TSH-suppressive therapy can reduce bone mineral density in patients with differentiated thyroid carcinoma: a meta-analysis.

OBJECTIVE: To evaluate the effect of TSH-suppressive therapy on the bone mineral density in patients with differentiated thyroid carcinoma (DTC). MATERIALS AND METHODS: The cross-sectional, cohort, prospective controlled, and case-control studies on the bone mineral density change in patients with DTC after TSH-suppressive therapy from databases were searched, including PubMed, Embase, and Cochrane library databases. The effect of TSH-suppressive therapy on bone mineral density of lumbar, femoral neck, femoral greater trochanter, and Ward triangle was analyzed. Data from the database establishment to January 2019 were all reviewed. Meta-analysis was performed with RevMan 5.3 software after two reviewers independently screened the date. The categorical variables were expressed as odds ratios, while the numerical variables were expressed as mean differences. Based on the heterogeneity of the study, a comprehensive analysis was performed by using fixed or random effect models. RESULTS: A total of 11 studies involving 434 patients with differentiated thyroid cancer were included. No significant difference in the bone mineral density of lumbar indications between the experimental and control groups was observed (MD=0.00, 95% CI=-0.03-0.03, p=0.96). The bone mineral density of the femoral neck indications (MD=-0.01, 95% CI=-0.04-0.03, p=0.70). A significant difference between experimental and control groups in the bone mineral density of femoral trochanter indications was observed (MD=-0.11, 95% CI=-0.14-0.07, p<0.00001). The bone mineral density of Ward's triangle indications (MD=-0.06, 95% CI=-0.11-0.01, p=0.02). CONCLUSIONS: TSH-suppressive therapy in patients with DTC mainly reduces the proximal femur bone mineral density.

[Effects of intraoperative graft flow measurements on the early mid-term outcomes after off-pump coronary artery bypass grafting].

OBJECTIVE: To investigate and analyze the relationship between intraoperative graft flow measurements and the early mid-term outcomes after off-pump coronary artery bypass grafting (OPCAB). METHODS: Patients who underwent isolated OPCAB in the Department of Cardiac Surgery of Peking University People's Hospital from January 2013 to June 2016 were included. Perioperative characteristics, graft flow measurements and postoperative follow-up outcomes were retrospectively collected. Comparison was made between flow measurements of grafts and the early mid-term outcomes. Flow measurements of grafts included the mean flow (MF) and the pulsatility index (PI). The early outcomes included peri-operative myocardial infarction (PMI), use of an intra-aortic balloon pump (IABP), reoperation for all causes, new-onset atrial fibrillation and in-hospital or 30-day mortality. RESULTS: A total of 463 patients were included in the study. Mean age was (62.80±8.36) years, and 24.8% were females. The total number of grafts was 1 435, which averaged 3.10 grafts per patient. The MF and PI were separately (32.34±14.45) mL/min and 2.87±0.92. Of all the patients, 23(5%) had PMI, and 11 used IABP. Observed in-hospital or 30-day mortality was 0.86% (4 patients). Compared with non-PMI group, the MF was lower and the PI was higher in the PMI group (P<0.05). However, the differences of other early outcomes had no statistical significance between the PMI group and the non-PMI group. The lower MF (Wald=5.684, P=0.017, 95%CI: 0.894-0.989) and the higher PI (Wald=9.040, P=0.003, 95%CI: 1.252-2.903) were risk factors of PMI in multivariable Logistic regression modeling. The longest follow-up time was 37 months, and 7 patients died. The differences of graft flow measurements between the surviving group and the nonsurvivors had no statistical significance, but overall mid-term survival was lower in patients with poor left internal mammary artery (LIMA) to left anterior descending artery (LAD) graft flow (MF<10 mL/min; OR=9.6, P<0.05). CONCLUSION: Intraoperative graft flow parameters during OPCAB can predict the early mid-term outcomes. The lower MF and the higher PI should increase the rate of PMI. A lower flow of LIMA to LAD graft (<10 mL/min) should increase the rate of midterm mortality, but further research will be needed to confirm and explore the findings.

[Expand prelacrimal recess-maxillary ainus approach for inferior orbital walls fracture treatment].

Objective: To investigate the surgical technique and curative effect of transnasal endoscopic anterior lacrimal approach for the treatment of sacral wall fractures. Method: Retrospective clinical analysis of 5 patients with inferior orbital walls fracture treated by expanding prelacrimal recess-maxillary ainus under nasal endoscope was studied, and the surgical method and its efficacy were annalyzed. Result: After 1 year of follow-up,4 patients' diplopia symptom disappeared, and 1 patient's diplopia symptom was significantly relieved compared with preoperation, the range of eye movement was normal and enophthalmos were totally corrected.Conclusion: Expanding prelacrimal recess-maxillary ainus approach for the treatment of the inferior orbital walls fracture is an effective surgical method.It has the characteristics of less trauma,no incision on the face, clear visual field and wide space of operation, which is worthy of clinical promotion.

[A Meta-analysis of sublingual immunotherapy in the treatment of seasonal allergic rhinitis].

Objective:To systematically evaluate the efficacy and adverse reactions of sublingual immunotherapy for patients with seasonal allergic rhinitis.Method:Literature databases including PubMed, Embase, Cochrane Library, Medline, CBM, Wanfang, CNKI. The time of literature search was limited from January of 2008 to December of 2017.The literature of randomized controlled trials of sublingual immunotherapy for seasonal allergic rhinitis was screened,the quality of the included literature was evaluated,data was extracted,and meta-analysis was performed using RevMan5.3 software.Result:A total of 10 articles were included. The results of meta-analysis showed that for seasonal allergic rhinitis sublingual immunotherapy compared with the control group can reduce symptom scores （SMD=-0.30, 95%CI［-0.39,-0.21］,P<0.000 01) and medication scores (SMD=-0.18, 95%CI［-0.29，-0.08］, P=0.000 8); sublingual immunotherapy for seasonal allergic rhinitis is not restricted by age in the relief of symptoms, and there is no age restriction on reduce medication requirements; sublingual immunotherapy had a higher incidence of adverse reactions than the control group, but it was mostly localized, such as oral pruritus, ear pruritus, throat irritation.Conclusion:Sublingual immunotherapy can alleviate the symptoms and reduce medication requirements in patients with seasonal allergic rhinitis. The adverse reactions are slightly controllable.

[Nasal irrigation with different concentrations of saline as an adjunctive treatment in allergic rhinitis:A systematic review and Meta-analysis].

Objective:To compare the clinical efficacy of different concentrations of saline irrigation in adjuncative treatment of allergic rhinitis by Meta-analysis. Method:According to the inclusion and exclusion criteria, the studies using random controlled trials were retrieved from the Pubmed, Web of science, The Cochrane Library, Embase et al. The Mata-analysis was performed by using RevMan 5.3 software. Result:In total, 1 457 patients were enrolled in 14 randomized controlled trials, including 739 in the isotonic saline group, 350 in the hypertonic saline group,Times New Roman 368 without saline irragation. The results of Meta-analysis showed that the VAS score of saline irrigation group was lower than no saline irrigation group［95%CI (-1.57, -0.15), P=0.02］, the nasal RQLQ score was lower［95%CI (-3.93, -0.43), P=0.01］, and the effective rate was higher［95%CI(1.15, 1.45), P<0.01］; The score of nasal symptoms and signs in hypertonic saline group was lower than that in normal saline group［95%CI(-1.68, -0.63), P<0.01］, and the effective rate was higher［95%CI(1.19, 1.47), P<0.01］. There were significant differences between the two groups. Conclusion:The efficacy of saline irrigation as an adjunctive treatment in allergic rhinitis is significant. The effect of hypertonic saline irrigation was better than that of isotonic saline.

[The clinical efficacy of vidian neurectomy and conservative treatment on moderate-severe allergic rhinitis: a Meta-analysis].

Objective: To compare the clinical effects of vidian neurectomy with conservative management in the treatment for moderate-severe allergic rhinitis. Method: The studies using case controlled trials which were retrieved from Embase, Pubmed, Web of Science, Cochrane Library etc. The Cochrane risk assessment criteria were used to evaluate the quality of the articles that met the inclusion criteria. Manager 5.3 software was used to data analysis. Result: Six articles were included in meta-analysis. Meta-analysis showed that vidian neurectomy group got lower RQLQ scoresï¼»95%CI (-0.98,-0.63),P<0.001ï¼½, less inCIdence of complicationsï¼»95%CI (0.17, 0.67), P=0.002ï¼½, lower VAS scoreï¼»95%CI (-3.97,-3.65), P<0.001ï¼½and higher clinically effective ratioï¼»95%CI (1.18, 50.52), P=0.03ï¼½than conservative treatment group. Conclusion:In summary, we believe that nasal endoscopic vidian neurectomy in the treatment of moderate-severe allergic rhinitis is superior to conservative treatment.

Epidemiological investigation and risk factors of Peste des petitis ruminants (PPR) in yaks (Bos grunniens) and cattle in five regions of China.

To investigate the prevalence of Peste des petitis ruminants in yaks and cattle in poorly studied areas of China. A total of 1202 and 560 blood samples were collected from yaks and cattle, respectively and processed using a commercial ELISA kit. Multivariable logistic regression model was piloted to find the variables, potentially associated with exposure of PPR infection in yaks and cattle. Results indicated that the overall prevalence of PPR in yaks was 11.2%. A total 66 (11.8%) out of 560 were examined out to be positive to PPR in cattle in Jiangxi province. According to conditional stepwise logistic regression, region, age and gender were found to be the more influencing risk factors in yaks, while region and age were found to be the potential risk factors in cattle. The current results reported the prevalence and associated risk factors of PPR in bovine for the first time in China.

Antibiotic resistance and screening of the resistant genes of Escherichia coli (E. coli) isolated from diarrheal yak calves in Sichuan Province, China.

This study was conducted to determine the antibiotic and screening resistance genes of Escherichia coli (E. coli) isolated from diarrheal yak calves from high remote plateau in Sichuan, China. A total 41 rectal swabs were obtained from diarrheal yak calves. E. coli were isolated and identified. The antimicrobial sensitivity was tested by piloting the disk diffusion method for 21 antibiotics. Polymerase chain reaction was employed to detect the resistance genes. The results showed that the drug resistance ranged from 2.4% (amikacin) to 53.7% (tetracycline), while no isolates were found resistant to neomycin and polymyxin B. Multi-drug resistance was detected in 4.9% isolates to 17 antimicrobial agents; and 24.4% isolates were found susceptible to all antimicrobial agents. The aminoglycoside resistance genes of aac(3)-lla, ant(3')-la and aph(3')-lla was positive in 4.9%, 2.1% and 7.3% E. coli isolates respectively. The 4.9% and 2.1% of E. coli isolates were detected in b-Lactam resistance genes of TEM and CTX-M, respectively; and 12.2% and 4.9% of E. coli isolates were found to have Tetracycline resistance genes of tetM and tetA, respectively. The present study reveals that the yak calves from high cold plateau are potential reservoir of E. coli with widely distributed multiple drug resistance which requires the attention of concerned authorities regarding the use of non-standard antibiotics.

Epidemiological investigation and risk factors of Peste des petitis ruminants (PPR) in yaks (Bos grunniens) and cattle in five regions of China

@#To investigate the prevalence of Peste des petitis ruminants in yaks and cattle in poorly studied areas of China. A total of 1202 and 560 blood samples were collected from yaks and cattle, respectively and processed using a commercial ELISA kit. Multivariable logistic regression model was piloted to find the variables, potentially associated with exposure of PPR infection in yaks and cattle. Results indicated that the overall prevalence of PPR in yaks was 11.2%. A total 66 (11.8%) out of 560 were examined out to be positive to PPR in cattle in Jiangxi province. According to conditional stepwise logistic regression, region, age and gender were found to be the more influencing risk factors in yaks, while region and age were found to be the potential risk factors in cattle. The current results reported the prevalence and associated risk factors of PPR in bovine for the first time in China.

Enhanced superconductivity accompanying a Lifshitz transition in electron-doped FeSe monolayer.

The origin of enhanced superconductivity over 50 K in the recently discovered FeSe monolayer films grown on SrTiO3 (STO), as compared to 8 K in bulk FeSe, is intensely debated. As with the ferrochalcogenides AxFe2-ySe2 and potassium-doped FeSe, which also have a relatively high-superconducting critical temperature (Tc), the Fermi surface (FS) of the FeSe/STO monolayer films is free of hole-like FS, suggesting that a Lifshitz transition by which these hole FSs vanish may help increasing Tc. However, the fundamental reasons explaining this increase of Tc remain unclear. Here we report a 15 K jump of Tc accompanying a second Lifshitz transition characterized by the emergence of an electron pocket at the Brillouin zone centre, which is triggered by high-electron doping following in situ deposition of potassium on FeSe/STO monolayer films. Our results suggest that the pairing interactions are orbital dependent in generating enhanced superconductivity in FeSe.

Development and characterization of microsatellite markers of the eastern keelback mullet (Liza affinis).

Twenty-four polymorphic microsatellite loci were isolated and characterized for Liza affinis using a (GT)13-enriched genomic library. The number of alleles per locus ranged from 3 to 9, with a mean number of 6.250. The observed and expected heterozygosities ranged from 0.417 to 1.000 and from 0.550 to 0.861, with an average of 0.859 and 0.779, respectively. Deviation from Hardy-Weinberg proportions was detected at three loci. Evidence of null alleles was found at two loci. These markers will be useful in further studies investigating the genetic variation and population structure of this species, and may provide insights into the maintenance and efficient management of eastern keelback mullet resources.

Development of polymorphic microsatellite loci for a new fish species, Chinese sillago (Sillago sinica).

Sillago sinica is a newly identified species belonging to Sillaginidae, Perciforms, and was found along the coast of China in 2011. In the present study, 81 microsatellite loci were isolated from an enriched genomic library, and 24 positive clones containing microsatellite repeats had adequate flanking sequences for the development of PCR primers. Sixteen of these primers were monomorphic or would not amplify. Eight were polymorphic in an examined population with the number of alleles per locus ranging from 2 to 14. The number of observed and expected heterozygosities per locus varied from 0.125 to 0.958 and from 0.120 to 0.904, respectively. The polymorphism information content ranged from 0.110 to 0.721. All loci conformed to Hardy-Weinberg equilibrium (P > 0.05) after Bonferroni correction. There was no significant linkage disequilibrium between the eight polymorphic loci. These results suggest that these markers may be very useful for the characterization of natural populations of this species.

A cytological study of anther and pollen development in Camellia oleifera.

The plant species Camellia oleifera is an important producer of edible oil in China. However, it suffers from a low fruit-setting rate. This study used high resolution scanning electron microscopy of semi-thin tissue sections to investigate anther development and pollen formation, and to determine whether problems in forming functional pollen cause low seed setting rates. During anther development, cell sizes within the epidermis and end othecium gradually increase, and at the beginning of the microsporocyte phase, the cells become highly vacuolated. The cell walls of the inner wall cells thicken in a ribbon pattern during the later part of the two-cell pollen stage. Middle layer cells become flattened during the later part of the secondary sporogenous cell stage. A tapetum also forms at this stage; the secondary sporogenous cells begin to degrade at the early microspore stage and completely disappear by the time the pollen is mature, thus forming a glandular tapetum. In microsporocyte, cytokinesis occurs simultaneously with microsporocyte meiosis, and a tetrahedral arrangement is present in tetrads. Reproductive cells begin to form at the later stage of microsporogenesis; the nuclei of the reproductive cells are enlarged as the reproductive cells begin to move away from the pollen wall. Two-cell pollen is first formed after reproductive cells have left the pollen wall, and the number of inclusions in the pollen subsequently increases. The pollen matures for 5-8 days before flowering occurs. No pollen abortion phenomena were observed, suggesting that anther development in C. oleifera is normal and that functional pollen are formed.

Synergy of aminoglycoside antibiotics by 3-Benzylchroman derivatives from the Chinese drug Caesalpinia sappan against clinical methicillin-resistant Staphylococcus aureus (MRSA).

The in vitro antimicrobial activities of three 3-Benzylchroman derivatives, i.e. Brazilin (1), Brazilein (2) and Sappanone B (3) from Caesalpinia sappan L. (Leguminosae) were assayed, which mainly dealt with synergistic evaluation of aminoglycoside and other type of antibiotics against methicillin-resistant Staphylococcus aureus (MRSA) by the three compounds through the Chequerboard and Time-kill curve methods. The results showed that Compounds 1-3 alone exhibited moderate to weak activity against methicillin-susceptible S. aureus (MSSA) and other standard strains by MICs/MBCs ranged from 32/64 to >1024/>1024 µg/ml, with the order of activity as 1>2>3. Chequerboard method showed significant anti-MRSA synergy of 1/Aminoglycosides (Gentamicin, Amikacin, Etimicin and Streptomycin) combinations with (FICIs)50 at 0.375-0.5. The combined (MICs)50 values (µg/ml) reduced from 32-128/16-64 to 4-8/4-16, respectively. The percent of reduction by MICs ranged from 50% to 87.5%, with a maximum of 93.8% (1/16 of the alone MIC). Combinations of 2 and 3 with Aminoglycosides and the other antibiotics showed less potency of synergy. The dynamic Time-killing experiment further demonstrated that the combinations of 1/aminoglycoside were synergistically bactericidal against MRSA. The anti-MRSA synergy results of the bacteriostatic (Chequerboard method) and bactericidal (time-kill method) efficiencies of 1/Aminoglycoside combinations was in good consistency, which made the resistance reversed by CLSI guidelines. We concluded that the 3-Benzylchroman derivative Brazilin (1) showed in vitro synergy of bactericidal activities against MRSA when combined with Aminoglycosides, which might be beneficial for combinatory therapy of MRSA infection.

Inhibition of HLA-G expression via RNAi abolishes resistance of extravillous trophoblast cell line TEV-1 to NK lysis.

Remodelling of uterine spiral arteries occurs in the first trimester of pregnancy and involves an expanded and activated population of maternal natural killer (NK) cells in the decidua and extravillous trophoblast cells. Invasive trophoblasts encounter maternal NK cells during their invasion into the uterine tissue, posing the problem of susceptibility to NK lysis. Studies in vitro and in vivo suggested that the expression of HLA-G by invasive extravillous trophoblasts might provide invulnerability to NK cells, while there is still lack of direct evidence of HLA-G knockdown effect on trophoblast/NK interaction. A study was conducted to investigate the effects of down-regulated HLA-G on extravillous trophoblasts. The short hairpin RNA (shRNA) vector targeting HLA-G was constructed and transfected into the human first-trimester extravillous trophoblast cell line TEV-1. Western blotting and reverse transcription polymerase chain reaction (RT-PCR) revealed that in HLA-G shRNA transfected cells, the expression of HLA-G was significantly decreased. HLA-G expression was also visualised by confocal imaging. The HLA phenotype of TEV-1 cells and inhibitory receptors expression in NK cells were analysed by flow cytometry. A comparison between HLA-G knockdown and non-knockdown cells showed a significant difference in the HLA expression profile without altering HLA-C and HLA-E. Both primary NK cells and NK-92 cell line exhibited potent cytotoxicity against HLA-G knockdown cells via standard 4-h (51)Cr release assays. Expression of ILT2, ILT4 and KIR2DL4 in NK cells was unchanged after 4h of co-culture, while KIR2DL4 expression increased after 48h. We conclude that HLA-G contributes to trophoblast/NK interaction, acting as a key regulator of NK cytolysis in this human extravillous trophoblast cell model. In addition, TEV-1 cells share common HLA phenotype characters with extravillous trophoblast cells, and thus might be used as a good cell model. HLA-C expression in trophoblasts is not correlated with HLA-G translation and HLA-C alone was sufficient to boost HLA-E surface expression. In addition, RNA interference could be employed as a feasible and effective method to study HLA-G functions.

Development of a second-generation oncolytic Herpes simplex virus expressing TNFalpha for cancer therapy.

BACKGROUND: Tumour necrosis factor alpha (TNFalpha) therapy is a promising anti-cancer treatment when combined with radiotherapy due to its potent radio sensitising effects, but systemic toxicity has limited its clinical use. Previously, non-replicative adenovirus vectors have been used to deliver TNFalpha directly to the tumour, including under the control of a radiation sensitive promoter. Here, we have used an ICP34.5 deleted, oncolytic herpes simplex virus (HSV) for delivery to increase expression levels and spread through the tumour, and the use of the US11 true late HSV promoter to limit expression to where the virus replicates, i.e. selectively in tumour tissue. METHODS: TNFalpha expression under the CMV or US11 promoter was compared on cell lines CT26, BHK and Fadu. To further compare the activities of the promoters, expression of human TNFalpha was analysed in the presence and absence of acyclovir--an inhibitor of viral DNA replication and on HSV/ICP34.5- non-permissive cell line 3T6. The in vivo efficacy and toxicity of TNFalpha viruses were compared using A20 double flank tumour model in Balb/C mice and Fadu tumour model in nude mice. RESULTS: The results demonstrated that the US11 promoter significantly reduced and delayed TNFalpha expression as compared to use of the CMV promoter, especially in non-permissive cells or in the presence of acyclovir. Despite the reduced and more selective expression levels, US11 driven TNFalpha showed improved anti-tumour effects compared to CMV driven TNFalpha, and without the toxic side effects. CONCLUSIONS: This approach is therefore beneficial in increasing localised TNFalpha expression as compared to the use of non-replicative approaches, and combines the effects of TNFalpha with oncolytic virus replication which is expected to further enhance the efficacy of radiotherapy in a combined treatment approach.

ICP34.5 deleted herpes simplex virus with enhanced oncolytic, immune stimulating, and anti-tumour properties.

Herpes simplex virus type-1 (HSV1) in which the neurovirulence factor ICP34.5 is inactivated has been shown to direct tumour-specific cell lysis in several tumour models. Such viruses have also been shown to be safe in Phase I clinical trials by intra-tumoral injection in glioma and melanoma patients. Previous work has used serially passaged laboratory isolates of HSV1 which we hypothesized may be attenuated in their lytic capability in human tumour cells as compared to more recent clinical isolates. To produce ICP34.5 deleted HSV with enhanced oncolytic potential, we tested two clinical isolates. Both showed improved cell killing in all human tumour cell lines tested compared to a laboratory strain (strain 17+). ICP34.5 was then deleted from one of the clinical isolate strains (strain JS1). Enhanced tumour cell killing with ICP34.5 deleted HSV has also been reported by the deletion of ICP47 by the up-regulation of US11 which occurs following this mutation. Thus to further improve oncolytic properties, ICP47 was removed from JS1/ICP34.5-. As ICP47 also functions to block antigen processing in HSV infected cells, this mutation was also anticipated to improve the immune stimulating properties of the virus. Finally, to provide viruses with maximum oncolytic and immune stimulating properties, the gene for human or mouse GM-CSF was inserted into the JS1/34.5-/47- vector backbone. GM-CSF is a potent immune stimulator promoting the differentiation of progenitor cells into dendritic cells and has shown promise in clinical trials when delivered by a number of means. Combination of GM-CSF with oncolytic therapy may be particularly effective as the necrotic cell death accompanying virus replication should serve to effectively release tumour antigens to then induce a GM-CSF-enhanced immune response. This would, in effect, provide an in situ, patient-specific, anti-tumour vaccine. The viruses constructed were tested in vitro in human tumour cell lines and in vivo in mice demonstrating significant anti-tumour effects. These were greatly improved compared to viruses not containing each of the modifications described. In vivo, both injected and non-injected tumours showed significant shrinkage or clearance and mice were protected against re-challenge with tumour cells. The data presented indicate that JS1/ICP34.5-/ICP47-/GM-CSF acts as a powerful oncolytic agent which may be appropriate for the treatment of a number of solid tumour types in man.

Use of different thromboplastin reagents causes greater variability in international normalized ratio results than prolonged room temperature storage of specimens.

OBJECTIVE: To determine whether a 24-hour delay in testing affects international normalized ratio (INR) reproducibility as much as using alternative thromboplastin reagents. METHODS: Specimens from warfarin-treated patients were tested at 0 hours and again at 24 hours to determine the INR, each time using RecombiPlasTin, Innovin, and C-Plus thromboplastin reagents. RESULTS: There was no clinically significant difference in INRs when a specimen was tested with the same reagent at 0 and 24 hours. However, at 0 hours, the INRs were significantly higher when a specimen was tested using C-Plus and RecombiPlasTin as compared with the result with Innovin (both P < .0001). CONCLUSIONS: A specimen can be maintained at room temperature for 24 hours without a significant change in the INR. Changing the reagent, however, can result in statistically and clinically significant differences in the INR.