Lateral flow assay of pathogenic viruses and bacteria in healthcare.

Healthcare-associated pathogenic viruses and bacteria can have a serious impact on human health and have attracted widespread global attention. The lateral flow assay is a unidirectional detection based on the binding of a target analyte and a bioreceptor on the device via lateral flow. With incredible advantages over traditional chromatographic methods, such as rapid detection, ease of manufacture and cost effectiveness, these test strips are increasingly considered the ideal form for point-of-care applications. This review explores lateral flow assays for pathogenic viruses and bacteria, with a particular focus on methodologies, device components, construction methods, and applications. We anticipate that this review could provide exciting opportunities for developing new lateral flow devices for pathogens and advance related healthcare applications.

Synthesis of PNIPAAm-g-P4VP Microgel as Draw Agent in Forward Osmosis by RAFT Polymerization and Reverse Suspension Polymerization to Improve Water Flux.

Microgels have unique and versatile properties allowing their use in forward osmosis areas as a draw agent. In this contribution, poly(4-vinylpyridine) (P4VP) was synthesized via RAFT polymerization and then grafted to a poly(N-Isopropylacrylamide) (PNIPAAm) crosslinking network by reverse suspension polymerization. P4VP was successfully obtained by the quasiliving polymerization with the result of nuclear magnetic resonance and gel permeation chromatography characterization. The particle size and particle size distribution of the PNIPAAm-g-P4VP microgels containing 0, 5, 10, 15 and 20 wt% P4VP were measured by means of a laser particle size analyzer. It was found that all the microgels were of micrometer scale and the particle size was increased with the P4VP load. Inter/intra-molecular-specific interactions, i.e., hydrogen bond interactions were then investigated by Fourier infrared spectroscopy. In addition, the water flux measurements showed that all the PNIPAAm-g-P4VP microgels can draw water more effectively than a blank PNIPAAm microgel. For the copolymer microgel incorporating 20 wt% P4VP, the water flux was measured to be 7.48 L∙m-2∙h-1.

Zwitterionic Copolymer-Regulated Interfacial Polymerization for Highly Permselective Nanofiltration Membrane.

A highly permselective nanofiltration membrane was engineered via zwitterionic copolymer assembly regulated interfacial polymerization (IP). The copolymer was molecularly synthesized using single-step free-radical polymerization between 2-methacryloyloxyethyl phosphorylcholine (MPC) and 2-aminoethyl methacrylate hydrochloride (AEMA) (P[MPC-co-AEMA]). The dynamic network of P[MPC-co-AEMA] served as a regulator to precisely control the kinetics of the reaction by decelerating the transport of piperazine toward the water/hexane interface, forming a polyamide (PA) membrane with ultralow thickness of 70 nm, compared to that of the pristine PA (230 nm). Concomitantly, manipulating the phosphate moieties of P[MPC-co-AEMA] integrated into the PA matrix enabled the formation of ridge-shaped nanofilms with loose internal architecture exhibiting enhanced inner-pore interconnectivity. The resultant P[MPC-co-AEMA]-incorporated PA membrane exhibited a high water permeance of 15.7 L·m-2·h-1·bar-1 (more than 3-fold higher than that of the pristine PA [4.4 L·m-2·h-1·bar-1]), high divalent salt rejection of 98.3%, and competitive mono-/divalent ion selectivity of 52.9 among the state-of-the-art desalination membranes.

Short-term outcomes of radiofrequency ablation for hepatocellular carcinoma using cone-beam computed tomography for planning and image guidance.

BACKGROUND: Percutaneous radiofrequency ablation (RFA) is an effective treatment for unresectable hepatocellular carcinoma (HCC) and a minimally invasive alternative to hepatectomy for treating tumour recurrence. RFA is often performed using contrast-enhanced computed tomography (CECT) and/or ultrasonography. In recent years, angiographic systems with flat panel image detectors and advanced image reconstruction algorithms have broadened the clinical applications of cone-beam computed tomography (CBCT), including RFA. Several studies have shown the effectiveness of using CBCT for immediate treatment assessments and follow-ups. AIM: To assess the treatment response to RFA for HCC using CBCT. METHODS: Forty-eight patients (44 men; aged 37-89 years) with solitary HCC [median size: 3.2 (1.2-6.6) cm] underwent RFA and were followed for 25.6 (median; 13.5-35.2) mo. Image fusion of CBCT and pre-operative CECT or magnetic resonance imaging (MRI) was used for tumour segmentation and needle path and ablation zone planning. Real-time image guidance was provided by overlaying the three-dimensional image of the tumour and needle path on the fluoroscopy image. Treatment response was categorized as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD). Disease progression, death, time to progression (TTP), and overall survival (OS) were recorded. Kaplan-Meier and Cox regression analyses were performed. RESULTS: Initial post-RFA CECT/MRI showed 38 cases of CR (79.2%), 10 of PR (20.8%), 0 of SD, and 0 of PD, which strongly correlated with the planning estimation (42 CR, 87.5%; 6 PR, 12.5%; 0 SD; and 0 PD; accuracy: 91.7%, P < 0.01). Ten (20.8%) patients died, and disease progression occurred in 31 (35.4%, median TTP: 12.8 mo) patients, resulting in 12-, 24-, and 35-mo OS rates of 100%, 81.2%, and 72.2%, respectively, and progression-free survival (PFS) rates of 54.2%, 37.1%, and 37.1%, respectively. The median dose-area product of the procedures was 79.05 Gy*cm2 (range 40.95-146.24 Gy*cm2), and the median effective dose was 10.27 mSv (range 5.32-19.01 mSv). Tumour size < 2 cm (P = 0.008) was a significant factor for OS, while age (P = 0.001), tumour size < 2 cm (P < 0.001), tumour stage (P = 0.010), and initial treatment response (P = 0.003) were significant factors for PFS. CONCLUSION: Reliable RFA treatment planning and satisfactory outcomes can be achieved with CBCT.

Carbon Nanotube Field-Effect Transistor-Based Chemical and Biological Sensors.

Chemical and biological sensors have attracted great interest due to their importance in applications of healthcare, food quality monitoring, environmental monitoring, etc. Carbon nanotube (CNT)-based field-effect transistors (FETs) are novel sensing device configurations and are very promising for their potential to drive many technological advancements in this field due to the extraordinary electrical properties of CNTs. This review focuses on the implementation of CNT-based FETs (CNTFETs) in chemical and biological sensors. It begins with the introduction of properties, and surface functionalization of CNTs for sensing. Then, configurations and sensing mechanisms for CNT FETs are introduced. Next, recent progresses of CNTFET-based chemical sensors, and biological sensors are summarized. Finally, we end the review with an overview about the current application status and the remaining challenges for the CNTFET-based chemical and biological sensors.

Optimal postoperative adjuvant treatment strategy for HBV-related hepatocellular carcinoma with microvascular invasion: a propensity score analysis.

BACKGROUND: Microvascular invasion (MVI) is the most important risk factor associated with early postoperative recurrence in patients with hepatocellular carcinoma (HCC). However, the efficacy of postoperative adjuvant treatment for preventing recurrence in HCC patients with MVI has not been assessed. This study investigated the efficacy of postoperative adjuvant radiotherapy (RT) and transcatheter arterial chemoembolization (TACE) in HCC patients with MVI. MATERIALS AND METHODS: From July 2008 to December 2016, 117 hepatitis B virus (HBV)-related HCC patients with MVI were retrospectively divided into two groups based on postoperative adjuvant treatments. Propensity score matching (PSM) was performed to adjust for significant differences in baseline characteristics. Relapse-free survival (RFS) and overall survival (OS) of the two groups were analyzed before and after PSM. RESULTS: Of all patients, the RT group had significantly smaller tumor size and milder MVI classification. PSM analysis created 46 pairs of patients. After matching, the two groups of patients were similar in baseline characteristics. Multivariate analysis indicated that tumor size, MVI classification, and postoperative treatment strategies were independently associated with RFS; tumor size and MVI classification were independently associated with OS. Similar multivariate analysis results were demonstrated after matching propensity score. Survival analysis revealed that the estimated median RFS and OS of patients with RT and TACE were 25.74±8.12 vs 9.18±1.67 months (P=0.003) and 60.69±7.36 vs 36.53±5.34 months (P=0.262), respectively. The RT group had significantly longer RFS than the TACE group. CONCLUSION: Postoperative adjuvant RT offers better RFS for HCC patients with MVI than TACE.

Amperometric biosensing system directly powered by button cell battery for lactate.

The development of new signal systems for electrical biosensors could provide exciting new opportunities for biomedical analysis, pollutant monitoring, and explosive detection. The signal systems for commercial portable sensors involve the integration of a battery and a circuit conditioning system to power an amperometric biosensor. However, this increases the size and complexity of the entire system. In this study, we develop a simple amperometric biosensor that is directly powered by a button cell battery for the detection of lactate. A two-electrode sensing transducer was printed on cardboard or integrated on a ring. It was directly powered by a button cell battery, and connected to a multimeter for current measurement. This sensor showed a sensitive detection range of 0.04762-9.21429 mM and short measuring time of 2 min. These results show that this system can achieve an excellent sensing performance, and the construction of this new sensing system directly powered by a button cell battery offers a new method for further developing a wide range of miniaturized, flexible, portable, or wearable sensing systems, and these could be used in detecting various analytes that are important in medical diagnosis and environmental monitoring.

Dual-phase Cone-beam CT-based Navigation Imaging Significantly Enhances Tumor Detectability and Aids Superselective Transarterial Chemoembolization of Liver Cancer.

RATIONALE AND OBJECTIVES: The objective of this study was to investigate the impact of a dual-phase cone-beam computed tomography (DP-CBCT)-based navigation imaging during transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) in a perspective randomized study. MATERIALS AND METHODS: Forty-two patients with HCC (39 men, 57 ± 9 years, 13 first-time TACE) underwent TACE using three-dimensional image guidance with automatic detection of tumor-feeding vessels computed from DP-CBCT (early and delayed arterial phases). Forty-nine other patients with HCC (44 men, 55 ± 12 years, 14 first-time TACE) were treated conventionally using digital subtraction angiography (DSA). Tumor detectability in DP-CBCT was compared to DSA and preoperative CT or magnetic resonance (MR) imaging. Tumor-feeding vessel visibility was rated (good, fair, and poor) intraoperatively by the operators. The superselective embolization success rate, the number of DSA acquisitions, fluoroscopy time, and patient radiation dose were collected and compared using paired t test and the Mann-Whitney U test. RESULTS: Tumor detection of DP-CBCT was superior to DSA (100% vs 83%, P = .001) and comparable to CT-MR (96%, P = .456). Tumor and feeder visibilities were significantly enhanced by DP-CBCT (P < .001). Compared to using DSA, more superselective embolization was achieved (60% vs 49%) with less DSA acquisitions (n = 2.6 ± 0.8 vs n = 3.4 ± 0.7, P < .001) and shorter fluoroscopy time (4.1 ± 2.6 vs 7.1 ± 4.2 minutes, P < .001) with a slight increase in patient radiation exposure, that is, air kerma (median: 0.33, first to third quartiles: 0.24-0.48 vs 0.30, 0.24-0.44 Gy; P = .519) and dose-area product (134, 92-181 vs 97, 75-140 Gy⋅cm2, P = .048). CONCLUSIONS: DP-CBCT and navigation imaging improve tumor detectability and superselective embolization in TACE.

Postoperative adjuvant radiotherapy is associated with improved survival in hepatocellular carcinoma with microvascular invasion.

PURPOSE: Limited studies have compared the efficacy of postoperative adjuvant therapies in HCC patients with microvascular invasion (MVI). In this study we assess the efficacy of postoperative adjuvant conservative therapy (CT), trans-catheter arterial chemoembolization (TACE) and radiotherapy (RT) in HCC patients with MVI. RESULTS: Kaplan-Meier survival analysis revealed that patients in the RT group have significantly improved RFS (RT vs TACE: p = 0.011; RT vs CT: p < 0.001) and OS (RT vs. TACE: p = 0.034; RT vs CT: P < 0.001) compared to TACE and CT groups. Further, subgroup analysis based on the degree of MVI and surgical margin width showed that patients with narrow surgical margin have significantly longer RFS and OS after adjuvant RT than the TACE and CT, independent of degree of MVI. Multivariate analysis indicated that MVI classification is the independent prognostic factor associated with RFS and OS. MATERIALS AND METHODS: Between July 2008 and December 2015, 136 HCC patients with MVI were divided into three groups according to their adjuvant therapies. Survival outcomes namely relapse-free survival (RFS) and overall survival (OS) of the three groups were analyzed. CONCLUSIONS: Adjuvant radiotherapy following hepatectomy could result in better survival outcomes for HCC patients with MVI than TACE or CT.

Lactate dehydrogenase is a prognostic indicator in patients with hepatocellular carcinoma treated by sorafenib: results from the real life practice in HBV endemic area.

PURPOSE: Lactate dehydrogenase (LDH), which was an indirect marker of hypoxia, was a potentially prognostic factor in several malignancies. There is a lack of evidence about the prognostic value of serum LDH level in patients with hepatocellular carcinoma (HCC) receiving sorafenib treatment from hepatitis B virus endemic areas. MATERIALS AND METHODS: A total of 119 HBV-related HCC patients treated by sorafenib from a Chinese center were included into the study. They were categorized into 2 groups according to the cut-off value of pre-treatment LDH, which was determined by the time dependent receiver operating characteristics (ROC) curve for the overall survival. The prognostic value of LDH was evaluated. The relationships between LDH and other clinicopathological factors were also assessed. RESULTS: The cut-off value was 221 U/L. With a median follow up of 15 (range, 3-73) months, 91 patients reached the endpoint. Multivariate analysis proved that pre-treatment serum LDH level was an independent prognostic factor for both overall survival (OS) and progression-free survival (PFS). For patients whose pre-treatment LDH ≥ 221 U/L, increased LDH value after 3 months of sorafenib treatment predicted inferior OS and PFS. And patients with elevated pre-treatment LDH level predisposed to be featured with lower serum albumin, presence of macroscopic vascular invasion, advanced Child-Pugh class, advanced T category, higher AFP, and higher serum total bilirubin. CONCLUSIONS: Serum LDH level was a potentially prognostic factor in HCC patients treated by sorafenib in HBV endemic area. More relevant studies with reasonable study design are needed to further strengthen its prognostic value.

Concurrent sorafenib therapy extends the interval to subsequent TACE for patients with unresectable hepatocellular carcinoma.

BACKGROUND AND OBJECTIVES: To compare the impact of concurrent TACE + sorafenib versus TACE alone on overall survival (OS) and time to progression (TTP) in patients with unresectable hepatocellular carcinoma (uHCC). A secondary goal was to determine if sorafenib use increases the interval between courses of TACE. METHODS: This study enrolled 150 patients with uHCC from June 2011 to June 2014, including 50 treated with TACE + sorafenib and 100 treated with TACE alone. Factors associated with OS and TTP were identified by univariate and multivariate Cox-regression model analyses. Average TACE interval was defined as TTP/TACE frequency. RESULTS: The median OS (21.7 vs. 11.5 months) and TTP (10.2 vs. 6.7 months) were longer in the TACE + sorafenib group compared to the TACE group. Patients receiving combination therapy had higher survival rate (P < 0.032) and longer average interval to TACE (P < 0.001), but lower progression rate (P < 0.001). TACE + sorafenib therapy was associated with improved OS (P ≤ 0.009) and TTP (P ≤ 0.021). The majority of AEs identified in patients receiving the combination therapy were classified as Grades 1 and 2, and skin-related reactions and fatigue were the most common. CONCLUSION: Concurrent sorafenib with TACE provides survival benefits over TACE monotherapy, which may be related to a prolonged interval between subsequent TACE courses. J. Surg. Oncol. 2016;113:672-677. © 2016 Wiley Periodicals, Inc.

[Biodegradation Characteristics and Kinetics of p-nitrophenol by Strain Arthrobacter sp. CN2].

To investigate the application potential of the p-nitrophenol-degrading bacterium Arthrobacter sp. CN2 in practice, the effects of pH, salinity and additional carbon source were determined, and the degradation kinetics of p-nitrophenol was analyzed. Strain CN2 could degrade p-nitrophenol efficiently in a wide range of pH (7.0-8.0) and elevated salinity (0-60 g · L(-1)). Investigation of additional glucose found that 0.5% of glucose could significantly increase the degrading speed and the time to reach 90% of degradation rate was shortened by 16 hours. These results indicated that strain CN2 could degrade p-nitrophenol efficiently under different conditions and had a great potential for application in practice.

Efficacy and adverse events of transcatheter arterial chemoembolization in combination with sorafenib in the treatment of unresectable hepatocellular carcinoma.

The aim of the present study was to assess the association between the efficacy and adverse events (AEs) of transcatheter arterial chemoembolization (TACE) combined with sorafenib in patients with unresectable hepatocellular carcinoma (HCC). Between July 2008 and May 2011, 50 patients with unresectable HCC were enrolled and assigned to receive TACE combined with sorafenib in the present study. The primary outcomes were considered as time to disease progression (TTP) and sorafenib-related AEs. In the present study, 34 of 50 patients had disease progression with a median TTP (mTTP) of 210 days. The most common AEs included hand-foot skin reaction (HFSR), fatigue, diarrhea and hypertension. The mTTP of patients with HFSR extended 140 days compared to that of the patients without HFSR. Kaplan-Meier analysis was used for mTTP between the two groups of patients. This difference was statistically significant when analyzed by the univariate COX proportional hazards regression model. In conclusion, TACE in combination with sorafenib had an acceptable safety profile in the treatment of unresectable HCC. Additionally, it also revealed that HFSR served as a good prognostic predictor in using combination therapy. Therefore, discontinuation of sorafenib treatment should be prevented to avoid disease progression.

[Value of multi-slice helical CT in the diagnosis and differential diagnosis of thyroid lesions].

OBJECTIVE: To investigate the value of multi-slice helical CT in the differentiation of benign from malignant thyroid lesions. METHODS: The multi-slice helical CT images of 72 patients with 82 thyroid lesions were prospectively studied. The CT features including the margin, density of the lesion and cervical lymph node enlargement were evaluated double-blindly. All the image findings were compared with the pathological results, and analyzed statistically using the Chi-square test. RESULTS: Of 42 benign lesions, 38 (90.5 % ) showed well-defined margin, 13 (30. 9% ) contained low density nodular areas, 3 (7. 1% ) showed granular calcifications, and 2 (4. 8% ) had cervical lymph node enlargement. Of 40 thyroid carcinomas, 37 lesions(92.5% ) had irregular border, no lesion contained low density nodular areas, 14 (35. 0%) showed granular calcifications, and 31 (77. 5% ) had enlarged cervical lymph nodes. Nineteen lesions (55. 9% ) from 34 thyroid carcinoma patients who had undergone contrast enhanced CT scan showed complex density, while only 2(6. 3% ) of 32 benign lesions showed such findings on contrast enhancement. There were statistically significant differences between benign and malignant lesion in margin, low density nodular area, granular calcification, cervical lymph node enlargement and complex density( P <0.01). CONCLUSION: The findings of well-defined margin and low density nodular area in CT image may suggest benign thyroid lesions, whereas the presence of irregular border, granular calcifications and cervical lymph node enlargement as well as complex density may indicate thyroid malignancy.