Objective To investigate the function of glymphatic system in patients with mild traumatic brain injury via diffusion tensor imaging analysis along the perivascular space(DTI-ALPS)index and its relationship with clinical features.Methods The clinical and imaging data from 163 patients with mild traumatic brain injury were retrospectively collected,including 31 cases with MRI-negative findings and 132 cases with MRI-positive findings.In addition,29 healthy individuals underwent physical examinations were included as a control group.The differences in DTI-ALPS index and clinical features between mild traumatic brain injury and control group,as well as among subgroups of traumatic brain injury were analyzed.Results The DTI-ALPS index in patients with mild traumatic brain injury were significantly higher than those in control group(P＜0.05).Subgroup analysis showed that DTI-ALPS index of traumatic brain injury patients with MRI-negative findings and MRI-positive findings were all significantly higher than those of control group(P=0.023 and 0.004,respectively).Compared to control group,DTI-ALPS index in mild traumatic brain injury patients gradually increased with the progression of injury,and the difference was statistically significant(P=0.008).Conclusion Patients with mild traumatic brain injury exhibit increased functional activity of glymphatic system,as indicated by increased DTI-ALPS index,which further increase with the progression of injury.

Objective To investigate the function of glymphatic system in patients with mild traumatic brain injury via diffusion tensor imaging analysis along the perivascular space(DTI-ALPS)index and its relationship with clinical features.Methods The clinical and imaging data from 163 patients with mild traumatic brain injury were retrospectively collected,including 31 cases with MRI-negative findings and 132 cases with MRI-positive findings.In addition,29 healthy individuals underwent physical examinations were included as a control group.The differences in DTI-ALPS index and clinical features between mild traumatic brain injury and control group,as well as among subgroups of traumatic brain injury were analyzed.Results The DTI-ALPS index in patients with mild traumatic brain injury were significantly higher than those in control group(P＜0.05).Subgroup analysis showed that DTI-ALPS index of traumatic brain injury patients with MRI-negative findings and MRI-positive findings were all significantly higher than those of control group(P=0.023 and 0.004,respectively).Compared to control group,DTI-ALPS index in mild traumatic brain injury patients gradually increased with the progression of injury,and the difference was statistically significant(P=0.008).Conclusion Patients with mild traumatic brain injury exhibit increased functional activity of glymphatic system,as indicated by increased DTI-ALPS index,which further increase with the progression of injury.

BACKGROUND:Implant restoration has become an important means to treat anterior tooth loss,and it is particularly important to select appropriate implant restoration materials.However,at present,there are some deficiencies in clinical implant materials,and researchers have been exploring suitable implant materials.OBJECTIVE:To compare the biomechanical characteristics of implants made of different materials in restoring single missing maxillary anterior teeth.METHODS:The cone beam CT data of a patient with single maxillary central incisor loss were imported into 3-matic software to establish a three-dimensional finite element analysis model of single maxillary anterior tooth loss.The model was then imported into Marc Mentat.Eight sets of implant restoration models were designed according to different implant materials(polyetheretherketone,titanium-zirconium alloy,titanium alloy,and zirconia,with the elastic modulus of the four materials increasing in sequence)and cancellous bone density(high density,low density)to simulate the stress conditions of the maxillary anterior teeth in centric occlusion.The total displacements and von Mises stresses of implants,cortical bone stresses and cancellous bone strains were compared and analyzed.RESULTS AND CONCLUSION:(1)The maximum displacement of the implant gradually decreased with the increase of the modulus of elasticity of the material,and the value of the maximum displacement of the implant in the polyetheretherketone group exceeded 10 μm;the implant stress was concentrated in the labial neck in the models.The maximum stress gradually increased with the increase of the modulus of elasticity of the implant material,among which,the zirconia-low density bone model had the highest stress,which was 21.31 MPa;the cortical bone stress was concentrated in the cortical bone at the junction of the implant with the labial side,and the polyetheretherketone-low density bone group had the highest value,which was 29.90 MPa.(2)From the biomechanical point of view,titanium-zirconium alloy,titanium alloy,and zirconia can be used as implant materials for restoration of a single missing anterior tooth,and implant displacement is one of the common problems during implant restorations,but pure polyetheretherketone material may cause excessive implant displacement in implant restorations of anterior areas,causing implant failure.

BACKGROUND:Implant restoration has become an important means to treat anterior tooth loss,and it is particularly important to select appropriate implant restoration materials.However,at present,there are some deficiencies in clinical implant materials,and researchers have been exploring suitable implant materials.OBJECTIVE:To compare the biomechanical characteristics of implants made of different materials in restoring single missing maxillary anterior teeth.METHODS:The cone beam CT data of a patient with single maxillary central incisor loss were imported into 3-matic software to establish a three-dimensional finite element analysis model of single maxillary anterior tooth loss.The model was then imported into Marc Mentat.Eight sets of implant restoration models were designed according to different implant materials(polyetheretherketone,titanium-zirconium alloy,titanium alloy,and zirconia,with the elastic modulus of the four materials increasing in sequence)and cancellous bone density(high density,low density)to simulate the stress conditions of the maxillary anterior teeth in centric occlusion.The total displacements and von Mises stresses of implants,cortical bone stresses and cancellous bone strains were compared and analyzed.RESULTS AND CONCLUSION:(1)The maximum displacement of the implant gradually decreased with the increase of the modulus of elasticity of the material,and the value of the maximum displacement of the implant in the polyetheretherketone group exceeded 10 μm;the implant stress was concentrated in the labial neck in the models.The maximum stress gradually increased with the increase of the modulus of elasticity of the implant material,among which,the zirconia-low density bone model had the highest stress,which was 21.31 MPa;the cortical bone stress was concentrated in the cortical bone at the junction of the implant with the labial side,and the polyetheretherketone-low density bone group had the highest value,which was 29.90 MPa.(2)From the biomechanical point of view,titanium-zirconium alloy,titanium alloy,and zirconia can be used as implant materials for restoration of a single missing anterior tooth,and implant displacement is one of the common problems during implant restorations,but pure polyetheretherketone material may cause excessive implant displacement in implant restorations of anterior areas,causing implant failure.

Objective To observe the value of dual-source CT(DECT)virtual monoenergetic imaging(VMI)for differentiating prostate cancer(PC)and benign prostatic hyperplasia(BPH).Methods Thirty-three patients with PC(PC group)and 44 patients with BPH(BPH group)were retrospectively enrolled,and 40-100 keV(with 10 keV interval)VMI were reconstructed based on arterial phase DECT images,respectively.Clinical data,focal CT value and contrast-to-noise ratio(CNR)of VMI with different energy levels and conventional linear fusion images of arterial phase were compared between groups.Binary logistic regression models were constructed based on clinical data being significantly different between groups,focal CT value of VMI with energy level with the highest CNR,also focal CT value of conventional linear fusion images of arterial phase,respectively.The area under the receiver operating characteristic curve(AUC)was calculated to evaluate the efficacy of each model for differentiating PC and BPH.Results Free prostate-specific antigen(f-PSA),total prostate-specific antigen(t-PSA),focal CT value of 40-100 keV VMI and conventional linear fusion images of arterial phase in PC group were all higher,while short diameter in PC group was smaller than those in BPH group(all P＜0.05).Logistic regression models were constructed based on f-PSA,t-PSA,short diameter,CT value at 40 keV VMI and CT value at conventional linear fusion images of arterial phase,respectively,with AUC for differentiating PC and BPH of 0.879,0.902,0.701,0.911 and 0.857,respectively.Conclusion DECT VMI could be used as a supplementary examination for prostate diseases,and 40 keV VMI had the best efficacy for differentiating PC and BPH.

Antibody-drug conjugates(ADCs)are commonly heterogeneous and require extensive assessment of exposure-efficacy and exposure-safety relationships in preclinical and clinical studies.In this study,we report the generation of a monoclonal antibody against monomethyl auristatin E(MMAE)and the development,validation,and application of sensitive and high-throughput enzyme-linked immunosor-bent assays(ELISA)to measure the concentrations of MMAE-conjugated ADCs and total antibodies(tAb,antibodies in ADC plus unconjugated antibodies)in cynomolgus monkey sera.These assays were suc-cessfully applied to in vitro plasma stability and pharmacokinetic(PK)studies of SMADC001,an MMAE-conjugated ADC against trophoblast cell surface antigen 2(TROP-2).The plasma stability of SMADC001 was better than that of similar ADCs coupled with PEG4-Val-Cit,Lys(m-dPEG24)-Cit,and Val-Cit linkers.The developed ELISA methods for the calibration standards of ADC and tAb revealed a correlation be-tween serum concentrations and the OD450 values,with R2 at 1.000,and the dynamic range was 0.3-35.0 ng/mL and 0.2-22.0 ng/mL,respectively;the intra-and inter-assay accuracy bias％ranged from-12.2％to-5.2％,precision ranged from-12.4％to-1.4％,and the relative standard deviation(RSD)was less than 6.6％and 8.7％,respectively.The total error was less than 20.4％.The development and validation steps of these two assays met the acceptance criteria for all addressed validation parameters,which suggested that these can be applied to quantify MMAE-conjugated ADCs,as well as in PK studies.Furthermore,these assays can be easily adopted for development of other similar immunoassays.

Objective To analyze the pathologically confirmed pulmonary Actinomycosis in the 11 patients in focusing on clinical features and mis-diagnostic reasons so as to improve physicians' awareness of this rare disease and reduce the misdiagnosis.Methods We retrospectively reviewed the medical records of 11 cases with pathologically confirmed pulmonary Actinomycosis during January 2003-August 2015.The clinical data and main causes of misdiagnosis in these cases were collected and analyzed.Results The study included 11 patients with a mean age of(53.0 ± 11.6.0)years.Among the 11 cases,8 (72.7 ％) patients had complications,6 (54.5 ％) were current or ex-smokers.Main clinical manifestations of 11 cases were cough(11/11,100.0 ％),sputum(11/11,100.0 ％),hemoptysis (7/11,63.6％),chest pain(6/11,54.5％)and fever(3/11,27.3％).Ten patients presented with one lobe of lung lesions,including 4 patients in the lower lobe and 3 in the upper lobe of the left lung,2 in the upper lobe and 1 in the lower lobe of the right lung.While,the remained one case presented with lesion locating in right main bronchus.Iconography often presented as pulmonary mass shadow,consolidation shadow,spicule sign,lobulation sign,hilar and/or mediastinal lymphadenopathy and pleural effusion.Vacuolar lesions were observed in some of the focuses.Flexible bronchoscopy was performed in 8 (72.7％)patients.Among them,7 patients showed mucosal swelling and congestion,luminal occlusion with purulence secretion,2 cases with polypoid neoplasm.Initial misdiagnosis rate were 100％ (11/11),among which 7 cases were misdiagnosed as lung cancer,2 cases as fungus infection,and 1 case as pulmonary tuberculosis and 1 case as pneumonia,respectively.All patients were definitely diagnosed by biopsy finding an evidence of hyphae of Actinomycosis in lung tissue specimens.The definitive diagnosis was made by CT-guided percutaneous lung biopsy in 4 cases,by transbronchial lung biopsy (TBLB)in 5 cases and by thoracotomy or video-assisted thoracoscopic surgery(VATS) in 1 case respectively.Actinomycosis in most patients was cured with high-dose penicillin administration over a prolonged period.Conclusions The diagnosis of pulmonary Actinomycosis remains challenging via its non-specific clinical symptoms and iconography features,and the presence of comorbidity may further increase the difficulty and complexity of diagnosis,leading to delaying-or mistaking-diagnosis.Obtaining positively pathological specimens is diagnostic key.Transbronchial lung biopsy through a bronchoscope and CT-guided percutaneous needle biopsy are the priority methods.

AIM:To study whether the pulmonary infection of Escherichia coli (E.coli) interferes the glu-colipid metabolism in high-fat diet-induced obese mice.METHODS:High-fat diet-induced obese mice (n=48) and nor-mal chow-fed control mice ( n=48) were intranasally infused with 40 μL fluid containing 4 ×109 CFUs E.coli.The ser-um, periepididymal adipose tissue and liver were obtained at 0 d, 1 d, 2 d, 3 d and 4 d after infection.The body mass, periepididymal adipose tissue and liver were weighed , and the levels of fasting blood glucose (FBG), fasting blood insulin ( FINS) , free fatty acid ( FFA) and very-low-density lipoprotein ( VLDL) were measured by ELISA .The serum total cho-lesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol ( LDL-C) , and hepatic TG contents were detected , and the hepatic steatosis was observed under microscope with oil red O staining.RESULTS:Compared with day 0, the body mass, fat mass and fat index were decreased significantly from day 1 to day 4 after infection (P<0.05).The levels of FBG, FINS and HOMA-IR were apparently raised from day 2 to day 4 af-ter infection (P<0.05).The contents of serum FFA, TG and VLDL were increased markedly from day 1 to day 4 after in-fection (P<0.05).However, the concentrations of serum TC, LDL-C and HDL-C were decreased obviously from day 1 to day 3 ( P<0.05 ) .The liver mass , liver index and TG content were significantly increased from day 1 to day 4 ( P<0.05 ) .Consistently , the lipid droplet accumulation in the liver cells was increased obviously at day 2 and day 4 after infec-tion.Compared with control group , except the levels of serum TC , LDL-C and HDL-C in obese group substantially de-creased, the other indexes were increased by different degrees during the whole experiment period (P<0.05).CONCLU-SION:Pulmonary infection of Escherichia coli exacerbates the disorder of glucose and lipid metabolism in high-fat diet-in-duced obese mice , which contributes the development of insulin resistance and hepatic steatosis .

BACKGROUND: Donor antigen presenting cells immigrated into the recipient can induce the immunological tolerance of recipient T cells to donor, leading to a final acceptance to grafts, lnterleukin-10 (IL-10) modification maintains dendritic cells at a desirable differentiating state, which is an effective method to promote the protection to kidney in the simultaneous liver-kidney transplantation.OBJECTIVE: To observe the immigration of IL-10-modified dendritic cells in rats subjected to simultaneous liver-kidney transplantation and to investigate the mechanism of action.DESIGN, TIME AND SETTING: A randomized, controlled, animal experiment was performed in the Medical College of Sun Yat-sen University between June 2004 and February 2006.MATERIALS: Male DA donor rats (n=60) and Lewis recipient rats (n=60), both were adult and of clean grade, were included.Sixty Lewis rats were randomly and evenly divided into 3 groups: IL-10-modified cell group, simple cell group, and model control group.METHODS: Donor rat liver and kidney were harvested by simultaneous liver-kidney transplantation. Recipient rats in each group were subjected to orthotopic liver and left kidney transplantation to establish models of immunological rejection. Under sterile condition, donor rat femur and tibia were harvested. Dnlbecco's modified eagle's medium (DMEM) was used to wash out the bone marrow. After removal of red cells, dendritic cells were isolated and cultured by adherent method. After modified with 20 μg/L IL-10 for 72 hours, dendritic cells were intravenously transfused into rat bodies in the IL-10-modified group, 2×10(7) cells/rat, In the simple cell group, rats were treated with donor dendritic cells without modification with IL-10. Rats in the model control group received no any interventions.MAIN OUTCOME MEASURES: [1]Dynamic changes of vital sign, urine volume, liver and renal function in recipient tissues;[2] Pathohistological detection results;[3]Distribution of donor dendritic cells in the recipient rats by in situ hybridization.RESULTS: In the simple cell and model control groups, urinary volume was reduced to 0 mL 5-6 days after transplantation. In addition, both groups presented with severe acute rejection. In the IL-10-modified cell group, urinary volume maintained at 6-12mL within 2 weeks after transplantation. The acute rejection of liver and kidney transplantation was obviously inhibited, surviving for(20.0±2.6) days on average, which was significantly longer than that in the simple cell group and model control group. A probability value of less than 0.05 in the Log Rank test was considered statistically significant. There were many Y chromosome-labeled dendritic cells immigrated into the mesenteric lymph node in the recipient rats.CONCLUSION: IL-10-modified dendritic cells play an immunoprotective effect on the liver and kidney transplanted simultaneously. Donor immature dendritic cells immigrated into recipient tissue could reduce acute rejections and prolong the survival time of liver and kidney grafts and recipients.

The experiment was conducted to examine the effect of zinc toxicity on the peripheral blood T-lymphocyte by the method of flow cytometry(FCM) and ANAE.200 one-day-old Avian broilers were divided into four groups,and fed with the diets as follows:①control group(Zn 100 mg/kg diet) and ② zinc toxic groups(Zn 1 500 mg/kg diet,zinc toxic group Ⅰ;Zn 2 000 mg/kg diet,zinc toxic group Ⅱ;Zn 2 500 mg/kg diet,zinc toxic group Ⅲ) for seven weeks.The ANAE positive ratios of the peripheral blood T-lymphocytes were much lower in the three zinc toxic groups than that in control group at 7 weeks of age.CD4+ T cell numbers were reduced from 2 to 7 weekds of age in zinc toxic group Ⅲ and from 6 to 7 weeks of age in zinc toxic group Ⅱ,as compared with that of control group.The numbers of CD8+ T cell decreased at 2 and 4 weeks of age in zinc toxic groups Ⅱ and Ⅲ,and at 7 weeks of age in zinc grups Ⅰ and Ⅲ.CD4+/CD8+ ratio was higher at 2 and 4 weeks age,and lower at 6 and 7 weeks of age in zinc toxic groups Ⅰ,Ⅱ and Ⅲ than in control group.The results showed that zinc toxicity would suppress the development of T-lymphocytes and reduce the peripheral blood T-lymphocyte populations.Potential mechanism underlying these observations are also discussed.