DDIG-in: discriminating between disease-associated and neutral non-frameshifting micro-indels

Micro-indels (insertions or deletions shorter than 21 bps) constitute the second most frequent class of human gene mutation after single nucleotide variants. Despite the relative abundance of non-frameshifting indels, their damaging effect on protein structure and function has gone largely unstudied. We have developed a support vector machine-based method named DDIG-in (Detecting disease-causing genetic variations due to indels) to prioritize non-frameshifting indels by comparing disease-associated mutations with putatively neutral mutations from the 1,000 Genomes Project. The final model gives good discrimination for indels and is robust against annotation errors. A webserver implementing DDIG-in is available at http://sparks-lab.org/ddig.     

Robotic Partial Nephrectomy for Renal Tumors Larger than 4 cm: A Systematic Review and Meta-analysis

Background

With the establishment of minimally invasive surgery in society, the robot has been increasingly widely used in the urologic field, including in partial nephrectomy. This study aimed to comprehensively summarize the currently available evidence on the feasibility and safety of robotic partial nephrectomy for renal tumors of >4 cm.

Method and Findings

An electronic database search of PubMed, Scopus, Web of Science, and the Cochrane Library was performed. This systematic review and meta-analysis was based on all relevant studies that assessed robotic partial nephrectomy for renal tumors of >4 cm. Five studies were included. The meta-analysis involved 3 studies from 11 institutions including 154 patients, while the narrative review involved the remaining 2 studies from 5 institutions including 64 patients. In the meta-analysis, the mean ischemic time, operation time, and console time was 28, 319, and 189 minutes, respectively. The estimated blood loss and length of stay was 317 ml and 3.8 days, respectively. The rates of conversion, positive margins, intraoperative complications, postoperative complications, hilar clamping, and collecting system repair were 7.0%, 3.5%, 7.0%, 9.8%, 93.9%, and 47.5%, respectively. The narrative review showed results similar to those of the meta-analysis.

Conclusions

Robotic partial nephrectomy is feasible and safe for renal tumors of >4 cm with an acceptable warm ischemic time, positive margin rate, conversion rate, complication rate, operation time, estimated blood loss, and length of stay.     

Detection of Airway Anomalies in?Pediatric?Patients with Cardiovascular Anomalies with Low Dose Prospective ECG-Gated Dual-Source CT

Objectives

To assess the feasibility of low-dose prospective ECG-gated dual-source CT (DSCT) in detecting airway anomalies in pediatric patients with cardiovascular anomalies compared with flexible tracheobronchoscopy (FTB).

Methods

33 pediatrics with respiratory symptoms who had been revealed cardiovascular anomalies by transthoracic echocardiography underwent FTB and contrast material–enhanced prospective ECG-triggering CT were enrolled. The study was approved by our institution review board and written informed consent was obtained from all patients’ guardian. DSCT examinations were performed to detect cardiovascular abnormalities using weight-adjusted low–dose protocol. Two radiologists independently performed CT image analysis. The FTB reports were reviewed by an experienced pulmonologist. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of DSCT in the detection of airway anomalies were assessed. The tracheobronchial stenoses revealed on FTB were graded. Effective radiation dose was calculated.

Results

Thirty cases were diagnosed with tracheobronchial narrowing and/or abnormality in 33 patients by FTB, while 3 patients had normal FTB findings. Twenty-eight cases were diagnosed with airway anomalies by CT, of which 27 were correct positive. 3 patients with normal findings at CT had findings of tracheobronchial narrowing due to tracheobronchomalacia at inspiration at FTB. Sensitivity and specificity of CT were 90.0% (95% CI: 72.3%, 97.4%) and 66.7% (95% CI: 12.5 %, 98.2 %), respectively. PPV and NPV were 96.4% (95% CI: 79.8 %, 99.8%) and 40.0% (95% CI: 7.3%, 83.0%), respectively. Overall accuracy of DSCT in detecting airway anomalies in pediatrics with cardiovascular anomalies was 87.9% (95% CI: 74.5%, 97.6%). In grading of tracheobronchial stenosis, images from CT correlated closely (r = 0.89) with those of FTB. Mean effective dose was 0.60±0.20 mSv.

Conclusion

In pediatric patients, ECG-triggered CT to evaluate congenital cardiovascular anomalies can also be used to diagnose and characterize fixed airway involvement in relation to the vascular structures.     

人脑胶质瘤GDNF基因启动子I区H3组蛋白乙酰化修饰情况

目的：明确GDNF启动子I区在人脑胶质瘤中H,赖氨酸残基9位乙酰化（H3K9Ac）情况,探讨其对于GDNF在胶质瘤中表达的影响。方法：RT-PCR检测各组中GDNFmRNA的表达;建立基于Real．timePCR分析的染色质免疫共沉淀（CHIP）方法,检测12例胶质瘤与6例正常脑组织中GDNF基因启动子I区王H3组蛋白乙酰化情况。结果：Real-timePCR验证人脑胶质瘤GDNFmRNA的表达,转录水平随级另q的增高而增高,且低级别组、高级别组与正常组之间存在显著的统计学差异（P〈0．05）。启动子I区的H,组蛋白乙酰化水平,正常组与低级别组和高级别组之间比较均有显著性差异（P〈0．05）,且低级别与高级别之间也有显著性差异。结论：在人脑胶质瘤组织中,GDNF启动子I区发生了H3组蛋白高乙酰化修饰,这种修饰很可能会影响GDNF基因的表达。     

联合用药靶控静脉麻醉在纤维支气管镜检查术中的麻醉效果分析

目的：分析纤维支气管镜检查术中丙泊酚联合右美托咪啶靶控静脉麻醉的效果,为临床麻醉提供参考。方法：选取73例行纤维支气管镜检查术的患者作为研究对象,按麻醉方式不同分为观察组38例（采用右美托咪啶联合丙泊酚麻醉）和对照组35例（单用丙泊酚麻醉）。观察分析各时点心率、呼吸次数、平均动脉压、血氧饱和度、镇静效果评分、苏醒时间以及不良反应发生率等指标。结果：Ramsay评分：对照组6分的例数为22例（62．9％）,观察组为32（84．2％）,差异有统计学意义;丙泊酚总用量：观察组为（334．5±54．6）mg,对照组为（463．2±60．5）mg,差异有统计学意义,医生满意度：观察组为92．1％,对照组为74.3％,差异有统计学意义。结论：丙泊酚联合右美托咪啶靶控静脉麻醉安全有效,效果显著,适合纤维支气管镜检查术。     

Pierisformotoxins A – D,Polyesterified Grayanane Diterpenoids from Pieris formosa and Their cAMP‐Decreasing Activities

Four highly acylated diterpenoids, designated as pierisformotoxins A–D ( 1 – 4 , resp.), along with 26 known compounds, were isolated from the flowers of Pieris formosa. Among them, pierisformotoxins A and B ( 1 and 2 , resp.) were new highly acylated grayanane diterpenoids, of which the five‐membered ring A has undergone an oxidative cleavage between C(3) and C(4), followed by lactonization, to give rise to a five‐membered lactone ring between C(3) and C(5), differing from the previously reported grayanane diterpenoids with a 5/7/6/5 ring system. Results of the cAMP‐regulation‐activity assay showed that pierisformotoxin C ( 3 ) at 10 μM (inhibitory ratio (IR): 10.1%) or 2 μM (9.8%), and pierisformotoxin B ( 2 ) at 50 μM (13.9%) significantly decreased the cAMP level in N1E‐115 neuroblastoma cells (p<0.05).     

The First Report on Excellent Cycling Stability and Superior Rate Capability of Na3V2(PO4)3 for Sodium Ion Batteries

Sodium ion batteries are attractive for the rapidly emerging large‐scale energy storage market for intermittent renewable resources. Currently a viable cathode material does not exist for practical non‐aqueous sodium ion battery applications. Here we disclose a high performance, durable electrode material based on the 3D NASICON framework. Porous Na₃V₂(PO₄)₃/C was synthesized using a novel solution‐based approach. This material, as a cathode, is capable of delivering an energy storage capacity of ～400 mWh/g vs. sodium metal. Furthermore, at high current rates (10, 20 and 40 C), it displayed remarkable capacity retention. Equally impressive is the long term cycle life. Nearly 50% of the initial capacity was retained after 30,000 charge/discharge cycles at 40 C (4.7 A/g). Notably, coulombic efficiency was 99.68% (average) over the course of cycling. To the best of our knowledge, the combination of high energy density, high power density and ultra long cycle life demonstrated here has never been reported before for sodium ion batteries. We believe our findings will have profound implications for developing large‐scale energy storage systems for renewable energy sources.     

早期肠内营养辅助治疗重症胰腺炎的临床疗效分析

目的：探讨早期肠内营养辅助治疗重症胰腺炎的临床效果。方法：选择2009年4月-2012年2月我院收治的重症胰腺炎患者共46例,随机分为实验组和对照组各23例,实验组在综合治疗的基础采用早期肠内营养治疗（EN）,而对照组在综合治疗的基础上采用全胃肠外营养治疗（TPN）,比较两组患者的血清总蛋白、白蛋白、尿素氮水平及血淋巴细胞百分比变化、血淀粉酶和尿淀粉酶恢复正常时间、住院时间及病死率,并比较两组治疗前及治疗后24、48及72小时的APACHEII评分。结果：治疗后,实验组患者的血清总蛋白、白蛋白、尿素氮水平及血淋巴细胞百分比变化均较对照组明显增高,差异有统计学意义（P〈0．05）,而血淀粉酶、尿淀粉酶恢复时间、病死率及住院时间分别均明显较对照组降低或缩短,差异有统计学意义（P〈0．05）。治疗24、48及72小时后,实验组APACHEII评分均较治疗前显著减低（P〈o．05）,而对照组治疗24、48h后APACHEⅡ评分与治疗前比较差异无统计学意义（P〉0．05）,治疗72h后APACHEII评分较治疗前显著减低（P〈O．05）。结论：采用早期肠内营养辅助治疗重症胰腺炎患者能有效保护肠黏膜屏障功能,改善患者的营养状况,增强患者的免疫力,并改善患者的预后。