[Vascular endothelial growth factor promotes cancer stemness of triple-negative breast cancer via MAPK/ERK pathway]

OBJECTIVE

To investigate the role of vascular endothelial growth factor (VEGF) in regulating triple-negative breast cancer (TNBC) stem cells and the possible pathways involved in this regulatory mechanism.

METHODS

The Oncomine database, UALCAN database and Human Protein Atlas (HPA) database were used to analyze the expression of VEGF in breast cancer and its association with the molecular subtypes and prognosis of breast cancer. Sphere formation assay was carried out to examine the effects of hVEGF₁₆₅ on sphere formation ability of TNBC MDA-MB-231 cell line; Western blotting and RT-qPCR were performed to detect the expression of the tumor stem cell markers including CD44, c-Myc, Nanog, and ALDH1 and the activation of the related pathways.

RESULTS

Data from the online databases all showed a significant increase of VEGF expression in breast cancer tissues than in the adjacent tissues (P < 0.0001), and its expression level was associated with the molecular subtypes of breast cancer. Specifically, the expression of VEGF was markedly higher in TNBC than in other subtypes of breast cancer. Survival analysis showed that breast cancer patients with a high VEGF expression had a significantly shortened overall survival (P < 0.0001). In the cell experiments, the sphere formation ability of MDA-MB-231 cells was significantly enhanced after treatment with hVEGF₁₆₅ (P=0.0029). Compared with the monolayer cells, MDA-MB-231 spheres showed significantly increased expressions of VEGF, NRP-1, CD44, Nanog and c-Myc. Treatment with hVEGF₁₆₅ resulted in significant time-dependent up-regulation of the expressions of CD44, c-Myc, Nanog and ALDH1 and down-regulation of CD24 expression in the cells. The results of Western blotting demonstrated that treatment with hVEGF₁₆₅ caused significant activation of the ERK/MAPK pathway in MDA-MB-231 cells.

CONCLUSION

VEGF promotes cancer stemness of triple-negative breast cancer possibly through the ERK/MAPK pathway.

Evaluation of different late left ventricular remodeling definitions for predicting long-term outcomes in acute myocardial infarction patients undergoing percutaneous coronary intervention

Background

Late left ventricular remodeling (LLVR) after the index acute myocardial infarction (AMI) is a common complication, and is associated with poor outcome. However, the optimal definition of LLVR has been debated because of its different incidence and influence on prognosis. At present, there are limited data regarding the influence of different LLVR definitions on long-term outcomes in AMI patients undergoing percutaneous coronary intervention (PCI).

Purpose

To explore the impact of different definitions of LLVR on long-term mortality, re-hospitalization or an urgent visit for heart failure, and identify which definition was more suitable for predicting long-term outcomes in AMI patients undergoing PCI.

Methods

We prospectively observed 460 consenting first-time AMI patients undergoing PCI from January 2012 to December 2018. LLVR was defined as a ≥20% increase in left ventricular end-diastolic volume (LVEDV), or a &gt;15% increase in left ventricular end-systolic volume (LVESV) from the initial presentation to the 3–12 months follow-up, or left ventricular ejection fraction (LVEF) &lt;50% at follow up. These parameters of the cardiac structure and function were measuring through the thoracic echocardiography. The association of LLVR with long-term prognosis was investigated by Cox regression analysis.

Results

The incidence rate of LLVR was 38.1% (n=171). The occurrence of LLVR according to LVESV, LVEDV and LVEF definition were 26.6% (n=117), 31.9% (n=142) and 11.5% (n=51), respectively. During a median follow-up of 2 years, after adjusting other potential risk factors, multivariable Cox regression analysis revealed LLVR of LVESV definition [hazard ratio (HR): 2.50, 95% confidence interval (CI): 1.19–5.22, P=0.015], LLVR of LVEF definition (HR: 16.46, 95% CI: 6.96–38.92, P&lt;0.001) and LLVR of Mix definition (HR: 5.86, 95% CI: 2.45–14.04, P&lt;0.001) were risk factors for long-term mortality, re-hospitalization or an urgent visit for heart failure. But only LLVR of LVEF definition was a risk predictor for long-term mortality (HR: 6.84, 95% CI: 1.98–23.65, P=0.002).

Conclusions

LLVR defined by LVESV or LVEF may be more suitable for predicting long-term mortality, re-hospitalization or an urgent visit for heart failure in AMI patients undergoing PCI. However, only LLVR defined by LVEF could be used for predicting long-term mortality.

Funding Acknowledgement

Type of funding sources: None. Association Between LLVR and outcomesKaplan-Meier Estimates of the Mortality

Predictive value of neutrophil percentage-to-albumin ratio for contrast-associated acute kidney injury in patients without chronic kidney disease undergoing elective percutaneous coronary intervention

Background

Although previous studies have demonstrated that neutrophil and albumin are biomarkers of inflammation and malnutrition, which are highly related with contrast-associated acute kidney injury (CA-AKI). However, there has been no study investigated the combined evaluation of neutrophil and albumin in predicting CA-AKI.

Purpose

To explore the predictive value of neutrophil percentage-to-albumin ratio (NPAR) for CA-AKI in patients undergoing elective percutaneous coronary intervention (PCI).

Methods

We prospectively observed 5083 consenting patients without chronic kidney disease (CKD) undergoing elective PCI from January 2012 to December 2018. NPAR was calculated as neutrophil percentage numerator divided by serum albumin concentration. CA-AKI was defined as an increase in serum creatinine (SCr) ≥50% or 0.3 mg/dL within 48 hours after contrast medium exposure. The association between NPAR and CA-AKI was investigated by logistic regression analysis. The area under the receiver-operating characteristic curve (AUC), continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were calculated to make comparison for CA-AKI prediction.

Result

The incidence of CA-AKI was 5.6% (n=286). The median NPAR was 14.9 (13.0–17.1). According to the receiver operating characteristic curves (ROC), the best cut-off value of NPAR for predicting CA-AKI was 15.7 with 66.8% sensitivity and 61.9% specificity (C statistic=0.679; 95% CI, 0.666–0.691). NPAR displayed higher AUC value in comparison to neutrophil percentage (p&lt;0.001), but not albumin (P=0.063), as a predictor of CA-AKI. However, NPAR significantly improved the prediction of CA-AKI in the continuous NRI and IDI over neutrophil percentage (NRI: 0.353, 95% CI: 0.234–0.472, P&lt;0.001; IDI: 0.017, 95% CI: 0.010–0.024, p&lt;0.001) and albumin (NRI: 0.141, 95% CI: 0.022–0.260, P=0.020; IDI: 0.009, 95% CI: 0.003–0.015, p=0.003) alone. After adjusting for potential confounding risk factors of CA-AKI, multivariable logistic analysis showed that NPAR &gt;15.7 was a strong independent predictor of CA-AKI (OR=1.998, 95% CI, 1.511–2.643, p&lt;0.001).

Conclusion

NPAR is an independent predictor of CA-AKI, which significantly improved the prediction of CA-AKI over neutrophil and albumin alone in patients without CKD undergoing elective PCI.

Funding Acknowledgement

Type of funding sources: None. ROC for NPAR to predict CA-AKIPredictors of CA-AKI

The De-Ritis ratio is associated with contrast-associated acute kidney injury in patients undergoing elective percutaneous coronary intervention

Background

Preoperative liver dysfunction has been demonstrated as a poor prognostic factor after major surgery. Recent researches discovered that an increased De-Ritis ratio (aspartate aminotransferase-to-alanine aminotransferase ratio) reflects the liver dysfunction and was associated with adverse cardiovascular and renal outcomes. However, there is a lack of data exploring the predictive value of the De-Ritis ratio on contrast-associated acute kidney injury (CA-AKI) in patients undergoing elective percutaneous coronary intervention (PCI).

Purpose

To evaluate the predictive value of the De-Ritis ratio for CA-AKI in patients undergoing elective PCI.

Methods

We conducted a prospective, observational study with 5780 consenting patients undergoing elective PCI from January 2012 to December 2018. CA-AKI was defined as an increase in serum creatinine (SCr) ≥50% or 0.3 mg/dL within 48 hours after contrast medium exposure. The relationship between the De-Ritis ratio and CA-AKI was investigated by logistic regression analysis. The predictive utility of the De-Ritis ratio was determined and compared using the area under the receiver-operating characteristic curve (AUC).

Result

CA-AKI developed in 363 (6.3%) patients. The median De-Ritis ratio was 1.00 (0.77–1.33). The De-Ritis ratio showed an AUC of 0.636 (95% confidence interval (CI): 0.624–0.649; P&lt;0.001) in predicting CA-AKI, which was significantly greater than aspartate aminotransferase (AST) (AUC: 0.636 vs 0.589, p=0.015) and alanine aminotransferase (ALT) (AUC: 0.636 vs 0.506, p&lt;0.001). The best cut-off value of the De-Ritis ratio for predicting CA-AKI was 1.30 with 47.1% sensitivity and 74.7% specificity. Multivariable logistic analysis showed that the De-Ritis ratio &gt;1.30 was a remarkable independent predictor of CA-AKI (OR=1.757, 95% CI, 1.385–2.229, p&lt;0.001) even after adjusting for other CA-AKI risk factors.

Conclusion

The De-Ritis ratio is an independent risk factor for predicting CA-AKI in patients undergoing elective PCI.

Funding Acknowledgement

Type of funding sources: None. ROC for De-Ritis ratio to predict CA-AKIPredictors of CA-AKI

[Epidemiological characteristics of Chlamydia pneumoniae in cases with acute respiratory infection in Beijing, 2015-2019]

Objective: To analyze the epidemiological characteristics of Chlamydia pneumoniae infection among patients with acute respiratory infection in Beijing from 2015 to 2019. Methods: The epidemiological data of acute respiratory infection patients from 35 sentinel hospitals in Beijing were collected by the respiratory pathogen surveillance system in Beijing. The clinical samples were collected to detect Chlamydia pneumoniae, and the sequence of the VD4 region of the ompA gene in positive samples was analyzed. Results: From January 2015 to December 2019, the overall positive rate of Chlamydia pneumoniae among patients with acute respiratory infection in Beijing was 0.34% (129/37 460). The positive rate of Chlamydia pneumoniae generally increased in March, reaching the peak in May, and started to drop in July, with a duration of about 5-8 months. The epidemic season in different years fluctuated by 1-2 months. The positive monthly rate of Chlamydia pneumoniae was no less than 0.30% in every epidemic season. The positive rate of Chlamydia pneumoniae was the highest in the 5-44 years old group and the highest in 10-14 year-olds. The risk of Chlamydia pneumoniae infection increased with age in patients younger than 25 years old and decreased in those older one aged than 25 years of age. The positive rates in male and female patients were 0.33% (68/20 830) and 0.37% (61/16 528), respectively, and there was no significant difference between the two groups (χ²=0.486, P=0.486). The positive rate of Chlamydia pneumoniae in patients with common pneumonia was higher than that in patients with upper pneumonia and severe pneumonia (χ²=36.797, P<0.01). Other respiratory pathogens were also detected in the Chlamydia pneumoniae samples, and the top four pathogens appeared as Haemophilus influenzae (15 cases), Streptococcus pneumoniae (13 cases), Rhinovirus (8 cases), and Stenotrophomonas maltophilia (7 cases). 101 strains of 129 Chlamydia pneumoniae positive samples were identified as type A by sequencing. Conclusions: The annual epidemic pattern of Chlamydia pneumoniae in Beijing, is unimodal, and the epidemic season generally appears from March to July. The seasonal characteristics of Chlamydia pneumoniae in Beijing can be used for the differential diagnosis of Chlamydia pneumoniae from other respiratory pathogens. Chlamydia pneumoniae is most common in people aged 5-44 years, and the primary genotype is type A. People aged 10-44 years old suffer the highest incidence. If the nucleic acid positive rate of Chlamydia pneumoniae exceeds 0.30% for two consecutive months, the high prevalence period of Chlamydia pneumoniae can be preliminarily expected. Chlamydia pneumoniae infection has a higher probability of progressing to severe pneumonia from general pneumonia.

[Clinical characteristics of patients infected with Chlamydia pneumoniae in Beijing from 2015 to 2019]

Objective: To aralyze the clinical characteristics of Chlamydia pneumoniae infection in Beijing. Methods: Based on Beijing Respiratory Pathogen Surveillance System, acute respiratory infection patients were recruited from 35 different types of sentinel hospitals in Beijing. Their epidemiological and clinical data were systematically collected and clinical specimens were also obtained. Nuclear acid testing was performed for 30 types of respiratory pathogens (including Chlamydia pneumoniae). The identified patients of Chlamydia pneumoniae infection were divided into two groups, the acute upper respiratory tract infection (AURI) group and pneumoniae group. The differences in clinical characteristics, laboratory examination and prognosis were compared by using independent sample t test, Mann-Whitney U test, χ² test or Fisher's exact probability test. Results: A total of 119 patients of Chlamydia pneumoniae infection were included, including 12 patients in the AURI group and 107 patients in pneumoniae group. Chlamydia pneumoniae infection mainly occurred in people aged from 5 to 44 years, accounting for 81.5% (97/119). The three most common clinical symptoms were cough (92.4%, 110/119), fever (88.8%, 95/107), and sputum production (76.5%, 91/119). White blood cell counts increased in 39.3% (46/117) of patients. Neutrophile granulocyte proportion increased in 39.7% (46/116) of patients. Platelet count increased in 36.9% (41/111) of patients. An increase of the creatine kinase MB isoenzyme (CKMB) was observed in 12 pneumonia patients (24.5%, 12/49). Radiological examination showed that 90.6% (87/105) of patients in the pneumoniae group had pulmonary parenchymal changes; the lesion occurred most commonly in the lower right lung lobe (34.3%, 36/105) and the lower left lung lobe (27.6%, 29/105). Although 73.8% (79/107) of patients in the pneumoniae group were hospitalized, no case received intensive care unit or mechanical ventilation. As to outcomes, one patient developed respiratory failure and 6 patients suffered myocardial injury. No death was observed in this study. The median days of hospitalization and course of illness for pneumonia patients M(P₂₅,P₇₅) were 10.0 (7.0, 13.0) days and 18.0 (13.5, 22.0) days, respectively. Conclusion: Generally, Chlamydia pneumoniae infections in Beijing from 2015 to 2019 were mild, and the main clinical manifestations were cough, fever and sputum. However, most patients in the pneumoniae group caused by Chlamydia pneumoniae still required hospitalization but with a better outcome.

Development of a multi-channel 320 GHz interferometer for high density plasma measurement in Heliotron J

We report the development of a new interferometer with two stable, high-power, 320 GHz solid-state sources in Heliotron J. A heterodyne Michelson interferometer optical scheme is employed. Two solid-state oscillators are utilized as sources with a fixed frequency at 320 GHz and frequency tunable of 312-324 GHz. Quasi-optical techniques are used for beam transmission. The beam is elongated in the vertical direction with two off-axis parabolic mirrors and injected into the plasma as a sheet beam for the multi-channel measurement (>5 ch.). Passing through the plasma, the beam is reflected at a retroreflector-array installed at the vacuum chamber wall. The retroreflector-array is a bunch of retroreflector structures, which can suppress the beam refraction caused by plasma without much space inside a vacuum chamber unlike a single retroreflector and can facilitate the system design. The source, detectors, and the retroreflector-array are tested to evaluate their basic performance on a tabletop experiment.

[Pilot study of genetic counseling and prenatal diagnosis in androgen insensitivity syndrome: with 3 families reports]

Objective: To explore genetic counseling and prenatal diagnosis strategies for women who have androgen insensitivity syndrome (AIS) family history or pregnancy history of AIS proband. Methods: Three families of complete AIS (CAIS) were retrospectively reported and summarized. The subsequent pregnancies and processes of prenatal diagnosis were followed up. Results: Among three CAIS families, one family had androgen receptors (AR) gene mutation diagnosis; the other two families were diagnosed clinically without gene diagnosis. All three mothers of CAIS probands were in pregnant again when they sought counseling, with gestational weeks between 7－13 weeks. They underwent chorionic villi sampling or amniocentesis in their second trimester (at 12, 16, 17 weeks respectively). Chromosome gender of all three fetuses were 46,XY, which was inconsistent with the ultrasonographic phenotype of external genitalia. All patients chose selective abortion in their second trimester. The external genitalia of all aborted fetuses were female phenotype, which supported the diagnosis of CAIS. Conclusion: Genetic counseling and prenatal diagnosis should be provided to high-risk patients with family history of AIS or proband pregnancy history, so as to achieve the goal of good childbearing and sound childrearing.

PADI4, negatively regulated by miR-335-5p, participates in regulating the proliferation, migration, invasion and radiosensitivity of nasopharyngeal carcinoma cells

Peptidyl arginine deiminase 4 (PADI4), an enzyme that converts arginine residues to citrulline residues in the presence of calcium ions, affects the biochemical activities of proteins. The biological function of PADI4 as well as its mechanism in nasopharyngeal carcinoma (NPC) necessitates further investigation. PADI4 expression in NPC tissues and cells was detected using Western blot. qRT-PCR was used to determine the expression of miR-335-5p and PADI4 mRNA in NPC tissues and cells. BrdU assay and CCK-8 assay were employed to detect cell proliferation. Cell migration and invasion were evaluated using Transwell assay. NPC cells were exposed to different doses of radiation in vitro, and then colony formation assays were used to detect colony survival. The target relationship between miR-335-5p and PADI4 was verified using Western blot, qRT-PCR, and dual-luciferase reporter gene assays. Compared with normal mucosal epithelial tissues and cell lines, the expression level of PADI4 in NPC tissues and cells was significantly up-regulated. PADI4 overexpression promoted the proliferation, migration, and invasion of NPC cells. Under radiation, NPC cell survival was significantly promoted by the up-regulation of PADI4. Conversely, knock-down of PADI4 suppressed the above-mentioned malignant phenotypes. MiR-335-5p could bind with the 3' UTR of PADI4 mRNA, and suppressed the expression of PADI4. PADI4 down-regulated the expression of p21 and activated the mTOR signaling pathway. PADI4, which is negatively regulated by miR-335-5p, promotes the proliferation, migration, invasion and radioresistance of NPC cells by regulating the p21 and mTOR signaling pathways.

Peri-prostatic adipose tissue measurements using MRI predict prostate cancer aggressiveness in men undergoing radical prostatectomy

OBJECTIVES

To evaluate the effect of peri-prostatic adipose tissue (PPAT) measurements using preoperative MRI on the prediction of prostate cancer (PCa) aggressiveness in men undergoing radical prostatectomy (RP).

METHODS

We performed a retrospective study on 179 consecutive patients receiving RP from June 2016 to October 2018. Clinical characteristics were collected. PPAT measurements including peri-prostatic fat area (PPFA) and peri-prostatic fat area to prostate area (PA) ratio (PPFA/PA) were calculated by MRI. Multivariable logistic regression analysis was performed to identify independent predictors of PCa lymph node metastasis (LNM). The predictive performance was estimated through ROC curves. Nomograms were created based on the predictors.

RESULTS

Pathologic Gleason score positively correlated with digital rectal examination (DRE), PSA, PPFA/PA, P504S, and Ki-67 (all P < 0.05). ROC curves revealed that high PPFA and high PPFA/PA were associated with LNM (both P < 0.05). Multivariate analysis revealed that high PPFA/PA, pathologic Gleason score, pT stage, and Ki-67 were independently predictive of LNM. The nomograms were created and the C-index was 0.945.

CONCLUSIONS

PPFA/PA is an independent predictor for LNM along with Gleason score, pT stage, and Ki-67. PPFA/PA may help predict LNM in men undergoing RP, thus providing adjunctive information for therapeutic strategy and prognosis.

Energy value of rice, broken rice, and rice bran for broiler chickens by the regression method

The objective of this study was to determine the ileal digestible energy (IDE), ME, and ME_n of rice, broken rice, and rice bran. The birds were fed a standard starter diet from day 0 to 14 and experimental diets from day 15 to 21 after hatching. A total of 336 birds were grouped by BW and assigned to 7 diets, each diet comprised 8 replicates with 6 birds per replicate. The diets comprised a reference diet (RD) and 6 test diets (TD). The TD contained 2 levels of rice, broken rice or rice bran that partly replaced the energy sources in the RD at 120 or 240 g/kg (rice and broken rice) or 150 or 300 g/kg (rice bran). Addition of rice or broken rice to RD linearly increased (P < 0.01) ileal digestibility of DM, energy, as well as total tract metabolizability of DM, energy, and N-corrected energy in the TD. The inclusion of rice bran in the TD linearly decreased (P < 0.01) energy digestibility and utilization in the test diet. Regressions of rice-associated, broken rice-associated, or rice bran-associated IDE, ME, or ME_n intake in kcal against rice, broken rice, or rice bran intake were as follows: IDE = Y = 2 (6) + 3,185 (73) × Rice + 3,199 (72) × Broken Rice + 2,562 (61) × Rice Bran, r2 = 0.98; ME = Y = 8 (6) + 3,103 (72) × Rice + 3,190 (71) × Broken Rice + 2,709 (60) × Rice Bran, r2 = 0.98; ME_n = Y = 4 (5) + 3,014 (68) × Rice + 3,092 (101) × Broken Rice + 2,624 (57) × Rice Bran, r2 = 0.98; Based on the regression equations, the IDE, ME, ME_n values (kcal/kg of DM) of rice were 3,185, 3,103 and 3,014, respectively, while for broken rice, the values were 3,199, 3,190, and 3,092 and for rice bran, the values were 2,562, 2,709, and 2,624, respectively.

Relationship between vasomotor symptoms and metabolic syndrome in Chinese middle-aged women

PURPOSE

This study aimed to find the associations between vasomotor symptoms (VMS) and metabolic syndrome (MetS) in Chinese middle-aged women in a cross-sectional study.

METHODS

A total of 675 participants were recruited from an urban Chinese community. MetS was defined by the 2009 criteria of the Joint Interim Statement. VMS including hot flashes and sweats, blood pressure, weight, height, waist circumference (WC), serum glucose, triglycerides, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), estradiol, and follicle-stimulating hormone (FSH) were collected.

RESULTS

The presence of hot flashes was independently associated with the risk of MetS after adjusting for age, menopausal status, FSH_log, estradiol_log, and physical activity (odds ratio: 1.98, 95% confidence interval: 1.21-3.24, p = 0.006). Both hot flashes and sweats were also independently associated with WC (for hot flashes, p = 0.016; and for sweats, p = 0.007) and triglycerides (for hot flashes, p = 0.041; and for sweats, p = 0.014) significantly. However, VMS were not significantly associated with blood pressure, glucose, HDL, and LDL.

CONCLUSION

Women with hot flashes had a higher risk of MetS. Both hot flashes and sweats were related to a higher amount of central fat indicated by WC and higher triglycerides, but were not related to blood pressure, glucose, and HDL in Chinese women.

Predictor Biomarkers of Nonelective Hospital Readmission and Mortality in Malnourished Hospitalized Older Adults

BACKGROUND

90-day mortality and rehospitalizations are important hospital quality metrics. Biomarkers that predict these outcomes among malnourished hospitalized patients could identify those at risk and help direct care plans.

OBJECTIVES

To identify biomarkers that predict 90-day (primary) and 30-day (secondary) mortality or nonelective rehospitalization.

DESIGN AND PARTICIPANTS

An analysis of the ability of biomarkers to predict 90- and 30-day mortality and rehospitalization among malnourished hospitalized patients.

SETTING

52 blood biomarkers were measured in 193 participants in NOURISH, a randomized trial that determined the effects of a nutritional supplement on 90-day readmission and death in patients >65 years. Composite outcomes were defined as readmission or death over 90-days or 30-days. Univariate Cox Proportional Hazards models were used to select best predictors of outcomes. Markers with the strongest association were included in multivariate stepwise regression. Final model of hospital readmission or death was derived using stepwise selection.

MEASUREMENTS

Nutritional, inflammatory, hormonal and muscle biomarkers.

RESULTS

Mean age was 76 years, 51% were men. In univariate models, 10 biomarkers were significantly associated with 90-day outcomes and 4 biomarkers with 30-day outcomes. In multivariate stepwise selection, glutamate, hydroxyproline, tau-methylhistidine levels, and sex were associated with death and readmission within 90-days. In stepwise selection, age-adjusted model that included sex and these 3 amino-acids demonstrated moderate discriminating ability over 90-days (C-statistic 0.68 (95%CI 0.61, 0.75); age-adjusted model that included sex, hydroxyproline and Charlson Comorbidity Index was predictive of 30-day outcomes (C-statistic 0.76 (95%CI 0.68, 0.85).

CONCLUSIONS

Baseline glutamate, hydroxyproline, and tau-methylhistidine levels, along with sex and age, predict risk of 90-day mortality and nonelective readmission in malnourished hospitalized older patients. This biomarker set should be further validated in prospective studies and could be useful in prognostication of malnourished hospitalized patients and guiding in-hospital care.

Overexpression of PKMYT1 indicates the poor prognosis and enhances proliferation and tumorigenesis in non-small cell lung cancer via activation of Notch signal pathway

OBJECTIVE

The protein kinase, membrane‑associated tyrosine/threonine 1 (PKMYT1) has been implicated as an important factor promoting the tumorigenesis of hepatocellular carcinoma and colorectal cancer. The current study was designed to explore the functional role of PKMYT1 in non-small cell lung cancer (NSCLC) cell behaviors and to investigate the possible molecular mechanisms.

PATIENTS AND METHODS

The expression levels of PKMYT1 in NSCLC tissues and cell lines were determined by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The clinical and prognostic significance of PKMYT1 in 153 cases of NSCLC was determined. We also evaluated the effects of KMYT1 on NSCLC cell proliferation, migration, and invasion in vitro. Western blot was performed to assure whether PKMYT1 affected the Notch signal pathway and MET pathway.

RESULTS

We observed that PKMYT1 expression was significantly up-regulated in both NSCLC tissues and cell lines. Higher expression of PKMYT1 was associated with clinical stage and lymph nodes metastasis. Clinical survival assays demonstrated that patients with high PKMYT1 expression had a shorter overall survival time than those with low PKMYT1 expression. Moreover, the multivariate analysis confirmed that increased expression of PKMYT1 was an independent predictor of overall survival. Functionally, knockdown of PKMYT1 in the NSCLC cell lines A549 and H1299 suppressed NSCLC cells proliferation, invasion and migration, and promoted apoptosis. In addition, the down-regulation of PKMYT1 resulted in the inhibition of EMT in NSCLC cells. Further mechanistic studies revealed that when PKMYT1 was silenced, the expression levels of Notch1, p21, and Hes1 were respectively downregulated, suggesting that PKMYT1 could promote the activity of the Notch signal pathway.

CONCLUSIONS

PKMYT1 plays a significant role in NSCLC aggressiveness and clinical outcome, and may serve as a promising therapeutic target for this disease.

[Analysis on the cluster epidemic of coronavirus disease 2019 in Guangdong Province]

Objective: Analysis of clustering characteristics of coronavirus disease 2019 (COVID-19) in Guangdong Province. Methods: The COVID-19 cases in Guangdong Province onset from January 1 to February 29, 2020 were collected from Chinese information system for disease control and prevention and Emergency Public Reporting System. Obtain the epidemiological survey data of the cluster epidemic situation, and clarify the scale of cluster epidemic situation, the characteristics of the index cases, family and non-family subsequent cases. Calculate serial interval according to the onset time of the index cases and subsequent cases, secondary attack rate based on the close contacts tracking results, the characteristics of different cases in the clustered epidemic were compared. Results: A total of 283 cluster were collected, including 633 index cases, 239 subsequent cases. Families are mainly clustered, the total number involved in each cluster is in the range of 2-27, M (P₂₅, P₇₅) are 2.0 (2.0, 4.0). During January 15 to February 29, the secondary attack rate is 2.86% (239/8 363) in Guangdong Province, the family secondary attack rate was 4.84% (276/3 697), and the non-family secondary attack rate was 1.32% (61/4 632). According to the reporting trend of the number of cases in Guangdong Province, it can be divided into four stages, the rising stage, the high platform stage, the descending stage and the low level fluctuation period. The secondary attack rate of the four stages were 3.5% (140/3 987), 2.3% (55/2 399), 2.6% (37/1 435), 1.3% (7/542), respectively. The difference was statistically significant (P=0.003). Conclusion: COVID-19 cluster mainly occurs in families in Guangdong Province. The scale of the clustered epidemic was small; the serial interval was short; and the overall secondary attack rate was low.