Intracranial peak pressure as a predictor for perioperative mortality after spontaneous intracerebral hemorrhage evacuation and decompressive craniectomy.

BACKGROUND: An optimal intracranial pressure (ICP) management target is not well defined in patients with spontaneous intracerebral hemorrhage. The aim of this study was to explore the association between perioperative ICP monitoring parameters and mortality of patients with spontaneous intracerebral hematoma undergoing emergency hematoma removal and decompressive craniectomy (DC), to provide evidence for a target-oriented ICP management. METHODS: The clinical and radiological features of 176 consecutive patients with spontaneous intracerebral hemorrhage that underwent emergent hematoma evacuation and DC were reviewed. The Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS) scores were assessed 2 weeks after surgery. Multivariate logistic regression analysis was performed to identify predictors for perioperative death. RESULTS: Forty-four cases (25.0%) were assigned to the ICP group. In patients with an ICP monitor, the median peak ICP value was 25.5 mmHg; 50% of them had a peak ICP value of more than 25 mmHg. The median duration of ICP > 25 mmHg was 2 days. Without a target-specific ICP management, the mortality at 2 weeks after surgery was similar between patients with or without an ICP monitor (27.3% versus 18.2%, p = 0.20). In multivariable analysis, the peak ICP value (OR 1.11, 95% CI 1.004-1.234, p = 0.04) was significantly associated with perioperative death in the ICP group. The area under ROC curve of peak ICP value was 0.78 (95%CI 0.62-0.94) for predicting mortality, with a cut-off value of 31 mmHg. CONCLUSION: Compared with a persistent hyperintracranial pressure, a high ICP peak value might provide a better prediction for the mortality of patients with spontaneous intracerebral hemorrhage evacuation and DC, suggesting a tailored ICP management protocol to decrease ICP peak value.

Effects and mechanism of ultrasound treatment on Chironomus kiiensis eggs.

Chironomids are abundant insects in freshwater ecosystems and lay in still or slow-moving water. The walls of sedimentation tanks in drinking water treatment plants (DWTP) provide such laying habitat, which can lead to larval outbreaks in plant effluent. While chironomid larvae are often associated with poor hygiene, effective methods to control outbreaks are needed. Here, we assessed the effect of ultrasound treatment on Chironomus kiiensis' eggs. The mortality rate of eggs was examined after ultrasound treatment, and the protein content (heat shock protein 70 and hemoglobin) and enzymatic activities of acetylcholinesterase, cytochrome P450, and glutathione S-transferases involved in the ultrasound-induced stress response were analyzed before and after treatment. COMSOL software was also used to examine the characteristics of the ultrasonic field, including frequency, power, exposure distance, and time. Higher egg mortality was observed at lower frequencies. At 28 kHz, 450 W, 15-mm exposure distance, and 75-s exposure time, 72.4% of eggs showed apoptosis after exposure. At higher frequencies (68 kHz), mortality decreased to 50.9%. Exposure time and distance also significantly affected egg mortality. From the geometric models, it could be seen that C. kiiensis' eggs sustained much greater acoustic pressure (2379 Pa) with 28-kHz exposure than that with 68-kHz exposure (422 Pa); however, the propagation distance was greater at the higher frequency. The hydraulic shear force effect of the ultrasonic radiation appeared to be the primary factor in egg mortality. We expected that array of ultrasonic transducers embedded in the walls of water treatment plants could be effective in killing Chironomus' eggs and highlight the potential for ultrasound as an effective treatment for the prevention of Chironomus outbreaks in treatment plant effluents.

Microbial composition and nitrogen removal pathways in a novel sequencing batch reactor integrated with semi-fixed biofilm carrier: evidence from a pilot study for low- and high-strength sewage treatment.

The sequencing batch reactor (SBR) activated sludge process is a well-established technology for sewage treatment. One of the drawbacks of SBRs, however, total nitrogen (TN) removals is insufficient. By means of introducing four improvements, including semi-fixed biofilm carrier, sludge elevation mixing and change for the mode of influent and effluent, compliant standard for TN discharge was obtained in this novel SBR configuration during low- and high-strength sewage load. To illustrate the microbial compositions and functions of the attached biofilm on semi-fixed carrier and the suspended aggregates, as well as the nitrogen removal pathway, high throughput 16S rRNA gene amplicon sequencing, PICRUSt2 algorithm, and KEGG database were applied. The results revealed that (i) the microbial communities from suspended aggregates and biofilm samples were significantly different from each other; (ii) during low-strength sewage loads, TN removal was mainly by nitrification-denitrification. The suspended aggregates was responsible for denitrification, while the biofilm was focused on ammonium oxidation; (iii) during high-strength sewage loads, function of nitrate reductase from suspended aggregates was faded, and anammox and N assimilation by biofilm became dominant. Meanwhile, TN removal referring to the formation of L-glutamine via assimilation was the main pathway.

Integrated Analysis of Mutations, miRNA and mRNA Expression in Glioblastoma.

BACKGROUND: Glioblastoma multiforme (GBM) is a common, malignant brain tumor in adults, with a median survival of only 15-23 months. Organisms respond to disease stress through sophisticated mechanisms at the physiological, transcriptional and metabolic levels. However, the molecular regulatory networks responsible for occurrence, progression and recurrence of glioma have yet to be elucidated. METHODS: In this study, we sought to determine the cause of gliomas by developing an RNA-seq technique that analyzes mRNA and small RNA (sRNA) with the aim of discovering potential methods for precisely blocking key signaling pathways in occurrence, progression, and recurrence. The explication of mechanisms leading to GBM formation has become a feasible and promising new therapeutic method. RESULTS: GBM-associated genes were identified based on their expression during the disease stress response. Analysis of the inverse correlations between microRNAs (miRNAs) and target mRNAs revealed 43 mRNA-miRNA interactions during disease progression. BOC-SMO and BOC-RAS were found to promote the malignant progression of glioma. A total of 3088 differentially expressed genes were identified as involved in several biological processes, such as amino acid metabolism, protein transport associated with immune response, cell proliferation, and cell apoptosis. Fifteen miRNAs were also identified as being differentially expressed in GBM and control groups. CONCLUSION: The results of this study provide an important foundation for understanding the pathogenesis of glioma and discovering new therapeutic targets.

Geometrical and Hemodynamic Characteristic Changes of Small Anterior Communicating Artery Aneurysms during Follow-ups in a Retrospective Analysis.

BACKGROUND: Small intracranial aneurysms have a low risk of rupture. However, ruptured anterior communicating artery (ACoA) aneurysms are usually smaller in clinical practice. The retrospective study aimed to investigate the geometrical and hemodynamic changes of small unruptured ACoA aneurysms during serial follow-ups. MATERIALS AND METHODS: We retrospectively collected patients with small unruptured ACoA aneurysms that were not repaired, who had serial follow-ups from the Electronic Medical Record System in four tertiary hospitals. The geometrical parameters of ACoA aneurysms were measured using a three-dimensional reconstructed model. Intra-aneurysmal hemodynamic parameters were computed using a high-resolution computational fluid dynamics model. Geometrical and hemodynamic changes of the aneurysms were evaluated at each follow-up. RESULTS: Five patients with small unruptured ACoA aneurysms that were not repaired were identified and included in this analysis. Aneurysms rupture occurred in two patients with aneurysm growth. The formation and enlargement of an irregular bleb at the aneurysm neck or dome were observed before the rupture. Ruptured aneurysms showed high wall shear stress (WSS) in the high inflow zone of aneurysm neck while low WSS and high oscillatory shear index (OSI) in the flow-recirculating region of aneurysm dome. Three unruptured aneurysms maintained a stable morphology and a physiological level of WSS. CONCLUSIONS: Aneurysm growth, low WSS, and high OSI at the dome and/or high WSS at the neck potentially contribute to the rupture of small ACoA aneurysms. These aneurysms should be considered for the treatment regardless of the small size.

[Application of continuous monitoring of intracranial pressure and brain oxygen partial pressure in the treatment of patients with severe craniocerebral injury].

OBJECTIVE: To investigate the effects of continuous monitoring intracranial pressure (ICP) and brain oxygen partial pressure (PbtO2) on the prognosis of patients with severe craniocerebral injury. METHODS: A prospective randomized controlled trial was conducted. Seventy patients with severe craniocerebral injury with a Glasgow coma score (GCS) 4-8 admitted to the neurosurgical intensive care unit (NICU) of the People's Hospital of Inner Mongolia Autonomous Region from January 2017 to May 2020 were enrolled, and they were divided into ICP monitoring group and ICP+PbtO2 monitoring group by random number table. Patients in ICP monitoring group received ICP monitoring and were given traditional treatment of controlling ICP and cerebral perfusion pressure (CPP), the therapeutic target was ICP < 20 mmHg (1 mmHg = 0.133 kPa) and CPP > 60 mmHg. Patients in ICP+PbtO2 monitoring group were given ICP and PbtO2 monitoring at the same time, and oxygen flow was adjusted on the basis of controlling ICP and CPP to maintain the PbtO2 > 20 mmHg, and the therapeutic target of ICP and CPP was the same as the ICP monitoring group. ICP and PbtO2 values were recorded during monitoring in the two groups, the results of CPP, GCS and arterial blood gas analysis were recorded, and the prognosis at 3 months and 6 months after injury was compared by Glasgow outcome scale (GOS) score between the two groups. GOS score > 3 was considered as good prognosis. Kaplan-Meier survival curve was drawn, and the 3-month and 6-month cumulative survival rates of the two groups were analyzed. Linear regression analysis was used to further evaluate the relationship between PbtO2 and GOS score. RESULTS: Finally, a total of 70 patients with severe craniocerebral injury were enrolled in the analysis, 34 patients received ICP combined with PbtO2 monitoring and guided therapy, and 36 patients received ICP monitoring alone. The average ICP of ICP+PbtO2 monitoring group was significantly lower than that of ICP monitoring group (mmHg: 13.4±3.2 vs. 18.2±8.3, P < 0.01). Although the CPP in both groups was great than 60 mmHg, the average CPP of ICP+PbtO2 monitoring group was significantly higher than that of ICP monitoring group (mmHg: 82.1±10.5 vs. 74.5±11.6, P < 0.01). No significant difference was found in average GCS score or arterial partial pressure of carbon dioxide (PaCO2) between the ICP+PbtO2 monitoring group and ICP monitoring group [GCS score: 5.3±2.3 vs. 5.2±2.2, PaCO2 (mmHg): 33.5±4.8 vs. 32.6±5.2, both P > 0.05]. The average arterial partial pressure of oxygen (PaO2) of ICP+PbtO2 monitoring group was obviously higher than that of ICP monitoring group (mmHg: 228.4±93.6 vs. 167.3±81.2, P < 0.01). Compared with the ICP monitoring group, the good outcome rates of 3 months and 6 months after injury in the ICP+PbtO2 monitoring group were significantly higher (3 months: 67.6% vs. 38.9%, 6 months: 70.6% vs. 41.7%, both P < 0.05). Kaplan-Meier survival curve showed that the 3-month and 6-month cumulative survival rates of ICP+PbtO2 monitoring group were significantly higher than those of ICP monitoring group (3 months: 85.3% vs. 61.1%, Log-Rank test: χ2 = 5.171, P = 0.023; 6 months: 79.4% vs. 55.6%, Log-Rank test: χ2 = 4.511, P = 0.034). Linear regression analysis showed that PbtO2 was significantly correlated with GOS score at 3 months and 6 months after injury in patients with severe craniocerebral injury (r values were 0.951 and 0.933, both P < 0.01). CONCLUSIONS: PbtO2 compared with ICP monitoring guiding therapy is valuable in improving the prognosis of patients with severe craniocerebral injury. It can improve the prognosis at 3-6 months after injury.

LncRNA NEAT1 promotes glioma cancer progression via regulation of miR-98-5p/BZW1.

BACKGROUND: Glioma is the most common malignant tumor in the human central nervous system. Long noncoding RNA nuclear paraspeckle assembly transcript 1 (NEAT1) promotes oncogenesis in various tumors. In the present study, we aimed to examine the role of NEAT1 in altering the properties of gliomas. METHODS: Quantitative real-time PCR technology was used to determine the expression levels of relevant genes in tumor tissues and cell lines. The protein expression levels were validated by Western blotting. Cell counting kit-8 (CCK-8) and colony formation assays were used to test the cell proliferation ability. A luciferase reporter assay was used to determine the interactions of the genes. Tumor xenografts were used to detect the role of NEAT1 in gliomas in vivo. RESULTS: We demonstrated that NEAT1 up-regulated glioma cells and negatively correlated with miR-98-5p in glioma tissues. A potential binding region between NEAT1 and miR-98-5p was confirmed by dual-luciferase assays. NEAT1 knockdown inhibited glioma cell proliferation. The inhibition of miR-98-5p rescued the knockdown of NEAT1 in glioma cells. Basic leucine zipper and W2 domain containing protein 1 (BZW1) was identified as a direct target of miR-98-5p. We also identified that BZW1 was positively correlated with NEAT1 in glioma tissues. NEAT1 knockdown inhibited glioma cell proliferation in vivo via miR-98-5p/BZW1. CONCLUSION: Our results suggest that NEAT1 plays an oncogenic function in glioma progression. Targeting NEAT1/miR-98-5p/BZW1 may be a novel therapeutic treatment approach for glioma patients.

Effects of ultrasound on invasive golden mussel Limnoperna fortunei mortality and tissue lesions.

Biofouling by the invasive golden mussel Limnoperna fortunei deleteriously affects artificial water systems, but few effective, environmentally friendly antifouling strategies exist. We propose ultrasound for control of this invasive mussel and report minimum exposure times to kill juveniles and adults at ultrasonic powers ranging 300-600 W from a fixed distance of 8.5 cm. Analysis using a PMA + RT-qPCR assay revealed the formation of tissue lesions in response to ultrasound, with gill tissue more prone to injury than adductor muscle tissue. Shell microstructure determined using scanning electron microscopy (SEM) + energy dispersive X-ray spectroscopy (EDS) is plywood-like, with a thicker shell and increased numbers of prism and nacre layers in adult mussels that provide greater resistance to ultrasound, reducing mortality and tissue lesions. Our results suggest L. fortunei biomass could be effectively reduced by ultrasound, especially for early life-history stages without, or with only immature shells.

UV dose effects on the revival characteristics of microorganisms in darkness after UV disinfection: Evidence from a pilot study.

Ultraviolet (UV) disinfection during water supply treatment aims to reduce the number of bacteria. Although UV disinfection is effective at inactivating most microorganisms, some microbe species may be entirely impervious. A pilot study was conducted to compare the quantity and community component of bacteria in surface water collected from filtration effluent before UV disinfection with different doses of UV, and those 1 and 2 days afterwards, in darkness. The aim was to elucidate the relationship between the UV dose and the total revived microorganisms in darkness after UV disinfection. In the filtration effluent samples, Gammaproteobacteria, Bacilli, Actinobacteria, and Alphaproteobacteria were the predominant classes. After storage in the dark at a constant temperature of 19 °C, the UV-disinfected samples showed a considerable increase in Bacilli, while Gammaproteobacteria remained the predominant population. Genera such as Exiguobacterium, Citrobacter, Acinetobacter, and Pseudomonas presented a selective advantage in terms of revival in darkness after UV disinfection, irrespective of the UV dose and storage time. The lowest rate of microbial revival (5% day-1) was noted at a UV dose of 266.10 mJ m-2 (with an average UV illumination time of 124.4 s and an average intensity of 86.61 W m-2). Our results suggest that higher UV intensity and lower illumination time are key factors in minimizing the revival of microorganisms in darkness.

A novel endovenous laser ablation strategy of treatment of greater saphenous vein varicosities with difficult wire placement.

AIM: To investigate the efficacy and early postoperative morbidity of a novel endovenous laser ablation (IEVLA) strategy of treatment of the great saphenous vein (GSV) with difficulty of wire placement. METHODS: Sixty patients with serious GSV incompetence in 73 limbs were randomized into two treatment groups: Group 1 underwent traditional endovenous laser ablation (TEVLA) surgery and group 2 received IEVLA. Local pain, ecchymosis, induration, paraesthesia in treated regions, thrombotic diseases, vein diameter, treated vein length, delivered energy, operation duration, success rate in placement of the laser fiber and venous clinical severity (VCS) scores were recorded for both group. Follow-up were conducted on the 2nd day, 7th day, and 1st, 2nd, 3rd and 6th month postoperatively. RESULTS: In group 1, induration was present in 18 cases, ecchymosis in 19, paraesthesia in 9, pulmonary embolism (PE) in 1 case, and deep vein thrombus (DVT) in 3. While in group 2, induration present in 29, ecchymosis in 23, paraesthesia in 17 with and no patients were complicated with PE or DVT. Although no difference in improvement of VCS score existed between the two groups at each follow-up time point, group 2 had significantly shorter operation time and higher success rate (P < 0.05). CONCLUSION: IEVLA is a more effective and safe technique for treatment of serious GSV varicosities with difficulty of wire placement.

Inhibition of autophagy using 3-methyladenine increases cisplatin-induced apoptosis by increasing endoplasmic reticulum stress in U251 human glioma cells.

Cisplatin is one of the most widely used chemotherapeutic drugs; however, the side effects and drug resistance limit its usage. Previous findings have demonstrated that cisplatin kills tumor cells through endoplasmic reticulum (ER) stress, which provides a novel method to minimize cisplatin toxicity and circumvent cisplatin resistance. ER stress induces cell autophagy, cell apoptosis and the complicated regulatory network between them. The role of autophagy in cisplatin chemotherapy remains to be elucidated. 3-Methyladenine (3-MA) is normally used as an inhibitor of autophagy. The present study reveals a significant role of the inhibition of autophagy by treatment with 3-MA and cisplatin in combination in U251 human glioma cells. It was demonstrated that cisplatin induced the ER stress associated with apoptosis and autophagy in U251 cells. Inhibition of autophagy by 3-MA increased the expression levels of protein disulfide isomerase, ubiquitinated proteins, glucose regulated protein 78 and CCAAT-enhancer-binding protein homologous protein, and induced the activation of caspase-4 and caspase-3. Treatment with 3-MA combined with cisplatin increased cisplatin-induced apoptosis by increasing ER stress. Therefore, the inhibition of autophagy has the potential to improve cisplatin chemotherapy.

Improved productivity of poly (3-hydroxybutyrate) (PHB) in thermophilic Chelatococcus daeguensis TAD1 using glycerol as the growth substrate in a fed-batch culture.

A particularly successful polyhydroxyalkanoate (PHA) in industrial applications is poly (3-hydroxybutyrate) (PHB). However, one of the major obstacles for wider application of PHB is the cost of its production and purification. Therefore, it is desirable to discover a method for producing PHB in large quantities at a competitive price. Glycerol is a cheap and widely used carbon source that can be applied in PHB production process. There are numerous advantages to operating fermentation at elevated temperatures; only several thermophilic bacteria are able to accumulate PHB when glycerol is the growth substrate. Here, we report on the possibility of increasing PHB production at low cost using thermophilic Chelatococcus daeguensis TAD1 when glycerol is the growth substrate in a fed-batch culture. We found that (1) excess glycerol inhibited PHB accumulation and (2) organic nitrogen sources, such as tryptone and yeast extract, promoted the growth of C. daeguensis TAD1. In the batch fermentation experiments, we found that using glycerol at low concentrations as the sole carbon source, along with the addition of mixed nitrate (NH4Cl, tryptone, and yeast extract), stimulated PHB accumulation in C. daeguensis TAD1. The results showed that the PHB productivity decreased in the following order: two-stage fed-batch fermentation > fed-batch fermentation > batch fermentation. In optimized culture conditions, a PHB amount of 17.4 g l(-1) was obtained using a two-stage feeding regimen, leading to a productivity rate of 0.434 g l(-1) h(-1), which is the highest productivity rate reported for PHB to date. This high PHB biosynthetic productivity could decrease the total production cost, allowing for further development of industrial applications of PHB.

Degradation of forchlorfenuron by nitrification and denitrification reactions in the gut and shell biofilm of Limnoperna fortunei.

The capacity and mechanism of Limnoperna fortunei to reduce the concentration of forchlorfenuron [or 1-(2-chloropyridin-4-yl)-3-phenylurea (CPPU)] in water has been studied under laboratory conditions. Firstly, the evasive response of mussels to CPPU (10, 20, 40 and 60 mg L(-1)) was evaluated, and a toxicity test was carried out at these concentrations. Secondly, the effect of two different sizes of mussels on CPPU concentrations was investigated in a 24-day experiment. Thirdly, the role of intact mussels and valvae only were respectively evaluated in another 24-day experiment. The CPPU concentration decreased by about 40 % in the presence of large mussels and about 20 % in the presence of valvae only. Finally, nucleic acid extracts from the gut and biofilm microbial communities of L. fortunei were analyzed, and the number of copies of the bacterial genes amoA, nirK and nirS were determined. Based on these results, we propose possible mechanisms for CPPU degradation involving bacteria-associated nitrification and denitrification reactions. In summary, we found that the CPPU half-life depended on the presence of mussels, their size and their associated microorganisms.

Algae consumption and nitrate removal in a raw water transport system by Limnoperna fortunei and its associated microorganisms.

This laboratory-scale study investigated the effect of Limnoperna fortunei on chlorophyll a, phosphates, ammonia, and nitrates in a simulated raw water transport system, with a special focus on the isolation and identification of microbes in the biofilm attached to the shell surface. These microbes appear to be involved in the decreased concentration of nitrates observed in the water. The microbial communities in the raw water and on the surface of the mussel's shell were investigated through various methods, including a 16S rRNA phylogenetic analysis, which revealed significant diversity in terms of the structure and abundance of microbial species present. Two aerobic denitrifying bacteria (I-N38 and I-N45) were identified in shell biofilm that were capable of removing 95.5 and 100% of nitrates, respectively, within 24 hours.

Downregulation of Ezh2 expression by RNA interference induces cell cycle arrest in the G0/G1 phase and apoptosis in U87 human glioma cells.

The Ezh2 gene is an important member of the polycomb-group (PcG) family. As a newly identified oncogene, the expression of Ezh2 has been shown to be significantly increased in prostate cancer, breast cancer, renal cell carcinoma and hepatic cancer; however, a role for Ezh2 in the occurrence of glioma has not yet been reported. In this study, we found that the Ezh2 gene is highly expressed in U87 human glioma cells. Using RNA interference, we demonstrated that the downregulation of Ezh2 expression in U87 human glioma cells resulted in apoptosis and a cell cycle arrest in the G0/G1 phase. In addition, we found that silencing of the Ezh2 gene altered the mitochondrial membrane potential and promoted the release of cytochrome c from the mitochondria. Furthermore, the reduced expression of Ezh2 altered the Bax and Bcl-2 protein levels and led to the activation of caspase 9 and 3. These results indicate that the apoptosis induced in U87 human glioma cells by the silencing of the Ezh2 gene is related to the mitochondrial pathway.

[Antibody detection in sera of patients with Schistosomiasis japonica by dot immunogold filtration assay].

Serum antibody of schistosomiasis patients was detected by dot immunogold filtration method (DIGFA) in laboratory and field, and F-ELISA was used as control. The results showed that there was no significant difference between these two assays in sensitivity and specificity (P > 0.05), with a high coincidence. DIGFA is easy to operate and may deserve a wide application in the diagnosis of schistosomiasis.