Perfluorobutane (Sonazoid) Contrast-enhanced ultrasound to diagnose hepatocellular carcinoma: A systematic review and meta-analysis.

AIM: This meta-analysis aimed to assess the precision of Sonazoid contrast-enhanced ultrasound (CEUS) to distinguish hepatocellular carcinoma (HCC) from focal liver lesions (FLLs). MATERIAL AND METHODS: The Cochrane Library, Embase, PubMed, and Web of Science databases were systematically searched and checked for studies using Sonazoid CEUS to characterize HCC. A comprehensive meta-analysis was conducted, involving data pooling, subgroup analyses, meta-regression, and investigation of publication bias. RESULTS: The meta-analysis included fourteen studies. The overall diagnostic accuracy for characterizing HCC was as follows (all ranges show the 95% confidence interval): pooled sensitivity of 0.87 (0.80-0.92), pooled specificity of 0.95 (0.91-0.97), and a diagnostic odds ratio of 121 (61-241). The overall weighted area under the curve was 0.97 (0.95-0.98). The pooled sensitivity, specificity, and diagnostic odds ratio for Sonazoid and Sonovue were 0.75 (0.63- 0.84), 0.97 (0.86-0.99), 82 (15-445); and 0.64 (0.51-0.76), 0.98 (0.91-0.99), 72 (17-311), respectively. The sources of heterogeneity were identified as the study location, prevailing risk factor, reference diagnosis standard, criteria of Sonazoid CUES, and the proportion of cases of HCC. We observed no potential publication bias. CONCLUSION: Sonazoid CEUS is efficient to distinguish HCC from FLLs, with good sensitivity and specificity. It is comparable to Sonovue CEUS to diagnose HCC.

Case report: Apalutamide-induced severe lethal cutaneous adverse effects in China.

Introduction: Apalutamide is a novel agent for castration-resistant prostate cancer while skin rashes are the most common untoward reactions. Up to now, most of the reported dermatologic adverse events (dAEs) allocated to mild and moderate with a fair prognosis. Herein, we report a case series of severe dAEs in China caused by apalutamide. Case presentation: The four patients all developed severe and lethal drug eruptions including Stevens-Johnson syndrome and toxic epidermal necrolysis with a mean incubation period of 40 days. On the basis of the medical condition, all the patients were suggested to withdraw apalutamide and three of them recovered. Of note, attempts of rechallenges of apalutamide may be fatal. Discussion: The incidence of dAEs in previously conducted clinical trials exceeded 20%, with maculopapular rashes being the most common feature. However, the incidence and severity varied in different geographic regions and ethnicities. Inadequate attention was paid to severe cutaneous adverse reactions. Long latency may easily lead to the misdiagnosis of dAEs, and immediate withdrawal of apalutamide is the cornerstone of therapies. Conclusion: Special and adequate attention should be paid to apalutamide-attributed severe cutaneous adverse effects. Besides, the prognosis of severe drug eruptions may be disappointing, and in-time withdrawal is vital.

A novel preparation process of straw-based iron material for enhanced persulfate activation of reactive black 5 degradation.

In this study, a new straw-iron composite material (ST@Fe) was synthesized through impregnation and freeze-drying process for persulfate (PS) activation to degrade reactive black 5 (RB5). Scanning electron microscope, Brunauer-Emmett-Teller, Fourier transform infrared spectrometry, and X-ray photoelectron spectroscopy confirmed that straw owns huge pore structure and varieties of organic functional groups, including hydroxyl carboxyl groups, which could effectively adsorb and complex iron ions. The interaction between the active iron particles in ST@Fe and straw generated Fe2+ for PS activation, effectively degrading over 94.80% of RB5 at an initial concentration of 20 ppm in 100 min with a specific degradation capacity of 18.97 min-1 per unit of iron ions. ST@Fe/PS system demonstrated high tolerance in a wide initial pH range, which could gradually attack the RB5 molecular structure and significantly reduce the mineralization of water. Quenching experiments and electron paramagnetic resonance demonstrated the efficient generation of ROS including sulfate radicals, hydroxyl radicals, and singlet oxygen, and confirmed the dominance of sulfate radicals in the degradation process. The continuous degradation capacity and reusability of ST@Fe were also evaluated, which proved that the contaminant could be effectively degraded even after multiple cycles in the simulated textile wastewater, indicating its potential for use in practical remediation. This work provided a new method for the preparation of modified functional materials for the degradation of organic pollutants in textile wastewater and posed a novel strategy for the utilization of waste biomass.

Recent advances in electronic skins: material progress and applications.

Electronic skins are currently in huge demand for health monitoring platforms and personalized medicine applications. To ensure safe monitoring for long-term periods, high-performance electronic skins that are softly interfaced with biological tissues are required. Stretchability, self-healing behavior, and biocompatibility of the materials will ensure the future application of electronic skins in biomedical engineering. This mini-review highlights recent advances in mechanically active materials and structural designs for electronic skins, which have been used successfully in these contexts. Firstly, the structural and biomechanical characteristics of biological skins are described and compared with those of artificial electronic skins. Thereafter, a wide variety of processing techniques for stretchable materials are reviewed, including geometric engineering and acquiring intrinsic stretchability. Then, different types of self-healing materials and their applications in electronic skins are critically assessed and compared. Finally, the mini-review is concluded with a discussion on remaining challenges and future opportunities for materials and biomedical research.

Suppressor of Fused Inhibits Skin Wound Healing.

Objectives: To investigate the effect of suppressor of fused (Sufu) on epidermal and dermal cellular properties and in wound healing. Approach: Transgenic (TG) mice overexpressing human Sufu (hSufu) in the epidermis were applied to investigate the effects of Sufu on epidermal and dermal cellular properties and in wound healing. Results: Histological staining revealed a reduction of epidermal and dermal thickness and an increase of hypodermal adipose tissue in homozygous K14-hSufu TG mice when compared with wild-type (WT) controls. TG mice exhibited significantly delayed skin wound healing. Moreover, the migratory and proliferative capabilities of cultured keratinocytes were decreased in K14-hSufuTG mice. Transforming growth factor-ß treatment increased the expression of α-smooth muscle actin more in WT than in TG fibroblasts. Sufu overexpression significantly decreased the expression of ß-catenin, glioma transcription factor 1 (Gli1), and matrix metalloproteinase-3 in wounds of K14-hSufu TG mice when compared with controls, probably indicating a delaying effect of Sufu on wound healing via blocking the hedgehog (Hh)/Gli and Wnt/ß-catenin pathway. Innovation: Our results indicate a new property of Sufu in the process of skin wound healing. It provides an important basis for Sufu as a potential target for skin wound healing. Conclusion: Our findings suggest that Sufu overexpression in the epidermis impairs wound healing via dampening the Hh/Gli and Wnt/ß-catenin signaling pathway. These data provide an important basis for further analyses of Sufu in skin wound healing.

DeepDDG: Predicting the Stability Change of Protein Point Mutations Using Neural Networks.

Accurately predicting changes in protein stability due to mutations is important for protein engineering and for understanding the functional consequences of missense mutations in proteins. We have developed DeepDDG, a neural network-based method, for use in the prediction of changes in the stability of proteins due to point mutations. The neural network was trained on more than 5700 manually curated experimental data points and was able to obtain a Pearson correlation coefficient of 0.48-0.56 for three independent test sets, which outperformed 11 other methods. Detailed analysis of the input features shows that the solvent accessible surface area of the mutated residue is the most important feature, which suggests that the buried hydrophobic area is the major determinant of protein stability. We expect this method to be useful for large-scale design and engineering of protein stability. The neural network is freely available to academic users at http://protein.org.cn/ddg.html .

Computational Protein Design with Deep Learning Neural Networks.

Computational protein design has a wide variety of applications. Despite its remarkable success, designing a protein for a given structure and function is still a challenging task. On the other hand, the number of solved protein structures is rapidly increasing while the number of unique protein folds has reached a steady number, suggesting more structural information is being accumulated on each fold. Deep learning neural network is a powerful method to learn such big data set and has shown superior performance in many machine learning fields. In this study, we applied the deep learning neural network approach to computational protein design for predicting the probability of 20 natural amino acids on each residue in a protein. A large set of protein structures was collected and a multi-layer neural network was constructed. A number of structural properties were extracted as input features and the best network achieved an accuracy of 38.3%. Using the network output as residue type restraints improves the average sequence identity in designing three natural proteins using Rosetta. Moreover, the predictions from our network show ~3% higher sequence identity than a previous method. Results from this study may benefit further development of computational protein design methods.

Inhibition of the hedgehog pathway leads to antifibrotic effects in dermal fibrosis.

Dermal fibrosis is characterized by the activation of the matrix-producing 'positive' myofibroblasts, and the relentless production and deposition of extracellular matrix. The hedgehog pathway has recently been demonstrated to work in a pro-fibrotic manner in systemic sclerosis (SSc). A negative regulator of the hedgehog pathway (Hh), the suppressor of fused (Sufu), was shown to be involved in the activation of fibrotic diseases. However, the exact role of Sufu in fibrosis has not been investigated so far. In our study, we aimed to define the role of sufu in the process of fibrosis using dermal fibroblasts of healthy donors that were cultured in vitro. Cyclopamine, a Smo antagonist, and Sufu lentivector were used to treat or transfect cells. The expression of fibrosis markers and ERK1/2, Smad2, and GSK3ß at the protein level was determined by Western blot. Fibroblast migration was measured by in vitro wound healing assay. Bleomycin-induced dermal fibrosis mouse model was introduced to assess the effect of cyclopamine on dermal fibrosis in vivo. We found that cyclopamine significantly upregulated the expression of Sufu. Both cyclopamine and Sufu lentivector reduced migration and myofibroblast differentiation of human dermal fibroblasts at a statistically significant level. Furthermore, cyclopamine reversed dermal fibrosis induced by TGF-ß1. Cyclopamine and the overexpression of Sufu inhibited the phosphorylation of GSK-3ß and restrained the migration of fibroblasts. Dermal fibrosis was inhibited by intraperitoneal injection of cyclopamine in a mouse model of scleroderma. Our findings suggest that cyclopamine and Sufu-overexpression may effectively inhibit the endogenous as well as the TGF-ß1-induced activation of fibroblasts through subsequent activation of GSK-3ß. Sufu agonists may be a promising approach in the development of antifibrotic medications for dermal fibrosis and systemic sclerosis.

Meta-Analysis of Laparoscopic versus Open Hepatectomy for Live Liver Donors.

OBJECTIVE: To document the safety and efficacy of laparoscopic living donor hepatectomy in comparison with open liver resection for living donor liver transplantation. METHODS: Medline database, EMASE and Cochrane library were searched for original studies comparing laparoscopic living donor hepatectomy (LLDH) and open living donor hepatectomy (OLDH) by January 2015. Meta-analysis was performed to evaluate donors' perioperative outcomes. RESULTS: Nine studies met selection criteria, involving 1346 donors of whom 318 underwent LLDH and 1028 underwent OLDH. The Meta analysis demonstrated that LLDH group had less operative blood loss [patients 1346; WMD: -56.09 mL; 95%CI: -100.28-(-11.90) mL; P = 0.01], shorter hospital stay [patients 737; WMD: -1.75 d; 95%CI: -3.01-(-0.48) d; P = 0.007] but longer operative time (patients 1346; WMD: 41.05 min; 95%CI: 1.91-80.19 min; P = 0.04), compared with OLDH group. There were no significant difference in other outcomes between LLDH and OLDH groups, including overall complication, bile leakage, postoperative bleeding, pulmonary complication, wound complication, time to dietary intake and period of analgesic use. CONCLUSIONS: LLDH appears to be a safe and effective option for LDLT. It improves donors' perioperative outcomes as compared with OLDH.

Surgical management of isolated retroperitoneal Castleman's disease: A case report.

Castleman's disease (CD) is an uncommon, poorly understood lymphoproliferative disease. Retroperitoneal forms may present as either a unicentric or multicentric disease. The present study reports the case of a 36-year-old man who was referred to the First Affiliated Hospital, School of Medicine, Zhejiang University (Hangzhou, China), for a detailed examination of an abdominal mass. The abdominal ultrasound and computed tomography scans revealed a solid mass localized in the region between segment 1 of the liver and the pancreas. An endosonography-guided fine-needle aspiration biopsy revealed chronic inflammation and lymphadenosis. The present study reports a rare case, in which the patient was treated with an exploratory laparotomy and resection. The retroperitoneal mass was pathologically diagnosed as CD of the hyaline vascular type. The patient was closely followed-up for 11 months and is presently free of disease. In conclusion, the possibility of unicentric CD should be considered when facing a solid hypervascular retroperitoneal mass. A complete surgical resection may successfully treat the disease without an unnecessarily extensive resection for the unicentric type.