Publications by authors named "Zhijun Zhu"

60 Publications

Assessment of breast arteries and lymph nodes by 3D MR angiography enhancement imaging: feasibility and pilot clinical results.

BMC Med Imaging 2021 Jun 7;21(1):97. Epub 2021 Jun 7.

Shenzhen Institute of Advanced Technology, Chinese Academy of Science, 1068 Xueyuan Avenue, Shenzhen, 518055, People's Republic of China.

Background: Conventional dynamic contrast enhanced (DCE) magnetic resonance (MR) hardly achieves a good imaging performance of arteries and lymph nodes in the breast area. Therefore, a new imaging method is needed for the assessment of breast arteries and lymph nodes.

Methods: We performed prospective research. The research included 52 patients aged from 25 to 64 between June 2019 and April 2020. The isotropic e-THRIVE sequence scanned in the coronal direction after DCE-THRIVE. Reconstructed images obtained by DCE-THRIVE and the coronal e-THRIVE were compared mainly in terms of the completeness of the lateral thoracic artery, thoracodorsal artery, and lymph nodes. We proposed a criterion for evaluating image quality. According to the criterion, images were assigned a score from 1 to 5 according to the grade from low to high. Two board-certified doctors evaluated images individually, and their average score was taken as the final result. The chi-square test was used to assess the difference.

Results: The coronal e-THRIVE score is 4.60, which is higher than the DCE-THRIVE score of 3.48, there are significant differences between the images obtained by two sequences (P = 1.2712e-8). According to the score of images, 44 patients (84.61%) had high-quality images on the bilateral breast. Only 3 patients' (5.77%) images were not ideal on both sides. The improved method is effective for most patients to get better images.

Conclusions: The proposed coronal e-THRIVE scan can get higher quality reconstruction images than the conventional method to visualize the course of arteries and the distribution of lymph nodes in most patients, which will be helpful for the clinical follow-up treatment.
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http://dx.doi.org/10.1186/s12880-021-00629-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8185933PMC
June 2021

MicroRNA let-7i-3p affects osteoblast differentiation in ankylosing spondylitis via targeting PDK1.

Cell Cycle 2021 May 28:1-11. Epub 2021 May 28.

Department of Orthopedics, The Affiliated People's Hospital of Jiangsu University, Zhenjiang, China.

Ankylosing spondylitis (AS) is a chronic autoimmune disease in which let-7i has been studied to involved. But, whether let-7i-3p could regulate osteoblast differentiation in AS remains unclear. This research targeted to decipher the impact of let-7i-3p on AS progression by modulating pyruvate dehydrogenase kinase 1 (PDK1). The bone mineral density of femur and lumbar vertebra and the maximum loading and bending elastic modulus of tibia, tumor necrosis factor-α (TNF-α), matrix metalloproteinase (MMP)-3, osteoprotegerin (OPG) and receptor activator of nuclear factor-κB ligand (RANKL) in serum of AS mice, the pathological condition of synovial tissue were determined via let-7i-3p inhibitor and OE-PDK1 in animal experiment. Also, the cell viability and ALP activity were measured by let-7i-3p inhibitor and OE-PDK1 in cell experiments. let-7i-3p and PDK1 expression were detected. Let-7i-3p raised and PDK1 declined in AS mice. Depleted let-7i-3p and restored PDK1 increased bone mineral density and maximum loading and bending elastic modulus of tibia, reduced TNF-α, MMP-3 and RANKL contents, attenuated the pathological condition of synovial tissue and raised OPG content in AS mice. In cell experiments, up-regulating PDK1 and down-regulating let-7i-3p enhanced cell viability and ALP activity in AS mice. Low expression of let-7i-3p could enhance osteoblast differentiation in AS by up-regulating PDK1.
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http://dx.doi.org/10.1080/15384101.2021.1930680DOI Listing
May 2021

Efficient organic mulch thickness for soil and water conservation in urban areas.

Sci Rep 2021 Mar 18;11(1):6259. Epub 2021 Mar 18.

Quzhou Municipal Water Resources Bureau, Quzhou, China.

The use of organic mulch is important for urban green applications. For urban areas in arid and semiarid regions receiving short high-intensive rainfall, rainfall characteristics, and soil slope play an important role for mulch functioning. These properties of mulch were studied. For this purpose, rainfall simulation experiments using organic mulching were conducted in Jiufeng National Forestry Park to analyze the influence of organic mulch under different slope and heavy rainfall events. The results showed that soil water content displayed a decreasing tendency with increasing mulch application. Compared to bare soil, a mulch application of 0.25 kg/m and 0.50 kg/m led to maximum soil water content and maximum runoff decrease occurred for 0.50 kg/m mulch. Higher application rate of mulch displayed less soil water content and greater runoff. The runoff amount and runoff generation rate decreased by 28-83% and 21-83%, respectively, as compared to bare soil. With a mulch application of 0.25-1.00 kg/m, soil drainage accounted for 56-60% of total rainfall. Overall, an efficient mulch application was found to be 0.25-0.50 kg/m. The results of this study are relevant for arid and semiarid urban regions that experience heavy rainfall.
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http://dx.doi.org/10.1038/s41598-021-85343-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7973797PMC
March 2021

Mycophenolate mofetil enhances the effects of tacrolimus on the inhibitory function of regulatory T cells in patients after liver transplantation via PD-1 and TIGIT receptors.

Immunopharmacol Immunotoxicol 2021 Apr 3;43(2):239-246. Epub 2021 Mar 3.

Department of Hepatobiliary Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China.

Objective: Regulatory T cells (Tregs) induce immune tolerance in patients after organ transplantation. Various immunosuppressors can affect Tregs function through different mechanisms. PD-1 and TIGIT are important receptors on Tregs surface. Here, we investigated the effects of Tacrolimus and mycophenolate mofetil (MMF) on the inhibitory function of Tregs and explored the regulatory mechanism in patients after liver transplantation.

Methods: Thirty patients that underwent a liver transplant and 15 healthy people were enrolled. Fifteen patients received Tacrolimus only, and 15 received a combination of Tacrolimus and MMF. Tregs and effector T cells (Teffs) were isolated using magnetic beads and were mixed at different ratios of 0:1, 1:4, 1:2 and 1:1. An inhibition assay was performed by adding anti-PD-1 and anti-TIGIT when the mixture ratio was 1:1. The Tregs inhibition rate was determined and the levels of IFN-γ and TNF-α were measured.

Results: As the ratios of Tregs to Teffs in the mixture increased, the Tregs inhibition rate increased and the levels of IFN-γ and TNF-α decreased. At each mixture ratio, Tacrolimus + MMF group had the highest Tregs inhibition rate compared to Tacrolimus and control group. At the specific mixture ratio of 1:1, the addition of both anti- PD-1 and anti-TIGIT led to lower Tregs inhibition rate and higher IFN-γ and TNF-α levels in all three groups as opposed to the addition of each antibody separately. Additionally, both the decrease in the Tregs inhibition rate and the increase in the IFN-γ and TNF-α levels were the most for Tacrolimus + MMF group among all cases, either adding antibodies alone or mixed.

Conclusion: Tacrolimus and MMF enhanced the function of Tregs by synergistically affecting PD-1 and TIGIT in liver transplant patients.
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http://dx.doi.org/10.1080/08923973.2021.1891247DOI Listing
April 2021

Intermedin facilitates hepatocellular carcinoma cell survival and invasion via ERK1/2-EGR1/DDIT3 signaling cascade.

Sci Rep 2021 01 12;11(1):488. Epub 2021 Jan 12.

Department of Critical Care Medicine, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, No. 1, Ke Yuan 4th Road, Gao Peng Street, Chengdu, 610041, Sichuan, People's Republic of China.

As one of the most malignant cancer types, hepatocellular carcinoma (HCC) is highly invasive and capable of metastasizing to distant organs. Intermedin (IMD), an endogenous peptide belonging to the calcitonin family, has been suggested playing important roles in cancer cell survival and invasion, including in HCC. However, how IMD affects the behavior of HCC cells and the underlying mechanisms have not been fully elucidated. Here, we show that IMD maintains an important homeostatic state by activating the ERK1/2-EGR1 (early growth response 1) signaling cascade, through which HCC cells acquire a highly invasive ability via significantly enhanced filopodia formation. The inhibition of IMD blocks the phosphorylation of ERK1/2, resulting in EGR1 downregulation and endoplasmic reticulum stress (ER) stress, which is evidenced by the upregulation of ER stress marker DDIT3 (DNA damage-inducible transcript 3). The high level of DDIT3 induces HCC cells into an ER-stress related apoptotic pathway. Along with our previous finding that IMD plays critical roles in the vascular remodeling process that improves tumor blood perfusion, IMD may facilitate the acquisition of increased invasive abilities and a survival benefit by HCC cells, and it is easier for HCC cells to obtain blood supply via the vascular remodeling activities of IMD. According to these results, blockade of IMD activity may have therapeutic potential in the treatment of HCC.
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http://dx.doi.org/10.1038/s41598-020-80066-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7803743PMC
January 2021

Post-transplant Lymphoproliferative Disorder in Recipient's Reconstructed Middle Hepatic Vein After Pediatric Living Donor Liver Transplant: A Case Report.

Transplant Proc 2021 May 25;53(4):1308-1312. Epub 2020 Dec 25.

Department of Liver Transplantation, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Background: Post-transplant lymphoproliferative disorder (PTLD) is known as one of the most frequent post-transplant neoplastic diseases, which may lead to recipient and graft morbidity after liver transplant.

Patient: A 14-year-old boy received pediatric living donor liver transplant (right living graft) 29 months ago, with etiology of biliary atresia. During 22-month follow-up after transplant, computed tomography and positron emission tomography with computed tomography scan showed a single progressive mass locating in the graft cutting surface with occlusive reconstructed middle hepatic vein (MHV). Serology was negative for Epstein-Barr virus serology. Mild fever and pneumonia did not improve after 1-week intravenous antibiotics. PTLD was considered.

Results: A surgical resection was scheduled and performed in compliance with the Helsinki Congress and the Istanbul Declaration. During laparotomy, a single mass located in the reconstructed MHV from segment V to the inferior vena cava was confirmed. Postoperative immunohistochemical result showed CD 3(+), CD 20(+), CD 38(+), CD 10(-), CD 56(-), Ki-67(+, 20%-30%), Epstein-Barr virus-encoded RNA(-), and Epstein-Barr virus nuclear antigen 2(-). Polymorphic PTLD was eventually diagnosed. No recurrence or new set lesions were detected after 6-month follow-up.

Conclusions: This is the first case describing PTLD may originate from reconstructed MHV after pediatric living donor liver transplant. As a life-threatening complication of liver transplant, surgical resection should be considered as a safe and feasible treatment for the single resectable mass.
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http://dx.doi.org/10.1016/j.transproceed.2020.10.045DOI Listing
May 2021

Improved Transcatheter aortic valve implantation for aortic regurgitation using a new-type stent: the first preclinical experience.

J Cardiothorac Surg 2020 Sep 29;15(1):276. Epub 2020 Sep 29.

Department of Cardiology, The 903 Hospital of the Chinese People's Liberation Army, No. 40 JiChang Road, Jianggang District, Hangzhou, 310004, Zhejiang Province, China.

Background: In this study, we sought to evaluate the feasibility of improved transcatheter aortic valve implantation (TAVI) in noncalcified aortic valve by using the novel concept of double-layer ChenValve prosthesis. TAVI was initially considered as an alternative treatment for high-risk patients with aortic stenosis. However, non noncalcified aortic valve disease was considered as a contraindication to TAVI.

Methods: ChenValve prosthesis, which consisted of a self-expanding Nitinol ring, a balloon-expandable cobalt-chromium alloy stent and a biological valve, was implanted at the desired position under fluoroscopic guidance in a transapical approach through a 20F sheath in 10 goats. Aortic angiography was performed to measure the diameter of the aotic annulus and assess the performance of the artificial valve. The ultrasound was used to evaluate the regurgitation or paravalvular leakage and trans-prosthetic vascular flow velocity postoperatively. The aortogram and transthoracic echocardiography were applied to observe whether the valve stent was implanted at the desired position.

Results: ChenValve prosthesis was successfully transppical implanted in all animals. The aortogram and transthoracic echocardiography performed immediately after implantation revealed that the valve stent was implanted at the desired position. There was no significant paravalvular leakage, obstruction of coronary artery ostia, stent malpositioning or dislodgement occurred.

Conclusions: This preliminary trial with the novel double-layer ChenValve prosthesis demonstrated the feasibility of improved TAVI in noncalcified aortic valve. The mechanism of Nitinol ring-guided locating the aortic sinus enables us to anatomically correct position the artifact valve. This improved strategy seems to make the TAVI process more safe and repeatable in noncalcified aortic valve.
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http://dx.doi.org/10.1186/s13019-020-01327-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7525934PMC
September 2020

MicroRNA‑92a promotes non‑small cell lung cancer cell growth by targeting tumor suppressor gene FBXW7.

Mol Med Rep 2020 Oct 28;22(4):2817-2825. Epub 2020 Jul 28.

Department of Thoracic Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 201999, P.R. China.

MicroRNA (miRNA/miR)‑92a has been identified as being significantly downregulated in non‑small cell lung cancer (NSCLC) tissues using a miRNA array. However, its biological function and molecular mechanisms in NSCLC have not been fully elucidated. The aim of the present study was to determine the role of miR‑92a in NSCLC and the mechanisms by which it affects NSCLC cells. The expression levels of miR‑92a in NSCLC tissues and cell lines were analyzed using reverse transcription‑quantitative PCR. Cell viability and cell apoptosis were determined using an MTT assay and flow cytometry, respectively. It was observed that miR‑92a was significantly upregulated in NSCLC tissues and cell lines. Inhibition of miR‑92a significantly suppressed viability of NSCLC cells, with concomitant downregulation of key proliferative genes, such as proliferating cell nuclear antigen and Ki‑67. miR‑92a downregulation induced apoptosis of NSCLC cells, as evidenced by flow cytometry and apoptosis‑related protein detection. Luciferase assays confirmed that miR‑92a could directly bind to the 3'‑untranslated region of tumor suppressor F‑box/WD repeat‑containing protein 7 (FBXW7) and suppress its translation. Furthermore, small interfering RNA‑mediated FBXW7 inhibition partially attenuated the tumor suppressive effect of an miR‑92a inhibitor on NSCLC cells. Collectively, these findings demonstrated that miR‑92a might function as an oncogene in NSCLC by regulating FBXW7. In conclusion, miR‑92a could serve as a potential therapeutic target in NSCLC treatment.
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http://dx.doi.org/10.3892/mmr.2020.11373DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7453619PMC
October 2020

FoxA2 inhibits the proliferation of hepatic progenitor cells by reducing PI3K/Akt/HK2-mediated glycolysis.

J Cell Physiol 2020 12 4;235(12):9524-9537. Epub 2020 Jun 4.

Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

FoxA2 is an essential transcription factor for liver organogenesis and homeostasis. Although reduced expression of FoxA2 has been associated with chronic liver diseases, hepatic progenitor cells (HPCs) that are activated in these circumstances express FoxA2. However, the functional effects and underlying mechanism of FoxA2 in HPCs are still unknown. As revealed by immunostaining, HPCs expressed FoxA2 in human cirrhotic livers and in the livers of choline-deficient diet supplemented with ethionine (CDE) rats. Knocking down FoxA2 in HPCs isolated from CDE rats significantly increased cell proliferation and aerobic glycolysis. Moreover, gene transcription, protein expression, and the enzyme activities of hexokinase 2 (HK2) were upregulated, and blocking HK2 activities via 2-deoxyglucose markedly reduced cell proliferation and aerobic glycolysis. Kyoto Encyclopedia of Genes and Genomes analysis revealed that FoxA2 knockdown enhanced the transcription of genes involved in the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) pathway and triggered downstream Akt phosphorylation. Blocking the PI3K/Akt pathway by Ly294002 inhibited HK2 activities, aerobic glycolysis, and cell proliferation in FoxA2-knockdown cells. Therefore, FoxA2 plays an important role in the proliferation and inhibition of HPCs by suppressing PI3K/Akt/HK2-regulated aerobic glycolysis.
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http://dx.doi.org/10.1002/jcp.29759DOI Listing
December 2020

Laparoscopic Left Lateral Monosegmentectomy in Pediatric Living Donor Liver Transplantation Using Real-Time ICG Fluorescence In Situ Reduction.

J Gastrointest Surg 2020 09 12;24(9):2185-2186. Epub 2020 May 12.

Department of Liver Transplantation, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.

Background: Nowadays, laparoscopic left lateral sectionectomy has been acknowledged as a standard practice in pediatric living donor liver transplantation (PLDLT). We here report the first case of laparoscopic left lateral monosegmentectomy (L-LLM) in PLDLT using real-time ICG fluorescence in situ reduction in China.

Method: A 35-year-old father volunteered for living donation to his daughter who diagnosed with liver cirrhosis and portal hypertension after Kasai operation due to biliary atresia. Preoperative liver function was normal. Liver dynamic CT showed a left lateral graft volume of 387.5cm with a graft to recipient weight ratio (GRWR) of 4.45%. Ratio of the maximum thickness of the left lateral segment to the anteroposterior diameter of the recipient's abdominal cavity was 1.09. The estimated segment II volume was 245.3cm and GRWR was 2.82%. L-LLM was scheduled. No anatomic variation was seen.

Results: The transection was divided into two stages. Stage I: Separating the left lateral section along the right side of sickle ligament. Stage II: Anatomic in situ reduction of segment III by using real-time ICG fluorescence. The left bile duct was transected above the bifurcation by ICG fluorescence cholangiography. The total operation time was 200 min without transfusion. The final graft weight was 225.2 g with GRWR of 2.59%. The donor was discharged uneventfully on postoperative day 4, while the graft function recovered to normal in recipient without any graft-related complication.

Conclusion: L-LLM with in situ reduction is feasible in PLDLT by using real-time ICG fluorescence in experienced transplant center.
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http://dx.doi.org/10.1007/s11605-020-04534-5DOI Listing
September 2020

Biliary atresia in twins'population: a retrospective multicenter study in mainland China.

Pediatr Surg Int 2020 Jun 4;36(6):711-718. Epub 2020 May 4.

Department of General Surgery, Tianjin Children's Hospital, LongYan Road 238, Beichen District, Tianjin, 300134, China.

Aim: We evaluated the demographic of biliary atresia (BA) children from twins family and aimed to investigated what it can add to the twins' literature and our understanding of the disease.

Methods: This study contains 11 medical centers in mainland China and the medical record of twins with BA was retrospectively analyzed from January 2012 to December 2018. Follow-up was carried out by out-patient review and questionnaire.

Results: The study included 19 twin pairs in whom there was discordance for BA. Sixteen (84.2%) affected twin underwent Kasai Procedure (KP); median age at KP was 78 (49-168) days. There were ten affected twins that became jaundice-free at 3 months post-KP, and eight occurred with different degrees of cholangitis post-KP. Six affected twins received Liver Transplantation (LT) successfully. The 2 year native liver survival rate and the 2 year overall survival rate of affected twins were 61.1 and 94.4%, respectively. There were three affected monozygotic (MZ) twins and one healthy co-twin with BA-associated congenital malformations, all of which were cardiac malformations. The number of virus infection of affected MZ twins was significantly more (p = 0.04) than affected dizygotic (DZ) twin.

Conclusions: Discordance for BA in 19 pairs of twins supported that BA may be related to genetic phenotype or penetrance. The difference in genetic background between MZ and DZ affects the susceptibility of the host to virus infection. High acceptance of KP (84.2%) in our study implied a high motivation for treatment for twins with BA. Delays of KP (78 days) in affected twin may be related to the postnatal gradual onset and the late diagnosis.
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http://dx.doi.org/10.1007/s00383-020-04662-8DOI Listing
June 2020

Management of COVID-19 in patients after liver transplantation: Beijing working party for liver transplantation.

Hepatol Int 2020 Jul 10;14(4):432-436. Epub 2020 Apr 10.

Liver Transplantation Center, The Fifth Medical Center of Chinese PLA General Hospital, 100 West 4th Ring Middle Road, Beijing, 100039, China.

Annually, around 850 liver transplantation is performed in Beijing, China. Recently, the new coronavirus pneumonia (COVID-19) caused by 2019 novel coronavirus (2019-nCoV) has affected nearly 200 countries worldwide. 2019-nCov can cause severe lung disease, multiple-organ damage, and significant mortalities. Liver transplant recipients, because of long-term oral immunosuppressant effects, may be more susceptible to 2019-nCoV infection and have a worse prognosis than the general population. It is urgent to set up guidelines for the prevention, diagnosis, and treatment of COVID-19 in liver transplant recipients. In this article, we reviewed the clinical aspects of 2019-nCoV infection, characteristics of liver transplant recipients, immunosuppressant usage, and potential drug interactions to provide recommendations to clinical staff managing liver transplant recipients during the COVID-19 epidemic.
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http://dx.doi.org/10.1007/s12072-020-10043-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7146012PMC
July 2020

Sequencing data of cell-free DNA fragments in living-related liver transplantation for inborn errors of metabolism.

Data Brief 2020 Apr 25;29:105183. Epub 2020 Jan 25.

Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, China.

Graft derived cell-free DNA was recently reported as a non-invasive biomarker to detect graft damage or rejection after liver transplantation. There are a number of methods for quantification of Gcf-DNA, including quantitative-PCR, digital droplet PCR and massively parallel sequencing (next generation sequencing). Here we present the NGS data and fragment size distribution of cell-free DNA in the plasma of patients with inborn errors of metabolism who underwent living-related liver transplantation. For more insights please see Analysis of fragment size distribution of cell-free DNA: a potential noninvasive marker to monitor graft damage in living-related liver transplantation for inborn errors of metabolism. [1].
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http://dx.doi.org/10.1016/j.dib.2020.105183DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7013363PMC
April 2020

Self-Driven Multicolor Electrochromic Energy Storage Windows Powered by a "Perpetual" Rechargeable Battery.

ACS Appl Mater Interfaces 2019 Dec 11;11(51):48013-48020. Epub 2019 Dec 11.

School of Mechanical and Materials Engineering , Washington State University , Pullman , Washington 99164 , United States.

Electrochromic windows (ECWs) become an appealing concept for green buildings. However, conventional ECWs need external biases to operate causing energy consumption and are usually restricted by monotonous color. Recently, electrochromic energy storage windows (EESWs) integrating the functions of electrochromism and energy storage in one device have attracted particular attention in various fields, such as self-powered addressable displays, human-readable batteries, and most importantly energy-efficient smart windows. Herein, a color-tunable (nonemissive-red-yellow-green) self-powered EESW is initially presented utilizing Prussian blue (PB) as a controller of the fluorescent component of CdSe quantum dots. The key design feature is that without any external stimuli, the EESW can be powered by a rechargeable "perpetual" battery, which is composed of two half-cell couples of Fe/PB and Prussian white (PW)/Pt. This technique allows to achieve only by switching the connection status of the two half-cells, the fast discharging and self-charging process of the EESWs with high and sustainable charge-storage capacity. Remarkably, the fabricated self-powered EESWs exhibit quick response ("off" 7 s, "on" 50 s), large transmittance spectra contrast, and high fluorescent contrast modulation (60-86%) over a wide optical range, and great reproducibility (only 3% of the modulation ratio decreased after 30 cycles), which is comparable to ECWs powered by an electrochemical potentiostat.
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http://dx.doi.org/10.1021/acsami.9b14526DOI Listing
December 2019

A study on a cohort of 301 Chinese patients with isolated methylmalonic acidemia.

J Inherit Metab Dis 2020 05 26;43(3):409-423. Epub 2019 Nov 26.

Department of Pediatrics, Peking University First Hospital, Beijing, China.

Methylmalonic acidemia (MMA) is the most common organic acidemia in China. This study aimed to characterise the genotypic and phenotypic variabilities, and the molecular epidemiology of Chinese patients with isolated MMA. Patients (n = 301) with isolated MMA were diagnosed by clinical examination, biochemical assays, and genetic analysis. Fifty-eight patients (19.3%) were detected by newborn screening and 243 patients (80.7%) were clinically diagnosed after onset. Clinical onset ranged from the age of 3 days to 23 years (mean age = 1.01 ± 0.15 years). Among 234 MMA patients whose detailed clinical data were available, 170 (72.6%) had early onset disease (before the age of 1 year), and 64 (27.4%) had late-onset disease. The 234 MMA patients manifested with neuropsychiatric impairment (65.4%), haematological abnormality (31.6%), renal damage (8.5%), and metabolic crises (67.1%). Haematological abnormality was significantly more common in early-onset patients than that in late-onset patients. The incidence of metabolic crises was significantly high (P < 0.001) in patients with mut type than those with other types of isolated MMA. Variations (n = 122) were identified in MMUT, MMAA, MMAB, MMADHC, SUCLG1, and SUCLA2, of which 45 were novel. c.729_730insTT was the most frequent MMUT mutation, with a significantly higher frequency in our patients than that in 151 reported European patients. The frequency of c.914T>C in MMUT in our cohort was also higher than that in 151 European patients. MMUT mutations c.729_730insTT and c.914T>C are specific for the Chinese population. Our study expanded the spectrum of phenotypes and genotypes in isolated MMA.
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http://dx.doi.org/10.1002/jimd.12183DOI Listing
May 2020

Hydrothermal synthesis of polydopamine-functionalized cobalt-doped lanthanum nickelate perovskite nanorods for efficient water oxidation in alkaline solution.

Nanoscale 2019 Nov 17;11(41):19579-19585. Epub 2019 Oct 17.

State Key Laboratory of Electroanalytical Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, Jilin 130022, China.

Perovskite oxides have attracted great attention recently for their low cost and high intrinsic activity in the electrochemical oxygen evolution reaction (OER). In this work, we synthesized highly efficient OER electrocatalysts in alkaline solution by carbonization of polydopamine (PDA)-functionalized cobalt-doped lanthanum nickelate perovskite nanorod (LaNiCo) complexes. The calcination temperature and molar ratio for La, Ni, and Co were optimized. The as-prepared complex with a molar ratio of 5 : 3 : 2 (La : Ni : Co) and a calcination temperature of 500 °C displayed enhanced OER activity and excellent durability. In 1.0 M KOH, the overpotential of the as-prepared catalyst at a current density of 10 mA cm was 0.360 V, which is comparable to those of noble metal-based materials or perovskite-based materials. The Tafel slope is 48.1 mV dec, which is smaller than those of prepared composites. The satisfactory oxygen evolution activity could be attributed to the increased CoO, O/O, pyridine N, and quaternary N species after calcination treatment, and the improved amount of Ni during the OER process, as well as the high surface area and electrochemical surface area.
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http://dx.doi.org/10.1039/c9nr06519aDOI Listing
November 2019

Multiscale porous Fe-N-C networks as highly efficient catalysts for the oxygen reduction reaction.

Nanoscale 2019 Nov 25;11(41):19506-19511. Epub 2019 Sep 25.

College of Chemistry, Central China Normal University, Wuhan, 430079, P. R. China.

Non-Pt catalysts with excellent performance regarding the oxygen reduction reaction (ORR) have aroused enormous interest in recent years. Herein, we propose a dual-template method to synthesize a multiscale porous Fe-N-C (FeNC) catalyst. SiO and Zn are used as co-templates to produce a multiscale porous structure. Chitosan and glutaraldehyde are used as building blocks to fabricate the frameworks of the hydrogel. After lyophilization and annealing treatments, FeNC aerogel with a multiscale porous structure could be obtained. The as-prepared FeNC catalyst annealed at 900 °C (FeNC-900) exhibits a larger electrochemically active surface area and an improved ORR activity compared to FeNC annealed at other temperatures. FeNC-900 shows a superior ORR performance in comparison with that of commercial Pt/C in terms of the onset potential and half-wave potential, i.e., 0.959 and 0.837 V, which are 28 mV and 10 mV higher than those of Pt/C, respectively. Multiscale porosity is responsible for the outstanding ORR performance of FeNC-900. The electron transfer number of FeNC-900 for the ORR was calculated to be 3.95, which is comparable with that of Pt/C. In addition, the FeNC-900 catalyst possesses an excellent long-term duration and anti-poisoning capacity against methanol crossover. All these results endow the FeNC catalyst with tremendous potential for use in fuel cells.
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http://dx.doi.org/10.1039/c9nr05726aDOI Listing
November 2019

Reversible self-powered fluorescent electrochromic windows driven by perovskite solar cells.

Chem Commun (Camb) 2019 Oct;55(80):12060-12063

State Key Laboratory of Electroanalytical Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, Jilin 130022, China and University of Science and Technology of China, Hefei, Anhui 230026, China and University of Chinese Academy of Sciences, Beijing, 100039, China.

Self-powered electrofluorochromic devices (EFCDs) have attracted particular attention for smart windows of green buildings. In this work, we report a perovskite solar cell (PSC) driven self-powered EFCD. For the first time, electrochromic material polyoxometalates (POMs) and a fluorescent component are made into wet adhesives. A special design feature is that POMs and magnesium composed a battery powering the EFCD bleaching, and the device can be quickly coloured after connecting with the PSCs by the electrical power generated through solar energy conversion. Therefore, without any additional external bias, the fabricated EFCD undergoes an electrochromic transition from white semitransparent to dark blue-tinted, and under UV it presents reversible fluorescence switching between yellow and dark.
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http://dx.doi.org/10.1039/c9cc05779jDOI Listing
October 2019

Performance Evaluation of IGRA-ELISA and T-SPOT.TB for Diagnosing Tuberculosis Infection.

Clin Lab 2019 Aug;65(8)

Background: To explore the application value of IGRA-ELISA in the diagnosis of tuberculosis.

Methods: A total of 68 tuberculosis and 58 other pulmonary disease case samples were obtained. All the samples were tested by IGRA-ELISA and T-SPOT.TB assay in parallel. The consistency of IGRA-ELISA and T-SPOT.TB in the diagnosis of TB was analyzed. Five different methods for the diagnosis of TB were assayed: IGRA-ELISA, T-SPOT.TB, AFB staining, TB-Ab, and PPD. For the different PPD positive degrees, IGRA-ELISA and T-SPOT.TB positive rates were calculated. AFB staining positive and negative samples were analyzed by IGRA-ELISA, T-SPOT.TB, TB-Ab, and PPD. Positive rates, sensitivity, specificity, PPV, NPV and accuracy values of the five different detection methods were compared.

Results: There was good consistency between IGRA-ELISA and T-SPOT.TB in the diagnosis of TB and other pulmonary diseases. Compared with T-SPOT.TB, there was a significant correlation between the absorbance value of IGRA-ELISA and the number of ESAT-6 or CFP-10-specific SFCs (r = 0.902, p < 0.001; r = 0.901, p < 0.001). There was a significant difference in the positive rates among the above five different detection methods in the TB group and non-TB group (p < 0.001). For the different PPD positive degrees, there were highly significant differences in the positive rates of IGRA-ELISA and T-SPOT.TB in non-TB group; no similar trend was observed in the TB group. No significant differences in sensitivity, specificity, PPV, NPV, accuracy, LR+ and LR- were observed between IGRA-ELISA and T-SPOT.TB. The positive rates of IGRA-ELISA and T-SPOT.TB in the TB group were significantly higher than that of AFB staining, TB-Ab, and PPD (p < 0.05). IGRA-ELISA and T-SPOT.TB combined with AFB staining could further improve the sensitivity of tuberculosis detection without reducing its specificity. The AUC of IGRA-ELISA, ESAT-6, CFP-10, and T-SPOT.TB were 0.923, 0.893, 0.937, and 0.919, respectively.

Conclusions: There was good correlation and consistency between the IGRA-ELISA and T-SPOT.TB in the diagnosis of TB. The sensitivity and accuracy of IGRA-ELISA were significantly better than those of AFB staining, TB-Ab, and PPD. IGRA-ELISA combined with AFB staining could further improve the diagnosis of tuberculosis.
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http://dx.doi.org/10.7754/Clin.Lab.2019.181109DOI Listing
August 2019

Self-Rechargeable-Battery-Driven Device for Simultaneous Electrochromic Windows, ROS Biosensing, and Energy Storage.

ACS Appl Mater Interfaces 2019 Aug 26;11(31):28072-28077. Epub 2019 Jul 26.

State Key Laboratory of Electroanalytical Chemistry, Changchun Institute of Applied Chemistry , Chinese Academy of Sciences , Changchun , Jilin 130022 , China.

A self-powered electrochromic device (ECD) powered by a self-rechargeable battery is easily fabricated to achieve electrochromic window design, quantitative reactive oxygen species (ROS) sensing, and energy storage. The special design of the battery was composed of Prussian blue (PB) and magnesium metal as the cathode and anode, respectively, which exhibits fast self-charging and high power-density output for continuous and stable energy supply. Benefitting from the fast electrochromic response of PB, it was not only used for structuring self-rechargeable batteries but also used as an electrochromic display for highly sensitive self-powered ROS sensing and visual analysis. We believe that this work provides a solution to self-powered ECDs limited to a single application and could combine the applications in smart windows, ROS sensing, and other fields together, and in the meantime provide a solution for energy supply problems.
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http://dx.doi.org/10.1021/acsami.9b08715DOI Listing
August 2019

Prospective study on changes in the donor gallbladder contraction function after left lateral lobe hepatectomy.

Pediatr Transplant 2019 08 5;23(5):e13395. Epub 2019 Jun 5.

Liver Transplantation Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

This study aimed to evaluate the feasibility of donor gallbladder preservation in liver transplantation. Conventional removal of the donor gallbladder is applied in a majority of pediatric liver transplantation. A total of 42 donors who underwent gallbladder preservation in liver transplantation from October 2013 to December 2015 at the Beijing Friendship Hospital, China, were enrolled for the study. The changes in gallbladder volume and the gallbladder EF of donors before and after surgery were measured through ultrasound, and the changes in the donor gallbladder contraction function before and after surgery were evaluated to help verify the feasibility of gallbladder preservation in living donor left lateral lobe hepatectomy. The gallbladder emptying index dropped to 42.67% in 2 weeks after surgery and gradually increased with the length of recovery time, which could reach 69.14% in 3 months after surgery. At that time, 97.6% of the donors were considered to have recovered their gallbladder contraction function. The gallbladder contraction function at an early stage after gallbladder preservation in liver transplantation is not obviously improved, but it can recover to a normal level in 1 month after surgery, indicating that the gallbladder preservation in hepatectomy of living donor can effectively guarantee the gallbladder contraction function.
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http://dx.doi.org/10.1111/petr.13395DOI Listing
August 2019

Surface charge controlled nucleoli selective staining with nanoscale carbon dots.

PLoS One 2019 31;14(5):e0216230. Epub 2019 May 31.

Department of Chemical Engineering, Northeastern University, Boston, Massachusetts, United States of America.

Organelle selective imaging can reveal structural and functional characters of cells undergoing external stimuli, and is considered critical in revealing biological fundamentals, designing targeted delivery system, and screening potential drugs and therapeutics. This paper describes the nucleoli targeting ability of nanoscale carbon dots (including nanodiamond) that are hydrothermally made with controlled surface charges. The surface charges of carbon dots are controlled in the range of -17.9 to -2.84 mV by changing the molar ratio of two precursors, citric acid (CA) and ethylenediamine (EDA). All carbon dots samples show strong fluorescence under wide excitation wavelength, and samples with both negative and positve charges show strong fluorescent contrast from stained nucleoli. The nucleoli selective imaging of live cell has been confirmed with Hoechst staining and nucleoli specific staining (SYTO RNA-select green), and is explained as surface charge heterogeneity on carbon dots. Carbon dots with both negative and positive charges have better ability to penetrate cell and nucleus membranes, and the charge heterogeneity helps carbon dots to bind preferentially to nucleoli, where the electrostatic environment is favored.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0216230PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6544201PMC
January 2020

Analysis of fragment size distribution of cell-free DNA: A potential non-invasive marker to monitor graft damage in living-related liver transplantation for inborn errors of metabolism.

Mol Genet Metab 2019 05 14;127(1):45-50. Epub 2019 Mar 14.

Liver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China. Electronic address:

Graft-derived-cell-free DNA (Gcf-DNA) in plasma is a promising biomarker to monitor graft-rejection after liver transplantation (LTx). However, current methods of measuring Gcf-DNA have several limitations including high cost, long turnaround-time and the need to request donor's genetic information. In this study, eleven patients diagnosed with different inborn errors of metabolism (IEMs) who required living-related LTx were enrolled in order to establish a potentially useful noninvasive method to monitor graft damage. Circulating cell-free DNA (cfDNA) was extracted from plasma specimens serially collected at specific time points (day 0, day 1, day 7, day 14, day 30, day 60) after LTx. The distribution of Gcf-DNA fragment sizes was measured using sequencing read lengths and quantified by using Y-chromosome capture methodology in seven sex-mismatched recipients. In the analysis of fragment size distribution, we observed Gcf-DNA exhibited smaller fragment sizes than the recipient-cfDNA. Based on this phenomenon, two fragment sizes (105-145 bp, 160-170 bp) of the cfDNA pool were extracted to enrich Gcf-DNA. Accordingly, the ratio of short fragments to long fragments (S/L-Frag) in cfDNA was calculated. A high S/L-Frag ratio pointed towards an early trend of graft injury when compared to two routine liver function enzymes (ALT and AST) and Gcf-DNA, and it significantly correlated with ALT (P < 0.0001) and AST (P < 0.0001) during full-blown rejection. In conclusion, we established the Gcf-DNA size profile in patients who have undergone living-related LTx and established a potential biomarker to monitor graft function after LTx.
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http://dx.doi.org/10.1016/j.ymgme.2019.03.004DOI Listing
May 2019

Hepatic artery reconstruction with interposition of donor's right gastroepiploic artery graft in pediatric living donor liver transplantation for metabolic disease.

Pediatr Transplant 2019 06 23;23(4):e13418. Epub 2019 Apr 23.

Liver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Objective: We introduce the indications, technique, results of our experience using donor's RGEA as interposition vessel to solve hepatic artery reconstruction problems in P-LDLT.

Methods: A retrospective analysis of P-LDLT for children with metabolic diseases from June 2013 to November 2018 in our center was carried out. The arterial conditions, reconstruction methods, and prognosis were analyzed.

Results: A total of 73 children with metabolic diseases underwent P-LDLT during the period. The LLF was the main graft, accounting for 71.2%. The donor's RGEA was utilized in five cases. There were three children with OTCD and two children with deficiency of CPS1 and MSUD, respectively. In three cases, the grafts' left hepatic arteries were anastomosed with the recipients' PHA using donors' RGEA as interposition vessel. In other two cases, the donors' RGEA was interposed between graft's MHA and the recipient's bifurcation of PHA and GDA. The average follow-up time was 19.7 ± 15.9 month. There were two cases of artery thrombosis or occlusion, and the incidence was 2.7%. No arterial complications occurred in children using RGEA (follow-up time 5.0 ± 3.4 months).

Conclusion: In P-LDLT for patients with metabolic diseases, the application of RGEA as an interposition vessel can solve caliber mismatch and short arteries problem and achieve good results. Compared with traditional arterial anastomosis, it may reduce the incidence of arterial complications.
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http://dx.doi.org/10.1111/petr.13418DOI Listing
June 2019

Microfluidic chip combined with magnetic-activated cell sorting technology for tumor antigen-independent sorting of circulating hepatocellular carcinoma cells.

PeerJ 2019 1;7:e6681. Epub 2019 Apr 1.

Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, P. R. China.

Purpose: We aimed to generate a capture platform that integrates a deterministic lateral displacement (DLD) microfluidic structure with magnetic-activated cell sorting (MACS) technology for miniaturized, efficient, tumor antigen-independent circulating tumor cell (CTC) separation.

Methods: The microfluidic structure was based on the theory of DLD and was designed to remove most red blood cells and platelets. Whole Blood CD45 MicroBeads and a MACS separator were then used to remove bead-labeled white blood cells. We established HepG2 human liver cancer cells overexpressing green fluorescent protein by lentiviral transfection to simulate CTCs in blood, and these cells were then used to determine the CTC isolation efficiency of the device. The performance and clinical value of our platform were evaluated by comparison with the Abnova CytoQuest™ CR system in the separating of blood samples from 12 hepatocellular carcinoma patients undergoing liver transplantation in a clinical follow-up experiment. The isolated cells were stained and analyzed by confocal laser scanning microscopy.

Results: Using our integrated platform at the optimal flow rates for the specimen (60 µl/min) and buffer (100 µl/min per chip), we achieved an CTC yield of 85.1% ± 3.2%. In our follow-up of metastatic patients, CTCs that underwent epithelial-mesenchymal transition were found. These CTCs were missed by the CytoQuest™ CR bulk sorting approach, whereas our platform displayed increased sensitivity to EpCAM CTCs.

Conclusions: Our platform, which integrates microfluidic and MACS technology, is an attractive method for high-efficiency CTC isolation regardless of surface epitopes.
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http://dx.doi.org/10.7717/peerj.6681DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6448555PMC
April 2019

[A twenty-year review of clinical liver transplantation].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2019 Mar;31(3):269-280

Organ Transplantation Center, Tianjin First Center Hospital, Tianjin Clinical Medical Research Center for Organ Transplantation, Key Laboratory of National Health Commission for Critical Care and Emergency Medicine, Key Laboratory of Chinese Academy of Medical Sciences for Organ Transplantation, Tianjin Key Laboratory for Organ Transplantation, Tianjin 300192, China.

Objective: To review the development of adult and pediatric liver transplantation in Tianjin First Center Hospital, and to enhance academic exchanges, improve technological innovation, and jointly promote the progress and maturity in the field of liver transplantation.

Methods: The development of liver transplantation in Tianjin First Center Hospital was analyzed. The clinical data of adult and pediatric liver transplantation from September 1998 to September 2018 were collected. The important events and technological innovation achievements of liver transplantation during the 20 years were summarized.

Results: The first clinical liver transplantation was attempted in Tianjin First Central Hospital in April 1980. The first long-term survival adult liver transplantation in China was completed in 1994 (11 years survival after the operation). The specialized team of liver transplantation was formally established in September 1998. The 20-year clinical exploration and progress reflected the characteristics of era changes and technological innovation during the rapid development of liver transplantation in China. Our center performed liver re-transplantation in January 1999, reduced-size pediatric liver transplantation in August 2000. In May 2001, we organized the formulation for the preventive and treatment plan for hepatitis B recurrence after liver transplantation. We performed combined liver and kidney transplantation in July 2002, split liver transplantation (SLT) in April 2004, the first domino liver transplantation (DLT) in August 2005. Pediatric living donor liver transplantation (LDLT) was initiated in October 2006, adult LDLT was carried out in August 2007. In September 2007, the first living donor combined liver and kidney transplantation from the same donor in Asia was performed. The first domino+living donor double grafts liver transplantation in the world was performed in January 2009. In March 2011, we performed laparoscopically assisted right hepatic lobe liver transplantation (LDLT) with middle hepatic vein. In May 2014, living donor laparoscopic left lateral lobe procurement was successfully established. In April 2016, simultaneous liver, pancreas and kidney multi-organ transplantation was completed. Domino donor-auxiliary liver transplantation was performed in February 2017. In December 2017, extracorporeal membrane oxygenation (ECMO)-supported liver transplantation in a patient with severe pulmonary hypertension was successfully completed. Liver transplantation combined with partial splenectomy was established in April 2018. Cross-domino liver transplantation (hypersensitive kidney transplantation with auxiliary liver transplantation+pediatric liver transplantation) was performed in May 2018. During the 20 years, the team has performed or assisted other centers in Beijing, Shanghai, Guangzhou and Shenzhen to carry out more than 10 000 cases of liver transplantations. A total of 7 043 cases of various types of liver transplantation were performed in the single center of the hospital (6 005 adult liver transplantations and 1 038 pediatric liver transplantations). Concerning adult liver transplantation, the cumulative 1-year, 3-year and 5-year survival rate from September 1998 to March 2003 were 83.1%, 73.0% and 69.0%, from April 2003 to March 2009 were 85.3%, 76.2% and 72.1% and from April 2009 to September 2018 were 87.5%, 79.2% and 75.1%, respectively. The cumulative 1-year, 3-year and 5-year survival rate for pediatric liver transplantation were 93.5%, 92.2% and 90.2%, respectively. The nucleoside (acid) analogue combined with low dose hepatitis B immunoglobulin (HBIG) was developed to prevent the recurrence of hepatitis B after liver transplantation, this plan has reduced the recurrence rate of hepatitis B and the 5-year re-infection rate of hepatitis B virus (HBV) after liver transplantation significantly. The risk assessment system for tumor recurrence after liver transplantation was established and individual treatment method was established based on this assessment system. Continuous exploration and improvement of liver transplantation for liver cancer, liver re-transplantation, liver transplantation with portal vein thrombosis, SLT, DLT and multi-organ combined transplantation have significantly improved the clinical efficacy of patients and the post-operative survival rate.

Conclusions: The liver transplantation team of Tianjin First Center Hospital has carried out a scientific and technological exploration on the key problems and technical difficulties of clinical liver transplantation. This work strongly has initiated and promoted the rapid development of liver transplantation in China. The restrictive barrier of hepatitis B recurrence after liver transplantation has been overcome. The risk prevention and control system of tumor recurrence after liver transplantation has been established. A series of innovative achievements that can be popularized have been achieved in the field of complex liver transplantation and expansion of donor liver source. The iterative progress and sustainable development of liver transplantation have been realized.
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http://dx.doi.org/10.3760/cma.j.issn.2095-4352.2019.03.004DOI Listing
March 2019

Roots-Enhanced Preferential Flows in Deciduous and Coniferous Forest Soils Revealed by Dual-Tracer Experiments.

J Environ Qual 2019 01;48(1):136-146

Macropores formed by roots are crucial channels for preferential flows in forest soils that are largely responsible for water percolation and solute leaching. Using dual-tracer experiments (Brilliant Blue FCF and bromide [Br]), this study investigated the preferential flows of water and solutes in a deciduous forest dominated by Bl. and a coniferous forest mainly planted with (L.) Franco. Dye-stained patterns and concentrations of Brilliant Blue and Br were obtained in vertical soil profiles (0-30 cm), whereas stained and unstained roots were collected and analyzed in horizontal soil profiles to a 30-cm soil depth. Brilliant Blue and Br were mainly accumulated in the 0- to 20-cm soil depth, which had greater total root length density than the 20- to 30-cm soil depth ( < 0.05). Only part of the roots facilitated the preferential flows, with finer roots (i.e., diameter <1 mm) contributing the most. More intriguingly, the coniferous forest soil had a greater degree of preferential flows and greater tracer concentrations at deeper soil depth than the deciduous forest soil, suggesting the importance of tree species and forest composition on water and solute transport in forest ecosystems.
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http://dx.doi.org/10.2134/jeq2018.03.0091DOI Listing
January 2019

Impact of perioperative blood transfusion on gene expression biomarkers in patients with gastrointestinal cancer.

Transfus Apher Sci 2018 Oct 1;57(5):656-660. Epub 2018 Aug 1.

Department of Anesthesiology, ChaoHu Hospital of Anhui Medical University, ChaoHu, Anhui, 238000, China. Electronic address:

Objectives: To explore the impacts of perioperative blood transfusion on specific pattern of inflammatory gene expression and nosocomial infections in gastrointestinal cancer patients.

Methods: A total of 60 gastrointestinal cancer patients aged over 27 years were recruited, blood transfusion was administered to 30 patients. The peripheral venous blood was drawn from the 30 patients undergoing transfusions and messenger RNA (mRNA) was extracted from PAXGene tubes collected before surgery and at 48 h following the operation. T-helper cell subtype transcription factors were quantified using quantitative real-time polymerase chain reaction. These genes were selected based on their ability to represent specific immune pathways and their expression level of Th1, Th2 and Th17 and the major Treg-specific TFs T-bet, GATA-3, RORγt and FOXP3 were measured. Postoperative infections were documented using predefined criteria.

Results: There were significantly lower in Th1-specific TF T-bet (P < 0.001) mRNA levels and significantly higher in Th2-specifc TF, GATA-3 (P < 0.001) mRNA levels assayed at 48 h. There was significantly lower in T-bet mRNA/GATA-3 (P < 0.001) mRNA ratio assayed at 48 h. There were significantly higher in Th17-specific TF RORγt (P < 0.001) and Treg-specific TF Foxp3 (P < 0.001) mRNA levels assayed at 48 h. Patients receiving a blood transfusion were more likely to develop postoperative infections (P = 0.02).

Conclusion: There is an association between an immunosuppressive pattern of gene expressions and blood transfusion. This gene expression profile includes a reduction in the activity of T helper cell type 1 (Th1) pathways in those patients receiving a blood transfusion. Furthermore, blood transfusion was associated with an increased susceptibility to nosocomial infections.
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http://dx.doi.org/10.1016/j.transci.2018.07.022DOI Listing
October 2018

Expanded Criteria Donor-Related Hyperkalemia and Postreperfusion Cardiac Arrest During Liver Transplantation: A Case Report and Literature Review.

Ann Transplant 2018 Jul 3;23:450-456. Epub 2018 Jul 3.

Division of Liver Transplantation Surgery, Department of Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China (mainland).

BACKGROUND Liver transplantation (LT) using extended criteria donor (ECD) grafts is frequently associated with a high flush fluid potassium concentration (FFK) and acute hyperkalemia after reperfusion, which puts patients at greater risk of postreperfusion cardiac arrest (PRCA). CASE REPORT Herein, we present a case with an extremely high FFK that was successfully pretreated to avoid the risk of PRCA. A 3-year-old boy with biliary atresia underwent LT from a 623-g donation after brain death liver graft with localized frostbite on the right lobe surface. The FFK was 18.8 mmol/L after flushing with 1000 mL of 5% albumin. To prevent PRCA due to acute hyperkalemia, further portal vein (PV) flush, retrograde reperfusion via the inferior vena cava, and antegrade reperfusion via the PV were adopted to remove the excessive potassium ions. Ultimately, the liver graft was reperfused when the perfused blood potassium concentration was 7.5 mmol/L without subsequent development of PRCA during the immediate reperfusion period. Nevertheless, the patient still experienced vasoplegic syndrome during the late reperfusion period. CONCLUSIONS Our case illustrates that the FFK measurement is helpful for identifying ECD-related hyperkalemia and for providing advance warning of PRCA. Future investigations are warranted to confirm the relationship between high FFK and PRCA and to observe the effectiveness of other interventions to prevent PRCA due to ECD-related hyperkalemia.
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http://dx.doi.org/10.12659/AOT.909308DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248011PMC
July 2018

Diagnosis, Incidence, Predictors and Management of Postreperfusion Syndrome in Pediatric Deceased Donor Liver Transplantation: A Single-Center Study.

Ann Transplant 2018 May 18;23:334-344. Epub 2018 May 18.

Division of Liver Transplantation Surgery, Department of Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China (mainland).

BACKGROUND Postreperfusion syndrome (PRS) is a dreadful and well-documented complication in adult liver transplantation (LT). However, information regarding PRS in pediatric LT is still scarce. We aimed to identify the incidence, risk factors and associated outcomes of pediatric LT in a single-center study. MATERIAL AND METHODS The medical records of 75 consecutive pediatric patients who underwent deceased donor liver transplantation (DDLT) from July 2015 to October 2017 were retrospectively reviewed. PRS was determined according to the Peking criteria when significant arrhythmia or refractory hypotension occurred following revascularization of the liver graft. Patients were divided into PRS and non-PRS groups. Preoperative, intraoperative, and postoperative data were collected and compared between the 2 groups. Independent risk factors for PRS were analyzed using binary logistic regression analysis. RESULTS PRS occurred in 26 patients (34.7%). Univariate analysis showed that the graft-to-recipient weight ratio (P=0.023), donor warm ischemia time (P<0.001), and the use of an expanded criteria donor (ECD) liver graft (P<0.001) were significant predictors of PRS. Binary logistic regression showed that the use of an ECD liver graft (odds ratio [OR]: 18.668; 95% confidence interval [95% CI]: 4.866-71.622) and lower hematocrit (HCT) level before reperfusion (OR: 0.878; 95% CI: 0.782-0.985) were independent predictors of PRS. PRS was significantly associated with early allograft dysfunction (73.1% vs. 18.4%, P<0.001), primary nonfunction (11.5% vs. 0.0%, P=0.039), and a prolonged hospital stay (median: 30.5 vs. 21.0, P=0.007). CONCLUSIONS The use of an ECD liver graft and lower HCT level before reperfusion were independent risk factors for PRS in pediatric DDLT. Intraoperative PRS occurrence seems to be associated with poor liver allograft function and worsened patient postoperative outcomes.
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http://dx.doi.org/10.12659/AOT.909050DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248285PMC
May 2018