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Background Tumor-infiltrating immune cells are present in various malignant tumors, but their clinical significance in gastric cancer (GC) remains unclear. This study aimed to investigate the prognostic significance of tumor-infiltrating lymphocytes (TILs) and tumor-associated macrophages (TAMs). Methods Using a prospective database containing 401 cases of GC, we evaluated TIL (cluster of differentiation 8 (CD8) expression) and TAM (cluster of differentiation 68 (CD68) expression) statuses via immunohistochemical staining. Results Compared with CD8+ TIL-negative cases ( n  = 196, 48.6%), CD8+ TIL-positive cases ( n  = 205, 51.1%) showed significantly better recurrence-free survival (RFS) [log-rank p <0.001; multivariate HR: 0.372; 95% confidence interval (CI): 0.239–0.579, p <0.001]. In contrast, compared with CD68+ TAM-negative cases ( n  = 217, 54.1%), CD68+ TAM-positive cases ( n  = 184, 45.9%) had significantly poor RFS [log-rank p <0.001; multivariate HR: 2.182; 95% CI: 1.435–3.318, p <0.001]. Thus, patients with a positive CD8+ TIL and negative CD68+ TAM status exhibited significantly increased RFS. Multivariate analysis demonstrated that CD8+ TILs and CD68+ TAMs may serve as independent prognostic markers for RFS. Incorporating CD8+ TIL and CD68+ TAM statuses into the AJCC TNM system generated a predictive model with better predictive accuracy for RFS. More importantly, patients with a positive TIL and negative TAM status showed a tendency of improved RFS after postoperative adjuvant chemotherapy (PAC). Similar results were obtained by overall survival (OS) analysis. Conclusions CD8+ TIL and CD68+ TAM statuses were identified as independent prognostic factors that may be integrated into the current TNM staging system to refine risk stratification and to better predict the survival benefit from PAC in patients with GC. Trial registration The current controlled trial was registered at ClinicalTrials.gov (ID: NCT02327481 ) on December 30, 2014.

Common buckwheat is a health-care crop, and continuous cropping is one of the main factors restricting its high-yielding. In order to clarify the mechanism of continuous cropping of buckwheat, 4, 5and 6 years continuous cropping treatments were set up. We obtained the following results. The available nutrients content in rhizosphere soil, soil enzyme activity, leaf area, chlorophyll and soluble protein content, the peroxidase(POD) activity of leaves, agronomic traits, root index (except average diameter) of Fengtian1(FT1) decreased significantly with the increase of continuous cropping years. While, soil pH and the number of fungi in rhizosphere soil increased significantly, the number of bacteria in rhizosphere soil and the activity of catalase (CAT) and superoxide dismutase(SOD) in leaves first increased and then decreased. The yields of continuous cropping for 6 years were 12 times lower than the control crop. In conclusion, continuous cropping has certain effects on growth and yields of buckwheat.

To report the feasibility, efficacy, and toxicity of stereotactic body radiotherapy (SBRT) for the treatment of portal vein tumor thrombosis (PVTT) and/or inferior vena cava tumor thrombosis (IVCTT) in patients with advanced hepatocellular carcinoma (HCC). Forty-one patients treated with SBRT using volumetric modulated arc therapy (VMAT) for HCC with PVTT/IVCTT between July 2010 and May 2012 were analyzed. Of these, 33 had PVTT and 8 had IVCTT. SBRT was designed to target the tumor thrombosis and deliver a median total dose of 36 Gy (range, 30-48 Gy) in six fractions during two weeks. The median follow-up was 10.0 months. At the time of analysis, 15 (36.6%) achieved complete response, 16 (39.0%) achieved partial response, 7 (17.1%) patients were stable, and three (7.3%) patients showed progressive disease. No treatment-related Grade 4/5 toxicity was seen within three months after SBRT. One patient had Grade 3 elevation of bilirubin. The one-year overall survival rate was 50.3%, with a median survival of 13.0 months. The only independent predictive factor associated with better survival was response to radiotherapy. VMAT-based SBRT is a safe and effective treatment option for PVTT/IVCTT in HCC. Prospective randomized controlled trials are warranted to validate the role of SBRT in these patients.

Background Magnetic resonance imaging (MRI) is the gold standard for evaluating body composition. However, the reference ranges have not been established. Methods Three lean tissue and seven adipose tissue parameters based on MRI data from the UK Biobank were used in this study. Participants with European ancestry and data on at least one parameter were screened. Age‐ and sex‐specific percentile curves were generated using the lambda–mu–sigma method. Three levels of reference ranges were provided, which were equivalent to the mean ± 1 standard deviation (SD), 2 SDs and 2.5 SDs. Results The final analysis set for each parameter ranged from 4842 to 14 148 participants (53.4%–56.6% women) with a median age of 61. For lean tissue parameters, compared with those at age 45, the median total lean tissue volume and total thigh fat‐free muscle volume at age 70 were 2.83 and 1.73 L, and 3.02 and 1.51 L lower in men and women, respectively. The median weight‐to‐muscle ratios at age 45 were 0.51 and 0.83 kg/L lower compared with those at age 70 in men and women, respectively. Adipose tissue parameters showed inconsistent differences. In men, the median muscle fat infiltration, visceral adipose tissue (VAT) volume, total abdominal adipose tissue index and abdominal fat ratio were 1.48%, 0.32 L, 0.08 L/m2 and 0.4 higher, and the median abdominal subcutaneous adipose tissue (ASAT) volume and total adipose tissue volume were 0.47 and 0.41 L lower, respectively, at age 70 than at age 45. The median total trunk fat volume was approximately 9.53 L at all ages. In women, the median muscle fat infiltration and VAT volume were 1.68% and 0.76 L higher, respectively, at age 70 than at age 45. The median ASAT volume, total adipose tissue volume, total trunk fat volume, total abdominal adipose tissue index and abdominal fat ratio were 0.35 L, 0.78 L, 1.12 L, 0.49 L/m2 and 0.06 higher, respectively, at age 60 than at age 45. The medians of the former three parameters were 0.33 L, 0.14 L and 0.20 L lower, at age 70 than at age 60. The medians of the latter two parameters were approximately 3.64 L/m2 and 0.55 at ages between 60 and 70. Conclusions We have established reference ranges for MRI‐measured body composition parameters in a large community‐dwelling population. These findings provide a more accurate assessment of abnormal adipose and muscle conditions.

A tropical cyclone (TC) precipitation prediction scheme has been developed based on the physical quantities of the NCEP/NCAR reanalysis data as potential predictors and using fuzzy neural network (FNN) model. TC precipitation samples from 172 tropical cyclones (TCs) affecting Guangxi, China, spanning 1980–2015 are used for model development. The FNN model input is constructed from potential predictors by employing both a stepwise regression method (SRM) and a locally linear embedding (LLE) algorithm. The LLE algorithm is capable of finding meaningful low-dimensional architectures hidden in their nonlinear high-dimensional data space and separating the underlying factors. In this scheme, the newly developed model, which is termed the FNN–LLE model, is used for daily TC precipitation prediction from 20:00 (Beijing Time, or BT) of the previous day to 20:00 BT of the current day at 89 stations covering Guangxi, China. Using identical modeling samples and independent samples, predictions of the FNN–LLE model are compared with the widely used SRM and interpolation method using the fine-mesh data of the European Centre for Medium-Range Weather Forecasts (ECMWF) in terms of the performance of TC rainfall prediction at 89 stations in Guangxi. The root-mean-square error (RMSE), bias, and equitable threat score (ETS) results were employed to assess the predicted outcomes. Results show that the FNN–LLE model is superior to the interpolation method by ECMWF and SRM for TC precipitation prediction with RMSE values of 21.94, 24.07, and 25.22 in FNN–LLE model, interpolation method by ECMWF and SRM, respectively. Moreover, FNN–LLE model having average bias and ETS values close to 1.0 gave better predictions than did the interpolation method by ECMWF and SRM.

AbstractSystemic lupus erythematosus (SLE) is a prototypic autoimmune disease and a common complication of SLE is lupus nephritis (LN) during which lupus autoantibodies and proinflammatory cytokines attack the kidney and cause renal dysfunction. The current treatments to LN are limited due to a poor understanding of the pathogenesis. Here, we studied the molecular mechanisms of LN by investigating the function of circELK4/miR-27b-3p axis. MRL/lpr mice and LPS-treated HK-2 cells were used as the mouse model and cell model of LN, respectively. Blood samples were collected from LN patients. qRT-PCR and western blot were used to measure expression levels of circELK4, miR-27b-3p, apoptosis-related proteins, cytokines, and STING/IRF-3/IFN-I signaling. ELISA was performed to examine levels of cytokines including IL-6 and TNF-α. H&E staining was used to examine kidney morphology. TUNEL staining and flow cytometry were used to determine cell apoptosis. Dual luciferase activity assay and RNA pull down were employed to validate the interactions of circELK4/miR-27b-3p and miR-27b-3p/STING. CircELK4 was elevated in LN mice, patients, and LPS-treated HK-2 cells. Knockdown of circELK4 attenuated renal injury in LN mice and LPS-induced HK-2 cell injury. CircELK4 directly bound to miR-27b-3p while miR-27b-3p targeted STING. Moreover, overexpression of circELK4 could partially reverse the effects of miR-27b-3p mimics on cell apoptosis and inflammation. Furthermore, circELK4/miR-27b-3p regulated renal cell damage via modulating STING/IRF3/IFN-I signaling. CircELK4 contributes to renal injury by promoting inflammation and cell apoptosis via acting as a miR-27b-3p sponge to modulate STING/IRF3/IFN-I signaling in LN.

Gastric cancer (GC) is one of the most common cancers in the world, and the tumor microenvironment (TME) plays a vital role in the occurrence and development of GC. In this study, we obtained differential expressed genes in GC tissues from The Cancer Genome Atlas. After ESTIMATE and weighted correlation network analysis, we obtained differentially expressed genes (DEGs). With further screening DEGs of immune infiltration and then through Kaplan‐Meier survival analysis, least absolute shrinkage and selection operator regression analysis and COX analysis, we found that VCAN was a gene positively correlated with high immune infiltration and poor prognosis of patients in GC. In addition, we selected a Gene Expression Omnibus dataset (GSE84433) to verify the effect of VCAN on the patient's prognosis, and analyzed the value of VCAN in immunotherapy through TIMER database and TISIDB. In conclusion, we hold the view that VCAN may affect the development of GC by regulating the TME, which may act as a potential therapeutic target for GC. VCAN is not only associated with poor prognosis of GASTRIC cancer but also associated with immune infiltration, and maybe a key molecule in immunotherapy for gastric cancer.

Background Vacuum sealing drainage (VSD) is widely applied in complex wound repair. We aimed to compare traditional debridement and drainage and VSD in treating Fournier’s gangrene (FG). Methods Data of patients surgically treated for FG were retrospectively analyzed. Results Of the 36 patients (men: 31, women: 5; mean age: 53.5 ± 11.3 [range: 28–74] years) included in the study, no patients died. Between-group differences regarding sex, age, BMI, time from first debridement to wound healing, number of debridements, FGSI, and shock were not statistically significant ( P  > 0.05). However, lesion diameter, colostomy, VAS score, dressing changes, analgesic use, length of hospital stay, and wound reconstruction method (χ 2  = 5.43, P  = 0.04) exhibited statistically significant differences. Tension-relieving sutures (6 vs. 21) and flap transfer (4 vs. 2) were applied in Groups I and II, respectively. Conclusion VSD can reduce postoperative dressing changes and analgesic use, and shrunk the wound area, thereby reducing flap transfer in wound reconstruction.

While it is known that spermatogonial stem cells (SSCs) initiate the production of male germ cells, the mechanisms of SSC self-renewal, proliferation, and differentiation remain poorly understood. We have previously identified Strawberry Notch 1 (SBNO1), a vertebrate strawberry notch family protein, in the proteome profile for mouse SSC maturation and differentiation, revealing SBNO1 is associated with neonatal testicular development. To explore further the location and function of SBNO1 in the testes, we performed Sbno1 gene knockdown in mice to study the effects of SBNO1 on neonatal testicular and SSC development. Our results revealed that SBNO1 is required for neonatal testicular and SSC development in mice. Particularly, in vitro Sbno1 gene knockdown with morpholino oligonucleotides caused a reduction of SSCs and inactivation of the noncanonical Wnt pathway, through Jun N-terminal kinases. Our study suggests SBNO1 maintains SSCs by promoting the noncanonical Wnt pathway.

Background Immune thrombocytopenic purpura and thrombotic thrombocytopenic purpura are both causes of thrombocytopenia. Recognizing thrombotic thrombocytopenic purpura is crucial for subsequent treatment and prognosis. In clinical practice, corticosteroids and rituximab can be used to treat both immune thrombocytopenic purpura and thrombotic thrombocytopenic purpura; plasma exchange therapy is the first-line treatment in thrombotic thrombocytopenic purpura, while corticosteroids are strongly recommended as first-line treatment in immune thrombocytopenic purpura. The differential diagnosis of immune thrombocytopenic purpura and thrombotic thrombocytopenic purpura is essential in clinical practice. However, case reports have suggested that immune thrombocytopenic purpura and thrombotic thrombocytopenic purpura can occur concurrently. Case presentation We report the case of a 32-year-old Asian female without previous disease who presented with pancytopenia, concurrent with immune thrombocytopenic purpura and thrombotic thrombocytopenic purpura. The morphology of the megakaryocytes in the bone marrow indicated immune-mediated thrombocytopenia. The patient received glucocorticoid treatment, and her platelet count increased; however, schistocytes remained high during the course of the therapy. Further investigations revealed ADAMTS13 activity deficiency and positive ADAMTS13 antibodies. The high titer of antinuclear antibody and positive anti-U1-ribonucleoprotein/Smith antibody indicated a potential autoimmune disease. However, the patient did not fulfill the current criteria for systemic lupus erythematosus or mixed connective tissue disease. The patient responded well to plasma exchange therapy, and her platelet count remained normal on further follow-up. Conclusions Concurrence of immune thrombocytopenic purpura and thrombotic thrombocytopenic purpura is rare, but clinicians should be aware of this entity to ensure prompt medical intervention. Most of the reported cases involve young women. Human immunodeficiency virus infection, pregnancy, and autoimmune disease are the most common underlying conditions.