[Clinical characteristics and prognostic factors of patients with anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis associated interstitial lung disease].

Objective: To analyze the clinical characteristics and prognostic factors of patients with anti-melanoma differentiation-associated gene 5 (anti-MDA5)-positive dermatomyositis associated interstitial lung disease (DM-ILD). Methods: The patients with MDA5+DM-ILD who were admitted to Department of Respiratory Medicine, Nanjing Drum Tower Hospital from January 2017 to March 2021 were enrolled. The clinical data and survival information were analyzed retrospectively. Patients were divided into survival group or death group, and rapid progressive ILD (RP-ILD) group or non-rapid progressive ILD group, according to their survival status and clinical progression. Results: A total of 105 patients with anti-MDA5+DM-ILD (median age of onset 54 years) were enrolled, 58% being female (61 cases). The main sub-type of dermatomyositis was amyopathic dermatomyositis (n=74, 70%), followed by dermatomyositis (n=31, 30%). The main extrapulmonary manifestations were skin lesions (n=60, 57.1%), muscle manifestations(n=20, 19%) and arthralgia/arthritis (n=20, 19%). 15.4% of the patients had positive ANA (antibody titer≥1∶320), and 61.9% of the patients had anti-RO-52 kDa antibody. A total of 66 patients (62.8%) developed RP-ILD, and 58 patients (56.3%) died. Lower oxygenation index (OR=0.974, 95%CI:0.954-0.994, P=0.012) and no joint pain (OR=0.032, 95%CI: 0.002-0.663 P=0.026) were independent risk factors for RP-ILD. Cox regression analysis showed that RP-ILD (HR=3.194, 95%CI:1.025-9.954, P=0.045), older than 53 years (HR=3.450, 95%CI: 1.388-8.577, P=0.008), ferritin level more than 1 330.5 ng/ml (HR=3.032, 95%CI 1.208-7.610, P=0.018) and C-reactive protein (CRP) above 16.95 mg/L (HR=2.794, 95%CI:1.102-7.084, P=0.030) were independent predictors of mortality. Conclusions: The clinical manifestations of patients with anti-MDA5+DM-ILD presenting to the respiratory department were heterogeneous, with most being amyopathic dermatomyositis, and both the incidence of RP-ILD and the risk of death were high. Even in the absence of associated rash, joint, or muscle manifestations, anti-MDA5 antibody screening should be considered in patients with rapidly progressive ILD who were negative on baseline autoantibody screening but positive for anti-RO52kDa antibody.

[Analysis of prognosis and associated factors in multiple recurrent epithelial ovarian cancer with three times or more cytoreductive surgeries].

Objective: To explore the prognosis of epithelial ovarian cancer patients with multiple recurrences (≥2 times) who underwent three times or more cytoreductive surgeries, and to analyze the factors associated with prognosis. Methods: The clinicopathological data and follow-up data of 23 patients with ovarian cancer admitted to the Obstetrics and Gynecology Hospital of Fudan University from January 1, 2015 to January 30, 2022 with three times or more cytoreductive surgeries were collected. The degree of surgical resection, site of recurrence and metastasis, postoperative complications, and prognosis were retrospectively analyzed. The univariate Cox proportional hazards model was performed to identify the variables associated with survival. Results: (1) The median age of 23 patients with multiple recurrent ovarian cancer was 48 years old (44-55 years). Among them, 18 cases underwent tertiary cytoreductive surgery (TCS), 2 cases underwent quaternary cytoreductive surgery, 2 cases underwent quinary cytoreductive surgery, and 1 case underwent senary cytoreductive surgery. Among the 23 patients with multiple recurrent ovarian cancer, 21 cases (91%, 21/23) had serous carcinoma, 16 cases (70%, 16/23) had advanced stage (stage Ⅲ-Ⅳ), and 19 cases (83%, 19/23) had high differentiation. (2) Based on the premise that satisfactory cytoreduction was achieved by primary debulking surgery (PDS) and no visible residual disease (R0) was achieved by secondary cytoreductive surgery (SCS), the maximum diameter of the recurrent tumors was up to 10.0 cm and 62% (20/32) of patients with multiple metastatic sites. The R0 rate for three times or more cytoreductive surgeries (32 times in total) reached 88% (28/32), with a postoperative complication rate of 47% (15/32), and only 3% (1/32) for grade Ⅲ or above. During a median follow-up time of 31.1 months (20.6-43.9 months) after TCS, 20 patients (87%, 20/23) recurred after TCS, and 8 patients (35%, 8/23) eventually died of ovarian cancer. Among them, the three-year postoperative survival rate of 22 patients with R0 was 57.6%, and the patient with residual lesions ≥1 cm died at 9.2 months after TCS. (3) In univariate analysis, ages, the time interval between PDS and SCS >32 months, the interval between SCS and TCS >16 months, and no metastatic peritoneal carcinoma were associated with longer progression free survival after TCS (all P<0.05); while treatment-free interval (TFI) >10 months after SCS, the interval between SCS and TCS >16 months, no ascites and platinum-sensitive status were associated with disease-specific survival after TCS (all P<0.05). Conclusions: It is feasible to perform three times or more cytoreductive surgeries in patients with multiple recurrent ovarian cancer who are expected to achieve R0 and have manageable complications. However, the pros and cons of surgery need to be carefully evaluated for the patients whose ascites are massive and whose previous cytoreduction does not achieve R0. A prolonged TFI and previously longer surgical interval might get potential survival benefits.

[Predictive value of blood cell parameters in the diagnosis of vasovagal syncope in children].

Objective: To investigate the predictive value of blood cell parameters in children with vasovagal syncope (VVS). Methods: In this case-control study, the VVS group included 111 patients with unexplained syncope or prodromata who were diagnosed with VVS by head-up tilt test in the Second Xiangya Hospital, Central South University from January 2018 to October 2020, and 111 healthy children were enrolled as control. The differences in blood cell parameters between the 2 groups were compared by t test and Mann-Whitney U test. Multivariate binary Logistic regression was used to analyze the independent correlation factors of VVS, and receiver operating characteristic (ROC) curve to explore the predictive value of blood cell parameters for diagnosing VVS. Results: Sex composition ratios were consistent in the 2 groups (51 males vs. 60 females), while the age of the VVS group was higher than that of the control group (11.0 (8.0, 12.5) vs. 8.0 (7.0, 11.0) years, Z=4.39, P<0.001). Compared with the control group, VVS group had lower level of white blood cell (WBC) (6.0 (5.3, 7.1)×109 vs. 8.6 (6.7, 10.1)×109/L, Z=-7.96, P<0.001), lymphocyte (LY) (2.3 (1.9, 2.7)×109 vs. 4.0 (2.8, 6.3)×109/L, Z=-8.49, P<0.001), lymphocyte ratio (0.39 (0.33, 0.44) vs. 0.52 (0.37, 0.69), Z=-5.59, P<0.001), monocyte (0.3 (0.3, 0.4)×109 vs. 0.4 (0.3, 0.6)×109/L, Z=-6.19, P<0.001), eosinophil (0.1 (0.1, 0.2)×109 vs. 0.2 (0.2, 0.4)×109/L, Z=-5.75, P<0.001), mean corpuscular-hemoglobin concentration (MCHC) ((328±12) vs. (333±11) g/L, t=-3.27, P<0.001) and blood platelet (263 (235, 313)×109 vs. 341 (295, 409)×109/L, Z=-2.69, P<0.001), but higher neutrophil ratio (0.53 (0.48, 0.58) vs. 0.37 (0.22, 0.54), Z=5.86, P<0.001), hematocrit (0.39±0.04 vs. 0.37±0.04, t=2.75, P=0.006), mean corpuscular volume (MCV) (85 (82, 88) vs. 81 (78, 84) fl, Z=5.56, P<0.001), mean corpuscular hemoglobin (28 (27, 29) vs. 27 (26, 28) pg, Z=3.39, P=0.001), red cell distribution width (39 (37, 41) vs. 37 (36, 40) fl, Z=4.02, P<0.001) and mean platelet volume (11 (10, 11) vs. 10 (9, 11) fl, Z=2.81, P=0.005) levels. After adjusting for confounding factors such as sex and age, LY (OR=0.42, 95%CI 0.29-0.62, P<0.001), WBC (OR=0.75, 95%CI 0.59-0.95, P=0.015), MCHC (OR=0.94, 95%CI 0.91-0.97, P<0.001) were independent negative correlation factors of VVS, while MCV (OR=1.08, 95%CI 1.01-1.15, P=0.021) was independent positive correlation factor. ROC curve showed that the combination of LY, WBC, MCV and MCHC had acceptable predictive value for the diagnosis of VVS, with area under curve of 0.88, sensitivity of 0.80, specificity of 0.83, and Youden index of 0.63. Conclusions: Compared with healthy children, the blood cell parameters usually change in those with VVS. Combination of LY, WBC, MCHC and MCV can facilitate the diagnosis of VVS in children with unexplained syncope or prodromata.

[Laterally extended endopelvic resection for advanced or recurrent gynecological malignancies: clinicopathological analysis].

To explore the feasibility and safety of laterally extended endopelvic resection (LEER) for advanced and recurrent gynecological malignancies with pelvic sidewall involvement and to evaluate this therapeutic potential of this novel salvage treatment. The clinicopathological data of 5 patients with gynecological malignancies who received laparoscopic LEER treatment in Obstetrics and Gynecology Hospital of Fudan University from January 2019 to September 2021 were retrospectively analyzed, including 3 cases of recurrent cervical cancer, 1 case of primary advanced endometrial cancer and 1 case of pelvic aggressive angiomyxoma. Among them, four patients achieved complete resection (R0) with a negative resection margin; the other patient with recurrent cervical cancer did not complete surgery because of the extreme risk of continuing surgery. The median operation time was 345 (225-482) minutes and the median blood loss was approximately 300 (200-600) ml. Complications occurred in three patients, including lymphocysts, urinary tract infections, and deep venous thrombosis of the lower extremities. Within a median follow-up time of 283 (128-715) days, 4 patients survived tumor-free, and 1 patient died. The high rate of complete resection (R0) and the encouraging oncological outcomes suggest that LEER may be an alternative treatment option for patients with advanced and recurrent gynecological malignancies involving the pelvic sidewall.

[Ocular biometry of infants and young children with congenital cataract].

Objective: To understand the developmental characteristics of early ocular biological parameters in patients with congenital cataract. Methods: Retrospective case series study. The ocular biometry data such as the axial length, corneal curvature, anterior chamber depth and central corneal thickness of 169 patients under 3 years old who were diagnosed with congenital cataract in Eye Hospital of Wenzhou Medical University (Hangzhou Branch) from June 2016 to June 2020 were reviewed, and they were analyzed by 3 age groups. There were 87, 41, and 41 patients in three age groups, 1 to 6 months, 7 to 12 months, and 13 to 36 months, respectively; 108 patients with bilateral affected eyes and 61 patients with unilateral affected eyes were included; 84 patients with partial opacity lens and 85 patients with total opacity lens were included. The right eyes of the patients with bilateral congenital cataract were selected for analysis. Statistical analysis of ocular biological parameters between groups was performed using the independent samples t-test and paired samples t-test. Statistical analysis of the relationship between age in months and biological parameters was performed using the Pearson's correlation test. Results: The axial length at the age of 1 to 6 months in the affected eyes of patients with bilateral cataract was (17.59±1.19) mm, it was shorter than the affected eyes of patients with unilateral cataract [(18.18±1.34) mm], and the axial length in the affected eyes of patients with unilateral cataract were shorter than the healthy eyes [(19.01±0.93) mm]. At the age of 7 to 12 months, the axial length in the affected eyes of patients with unilateral cataract [(19.89±0.74) mm] was shorter than the healthy eyes [(20.48±0.43) mm]. The differences were statistically significant (t=-2.06, -5.62, -3.47, all P<0.05). The axial length in the affected eyes with partial opacity at the age of 1 to 6 months was shorter than those with total opacity [(17.43±1.14) mm vs. (18.06±1.29) mm; t=-2.38, P=0.020]. The difference in axial length (affected eyes vs. healthy eyes) was significantly correlated with the age in months in partial cataract (r=0.53, P=0.001). The corneal curvature in the affected eyes of patients with unilateral cataract was flatter than the healthy eyes at the age of 7 to 12 months [(42.41±1.82) D vs. (43.19±1.96) D; t=-2.29, P=0.038], but was steeper at the age of 13 to 36 months [(43.36±2.32) D vs. (42.55±1.88) D; t=2.17, P=0.043]. The anterior chamber depth in the affected eyes of patients with unilateral cataract was less than the healthy eyes at the age of 1 to 6 months [(2.44±0.37) mm vs. (2.58±0.33) mm; t=-2.08, P=0.048].The central corneal thickness in the affected eyes of patients with unilateral cataract was thicker than the healthy eyes both at the age of 1 to 6 months and 7 to 12 months [(555.26±46.95) µm vs. (541.85±40.78) µm, (542.93±27.63) µm vs. (530.93±30.36) µm; t=3.82, 2.26; P=0.001, 0.040]. Conclusions: Congenital cataracts maybe affect the early development of axial length, corneal curvature, anterior chamber depth and central corneal thickness. The degree of lens opacity maybe affecte the early axial length development. The axial length in eyes with partial opacity can be shorter than those with total opacity before the age of 6 months, and thereafter gradually outnumbered the latter.

Mechanisms of primary and acquired resistance to PD-1/PD-L1 blockade and the emerging role of gut microbiome

As a very promising immunotherapy, PD-1/PD-L1 blockade has revolutionized the treatment of a variety of tumor types, resulting in significant clinical efficacy and lasting responses. However, these therapies do not work for a large proportion of patients initially, which is called primary resistance. And more frustrating is that most patients eventually develop acquired resistance after an initial response to PD-1/PD-L1 blockade. The mechanisms that lead to primary and acquired resistance to PD-1/PD-L1 inhibition have remained largely unclear. Recently, the gut microbiome has emerged as a potential regulator for PD-1/PD-L1 blockade. This review elaborates on the current understanding of the mechanisms in terms of PD-1 related signaling pathways and necessary factors. Moreover, this review discusses new strategies to increase the efficacy of immunotherapy from the perspectives of immune markers and gut microbiome (AU)

Continuous detection of norovirus and astrovirus in wastewater in a coastal city of China in 2014-2016.

Norovirus (NoV) and human astrovirus (HAstV) are important causative agents of acute gastroenteritis in children and adults. They are comprised of multiple genotypes and attention should be paid to genotype changes or emergence of new genetic variants. To study the prevalence and diversity of NoV GI, GII, and HAstV circulating in eastern China, we conducted a three-year environmental surveillance in a coastal city of Yantai. Thirty-six sewage samples were collected, processed, and examined for the presence of viral genomes by PCR. The results showed that NoV GI, GII, and HAstV were detected in all 36 samples. Six NoV GI genotypes, 11 NoV GII genotypes, and 5 HAstV serotypes were identified; GI.6, GII.17, and HAstV-5 were the most prevalent types, respectively. Persistent existence of NoV GII.17 Kawasaki 308 variant was observed during whole study period. Phylogenetic analysis reflected multiple transmission lineages in local population for both viruses. Our results reflect continuous presence of enteric viruses in sewage, improve our understanding on their molecular epidemiology, and demonstrate surveillance on sewage is an effective approach in understanding the local circulation of enteric viruses.

Mechanisms of primary and acquired resistance to PD-1/PD-L1 blockade and the emerging role of gut microbiome.

As a very promising immunotherapy, PD-1/PD-L1 blockade has revolutionized the treatment of a variety of tumor types, resulting in significant clinical efficacy and lasting responses. However, these therapies do not work for a large proportion of patients initially, which is called primary resistance. And more frustrating is that most patients eventually develop acquired resistance after an initial response to PD-1/PD-L1 blockade. The mechanisms that lead to primary and acquired resistance to PD-1/PD-L1 inhibition have remained largely unclear. Recently, the gut microbiome has emerged as a potential regulator for PD-1/PD-L1 blockade. This review elaborates on the current understanding of the mechanisms in terms of PD-1 related signaling pathways and necessary factors. Moreover, this review discusses new strategies to increase the efficacy of immunotherapy from the perspectives of immune markers and gut microbiome.

The three-dimensional evaluation of positional change in mandibular condyle after intraoral vertical ramus osteotomy.

OBJECTIVES: The purpose of this study was to compare the changes of the condylar axis, the anteroposterior condylar position relative to the glenoid fossa, after intraoral vertical ramus osteotomy (IVRO). STUDY DESIGN: 21 patients diagnosed as skeletal class III malocclusion underwent IVRO and were followed according to the authors' postoperative management regimen. The three-dimensional positions of the condyles were evaluated by cone-beam computerized tomography (CBCT) at pre-op, post-op, and at follow-up. CBCT images were referenced to assess the condylar axis change and the anteroposterior condylar position in the glenoid fossa. A repeated-measures analysis of variance (P<0.05) also was performed. RESULTS: After surgery, both the axial condylar angles and the anteroposterior condylar position were significantly different (P<0.05). The coronal condylar axis rotated outwardly. The anteroposterior condylar position in the glenoid fossa had moved from the concentric to the anterior position. But the condyle changes between post-op and follow-up (P>0.05) were insignificant. CONCLUSIONS: With postoperative intermaxillary elastic traction, the condyles changed their positions physiologically for newly established jaw movement after IVRO.

Analysis of the Incidence and Clinical Significance of Long and Short Corrected QT Interval in Electrocardiogram in Healthy Population of Changsha in China

ABSTRACT Objective: To analyse the incidence of long and short corrected QT (QTc) in a healthy sample of the population of Changsha in China. Methods: Standard 12-lead electrocardiograms (ECGs) were performed on 4025 subjects in Changsha of China, whose age ranged from 6 minutes after birth to 83 years, between January 1993 and December 2012. Heart rate and QT interval were measured and recorded. Corrected QT was calculated with Bazett´s formula (QTc = QT/RR0.5). All recruited individuals had taken healthy examination, ruling out general health issue, in The Second Xiangya Hospital of Central South University. Statistical analyses were performed using the SPSS 16.0 software (IBM Corp, Armonk, NY, USA). Results: The incidence of short QTc was 7.13% (287/4025 cases). The peak values of the incidence were in the 30-40 years group (15.71%). The low values were in the 1-3 months group and 3-6 months group (0%, 0.76%), respectively. The incidence of long QTc was 3.16% (127/4025 cases). The values diminished significantly after adulthood. The low values were in the age groups of 18-30 years (0.86%) and 30-40 years (0.71%), respectively. After the age of 50 years, the incidence of long QTc increased with age 50-60 years and 60-70 years and 70-83 years (7.89%, 9.06%, 14.06%), respectively. There was no statistically significant difference between the genders (p > 0.05). Conclusion: The peak incidences of long and short QTc existed in two separate age groups in the healthy sample. The peak incidence of short QTc was in the age group of 18-40 years, and the peak incidence of long QTc was in the age group beyond the 50 years. For these two age groups, it was recommended to pay close attention to the changes in their QTc in order to prevent cardiovascular events.

[Network analysis and characteristics of keystone taxa in periodontitis].

Subgingival microorganisms can orchestrate the microbial community under the influence of environmental factors, thus causing the initiation and progression of periodontitis. Keystone taxa play an important role in the dynamic changes of microbial community. The co-occurrence network analysis may pave the way for screening periodontitis associated candidate keystone taxa in the periodontal microflora. These microorganisms, e.g. Porphyromonas gingivalis, might function via myriad of intermediary taxa or as the chokepoint community-remodeling drivers in response of environmental factors. Herein, we review and discuss the construction of microbial co-occurrence network, the way of screening and identifying keystone taxa using network analysis as well as the characteristic of candidate keystone taxa related to periodontitis for the purpose that keystone taxa and the role they played in dynamic succession of microflora could be well investigated.

Downregulation of CDCA3 expression inhibits tumor formation in pancreatic cancer.

Downregulation of cell division cycle-associated 3 (CDCA3) markedly inhibited cell growth and induced apoptosis in tumors. However, the effect of CDCA3 in pancreatic cancer (PAC) was rarely investigated. Therefore, this study attempted to clarify the role of CDCA3 in PAC. The mRNA and protein expression of CDCA3 were examined in PAC cell lines and tumor tissues by using real-time quantitative PCR (RT-qPCR), western blotting (WB), and immunohistochemistry (IHC). The effects of CDCA3 downregulation on cell proliferation, apoptosis, and colony information were investigated through MTT assay, Annexin V-APC single staining cell apoptosis detection, and colony formation test. The microarray and ingenuity pathway analysis were employed to explore the potential regulatory relation. The tumor xenograft model was established for determining the effect of CDCA3 downregulation on the growth of PAC in vivo. The results showed that the expression of CDCA3 in tumor tissues was higher than that of normal tissues (p<0.05). In addition, the mRNA expression of CDCA3 was markedly increased in PANC-1 cells and SW 1990 cells when compared with human pancreatic duct epithelial (HPDE) cells (p<0.05). MTT assay showed that the cell proliferation of PANC-1 cells and SW 1990 cells was significantly inhibited after the lentivirus transfection of CDCA3 knockdown (p<0.05). Annexin V-APC apoptosis assays suggested that the apoptotic cell number was markedly increased in the shCDCA3 group compared to that in the shCtrl group in SW 1990 cells and PANC-1 cells (p<0.05). Meanwhile, the activity of caspase-3/7 was obviously elevated in the shCDCA3 group compared to the shCtrl group (p<0.05). The colony formation was notably inhibited in the shCDCA3 group relative to the shCtrl group in SW 1990 cells (p<0.05). Moreover, the tumor growth was evidently suppressed in the shCDCA3 group compared with the shCtrl group in vivo (p<0.05). These findings revealed that CDCA3 plays a crucial role in the progress of PCA by regulating cell apoptosis and proliferation, which may serve as a potential target for PAC treatment.

Analysis of azimuthal magnetorotational instability of rotating magnetohydrodynamic flows and Tayler instability via an extended Hain-Lüst equation.

We consider a differentially rotating flow of an incompressible electrically conducting and viscous fluid subject to an external axial magnetic field and to an azimuthal magnetic field that is allowed to be generated by a combination of an axial electric current external to the fluid and electrical currents in the fluid itself. In this setting we derive an extended version of the celebrated Hain-Lüst differential equation for the radial Lagrangian displacement that incorporates the effects of the axial and azimuthal magnetic fields, differential rotation, viscosity, and electrical resistivity. We apply the Wentzel-Kramers-Brillouin method to the extended Hain-Lüst equation and derive a comprehensive dispersion relation for the local stability analysis of the flow to three-dimensional disturbances. We confirm that in the limit of low magnetic Prandtl numbers, in which the ratio of the viscosity to the magnetic diffusivity is vanishing, the rotating flows with radial distributions of the angular velocity beyond the Liu limit, become unstable subject to a wide variety of the azimuthal magnetic fields, and so is the Keplerian flow. In the analysis of the dispersion relation we find evidence of a new long-wavelength instability which is caught also by the numerical solution of the boundary value problem for a magnetized Taylor-Couette flow.

[Clinical value of myositis antibodies in patients with connective tissue disease-associated interstitial lung diseases].

Objective: To investigate the clinical significance of detection of myositis-specific antibodies (MSAs) and myositis-associated antibodies (MAAs) in patients with connective tissue disease-associated interstitial lung diseases (CTD-ILD). Methods: Serum samples of 120 patients with CTD-ILD admitted to the Department of Respiratory, Affiliated Drum Tower Hospital of Nanjing University Medical College from December 2016 to April 2018 were collected for analysis. The patients included 45 with polymyositis/dermatomyositis (PM/DM), 36 with Sjogren's syndrome (SS) and 39 with undifferentiated connective tissue disease (UCTD). There were 37 males and 83 females with an average age of (56±11) years. Thirty-two patients with non-CTD-ILD, 10 males and 22 females with an average age of (42±17) years, were enrolled as the control group. Euroline Autoimmune Inflammatory Myopathies 16 Ag kit was used for detecting MSAs and MAAs, and the positive rates of serum MSAs and MAAs were calculated. The antibody distribution and clinical characteristics of different groups were analyzed and compared. Results: Eighty-nine of the 120 patients with CTD-ILD were positive for MSA and/or MAA (74.2%), and the detection rates of MSAs and MAAs were 52.5% (63/120) and 61.7% (74/120) respectively. No myositis antibody was detected in the non-CTD-ILD group. The detection rates of MSAs in PM/DM-ILD group, SS-ILD group and UCTD-ILD group were 75.6% (34/45), 33.3%(12/36) and 43.6%(17/39) respectively. The total detection rate of MSAs in PM/DM group was significantly higher than that in SS group and UCTD group (χ(2)=14.53, 8.95, 0.01). The anti-ARS was the most frequent (50/120, 41.7%). The positive rates of MAAs in the three groups were 64.4%(29/45), 77.8%(28/36), 43.6%(17/39) respectively, and anti-Ro-52 accounted for 60%(72/120), and were highly correlated with MSAs such as anti-Jo-1 antibodies. Conclusion: Myositis antibody profiling should be performed in patients with ILD who were negative for conventional autoimmune antibody testing and had no CTD. In patients with SS-ILD and UCTD-ILD, the myositis antibody spectrum could detect the presence of myositis-specific antibodies and myositis-related antibodies in some patients, and its role in clinical diagnosis and treatment needed further observation.

Adaptive laser shock micro-forming for MEMS device applications.

Laser shock micro-forming is a non-thermal laser forming method that uses laser-induced shockwave to modify surface properties and to adjust shapes and geometry of work pieces. The magnitude and spatial distribution of the laser-induced shockwaves depend on the energy profiles of the laser beam focused on sample surfaces. In this paper, we present an adaptive optical technique to engineer spatial profiles of laser beams to control the shapes, sizes, and locations of the laser-induced shockwaves and the resulting forming features. Using a spatial light modulator, this adaptive laser beam forming tool was used to process free-standing MEMS structures in aluminum, which has led to highly uniform forming features. Shockwave simultaneously excited by multiple laser beams generated by the spatial light modulator and its effects on the micro-forming process were also studied. The results presented in this paper show that the adaptive optics laser beam forming is an effective and flexible method to generate shockwave with various shapes and sizes of wavefront and at multiple locations for laser processing at microscales.

Upregulation of miR-3658 in bladder cancer and tumor progression.

Despite increasing advances in surgical techniques and adjuvant chemotherapies, bladder cancer remains the ninth leading cause of male malignancy-associated deaths worldwide. Several microRNAs (miRNAs) have been identified to be closely associated with the progression and prognosis of, and response to treatments in various human cancers. However, few studies have investigated the role of miR-3658 in bladder cancer. In this study, we examined the expression of miR-3658 in 96 pairs of bladder cancer tissues and adjacent non-tumor tissues via quantitative reverse-transcription polymerase chain reaction. Results showed that expression of miR-3658 was up-regulated in the bladder cancer tissues as compared with that in the corresponding control tissues (4.15 ± 2.78 vs 2.17 ± 1.14; P < 0.0001). Furthermore, higher miR-3658 expression was significantly associated with lymph node invasion, distant metastasis, histological grade, TNM stage, and tumor recurrence in bladder cancer (all P < 0.0001). miR-3658 expression was not associated with other clinicopathological variables such as age, gender, tumor size, and number (all P > 0.05). Our study revealed that miR-3658 overexpression is involved in tumor progression of bladder cancer, indicating that the miRNA possesses prognostic values.

[Clinical characteristics of orthostatic hypertension with hemodynamic response of vasovagal syncope and postural orthostatic tachycardia syndrome in children and adolescents].

OBJECTIVE: To analyze the clinical characteristics of orthostatic hypertension (OHT) with hemodynamic response of vasovagal syncope (VVS) and postural orthostatic tachycardia syndrome (POTS) in children and adolescents. METHOD: Children and adolescents admitted to the Second Xiangya Hospital from July 2008 to April 2015 were included, and divided into three groups according to the results of head-up tilt test (HUTT): OHT group, OHT+ VVS group, OHT+ POTS group. The clinical characteristics were analyzed. RESULT: Totally 629 cases were included, 300 cases in OHT group, 264 cases in OHT+ VVS group and 65 cases in OHT+ POTS group. Syncope and dizziness were the main symptoms of the three groups, and the proportion of patients complaining syncope in OHT+ VVS group was higher than that in OHT group (49.6% vs. 35.7%, χ(2)=11.211, P<0.05) and in OHT+ POTS group (49.6% vs. 27.7%, χ(2)=10.123, P<0.05). Baseline heart rate (HR)((78±14) beat/min vs. (77±12) beat/min, t=2.570, P<0.05), HUTT 3 min HR ((100±14) beat/min vs. (94±13) beat/min, t=17.464, P<0.05) and ΔHR ((22±12) beat/min vs. (17±9) beat/min, t=19.303, P<0.05) were higher in OHT+ VVS group than in OHT group. When compared with OHT group, baseline systolic blood pressure (SBP) ((105±10) mmHg(1 mmHg=0.133 kPa) vs. (103±10) mmHg, t=4.918, P<0.05), HUTT 3 min SBP((114±10) mmHg vs. (113±11) mmHg, t=4.046, P<0.05), baseline diastolic blood pressure (DBP)((64±6) mmHg vs. (63±7) mmHg, t=2.618, P<0.05), HUTT 3 min DBP((78±8) mmHg vs. (77±8) mmHg, t=3.302, P<0.05), HUTT 3 min HR ((107±14) beat/min vs. (94±13) beat/min, t=24.229, P<0.05) and ΔHR ((32±11) beat/min vs. (17±9) beat/min, t=39.146, P<0.05) in OHT+ POTS group were significantly higher, and baseline HR((75±14) beat/min vs. (77±12) beat/min, t=-4.221, P<0.05)in OHT+ POTS group was lower. CONCLUSION: OHT with higher supine HR, upright HR and HR change is more susceptible to being complicated with VVS, while OHT with higher supine and upright SBP, higher supine and upright DBP and lower supine HR is more susceptible to being accompanied by POTS.

Radical tessellation of the packing of spheres with a log-normal size distribution.

The packing of particles with a log-normal size distribution is studied by means of the discrete element method. The packing structures are analyzed in terms of the topological properties such as the number of faces per radical polyhedron and the number of edges per face, and the metric properties such as the perimeter and area per face and the perimeter, area, and volume per radical polyhedron, obtained from the radical tessellation. The effect of the geometric standard deviation in the log-normal distribution on these properties is quantified. It is shown that when the size distribution gets wider, the packing becomes denser; thus the radical tessellation of a particle has decreased topological and metric properties. The quantitative relationships obtained should be useful in the modeling and analysis of structural properties such as effective thermal conductivity and permeability.

Hepatic resection for synchronous hepatic metastasis from gastric cancer.

BACKGROUND: The role of surgical resection for synchronous hepatic metastases arising from gastric adenocarcinoma has not been established. This study was designed to explore the clinicopathologic features and surgical results of these patients. METHODS: Twenty-five (4.8%) of 526 patients diagnosed with synchronous hepatic metastatic gastric cancer received hepatectomy and gastrectomy at the same time; 2 cases underwent repeat hepatectomy after intrahepatic recurrence. Clinicopathologic parameters of the hepatic metastases and the surgical results for all 25 patients were analysed. RESULTS: The 1-, 3-, and 5-year overall survival (OS) and recurrence-free survival (RFS) rates after resection were 96.0%, 70.4%, and 29.4%, respectively, and 56.0%, 22.3%, and 11.1%, respectively. Five patients survived for more than 5 years after surgery, and no mortality has occurred within 30 days after resection. Univariate analysis revealed that patients with multiple hepatic metastases suffered poorer OS (P = 0.026) and RFS (P = 0.035) than those with solitary hepatic metastasis. Postoperative adjuvant chemotherapy was a significant indicator of a favourable OS (P = 0.022). Number of metastatic lesions remained significant in the multivariate analysis of OS and RFS (P = 0.039, P = 0.049, respectively). None of variables of the primary lesion was a significant prognostic factor for those patients. CONCLUSIONS: Gastric cancer patients with a solitary synchronous liver metastasis may be good candidates for hepatic resection. Postoperative adjuvant chemotherapy may provide a benefit by aiding in OS.

Quantitative analysis of contrast-enhanced ultrasonography: differentiating focal nodular hyperplasia from hepatocellular carcinoma.

OBJECTIVE: To explore the potential of quantitative analysis of contrast-enhanced ultrasonography (CEUS) in differentiating focal nodular hyperplasia (FNH) from hepatocellular carcinoma (HCC). METHODS: 34 cases of FNH and 66 cases of HCC (all lesions <5 cm) were studied using CEUS to evaluate enhancement patterns and using analytic software Sonoliver® (Image-Arena™ v.4.0, TomTec Imaging Systems, Munich, Germany) to obtain quantitative features of CEUS in the region of interest. The quantitative features of maximum of intensity (IMAX), rise slope (RS), rise time (RT) and time to peak (TTP) were compared between the two groups and applied to further characterise both FNH and HCC with hypoenhancing patterns in the late phase on CEUS. RESULTS: The sensitivity and specificity of CEUS for diagnosis of FNH were 67.6% and 93.9%, respectively. For quantitative analysis, IMAX and RS in FNHs were significantly higher than those in HCCs (p<0.05), while RT and TTP in FNHs were significantly shorter (p<0.05). Both the 11 FNHs and 62 HCCs with hypo-enhancing patterns in the late phase were further characterised with their quantitative features, and the sensitivity and specificity of IMAX for diagnosis of FNH were 90.9% and 43.5%, RS 81.8% and 80.6%, RT 90.9% and 71.0%, and TTP 90.9% and 71.0%, respectively. CONCLUSION: The quantitative features of CEUS in FNH and HCC were significantly different, and they could further differentiate FNH from HCC following conventional CEUS. ADVANCES IN KNOWLEDGE: Our findings suggest that quantitative analysis of CEUS can improve the accuracy of differentiating FNH from HCC.