets were characterized with transmission electron microscopy, atomic force microscopy, and Raman spectroscopy. In addition to its simplicity and scalability, the present synthesis can produce graphene sheets with excellent qualities in terms of sizes, purity, and crystal quality. The as-produced graphene sheets can be easily transferred to solid substrates for further processing. Field-effect transistors based on individual graphenes were fabricated and shown to have high ambipolar carrier mobilities.

Well-aligned ZnO nanowire (NW) arrays with durable and reproducible p-type conductivity were synthesized on alpha-sapphire substrates by using N2O as a dopant source via vapor-liquid-solid growth. The nitrogen-doped ZnO NWs are single-crystalline and grown predominantly along the [110] direction, in contrast to the [001] direction of undoped ZnO NWs. Electrical transport measurements reveal that the nondoped ZnO NWs exhibit n-type conductivity, whereas the nitrogen-doped ZnO NWs show compensated highly resistive n-type and finally p-type conductivity upon increasing N2O ratio in the reaction atmosphere. The electrical properties of p-type ZnO NWs are stable and reproducible with a hole concentration of (1-2) x 10(18) cm(-3) and a field-effect mobility of 10-17 cm2 V(-2) s(-1). Surface adsorptions have a significant effect on the transport properties of NWs. Temperature-dependent PL spectra of N-doped ZnO NWs show acceptor-bound-exciton emission, which corroborates the p-type conductivity. The realization of p-type ZnO NWs with durable and controlled transport properties is important for fabrication of nanoscale electronic and optoelectronic devices.

Background: Sinus of Valsalva aneurysm is a rare cardiac anomaly, and the difference between Asian and Western countries in its occurrence is not well established. This study was designed to investigate the difference between Asian and Western patients., Methods: Between September 1988 and February 2006, 83 patients with sinus of Valsalva aneurysm underwent surgical repair in our institute. The aneurysms originated from the right and noncoronary sinus in 74 and 9, respectively, and ruptured into the right ventricle in 52 patients, the right atrium in 30, and the left ventricle in 1. Ventricular septal defect (n = 38), aortic regurgitation (n = 21), and bicuspid aortic valve (n = 4) were the common coexisting anomalies. To compare the differences between Asian and Western patients in sinus of Valsalva aneurysm, 1049 cases (654 Asian patients versus 395 Western) were collected from the literature., Results: Sixty-six patients were followed up for 9.6 +/- 3.8 years. The cardiac function of 15 patients with aortic regurgitation was worse than that of those with no aortic regurgitation (p < 0.05). There was no difference between the direct closure and the patch closure (p > 0.05). Analysis of all collected cases revealed that aneurysm of the sinus of Valsalva in Asian patients compared with Western series is characterized by a higher incidence, more aneurysms originating from the right coronary sinus (85.8% versus 67.9%), more aneurysm rupture into the right ventricle (72.5% versus 60%), a higher incidence of association with ventricular septal defect (52.4% versus 37.5%), and lower incidence of association with bicuspid aortic valve (0.6% versus 7.8%). However, both Asian and Western patient series have similar incidence of combination with aortic regurgitation (33.6% versus 32.7%)., Conclusions: Long-term results of ruptured sinus of Valsalva aneurysm are associated with preoperative aortic regurgitation. The difference between Asian and Western patients with ruptured aneurysm of the sinus of Valsalva is significant.

Objective: To explore the therapeutic effects and mechanisms of Zhubi capsule on adjuvant arthritis (AA) in rats., Method: The model of rat was induced by intradermal injection of CFA. The perimeter of ankle joint was measured at different time points. Con A-induced splencyte proliferation was examined by MIT assay and the expression of IL-1, IL-6 in synovium was determined by immunohistochemical method., Result: After the preventive administration of Zhubi capsule (5.2, 2.6, 1.3 g x kg x d(-1), x 25 d), it was found that Zhubi capsule significantly inhibited the primary and secondary ankle joint swelling. The increased Con A-induced splencyte proliferation reaction and the activated IL1, IL-6 expression of AA rat were suppressed by the treatment with Zhubi capsule., Conclusion: Zhubi capsule has a therapeutic effect on AA rats, and its mechanism is related to the immunoregulative function.

Objective: To compare the hemostatic effect of Flos Sophorae in crude, parched and carbonized forms and its extracts, including rutin, quercetin and tannin., Methods: All the testing samples were orally administered to the experimental animals for 5 days, then the bleeding time (BT), coagulation time (CT), platelet count and capillary permeability (CP) in the treated mice were tested, and the prothrombin time (PT), fibrinogen (FBG) content and platelet aggregation rate (PAR) in the treated rats were determined., Results: All the samples could lower the CP, BT and CT in mice and also decrease the plasma PT in rats. All three forms of Flos Sophorae could increase FBG in rats, while the three extracts of it could inhibit the PAR in rats obviously. In addition, rutin had the effect of raising the platelet count., Conclusion: All the three forms and three extracts of Flos Sophorae have hemostatic effect, the effect of parched and carbonized form is higher than that of crude drug. The mechanism of the hemostatic effect of the six kinds of sample might be various.