Relationship between starch fine structure and simulated oral processing of cooked japonica rice.

Background: Simulated oral processing can be used to evaluate the palatability of cooked rice. Previously, we established a simulated oral processing method using a texture analyzer equipped with a multiple extrusion cell probe (TA/MEC). However, the relationship between oral processing and starch fine structure remains unknown. Methods: In this study, we analyzed the oral processing properties using TA/MEC and characterized the starch fine structure of japonica rice by size-exclusion chromatography (SEC) and fluorophore-assisted capillary electrophoresis (FACE). The relationship between starch fine structure and oral processing of cooked japonica rice was further investigated. Results: Cooked rice structure contains fast-breakdown (Type I structure), slow-breakdown (Type II structure) and unbreakable structures (Type III structure). Fast-breakdown and slow-breakdown structure were positively correlated with the content of amylose and shorter amylopectin branches. The content of longer amylopectin branches was positively correlated with the contribution of unbreakable structure. Conclusion: The results indicated that cooked japonica rice varieties with more amylose and shorter amylopectin branches tend to form a harder texture and need more work to break down the fast and slow breakdown structures related to rice kernel fragmentation. Meanwhile, cooked japonica rice varieties possess stronger molecular entanglements due to their longer amylopectin branches and contribute more to the breakdown of unbreakable structures. These results can guide breeders to select rice varieties with desirable eating qualities for cultivation.

Subaxial lordosis loss and influence factors after posterior atlantoaxial fusion.

Cervical sagittal balance is an important evaluation index of cervical physiological function and surgical efficacy. Subaxial kyphosis after atlantoaxial fusion is negatively associated with worse clinical outcomes and higher incidence of lower cervical disk degeneration. OBJECTIVES: This study aimed to confirm the factors that influence subaxial lordosis loss after posterior atlantoaxial fusion. METHODS: We performed a retrospective review of all patients following posterior C1-C2 fusion for atlantoaxial dislocation between January 2015 and December 2017. All charts, records, and imaging studies were reviewed for each case, and preoperative, immediate postoperative, and final follow-up plain films were evaluated. Comparing final follow-up and preoperative C2-C7 angle, patients were divided into two groups for further comparison: subaxial lordosis loss group and subaxial lordosis increase group. RESULTS: A total of 18 patients were included in the review, with an average radiographic follow-up of 8.4 ± 3.7 months (range 6-17 months). Subaxial lordosis loss was observed in 5 cases (27.8%) at the final follow-up, whereas 13 cases had an increase in subaxial lordosis. The cervical sagittal parameters of preoperative and final follow-up between two groups were compared, the preoperative C2-C7 angle of the subaxial lordosis loss group was bigger than the subaxial lordosis increase group (27.6° ± 10.5° vs 10.5° ± 10.5°, P < 0.05), but there was no statistical difference in other parameters. Univariate chi-square analysis showed that reduction in subaxial lordosis after posterior atlantoaxial fusion was associated with preoperative C2-C7 angle ≥ 20° (χ2 = 4.923, P = 0.026). However, Logistic regression analysis showed that the preoperative C2-C7 angle ≥ 20° was not an independent risk factor (OR = 0.147, P = 0.225). CONCLUSION: Our study demonstrates that subaxial lordosis loss may occur after posterior atlantoaxial fusion, and preoperative C2-C7 angle ≥ 20° was a risk factor of postoperative loss of subaxial lordosis.

Characterization of Changes and Driver Microbes in Gut Microbiota During Healthy Aging Using A Captive Monkey Model.

Recent population studies have significantly advanced our understanding of how age shapes the gut microbiota. However, the actual role of age could be inevitably confounded due to the complex and variable environmental factors in human populations. A well-controlled environment is thus necessary to reduce undesirable confounding effects, and recapitulate age-dependent changes in the gut microbiota of healthy primates. Herein we performed 16S rRNA gene sequencing, characterized the age-associated gut microbial profiles from infant to elderly crab-eating macaques reared in captivity, and systemically revealed the lifelong dynamic changes of the primate gut microbiota. While the most significant age-associated taxa were mainly found as commensals such as Faecalibacterium, the abundance of a group of suspicious pathogens such as Helicobacter was exclusively increased in infants, underlining their potential role in host development. Importantly, topology analysis indicated that the network connectivity of gut microbiota was even more age-dependent than taxonomic diversity, and its tremendous decline with age could probably be linked to healthy aging. Moreover, we identified key driver microbes responsible for such age-dependent network changes, which were further linked to altered metabolic functions of lipids, carbohydrates, and amino acids, as well as phenotypes in the microbial community. The current study thus demonstrates the lifelong age-dependent changes and their driver microbes in the primate gut microbiota, and provides new insights into their roles in the development and healthy aging of their hosts.

Combining clinical examination with exome sequencing for the diagnosis and treatment of Marfan syndrome: a case series of 6 families from China.

BACKGROUND: Marfan syndrome (MFS) is a rare autosomal dominant connective tissue disorder. Diagnosing MFS can be challenging as the disease's severity and clinical manifestations differ between pathogenic variants, and because a lack of published information currently exists on phenotype-genotype correlations. This report aims to underline the clinical manifestations associated with fibrillin-1 (FBN1) gene mutations by assessing MFS in 6 families from China. METHODS: We diagnosed 6 patients and their relatives with MFS by combining a clinical examination (based on the 2010 revised Ghent nosology criteria) with a targeted next-generation sequencing analysis. The functional analysis of the causal mutations and clinical details of the affected patients were then assessed. RESULTS: We identified 6 pathogenic mutations in FBN1, including 1 novel frameshift, 1 nonsense, and 4 missense mutations. Most uniquely, mitral valve prolapses (MVP) and ectopia lentis (EL) were found in the cysteine-related mutations. Typically, facial symptoms of MFS are observed in frameshift or nonsense mutants, not in cysteine-related ones. Furthermore, the patients with premature terminal codons had a more serious skin condition than patients with missense mutations, partly indicating the important effect FBN1 has on skin. CONCLUSIONS: This study expands the mutation spectrum of MFS and highlights possible genotype-phenotype correlations, thereby improving the early diagnosis and symptomatic treatment of the disease.

A novel variant in fibrillin-1 is responsible for early-onset familial thoracic aortic aneurysms in Marfan patients.

BACKGROUND: Marfan syndrome (MFS) is an inherited connective tissue disorder that affects the skeletal, ocular, and cardiovascular system. The disease's severity and clinical manifestations vary greatly due to pathogenic variants which, combined with a lack of research on the correlation between MFS's genotype and phenotype, make MFS a challenging disease to diagnose. This study aims to further the understanding of MFS by shedding light on the clinical manifestation of a novel variant in fibrillin-1 (FBN1)-the protein responsible for the genetic defects that lead to MFS. METHODS: A patient was diagnosed with MFS by combining a clinical examination (based on the 2010 revision to Ghent nosology criteria) with a targeted next-generation sequence analysis. The functional analysis of the causal mutation and the clinical details of the affected patient were then analyzed. RESULTS: The FBN1 heterozygous variant c.5081_5082insT, which is known to delete large fragments from amino acids 1702 to 2871, was found in the proband patient and her son. The two also displayed the skeletal and cardiovascular manifestations of MFS. In addition, the 14-year-old son was identified as having a dilated aortic bulb at the same rupture site of the proband's dissection, and the proband's mother also died at age 32 due to aortic dissection. CONCLUSIONS: The FBN1 variant c.5081_5082insT (p.Leu1694fs*9) is a pathogenic mutation that can cause MFS patients to experience early-onset familial thoracic aortic aneurysms (TAA). We hope that this discovery can provide further insight into the treatment of MFS patients with truncating variants in exons 42-65.

Evaluation of Percutaneous Transforaminal Endoscopic Discectomy in the Treatment of Lumbar Disc Herniation: A Retrospective Study.

OBJECTIVE: The objective of the present study was to evaluate the safety and efficacy of percutaneous transforaminal endoscopic discectomy (PTED) and open fenestration discectomy (OFD) in the treatment of lumbar disc herniation (LDH). METHODS: Patients in our hospital with LDH who received PTED (n = 71) and OFD (n = 39) from 2013 to 2014 were retrospectively studied. Patient information, including age, gender, visual analogue scale (VAS) score for low back pain and leg pain, body weight, height, Oswestry disability index (ODI), Japanese Orthopedic Association (JOA), and recurrence, was collected. The patients in the two groups were followed up for an average of 63 months after surgery. RESULTS: A total of 136 patients completed the operation and 110 patients were followed up completely. There was no significant difference in baseline data between the two groups (P > 0.05). The postoperative low back pain, leg pain, ODI, and JOA of the two groups were better than those preoperatively (P < 0.05). One week after surgery, the recovery of PTED patients was better than that of OFD. The ODI score of the PTED group was lower than that of the OFD group (10 [8, 12] vs 14 [11, 16]; P < 0.05), the waist VAS score of the PTED group was lower than that of the OFD group (2 [2, 3] vs 3 [2, 4]; P < 0.05), the leg VAS score of the PTED group was lower than that of the OFD group (1 [0,1] vs 1 [1, 2]; P < 0.05), while the JOA score of the PTED group was higher than that of OFD group [19(16, 20) vs 12(10, 17); P < 0.05]. There were no significant differences in ODI, JOA, waist and leg VAS scores between the two groups at 1 month after surgery and at subsequent follow-up (P > 0.05). At the end of the follow up, 89.7% (35/39) of patients in the OFD group had excellent improvement in the JOA score, and 88.7% (63/71) of patients in the PTED group had an excellent improvement. There was no significant difference between the two (P > 0.05). There was also no significant difference in the recurrence rate between the two groups [(5/71) vs (3/39); P > 0.05]. [Correction added on 05 March 2021, after first online publication: "3/29" was amended to "3/39" in the preceding sentence.] CONCLUSION: Both PTED and OFD can achieve good mid-term efficacy in the treatment of LDH but PTED has certain advantages, including the small incision, a shorter hospital stay, and quicker, earlier recovery. However, prospective randomized controlled studies with a larger sample size are needed.

A novel missense mutation of RPGR identified from retinitis pigmentosa affects splicing of the ORF15 region and causes loss of transcript heterogeneity.

Mutations in the retinitis pigmentosa GTPase regulator (RPGR) gene, are the major cause of X-linked retinitis pigmentosa (RP), in which exon open reading frame 15 (ORF15) of RPGR has been implicated to play a substantial role. We identified a novel hemizygous missense mutation E585K of RPGR from whole-exome sequencing of RP. RNA-Seq analysis and functional study were conducted to investigate the underlying pathogenic mechanism of the mutation. Our results showed that the mutation actually affected RPGR ORF15 splicing. RNA-Seq analysis of the human retina followed by validation in cells revealed a complex splicing pattern near the 3' boundary of RPGR exon 14 in the ORF15 region, resulting from a variety of alternative splicing events (ASEs). The wildtype RPGR mini-gene expressed in human 293T cells confirmed these ASEs in vitro. In contrast, without new RNA species detected, the mutant mini-gene disrupted the splicing pattern of the ORF15 region, and caused loss of RPGR transcript heterogeneity. The RNA species derived from the mutant mini-gene were predominated by a minor out-of-frame transcript that was also observed in wildtype RPGR, resulting from an upstream alternative 5' splice site in exon 14. Our findings therefore provide insights into the influence of RPGR exonic mutations on alternative splicing of the ORF15 region, and the underlying molecular mechanism of RP.

A combined ultrasonic B-mode and color Doppler system for the classification of breast masses using neural network.

OBJECTIVES: To develop a dual-modal neural network model to characterize ultrasound (US) images of breast masses. MATERIALS AND METHODS: A combined US B-mode and color Doppler neural network model was developed to classify US images of the breast. Three datasets with breast masses were originally detected and interpreted by 20 experienced radiologists according to Breast Imaging-Reporting and Data System (BI-RADS) lexicon ((1) training set, 103212 masses from 45,433 + 12,519 patients. (2) held-out validation set, 2748 masses from 1197 + 395 patients. (3) test set, 605 masses from 337 + 78 patients). The neural network was first trained on training set. Then, the trained model was tested on a held-out validation set to evaluate agreement on BI-RADS category between the model and the radiologists. In addition, the model and a reader study of 10 radiologists were applied to the test set with biopsy-proven results. To evaluate the performance of the model in benign or malignant classifications, the receiver operating characteristic curve, sensitivities, and specificities were compared. RESULTS: The trained dual-modal model showed favorable agreement with the assessment performed by the radiologists (κ = 0.73; 95% confidence interval, 0.71-0.75) in classifying breast masses into four BI-RADS categories in the validation set. For the binary categorization of benign or malignant breast masses in the test set, the dual-modal model achieved the area under the ROC curve (AUC) of 0.982, while the readers scored an AUC of 0.948 in terms of the ROC convex hull. CONCLUSION: The dual-modal model can be used to assess breast masses at a level comparable to that of an experienced radiologist. KEY POINTS: • A neural network model based on ultrasonic imaging can classify breast masses into different Breast Imaging-Reporting and Data System categories according to the probability of malignancy. • A combined ultrasonic B-mode and color Doppler neural network model achieved a high level of agreement with the readings of an experienced radiologist and has the potential to automate the routine characterization of breast masses.

Polymicrobial and Monomicrobial Infections after Spinal Surgery: A Retrospective Study to Determine which Infection is more Severe.

STUDY DESIGN: A retrospective clinical review. PURPOSE: To investigate the difference in clinical manifestations and severity between polymicrobial and monomicrobial infections after spinal surgery. OVERVIEW OF LITERATURE: Surgical site infections (SSIs) after spinal surgery are a major diagnostic and therapeutic challenge for spinal surgeons. Polymicrobial infections after spinal surgery seem to result in poorer outcomes than monomicrobial infections because of complementary resistance to antibiotics. However, comparison of the clinical manifestations and severity between polymicrobial and monomicrobial infections are limited. METHODS: Sixty-seven patients with SSIs after spinal surgery were studied: 20 patients with polymicrobial infections and 47 with monomicrobial infections. Pathogenic bacteria identified were counted and classified. Age, sex, and body mass index were compared between the two groups to identify homogeneity. The groups were compared for clinical manifestations by surgical site, postoperative time to infection, infection site, incisional drainage, incisional swelling, incisional pain, neurological signs, temperature, white blood cell count, and the percentage of neutrophils. Finally, the groups were compared for severity by hospital stay, number of rehospitalizations, number of debridements, duration of antibiotics administration, number of antibiotics administered, and implant removal. RESULTS: Polymicrobial infections comprised 29.9% of SSIs after spinal surgery, and most polymicrobial infections (70.0%) were caused by two species of bacteria only. There was no difference between the groups in terms of clinical manifestations and severity. In total, 96 bacterial strains were isolated from the spinal wounds: 60 strains were gram-positive and 36 were gram-negative pathogenic bacteria. Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, and Enterobacter cloacae were cultured in order of the frequency of appearance. CONCLUSIONS: Most polymicrobial infections were caused by two bacterial species after spinal surgery. There was no difference in clinical manifestations or severity between polymicrobial and monomicrobial infections.

Genistein accelerates refractory wound healing by suppressing superoxide and FoxO1/iNOS pathway in type 1 diabetes.

Refractory wounds in diabetic patients constitute a serious complication that often leads to amputation with limited treatment regimens. The present study was designed to determine the protective effect of the soy isoflavone genistein on diabetic wound healing and investigate underlying mechanisms. Streptozotocin (STZ)-induced type 1 diabetic mice with full-thickness excisional wounds received 0.2, 1 or 5mg/kg/day of genistein via subcutaneous injection. Genistein dose-dependently rescued the delay of wound closure in diabetic mice. A dose of 5 mg/kg/day of genistein treatment significantly increased the mean perfusion rate, and in vitro treatment with genistein protected against high glucose-induced impairment of capillary tube formation in cultured endothelial cells. Diabetic conditions significantly increased superoxide anion (O(2)·(-)) production and nitrotyrosine formation, and decreased nitrite levels in wound tissues. Genistein treatment at all doses normalized the elevated O(2)·(-) production and nitrotyrosine formation, and reversed the attenuated nitrite level. In diabetic wound tissues, the inducible nitric oxide synthase (iNOS) was activated, and genistein administration prevented increased iNOS activity. Moreover, genistein attenuated diabetic cutaneous silent information regulator 1 and forkhead box O transcription factor 1 (FoxO1) levels and potentiated ac-FoxO1 in a dose-dependent manner. Genistein rescued the delayed wound healing and improved wound angiogenesis in STZ-induced type 1 diabetes in mice, at least in part, by suppression of FoxO1, iNOS activity and oxidative stress.

[Clinical value of 64-slice spiral 3-phase CT enhanced scanning for preoperative TNM staging assessment of gastric carcinoma].

OBJECTIVE: To explore the clinical value of 64-slice spiral 3-phase CT enhanced scanning for preoperative TNM staging assessment of gastric carcinoma. METHODS: A retrospective study was performed to review the 64-slice spiral 3-phase CT enhanced scanning of 120 patients with gastric cancer diagnosed by biopsy prior to operation and postoperative pathological reports. All the findings were reviewed by two senior radiologic diagnosticians separately and compared with pathological findings. RESULTS: The accuracy of 64-slice spiral CT enhanced scan was 79.2%(95/120) for T staging, 66.7%(10/15) for T1, 66.7%(14/21) for T2, 84.0%(42/50) for T3, and 85.3%(29/34) for T4. For gastric wall with single layer and multiple layers, the accuracy of CT enhanced scanning was 59.4%(19/32) and 81.8%(72/88) for T staging, and the difference was statistically significant(P<0.05). The accuracy of 64-slice spiral CT enhanced scan was 73.9%(85/115) for N staging, 75.5%(37/49) for N0, 70.3%(26/37) for N1, 75.9%(22/29) for N2. The accuracy of 64-slice spiral CT enhanced scanning was 89.2% for M staging. CONCLUSION: 64-slice spiral CT 3-phase enhanced scanning can monitor the invasion, lymphatic metastasis, and distant metastasis of gastric cancer dynamically, which may become an important examination item for the preoperative evaluation of gastric cancer.

[Research advances on aquaporins and vascular function regulation and related diseases].

Aquaporins (AQPs), mainly distributed in epithelial and endothelial cells, are a family of channel-forming membrane proteins, originally confirmed to mediate the cellular water-transportation. AQPs are essential for maintaining homeostasis of the body water. Recently, studies have shown that AQPs may be involved in vascular function regulation and the development of related diseases, especially in cerebral ischemia, congestion heart failure, hypertension and tumor angiogenesis. Therefore, further studies are needed to elucidate mechanism accounting for the association between AQPs and vascular function related diseases, which may lead to novel approaches to the prevention and treatment of these diseases. In this review, we will discuss the expression and physiological roles of AQPs in vascular tissues and summarize recent progress in the relationship between AQPs and vascular function related diseases.

Ganoderma lucidum polysaccharide accelerates refractory wound healing by inhibition of mitochondrial oxidative stress in type 1 diabetes.

BACKGROUND/AIMS: Refractory wounds in diabetic patients constitute a serious complication that often leads to amputation with limited treatment regimens. The present study was designed to determine the protective effect of Ganoderma lucidum polysaccharide (Gl-PS) on diabetic wound healing and investigate underlying mechanisms. METHODS: Streptozotocin (STZ)-induced type 1 diabetic mice with full-thickness excisional wounds were intragastrically administered with 10, 50 or 250 mg/kg/day of Gl-PS. RESULTS: Gl-PS dose-dependently rescued the delay of wound closure in diabetic mice. 50 and 250 mg/kg/day of Gl-PS treatment significantly increased the mean perfusion rate around the wound in diabetic mice. Diabetic conditions markly increased mitochondrial superoxide anion (O(2)·(-)) production, nitrotyrosine formation, and inducible nitric oxide synthase (iNOS) activity in wound tissues, which were normalized with Gl-PS treatment. In diabetic wound tissues, the protein level of manganese superoxide dismutase (MnSOD) was unchanged whereas MnSOD activity was inhibited and its nitration was potentiated; Gl-PS administration suppressed MnSOD nitration and increased MnSOD and glutathione peroxidase (GPx) activities. Moreover, Gl-PS attenuated the redox enzyme p66Shc expression and phosphorylation dose-dependently in diabetic mice skin. CONCLUSION: Gl-PS rescued the delayed wound healing and improved wound angiogenesis in STZ-induced type 1 diabetic mice, at least in part, by suppression of cutaneous MnSOD nitration, p66Shc and mitochondrial oxidative stress.