A Traditional Chinese Patent Medicine ZQMT for Neovascular Age- Related Macular Degeneration: A Multicenter Randomized Clinical Trial

BACKGROUND

Anti-VEGF agent ranibizumab has been extensively used as a standard treatment for wet AMD. We investigated whether traditional Chinese medicine could serve as a complementary therapy for this disease.

METHODS

144 patients with neovascular age-related macular degeneration received either intravitreal ranibizumab treatment as needed plus placebo or intravitreal ranibizumab treatment as needed plus an FDA approved traditional Chinese patent medicine named ZQMT. Both groups received treatment for 24 weeks. The primary outcome was the mean change of visual acuity at week 24 as compared to the baseline.

RESULTS

We found that intravitreal ranibizumab treatment plus ZQMT was non-inferior to the treatment with intravitreal ranibizumab alone in improving visual acuity scores at week 24 with patients in both groups who gained substantial numbers of letters. In addition, we found that ZQMT treatment resulted in significant improvements in reducing retinal hemorrhage, fluid, and lesion size. Importantly, administration of ZQMT reduced the number of needed ranibizumab injections (P<0.0001, analysis of variance) in wet AMD patients leading to a significant reduction of drug cost.

CONCLUSION

The combinatory therapy of ranibizumab and traditional Chinese patent medicine ZQMT had equivalent effects on visual acuity improvement and safety profiles as the ranibizumab treatment alone. Ranibizumab injections coupled with ZQMT offer therapeutic advantages in terms of reduction of retinal lesions and ease the financial burden of patients undergoing treatment by reducing the frequency of necessary ranibizumab injections.

A nomogram based on bi-regional radiomics features from multimodal magnetic resonance imaging for preoperative prediction of microvascular invasion in hepatocellular carcinoma

Background

We aimed to develop and validate a nomogram combining bi-regional radiomics features from multimodal magnetic resonance imaging (MRI) and clinicoradiological characteristics to preoperatively predict microvascular invasion (MVI) of hepatocellular carcinoma (HCC).

Methods

A total of 267 HCC patients were divided into training (n=194) and validation (n=73) cohorts according to MRI data. Bi-regional features were extracted from whole tumors and peritumoral regions in multimodal MRI. The minimum redundancy maximum relevance (mRMR) algorithm was applied to select features and build signatures. The predictive performance of the optimal radiomics signature was further evaluated within subgroups defined by tumor size and alpha fetoprotein (AFP) level. Then, a radiomics nomogram including the optimal radiomics signature, radiographic descriptors, and clinical variables was developed using multivariable regression. The nomogram performance was evaluated based on its discrimination, calibration, and clinical utility.

Results

The fusion radiomics signature derived from triphasic dynamic contrast-enhanced (DCE) MR images can effectively classify MVI and non-MVI HCC patients, with an AUC of 0.784 (95% CI: 0.719-0.840) in the training cohort and 0.820 (95% CI: 0.713-0.900) in the validation cohort. The fusion radiomics signature also performed well in the subgroups defined by the two risk factors, respectively. The nomogram, consisting of the fusion radiomics signature, arterial peritumoral enhancement, and AFP level, outperformed the clinicoradiological prediction model in the validation cohort (AUCs: 0.858 vs. 0.729; P=0.022), fitting well in the calibration curves (P>0.05). Decision curves confirmed the clinical utility of the nomogram.

Conclusions

The radiomics nomogram can serve as a visual predictive tool for MVI in HCCs, and thus assist clinicians in selecting optimal treatment strategies to improve clinical outcomes.

The risk of endometriosis after exposure to endocrine-disrupting chemicals: a meta-analysis of 30 epidemiology studies

Endocrine-disrupting chemicals (EDCs) are suspected to be associated with endometriosis (EMs). This study aimed to synthesize published data and evaluate the relationship between four classic EDCs exposure and the risk of EMs. A systematic literature search for original peer reviewed papers was performed in the databases PubMed, EMBASE, and Web of Science based on inclusion criteria up to January 2018. Subsequently, a total of 20 papers conducting 30 studies fulfilled the eligibility criteria and were included in this meta-analysis (four studies for bisphenol A (BPA), 12 studies for polychlorinated biphenyls (PCBs), eight studies for organochlorine pesticides (OCPs), and six studies for phthalate esters (PAEs)). The overall odds ratio (OR) across all exposures and EMs was 1.41 (95% confidence interval (CI): 1.23-1.60). When assessing four specific chemicals, respectively, consistent increases in the risk of EMs were found in PCBs group (OR = 1.58; 95% CI: 1.18-2.12), OCPs group (OR = 1.40; 95% CI: 1.02-1.92) and PAEs group (OR = 1.27; 95% CI: 1.00-1.60), while BPA showed no significant association with EMs. Besides, in the di-(2-ethylhexyl)-phthalate (DEHP) group - the most commonly used PAEs, significant risk was also found (OR = 1.42; 95% CI: 1.19-1.70). The current meta-analysis strengthens the evidence that specific EDCs or their metabolites may promote the occurrence of EMs.

Profiling the epigenetic interplay of lncRNA RUNXOR and oncogenic RUNX1 in breast cancer cells by gene in situ cis-activation

RUNX1 is frequently mutated as chromosomal translocations in a variety of hematological malignancies. Recent studies show that RUNX1 is also mutated somatically in many solid tumors. We have recently identified a 260 kb un-spliced intragenic overlapping long noncoding RNA RUNXOR in the RUNX1 locus, yet its role as an epigenetic regulator in tumors remains to be characterized. To delineate this RUNXOR-RUNX1 regulatory interplay in breast cancer cells, we devised a novel "gene in situ cis-activation" approach to activate the endogenous RUNXOR gene. We found that the in situ activation of RUNXOR lncRNA upregulated RUNX1 in cis from the P1 promoter. The preferred activation of the P1 promoter caused a shift to the RUNX1c isoform expression. Using a chromatin conformation capture (3C) approach, we showed that RUNXOR lncRNA epigenetically activated the RUNX1 P1 promoter in cis by altering the local chromatin structure. The binding of RUNXOR lncRNA triggered DNA demethylation and induced active histone modification markers in the P1 CpG island. Changes in RUNX1 isoform composition correlated with a trend to cell cycle arrest at G0/G1, although cell proliferation rate, apoptosis, and migration ability were not significantly changed. Our results reveal an underlying epigenetic mechanism by which the lncRNA regulates in cis the RUNX1 promoter usage in breast cancer cells, thereby shedding light on potential genetic therapies in malignancies in which RUNX1 loss-of-function mutations frequently occur.

Profiling the long noncoding RNA interaction network in the regulatory elements of target genes by chromatin in situ reverse transcription sequencing

Long noncoding RNAs (lncRNAs) can regulate the activity of target genes by participating in the organization of chromatin architecture. We have devised a “chromatin-RNA in situ reverse transcription sequencing” (CRIST-seq) approach to profile the lncRNA interaction network in gene regulatory elements by combining the simplicity of RNA biotin labeling with the specificity of the CRISPR/Cas9 system. Using gene-specific gRNAs, we describe a pluripotency-specific lncRNA interacting network in the promoters of Sox2 and Pou5f1, two critical stem cell factors that are required for the maintenance of pluripotency. The promoter-interacting lncRNAs were specifically activated during reprogramming into pluripotency. Knockdown of these lncRNAs caused the stem cells to exit from pluripotency. In contrast, overexpression of the pluripotency-associated lncRNA activated the promoters of core stem cell factor genes and enhanced fibroblast reprogramming into pluripotency. These CRIST-seq data suggest that the Sox2 and Pou5f1 promoters are organized within a unique lncRNA interaction network that determines the fate of pluripotency during reprogramming. This CRIST approach may be broadly used to map lncRNA interaction networks at target loci across the genome.

Targeting Gpr52 lowers mutant HTT levels and rescues Huntington's disease-associated phenotypes

See Huang and Gitler (doi:10.1093/brain/awy112) for a scientific commentary on this article.

Lowering the levels of disease-causing proteins is an attractive treatment strategy for neurodegenerative disorders, among which Huntington’s disease is an appealing disease for testing this strategy because of its monogenetic nature. Huntington’s disease is mainly caused by cytotoxicity of the mutant HTT protein with an expanded polyglutamine repeat tract. Lowering the soluble mutant HTT may reduce its downstream toxicity and provide potential treatment for Huntington’s disease. This is hard to achieve by small-molecule compound drugs because of a lack of effective targets. Here we demonstrate Gpr52, an orphan G protein-coupled receptor, as a potential Huntington’s disease drug target. Knocking-out Gpr52 significantly reduces mutant HTT levels in the striatum and rescues Huntington’s disease-associated behavioural phenotypes in a knock-in Huntington’s disease mouse model expressing endogenous mutant Htt. Importantly, a novel Gpr52 antagonist E7 reduces mutant HTT levels and rescues Huntington’s disease-associated phenotypes in cellular and mouse models. Our study provides an entry point for Huntington’s disease drug discovery by targeting Gpr52.

Degradation of norfloxacin in aqueous solution with UV/peroxydisulfate

The frequent detection of antibiotics in water bodies gives rise to concerns about their removal technology. In this study, the degradation kinetics and mechanisms of norfloxacin (NOR), a typical fluoroquinolone pharmaceutical, by the UV/peroxydisulfate (PDS) was investigated. NOR could be degraded effectively using this process, and the degradation rate increased with the increasing dosage of PDS but decreased with the increasing concentration of NOR. In real water, the degradation of NOR was slower than that in ultrapure water, which indicated that laboratory results cannot be directly used to predict the natural fate of antibiotics. Further experiments suggested that the degradation of NOR was the most fast under neutral condition, the existence of HA or FA inhibited the degradation of NOR, and the presence of inorganic ions (NO₃ ^-, Cl^-, CO₃ ^2- and HCO₃ ^-) had no significant effect on degradation of NOR. Total organic carbon (TOC) removal rate (40%) indicated NOR was not completely mineralized, and six transformation products were identified, and possible degradation pathways of NOR had been proposed. It can be prospected that UV/PDS technology could be used for advanced treatment of wastewater containing fluoroquinolones.

Tapered fiber-based intravascular photoacoustic endoscopy for high-resolution and deep-penetration imaging of lipid-rich plaque

High-resolution intravascular photoacoustic (IVPA) imaging can potentially improve the identification of atherosclerosis plaque. However, the absorption of water and the low coupled laser energy resulted in insufficient excitation energy provided by the single-mode fiber-based IVPA endoscope to achieve high-resolution and deep-penetration plaque imaging. In this paper, we developed a 1 mm diameter IVPA endoscope assembled with a Ø25-Ø9 μm tapered fiber. Owing to high coupling efficiency and the small output facula of tapered fiber, the IVPA endoscope has an optimal lateral resolution of 18 μm and a large imaging-depth covering from the intima to the peri-adventitial adipose, as confirmed by imaging results respectively. Furthermore, IVPA imaging in the blood has confirmed that the tapered fiber-based endoscope can display the distribution and the relative concentration of lipid in ex vivo plaque precisely. By the obtained histology-like images, IVPA imaging shows great potential for accurately imaging atherosclerosis plaque.

Preparation of montmorillonite grafted polyacrylic acid composite and study on its adsorption properties of lanthanum ions from aqueous solution

Montmorillonite grafted polyacrylic acid composite (GNM) was prepared by using ultraviolet radiation grafting method in this work. The synthesized materials were characterized by XRF, SEM, FTIR, XRD, TG, and XPS. The experimental equilibrium data indicates that the adsorbent is suitable for the Langmuir model and belongs to the pseudo-second-order kinetic model. The entire adsorption process is spontaneous, endothermic, and chaotically enhanced by thermodynamic analysis. The maximum adsorption capacity of La(III) by GNM was 280.54 mg/g at 313.15 K. In addition, the regeneration experiment shows that the adsorbent has good reusability and stable desorption efficiency. This study demonstrates that GNM has high adsorption performance and La(III) adsorption and regeneration capabilities to solve the water pollution caused by rare earth ions and regeneration capabilities for La(III).

Genome-wide target interactome profiling reveals a novel EEF1A1 epigenetic pathway for oncogenic lncRNA MALAT1 in breast cancer

Breast cancer is the most common cancer in women worldwide, accounting for approximately 500,000 deaths each year. MALAT1 is a highly conserved long noncoding RNA (lncRNA), and its increased expression is associated with relapse and metastatic progression in breast cancer. We performed RNA reverse transcription-associated trap sequencing (RAT-seq) to characterize the genome-wide target interaction network for MALAT1 and showed that MALAT1 interacted with multiple pathway target genes that are closely related to tumor progression and metastasis. Notably, MALAT1 bound to the promoter regulatory element of the translation elongation factor 1-alpha 1 gene EEF1A1. Knockdown of MALAT1 by shRNA caused significant downregulation of EEF1A1 in breast cancer MDA-MB231 and SKRB3 cells. Using a luciferase reporter assay, we showed that knockdown of MALAT1 reduced the promoter activity of EEF1A1 in these two breast cancer cells. Chromatin immunoprecipitation (ChIP) assay indicated that MALAT1 regulated EEF1A1 by altering the histone 3 lysine 4 (H3K4) epigenotype in the gene promoter. MALAT1 was overexpressed in breast cancer tissues and breast cancer cells. Knockdown of MALAT1 reduced cell proliferation and invasion by arresting cells at the G0/G1 phase. Ectopic overexpression of EEF1A1 reversed the altered tumor phenotypes induced by MALAT1 shRNA treatment. These data suggest an epigenetic mechanism by which MALAT1 lncRNA facilitates a pro-metastatic phenotype in breast cancer by trans-regulating EEF1A1.

Laparoscopic management of enterohepatic migrated fish bone mimicking liver neoplasm: A case report and literature review

RATIONALE

Accidental ingestion of a foreign body is common in daily life. But the hepatic migration of perforated foreign body is rather rare.

PATIENT CONCERNS

A 37-year-old man presented with a history of vague epigastric discomfort for about 2 months.

DIAGNOSIS

A diagnosis of the foreign body induced hepatic inflammatory mass was made based on abdominal computed tomographic scan and upper gastrointestinal endoscopy.

INTERVENTIONS

The patient underwent laparoscopic laparotomy. During the operation, inflammatory signs were seen in the lesser omentum and segment 3 of liver. B- Ultrasound guided excision of the mass (in segment 3) was performed. Dissecting the specimen revealed a fish bone measuring 1.7 cm in length.

OUTCOMES

The patient recovered uneventfully and was discharged on day 5 after surgery.

LESSONS

This study shows the usefulness of endoscopy for final diagnosis and treatment in foreign body ingestion. Early diagnosis and decisive treatment in time are lifesaving for patients with this potentially lethal condition.

Successful treatment of invasive fungal rhinosinusitis caused by Cunninghamella: A case report and review of the literature

BACKGROUND

Invasive fungal rhinosinusitis (IFR) caused by Cunninghamella is very rare but has an extremely high fatality rate. There have been only seven cases of IFR caused by Cunninghamella reported in English and, of these, only three patients survived. In this article, we present another case of IFR caused by Cunninghamella, in which the patient was initially treated successfully but then deteriorated due to a relapse of leukemia 2 mo later.

CASE SUMMARY

A 50-year-old woman presented with a 2-mo history of right ocular proptosis, blurred vision, rhinorrhea and nasal obstruction. Nasal endoscopic examination showed that the middle turbinate had become necrotic and fragile. Endoscopic sinus surgery and enucleation of the right orbital contents were performed successively. Additionally, the patient was treated with amphotericin B both systematically and topically. Secretion cultivation of the right eye canthus showed infection with Cunninghamella, while postoperative pathology also revealed fungal infection. The patient’s condition gradually stabilized after surgery. However, the patient underwent chemotherapy again due to a relapse of leukemia 2 mo later. Unfortunately, her leukocyte count decreased dramatically, leading to a fatal lung infection and hemoptysis.

CONCLUSION

Aggressive surgical debridements, followed by antifungal drug treatment both systematically and topically, are the most important fundamental treatments for IFR.

Fast distributed dynamic strain sensing using a modified gain-profile tracing technique

Gain-profile tracing (GPT) is a useful strategy of distributed sensing in BOTDA technique for achieving high spatial resolution, which has not been used for the dynamic strain measurement previously. In this paper, we propose a modified gain-profile tracing (MGPT) technique for fast dynamic strain measurement while maintaining the advantage of high spatial resolution. This technique is based on a modified pump pulse modulation scheme and the slope-assisted demodulation method. The time consumption using MGPT technique for a single pump pulse measurement of dynamic strain is less by 25% than the conventional GPT technique. The spatial resolution of our BOTDA system using MGPT technique is 50cm and maximal frequency of dynamic strain detection could be up to 53.5 Hz for 248m sensing length. In the experiments, we measure two vibration events spacing 50 cm with the frequency of 14.0 Hz and 17.0 Hz in a 248 m single-mode fiber. The proposed method is a potential real-time dynamic alternative for distributed structural health monitoring.

Combined RNA-seq and RAT-seq mapping of long noncoding RNAs in pluripotent reprogramming

Pluripotent stem cells hold great investigative potential for developmental biology and regenerative medicine. Recent studies suggest that long noncoding RNAs (lncRNAs) may function as key regulators of the maintenance and the lineage differentiation of stem cells. However, the underlying mechanisms by which lncRNAs affect the reprogramming process of somatic cells into pluripotent cells remain largely unknown. Using fibroblasts and induced pluripotent stem cells (iPSCs) at different stages of reprogramming, we performed RNA transcriptome sequencing (RNA-Seq) to identify lncRNAs that are differentially-expressed in association with pluripotency. An RNA reverse transcription-associated trap sequencing (RAT-seq) approach was then utilized to generate a database to map the regulatory element network for lncRNA candidates. Integration of these datasets can facilitate the identification of functional lncRNAs that are associated with reprogramming. Identification of lncRNAs that regulate pluripotency may lead to new strategies for enhancing iPSC induction in regenerative medicine.

Effects of two different broiler flooring systems on production performances, welfare, and environment under commercial production conditions

Research comparing conventional litter and alternative perforated flooring (netting) systems is relatively limited under commercial production conditions. A comprehensive comparison of broiler production performances, welfare quality, and housing environment of two broiler houses with conventional litter and new perforated plastic floors was conducted over four flocks for eight months in eastern China. The two broiler houses each had 31,700 broilers per flock on average and were ventilated using a negative-pressure system. Prior to the onset of the monitoring, litter/manure in all houses was removed. The environmental conditions, gaseous concentrations, and ventilation rate were recorded continuously. Production performance and welfare quality data were collected weekly. Results showed that indoor temperature and relative humidity were not affected by the different floors when the two houses had the same ventilation configuration and management. The average ammonia concentration was lower at 10.44 ppm in the litter house compared to 15.02 ppm in the netting flooring house due to the manure accumulation under the floor. Broiler production performance including live weight, feed conversion, and mortality, was not affected by the netting floor compared to the litter system. In addition, the results suggested that birds raised in the netting floor house may increase breast blister incidence. In this study, the welfare quality parameters including hock and foot pad lesions, lameness, and fearfulness levels were similar in both for both flooring systems.

Friend leukemia virus integration 1 promotes tumorigenesis of small cell lung cancer cells by activating the miR-17-92 pathway

Small cell lung cancer (SCLC) is regarded as the most devastative type of human lung malignancies. The rapid and disseminated growth pattern remains the primary cause of poor clinical prognosis in patients with SCLC. However, the molecular factors that drive rapid progression of SCLC remain unclear. Friend leukemia virus integration 1 (FLI1), an Ets transcription factor family member, has been previously reported to act as a major driver of hematological malignancies. In this study, we explored the potential role of FLI1 in SCLC. Using immunohistochemical staining, we found that FLI1 was significantly upregulated in SCLC tissues, compared to that in non-small cell lung cancer (NSCLC) and normal lung tissues (p < 0.01). The expression score of FLI1 oncoprotein was associated with the extensive stage of SCLC and the overexpressed Ki67. Knockdown of FLI1 with small interfering RNA (siRNA) or short hairpin RNA (shRNA) promoted apoptosis and induced repression of cell proliferation, tumor colony formation and in vivo tumorigenicity in highly aggressive SCLC cell lines. Importantly, we discovered that FLI1 promoted tumorigenesis by activating the miR-17-92 cluster family. This study uncovers FLI1 as an important driving factor that promotes tumor growth in SCLC through the miR-17-92 pathway. FLI1 may serve as an attractive target for therapeutic intervention of SCLC.

Validating the pivotal role of the immune system in low-dose radiation-induced tumor inhibition in Lewis lung cancer-bearing mice

Although low-dose radiation (LDR) possesses the two distinct functions of inducing hormesis and adaptive responses, which result in immune enhancement and tumor inhibition, its clinical applications have not yet been elucidated. The major obstacle that hinders the application of LDR in the clinical setting is that the mechanisms underlying induction of tumor inhibition are unclear, and the risks associated with LDR are still unknown. Thus, to overcome this obstacle and elucidate the mechanisms mediating the antitumor effects of LDR, in this study, we established an in vivo lung cancer model to investigate the participation of the immune system in LDR-induced tumor inhibition and validated the pivotal role of the immune system by impairing immunity with high-dose radiation (HDR) of 1 Gy. Additionally, the LDR-induced adaptive response of the immune system was also observed by sequential HDR treatment in this mouse model. We found that LDR-activated T cells and natural killer cells and increased the cytotoxicity of splenocytes and the infiltration of T cells in the tumor tissues. In contrast, when immune function was impaired by HDR pretreatment, LDR could not induce tumor inhibition. However, when LDR was administered before HDR, the immunity could be protected from impairment, and tumor growth could be inhibited to some extent, indicating the induction of the immune adaptive response by LDR. Therefore, we demonstrated that immune enhancement played a key role in LDR-induced tumor inhibition. These findings emphasized the importance of the immune response in tumor radiotherapy and may help promote the application of LDR as a novel approach in clinical practice.

Preparation, characterization, and pharmacokinetics in swine of a florfenicol enteric formulation prepared using hot-melt extrusion technology

The objective of this work was to manufacture an enteric formulation of florfenicol (FF) using hot-melt extrusion (HME) technology and to evaluate its in vitro dissolution and in vivo pharmacokinetics. For the HME process, hypromellose acetate succinate LG (HPMCAS-LG) was the enteric polymer mixed with FF, and the two components were extruded with a standard screw configuration at a speed of 50 rpm. Differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), powder X-ray diffraction (PXRD), and Fourier transform infrared spectroscopy (FT-IR) were performed to characterize the HME extrudate. The release percentage of the enteric formulation in the acidic stage was <10% of the loaded FF, whereas that in the phosphate buffer stage was >80%. Pharmacokinetic evaluations in swine revealed that the enteric formulation had a longer t_1/2λ and MRT than commercially available FF powder (FULAIKA^® ), indicating that the novel formulation exhibited enteric and sustained release properties. Compared with the commercial product, the relative bioavailability of the enteric formulation reached up to 117.2%. This study suggests that this formulation may have potential for future commercialization.

Prevalence and natural course of occult hepatitis B virus infection in residents of 2 communities of Wuwei City, Gansu Province, China

Occult hepatitis B infection (OBI) is characterized by serum hepatitis B surface antigen (HBsAg) negative and hepatitis B virus (HBV) DNA positive (HBsAg-/HBV DNA+). Occult hepatitis B infection in community-based populations has been scarcely investigated, and OBI outcomes remain unclear, especially in Wuwei, a region located in Northwest China. This region is one of the areas in China that has the highest prevalence of chronic HBV infection. A prospective study was performed in the general population of 2 towns of Wuwei from June 2011 to May 2014. A questionnaire was used to collect demographic and medical data, and serum samples were collected from the participants and stored until analysis. DNA was detected using quantitative PCR (qPCR) or nested PCR, the HBV DNA from HBV DNA-positive or possible positive (below the detection limit) subjects was extracted and amplified by nested PCR, and the PCR products were sequenced. Sequence analysis was performed using the Mega 6.0 program and CLC sequence viewer software. Hepatitis B virus DNA was detected in 90 of 3,080 HBsAg-negative subjects, and the prevalence of OBI in the study population was 2.92% (90/3,080, 95% CI: 2.33%-3.51%). Hepatitis B virus genomes in 51 of 80 objects (63.75%) contained mutations in the "a" determinant of HBsAg. After 2 years follow-up, 42 of 90 HBV DNA of OBI subjects remained positive, and the natural clearance rate of OBI subjects was 53.3%. Occult hepatitis B infection prevalence in this cohort was much lower than chronic HBV infection in the same region. HBV DNA was cleared in most OBI subjects during the 2 year period. Our data suggest that some OBI may represent a late stage of resolving the HBV infection process.

Distinct biological effects of low-dose radiation on normal and cancerous human lung cells are mediated by ATM signaling

Low-dose radiation (LDR) induces hormesis and adaptive response in normal cells but not in cancer cells, suggesting its potential protection of normal tissue against damage induced by conventional radiotherapy. However, the underlying mechanisms are not well established. We addressed this in the present study by examining the role of the ataxia telangiectasia mutated (ATM) signaling pathway in response to LDR using A549 human lung adenocarcinoma cells and HBE135-E6E7 (HBE) normal lung epithelial cells. We found that LDR-activated ATM was the initiating event in hormesis and adaptive response to LDR in HBE cells. ATM activation increased the expression of CDK4/CDK6/cyclin D1 by activating the AKT/glycogen synthase kinase (GSK)-3β signaling pathway, which stimulated HBE cell proliferation. Activation of ATM/AKT/GSK-3β signaling also increased nuclear accumulation of nuclear factor erythroid 2-related factor 2, leading to increased expression of antioxidants, which mitigated cellular damage from excessive reactive oxygen species production induced by high-dose radiation. However, these effects were not observed in A549 cells. Thus, the failure to activate these pathways in A549 cells likely explains the difference between normal and cancer cells in terms of hormesis and adaptive response to LDR.

Loss of insulin-like growth factor II imprinting is a hallmark associated with enhanced chemo/radiotherapy resistance in cancer stem cells

Insulin-like growth factor II (IGF2) is maternally imprinted in most tissues, but the epigenetic regulation of the gene in cancer stem cells (CSCs) has not been defined. To study the epigenetic mechanisms underlying self-renewal, we isolated CSCs and non-CSCs from colon cancer (HT29, HRT18, HCT116), hepatoma (Hep3B), breast cancer (MCF7) and prostate cancer (ASPC) cell lines. In HT29 and HRT18 cells that show loss of IGF2 imprinting (LOI), IGF2 was biallelically expressed in the isolated CSCs. Surprisingly, we also found loss of IGF2 imprinting in CSCs derived from cell lines HCT116 and ASPC that overall demonstrate maintenance of IGF2 imprinting. Using chromatin conformation capture (3C), we found that intrachromosomal looping between the IGF2 promoters and the imprinting control region (ICR) was abrogated in CSCs, in parallel with loss of IGF2 imprinting in these CSCs. Loss of imprinting led to increased IGF2 expression in CSCs, which have a higher rate of colony formation and greater resistance to chemotherapy and radiotherapy in vitro. These studies demonstrate that IGF2 LOI is a common feature in CSCs, even when the stem cells are derived from a cell line in which the general population of cells maintain IGF2 imprinting. This finding suggests that aberrant IGF2 imprinting may be an intrinsic epigenetic control mechanism that enhances stemness, self-renewal and chemo/radiotherapy resistance in cancer stem cells.

Biomaterial Strategies to Reduce Implant-Associated Infections

Although the prophylaxis in controlling sterility within the operating room environment has been greatly improved, implant-associated infection is still one of the most serious complications in implant surgeries due to the existence of immune depression in the peri-implant area. The antibacterial ability of materials themselves logically becomes an important factor in preventing implant-associated infections. With the understanding of the pathogenesis of implant-associated infections, many approaches have been developed through providing an anti-adhesive surface, delivering antibacterial agents to disrupt cell-cell communication and preventing bacteria aggregation or biofilm formation, or killing bacteria directly (lysing the cell membrane). In this article, we review the current strategies in improving the antibacterial ability of materials to prevent implant infection and further present promising tactics in materials design and applications.

Separation and purification using GO and r-GO membranes

Many materials with varied characteristics have been used for water purification and separation applications. Recently discovered graphene oxide (GO), a two-dimensional derivative of graphene has been considered as a promising membrane material for water purification due to its excellent hydrophilicity, high water permeability, and excellent ionic/molecular separation properties. This review is focussed on the possible versatile applicability of GO membranes. It is also known that selective reduction of GO results in membranes with a pore size of ∼0.35 nm, ideally suited for desalination applications. This article presents the applicability of graphene-based membranes for multiple separation applications. This is indeed the first review article outlining a comparison of GO and r-GO membranes and discussing the suitability for applications based on the porosity of the membranes.

This review article outlines a comparison of GO and r-GO membranes for separation and purification applications.

The associations between CYP24A1 polymorphisms and cancer susceptibility: A meta-analysis and trial sequential analysis

PURPOSE

Published data have shown that vitamin D may have a protective effect on cancer development. CYP24A1, the main enzyme responsible for the degradation of active vitamin D, plays an important role in many cancer related cellular processes. Up to now, relationships between CYP24A1 polymorphisms and cancer susceptibility have been widely investigated, whereas the results are inconsistent. The aim of present meta-analysis was to explore the associations between CYP24A1 polymorphisms and cancer susceptibility.

METHODS

We searched on EMBASE, Web of Science, PubMed and China National Knowledge Infrastructure (CNKI) electronic databases (up to July 1, 2017) for relevant studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to make the evaluation clear.

RESULTS

Twenty-nine studies published in eight publications involving 20,593 cases and 25,458 controls were included. Five CYP24A1 gene polymorphisms were evaluated: rs2181874, rs2585428, rs4809960, rs6022999, and rs6068816. Our analyses suggested that rs2585428 and rs4809960 polymorphisms were significantly associated with overall cancer risk. Stratification analyses of ethnicity indicated that rs2585428 and rs4809960 polymorphisms decreased the risk of cancer among Caucasians. When studies were stratified by cancer type, our results indicated that rs2585428 significantly decreased the risk of pancreas cancer, while rs4809960 significantly decreased the risk of breast cancer. There were no associations of rs2181874, rs6022999, or rs6068816 with overall cancer risks.

CONCLUSION

Associations between CYP24A1 polymorphisms and cancer risks were examined, and additional multi-center studies with large samples are necessary to validate our results.

Low-dose irradiation inhibits proliferation of the p53null type human prostate cancer cells through the ATM/p21 pathway

Low-dose ionizing radiation (LDIR) induces hormesis, exerts an adoptive effect on normal mammalian cells and stimulates cell proliferation; however, this effect is absent in cancer cells. Little is known on the molecular mechanisms underlying this differential response between normal and cancer cells. In the present study, it was demonstrated that the human prostate cancer cell line PC-3 and the normal prostate cell line RWPE-1 exhibited differential biological responses to LDIR. Through cell cycle analyses, it was demonstrated that LDIR inhibited cell growth and arrested the cell cycle at the S and G2/M phases in PC-3 cells, but not in RWPE-1 cells. Using western blotting, it was demonstrated that LDIR at 75 mGy induced the expression of ataxia-telangiectasia mutated (ATM) protein in PC-3 as well as RWPE-1 cells. However, the ATM̸p21 pathway was activated in PC-3, but not in RWPE-1 cells. Although the expression of p53 was not affected by 75 mGy LDIR in RWPE-1 cells, the ATM̸p21 pathway was activated when RWPE-1 cells lost p53 function. In addition, when using ATM inhibitors, the ATM̸p21 pathway was inactivated in both cell lines, and the LDIR-induced cell proliferation inhibition was also abolished. These findings suggested that the ATM/p21 pathway directly participated in the LDIR-induced cell proliferation inhibition in p53null type prostate tumor cells, whereas this mechanism was absent in normal prostate cells. Thus, p53 may affect cell stability following LDIR, and plays a crucial role in regulating the ATM/p21 pathway activated by LDIR.

Adsorption of mercury ions from wastewater aqueous solution by amide functionalized cellulose from sugarcane bagasse

A novel effective cellulose-based adsorbent was prepared through two common reactions, which included the esterification of sugarcane bagasse cellulose with excess stearic acid and the reaction of grafting polyacrylamide brush by ultraviolet radiation initiation. The adsorbent can effectively adsorb Hg(II) ion from wastewater. The characterization of the adsorbents was conducted by optical microscope (OM), scanning electron microscopy (SEM-EDS) and infrared spectrometry (FTIR). Full kinetic and thermodynamic investigations as well as isotherm analysis were also undertaken. Due to the abundant amide groups, the cellulose-based adsorbents exhibit excellent adsorption performance for the removal of Hg(II) ion from aqueous solution with a maximum adsorption capacity of 178mg/g. Furthermore, the cellulose-based adsorbents can be easily separated from the aqueous solution after adsorption and regenerated using 0.2M HCl solution, which exhibits high adsorption capacity after six adsorption-desorption cycles. In view of the easily-operated cost-effective preparation technique, substantial adsorption efficiency and excellent adsorption recyclability, therefore, the eco-friendly cellulose-based adsorbents could be used for water purification effectively. More importantly, this work improves value of low-cost biomass resources.

Peripheral Blood Leukocyte Expression of lncRNA MIAT and Its Diagnostic and Prognostic Value in Ischemic Stroke

BACKGROUND

Ischemic stroke (IS) is an extremely heterogeneous disease with variable pathogenesis. Due to the lack of early diagnostic markers, the mortality rate of IS remains high. Cumulative evidence shows that long noncoding RNAs among noncoding RNAs play important roles in cardiovascular diseases. In the present study, we focused on the expression pattern of myocardial infarction-associated transcript (MIAT) and its clinical significance in IS.

METHODS

Blood samples were obtained from IS patients (n = 189) and healthy controls (n = 189). The National Institutes of Health Stroke Scale (NIHSS) was measured at the time of admission. Short-term functional outcome was measured by the modified Rankin Scale (mRS) at 3 months after admission. Multivariate analyses were performed using logistic regression models. The receiver operating characteristic (ROC) curve was used to evaluate the accuracy of MIAT in the diagnosis and prognosis of IS.

RESULTS

In IS patients, MIAT expression level was significantly upregulated and correlated with NIHSS scores (r = .421, P <.001), mRS (r = .339, P <.001), high-sensitivity C-reactive protein (r = .309, P <.001), and infarct volume (r = .318, P <.001). ROC curves indicated that MIAT could serve as a potential marker for discriminating IS patients from the controls with an area under the curve of .842 (95% confidence interval, .802-.881). The overall survival analysis showed that patients with higher MIAT expression had a relatively poor prognosis. Meanwhile, the multivariate analysis revealed that MIAT was an independent prognostic marker of functional outcome and death in patients with IS.

CONCLUSION

Our data suggested that MIAT might be a potential diagnostic and prognostic indicator in IS.

Targeted breast cancer therapy by harnessing the inherent blood group antigen immune system

Cancer gene therapy has attracted increasing attention for its advantages over conventional therapy in specific killing of tumor cells. Here, we attempt to prove a novel therapeutic approach that targets tumors by harnessing the blood antigen immune response system, which is inherently present in patients with breast cancers. Breast cancer MDA-MB-231 cells expressed blood group H antigen precursor. After ectopic expression of blood group A glycosyltransferase, we found that the H precursor was converted into the group A antigen, appearing on the surface of tumor cells. Incubation with group B plasma from breast cancer patients activated the antigen-antibody-complement cascade and triggered tumor cell killing. Interestingly, expression of blood A antigen also reduced tumorigenesis in breast cancer cells by inhibiting cell proliferation, migration, and tumor sphere formation. Cell cycle analysis revealed that cancer cells were paused at S phase due to the activation of cell cycle regulatory genes. Furthermore, pro-apoptotic genes were unregulated by the A antigen, including BAX, P21, and P53, while the anti-apoptotic BCL2 was down regulated. Importantly, we showed that extracellular HMGB1 and ATP, two critical components of the immunogenic cell death pathway, were significantly increased in the blood A antigen-expressing tumor cells. Collectively, these data suggest that blood antigen therapy induces specific cancer cell killing by activating the apoptosis and immunogenic cell death pathways. Further translational studies are thereby warranted to apply this approach in cancer immuno-gene therapy.

Targeting GRP78 as a Basis for Enhanced Glioma Cells Killing by anti-TfR antibody

AIM

Studies have shown that chemotherapeutic drugs induced endoplasmic reticulum (ER) stress in glioblastoma cells. In our previous study, we have demonstrated anti-TfR monoclonal antibody 7579 enhanced the anti-tumor effects of chemotherapeutic drugs on human glioma cells in vitro. In our study, we therefore investigated whether the anti-TfR antibody alone or the combination of anti-TfR antibody with chemotherapeutic drug would lead to increased ER stress.

MATERIAL AND METHODS

We detected ER stress after cells were treated with anti-TfR mAb or/and Nimustine by western blot analysis. We detected the colony survival and apoptosis of cells after transfection with siRNA and treated with anti-TfR mAb or/and Nimustine by lableing with methylene blue and FCM.

RESULTS

The anti-TfR antibody could elevate expression GRP78/BiP and CHOP/GADD153 and lead to further increased ER stress when combined with Nimustine. Small interfering RNA (siRNA) against the ER stress marker GRP78 further sensitized the glioma cells to killing by the anti-TfR antibody or/and Nimustine.

CONCLUSION

Our results show that the anti-tumor effects of anti-TfR antibody trigger the ER stress response, and that this effect is achieved via the siRNA against GRP78 for glioma cell growth and survival. These results hold promise as a clinical approach to gene therapy for malignant gliomas.

Increased acetylation of microtubules rescues human tau-induced microtubule defects and neuromuscular junction abnormalities in Drosophila

Tau normally associates with and stabilizes microtubules (MTs), but is hyperphosphorylated and aggregated into neurofibrillary tangles in Alzheimer's disease and related neurodegenerative diseases, which are collectively known as tauopathies. MTs are regulated by different forms of post-translational modification, including acetylation; acetylated MTs represent a more stable microtubule population. In our previous study, we showed that inhibition of histone deacetylase 6 (HDAC6), which deacetylates tubulin at lysine 40, rescues defects in MTs and in neuromuscular junction growth caused by tau overexpression. However, HDAC6 also acts on other proteins that are involved in distinct biological processes unrelated to tubulins. In order to examine directly the role of increased tubulin acetylation against tau toxicity, we generated a site-directed α-tubulin^K40Q mutation by CRISPR/Cas9 technology to mimic the acetylated MTs and found that acetylation-mimicking α-tubulin rescued tau-induced MT defects and neuromuscular junction developmental abnormalities. We also showed that late administration of ACY-1215 and tubastatin A, two potent and selective inhibitors of HDAC6, rescued the tau-induced MT defects after the abnormalities had already become apparent. Overall, our results indicate that increasing MT acetylation by either genetic manipulations or drugs might be used as potential strategies for intervention in tauopathies.

Highlighted Article: Increased acetylation of microtubules by genetic and pharmacological approaches rescues human tau overexpression-induced toxicity in Drosophila muscles and neurons.

[Analysis of sonographic characteristics of thyroid nodules diagnosed as false positive or negative results in shear wave elastography]

Objective:In order to improve diagnostic accuracy, we study the characteristics of two dimensional ultrasound and shear wave elastography in the diagnosis of false negative or false positive thyroid nodules by shear wave elastography.Method:One hundred and eighty-nine nodules in 189 consecutive patients who had been determined by surgical operation and pathology. Conventional ultrasound features and SWE elasticity imaging characteristics and properties of the final postoperative pathology were recorded. A comparative study between true and false results of quantitative SWE elasticity imaging, and the corresponding conventional ultrasound nodule characteristics were compared.Result:Postoperative pathology showed 189 nodules, 74(39.2%) were benign and 115(60.8%) were malignant. The sensitivity, specificity of conventional ultrasound in the diagnosis of thyroid nodules were 56.5% and 81.1% respectively, and those of SWE were 60.9% and 85.1%. The false positive rate of shear wave elastography in diagnosing benign nodules and the false negative rate of malignant nodules were 14.9% and 39.1%, respectively. The false negative rate was higher than the false positive rate. A vertical growth (P< 0.01) and smaller diameter of the masses were significantly associated with false SWE findings (P< 0.01).Conclusion:The SWE imaging has important significance for differentiating benign and malignant thyroid nodules, but false results are inevitable, which requires clinicians conjunction with other test results to prevent errors judgment when reviewing the SWE imaging.

Association of the lipoprotein lipase gene Ser447Ter polymorphism with hypertension and blood pressure variation: evidence from an updated meta-analysis

The polymorphism of lipoprotein lipase (LPL) gene Ser447Ter (S447X) has long been linked to hypertension and blood pressure variation, but the established data remained controversial. To better elucidate this inconsistency, a meta-analysis was conducted. We comprehensively searched electronic databases, including Pubmed, EMBASE, China National Knowledge Infrastructure (CNKI), Web of Science, for all literatures with the last update on February 2016. The strength of association was calculated by using odds ratios (ORs) and weighted mean differences (WMDs) with corresponding 95% confidence intervals (CIs). Further stratified analyses, cumulative meta-analysis analysis, and sensitivity analyses were performed. A total of 14 studies (3592 cases and 4643 controls) for hypertension and 14 studies (n = 9254) for blood pressure were included. Overall, significant associations were revealed between S447X polymorphism and hypertension risk using allelic comparison (OR = 0.86, 95%CI 0.77 to 0.96), heterozygote comparison (OR = 0.85, 95%CI 0.75 to 0.96), and the dominant model (OR = 0.85, 95%CI 0.75 to 0.96), especially in Asians. Furthermore, in subgroup analyses restricted to the population-based controls studies, the high-quality studies, and the large sample size studies, these significant associations were still observed. As for blood pressure association, significant reductions of systolic blood pressure (WMD = -1.25 mmHg, 95%CI -2.25 to -0.25 mmHg) and diastolic blood pressure (WMD = -1.91 mmHg, 95%CI -3.25 to -0.56 mmHg) levels were found using dominant model. No publication bias was observed in any comparison model. Therefore, current meta-analysis suggested that the LPL S447X polymorphism is likely to be a protective factor in the development of hypertension.

USP22 mediates the multidrug resistance of hepatocellular carcinoma via the SIRT1/AKT/MRP1 signaling pathway

Drug treatments for hepatocellular carcinoma (HCC) often fail because of multidrug resistance (MDR). The mechanisms of MDR are complex but cancer stem cells (CSCs), which are able to self‐renew and differentiate, have recently been shown to be involved. The deubiquitinating enzyme ubiquitin‐specific protease 22 (USP22) is a marker for CSCs. This study aimed to elucidate the role of USP22 in MDR of HCC and the underlying mechanisms. Using in vitro and in vivo assays, we found that modified USP22 levels were responsible for the altered drug‐resistant phenotype of BEL7402 and BEL/FU cells. Downregulation of USP22 dramatically inhibited the expression of ABCC1 (encoding MRP1) but weakly influenced ABCB1 (encoding P‐glycoprotein). Sirtuin 1 (SIRT1) was reported previously as a functional mediator of USP22 that could promote HCC cell proliferation and enhance resistance to chemotherapy. In this study, USP22 directly interacted with SIRT1 and positively regulated SIRT1 protein expression. Regulation of the expression of both USP22 and SIRT1 markedly affected the AKT pathway and MRP1 expression. Inhibition of the AKT pathway by its specific inhibitor LY294002 resulted in downregulation of MRP1. USP22 and MRP1 expression was detected in 168 clinical HCC samples by immunohistochemical staining, and a firm relationship between USP22 and MRP1 was identified. Together, these results indicate that USP22 could promote the MDR in HCC cells by activating the SIRT1/AKT/MRP1 pathway. USP22 might be a potential target, through which the MDR of HCC in clinical setting could be reversed.

Desoxycorticosterone pivalate-salt treatment leads to non-dipping hypertension in Per1 knockout mice

AIM

Increasing evidence demonstrates that circadian clock proteins are important regulators of physiological functions including blood pressure. An established risk factor for developing cardiovascular disease is the absence of a blood pressure dip during the inactive period. The goal of the present study was to determine the effects of a high salt diet plus mineralocorticoid on PER1-mediated blood pressure regulation in a salt-resistant, normotensive mouse model, C57BL/6J.

METHODS

Blood pressure was measured using radiotelemetry. After control diet, wild-type (WT) and Per1 (KO) knockout mice were given a high salt diet (4% NaCl) and the long-acting mineralocorticoid deoxycorticosterone pivalate. Blood pressure and activity rhythms were analysed to evaluate changes over time.

RESULTS

Blood pressure in WT mice was not affected by a high salt diet plus mineralocorticoid. In contrast, Per1 KO mice exhibited significantly increased mean arterial pressure (MAP) in response to a high salt diet plus mineralocorticoid. The inactive/active phase ratio of MAP in WT mice was unchanged by high salt plus mineralocorticoid treatment. Importantly, this treatment caused Per1 KO mice to lose the expected decrease or 'dip' in blood pressure during the inactive compared to the active phase.

CONCLUSION

Loss of PER1 increased sensitivity to the high salt plus mineralocorticoid treatment. It also resulted in a non-dipper phenotype in this model of salt-sensitive hypertension and provides a unique model of non-dipping. Together, these data support an important role for the circadian clock protein PER1 in the modulation of blood pressure in a high salt/mineralocorticoid model of hypertension.

L6H21 prolonged rats survival after limb allotransplantation by inhibiting acute rejection

OBJECTIVE

Preventing and reducing allograft rejection play a far more important role in limb allotransplantation. We previously found L6H21 could inhibit LPS-induced (lipopolysaccharide LPS) overexpression inflammatory factors in macrophages and specifically targets to MD-2 (myeloid differential protein-2 MD-2) required for TLR4 (Toll-like receptor 4 TLR4) activation and represented an important therapeutic target in inflammatory disorders. Therefore, we evaluated the effect and explored the mechanism of L6H21 in rats' limb allograft model.

MATERIALS AND METHODS

The efficacy of L6H21 was evaluated in limb allograft rats and cyclosporine (CY-A) was used as a positive control agent. T-Lymphocyte in blood was analyzed and dendritic cells (DCs) separated from spleens using flow cytometry. ELISA was used to measure serum cytokine levels. Analysis of protein expressions was performed using Western blotting.

RESULTS

L6H21 reduced the risk of acute rejection and prolonged survival of limb allograft rats. At 3 d and 5 d post-transplant, the ratio of CD4+/CD8+ was decreased in L6H21 group. L6H21 suppressed the content of IL-1α at 7d, IL-5 and IL-10 at both 3 d and 7 d after transplantation. L6H21 decreased the protein expressions of IRF3, p-IRF3, P38, p-P38 and p-IκBα while increased IκBα expression and decreased the ratio of p-IRF3/ IRF3, p-P38/ P38, p-IκBα/IκBα correspondingly.

CONCLUSIONS

L6H21 could reduce the risk of acute rejection and prolong the survival of limb allograft rats through inhibiting the ratio of CD4+/CD8+ in blood and serum cytokine levels and suppressing protein expressions of IRF3, p-IRF3, P38, p-P38 and p-IκBα in DCs. So, it may serve as a potential candidate for the treatment of allograft rejection.

Specific Photothermal Ablation Therapy of Endometriosis by Targeting Delivery of Gold Nanospheres

Endometriosis is difficult to treat since the side effects of the current therapeutic method and the high recurrence rate; thus, newer and safer therapeutic approaches are urgently needed. This work investigates the enhanced permeability and retention effect of CdTe quantum dots (QDs) and hollow gold nanospheres (HAuNS) in endometriosis to increase the delivery of HAuNS into lesion cells. The surface of HAuNS is successfully conjugated with a TNYL peptide that has specific affinity for the EphB4 receptor, which is a member of the Eph family of receptor tyrosine kinases. It is found that the EphB4 receptor is overexpressed in endometriosis lesions. The data indicate that both QDs and HAuNS can efficiently accumulate in endometriotic lesions through permeable vessels and the TNYL-conjugated HAuNS (TNYL-HAuNS) accumulate more via the interaction with EphB4. The specific photothermal ablation therapy based on TNYL-HAuNS significantly inhibits the growth of the endometriotic volume and induces the atrophy and degeneration of ectopic endometrium with no detectable toxicity to the normal organs. The level of TNF-α and estradiol also significantly decreases in the endometriotic lesions, indicating that the treatment enables a recovery from hormonal imbalance and inflammatory injury. This work can be a valuable reference for future endometriosis therapy.