Cross-camera Performance of Deep Learning Algorithms to Diagnose Common Ophthalmic Diseases: A Comparative Study Highlighting Feasibility to Portable Fundus Camera Use

PURPOSE

To compare the inter-camera performance and consistency of various deep learning (DL) diagnostic algorithms applied to fundus images taken from desktop Topcon and portable Optain cameras.

METHODS

Participants over 18 years of age were enrolled between November 2021 and April 2022. Pair-wise fundus photographs from each patient were collected in a single visit; once by Topcon (used as the reference camera) and once by a portable Optain camera (the new target camera). These were analyzed by three previously validated DL models for the detection of diabetic retinopathy (DR), age-related macular degeneration (AMD), and glaucomatous optic neuropathy (GON). Ophthalmologists manually analyzed all fundus photos for the presence of DR and these were referred to as the ground truth. Sensitivity, specificity, the area under the curve (AUC) and agreement between cameras (estimated by Cohen's weighted kappa, K) were the primary outcomes of this study.

RESULTS

A total of 504 patients were recruited. After excluding 12 photographs with matching errors and 59 photographs with low quality, 906 pairs of Topcon-Optain fundus photos were available for algorithm assessment. Topcon and Optain cameras had excellent consistency (Κ=0.80) when applied to the referable DR algorithm, while AMD had moderate consistency (Κ=0.41) and GON had poor consistency (Κ=0.32). For the DR model, Topcon and Optain achieved a sensitivity of 97.70% and 97.67% and a specificity of 97.92% and 97.93%, respectively. There was no significant difference between the two camera models (McNemar's test: x2=0.08, p = .78).

CONCLUSION

Topcon and Optain cameras had excellent consistency for detecting referable DR, albeit performances for detecting AMD and GON models were unsatisfactory. This study highlights the methods of using pair-wise images to evaluate DL models between reference and new fundus cameras.

Comparing Common Retinal Vessel Caliber Measurement Software with an Automatic Deep Learning System

PURPOSE

To compare the Retina-based Microvascular Health Assessment System (RMHAS) with Integrative Vessel Analysis (IVAN) for retinal vessel caliber measurement.

METHODS

Eligible fundus photographs from the Lingtou Eye Cohort Study were obtained alongside their corresponding participant data. Vascular diameter was automatically measured using IVAN and RMHAS software, and intersoftware variations were assessed by intra-class correlation coefficients (ICC), and 95% confidence intervals (CIs). Scatterplots and Bland-Altman plots assessed the agreement between programs, and a Pearson's correlation test assessed the strength of associations between systemic variables and retinal calibers. An algorithm was proposed to convert measurements between software for interchangeability.

RESULTS

ICCs between IVAN and RMHAS were moderate for CRAE and AVR (ICC; 95%CI)(0.62; 0.60 to 0.63 and 0.42; 0.40 to 0.44 respectively) and excellent for CRVE (0.76; 0.75 to 0.77). When comparing retinal vascular calibre measurements between tools, mean differences (MD, 95% confidence intervals) in CRAE, CRVE, and AVR were 22.34 (-7.29 to 51.97 µm),-7.01 (-37.68 to 23.67 µm), and 0.12 (-0.02 to 0.26 µm), respectively. The correlation of systemic parameters with CRAE/CRVE was poor and the correlation of CRAE with age, sex, systolic blood pressure, and CRVE with age, sex, and serum glucose were significantly different between IVAN and RMHAS (p < 0.05).

CONCLUSIONS

CRAE and AVR correlated moderately between retinal measurement software systems while CRVE correlated well. Further studies confirming this agreeability and interchangeability in large-scale datasets are needed before softwares are deemed comparable in clinical practice.

Erratum: Global Polarization of Ξ and Ω Hyperons in Au+Au Collisions at sqrt[s_{NN}]=200 GeV [Phys. Rev. Lett. 126, 162301 (2021)]

This corrects the article DOI: 10.1103/PhysRevLett.126.162301.

[Preliminary experience of transcatheter pulmonary valve replacement using domestic balloon-expandable valve]

Objectives: To evaluate the feasibility and preliminary clinical results of transcatheter pulmonary valve replacement (TPVR) with the domestically-produced balloon-expandable Prizvalve system. Methods: This is a prospective single-center observational study. Patients with postoperative right ventricular outflow tract (RVOT) dysfunction, who were admitted to West China Hospital of Sichuan University from September 2021 to March 2023 and deemed anatomically suitable for TPVR with balloon-expandable valve, were included. Clinical, imaging, procedural and follow-up data were analyzed. The immediate procedural results were evaluated by clinical implant success rate, which is defined as successful valve implantation with echocardiography-assessed pulmonary regurgitation Collapse

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MESH Headings

• Male
• Humans
• Pulmonary Valve/surgery
• Heart Valve Prosthesis/adverse effects
• Heart Valve Prosthesis Implantation
• Constriction, Pathologic/complications
• Constriction, Pathologic/surgery
• Prospective Studies
• Ventricular Outflow Obstruction/etiology
• Ventricular Outflow Obstruction/surgery
• Treatment Outcome
• Cardiac Catheterization/methods
• Transcatheter Aortic Valve Replacement

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Grants

• 2022ZDZX0030 Sichuan Science and Technology Program

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[Endoscopic hand-suturing combined with titanium clips for rectal defects closure after endoscopic submucosal dissection: a pilot study]

Objective: To explore the feasibility of endoscopic hand-suturing (EHS) for rectal defects closure after endoscopic submucosal dissection (ESD), and the clinical practicability of EHS combined with titanium clips. Methods: This is a prospective study performed by two experienced endoscopists from the Cancer Hospital, Chinese Academy of Medical Sciences who had received EHS training in sixporcine gastric ESD defects in vivo before the study. From December 2022 to February 2022, 20 patients with rectal mucosal lesions or submucosal diseases underwent ESD. Then EHS combined with titanium clips was adopted to close the rectal ESD defects. Specifically, we first sutured the defects as much as possible through EHS, then use titanium clips to fix the tail of the suture, and finally use additional titanium clips to close the residual parts of the defects that cannot be sutured. The main observational indicators were complete closure of the wound and delayed bleeding within one month after surgery. Results: In the 20 rectal cases, the size of defects ranged from 2.2 to 3.6 cm, with a median of 2.7 cm. All cases achieved complete closure without delayed bleeding, of which 12 (60.0%) were completely sutured with EHS and 8 (40.0%) required additional titanium clips to achieve complete closure after suturing. Conclusion: EHS technique is feasible and safe for rectum. EHS combined with titanium clips can also effectively close the rectal ESD defects, prevent postoperative delayed bleeding, and may be easier to be implemented in clinical practice.

Self-Supported 3D PtPdCu Nanowires Networks for Superior Glucose Electro-Oxidation Performance

The development of non-enzymatic and highly active electrocatalysts for glucose oxidation with excellent durability for blood glucose sensors has aroused widespread concern. In this work, we report a fast, simple, and low-cost NaBH4 reduction method for preparing ultrafine ternary PtPdCu alloy nanowires (NWs) with a 3D network nanostructure. The PtPdCu NWs catalyst presents significant efficiency for glucose oxidation-reduction (GOR), reaching an oxidative peak-specific activity of 0.69 mA/cm2, 2.6 times that of the Pt/C catalyst (0.27 mA/cm2). Further reaction mechanism investigations show that the NWs have better conductivity and smaller electron transfer resistance. Density functional theory (DFT) calculations reveal that the alloying effect of PtPdCu could effectively enhance the adsorption energy of glucose and reduce the activation energy of GOR. The obtained NWs also show excellent stability over 3600 s through a chronoamperometry test. These self-supported ultrafine PtPdCu NWs with 3D networks provide a new functional material for building blood glucose sensors and direct glucose fuel cells.

Dipeptidase‑2 is a prognostic marker in lung adenocarcinoma that is correlated with its sensitivity to cisplatin

Lung cancer accounts for the highest percentage of cancer morbidity and mortality worldwide, and lung adenocarcinoma (LUAD) is the most prevalent subtype. Although numerous therapies have been developed for lung cancer, patient prognosis is limited by tumor metastasis and more effective treatment targets are urgently required. In the present study, gene expression profiles were extracted from the Gene Expression Omnibus database and mRNA expression data were downloaded from The Cancer Genome Atlas database. In addition, TIMER 2.0 database was used to analyze the expression of genes in normal and multiple tumor tissues. Protein expression was confirmed using the Human Protein Atlas database and LUAD cell lines, sphere formation assay, western blotting, and a xenograft mouse model were used to confirm the bioinformatics analysis. Dipeptidase‑2 (DPEP2) expression was significantly decreased in LUAD and was negatively associated with prognosis. DPEP2 overexpression substantially inhibited epithelial‑mesenchymal transition (EMT) as well as LUAD cell metastasis, and limited the expression of the cancer stem cell transformation markers, CD44 and CD133. In addition, DPEP2 improved LUAD sensitivity to cisplatin by inhibiting EMT; this was verified in vitro and in vivo. These data indicated that DPEP2 upregulates E‑cadherin, thereby regulating cell migration, cancer stem cell transformation, and cisplatin resistance, ultimately affecting the survival of patients with LUAD. Overall, the findings of the present suggest that DPEP2 is important in the development of LUAD and can be used both as a prognostic marker and a target for future therapeutic research.

[Risk factors analysis and prediction model construction of submucosal deep infiltration of early colorectal tumor]

Objective: To investigate the risk factors for the development of deep infiltration in early colorectal tumors (ECT) and to construct a prediction model to predict the development of deep infiltration in patients with ECT. Methods: The clinicopathological data of ECT patients who underwent endoscopic treatment or surgical treatment at the Cancer Hospital, Chinese Academy of Medical Sciences from August 2010 to December 2020 were retrospectively analyzed. The independent risk factors were analyzed by multifactorial regression analysis, and the prediction models were constructed and validated by nomogram. Results: Among the 717 ECT patients, 590 patients were divided in the within superficial infiltration 1 (SM1) group (infiltration depth within SM1) and 127 patients in the exceeding SM1 group (infiltration depth more than SM1). There were no statistically significant differences in gender, age, and lesion location between the two groups (P>0.05). The statistically significant differences were observed in tumor morphological staging, preoperative endoscopic assessment performance, vascular tumor emboli and nerve infiltration, and degree of tumor differentiation (P<0.05). Multivariate regression analysis showed that only erosion or rupture (OR=4.028, 95% CI: 1.468, 11.050, P=0.007), localized depression (OR=3.105, 95% CI: 1.584, 6.088, P=0.001), infiltrative JNET staging (OR=5.622, 95% CI: 3.029, 10.434, P<0.001), and infiltrative Pit pattern (OR=2.722, 95% CI: 1.347, 5.702, P=0.006) were independent risk factors for the development of deep submucosal infiltration in ECT. Nomogram was constructed with the included independent risk factors, and the nomogram was well distinguished and calibrated in predicting the occurrence of deep submucosal infiltration in ECT, with a C-index and area under the curve of 0.920 (95% CI: 0.811, 0.929). Conclusion: The nomogram prediction model constructed based on only erosion or rupture, local depression, infiltrative JNET typing, and infiltrative Pit pattern has a good predictive efficacy in the occurrence of deep submucosal infiltration in ECT.

Average capacity of an underwater wireless communication link with the quasi-Airy hypergeometric-Gaussian vortex beam based on a modified channel model

Prompted by alleviating the random perturbation of underwater channel and enhancing the performance for the orbital angular momentum (OAM) -based underwater wireless optical communication (UWOC), the quasi-Airy Hypergeometric-Gaussian (QAHyGG) vortex beam is first proposed and demonstrated. Moreover, an underwater channel model is first modified for more accurate simulated results of the propagation property of various beams. Based on the modified model, the transmission and communication performance of three different OAM-carrying beams (the Gauss vortex (GV) beam, the Hypergeometric-Gaussian (HyGG) vortex beam, and the QAHyGG vortex beam) are comparatively studied. In addition, the parameters optimization of the QAHyGG vortex beam is made for further enhancing the average capacity. The results show that the QAHyGG vortex beam exhibits higher received power and lower crosstalk probability under different channel conditions. The average capacity of the QAHyGG vortex beam has enhanced by ∼8% and ∼27% compared with the HyGG vortex beam and the GV beam at 100m, respectively. The QAHyGG vortex beam is more suitable in an OAM-based UWOC system with a limited-size receiving aperture or lower transmit power. Besides, the average capacity will improve effectively at longer distances with the optimized beam parameters. These research results can provide advances in designing the practical OAM-based UWOC system.

Diagnostic value of Kaiser score combined with breast vascular assessment from breast MRI for the characterization of breast lesions

Objectives

The Kaiser scoring system for breast magnetic resonance imaging is a clinical decision-making tool for diagnosing breast lesions. However, the Kaiser score (KS) did not include the evaluation of breast vascularity. Therefore, this study aimed to use KS combined with breast vascular assessment, defined as KS^*, and investigate the effectiveness of KS^* in differentiating benign from malignant breast lesions.

Methods

This retrospective study included 223 patients with suspicious breast lesions and pathologically verified results. The histopathological diagnostic criteria were according to the fifth edition of the WHO classification of breast tumors. The KS^* was obtained after a joint evaluation combining the original KS and breast vasculature assessment. The receiver operating characteristic (ROC) curve was used for comparing differences in the diagnostic performance between KS^* and KS, and the area under the receiver operating characteristic (AUC) was compared.

Results

There were 119 (53.4%) benign and 104 (46.6%) malignant lesions in total. The overall sensitivity, specificity, and accuracy of increased ipsilateral breast vascularity were 69.2%, 76.5%, and 73.1%, respectively. The overall sensitivity, specificity, and accuracy of AVS were 82.7%, 76.5%, and 79.4%, respectively. For all lesions included the AUC of KS^* was greater than that of KS (0.877 vs. 0.858, P = 0.016). The largest difference in AUC was observed in the non-mass subgroup (0.793 vs. 0.725, P = 0.029).

Conclusion

Ipsilaterally increased breast vascularity and a positive AVS sign were significantly associated with malignancy. KS combined with breast vascular assessment can effectively improve the diagnostic ability of KS for breast lesions, especially for non-mass lesions.

Chiral separation of sesquineolignans from the stems and leaves of Neoshirakia japonica

Twelve pairs of sesquineolignan enantiomers (1a/1b-6a/6b and 1c/1d-6c/6d), including twenty one undescribed and three known (2b, 3b, and 4b) sesquineolignans were isolated from an ethanol extract of the stems and leaves of Neoshirakia japonica (Euphorbiaceae). The successful separation of twelve pairs of enantiomers with mirror image-like electronic circular dichroism (ECD) curves and opposite specific rotation values, as one of the most important steps in compound isolation, was carried out by chiral HPLC columns. The absolute configurations of all undescribed sesquineolignans were elucidated by comprehensive analysis of their experimental ECD spectra. The effects of all the isolates on antineuroinflammatory and radical scavenging activity were evaluated. Compared with the positive control minocycline (IC₅₀ = 1.2 μM), compounds 1a/1b/1c/1d-6a/6b/6c/6d with IC₅₀ values being greater than 50 μM displayed almost no effect on the inhibition of NO production in LPS-induced BV-2 microglial cells. The results of DPPH-radical scavenging activity for them showed that compound 3c had moderate radical scavenging ability (EC₅₀ = 48.47 μM), while the EC₅₀ value of positive control vitamin C was 18.21 μM.

Effect of Micro-Nano Bubble Water and Silica Fume on Properties of C60 Concrete

Micro-nano bubble water (WNBW) in concrete is relatively uncommon due to its newness as a technology. This paper presents the preparation of C60 concrete with 35% fly ash (FA) through WNBW and varying amounts of silica fume (0%, 4%, 7%, and 10% SF). The study examines the impact of WNBW and SF on the working performance, compressive strength, and durability of concrete. The findings indicate that applying WNBW and SF independently or jointly deteriorates the working performance of fresh concrete. However, compared to regular mixing water, WNBW reduces the concrete passing time through the V-funnel, decreasing by 40%, 39.1%, 42.9%, and 50.5% for the four varying SF contents. Furthermore, using WNBW, SF, or both resulted in the increased compressive strength of concrete at 7 days and 28 days, with 7% SF content yielding a 12.2% and 6.6% increase, respectively. Using a combination of WNBW and SF has been shown to decrease the impermeability of concrete effectively. The addition of 4% SF results in the lowest electric flux when using regular mixing water, with a discernible decrease of 30.1% compared to the control group. Conversely, using WNBW as mixing water yields a decrease in electric flux at each SF content, with the maximum decrease being 39.7%. Furthermore, both the single and combined use of these materials can contribute to the reduction in the carbonation resistance of the concrete. C60 concrete mixed with 7% SF and 100% WNBW boasts enhanced frost resistance, as indicated by the mass loss and dynamic elastic modulus loss being the least following freeze-thaw under the same SF content. According to the findings of the tests, there is evidence that the incorporation of 7% SF and 100% WNBW into C60 concrete results in lowered viscosity, a highly advantageous attribute for actual construction. Additionally, this mixture displays impressive compressive strength and durability properties. These results provide technical support regarding the integration of WNBW and SF in C60 concrete.

Foegraecumoside O and P, a Pair of Triterpenoid Saponins with a 4/5/6 Fused Tricyclic Oleanane Carbon Skeleton from Lysimachia foenum-graecum Hance

Lysimachia foenum-graecum Hance (Primulaceae) is a medicinal plant used for cold, pain, ascariasis, etc., in China. Triterpenoid saponins have been found to be the main components of this genus. In this work, a pair of oleanane-type triterpenoid saponins with an unprecedented 4/5/6 fused tricyclic skeleton, foegraecumoside O (1) and foegraecumoside P (2) were isolated from the butanol fraction of the aerial parts of L. foenum-graecum. Their structures were determined using chemical methods and extensive spectroscopic analyses, along with quantum chemical calculations. Compound 2 displayed moderate cytotoxicity against HepG2, MGC-803, T24, NCI-H460, A549, and A549/CDDP (drug-resistant lung-cancer cell line) with IC₅₀ at 12.4-19.2 μM in an MTT assay, comparing with the positive control doxorubicin, which had IC₅₀ at 0.53-4.92 μM, but was inactive for A549/CDDP. Furthermore, a possible biosynthetic pathway for forming compounds 1 and 2 was proposed.

Optical noise-resistant nonreciprocal phonon blockade in a spinning optomechanical resonator

A scheme of nonreciprocal conventional phonon blockade (PB) is proposed in a spinning optomechanical resonator coupled with a two-level atom. The coherent coupling between the atom and breathing mode is mediated by the optical mode with a large detuning. Due to the Fizeau shift caused by the spinning resonator, the PB can be implemented in a nonreciprocal way. Specifically, when the spinning resonator is driven from one direction, the single-phonon (1PB) and two-phonon blockade (2PB) can be achieved by adjusting both the amplitude and frequency of the mechanical drive field, while phonon-induced tunneling (PIT) occurs when the spinning resonator is driven from the opposite direction. The PB effects are insensitive to cavity decay because of the adiabatic elimination of the optical mode, thus making the scheme more robust to the optical noise and still feasible even in a low-Q cavity. Our scheme provides a flexible method for engineering a unidirectional phonon source with external control, which is expected to be used as a chiral quantum device in quantum computing networks.

Guanxinning injection ameliorates cardiac remodeling in HF mouse and 3D heart spheroid models via p38/FOS/MMP1-mediated inhibition of myocardial hypertrophy and fibrosis

BACKGROUND

Heart failure (HF) is a cardiovascular disease with high morbidity and mortality. Guanxinning injection (GXNI) is clinically used for the treatment of coronary heart disease, but its therapeutic efficacy and potential mechanism for HF are poorly understood. This study aimed to evaluate the therapeutic potential of GXNI on HF, with a special focus on its role in myocardial remodeling.

METHODS

3D cardiac organoids and transverse aortic constriction (TAC) mouse models were established and utilized. Heart function and pathology were evaluated by echocardiography, hemodynamic examination, tail-cuff blood pressure and histopathology. Key targets and pathways regulated by GXNI in HF mouse heart were revealed via RNA-seq and network pharmacology analysis, and were verified by RT-PCR, Western blot, immunohistochemistry and immunofluorescence.

RESULTS

GXNI significantly inhibited cardiac hypertrophy and cells death. It protected mitochondrial function in cardiac hypertrophic organoids and markedly improved cardiac function in HF mice. Analysis of GXNI-regulated genes in HF mouse hearts revealed that IL-17A signaling in fibroblasts and the corresponding p38/c-Fos/Mmp1 pathway prominently mediated cardiac. Altered expressions of c-Fos, p38 and Mmp1 by GXNI in heart tissues and in cardiac organoids were validated by RT-PCR, WB, IHC, and IF. H&E and Masson staining confirmed that GXNI substantially ameliorated myocardial hypertrophy and fibrosis in HF mice and in 3D organoids.

CONCLUSION

GXNI inhibited cardiac fibrosis and hypertrophy mainly via down-regulating p38/c-Fos/Mmp1 pathway, thereby ameliorating cardiac remodeling in HF mice. Findings in this study provide a new strategy for the clinical application of GXNI in the treatment of heart failure.

Biochar-coupled organic fertilizer reduced soil water-dispersible colloidal phosphorus contents in agricultural fields

Soil water-dispersible colloidal phosphorus (WCP) presents high mobility, however, the regulatory effect of biochar-coupled organic fertilizer is rarely known, especially under different cropping patterns. This study investigated the P adsorption, soil aggregate stability, and WCP in three paddy and three vegetable fields. These soils were amended with different fertilizers (chemical fertilizer, CF; substitution of solid-sheep manure or liquid-biogas slurry organic fertilizer, SOF/LOF; substitution of biochar-coupled organic fertilizers, BSOF/BLOF). Results presented that the LOF averagely increased the WCP contents by 50.2% across the sites, but the SOF and BSOF/BLOF averagely decreased their contents by 38.5% and 50.7% in comparison with the CF. The WCP decline in the BSOF/BLOF-amended soils was mainly attributed to the intensive P adsorption capacity and soil aggregate stability. The BSOF/BLOF increased the amorphous Fe and Al contents in the fields in comparison with the CF, which improved the adsorption capacity of soil particles, further improving the maximum absorbed P (Q_max) and reducing the dissolved organic matter (DOC), leading to the improvement of > 2 mm water-stable aggregate (WSA_>2mm) and subsequent WCP decrease. This was proved by the remarkable negative associations between the WCP and Q_max (R² = 0.78, p < 0.01) and WSA_>2mm (R² = 0.74, p < 0.01). This study manifests that biochar-coupled organic fertilizer could effectively reduce soil WCP content via the improvement of P adsorption and aggregate stability.

CC-115 Mediates GSDME-Dependent Pyroptosis in Lung Adenocarcinoma Through the Akt/Bax Pathway

Chemotherapeutic agents remain the first-line treatment for solid tumors, including lung cancer, but chemotherapy resistance is hampering global efforts to treat this disease. CC-115 is a novel antitumoral compound used in phase I clinical trials. However, it is unclear whether CC-115 is effective against lung adenocarcinoma (LUAD). In the present study, we found that CC-115 induced lytic cell death in A549 and H1650 tumor cells via swelling of cells and formation of large bubbles on the plasma membrane that closely resembled those typical of pyroptosis, a type of programmed cell death linked to chemotherapy. We demonstrated that CC-115 exerts antitumor effects in LUAD through gasdermin E (GSDME)-mediated pyroptosis by acting as a dual inhibitor of DNA-PK and mTOR. CC-115 can inhibit Akt phosphorylation, impairing its inhibitory effect on Bax, thereby inducing pyroptosis via the Bax-mitochondrial intrinsic pathway. CC-115-induced pyroptosis was abrogated by treatment with the Akt activator SC79 or by depletion of Bax. Importantly, CC-115 significantly upregulated the expression of Bax and GSDME-N in a xenograft mouse model, with a reduction in tumor size. Our results revealed that CC-115 suppresses tumor growth by inducing GSDME-mediated pyroptosis through the Akt/Bax-mitochondrial intrinsic pathway, indicating CC-115 as a promising therapeutic agent for LUAD.

Modifiable predictors of type 2 diabetes mellitus and roles of insulin resistance and β-cell function over a 6-year study and 30-year follow-up

PURPOSE

This study aimed to examine the modifiable predictors of T2DM and the roles of insulin resistance (IR) and β-cell function over a 6-year study and 30-year follow-up.

METHODS

A total of 462 non-diabetic participants, 282 with impaired glucose tolerance (IGT), and 180 with normal glucose tolerance (NGT) were enrolled in this analysis. The Matsuda IR index and area under the curve of insulin-to-glucose ratio (AUCI/G-R) were used as IR and β-cell function indices in the analysis.

RESULTS

In all participants, multivariable analysis showed that BMI, glucose status, Matsuda IR index and systolic blood pressure (SBP) at baseline were independently associated with an increased risk of T2DM over 30 years, whereas lifestyle intervention and AUCI/G-R were inversely associated with this risk. The predictive effect of the Matsuda IR index and AUCI/G-R in participants with IGT was consistent with the results of all participants, whereas in those with NGT, only the Matsuda IR index, not the AUCI/G-R, predicted the development of T2DM (HR = 1.42, 95% CI 1.07-1.89 vs HR = 1.09, 95% CI 0.76-1.56). The predictive effect of the Matsuda IR index on T2DM existed even in participants with BMI < 25 (p = 0.049).

CONCLUSION

The modifiable predictors of T2DM in Chinese adults were high BMI, hypertension, mild hyperglycaemia, IR, and β-cell dysfunction. Both IR and β-cell function contributed to the development of T2DM in the long term; however, IR remains the initial and long-standing key risk factor for T2DM.

Dihydropyrimidine Dehydrogenase (DPD) as a Bridge between the Immune Microenvironment of Colon Cancers and 5-FU Resistance

BACKGROUND

The purpose of the present study was to investigate the role of the 5-Fluorouracil (5-FU) resistance-related factor dihydropyrimidine dehydrogenase (DPD) in tumor immunity and prognosis and to study the relationship between drug resistance and the immune microenvironment of colon cancer.

METHODS

Bioinformatics methods were used to analyze the expression of DPD associated with prognosis, immunity, microsatellite instability, and tumor mutational burden in colon cancer. Immunohistochemistry (IHC) was used to detect DPD, MLH1, MSH2, MSH6, and PMS2 in 219 colon cancer tissue samples. Additional IHC analyses were conducted to detect CD4, CD8, CD20, and CD163 in 30 colon cancer tissue samples with the most extensive immune infiltration. The significance of the correlations and clinical significance of DPD with immune infiltration, immune-related markers, microsatellite instability-related indicators, and prognosis were evaluated.

RESULTS

The major findings of the present study are as follows: (1) DPD was expressed in tumor and immune cells and associated with certain immune cell-related markers, particularly M2 macrophages that expressed CD163. (2) DPD expression significantly and positively correlated with immune cell markers and immune checkpoints PD-1 and PD-L1. High expression of DPD in immune cells, but not tumor cells, led to increased immune infiltration. (3) High expression of DPD in immune and tumor cells induced 5-FU resistance and was associated with unfavorable prognosis. (4) DPD expression closely correlated with microsatellite instability and tumor mutational burden and led to resistance to 5-FU in patients with microsatellite instability. (5) Bioinformatics analyses revealed that DPD was enriched in immune-related functions and pathways such as activation of T cells and macrophages.

CONCLUSIONS

DPD plays an important role in the immune microenvironment and drug resistance of colon cancers and their functional association.

[Risk factors for residual cancer or lymph node metastasis after endoscopic noncurable resection of early colorectal cancer]

Objective: Risk factors related to residual cancer or lymph node metastasis after endoscopic non-curative resection of early colorectal cancer were analyzed to predict the risk of residual cancer or lymph node metastasis, optimize the indications of radical surgical surgery, and avoid excessive additional surgical operations. Methods: Clinical data of 81 patients who received endoscopic treatment for early colorectal cancer in the Department of Endoscopy, Cancer Hospital, Chinese Academy of Medical Sciences from 2009 to 2019 and received additional radical surgical surgery after endoscopic resection with pathological indication of non-curative resection were collected to analyze the relationship between various factors and the risk of residual cancer or lymph node metastasis after endoscopic resection. Results: Of the 81 patients, 17 (21.0%) were positive for residual cancer or lymph node metastasis, while 64 (79.0%) were negative. Among 17 patients with residual cancer or positive lymph node metastasis, 3 patients had only residual cancer (2 patients with positive vertical cutting edge). 11 patients had only lymph node metastasis, and 3 patients had both residual cancer and lymph node metastasis. Lesion location, poorly differentiated cancer, depth of submucosal invasion ≥2 000 μm, venous invasion were associated with residual cancer or lymph node metastasis after endoscopic (P<0.05). Logistic multivariate regression analysis showed that poorly differentiated cancer (OR=5.513, 95% CI: 1.423, 21.352, P=0.013) was an independent risk factor for residual cancer or lymph node metastasis after endoscopic non-curative resection of early colorectal cancer. Conclusions: For early colorectal cancer after endoscopic non-curable resection, residual cancer or lymph node metastasis is associated with poorly differentiated cancer, depth of submucosal invasion ≥2 000 μm, venous invasion and the lesions are located in the descending colon, transverse colon, ascending colon and cecum with the postoperative mucosal pathology result. For early colorectal cancer, poorly differentiated cancer is an independent risk factor for residual cancer or lymph node metastasis after endoscopic non-curative resection, which is suggested that radical surgery should be added after endoscopic treatment.

[Spatial clustering analysis of scarlet fever incidence in China from 2016 to 2020]

OBJECTIVE

To investigate the incidence trend and spatial clustering characteristics of scarlet fever in China from 2016 to 2020 to provide evidence for development of regional disease prevention and control strategies.

METHODS

The incidence data of scarlet fever in 31 provinces and municipalities in mainland China from 2016 to 2020 were obtained from the Chinese Health Statistics Yearbook and the Public Health Science Data Center led by the Chinese Center for Disease Control and Prevention.The three-dimensional spatial trend map of scarlet fever incidence in China was drawn using ArcGIS to determine the regional trend of scarlet fever incidence.GeoDa spatial autocorrelation analysis was used to explore the spatial aggregation of scarlet fever in China in recent years.

RESULTS

From 2016 to 2020, a total of 310 816 cases of scarlet fever were reported in 31 provinces, municipalities directly under the central government and autonomous regions, with an average annual incidence of 4.48/100 000.The reported incidence decreased from 4.32/100 000 in 2016 to 1.18/100 000 in 2020(Z=103.47, P < 0.001).The incidence of scarlet fever in China showed an obvious regional clustering from 2016 to 2019(Moran's I>0, P < 0.05), but was randomly distributed in 2020(Moran's I>0, P=0.16).The incidence of scarlet fever showed a U-shaped distribution in eastern and western regions of China, and increased gradually from the southern to northern regions.Inner Mongolia Autonomous Region and Hebei and Gansu provinces had the High-high (H-H) clusters of scarlet fever in China.

CONCLUSION

Scarlet fever still has a high incidence in China with an obvious spatial clustering.For the northern regions of China with H-H clusters of scarlet fever, the allocation of health resources and public health education dynamics should be strengthened, and local scarlet fever prevention and control policies should be made to contain the hotspots of scarlet fever.

[Clinical characteristics and genetic analysis of a case with adult neuronal ceroid lipofuscinosis type 7 due to variant of MFSD8 gene]

OBJECTIVE

To explore the clinical characteristics and genetic variants in a patient with adult ceroid lipofuscinosis neuronal type 7 (ACLN7).

METHODS

A female patient diagnosed with ACLN7 in Henan Provincial People's Hospital in June 2021 was selected as the study subject. Clinical data, auxiliary examination and result of genetic testing were retrospectively analyzed.

RESULTS

The patient, a 39-year-old female, has mainly presented progressive visual loss, epilepsy, cerebellar ataxia and mild cognitive decline. Neuroimaging analysis has revealed generalized brain atrophy, prominently cerebellum. Fundus photography has revealed retinitis pigmentosa. Ultrastructural skin examination has revealed granular lipofuscin deposits in the periglandular interstitial cells. Whole exome sequencing revealed that she has harbored compound heterozygous variants of the MSFD8 gene, namely c.1444C>T (p.R482*) and c.104G>A (p.R35Q). Among these, c.1444C>T (p.R482*) was a well established pathogenic variant, while c.104G>A (p.R35Q) was a missense variant unreported previously. Sanger sequencing confirmed that the daughter, son and elder brother of the proband have respectively carried heterozygous c.1444C>T (p.R482*), c.104G>A (p.R35Q), and c.104G>A (p.R35Q) variants of the same gene. The family has therefore fit with the autosomal recessive inheritance pattern of the CLN7.

CONCLUSION

Compared with previously reported cases, this patient has the latest onset of the disease with a non-lethal phenotype. Her clinical features have involved multiple systems. Cerebellar atrophy and fundus photography may be indicative of the diagnosis. The c.1444C>T (p.R482*) and c.104G>A (p.R35Q) compound heterozygous variants of the MFSD8 gene probably underlay the pathogenesis in this patient.

QiShen YiQi and its components attenuate acute thromboembolic stroke and carotid thrombosis by inhibition of CD62P/PSGL-1-mediated platelet-leukocyte aggregate formation

BACKGROUND

QiShen YiQi (QSYQ) dropping pill, a component-based Chinese medicine consisting of benefiting Qi (YQ) and activating blood (HX) components, has been reported to exert a beneficial effect on cerebral ischemia-induced stroke. However, its efficacy and pharmacological mechanism on acute thromboembolic stroke is not clear.

PURPOSE

This study is to explore the preventative effect and pharmacological mechanism of QSYQ and its YQ/HX components on the formation of platelet-leukocyte aggregation (PLA) in acute thromboembolic stroke.

STUDY DESIGN AND METHODS

In vivo thromboembolic stroke model and FeCl₃-induced carotid arterial occlusion models were used. Immunohistochemistry, Western blot, RT-qPCR, and flow cytometry experiments were performed to reveal the pharmacological mechanisms of QSYQ and its YQ/HX components.

RESULTS

In thromboembolic stroke rats, QSYQ significantly attenuated infarct area, improved neurological recovery, reduced PLA formation, and inhibited P-selection (CD62P)/ P-selectin glycoprotein ligand-1 (PSGL-1) expressions. The YQ component preferentially down-regulated PSGL-1 expression in leukocyte, while the HX component preferentially down-regulated CD62P expression in platelet. In carotid arterial thrombosis mice, QSYQ and its YQ/HX components inhibited thrombus formation, prolonged vessel occlusion time, reduced circulating leukocytes and P-selectin expression. PLA formation and platelet/leukocyte adhesion to endothelial cell were also inhibited by QSYQ and its YQ/HX components in vitro.

CONCLUSION

QSYQ and YQ/HX components attenuated thromboembolic stroke and carotid thrombosis by decreasing PLA formation via inhibiting CD62P/PSGL-1 expressions. This study shed a new light on the prevention of thromboembolic stroke.