Publications by authors named "Shen Zhong"

57 Publications

The effect of total factor productivity of forestry industry on CO emissions: a spatial econometric analysis of China.

Sci Rep 2021 Jul 9;11(1):14200. Epub 2021 Jul 9.

School of Finance, Harbin University of Commerce, Heilongjiang, 150000, People's Republic of China.

Forestry plays an essential role in reducing CO emissions and promoting green and sustainable development. This paper estimates the CO emissions of 30 provinces in China from 2008 to 2017, and uses Global DEA-Malmquist to measure the total factor productivity of the forestry industry and its decomposition index. On this basis, by constructing a spatial econometric model, this paper aims to empirically study the impact of forestry industry's total factor productivity and its decomposition index on CO emissions, and further analyze its direct, indirect and total effects. The study finds that the impact of forestry industry's total factor productivity on CO emissions shows an "inverted U-shaped" curve and the inflection point is 0.9395. The spatial spillover effect of CO emissions is significantly negative. The increase of CO emissions in adjacent areas will provide a "negative case" for the region, so that the region can better address its own energy conservation and emission reduction goals. TFP of forestry industry also has positive spatial spillover effect. However, considering the particularity of forestry industry, this effect is not very significant. For other factors, such as foreign direct investment, urbanization level, industrial structure and technology market turnover will also significantly affect regional CO emissions.
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http://dx.doi.org/10.1038/s41598-021-93770-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270944PMC
July 2021

Hierarchically Microstructure-Bioinspired Flexible Piezoresistive Bioelectronics.

ACS Nano 2021 Jun 15. Epub 2021 Jun 15.

Key Laboratory of Advanced Technologies of Materials (Ministry of Education), School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu 610031, P. R. China.

The naturally microstructure-bioinspired piezoresistive sensor for human-machine interaction and human health monitoring represents an attractive opportunity for wearable bioelectronics. However, due to the trade-off between sensitivity and linear detection range, obtaining piezoresistive sensors with both a wide pressure monitoring range and a high sensitivity is still a great challenge. Herein, we design a hierarchically microstructure-bioinspired flexible piezoresistive sensor consisting of a hierarchical polyaniline/polyvinylidene fluoride nanofiber (HPPNF) film sandwiched between two interlocking electrodes with microdome structure. Ascribed to the substantially enlarged 3D deformation rates, these bioelectronics exhibit an ultrahigh sensitivity of 53 kPa, a pressure detection range from 58.4 to 960 Pa, a fast response time of 38 ms, and excellent cycle stability over 50 000 cycles. Furthermore, this conformally skin-adhered sensor successfully demonstrates the monitoring of human physiological signals and movement states, such as wrist pulse, throat activity, spinal posture, and gait recognition. Evidently, this hierarchically microstructure-bioinspired and amplified sensitivity piezoresistive sensor provides a promising strategy for the rapid development of next-generation wearable bioelectronics.
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http://dx.doi.org/10.1021/acsnano.1c01606DOI Listing
June 2021

[Supergenes:Generalists in Gene Expression].

Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2021 Apr;43(2):265-270

Key Laboratory of Transplant Medicine,Chinese Academy of Medical Sciences,Tianjin First Central Hospital,Tianjin 300192,China.

In eukaryote cells,transcription from genome DNA is a key process of gene expression.The transcription products contain not only messenger RNAs that code proteins,but also various types of non-coding RNAs.During transcription,some of the gene loci produce more than one kind of RNA molecule,including coding RNAs and more often non-coding RNAs.These gene loci that generate several kinds of RNA molecules are named supergenes.According to the transcription pattern,supergenes are divided into three types,known as types Ⅰ,Ⅱ and Ⅲ.In this review,we summarize the transcription pattern of each type of supergene,and exposit the role of these genes in cells.
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http://dx.doi.org/10.3881/j.issn.1000-503X.12419DOI Listing
April 2021

Soft Origami Optical-Sensing Actuator for Underwater Manipulation.

Front Robot AI 2020 10;7:616128. Epub 2021 Mar 10.

Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China.

Soft robots are ideal for underwater manipulation in sampling and other servicing applications. Their unique features of compliance, adaptability, and being naturally waterproof enable robotic designs to be compact and lightweight, while achieving uncompromized dexterity and flexibility. However, the inherent flexibility and high nonlinearity of soft materials also results in combined complex motions, which creates both soft actuator and sensor challenges for force output, modeling, and sensory feedback, especially under highly dynamic underwater environments. To tackle these limitations, a novel Soft Origami Optical-Sensing Actuator (SOSA) with actuation and sensing integration is proposed in this paper. Inspired by origami art, the proposed sensorized actuator enables a large force output, contraction/elongation/passive bending actuation by fluid, and hybrid motion sensing with optical waveguides. The SOSA design brings two major novelties over current designs. First, it involves a new actuation-sensing mode which enables a superior large payload output and a robust and accurate sensing performance by introducing the origami design, significantly facilitating the integration of sensing and actuating technology for wider applications. Secondly, it simplifies the fabrication process for harsh environment application by investigating the boundary features between optical waveguides and ambient water, meaning the external cladding layer of traditional sensors is unnecessary. With these merits, the proposed actuator could be applied to harsh environments for complex interaction/operation tasks. To showcase the performance of the proposed SOSA actuator, a hybrid underwater 3-DOFs manipulator has been developed. The entire workflow on concept design, fabrication, modeling, experimental validation, and application are presented in detail as reference for wider effective robot-environment applications.
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http://dx.doi.org/10.3389/frobt.2020.616128DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7988097PMC
March 2021

Research on grain production efficiency in China's main grain producing areas from the perspective of financial support.

PLoS One 2021 15;16(3):e0247610. Epub 2021 Mar 15.

Institute of Finance, Harbin University of Commerce, Harbin, China.

Grain production is vital to the national economy and people's livelihood, and improving grain production efficiency is of great significance to the sustainable development of China's economy and society. From the perspective of financial support, using the DEA global Malmquist productivity index model and based on the data of 13 main grain producing areas in China from 2001 to 2017, this paper discusses the evolution characteristics and regional distribution differences of the total factor productivity index of grain production in China's main grain producing areas. The results show that from 2001 to 2017, the total factor productivity index of grain production in China's main grain producing areas showed an overall fluctuation trend of gradual decline, with an average annual decline of 7.3%. From the perspective of spatial analysis, the grain production efficiency in China's main grain producing areas is characterized by uneven spatial development, which is generally manifested as the decreasing trend from the central region to the eastern and western regions. Meanwhile, it can be seen from the decomposition index that the change of total factor productivity of grain production in China's main grain producing areas mainly depends on the change of technical efficiency.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0247610PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7959381PMC
March 2021

Understanding the Percolation Effect in Triboelectric Nanogenerator with Conductive Intermediate Layer.

Research (Wash D C) 2021 4;2021:7189376. Epub 2021 Feb 4.

Key Laboratory of Advanced Technologies of Materials, Ministry of Education, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu 610031, China.

Introducing the conductive intermediate layer into a triboelectric nanogenerator (TENG) has been proved as an efficient way to enhance the surface charge density that is attributed to the enhancement of the dielectric permittivity. However, far too little attention has been paid to the companion percolation, another key element to affect the output. Here, the TENG with MXene-embedded polyvinylidene fluoride (PVDF) composite film is fabricated, and the dependence of the output capability on the MXene loading is investigated experimentally and theoretically. Specifically, the surface charge density mainly depends on the dielectric permittivity at lower MXene loadings, and in contrast, the percolation becomes the degrading factor with the further increase of the conductive loadings. At the balance between the dielectric and percolation properties, the surface charge density of the MXene-modified TENG obtained 350% enhancement compared to that with the pure PVDF. This work shed new light on understanding the dielectric and percolation effect in TENG, which renders a universal strategy for the high-performance triboelectronics.
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http://dx.doi.org/10.34133/2021/7189376DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7881766PMC
February 2021

Sulfur dioxide (SO) emission reduction and its spatial spillover effect in high-tech industries: based on panel data from 30 provinces in China.

Environ Sci Pollut Res Int 2021 Jun 18;28(24):31340-31357. Epub 2021 Feb 18.

School of Finance, Harbin University of Commerce, No.1, Xuehai Street, Songbei District, Harbin, Heilongjiang Province, China.

Industrial sulfur dioxide (SO) has become an important source of environmental pollution in China, and the regional SO emission reduction capacity is a comprehensive reflection of cleaner production capacity, environmental regulation, and economic development. It is obvious that high-tech industries play a crucial role in promoting the cleaner production capacity of the whole industry. Simultaneously, only considering the regional emission and the development of high-tech industry in isolation may deviate from actual economic characteristics. Therefore, by using the panel data of 30 provinces in China from 2005 to 2016, this paper adopts spatial autoregression model (SAR), spatial error model (SEM), and spatial Durbin model (SDM) to analyze the effect of the high-tech industry development on SO emission reduction under the spatial adjacency matrix (W1), geographic distance matrix (W2), and economic distance matrix (W3). In addition, this paper selects three indicators, which is SO removal rate, SO emission, and SO removal quantity, as explanatory variables, and R&D investment and number of enterprises in high-tech industry are selected to represent the industrial development level. The major conclusions are as follows: (1) The ability of SO emission reduction in the local province is significantly affected by the surrounding provinces, showing the agglomeration characteristics of "high-high" or "low-low." (2) The R&D investment of high-tech industry has a negative impact on SO removal rate and SO removal quantity, but a positive effect on the SO emissions for the local province, and has a positive effect on the emission reduction of surrounding provinces. (3) The expansion of high-tech industry has significantly improved the SO emission reduction capacity of the local province and its surrounding provinces. The robustness test supports the empirical conclusions of this paper. Finally, this paper puts forward some policy suggestions for government in environmental governance, such as "joint prevention and control" and the promotion of cleaner production.
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http://dx.doi.org/10.1007/s11356-021-12755-7DOI Listing
June 2021

Assessment of skin care behavior and cognition of patients with acne vulgaris in China.

Chin Med J (Engl) 2021 Feb 3;134(5):614-615. Epub 2021 Feb 3.

Department of Dermatology, the First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China.

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http://dx.doi.org/10.1097/CM9.0000000000001397DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929625PMC
February 2021

Outcomes of a modified Bresler procedure for the treatment of rectocele with rectal intussusception.

Gastroenterol Rep (Oxf) 2020 Dec 4;8(6):457-464. Epub 2020 Jul 4.

Department of Colorectal Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.

Background: Obstructed defecation syndrome (ODS) is a condition that is frequently caused by rectocele and rectal intussusception. This study aimed to evaluate the effectiveness of a modified Bresler procedure for the treatment of ODS. The outcomes of this modified procedure were compared with the stapled transanal rectal resection (STARR) procedure.

Methods: We performed a retrospective analysis of the clinical data from 76 female patients who presented with ODS between June 2014 and June 2016. The patients were divided into two treatment groups, namely Modified and STARR. Patients in the Modified group (=36) underwent the modified Bresler procedure, which involved posterior rectal-wall resection using a circular tubular stapler with multilevel purse-string sutures. Patients in the STARR group (=40) underwent the standard STARR procedure. We analysed post-operative complications, Wexner constipation scores (WCS), rectocele depths, and four-point post-operative satisfaction scales.

Results: Patients in the Modified group exhibited shorter operative times and fewer post-operative complications (both <0.05). At 12 months post-operatively, both the Modified and STARR groups displayed a significant improvement in the Wexner constipation score and the depth of rectocele. The post-operative WCS for the Modified group were significantly improved compared to those for the STARR group (<0.05), while there was no significant difference in the rectocele depth between the two groups (>0.05). Post-operative interviews at post-operative 12 months showed that patients in the Modified group had a better satisfaction (=0.05).

Conclusions: Our modified procedure may be an effective treatment strategy for patients experiencing ODS caused by rectocele and rectal intussusception, with fewer complications and effective relief of symptoms.
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http://dx.doi.org/10.1093/gastro/goaa027DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793192PMC
December 2020

Construction of ceRNA network and identification of two differentially expressed circRNAs in hepatocellular carcinoma by bioinformatic analysis.

Int J Clin Exp Pathol 2020 1;13(11):2727-2737. Epub 2020 Nov 1.

Department of General Surgery, Jinshan Branch of The Sixth People's Hospital of Shanghai China.

Covalently closed circular RNAs (circRNAs) display dysregulated expression in several types of cancer. However, their functions remain largely unclear. In this work, datasets GSE125469 and GSE128274 of hepatocellular carcinoma (HCC) were selected from Gene Expression Omnibus (GEO) database. To identify differentially expressed genes (DEGs) in HCC and adjacent tissues, we used R package DESeq for analysis. Then, 15 DEcircRNAs, 65 DEmiRNAs, and 2084 DEmRNAs were identified comparing HCC and normal tissues. Next, to predict the target relationship of circRNA-miRNA and miRNA-mRNA in DEGs, we use the databases CircInteractome and starBase v2.0 for analysis. Finally, the ceRNA network of circRNA-miRNA-mRNA was established by Cytoscape software based on 2 DEcircRNAs (hsa_circ_0007813 and hsa_circ_0089372), 2 DEmiRNAs, and 98 DEmRNAs. In addition, we conducted Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses of DEGs to explore the function of DEGs in HCC. Functional enrichment analyses indicated DEmRNAs might be associated with HCC occurrence and progression. In general, our research reveals an important role of ceRNA's molecular mechanism in HCC.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7716122PMC
November 2020

miRNAs in lung cancer. A systematic review identifies predictive and prognostic miRNA candidates for precision medicine in lung cancer.

Transl Res 2021 Apr 28;230:164-196. Epub 2020 Nov 28.

Centre for Pharmacology and Toxicology, Hannover Medical School, Hannover, Germany. Electronic address:

Lung cancer (LC) is the leading cause of cancer-related death worldwide and miRNAs play a key role in LC development. To better diagnose LC and to predict drug treatment responses we evaluated 228 articles encompassing 16,697 patients and 12,582 healthy controls. Based on the criteria of ≥3 independent studies and a sensitivity and specificity of >0.8 we found blood-borne miR-20a, miR-10b, miR-150, and miR-223 to be excellent diagnostic biomarkers for non-small cell LC whereas miR-205 is specific for squamous cell carcinoma. The systematic review also revealed 38 commonly regulated miRNAs in tumor tissue and the circulation, thus enabling the prediction of histological subtypes of LC. Moreover, theranostic biomarker candidates with proven responsiveness to checkpoint inhibitor treatments were identified, notably miR-34a, miR-93, miR-106b, miR-181a, miR-193a-3p, and miR-375. Conversely, miR-103a-3p, miR-152, miR-152-3p, miR-15b, miR-16, miR-194, miR-34b, and miR-506 influence programmed cell death-ligand 1 and programmed cell death-1 receptor expression, therefore providing a rationale for the development of molecularly targeted therapies. Furthermore, miR-21, miR-25, miR-27b, miR-19b, miR-125b, miR-146a, and miR-210 predicted response to platinum-based treatments. We also highlight controversial reports on specific miRNAs. In conclusion, we report diagnostic miRNA biomarkers for in-depth clinical evaluation. Furthermore, in an effort to avoid unnecessary toxicity we propose predictive biomarkers. The biomarker candidates support personalized treatment decisions of LC patients and await their confirmation in randomized clinical trials.
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http://dx.doi.org/10.1016/j.trsl.2020.11.012DOI Listing
April 2021

The Efficacy of Low Postoperative Radiation Dose in Patients with Advanced Hypopharyngeal Cancer without High-Risk Factors.

Cancer Manag Res 2020 21;12:7553-7560. Epub 2020 Aug 21.

Department of Head and Neck Radiotherapy, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China.

Objective: To evaluate the feasibility and efficacy of low postoperative radiotherapy (PORT) dose in patients with advanced hypopharyngeal squamous cell carcinoma (HPSCC) and identify prognostic factors in this group.

Patients And Methods: Between January 2013 and September 2015, 110 consecutive patients with HPSCC with no high-risk factors were treated postoperatively to 50 Gy (n=89), 56 Gy (n=12), and 60 Gy (n=9) in 2 Gy/fraction. Overall survival (OS), 3-year progression-free survival (PFS), 3-year loco-regional recurrence-free survival (LRFS), and treatment-related toxicities were analyzed.

Results: Median follow-up time was 40 months (range=6-75 months). The 3-year local-regional control (LRC) and 3-year neck control rate were 86.3% and 91.8%, respectively. The 3-year OS, PFS, and LRFS were 69.9%, 65.5%, and 80.5%, respectively. In a univariate analysis, T stage showed a significant correlation with improved OS, PFS, and LRFS (=0.008, =0.039, =0.034). On multivariate analysis, T stage showed a significant correlation with improved OS and PFS. N stage showed a significant correlation with improved PFS. However, interval surgery-radiotherapy, reconstructive methods, and RT dose cannot serve as a significant prognostic factor for survival outcome.

Conclusion: This study suggests that treating no high-risk factors for locally advanced HPSCC with a dose of 50 Gy to the whole operative bed and elective lymph node levels cannot compromise disease control and survival.
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http://dx.doi.org/10.2147/CMAR.S249725DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468485PMC
August 2020

Meta-analysis of laparoscopic anterior resection with natural orifice specimen extraction (NOSE-LAR) versus abdominal incision specimen extraction (AISE-LAR) for sigmoid or rectal tumors.

World J Surg Oncol 2020 Aug 19;18(1):215. Epub 2020 Aug 19.

Department of Colorectal Surgery, Hangzhou Third Hospital, Hangzhou, 310009, Zhejiang, People's Republic of China.

Background: Natural orifice specimen extraction surgery is a novel technique of minimally invasive surgery. The purpose of this study was to compare the safety of laparoscopic anterior resection with natural orifice specimen extraction (NOSE-LAR) and abdominal incision specimen extraction (AISE-LAR) for sigmoid or rectum tumors.

Methods: MEDLINE (PubMed), Embase, CENTRAL (Cochrane Central Register of Controlled Trials), Scopus, and ClinicalTrials databases were systematically searched for related articles up to August 2019. The primary outcomes included postoperative complications (overall postoperative complication, incision-related complication, anastomotic fistula, and severe complication) and pathologic results (lymph nodes harvested, proximal resection margin, and distal resection edge). The statistical analysis was performed on STATA 12.0 software.

Results: Ten studies comprising 1787 patients were used for meta-analysis. Compared with AISE-LAR, NOSE-LAR had more advantages in terms of overall postoperative complication (odds ratio (OR) = 0.65 (95% CI, 0.46 to 0.90; P = 0.01)), incision-related complication (OR = 0.13 (95% CI, 0.05 to 0.35; P < 0.01)), distal resection edge (weighted mean difference (WMD) = 0.17 cm (95% CI, 0.02 to 0.33 cm; P = 0.02)), recovery of gastrointestinal function (WMD = - 0.38 day (95% CI, - 0.70 to - 0.06 day; P = 0.02 )), pain scores in postoperative day 1 (WMD = - 1.64 (95% CI, - 2.31 to - 0.98; P < 0.01)), additional analgesics usage (OR = 0.21 (95% CI, 0.11 to 0.40; P < 0.01)) and hospital stay (WMD = - 0.71 day (95% CI, - 1.10 to - 0.32 day; P < 0.01)), while the operation time of NOSE-LAR was prolonged (WMD = 7.4 min (95% CI, 0.17 to 14.64 min; P = 0.04)). The anastomotic fistula, severe complication, lymph nodes harvested, proximal resection margin, intraoperative blood loss, and long-term outcomes in NOSE-LAR were comparable with AISE-LAR.

Conclusions: The safety of NOSE-LAR was demonstrated, and it could be an alternative to conventional surgery in laparoscopic anterior resection for sigmoid and rectal tumors. However, further randomized and multi-center trials are required.
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http://dx.doi.org/10.1186/s12957-020-01982-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7439723PMC
August 2020

A Cephalopod-Inspired Soft-Robotic Siphon for Thrust Vectoring and Flow Rate Regulation.

Soft Robot 2020 Aug 4. Epub 2020 Aug 4.

Department of Mechanical Engineering and The University of Hong Kong, Hong Kong, Hong Kong SAR.

Cephalopods could simultaneously achieve both accurate positioning and agile bodily maneuvers by coordinating the mantle and the funnel, which is ideal for underwater robotic applications toward a compact propulsor with combined thrust vectoring and regulation. For a wide range of underwater applications from videography to manipulation, this novel approach would offer a compact and integrated alternative to the state-of-the-art with multiple vectoring thrusters. This article presents a biomimetic soft-robotic siphon (BSRS) as the propulsor unit, consisting of a novel central flow-regulative duct (CFRD) encircled by three circumferential siphon actuation muscles (SAMs). Hydraulic pressurization of the SAMs could enable both thrust vectoring by deflecting the BSRS and flow regulation by proportionally alternating the orifice of the CFRD. The design, modeling, and fabrication of the BSRS are presented in detail. Experiments using a prototype BSRS were conducted for validating the performances of deflection deformation and flow regulation, showing bending range of over 180° and flow-restricting capability of up to 100%. A burst effect was achieved with the ability of exceeding the constant flow rate by up to 50%, enabling tremendous thrust increase in very short time. This work proves the feasibility of combining omnidirectional deflection with flow regulation within a soft-robotic mechanism, paving the way to compact water-jetting propulsion for underwater robots.
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http://dx.doi.org/10.1089/soro.2019.0152DOI Listing
August 2020

The total factor productivity index of science and technology innovations in the coastal regions of China between 2006 and 2016.

Environ Sci Pollut Res Int 2020 Jun 6. Epub 2020 Jun 6.

Harbin University of Commerce, Harbin, Heilongjiang, China.

As a kind of renewable resources, the effective utilization of marine resources has a significant influence on the sustainable development of economy. This paper employed the global Malmquist index model to measure the total factor productivity (TFP) and its decomposition index of marine science and technology (MST) in China's coastal areas from 2006 to 2016. The empirical results indicated that the overall level of TFP of MST is low with a trend of volatility. By analyzing the decomposition index, it was obvious that the increase of TFP of MST mainly depended on the improvement of technical progress and scale efficiency, and the pure technological efficiency did not have significant effect on it. Moreover, with the unceasing evolution of the spatial pattern of China's TFP of MST, the development of MST innovation industry was unbalanced. It should be noted that the TFP of MST for each region exists a distinct difference, such as Hebei; Hainan have higher TFP of MST, whereas Shandong, Tianjin, and Beijing have relatively low TFP. Thus, it is crucial to strengthen the construction of MST innovation system.
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http://dx.doi.org/10.1007/s11356-020-09300-3DOI Listing
June 2020

The Comparison of Laparoscopic Colorectal Resection with Natural Orifice Specimen Extraction versus Mini-Laparotomy Specimen Extraction for Colorectal Tumours: A Systematic Review and Meta-Analysis of Short-Term Outcomes.

J Oncol 2020 31;2020:6204264. Epub 2020 Jan 31.

Department of Colorectal Surgery, Hangzhou Third Hospital, Hangzhou 310009, Zhejiang, China.

Aim: The aims of this study were to compare the short-term outcomes of natural orifice specimen extraction surgery (NOSES) and conventional laparoscopic surgery (CLAPS) for colorectal tumours and to evaluate the safety and feasibility of NOSES in colorectal resection.

Methods: A literature review was performed on the PubMed, Cochrane Library, and Embase databases up to March 2019. Papers conforming to the inclusion criteria were used for further analysis. The short-term outcomes included intraoperative outcomes and postoperative recovery results. The weighted mean difference (WMD) was calculated for continuous outcomes and odds ratio (OR) for dichotomous results. Study quality was evaluated using the Newcastle-Ottawa Quality Assessment Scale (NOS) or the 6-item Jadad scale.

Results: Eight studies comprising 686 patients met the inclusion criteria. Compared with CLAPS, NOSES had more advantages in terms of postoperative complications, postoperative pain, recovery of gastrointestinal function, duration of hospital stay, and cosmetic results. The lymph nodes harvested and intraoperative blood loss in NOSES were comparable with CLAPS; however, a prolonged operative time was observed in NOSES.

Conclusions: NOSES was shown to be a safe and viable alternative to CLAPS in colorectal oncology in terms of short-term results. Further long-term and randomized trials are required.
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http://dx.doi.org/10.1155/2020/6204264DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218971PMC
January 2020

Effects of a cream containing madecassoside, 5% panthenol, and copper-zinc-manganese on improving postlaser resurfacing wound healing: A split-face, randomized trial.

Dermatol Ther 2020 07 20;33(4):e13533. Epub 2020 May 20.

Department of Medical Cosmetology, Shanghai Dermatology Hospital, Shanghai, China.

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http://dx.doi.org/10.1111/dth.13533DOI Listing
July 2020

MicroRNA Binding Site Polymorphisms of the Long-Chain Noncoding RNA are Associated with Risk and Prognosis of Colorectal Cancer in Chinese Han Population.

Genet Test Mol Biomarkers 2020 May 28;24(5):239-248. Epub 2020 Apr 28.

Department of Colorectal Surgery, The Third People's Hospital of Hangzhou, Hangzhou, China.

The metastasis-associated lung adenocarcinoma transcript 1 () gene's rs664589 locus is located within the binding site of the miRNA hsa-miR-194-5p for its cognate long-chain noncoding RNA (lncRNA) MALAT1. The aim of this study was to investigate the association between the rs664589 single nucleotide polymorphism (SNP) and the risk and prognosis of colorectal cancer (CRC) in the Chinese Han population. A cohort of 340 patients with CRC who underwent surgical resection and another group of 340 healthy subjects were enrolled in this study and analyzed for their rs664589 genotypes. In addition, quantitative real-time-polymerase chain reaction was used to detect the expression levels of the lncRNA MALAT1 and the hsa-miR-194-5p in cancer tissues and paracancerous normal tissues of CRC patients. The risk of CRC in subjects carrying the G allele at the rs664589 locus in the 3' untranslated region of the gene was 1.81 times higher than for C allele carriers. The expression levels of the in cancer tissues was significantly higher than that in paracancerous tissues, while the hsa-miR-194-5p expression level was significantly lower in cancerous tissues compared to cognate paracancerous tissues. The progression-free survival (PFS) rate for patients with the gene rs664589 locus GG genotype was significantly lower than that of CG genotype patients. Moreover, inhibited the expression of hsa-miR-194-5p. The risk of CRC was relatively higher among rs664589 G allele carriers, and the CRC patients with a G allele had a lower PFS. The likely mechanism underlying these observations is that the rs664589 SNP affects the binding efficiency between the and the miRNA has-miR-194-5p, although this awaits laboratory confirmation.
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http://dx.doi.org/10.1089/gtmb.2020.0013DOI Listing
May 2020

An Underwater Robotic Manipulator with Soft Bladders and Compact Depth-Independent Actuation.

Soft Robot 2020 Oct 28;7(5):535-549. Epub 2020 Feb 28.

Department of Mechanical Engineering, The University of Hong Kong, Hong Kong SAR, China.

An underwater manipulator is essential for underwater robotic sampling and other service operations. Conventional rigid body underwater manipulators generally required substantial size and weight, leading to hindered general applications. Pioneering soft robotic underwater manipulators have defied this by offering dexterous and lightweight arms and grippers, but still requiring substantial actuation and control components to withstand the water pressure and achieving the desired dynamic performance. In this work, we propose a novel approach to underwater manipulator design and control, exploiting the unique characteristics of soft robots, with a hybrid structure (rigid frame+soft actuator) for improved rigidity and force output, a uniform actuator design allowing one compact hydraulic actuation system to drive all actuators, and a novel fully customizable soft bladder design that improves performances in multiple areas: (1) force output of the actuator is decoupled from the working depth, enabling wide working ranges; (2) all actuators are connected to the main hydraulic line without actuator-specific control loop, resulting in a very compact actuation system especially for high-dexterity cases; (3) dynamic responses were improved significantly compared with the counter system without bladder. A prototype soft manipulator with 4-DOFs, dual bladders, and 15 N payload was developed; the entire system (including actuation, control, and batteries) could be mounted onto a consumer-grade remotely operated vehicle, with depth-independent performances validated by various laboratory and field test results across various climatic and hydrographic conditions. Analytical models and validations of the proposed soft bladder design were also presented as a guideline for other applications.
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http://dx.doi.org/10.1089/soro.2019.0087DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591381PMC
October 2020

Production of alkaline pectinase: a case study investigating the use of tobacco stalk with the newly isolated strain Bacillus tequilensis CAS-MEI-2-33.

BMC Biotechnol 2019 07 12;19(1):45. Epub 2019 Jul 12.

Key Laboratory of Tobacco Biology and Processing, Tobacco Research Institute of Chinese Academy of Agricultural Sciences, Qingdao, 266101, People's Republic of China.

Background: Tobacco stalk (TS), a major agricultural waste abundant in pectin, has resulted in concerns about the need for its reuse. The nicotine in TS is considered a chemical that is to\xic and hazardous to the environment.

Results: In this study, Bacillus tequilensis CAS-MEI-2-33 was isolated from cigar wrappers to produce alkaline pectinase using TS. Subsequently, the medium and fermentation conditions for the production of pectinase by B. tequilensis CAS-MEI-2-33 were optimized. The optimal fermentation period, pH of the initial fermentation medium, concentration of TS, and inoculum amount for B. tequilensis CAS-MEI-2-33 were 40 h, 40 g/L, 7.0, and 3%, respectively. Under optimal conditions, the pectinase activity was 1370 U/mL. Then, the enzymatic properties, such as the optimum pH, reaction temperature, temperature stability, and effects of metal ions, were studied. The optimal pH was determined to be 10.0, indicating that the enzyme was an alkaline pectinase. The optimal temperature was 40 °C, and pectinase activity was stable at 40 °C. The Ag metal ions were shown to remarkably promote enzyme activity. The pectinase was partly purified by ammonium sulfate precipitation, ion exchange chromatography, and Sephacryl S-100 chromatography. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and LC-MS/MS analyses were utilized to analyze the pectinase.

Conclusions: This study provided a new alkaline pectinase candidate and a new strategy for the use of TS.
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http://dx.doi.org/10.1186/s12896-019-0526-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6624900PMC
July 2019

[Effects of harvest on greenhouse gas emissions from forested swamp during non-growing season in Xiaoxing'an Mountains of China.]

Ying Yong Sheng Tai Xue Bao 2019 May;30(5):1713-1725

Center for Ecological Research, School of Forestry, Northeast Forestry University, Harbin 150040, China.

Soil greenhouse gas emission during non-growing season plays an important role in ecosystem carbon and nitrogen cycling in mid and high latitude regions. However, the effects of harvest on greenhouse gas emission during non-growing remain unclear. We measured the fluxes of CO, CH and NO and environmental factors (soil temperature, moisture, soil organic carbon and total nitrogen etc.) during non-growing season from four kinds of forested swamps (Alnus sibirica swamp, Betula platyphylla swamp, Larix gmelinii-Carex schmidti swamp, L. gmelinii-moss swamp) under different harvest disturbances for 10 years, including control (no cutting), 45% selective cutting, clear cutting, by using static chamber technique and gas chromatography in Xiaoxing'an Mountains, Northeast China. The aim of this study was to reveal the effects of harvest on greenhouse gas emission from temperate forested swamp during non-growing season and the main controlling factors. The results showed that the average fluxes of CO, CH and NO from four kinds of swamps distributed in 53.08-81.31 mg·m·h, 0.09-3.07 mg·m·h and 4.07-8.83 μg·m·h, respectively. Clear cutting significantly increased the fluxes of CO, CH, and NO from A. sibirica swamp and L. gmelinii-moss swamp. Selective cutting significantly increased CO fluxes from B. platyphylla swamp and L. gmelinii-moss swamp and decreased CO flux from A. sibirica swamp. Selective cutting significantly decreased CH fluxes from all the four forested swamps and NO flux from Larix gmelinii-Carex schmidti swamp. The CO fluxes from natural forested swamps were strongly influenced by soil temperature, soil organic carbon and C/N. CH fluxes were influenced by soil temperature, soil organic carbon. NO fluxes were affected by air temperature and soil pH. Harvesting increased the correlation between soil CO flux and air temperature, soil moisture and snow depth, the correlation between soil CH flux and air temperature, soil moisture and C/N, as well as the correlation between soil NO flux and soil total nitrogen and C/N. The annual cumulative contribution of CO, CH and NO emission from natural forested swamp during non-growing season were 33.2%-46.5%, 6.3%-9.1% and 61.5%-68.3%, respectively. The clear cutting increased the annual cumulative contribution of CO from B. platyphylla swamp and L. gmelinii-moss swamp and that of NO from other swamps except L. gmelinii-moss swamp. The selective cutting increased the annual cumulative contribution of CO, CH and NO from L. gmelinii-C. schmidti swamp and L. gmelinii-moss swamp, but decreased that from B. platyphylla swamp. The annual cumulative contributions of NO and CO during non-growing season were relatively high from temperate natural forested swamps, and clear cutting further increased their contribution, while the selective cutting just increased that of CH during non-growing season.
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http://dx.doi.org/10.13287/j.1001-9332.201905.036DOI Listing
May 2019

Overexpression of novel lncRNA NLIPMT inhibits metastasis by reducing phosphorylated glycogen synthase kinase 3β in breast cancer.

J Cell Physiol 2019 07 11;234(7):10698-10708. Epub 2018 Nov 11.

Department of Thyroid and Breast surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.

Long noncoding RNAs (lncRNAs) are considered as regulators of gene expression in cancers. However, cancer profiling has little focused on noncoding genes. Here, we reported that RP11-115N4.1 (here renamed novel lncRNA inhibiting proliferation and metastasis [NLIPMT]) was downregulated in breast cancer tissues. Ectopic expression of NLIPMT inhibited mammary cell proliferation, motility in vitro. Moreover, lnc-NLIPMT reduced the growth of implanted MDA-MB-231 cells in vivo. Mechanistically, glycogen synthase kinase 3β (GSK3β) was identified as an effector protein regulated by lnc-NLIPMT. Inhibition of GSK3β activity restored NLIPMT-induced inhibition of proliferation and motility in breast cancer cells. These data reveal that lnc-NLIPMT functions as a driver of breast cancer progression and might serve as a potential target for antimetastatic therapies.
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http://dx.doi.org/10.1002/jcp.27738DOI Listing
July 2019

Full realization of internal mammary artery injury after blunt chest trauma.

Turk Gogus Kalp Damar Cerrahisi Derg 2018 Jul 3;26(3):504-510. Epub 2018 Jul 3.

Department of Thoracic Surgery, Zhejiang University, Zheiang , China.

Due to the substantial and continual increase in the number of motorized vehicles globally, clinicians are faced with an enormous population at risk for suffering internal mammary artery injuries after blunt chest trauma. Nevertheless, very little attention has been paid to this issue by relevant health practitioners. In addition, there is a scarcity of extant research data, as well as societal guidelines, regarding internal mammary artery injury. In cases with undetected internal mammary artery injury, however, the outcome may be catastrophic or fatal. Thus, investigating and reviewing the anatomy, etiology, diagnostic approaches, and treatment strategies for patients with internal mammary artery injury are urgently needed.
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http://dx.doi.org/10.5606/tgkdc.dergisi.2018.15302DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7018279PMC
July 2018

A Wearable Detector for Simultaneous Finger Joint Motion Measurement.

IEEE Trans Biomed Circuits Syst 2018 06;12(3):644-654

This paper presents a wearable and stretchable detector for simultaneous finger joint motion measurement, providing the feasible technical solutions to solve the problems existing in the current devices. The sensor array installed in the detector consists of 14 custom-made bending sensors and an inertial measurement unit with high accuracy. The glove support for a sensor array, which is made of three silicone materials with different elasticity, not only overcomes the drawbacks of cloth support, but also addresses the compatibility between the stretch substrate and the inelastic sensing components. Besides, two-section electrical connection avoids the problems caused by the external wires in traditional solutions to enhance the durability of glove. The experiment results indicated that the wearable detector offers a good user experience by exerting a small force on fingers. The device also shows a strong durability as it worked properly after tens of thousands of bending. The measurement tests on a single sensor demonstrated that two kinds of sensors are both with high accuracy. Besides, the hand goniometric system has an excellent performance in terms of hand motion detection. The measurement error of the device in subjects with different hand sizes is within a reasonable range. The good properties of the sensory detector allow it to be applied in clinical applications.
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http://dx.doi.org/10.1109/TBCAS.2018.2810182DOI Listing
June 2018

MicroRNA-193a inhibits breast cancer proliferation and metastasis by downregulating WT1.

PLoS One 2017 10;12(10):e0185565. Epub 2017 Oct 10.

Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.

In many cancers, microRNA-193a (miR-193a) is a suppressor miRNA, but its underlying anti-oncogenic activity in breast cancer is not known. In this study, we found decreased miR-193a (specifically, miR-193a-5p) expression not only in breast cancer cell lines but also in breast cancer tissues as compared with the adjacent non-tumor tissues. Ectopic miR-193a overexpression inhibited the proliferation, colony formation, migration, and invasion of MDA-MB-231 and BT549 cells. miR-193a reduced Wilms' tumor 1 (WT1) expression and repressed luciferase reporter activity by binding WT1 coding region sequences; mutation of the predicted miR-193a binding site abolished this effect. miR-193a and WT1 expression were significantly inversely correlated in breast cancer tissues. Importantly, the anti-cancer activity induced by miR-193a was partially reversed by WT1 overexpression, indicating an important role for WT1 in such activity related to miR-193a. Our results reveal that miR-193a-WT1 interaction plays an important role in breast cancer metastasis, and suggest that restoring miR-193a expression is a therapeutic strategy in breast cancer.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0185565PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5634539PMC
October 2017

[Experimental research of neutrophil gelatinase-associated lipocalin siRNA encapsulated by urocanic acid-coupled chitosan on colon cancer cells].

Zhonghua Wei Chang Wai Ke Za Zhi 2017 Jun;20(6):694-700

Department of Coloproctology, The Third Peoples' Hospital of Hangzhou, Hangzhou 310009, China.

Objective: To explore the impact of neutrophil gelatinase-associated lipocalin (NGAL) knockdown by NGAL siRNA encapsulated with urocanic acid-modified chitosan nanoparticles (UAC) on the proliferation, migration and apoptosis of human colon cancer cells.

Methods: NGAL siRNA was encapsulated by UAC and chitosan (CTS) respectively, and then was transfected into human colon cancer cell lines HT29. The NGAL mRNA was detected by real-time quantitative PCR (RT-QPCR). Relationships of NGAL gene silencing with the proliferation, migration and apoptosis of HT29 cell were analyzed.

Results: Under the fluorescence microscope, the transfection efficiency of siRNA in UAC group was (37.52±7.17)%, which was significantly higher than (11.32±3.39)% in CTS group (t=6.102, P=0.005). Forty-eight hours after transfection, RT-QPCR examination showed that the level of NGAL mRNA expression was 0.350 in UAC group and 0.529 in CTS group with significant difference (t=-3.743, P=0.02), meanwhile both levels were significantly lower as compared to control group(F=163.538, P<0.001). Proliferation analysis revealed that after silencing NGAL gene, proliferation rate of UAC group and CTS group was slightly lower than control group, and no significant differences were found (F=9.520, P=0.438). However, migration assay demonstrated that the 24-hour migration rate of UAC group and CTS group was significantly lower than that of control group (F=6.756, P=0.029), meanwhile the migration rate of UAC group was slightly lower than that of CTS group [(77.90±7.14)% vs. (87.67±3.98)%, t=-1.704, P=0.164]. Apoptosis detection revealed that the apoptosis rate in UAC group was significantly higher than that in CTS group and the control group 2 days after transfection [(15.800±1.054)% vs. (12.900±0.656)%, (11.933±1.914)%, F=7.004, P=0.027].

Conclusions: The encapsulated ability and transfection efficiency of chitosan modified by urocanic acid elevate significantly. Silencing NGAL gene by UAC carrier can down-regulate the expression of NGAL mRNA in HT29 colon cell line, inhibit their migration and facilitate their apoptosis.
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June 2017

Early short-term intensive multidisciplinary diabetes care: A ten-year follow-up of outcomes.

Diabetes Res Clin Pract 2017 Aug 2;130:133-141. Epub 2017 Jun 2.

Division of Endocrinology and Metabolism, Department of Internal Medicine, Paochien Hospital, Ping Tung, Taiwan. Electronic address:

Objectives: To evaluate the outcome of an early short-term intensive diabetic care program followed by a regular out-patient shared-care education program.

Methods: We retrospectively reviewed the medical charts of 196 patients newly diagnosed with type 2 diabetes mellitus (DM) who were admitted to the hospital for intensive multidisciplinary interventions. For comparison, we also enrolled 206 patients with type 2 DM newly diagnosed but not receiving short-term intensive program. Both groups all attended an out-patient shared-care education program for more than one year. Outcome measure included average and standard deviation (SD) of glycated hemoglobin (HbA1c) over ten years, serum creatinine (Cr), lipid profile, urine albumin/Cr (UACR), and chronic diabetic complications after 10years later. The Kaplan-Meier event happening rates were used to compare the event rate of two samples. Multivariate Cox proportional-hazards models were used to investigate the influence of different variables on chronic complications.

Results: Patients who received short-term intensive diabetic education had less SD of HbA1cs: (0.7±0.7% vs. 1.0±0.8% (5.3±5.3mmol/mol vs 9.2±6.4mmol/mol), p<0.001), less new-onset coronary heart disease (CHD) (8.2% vs. 13.7%, p=0.005), lower serum Cr (1.4±0.7mg/dL vs. 1.5±0.9mg/dL, p=0.005), less progression of nephropathy was also revealed (13.5% vs. 21.2%, p=0.009) and lower UACR (4.7±1.4mg/g vs. 5.3±1.0mg/g, p<0.001). There were no group differences in age, gender distribution, average HbA1c, lipid profile, and new-onset of neuropathy and retinopathy. The independent predictors of CHD and nephropathy were short-term intensive diabetic education and SD of HbA1cs.

Conclusion: Initiation of earlier intensive short-term multidisciplinary interventions in patients with newly diagnosed DM may decrease coronary heart disease and nephropathy. These better outcomes may be related to less fluctuation in blood glucose levels.
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http://dx.doi.org/10.1016/j.diabres.2017.05.022DOI Listing
August 2017

A soft stretchable bending sensor and data glove applications.

Robotics Biomim 2016 1;3(1):22. Epub 2016 Dec 1.

Department of Mechanical Engineering, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR China ; HKU Shenzhen Institute of Research and Innovation, Shenzhen, China.

Soft sensors are required to accommodate the flexible and deformable natures of the human body in wearable device applications. They are also suitable for integration with soft robotic devices to monitor the performance status and provide references for feedback control. However, the choices for bending sensors are still highly limited. In this paper, a soft bending sensor is presented. By careful design with a blend of sensitive and insensitive regions, the sensor could be stretchable while being insensitive to stretching. An analytical study was presented on how to design the sensor with the named bending/stretching feature. This feature enables the sensor to be implemented in measuring human motions where a large amount of skin stretch is involved. Two sensor gloves were designed and fabricated based on the proposed soft bending sensor, aiming for different application scenarios. Both the sensor and the gloves were evaluated using a dedicated evaluation platform with experimental results compared against each other.
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http://dx.doi.org/10.1186/s40638-016-0051-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5133288PMC
December 2016

Heme oxygenase-1-transduced bone marrow mesenchymal stem cells in reducing acute rejection and improving small bowel transplantation outcomes in rats.

Stem Cell Res Ther 2016 11 20;7(1):164. Epub 2016 Nov 20.

Department of Organ Transplantation, Tianjin First Central Hospital, 24# Fukang Road, Nankai District, Tianjin, 300192, People's Republic of China.

Background: We determined whether bone marrow mesenchymal stem cells (BMMSCs) transduced with heme oxygenase-1 (HO-1), a cytoprotective and immune-protective factor, could improve outcomes for small bowel transplantation (SBTx) in rats.

Methods: We performed heterotopic SBTx from Brown Norway rats to Lewis rats, before infusing Ad/HO-1-transduced BMMSCs (Ad/HO-1/BMMSCs) through the superficial dorsal veins of the penis. Respective infusions with Ad/BMMSCs, BMMSCs, and normal saline served as controls. The animals were sacrificed after 1, 5, 7, or 10 days. At each time point, we measured small bowel histology and apoptosis, HO-1 protein and mRNA expression, natural killer (NK) cell activity, cytokine concentrations in serum and intestinal graft, and levels of regulatory T (Treg) cells.

Results: The saline-treated control group showed aggravated acute cellular rejection over time, with mucosal destruction, increased apoptosis, NK cell activation, and upregulation of proinflammatory and immune-related mediators. Both the Ad/BMMSC-treated group and the BMMSC-treated group exhibited attenuated acute cellular rejection at an early stage, but the effects receded 7 days after transplantation. Strikingly, the Ad/HO-1/BMMSC-treated group demonstrated significantly attenuated acute cellular rejection, reduced apoptosis and NK cell activity, and suppressed concentrations of inflammation and immune-related cytokines, and upregulated expression of anti-inflammatory cytokine mediators and increased Treg cell levels.

Conclusion: Our data suggest that Ad/HO-1-transduced BMMSCs have a reinforced effect on reducing acute rejection and protecting the outcome of SBTx in rats.
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http://dx.doi.org/10.1186/s13287-016-0427-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5116370PMC
November 2016

The Impact of Normal Range of Serum Phosphorus on the Incidence of End-Stage Renal Disease by A Propensity Score Analysis.

PLoS One 2016 28;11(4):e0154469. Epub 2016 Apr 28.

Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.

Background: Although hyperphosphatemia is deemed a risk factor of the progression of chronic kidney disease (CKD), it remains unclear whether the normal range of serum phosphorus likewise deteriorates CKD. A propensity score analysis was applied to examine the causal effect of the normal range of serum phosphorus on the incidence of end-stage renal disease (ESRD).

Methods: A retrospective CKD cohort of 803 participants in a single institution was analyzed. Propensity score was estimated using 22 baseline covariates by multivariate binary logistic regression for the different thresholds of time-averaged phosphorus (TA-P) in the normal range of serum phosphorus incremented by 0.1 mg/dL from 3.3 to 4.5 mg/dL.

Results: The incidence rate of ESRD was 33.9 per 1,000 person-years over median follow-up of 4.3 years. Total patients showed the mean baseline phosphorus of 3.37 mg/dL and were divided to quartile. The higher quartile was associated with the parameters consistent with the advancement of CKD. A stratified Cox regression showed the highest hazard ratio (HR) at TA-P 3.4 mg/dL (HR 17.60, 95% CI 3.92-78.98) adjusted for baseline covariates such as sex, age, diabetic nephropathy, estimated GFR, serum albumin, Na-Cl, phosphorus, LDL-C and proteinuria. Adjusted HRs remained high up to TA-P 4.2 mg/dL (HR 2.22, 95% CI 1.33-3.71). After propensity score matching conducted at the thresholds of TA-P 3.4, 3.6, 3.8 and 4.0 mg/dL, the higher levels of TA-P showed the higher HRs by Kaplan-Meier analysis (p < 0.05 by stratified log-rank test). The numbers needed to treat were calculated as 3.9 to 5.3 over 5 years.

Conclusions: The propensity score analysis shows that even the normal range of serum phosphorus clearly accelerates CKD progression to ESRD. Our results encourage clinicians to target serum phosphorus to inhibit CKD progression in the manner of 'the lower the better.'
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0154469PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4849666PMC
March 2017
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