FPR2 enhances colorectal cancer progression by promoting EMT process

Formyl peptide receptor-2 (FPR2) has been shown to promote various tumors, but its role in colorectal cancer (CRC) has not been clearly illuminated. The aim of this study was to investigate the effect of FPR2 interference on cell proliferation, migration, invasion, apoptosis, pro-angiogenesis of CRC cells, and also the mechanisms involved. Quantitative PCR assays were applied to assess the expression levels of FPR2 in CRC tissues. CRC cell line SW1116 was chosen to perform this study. We knocked down FPR2 gene by sh-RNA. Then, the cell proliferation was assayed by soft agar colony formation assay, the cell migration capacity was checked by wound healing assay, and cell invasion ability was detected by transwell assay. In addition, flow cytometric analysis was used to detect apoptosis, while endothelial tube formation assay was used to evaluate the effects of FPR2 on pro-angiogenesis in vitro. Tumorigenesis experiment in vivo was performed in nude mice. EMT-related proteins were studied by western blotting. Quantitative PCR demonstrated that FPR2 mRNA was highly expressed in the colorectal cancer tissues. SW1116 cells' capacities of proliferation, migration, invasion, anti-apoptosis and pro-angiogenesis were distinctly suppressed after silencing FPR2 in SW1116 by sh-RNA. Suppression FPR2 mRNA in SW1116 cells suppressed tumorigenicity in nude mice. The expression of proteins related to epithelial-mesenchymal transition (EMT) such as E-cadherin, N-cadherin, Snail, Slug and vimentin was changed after suppressing FPR2. In conclusion, our study demonstrated that FPR2 could promote CRC cells progression in vitro and in vivo that may relate to promoting EMT.

Deep Learning-Assisted Diagnosis of Cerebral Aneurysms Using the HeadXNet Model

IMPORTANCE

Deep learning has the potential to augment clinician performance in medical imaging interpretation and reduce time to diagnosis through automated segmentation. Few studies to date have explored this topic.

OBJECTIVE

To develop and apply a neural network segmentation model (the HeadXNet model) capable of generating precise voxel-by-voxel predictions of intracranial aneurysms on head computed tomographic angiography (CTA) imaging to augment clinicians' intracranial aneurysm diagnostic performance.

DESIGN, SETTING, AND PARTICIPANTS

In this diagnostic study, a 3-dimensional convolutional neural network architecture was developed using a training set of 611 head CTA examinations to generate aneurysm segmentations. Segmentation outputs from this support model on a test set of 115 examinations were provided to clinicians. Between August 13, 2018, and October 4, 2018, 8 clinicians diagnosed the presence of aneurysm on the test set, both with and without model augmentation, in a crossover design using randomized order and a 14-day washout period. Head and neck examinations performed between January 3, 2003, and May 31, 2017, at a single academic medical center were used to train, validate, and test the model. Examinations positive for aneurysm had at least 1 clinically significant, nonruptured intracranial aneurysm. Examinations with hemorrhage, ruptured aneurysm, posttraumatic or infectious pseudoaneurysm, arteriovenous malformation, surgical clips, coils, catheters, or other surgical hardware were excluded. All other CTA examinations were considered controls.

MAIN OUTCOMES AND MEASURES

Sensitivity, specificity, accuracy, time, and interrater agreement were measured. Metrics for clinician performance with and without model augmentation were compared.

RESULTS

The data set contained 818 examinations from 662 unique patients with 328 CTA examinations (40.1%) containing at least 1 intracranial aneurysm and 490 examinations (59.9%) without intracranial aneurysms. The 8 clinicians reading the test set ranged in experience from 2 to 12 years. Augmenting clinicians with artificial intelligence-produced segmentation predictions resulted in clinicians achieving statistically significant improvements in sensitivity, accuracy, and interrater agreement when compared with no augmentation. The clinicians' mean sensitivity increased by 0.059 (95% CI, 0.028-0.091; adjusted P = .01), mean accuracy increased by 0.038 (95% CI, 0.014-0.062; adjusted P = .02), and mean interrater agreement (Fleiss κ) increased by 0.060, from 0.799 to 0.859 (adjusted P = .05). There was no statistically significant change in mean specificity (0.016; 95% CI, -0.010 to 0.041; adjusted P = .16) and time to diagnosis (5.71 seconds; 95% CI, 7.22-18.63 seconds; adjusted P = .19).

CONCLUSIONS AND RELEVANCE

The deep learning model developed successfully detected clinically significant intracranial aneurysms on CTA. This suggests that integration of an artificial intelligence-assisted diagnostic model may augment clinician performance with dependable and accurate predictions and thereby optimize patient care.

Three-dimensional printing of metals for biomedical applications

Three-dimensional (3D) printing technology has received great attention in the past decades in both academia and industry because of its advantages such as customized fabrication, low manufacturing cost, unprecedented capability for complex geometry, and short fabrication period. 3D printing of metals with controllable structures represents a state-of-the-art technology that enables the development of metallic implants for biomedical applications. This review discusses currently existing 3D printing techniques and their applications in developing metallic medical implants and devices. Perspective about the current challenges and future directions for development of this technology is also presented.

Comparison of intravenous lidocaine and dexmedetomidine infusion for prevention of postoperative catheter-related bladder discomfort: a randomized controlled trial

BACKGROUND

Catheter-related bladder discomfort (CRBD) frequently occurs during recovery in patients who undergo intra-operative urinary catheterization. We conducted this study to compare the effect of intravenous lidocaine and dexmedetomidine infusion for preventing CRBD.

METHODS

120 patients undergoing elective open abdominal hysterectomy or hysteromyomectomy requiring urinary bladder catheterization were randomly allocated into three groups of 40 each. Group L received a 2 mg/kg lidocaine bolus followed by infusion of 1.5 mg/kg/h; Group D received a 0.5 μg/kg dexmedetomidine bolus followed by infusion of 0.4 μg/kg/h; Group C received a bolus and infusion of normal saline of equivalent volume. The incidence and different severity (mild, moderate, and severe) of CRBD were assessed on arrival in the postanaesthesia care unit at 0, 1, 2, and 6 h postoperatively.

RESULTS

The incidence of CRBD was significantly lower in Group L and Group D compared with Group C at 0, 1, and 2 h. However, there was no significant difference among the three groups regarding the different severity of CRBD at all time points. The requirement of rescue tramadol for CRBD was lower in group L and group D than in group C. The incidence of sedation was significantly higher in Group D compared to Group L and Group C, though no difference in other adverse effects was observed.

CONCLUSIONS

Intravenous lidocaine and dexmedetomidine infusion reduced the incidence of CRBD as well as the additional tramadol requirement for CRBD, but had no effect on the different severity of CRBD.

TRIAL REGISTRATION

ChiCTR-INR-16009162 . Registered on 5 September 2016.

[Morphological classification of acute isolated pontine infarction and it's clinical relevance]

Objective: To investigate a diffusion weighted imaging (DWI)-based morphological classification for acute isolated pontine infarcts (AIPI) and to assess differences in clinical characteristics, risk factors and functional outcomes among the different morphologies. Methods: All participants from SMART cohort with DWI-proven AIPI were included and categorized into 3 groups: basilar artery branch disease (BABD) group, small artery disease (SAD) group and large-artery-occlusive disease (LAOD) group, according to lesion extent of the transverse axial plane and basilar artery atherosclerosis severity. The clinical characteristics, vascular risk factors and 6-month's functional outcome was analyzed among 3 groups. Results: Of the 1 129 patients enrolled, 175 had AIPI. BABD was the most frequent subtype of AIPI (46.3%), followed by SAD (36.0%) and LAOD (17.7%). Neurological impairment on admission was more severe in the LAOD and BABD group than SAD group (P<0.001). In terms of risk factors, the percentage of hypertension was significant different among three groups (P<0.05). The average National Institute of Health stroke scale was 3.49 for SAD group, 5.93 for LAOD group, 5.97 for BABD group, and the differences were significant (P<0.001). The Poor outcome (mRS>2) was found in only 13.7% of patients at 6-month post-stroke and there was no difference among 3 groups. Conclusions: According to the morphological classification, BABD is the most frequent subtype of AIPI. The differences of the clinical characteristics and risk factors among three groups indicate that differences observed in morphology might have distinct pathophysiologic mechanisms. AIPI can be reliably classified based on morphology using clinical magnetic resonance images.

[Prevalence and risk factors of perivascular space in the population of Shunyi Study]

Objective: To investigate the prevalence on imaging, topographic distribution and risk factors of perivascular space (PVS) in community population. Methods: This study was based on the population of Shunyi Study in China from June 2013 to September 2016. One thousand two hundred and thirty-two stroke free participants older than 35 years, who completed cerebral MRI, were included. Cardiovascular risk factors were assessed by interview, physical examination and blood sample tests. PVS were evaluated on high-resolution 3-dimensional-T1WI, T2WI and FLAIR sequences. On T1WI, PVS were detected according to 3D imaging criteria. The number and anatomic location of large PVS (≥3 mm) were recorded. And severity of PVS was then semiquantitatively graded in both white matter (WM) and basal ganglia (BG). Associations between risk factors and PVS were analyzed by multinominal Logistic regression models and adjusted for age, gender and relevant confounders. Results: Perivascular spaces were observed in the BG or WM in every subject, aged (55±10) years and 37.3% male. Large PVS were detected in 19.0% (460/1 232) of participants. Severity of PVS was found to be strongly associated with age in both basal ganglia (severe versus mild: OR=1.81; 95%CI 1.45-2.27, P<0.01) and white matter (OR=1.39; 95%CI 1.13-1.71, P<0.01), and the proportion of subjects with hypercholesterolemia decreased with the severity of PVS in BG (OR=0.58, P=0.01) . The present of large PVS was found to be associated with age(present versus absent: OR=1.03, 95%CI 1.02-1.05, P<0.01) and ApoE ε4 carrier genotype(OR=1.53, 95%CI 1.01-2.23, P=0.04). Conclusions: Perivascular spaces are always detected in the BG or WM in elderly people, and large PVS are also prevalent in community-based population. The risk factors are different due to distribution and size, and may depend on anatomic or pathologic characteristics.

[The overview of the development of modern burn surgery in China]

Chinese modern burn surgery belongs to the western medicine system. From 1930s, the knowledge of modern burn surgery spread over China. Its development had experienced four stages: enlightening stage, exploratory stage, mature stage, and remodeling stage. Before the 1950s, medical personnel began to study those knowledges. The clinical treatment developed slowly and had little experience. From the 1950s to 1960s, Chinese burn surgery professionals made the painstaking exploration and accumulated rich clinical experiences. The success of severe burns treatment attracted worldwide attention. From the 1970s to the mid-1990s, as the regulations of burn diagnosis and treatment established in China, the clinical treatment developed widely. The world's leading therapeutic effects have achieved. The professional education system has been founded, and the professional societies have created. Those made medical personnel can access the scientific research achievement. Therefore, the leading talents emerged. Chinese modern burn surgery entered a mature stage. Since the late-1990s, Chinese modern burn surgery entered a remodeling stage. Besides increasing the cure rate and decrease disability rate of burn gradually, Chinese modern burn surgery need solve new problems such as that standardization of diagnosis and treatment sets up, the scope of diagnosis and treatment expands, professional training improves, etc.

Removal of prometryn from hydroponic media using marsh pennywort (Hydrocotyle vulgaris L.)

The aquatic plant Hydrocotyle vulgaris was evaluated for its efficacy in removing prometryn from nutrient solution. Under optimized experimental conditions, up to 94.0% of the initial prometryn was removed from the hydroponic culture medium by H. vulgaris in 30 days. The concentration of prometryn decreased from the initial level of 0.55 ± 0.013 mg/L to 0.036 ± 0.001 mg/L at the end of the experimental period. The removal kinetics followed first-order kinetic equation (Ct = 0.4569e^-0.09t). Half-life (t_1/2) of prometryn was greatly shortened from 27.16 days (without plant) to 5.58 days (with H. vulgaris). Approximately 22% of the initial prometryn residue was found in H. vulgaris tissue, while 11.7% was degraded by the plant in 30 days. The metabolites of prometryn detected were 2,4-diamino-1,3,5-triazine (in the hydroponic culture medium) and 2,4,6-trihydroxy-1,3,5-triazine (in plant tissue) after 30 days. The results indicate that H. vulgaris can be used for phytoextraction of prometryn and could potentially be effective in removing other s-trazine pesticides from contaminated aquatic ecosystems.

Validation of a revised Mandarin Chinese language version of the Postoperative Quality of Recovery Scale

The aim of the study was to validate a revised Mandarin version of the Postoperative Quality of Recovery Scale (PostopQRS) and to apply the revised version in a Chinese population. In a prospective design, bilingual volunteers completed the scale at baseline, day one, day seven, and day 14 in both languages, with the order of language and parallel forms randomised. In addition, lung cancer patients undergoing open or video-assisted thoracoscopic surgery (VATS) completed the Mandarin version prior to surgery, day one, day three, day seven, day 14, one month, and three months postoperatively. Sixty-eight volunteers participated in the validation part of the study and in the clinical application, 93 lung cancer patients were included. The scores in the Mandarin version were equal to the English version in all domains at all timepoints including the word generation task, when the Mandarin morpheme was included in any part of the Mandarin word. However, Mandarin scores were lower in the word generation task if the morpheme was only included in the first part of the word. In addition, the Mandarin version was able to identify lower rates of overall recovery (<i>P</i> <0.01), nociceptive (<i>P</i> <0.01), emotive (<i>P</i> <0.01), and activities of daily living recovery (<i>P</i>=0.02) after open surgery compared to after VATS. The revised Mandarin version is equivalent to the English version for the cognitive domain, if morpheme substitution for the word generation task is allowed as any part of the word, and it is able to discriminate quality of recovery in Chinese patients.

Prognostic Risk Factors for Complications Associated with Below the Knee Amputations

Category:

Other

Introduction/Purpose:

Below the knee amputation (BKA) is an effective surgical procedure for individuals with severe injury or infection to their lower extremities. However, patients who receive these procedures are subject to significant morbidity and a high rate of postoperative complications due to the presence of multiple concomitant comorbidities. Despite the wide practice of this intervention, prognostic risk factors aiding in predicting surgical outcomes in these patients are poorly understood. The purpose of this study is to evaluate risk factors that may contribute to the outcomes of BKA procedures.

Methods:

The clinical and radiographic outcomes for 89 patients ages 19-90 who underwent BKA were retrospectively evaluated from 2012-2017. Postoperative complications of mortality, infection, and reoperation were evaluated with patient and surgical variables. Patient variables included: age, ambulatory status, obesity, diabetes, HbA1C2 levels, neuropathy, smoking, Charlson Comorbidity Index (CCI), and American Society of Anesthesiologists (ASA) classification. Surgical variables evaluated included: presence of pre-op infection, pre-op ambulatory status, tourniquet time, tourniquet pressure, and usage of prophylactic antibiotics.

Results:

Of the patients evaluated there was an overall complication rate of 49% (44/89) and a mortality rate of 19% (17/89). Patients with diabetes (p=.035), a greater score on the Charlson Comorbidity Index (p=.001), and an ASA classification =3 (p=.005) were associated with a greater risk of mortality. Operative values (i.e. tourniquet time, tourniquet pressure etc.) did not affect patient mortality rates in a significant way, but there was a higher incidence of complications (i.e. mortality, post-op infections, and reoperations) with patients with pre-operative infections.

Conclusion:

Diabetes, a higher CCI score and a greater ASA value were found to be significant predictors of patient mortality after BKA (p<0.05). Future perioperative optimization in these patients identified as high risk may improve patient outcomes in the future.

Role of the Astroglial Glutamate Exchanger xCT in Ventral Hippocampus in Resilience to Stress

We demonstrate that stress differentially regulates glutamate homeostasis in the dorsal and ventral hippocampus and identify a role for the astroglial xCT in ventral dentate gyrus (vDG) in stress and antidepressant responses. We provide an RNA-seq roadmap for the stress-sensitive vDG. The transcription factor REST binds to xCT promoter in co-occupancy with the epigenetic marker H3K27ac to regulate expression of xCT, which is also reduced in a genetic mouse model of inherent susceptibility to depressive-like behavior. Pharmacologically, modulating histone acetylation with acetyl-L-carnitine (LAC) or acetyl-N-cysteine (NAC) rapidly increases xCT and activates a network with mGlu2 receptors to prime an enhanced glutamate homeostasis that promotes both pro-resilient and antidepressant-like responses. Pharmacological xCT blockage counteracts NAC prophylactic effects. GFAP⁺-Cre-dependent overexpression of xCT in vDG mimics pharmacological actions in promoting resilience. This work establishes a mechanism by which vDG protection leads to stress resilience and antidepressant responses via epigenetic programming of an xCT-mGlu2 network.

[The effects and mechanisms of berberine on proliferation of papillary thyroid cancer K1 cells induced by high glucose]

Objective: To study the effect and mechanisms of berberine (BBR) on the proliferation of papillary thyroid cancer K1 cells induced by high glucose. Methods: K1 cells were cultured under 5.5 mmol/L or 25 mmol/L glucose condition with or without different concentration of BBR (0, 10, 40 and 80 μmol/L) for 24 hours. The proliferations of K1 cells in each condition were detected by MTT. Western blot was used to measure the expression of nuclear factor erythroid 2-related factor 2(Nrf2), phosphoinositide 3-kinase (PI3K), protein kinase B (Akt) and phosphorylated-Akt (p-Akt). The distribution pattern of Nrf2 in K1 cells was determined using immunofluorescent staining. Results: Compared with 5.5 mmol/L condition, the proliferation rate [(126.64±5.41) % vs (87.31±3.67)%], expression levels of PI3K (0.425±0.019 vs 0.272±0.039), p-Akt/Akt (0.446±0.021 vs 0.168±0.035) and Nrf2 (0.597±0.014 vs 0.308±0.026), and Nrf2 distribution (93.0% vs 23.1%) in nuclear of K 1 cells under 25 mmol/L condition were significantly elevated, respectively (all P<0.01). Addition of BBR in 25 mmol/L condition dose dependently (10, 40, 80 μmol/L) lowered the proliferation rate of K1 cells [(111.76±4.10)%, (70.03±2.18)%, (32.41±3.76)% vs (126.64±5.41)%, all P<0.05], and suppressed the expression of PI3K, p-Akt/Akt, Nrf2, and Nrf2 nuclear distribution (P<0.05). Conclusions: BBR dose dependently inhibited the proliferation of high glucose-induced K1 cells. This effect was associated with the suppression on of PI3K/Akt signaling activation, Nrf2 expression and its nuclear translocation.

[The application of yeast hybrid systems in protein interaction analysis]

Yeast hybrid systems have been widely used due to their convenience and low cost. Based on these systems, many methods have been developed to analyze protein-protein, protein-DNA and protein-RNA interactions. In this paper, we are reviewing these different yeast hybrid systems. According to the number of hybrid proteins, yeast hybrid systems can be divided into three categories, yeast one-hybrid, yeast two-hybrid and yeast three-hybrid systems. Alternatively, yeast hybrid systems can be categorized according to the subcellular localization of the protein interaction process in the cell into nuclear protein-protein interactions, cytosol protein-protein interactions and membrane protein-protein interactions. Throughout the review, we focus on the progress and limitations of each yeast hybrid system over the recent years.