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Dao-Kui Xia,1,* Zhi-Gang Hu,2,3,* Yu-Feng Tian,4,* Fan-Jun Zeng2,3 1Department of Thoracic Surgery, Yichang Central People’s Hospital, Yichang, PR China; 2Department of Respiratory Medicine, Respiratory Disease Research Institute of China, Three Gorges University, Yichang, PR China; 3Department of Respiratory Medicine, Yichang Central People’s Hospital, Yichang, PR China; 4Department of Academic Management, Clinical Research Center, Three Gorges University, Yichang, PR China *These authors contributed equally to this work Background: Previous clinical studies reported inconsistent results on the associations of statins with the mortality and survival of lung cancer patients. This review and meta-analysis summarized the impact of statins on mortality and survival of lung cancer patients.Materials and methods: Eligible papers of this meta-analysis were searched by using PubMed, EMBASE, and Cochrane until July 2017. Primary end points were the mortality (all-cause mortality and cancer-specific mortality) and survival (progression-free survival and overall survival) of patients with statin use. Secondary end points were overall response rate and safety. The random-effects model was used to calculate pooled HRs and 95% CIs.Results: Seventeen studies involving 98,445 patients were included in the meta-analysis. In observational studies, the pooled HR indicated that statins potentially decreased the cancer-specific mortality and promoted the overall survival of lung cancer patients. Statins showed an association with decreased all-cause mortality in cohort studies (HR =0.77, 95% CI: 0.59–0.99), but not in case-control studies (HR =0.75, 95% CI: 0.50–1.10). However, statin use showed no impact on mortality and overall survival in randomized controlled trials. Meanwhile, this meta-analysis indicated that statin use did not affect the progression-free survival of lung cancer patients in observational studies and randomized controlled trials. In addition, statins potentially enhanced the effects of tyrosine kinase inhibitors (HR=0.86, 95% CI: 0.76–0.98) and chemotherapy (HR=0.86, 95% CI: 0.81–0.91) on the overall survival of patients with non-small-cell lung cancer, but did not increase overall response rate and toxicity.Conclusion: Statins were potentially associated with the decreasing risk of mortality and the improvement of overall survival in observational studies but not in randomized controlled trials. Keywords: statin, lung cancer, mortality, survival, statins, lung cancer, prognosis

In this paper, SSiB's development and some of its major parameterizations in the model are briefly reviewed. The soil moisture parameterizations, which are a key element in the model, are comprehensively described. The sensitivity study shows that hydraulic conductivity at saturation, B parameter, and wilting point have a profound impact on the simulation of soil moisture, but with different features. Both hydraulic conductivity at saturation and B parameter influence the soil moisture simulation by changing the soil hydraulic conductivity and the field capacity. The changes in equilibrium soil water content in this study are consistent with the changes in field capacity. The wilting point affects the soil moisture through vegetation transpiration. Through these sensitivity studies, improvements in modeling the soil moisture content of HAPEX-Mobilhy data are made. The soil moisture simulations at six Russian sites are also re-examined. After applying the results from the sensitivity studies of the HAPEX-Mobilhy data, the soil moisture simulation of the Russian data is significantly improved.

Populus euphratica is an important tree species in the arid regions of Northwest China, which is sensitive to climate changes. Climate of the Northwest China is changing to be "warm and humid", but how it would affect the regional forest growth is not clear. In this study, the radial growth response of P. euphratica to major climatic factors and their temporal changes during 1984-2021 were analyzed by using dendrochronology method in the desert oasis ecotone of Cele in the southern Tarim basin. The results showed that tree-ring width index of P. euphratica had a significant negative correlation with temperature in September of the previous year, and in February and May of current year, had significant positive correlation with precipitation in September of previous year and March and May of current year, and had significant positive correlations with SPEI in February and May of current year. The relationships between tree-ring width index and combined month climatic factors were more obvious. The results of moving correlation analysis showed that the correlation between tree-ring width index and temperature in the growing season tended to be strengthened in recent years, while the correlation between tree-ring width index and precipitation, SPEI tended to be declined or remain stable. The variations of the relationships between tree-ring width index and combined month climatic factors were more obvious compared that with single month. Current regional climate is conducive to the growth and development, as well as the improvement of ecological shelter function of P. euphratica forest in the desert oasis ecotone of Cele.

Spinal cord injury (SCI) is a severe and disabling injury of the central nervous system, with complex pathological mechanisms leading to sensory and motor dysfunction. Pathological processes, such as oxidative stress, inflammatory response, apoptosis, and glial scarring are important factors that aggravate SCI. Therefore, the inhibition of these pathological processes may contribute to the treatment of SCI. Currently, the pathogenesis of SCI remains under investigation as SCI treatment has not progressed considerably. Resveratrol, a natural polyphenol with anti-inflammatory and antioxidant properties, is considered a potential therapeutic drug for various diseases and plays a beneficial role in nerve damage. Preclinical studies have confirmed that signaling pathways are closely related to the pathological processes in SCI, and resveratrol is believed to exert therapeutic effects in SCI by activating the related signaling pathways. Based on current research on the pathways of resveratrol and its role in SCI, resveratrol may be a potentially effective treatment for SCI. This review summarizes the role of resveratrol in promoting the recovery of nerve function by regulating oxidative stress, inflammation, apoptosis, and glial scar formation in SCI through various mechanisms and pathways, as well as the deficiency of resveratrol in SCI research and the current and anticipated research trends of resveratrol. In addition, this review provides a background for further studies on the molecular mechanisms of SCI and the development of potential therapeutic agents. This information could also help clinicians understand the known mechanisms of action of resveratrol and provide better treatment options for patients with SCI., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background and Purpose: To identify anatomic prognostic factors and their potential roles in refining M1 classification for de novo metastatic nasopharyngeal carcinoma (M1-NPC)., Materials and Methods: All M1-NPC treated with chemotherapy and/or radiotherapy between 2010 and 2019 from two centers (training and validation cohort) were included. The prognostic value of metastatic disease extent and involved organs for overall survival (OS) were assessed by several multivariable analyses (MVA) models. A new M1 classification was proposed and validated in a separate cohort who received immuno-chemotherapy., Results: A total of 197 M1-NPC in the training and 307 in the validation cohorts were included for M1 subdivision study with median follow-up of 46 and 57 months. MVA model with "≤2 organs/≤5 lesions" as the definition of oligometastasis had the highest C-index (0.623) versus others (0.606-0.621). Patients with oligometastasis had better OS versus polymetastasis (hazard ratio [HR] 0.47/0.63) while liver metastases carried worse OS (HR 1.57/1.45) in MVA in the training/validation cohorts, respectively. We proposed to divide M1-NPC into M1a (oligometastasis without liver metastases) and M1b (liver metastases or polymetastasis) with 3-year OS of 66.5%/31.7% and 64.9%/35.0% in the training/validation cohorts, respectively. M1a subset had a better median progress-free survival (not reach vs. 17 months, p < 0.001) in the immuno-chemotherapy cohort (n = 163)., Conclusion: Oligometastasis (≤2 organs/≤5 lesions) and liver metastasis are prognostic for M1-NPC. Subdivision of M1-NPC into M1a (oligometastasis without liver metastasis) and M1b (liver metastasis or polymetastasis) depicts the prognosis well in M1-NPC patients who received immuno-chemotherapy., (© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)

Background/purpose: Epigallocatechin-3-gallate (EGCG) is playing an increasingly important role in the treatment of oral diseases. However, its mechanisms remain to be clarified. This study aimed to investigate the effect of EGCG on oxidative and inflammatory stress and bone loss in experimental periodontitis., Materials and Methods: Periodontitis was induced in rats, followed by gavage using different concentrations of EGCG for 5 weeks. The levels of interleukin-1β (IL-1β), interleukin-18 (IL-18), tumor necrosis factor-α (TNF-α), superoxide dismutase (SOD) and malondialdehyde (MDA) in rats were measured. The degree of alveolar bone loss and the number of inflammatory cells were detected. The integrated optical density of nuclear factor erythroid 2-related factor (Nrf2), heme oxygenase-1 (HO-1), NLR pyrin domain-containing 3 (NLRP3) and nuclear factor-kappaB p65 (NF-κB p65) was measured., Results: EGCG (200 mg/kg) significantly reduced alveolar bone loss in the ligated maxillary molars and the number of inflammatory cells in the EGCG-200 group compared with the periodontitis, EGCG-100 and EGCG-400 groups. 200 mg/kg was the optimal dose of EGCG and was used in subsequent experiments. The expression levels of IL-1β, IL-18, TNF-α and MDA were significantly lower and the expression level of SOD was significantly higher in the EGCG-200 group compared with the periodontitis group. The expression of NLRP3 and NF-κB p65 was significantly decreased, while the expression of Nrf2 and HO-1 was significantly increased in the EGCG-200 group compared with the periodontitis group., Conclusion: These results suggest that EGCG inhibits oxidative stress and inflammatory responses in the periodontitis model by modulating the Nrf2/HO-1/NLRP3/NF-κB p65 signaling pathway, thereby decreasing alveolar bone loss., Competing Interests: The authors declare that there are no competing interests in this study., (© 2023 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V.)

Objective: To investigate the therapeutic effect of gentisic acid (GA) on rheumatoid arthritis (RA) based on the miR-19b-3p/RAF1 axis., Methods: The cell counting kit-8 method was used to detect the growth inhibitory effect of different concentrations of GA on MH7A cells, and the drug concentration of GA was determined in the experiment. The quantificational real-time polymerase chain reaction (qRT-PCR) was used to detect the expression of miR-19b-3p and RAF1. RAF1, extracellular regulated protein kinases1/2 (ERK1/2) and phospho-ERK1/2 (p-ERK1/2) were examined by Western blotting. Three methods (dual-luciferase assay, qRT-PCR and Western blot analysis) were used to verify miR-19b-3p targeting RAF1. Flow cytometry was performed to detect MH7A cell apoptosis. Transwell and wound healing assays were used to determine the invasion and migration capacities of MH7A cells., Results: The growth of MH7A cells was gradually inhibited with increasing GA concentration. When the GA concentration exceeded 80 mmol/L, GA was significantly cytotoxic to MH7A cells, so the half maximal inhibitory concentration of GA for MH7A cells was calculated as 67.019 mmol/L. GA upregulated miR-19b-3p expression, downregulated RAF1 expression, inhibited ERK1/2 phosphorylation, induced MH7A cell apoptosis and suppressed MH7A cell invasion and migration (P<0.05 or P<0.01). RAF1 was identified as the target of miR-19b-3p and reversed inhibitory effects on miR-19b-3p expression (P<0.05 or P<0.01). The miR-19b-3p inhibitor upregulated RAF1 expression and ERK1/2 phosphorylation, suppressed MH7A cell apoptosis and induced MH7A cell invasion and migration (P<0.01)., Conclusion: GA regulated miR-19b-3p/RAF1 axis to mediate ERK pathway and inhibit the development of RA., (© 2022. The Chinese Journal of Integrated Traditional and Western Medicine Press and Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: To explore the sleep status and risk factors for sleep problems in infants and young children in Jilin Province., Methods: A total of 1 080 healthy infants and young children aged 0-3 years from eight prefecture-level cities and one autonomous prefecture in Jilin Province were selected as subjects. A self-designed questionnaire was used to collect the general information of the subjects, and the Brief Infant Sleep Questionnaire was used to understand the sleep status of the subjects. Multivariate logistic regression analysis was used to analyze the risk factors for sleep problems., Results: The total detection rate of sleep problems in the infants and young children was 38.24% (413/1 080). The total sleep time in the 4-11 month, 12-24 month, and 25-36 month age groups was higher than the recommended total sleep time ( P <0.05). Multivariate logistic regression analysis showed that full-term birth, higher educational level of the main caregiver, and higher daytime activity intensity were protective factors for sleep problems in the infants and young children ( P <0.05), while lower frequency of vitamin D supplementation, frequent night feeding, and maternal snoring were risk factors for sleep problems ( P <0.05)., Conclusions: The total sleep time of infants and young children over 4 months old in Jilin Province is higher than the recommended total sleep time, but the prevalence rate of sleep problems is higher. The occurrence of sleep problems is related to various factors. Strengthening follow-up on preterm infants, providing education on infant sleep knowledge to primary caregivers, and regularly supplementing with vitamin D can be beneficial in reducing sleep problems in infants and young children.

Background: The achenes/seeds of endemic jelly fig (Ficus pumila var. awkeotsang) fruit have been applied to prepare a traditional beverage in Taiwan. Upon fruit harvest, jelly fig latex exuded from stalks was discarded. Protease activity was monitored in its latex. Proteases capable of hydrolyzing proteins have many application aspects based on diverse characteristics. Commercial plant proteases are frequently from latex., Results: The latex protease of jelly fig, termed FaFicin, was purified to homogeneity with a molecular mass of ~32 kDa on sodium dodecyl sulfate-polyacrylamide gel electrophoresis. According to liquid chromatographic-tandem mass spectrometric analyses, the expected protein band of protease was matched to ficin A, ficin B or chymopapain from common fig or papaya. Iodoacetamide, an inhibitor of cysteine protease, inhibited its protease activity completely. Hence FaFicin was identified as a papain-like cysteine protease (PLCP), exhibiting more than 80% and 70% activity as assayed at pH 5-8 and 40-70 °C, respectively. It maintained ~89% of initial activity after 120 min at 55 °C and pH 7. Moreover, FaFicin could degrade the myosin and actin of meat, and clot milk., Conclusion: The ficin FaFicin was obtained, purified and identified as a PLCP member from agricultural waste: jelly fig latex. It possessed activity under a wide range of pH values and temperature, and exhibited excellent thermostability. Based on its initial evaluation as a meat tenderizer and milk clotting reagent, the application of FaFicin was possible, which may extend utilization of jelly fig. © 2022 Society of Chemical Industry., (© 2022 Society of Chemical Industry.)

OCT4 is a major transcription factor that maintains the pluripotency of stem cells, including embryonic stem cells, induced pluripotent stem cells and cancer stem cells. An increasing number of long noncoding RNAs have been reported to participate in the regulation of OCT4 expression through various mechanisms, including binding with the OCT4 gene promoter to regulate local methylation; promoting chromosomal spatial folding to form an inner ring, thereby aggregating OCT4 cis-acting elements scattered in discontinuous sites of the chromosome; competitively binding microRNAs with OCT4 to upregulate OCT4 expression at the posttranscriptional level; and sharing a promoter with OCT4. Moreover, the transcription of some long noncoding RNAs is regulated by OCT4, and certain long noncoding RNAs form feedback regulatory loops with OCT4. In this review, we summarized the research progress of the long noncoding RNAs involved in the regulation of OCT4 expression., (© 2022. The Author(s).)

Background: N-acetylglucosaminidase (NAGase) could liberate N-acetylglucosamine (GlcNAc) from GlcNAc-containing oligosaccharides. Trichoderma spp. is an important source of chitinase, particularly NAGase for industrial use. nag1 and nag2 genes encoding NAGase, are found in the genome in Trichoderma spp. The deduced Nag1 and Nag2 shares ~ 55% homology in Trichoderma virens. Most studies were focus on Nag1 and nag1 previously., Results: The native NAGase (TvmNAG2) was purified to homogeneity with molecular mass of ~ 68 kDa on SDS-PAGE analysis, and identified as Nag2 by MALDI/MS analysis from an isolate T. virens strain mango. RT-PCR analyses revealed that only nag2 gene was expressed in liquid culture of T. virens, while both of nag1 and nag2 were expressed in T. virens cultured on the plates. TvmNAG2 was thermally stable up to 60 °C for 2 h, and the optimal pH and temperature were 5.0 and 60-65 °C, respectively, using p-nitrophenyl-N-acetyl-β-D-glucosaminide (pNP-NAG) as substrate. The hydrolytic product of colloidal chitin by TvmNAG2 was suggested to be GlcNAc based on TLC analyses. Moreover, TvmNAG2 possesses antifungal activity, inhibiting the mycelium growth of Sclerotium rolfsii. And it was resistant to the proteolysis by papain and trypsin., Conclusions: The native Nag2, TvmNAG2 was purified and identified from T. virens strain mango, as well as enzymatic properties. To our knowledge, it is the first report with the properties of native Trichoderma Nag2., (© 2022. The Author(s).)

Objective: To study the mental health status of primary school students and the factors influencing the mental health status during the coronavirus disease 2019 (COVID-19) epidemic., Methods: Online questionnaire surveys were conducted among 3 600 primary school students aged 6-12 years in Jilin Province, China in April, 2020 (during the epidemic) and 3 089 primary school students in September, 2020 (during the regular epidemic prevention and control). The general information and the data related to the Mental Health Scale for Child and Adolescent were collected by the questionnaire surveys. The multivariate logistic regression analysis was used to evaluate the factors influencing the mental health status of the students during the epidemic., Results: The students during the epidemic had a significantly poorer mental health status in the emotional experience and volitional behavior than those during the regular epidemic prevention and control ( P < 0.05). The multivariate logistic regression analysis showed the risk of psychological problems of the students decreased with age ( OR =0.895). The girls were at a higher risk of psychological problems than boys ( OR =1.453). The students with father's and mother's charater between irritability and gentle were at a lower risk of psychological problems ( OR =0.496 and 0.470 respectively). The students from a family with a parental education style of a combination of encouraging and scolding were at a lower risk of psychological problems ( OR =0.263). The students from a single-parent family or an extended family were at a higher risk of psychological problems ( OR =2.995 and 3.446 respectively)., Conclusions: The COVID-19 epidemic has a certain impact on emotional experience and volitional behavior of primary school students. During the epidemic, particular attention should be paid to the mental health of primary school students, especially girls, younger students, and students from single-parent families, extended families or families with impatient parents and improper parental education.

Currently, COVID-19 has been reported in nearly all countries globally. To date, little is known about the viral shedding duration, clinical course and treatment efficacy of COVID-19 near Hubei Province, China. This multicentre, retrospective study was performed in 12 hospitals in Henan and Shaanxi Provinces from 20 January to 8 February 2020. Clinical outcomes were followed up until 26 March 2020. The viral shedding duration, full clinical course and treatment efficacy were analysed in different subgroups of patients. A total of 149 COVID-19 patients were enrolled. The median age was 42 years, and 61.1% (91) were males. Of them, 133 (89.3%) had fever, 131 of 144 (91%) had pneumonia, 27 (18.1%) required intensive care unit (ICU) management, 3 (2%) were pregnant, and 3 (2%) died. Two premature newborns were negative for SARS-CoV-2. In total, the median SARS-CoV-2 shedding period and clinical course were 12 (IQR: 9-17; mean: 13.4, 95% CI: 12.5, 14.2) and 20 (IQR: 16-24; mean: 21.2, 95% CI: 20.1, 22.3) days, respectively, and ICU patients had longer median viral shedding periods (21 [17-24] versus 11 [9-15]) and clinical courses (30 [22-33] vs. 19 [15.8-22]) than non-ICU patients (both p < .0001). SARS-CoV-2 clearances occurred at least 2 days before fatality in 3 non-survivors. Current treatment with any anti-viral agent or combination did not present the benefit of shortening viral shedding period and clinical course (all p > .05) in real-life settings. In conclusion, the viral shedding duration and clinical course in Henan and Shaanxi Provinces were shorter than those in Hubei Province, and current anti-viral therapies were ineffective for shortening viral shedding duration and clinical course in real-world settings. These findings expand our knowledge of the SARS-CoV-2 infection and may be helpful for management of the epidemic outbreak of COVID-19 worldwide. Further studies concerning effective anti-viral agents and vaccines are urgently needed., (© 2020 Blackwell Verlag GmbH.)

Background: Long-term survival after liver transplantation (LT) for hepatocellular carcinoma (HCC) patients remains poor because of tumor recurrence. To improve the prognosis of HCC patients after LT, we aimed to identify different transplantation criteria and risk factors related to tumor recurrence and evaluate the effect of preventive chemotherapy in a single center., Methods: In total, data on 20 variables and the survival of 199 patients with primary HCC who underwent LT between 2005 and 2015 were included for analysis. The patients were divided into the following three groups: Group 1, within the Milan and Hangzhou criteria (n = 51); Group 2, beyond the Milan but within the Hangzhou criteria (n = 36); and Group 3, beyond the Milan and Hangzhou criteria (n = 112). Survival probabilities for the three groups were calculated using multivariate Cox regression analysis. The association between preventive therapy and HCC-recurrence after LT was analyzed by multiple logistic regression analysis., Results: Child-Pugh stage C and hepatitis B virus (HBV) infection were independent risk factors for patients with tumor recurrence who did not meet the Milan criteria. The overall survival rates of the 199 patients showed statistically significant differences among the three groups (P < 0.001). Moreover, no significant difference was noted in the survival rate between Group 1 and Group 2 (P > 0.05). Multivariate logistic regression analysis showed that postoperative prophylactic chemotherapy reduced the risk of tumor recurrence in patients who did not meet the Hangzhou and Milan criteria (OR = 0.478; 95% CI: 0.308-0.741; P = 0.001)., Conclusions: Child-Pugh classification and HBV infection were the independent risk factors of tumor recurrence in HCC patients with LT. The Hangzhou criteria were effective and analogous compared with the Milan criteria. Preventive chemotherapy significantly reduced the risk of recurrence and prolonged the survival time for HCC patients beyond the Milan and Hangzhou criteria after LT., (Copyright © 2020. Published by Elsevier B.V.)

Our study aims to estimate the incidence of metachronous second primary lung cancer(SPLC) in initial primary lung cancer(IPLC) survivors and to determine whether radiotherapy affects the risk of metachronous SPLC in the first five years after the diagnosis of lung cancer. Incidence data of IPLC individuals who survived ≥2 years were obtained from SEER-18 database in 2004-2007. Joinpoint regression analysis and competing risk analysis were used to calculate the incidence of metachronous SPLC. Propensity score matching and decision analysis were available to estimate the effect of radiotherapy on metachronous SPLC. 264 of 11657 IPLC survivors with radiotherapy and 1090 of 24499 IPLC survivors without radiotherapy developed metachronous SPLC during 5-year follow-up, respectively. In joinpoint regression analysis, the 5-year incidence of metachronous SPLC in the radiotherapy group was lower than that in the nonradiotherapy group(2385 per 100,000 vs 4748 per 100,000, HR = 0.43,95% CI:0.39-0.47). Competing risk analysis showed that the survivors with radiotherapy were associated with the lower 5 year incidence of metachronous SPLC compared with those without radiotherapy(2.28% vs 4.47%, HR = 0.49,95% CI:0.43-0.57). Through propensity score matching, 4077 pairs of survivors were available to further study that radiotherapy potentially decreased the risk of developing metachronous SPLC with the adjustment of various factors(2.5% vs 3.3%, HR = 0.72, 95% CI:0.55-0.96). Decision analysis suggested that radiotherapy was a negative independent risk factor of metachronous SPLC with clinical net benefit in a range of risk thresholds (2% to 5%). Survivors of IPLC with radiotherapy likely had a low risk of metachronous SPLC during the first five years follow-up, especially non-small cell lung cancer.

A field experiment was conducted on Alhagi sparsifolia Shap. with a long-term clipping history (5-8 years) to investigate the adaptation strategy of A. sparsifolia to long-term clipping. The present study found that long-term clipping can reduce self-shading and increase the photosynthesis rate (Pn) in May. During the whole growth season, clipped plants can maintain a high Pn with less variation, which we denote as a 'stable photosynthesis strategy'. Although Pn in unclipped plants was higher than in the long-term clipping treatment in August, clipped plants accumulated more carbohydrates in shoots. The enhanced amount of carbohydrates could be correlated with the greater amount of lignin synthesis in stems. Therefore, long-term clipping induced the transition of A. sparsifolia from herbs to shrubs. After long-term clipping, plants allocated more resources to plant defence against stress, whereas the ratio of resources allocated to leaf growth decreased. Consequently, photosynthesis in long-term clipped plants decreased in August. In PSII, the energy used for both photochemical quenching and non-photochemical quenching decreased in the clipped plants during the early stage of the growth season. In addition, due to the lower stomatal conductance (gs), clipped plants retained more water in their leaves and suffered less water stress. Thus, clipped plants produced less reactive oxygen species (ROS), which in turn, delayed leaf senescence. Plants also exhibited over-compensatory growth after long-term clipping, but this phenomenon was not caused by the increase in specific leaf area (SLA). The stable photosynthesis strategy helped to extend the lifespan of plants in the growth season and improve their adaptation to light, temperature, and water stress.

Combination of microalgae cultivation and piggery wastewater treatment has become a hot topic in recent years. Nutrient removal from aerated piggery wastewater (APW) by Desmodesmus sp. CHX1 and the optimization of cultivation conditions were investigated in this study. Results indicated that Desmodesmus sp. CHX1 showed an efficient growth in APW, with specific growth rate of 0.26-0.56 d -1 . The biomass yield based on nutrient consumption was 9.65 g biomass/g NH 4 -N and 209.15 g biomass/g total phosphorus (TP) respectively. Desmodesmus sp. CHX1 performed well in nutrient removal from APW, with ammonium nitrogen (NH 4 -N) and TP removal efficiency (RE) of 78.46% and 91.66% respectively after 7 days of culture. Nutrient removal process fitted the pseudo-first-order kinetic equations well, with removal rate (RR) constant of 0.24 d -1 for NH 4 -N and 0.28 d -1 for TP. The optimum conditions for nutrient removal from APW by Desmodesmus sp. CHX1 were light intensity of 150 μmol photons m -2  s -1 in the photoperiod for 24 h when the temperature was set at 35°C with alga cell inoculation concentration of 30%. The removal efficiencies of NH 4 -N and TP were 88.26% and 95.06% respectively under the optimal conditions after 7 days of culture. Our results can be a good reference for enhancement of microalga production and the nutrient RE and further extend the application of the large-scale piggery wastewater treatment under a controlled environment.

Background: The prognosis of lung cancer with malignant pericardial effusion is very terrible owing to the impact of cardiac tamponade. The aim of our study seeks to identify prognostic factors and establish a prognostic nomogram of non small cell lung cancer (NSCLC) with malignant pericardial effusion., Methods: NSCLC patients with malignant pericardial effusion between 2010 and 2014 are searched from SEER database.Cancer-specific death of these patients are analyzed through the Kaplan-Meier method, Cox proportional hazard model and competing risk model. Prognostic nomogram of cancer-specific death is performed and validated with concordance index (C-index), calibration plots and internal validation population. Propensity score matching is used to evaluate whether chemotherapy affected the survival of study population., Results: 696 eligible NSCLC patients are involved in the study population, with 22.7% of 1-year survival rate and 8.9% of 2-year survival rate. Laterality, AJCC N, AJCC T, and chemotherapy are regarded as independent prognostic factors of cancer-specific death in the Cox proportional hazards model and competing risk model. The C-index of established nomogram is 0.703(95%CI:0.68-0.73) for cancer-specific death in the study population with acceptable calibration, which is significantly higher than classical TNM stage(C-index = 0.56, 95%CI:0.52-0.60). After 1:1 propensity score matching, chemotherapy potentially reduces the risk of cancer-specific death (HR = 0.42 95%CI: 0.31-0.58) of NSCLC with pericardial effusion., Conclusions: NSCLC with malignant pericardial effusion harbors low overall survival. One prognostic nomogram based on laterality, AJCC N, AJCC T and chemotherapy is developed for cancer-specific death to predict 1-year and 2-year survival rate with good performance., Competing Interests: The authors have declared that no competing interests exist.

Background: This study was designed to estimate the trends in 5-year incidence of metachronous second primary lung cancer(SPLC) and to establish a risk prediction model to identify candidates who were at high risk of developing metachronous SPLC., Methods: Incidence data between 2004 and 2007 were obtained from SEER database, including 42453 participants who survived ≥ 2 years after the initial diagnosis of lung cancer. Joinpoint regression analysis was used to calculate the 5-year incidence rates of metachronous SPLC per 100 000 population. Related risk factors of the survivors who developed MSPLC during five years were identified through logistic regression analysis, followed by establishment of risk prediction nomogram. Discrimination (C-index), calibration and decision analysis were further performed to assess the validation and clinical net benefit of risk prediction nomogram., Results: A total of 1412 survivors with lung cancer developed MSPLC during five years, with 3546 per 100 000 population of age-adjusted 5-year incidence. Age, histology, tumor stage, and radiation were recognized as risk factors of metachronous SPLC, as indicated by logistic regression analysis. The risk prediction nomogram of metachronous SPLC harbored moderate discrimination(C-index = 0.67) and good calibration, with the risk of 0.01 to 0.11.The decision curve analysis showed that clinical net benefit of this risk prediction nomogram in a range of risk thresholds (0.01 to 0.06) was higher compared to all-screening or no-screening strategies., Conclusions: Collectively, the cumulative risk of metachronous SPLC of the survivors increased over time. The risk prediction nomogram was available to select high-risk survivors who should regularly undergo computed tomography screening., Competing Interests: The authors have declared that no competing interests exist.

Male infertility has become a global health problem. Currently, the diagnosis of male infertility depends on the results of semen quality or requires invasive surgical intervention. The process is complex and time-consuming. Metabolomics is an emerging platform with unique advantages in disease diagnosis and pathological mechanism research. In this study, ultra-performance liquid chromatography-electrospray ionization-ion trap-time of flight mass spectrometry (UPLC-ESI-IT-TOFMS) combined with chemometrics methods was used to discover potential biomarkers of male infertility based on non-targeted plasma metabolomics. Plasma samples from healthy controls (HC, n = 43) and various types of infertile patients, i.e. , patients having oligozoospermia (OS, n = 36), asthenospermia (AS, n = 56) and erectile dysfunction (ED, n = 45) were analyzed by UPLC-ESI-IT-TOFMS. Principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA) were performed. The results of OPLS-DA showed that HCs could be discriminated from infertile patients including OS ( R 2 = 0.903, Q 2 = 0.617, AUC = 0.992), AS ( R 2 = 0.985, Q 2 = 0.658, AUC = 0.999) or ED ( R 2 = 0.942, Q 2 = 0.500, AUC = 0.998). Some potential biomarkers were successfully discovered by variable selection methods and variable important in the projection (VIP) in combination with the T -test. Statistical significance was set at p < 0.05; the Benjamini-Hochberg false discovery rate was used to reduce type 1 errors resulting from multiple comparisons. The identified biomarkers were associated with energy consumption, hormone regulation and antioxidant defenses in spermatogenesis. To elucidate the pathophysiology of male infertility, relative metabolic pathways were studied. It was found that male infertility is closely related to disturbed phospholipid metabolism, amino acid metabolism, steroid hormone biosynthesis metabolism, metabolism of fatty acids and products of carnitine acylation, and purine and pyrimidine metabolisms. Plasma metabolomics provides a novel strategy for the diagnosis of male infertility and offers a new insight to study pathogenesis mechanism., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Antivenom is the most effective method currently available for the treatment of poisonous snake bite. Allergic reactions to antivenom have been reported in the past. Here we shared a case of allergic reactions to antivenom in an old male patient who was bitten twice by the same snake (probably same one) at the same biting site within a month whereas the patient did not show any allergic disorder in the first bitten. Envenomations twice in a short period time by the same kind of snake are very rare. Physician should be alert to the occurrence of allergic reactions in treating this type of patients with antivenom. The skin allergy test has a certain value in predicting the allergic response before the second use of antivenom. Desensitization may reduce the incidence of allergic reactions, but this is insufficient. Rather than non-IgE-mediated immediate hypersensitivity, patients receiving the second treatment of antivenom may develop IgE-mediated immediate hypersensitivity. Once happened, the antivenom treatment should be stopped promptly and anti-allergy treatment should be given immediately., (Copyright © 2017 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.)

In order to explore the adaptive capacity of Alhagi sparsifolia to soil salinity (mild, mo-derate, severe saline soil), the distribution, adsorption and translocation characteristics of Na + , K + , Ca 2+ , Mg 2+ in different organs of A. sparsifolia, which is a dominant native vegetation in southern edge of Tarim basin, were investigated. The results showed that when grown on a mild and moderate saline soil, Na + distribution in different organs of A. sparsifolia followed the order of stem≈thorn>leaf>root; when grown on a severe saline soil, Na + distribution followed leaf>stem≈thorn>root. The distribution of Ca 2+ and Mg 2+ followed leaf >thorn>stem>root. With the increase of soil salt level, Na + content in different organs of A. sparsifolia increased, while K + content in leave decreased; meanwhile the increasing soil salt level significantly decreased the K + /Na + ratio in both root and leave, as well as the Ca 2+ /Na + and Mg 2+ /Na + ratios in all organs. The selective transportation coefficients for Ca 2+ -Na + and Mg 2+ -Na + followed order of stem-leaf>stem-thorn>root-stem under saline habitats. Based on the integrated analysis, in order to adapt to salinity habitat, A. sparsifolia could use multiple organs to accumulate Na + , depending on soil salt level. Na + could accumulate in stem and thorn at a relative low level, but in leaves at high levels. Besides, Ca 2+ and Mg 2+ could be the inorganic osmotic adjustment substances for A. sparsifolia to adapt the saline environment.

Background: Evidence on the benefits of combining cyclooxygenase-2 inhibitor (COX-2) in treating non-small cell lung cancer (NSCLC) is still controversial. We investigated the efficacy and safety profile of cyclooxygenase-2 inhibitors in treating NSCLC., Methods: The first meta-analysis of eligible studies was performed to assess the effect of COX-2 inhibitors for patients with NSCLC on the overall response rate (ORR), overall survival (OS), progression-free survival (PFS), one-year survival, and toxicities. The fixed-effects model was used to calculate the pooled RR and HR and between-study heterogeneity was assessed. Subgroup analyses were conducted according to the type of COX-2 inhibitors, treatment pattern, and treatment line., Results: Nine randomized clinical trials, comprising 1679 patents with NSCLC, were included in the final meta-analysis. The pooled ORR of patients who have NSCLC with COX-2 inhibitors was significantly higher than that without COX-2 inhibitors. In subgroup analysis, significantly increased ORR results were found on celecoxib (RR = 1.29, 95% CI: 1.09, 1.51), rofecoxib (RR = 1.61, 95% CI: 1.14, 2.28), chemotherapy (RR = 1.40, 95% CI: 1.20, 1.63), and first-line treatment (RR = 1.39, 95% CI: 1.19, 1.63). However, COX-2 inhibitors had no effect on the one-year survival, OS, and PFS. Increased RR of leucopenia (RR = 1.21, 95% CI: 1.01, 1.45) and thrombocytopenia (RR = 1.36, 95% CI: 1.06, 1.76) suggested that COX-2 inhibitors increased hematologic toxicities (grade ≥ 3) of chemotherapy., Conclusions: COX-2 inhibitors increased ORR of advanced NSCLC and had no impact on survival indices, but it may increase the risk of hematologic toxicities associated with chemotherapy.

A pot experiment was conducted to study the influences of different NaCl concentrations (0, 50, 100, 200, 400 mmol x L(-1)) on the growth, leaf hydrogen peroxide (H2O2), malonaldehyde (MDA) content, superoxide dismutases (SOD), catalases (CAT), peroxidase (POD), ascorbate peroxidase (APX) enzymes activity, water potential, soluble sugar and proline contents of Nitraria roborowskii. The results showed that the growth of N. roborowskii was not affected at lower NaCl concentrations (< or = 50 mmol L(-1)), while the SOD, POD, CAT and APX activities in leaves of N. roborowskii were increased. However, higher NaCl concentrations (> 50 mmol x L(-1)) restrained the growth parameters of crown area, number of branches, dry mass of leaf, branch and lateral root, and remarkably reduced the SOD, POD and CAT activities, soluble sugar and proline contents in leaves of N. roborowskii. H2O2 and MDA contents in leaves were increased and water potential was reduced with increasing NaCl concentrations.

Taking Cele oasis at the southern fringe of Taklimakan Desert as a case, this paper studied the effects of different disturbances (burning in spring, cutting in spring, and cutting in fall) on the morphological characteristics and aboveground biomass of natural vegetation Alhagi sparsifolia in the ecotone of oasis-desert. Burning in spring decreased the A. sparsifolia plant height, crown width, and biomass significantly, being harmful to the regeneration and growth of the vegetation. Cutting in spring decreased the A. sparsifolia plant height, crown width, and biomass but increased the leaf biomass, thorn length, and thorn diameter, whereas cutting in fall decreased the plant height and crown width but increased the ramification amount and biomass of A. sparsifolia. Moderate cutting in fall could benefit the protection of A. sparsifolia at the southern fringe of Taklimakan Desert.

Objective: To observe the histopathological features of posttransplant complications for hepatic allografts and evaluate their biopsy values., Methods: From January 1999 to May 2011, a total of 268 percutaneous hepatic allograft biopsies were conducted in 207 recipients and the diagnostic procedures for staining, classification and staging performed according to the Banff schema and Chinese Schema on hepatic allograft rejection., Results: Among them, there were ischemia/reperfusion injury (n = 26, 9.7%), acute T cell-mediated rejection (n = 83, 31.0%), acute antibody-mediated rejection (n = 12, 4.5%), chronic posttransplantation rejection (n = 31, 11.6%), immunosuppressive-induced liver injury (n = 70, 26.1%) and recurrent diseases (n = 18, 6.7%). Acute T cell-mediated rejection and drug-induced liver injury were two most common causes of allograft dysfunctions., Conclusion: Percutaneous hepatic allograft biopsy is valuable for the diagnosis and evaluation of various posttransplantation complications.

Background: Living donor kidney transplantation (LKT) has been booming in China. This study aimed to elucidate the renal function of both Chinese donors and recipients after the donation and transplantation., Methods: One hundred and forty-one pairs of donors and recipients for LKT were randomly selected and followed up for up to seven years. The donors' and recipients' renal function was recorded before and after operation., Results: The donors presented a mean age of (43.9 ± 7.5) years at donation. The female contributed 101/141 (71.6%) in all donors, and no effect was shown between genders on healthy donors' renal function. The donors' glomerular filtration rates (GFR) were (119.5 ± 20.4) ml/min, (85.2 ± 17.6) ml/min, (87.2 ± 15.9) ml/min, (82.1 ± 14.6) ml/min and (83.0 ± 13.7) ml/min preoperatively, and for five days, three months, one year and beyond one year after the operation. The donors for the period of 1 - 3 years, 3 - 5 years and more than 5 years after donation showed GFR as (83.9 ± 12.7) ml/min, (83.0 ± 17.6) ml/min, and (80.9 ± 20.8) ml/min, respectively, no statistically significant difference was found. Moreover, no significant clinical changes in blood pressure and proteinuria were found among the donors. In the recipients, delayed graft function (DGF) rate was 6.4%, acute rejection rate was 11.3%, and GFR were (66.5 ± 16.4) ml/min, (73.2 ± 19.6) ml/min and (63.9 ± 18.6) ml/min respectively at three months, one year and beyond one year post-transplantation respectively., Conclusion: The donors/recipients of LKT in Chinese population experience well-functioning remaining/donor kidneys.

A pot experiment was conducted to study the influence of different concentration (0, 50, 100, 200, and 400 mg kg(-1)) Ni and Cu on the growth, photosynthesis, and chlorophyll fluorescence characteristics of Peganum harmala seedlings. With increasing concentration Ni in the medium, the seedlings growth parameters, photosynthetic pigment content, net photosynthetic rate (P(n)), stomatal conductance (G(s)), transpiration rate (T(r)), maximal photochemical efficiency of PS II (F(v)/F(m)), quantum efficiency of electric transport of PS II (phi (PS II)), and coefficient of photochemical quenching (q(P)) of P. harmala decreased significantly, while the intercellular CO2 concentration (C(i)) and the coefficient of non-photochemical quenching (q(N)) were in adverse. The decrease of P(n) under Ni stress was mainly caused by non-stomatal limitation. At 50 mg kg(-1) Cu, the growth parameters, photosynthetic pigment content, P(n), G(s), T(r), C(i), F(v)/F(m), phi(PS II), and q(P) reached their peak values; at 100 mg kg(-1) Cu, the growth parameters, chlorophyll a and b contents, P(n), G(s), T(r), C(i), and F(v)/F(m) were still slightly higher than the control; while with the further increasing Cu concentration in the medium, all the test indices except q(N) tended to decrease. The decrease of P(n) under Cu stress was mainly caused by stomatal limitation.

Objective: To summarize the histopathological features of posttransplant complications for renal allografts and evaluate the biopsy values., Methods: Between January 1997 and May 2010, a total of 1712 percutaneous renal allograft biopsies were performed in 1500 kidney transplants and diagnostic procedures for staining, classification and staging had been performed according to the Banff 1997 and 2005 Schema., Results: There were 213 (14.2%) cases of acute T cell-mediated rejection post transplantation in 1500 kidney transplants. Meanwhile there were 36 (2.4%) cases of acute antibody-mediated rejection. Chronic T cell-mediated rejection and chronic antibody-mediated rejection were 251 (16.7%) cases and 45 (3.0%) cases, respectively. Acute CNI-nephrotoxicity and chronic CNI-nephrotoxicity were 106 (7.1%)cases and 251 (16.7%) cases, respectively. Relapsed or new nephropathy were 6 (0.4%) cases. Chronic CNI-nephrotoxicity is the most common cause of allograft dysfunction in the long survival recipients., Conclusion: Percutaneous renal allograft biopsy is valuable for the diagnosis of various posttransplantation complications.

The aggravation process of oasisization leads to changes of land use type in oasis rim. In order to discuss the effects of different land use types on soil properties and soil quality, the four land use types located Cele oasis rim in south margin of Tarim Basin, which are the cotton field, orchard, and Caligonum mongolicum Turcz land use type reclaimed by people and nature state land use type covered by Alhagi sparsifolia SHAP, were selected as study object. The relative soil quality index (RI) and the soil quality synthesis index (SQI) were used to analyse the changes of soil quality between four land use types within 0-20 cm, 2040 cm, 40-60 cm soil depth, respectively. Meantime, the fractal theory was used to analyse the particle-size distribution (PSD) property of top soil under different land use types. The results indicated that there was a significant difference in the soil organic matter and total nitrogen in same soil depth between four land use types; the order ranked according to RI was same to the order ranked according to SQI in each soil depth between four land use types. The cotton field and orchard have an obviously positive effect on soil quality of the top soil, however, the soil quality of Alhagi sparsifolia SHAP land use type was gradually increasing along with the increasing soil depth. The soil properties and soil quality of Caligonum mongolicum Turcz land use type were at the lowest level according to the comparison results among all land use types, and the calculation results of PSD fractal dimension also indicated the Caligonum mongolicum Turcz land use type had the worst ability on maintaining soil fine fractions.

The water physiological characteristics of four perennial plant species (Populus euphratica, Tamarix ramosissima, Calligonum caput-medusae, and Alhagi sparsifolia) around Cele Oasis in Xinjiang were studied through their vegetation growth period. No signs of serious drought stress were observed in any of the test perennial species during their vegetation growth, and irrigation had little effects on the water status of the plants (P > 0.05). The seasonal variation characteristics of water physiological parameters differed with the plants. A. sparsifolia had the highest predawn water potential (PWP) and daily mean sap flow, but the lowest mean water use efficiency (WUE); C. caput-medusae had the highest mean WUE, and its PWP and sap flow were stable and had less seasonal change; T. ramosissima had the lowest PWP during its growth, and had better adaptation ability to the environment; and P. euphratica had relatively stable water physiological characteristics during its growth. The four perennial plant species had deep root systems to access underground water to satisfy their large demands for water, and thus, well adapted to the harsh environmental conditions around Cele Oasis.

Based on the 2005-2007 experimental data in Cele oasis in the southern margin of Tarim Basin of Xinjiang, the soil quality of four typical types of farmland with different utilization intensity, i.e., farmland with high input, farmland with normal input, newly reclaimed farmland, and farmland in oasis' interior, was analyzed and assessed by using sustainable yield index, soil improvement index, and soil quality synthesis index. Among the farmlands, there were significant differences in the contents of soil organic matter, available nitrogen, and available phosphorus. Newly reclaimed farmland had the lowest level of soil quality, while the farmland in oasis' interior had relatively higher soil quality. This study could help the reasonable exploitation and utilization of farmlands in Cele oasis, and the protection of local farmland eco-environment.

Aim: To evaluate the impact of early steroid withdrawal on the incidence of rejection, tumor recurrence and complications after liver transplantation for advanced-stage hepatocellular carcinoma., Methods: Fifty-four patients underwent liver transplantation for advanced-stage hepatocellular carcinoma from April 2003 to June 2005. These cases were divided into a steroid-withdrawal group (group A, n = 28) and a steroid-maintenance group (group B, n = 26). In group A, steroid was withdrawn 3 mo after transplantation. In group B, steroid was continuously used postoperatively. The incidence of rejection, 6-mo and 1-year recurrence rate of carcinoma, 1-year survival rate, mean serum tacrolimus trough level, and liver and kidney function were compared between the two groups., Results: In the two groups, no statistical difference was observed in the incidence of rejection (14.3 vs 11.5%, P > 0.05), mean serum tacrolimus trough levels (6.9 +/- 1.4 vs 7.1 +/- 1.1 microg/L, P > 0.05), liver and kidney function after 6 mo [alanine aminotransferase (ALT): 533 +/- 183 vs 617 +/- 217 nka/L, P > 0.05; creatinine: 66 +/- 18 vs 71 +/- 19 micromol/L, P > 0.05], 6-mo recurrence rate of carcinoma (25.0 vs 42.3%, P > 0.05), and 1-year survival rate (64.2 vs 46.1%, P > 0.05). The 1-year tumor recurrence rate (39.2 vs 69.2%, P < 0.05), serum cholesterol level (3.9 +/- 1.8 vs 5.9 +/- 2.6 mmol/L, P < 0.01) and fasting blood sugar (5.1 +/- 2.1 vs 8.9 +/- 3.6 mmol/L, P < 0.01) were significantly different. These were lower in the steroid-withdrawal group than in the steroid-maintenance group., Conclusion: Early steroid withdrawal was safe after liver transplantation in patients with advanced-stage hepatocellular carcinoma. When steroids were withdrawn 3 mo post-operation, the incidence of rejection did not increase, and there was no demand to maintain tacrolimus at a high level. In contrast, the tumor recurrence rate and the potential of adverse effects decreased significantly. This may have led to an increase in long-term survival rate.

Objective: To report the modified technique and the short-term results of simultaneous pancreas-kidney transplantation (SPK) with the enteric drainage (ED) of exocrine secretions., Methods: From June 2000 to August 2006, thirty-eight patients with diabetes complicated with uremia underwent SPK. The pancreas graft was placed intraperitoneally with exocrine secretions drained into the proximal jejunum without Roux-en-Y procedure. The mean cold ischemic times of pancreas and kidney were (10 +/- 2.0) h and (7 +/- 2.0) h, respectively. Quadruple immunosuppressive therapy with antilymphocyte globulin or anti-CD25 monoclonal antibody, tacrolimus, mycophenolate mofetil and steroids was adopted except one patient., Results: The 6-month survival rates of patients and grafts were both 97.4% after transplantation. All patients achieved insulin-free euglycemia at (7 +/- 6.9) d postoperative except one. For preoperative patients, mean fasting insulin and C-peptide values were (9 +/- 8.1) mU/L and (6 +/- 4.5) mU/L. After operation, fasting insulin and C-peptide values of patients were (12 +/- 5.8) mU/L and (6 +/- 4.7) mU/L, respectively, which peaked to an insulin level of (57 +/- 43.0) mU/L and a C-peptide level of (11 +/- 6.8) mU/L with stimulation. There were eight cases of delayed renal graft function. All other patients achieved immediate renal graft function. No graft losses occurred due to leakage or intra-abdominal infection. The most common surgical complications were wound infection (n = 12), enteric anastomostic hemorrhage (n = 5) and perirenal hemorrhage (n = 2). Three patients (7.9%) had been reoperated for the reasons of intra-abdominal hemorrhage and perirenal hemorrhage., Conclusions: SPK is an effective treatment option for selected patients with diabetes mellitus and approaching end-stage renal disease. Enteric exocrine drainage by direct side-to-side anastomosis (without Roux-en-Y) seems to be a simple and reliable technique.

Background: Biliary complications continue to be an important determinant of the recipient's survival rate after orthotopic liver transplantation (OLT). The objective of this study was to evaluate the incidence of early biliary complications in OLT in the presence or absence of a T-tube., Methods: This retrospective study, based on inpatient data, focused on the relationship between T-tube placement and early biliary complications of 84 patients after OLT, from November 2002 to June 2005. Patients were divided into two groups based on whether or not a T-tube was used following bile duct reconstruction: T-tube group (group I, n = 33); non-T-tube group (group II, n = 51)., Results: 45.2% of OLT recipients had a malignant neoplasm. There were no significant differences in the demographic characteristics or operation data between the two groups. Overall, early biliary tract complications developed in 19.0% (16/84) of patients. The rate of early biliary complications was 30.3% (10/33) and 11.8% (6/51) in groups I II, respectively (p = 0.035). Biliary complications which were directly caused by T-tube placement occurred in 12.1% (4/33) of patients in group I. Overall, the percentage of malignant neoplasms, chronic viral cirrhosis, fulminant liver failure and other primary disease recipients with early biliary complications were 6.2%, 37.5%, 43.8% and 12.5%, respectively., Conclusion: This study suggests that the use of a T-tube in Chinese patients undergoing OLT causes a higher incidence of early biliary complications. Most of the early biliary complications occurred in chronic viral cirrhosis and fulminant liver failure recipients.

New antigens and strategies are necessary for vaccine development against schistosomiasis japonica. Using a pool of 43 high titred anti-SWA sera from individuals residing in an Schistosoma japonicum endemic area of China, we have cloned a S. japonicum gene by cDNA library screening. The recombinant Sj338 protein has 44-46% identity to a mitochondrial precursor receptor protein of humans and rats. Immunization of mice with the recombinant Sj338 conferred 27-32% (p<0.01) reduction in worm burdens following cercarial challenge. In an effort to identify protective epitopes in Sj338 and increase the level of protection, we screened a random 12-mer peptide library constructed in M13 using a polyspecific anti-Sj338 rabbit serum. After five rounds of biopanning, we identified 30 reactive clones consisting of 11 distinct peptide sequences. These clones shared limited primary sequence homology with the recombinant Sj338 protein. Anti-sera raised against these phage clones recognized recombinant Sj338 and SWAP by Western blot. In murine vaccination experiments using whole recombinant phage without adjuvant, four of these clones demonstrated worm reductions of 11.6-25.1% (p=ns - 0.05) compared to M13 vaccinated animals. Animals vaccinated with all four of these phage demonstrated 34.2% (p<0.01) worm reduction compared to controls vaccinated with M13 clone. These data suggest that mimotope peptides are potential vaccine candidates for S. japonicum.

Unlabelled: Liver transplantation for liver carcinoma with cirrhosis is a treatment still in dispute. The objectives were to summarize the survival and cost of 50 liver transplant cases performed for liver carcinoma over nearly 3 years., Methods: We performed 138 liver transplants from January 1999 to February 2002. There were 50 cases (36.2%) of liver carcinoma with HBV cirrhosis, which were divided into three stages based on the tumor pathology: Stage 1 cases showed a single mass (< or = 5 cm), 4 cases; Stage 2, a single mass > 5 cm or intrahepatic multiple masses without PV cancer embolus, 32 cases; and Stage 3: tumor invasion of the PV or perihepatic lymph nodes or organs, 14 cases. All patients received three to six courses of chemotherapy postoperatively., Results: All four cases of stage 1 survived > 1 year; one of them is at 3 years with good liver function and tumor free. The mean half-year medical cost was $27.100 +/- 108 in stage 1. The half-year survival and medical costs were 62.5% and $31,500 +/- 260 in stage 2 and 15.0% and $35,500 +/- 134 in stage 3., Conclusion: Liver transplantation is an effective treatment for early-stage liver carcinoma, that achieves good medical and economic results, but should be limited to advanced liver cancer.

Background: As a valid therapeutic option for patients with type 1 diabetes mellitus (IDDM) and secondary diabetic nephropathy, simultaneous pancreas-kidney transplantation (SPK) remains more undeveloped than other solid organ transplantations due to the restrictions of surgical techniques especially the modes of exocrine pancreatic secretion. The aim of this paper was to summarize our single-center experience in SPK with modified enteric drainage (ED)., Methods: From June 2000 to July 2003, 10 patients with IDDM associated with uremia received SPK. The pancreatic allograft exocrine secretion was drained into the proximal jejunum via a side-to-side duodenojejunostomy without Roux-en-Y anastomosis. Quadruple immunosuppressive regimen consisted of induction of tacrolimus (TAC)/cyclosporine (CsA), mycophenolate mofetil (MMF), steroids and antibodies, which included antilymphocyte globulin (ALG) or anti-CD25 monoclonal antibody., Results: ED-SPK without Roux-en-Y anastomosis was successful in all 10 patients without serious complications such as pancreatitis, graft thrombosis and pancreatic fistula. The patients regained immediate kidney allograft function and euglycemia with insulin-independence. Four patients survived over one year. Episodes of acute rejection were observed in 4 patients, 3 of whom showed reversion after treatment of OKT3 or insulin. Early postoperative complications included peritoneal infection (2 patients), wound infection (2) and renal hematoma (1)., Conclusion: ED-SPK without Roux-en-Y anastomosis is safe and preferable to the patients with IDDM associated with uremia.

Objective: To study the etiology, prevention and management of acute respiratory distress syndrome (ARDS) after liver transplantation., Methods: The clinical data of 104 patients with end-stage liver diseases who had had liver transplantations were retrospectively reviewed., Results: Seventeen patients (16.3%, 17/104) altogether were diagnosed as having ARDS after liver transplantation. Ten of them developed ARDS within 24 hours, of whom 1 died during the operation, and 7 developed ARDS 3 or 4 days after they were extubated and when methylprednisolone was tapered. Fourteen of the 17 ARDS patients (14/17) were found to have overloaded crystalloid infusion, massive transfusion of blood or blood products such as plasma, platelets, in addition to a prolonged surgical time secondary to serious bleeding during the diseased liver removal without evidence of active infection. One was found to have serious systemic infection and operatively disseminated intravascular coagulation. Four of the recipients developed ARDS suddenly when intravenous cyclosporine was given on the 3rd day after operation. One patient of the 4 had all of the aforementioned conditions. Two patients suffered from gastric aspiration. Five (30%, 5/17) of them survived ARDS with the combined treatment consisting of positive end-expiratory pressure mechanical ventilation suctioning as much edema fluid or sputum as possible, administration of diuretics, bolus of corticosteroids, and culture-based antibiotics. Hemeodialysis was indicated for patients with oliguric renal failure., Conclusions: ARDS is a serious multifactoral complication after liver transplantation with a high mortality and fatality. The most likely cause is fluid overload from crystalloid liquid infusion or massive transfusion. The other predisposing or contributing factors include sepsis, IV use of cyclosporine, fast tapering of corticosteroids, and gastric aspiration. Other factors such as transfusion-related acute lung injury (TRALI), and reperfusion syndrome of the newly implanted liver may also contribute. Though the treatment should primarily be supportive in nature, it is helpful to understand the predisposing and contributing factors and to aid in prevention, management and treatment.

Abnormalities of haemorheology were found in animal and human recipients of kidney and/or pancreas allografts during rejection episodes. Thirteen diabetic canines received solitary pancreatic transplantation and another 13 diabetic and uremic canines underwent combined pancreas and kidney transplantation. Determination of haemorheological parameters was performed before and after operation respectively. During rejection episodes of kidney or pancreas allografts, the values of plasma viscosity, blood reductive viscosity and fibrinogen were significantly higher than those without rejection. On the basis of animal experiments, the determination of haemorheological parameters had been performed on 33 patients (30 receiving renal transplant, 2 pancreatic transplant alone and the remaining 1 combined renal and pancreatic transplant). Consecutive monitoring on these patients showed that a rise in the values of plasma viscosity, blood reductive viscosity and fibrinogen could be demonstrated during rejection episodes. The changes appeared one to three days prior to clinical manifestations and were in accordance with the termination of rejection. Our studies suggest that variation of haemorheological parameters are associated with rejection and the abnormal haemorheology may be an essential factor contributing to graft dysfunction. Moreover, the use of these assays will be beneficial to early diagnosis and better management of rejection in the future.

Pro-vasopressin mRNA, neurophysin and arginine vasopressin (AVP) were assayed in the mouse anterior pituitary gland, in mouse anterior pituitary cells in culture and in the AtT-20 corticotrophic tumour cell line. Northern blot analysis revealed the presence of an approximately 700 base pair pro-vasopressin mRNA in anterior pituitary and AtT-20 cells. Neurophysin, identified by immunoblots, and AVP, identified by high-performance liquid chromatography and cross-reactivity with AVP antiserum, were detected in anterior pituitary cells and AtT-20 cells. Immunocytochemical staining with anti-neurophysin showed that approximately 40-45% of the dissociated anterior pituitary cells in culture and greater than 95% of the AtT-20 cells were stained. Anterior pituitary cells in culture and AtT-20 cells had a basal level of release of AVP in the 0.01-0.1 nM range. These results indicate that anterior pituitary cells and AtT-20 cells have the ability to synthesize and process pro-vasopressin to AVP and neurophysin, endogenously.