[A comparison of CAS risk model and CHA2DS2-VASc risk model in guiding anticoagulation treatment in Chinese patients with non-valvular atrial fibrillation]

Objective: To compare the differences between CAS risk model and CHA₂DS₂-VASc risk score in predicting all cause death, thromboembolic events, major bleeding events and composite endpoint in patients with nonvalvular atrial fibrillation. Methods: This is a retrospective cohort study. From the China Atrial Fibrillation Registry cohort study, the patients with atrial fibrillation who were>18 years old were randomly divided into CAS risk score group and CHA₂DS₂-VASc risk score group respectively. According to the anticoagulant status at baseline and follow-up, patients in the 2 groups who complied with the scoring specifications for anticoagulation were selected for inclusion in this study. Baseline information such as age and gender in the two groups were collected and compared. Follow-up was performed periodically to collect information on anticoagulant therapy and endpoints. The endpoints were all-cause death, thromboembolism events and major bleeding, the composite endpoint events were all-cause death and thromboembolism events. The incidence of endpoints in CAS group and CHA₂DS₂-VASc group was analyzed, and multivariate Cox proportional risk model was used to analyze whether the incidence of the endpoints was statistically different between the two groups. Results: A total of 5 206 patients with AF were enrolled, average aged (63.6±12.2) years, and 2092 (40.2%) women. There were 2 447 cases (47.0%) in CAS risk score group and 2 759 cases (53.0%) in CHA₂DS₂-VASc risk score group. In the clinical baseline data of the two groups, the proportion of left ventricular ejection fraction<55%, non-paroxysmal atrial fibrillation, oral warfarin and HAS BLED score in the CAS group were lower than those in the CHA₂DS₂-VASc group, while the proportion of previous diabetes history and history of antiplatelet drugs in the CAS group was higher than that in the CHA₂DS₂-VASc group, and there was no statistical difference in other baseline data. Patients were followed up for (82.8±40.8) months. In CAS risk score group, 225(9.2%) had all-cause death, 186 (7.6%) had thromboembolic events, 81(3.3%) had major bleeding, and 368 (15.0%) had composite endpoint. In CHA₂DS₂-VASc risk score group, 261(9.5%) had all-cause death 209(7.6%) had thromboembolic events, 112(4.1%) had major bleeding, and 424 (15.4%) had composite endpoint. There were no significant differences in the occurrence of all-cause death, thromboembolic events, major bleeding and composite endpoint between anticoagulation in CAS risk score group and anticoagulation in CHA₂DS₂-VASc risk score group (log-rank P =0.643, 0.904, 0.126, 0.599, respectively). Compared with CAS risk score, multivariable Cox proportional hazards regression models showed no significant differences for all-cause death, thromboembolic events, major bleeding and composite endpoint between the two groups with HR(95%CI) 0.95(0.80-1.14), 1.00(0.82-1.22), 0.83(0.62-1.10), 0.96(0.84-1.11), respectively. All P>0.05. Conclusions: There were no significant differences between CAS risk model and CHA₂DS₂-VASc risk score in predicting all-cause death, thromboembolic events, and major bleeding events in Chinese patients with non-valvular atrial fibrillation.

miR-485-3p regulated by MALAT1 inhibits osteosarcoma glycolysis and metastasis by directly suppressing c-MET and AKT3/mTOR signalling

AIMS

Osteosarcoma (OS) is an extremely malignant bone cancer with high incidence and rapid progression. This study aims to investigate the role and underlying mechanisms of MALAT1 and miR-485-3p in OS.

MATERIALS AND METHODS

qRT-PCR and Western blotting were utilized to measure the levels of miR-485-3p, MALAT1, c-MET, AKT3, p-mTOR, mTOR, glycolysis-related proteins or migration-related proteins. Colony formation and transwell assay were used to test the roles of miR-485-3p, MALAT1, c-MET and AKT3 in cancer cell proliferation, migration and invasion. Dual luciferase assay was used to validate the interactions of miR-485-3p/c-MET, miR-485-3p/AKT3, and MALAT1/miR-485-3p. Glucose uptake assay and measurement of lactate production were employed to determine the glycolysis process. Mouse tumour xenograft model was used to determine the effect of shMALAT1 and miR-485-3p mimics on tumour growth and metastasis in vivo.

KEY FINDINGS

miR-485-3p was decreased while c-MET, AKT3, and MALAT1 were increased in human OS tissues and cells. miR-485-3p bound directly to c-MET and AKT3 mRNAs and repressed OS cell glycolysis, proliferation, migration, and invasion through decreasing glycolysis-related proteins and migration-related proteins via inhibiting c-MET and AKT3/mTOR pathway. In addition, MALAT1 interacted with miR-485-3p and disinhibited c-MET and AKT3/mTOR signalling. Knockdown MALAT1 or overexpression of miR-485-3p restrained OS tumour growth and lung metastasis in vivo.

SIGNIFICANCE

miR-485-3p suppresses OS glycolysis, proliferation, and metastasis via inhibiting c-MET and AKT3/mTOR signalling and MALAT1 acts as a sponge of miR-485-3p. MALAT1 and miR-485-3p may be the key regulators in OS progression, and potential molecular targets for future OS therapy.

Effect of the Fusarium toxins, zearalenone and deoxynivalenol, on the mouse brain

The aim of this study was to find effects of Fusarium toxins on brain injury in mice. We evaluated the individual and combined effect of the Fusarium toxins zearalenone and deoxynivalenol on the mouse brain. We examined brain weight, protein, antioxidant indicators, and apoptosis. After 3 and 5days of treatment, increased levels of nitric oxide, total nitric oxide synthase, hydroxyl radical scavenging, and malondialdehyde were observed in the treatment groups. This was accompanied by reduced levels of brain protein, superoxide dismutase (apart from the low-dose zearalenone groups), glutathione, glutathione peroxidase activity, and percentage of apoptotic cells. By day 12, most of these indicators had returned to control group levels. The effects of zearalenone and deoxynivalenol were dose-dependent, and were synergistic in combination. Our results suggest that brain function is affected by zearalenone and deoxynivalenol.

Clinical features and prognosis of serum α-fetoprotein positive advanced gastric cancer

AIM: To investigate the clinical features and prognosis of serum α-fetoprotein (AFP) positive advanced gastric cancer.

METHODS: Forty-six cases of serum AFP positive advanced gastric cancer (study group), and 85 cases of advanced gastric cancer with normal serum AFP were enrolled (control group). Clinical data and survival were compared between the two groups.

RESULTS: Compared with the control group, the study group had a significantly increased degree of malignancy (P = 0.014), later postoperative pathological stages (P = 0.045), and higher incidence of hepatic metastases (P = 0.001). Median progress-free survival (PFS) in the study group was significantly shorter than that of the control group (4.5 mo vs 6.4 mo, P < 0.01). The 1-year survival rate in the study group was slightly lower than that in the control group (41.3% vs 52.9%, P = 0.203), and there was no significant difference. Kaplan-Meier survival curve analysis demonstrated that the median survival time in the study group was significantly shorter than that in the control group (10.8 mo vs 12.6 mo, P = 0.016).

CONCLUSION: Serum AFP positive advanced gastric cancer is a specific type of tumor, which has high malignancy, tends to develop liver metastasis, has no remarkable response to chemotherapy and has a poor prognosis. Abnormal increase of serum AFP is a sensitive indicator for poor prognosis.

The Fusarium toxin zearalenone and deoxynivalenol affect murine splenic antioxidant functions, interferon levels, and T-cell subsets

This study aimed to evaluate the effects of the Fusarium toxin zearalenone (ZEA) and deoxynivalenol (DON) on splenic antioxidant functions, IFN levels, and T-cell subsets in mice. Herein, 360 mice were assigned to nine groups for a 12-day study. Mice were administered an intraperitoneal injection for 4 consecutive days with different concentrations of ZEA alone, DON alone, or ZEA+DON. Spleen and blood samples were collected on days 0, 3, 5, 8, and 12. Mice in each of the experimental groups showed dysreglated splenic antioxidant functions, IFN levels, and T-cell subset frequencies, suggesting that the immune system had been affected. The ZEA+DON-treated groups, especially the group that received a higher concentration of ZEA+DON (Group D2Z2), showed more obvious effects on the dysregulation of splenic antioxidant functions, IFN levels, and T-cell subsets. This finding suggested that DON and ZEA exerted synergistic effects.

Effects of antibacterial peptide on cellular immunity in weaned piglets

The aim of this study was to evaluate the effects of antibacterial peptide (ABP) sufficiency on cellular immune functions by determining the spleen cell cycle and apoptosis, peripheral blood T cell subsets, and T cell proliferation function in weaned piglets. A total of 90 piglets (Duroc × Landrace × Yorkshire) of both sexes were randomly allotted to 5 dietary treatments. Each treatment consisted of 3 replicates with 6 piglets per replicate. The dietary treatments consisted of the negative control (NC; basal diet), positive control (PC; basal diet supplemented with 400 mg/kg Astragalus polysaccharide), and ABP (basal diet mixed with 250, 500, and 1,000 mg/kg ABP). The experimental lasted for 28 d. Two piglets from each replicate were selected randomly for blood samples extraction from the jugular vein to obtain peripheral blood T cell subsets, and T cell proliferation function analysis was performed on d 32, 39, 46, and 53. Two piglets from each replicate were selected and euthanized to observe the spleen cell cycle and apoptosis on d 39 and 53. In ABP-sufficient piglets, the G0/G1 phase of the spleen cell cycle was much lower (P < 0.05) and the S and G2 + M phases and proliferation index (PI) were greater (P < 0.05) than in NC piglets. The percentage of apoptotic cells in the spleen significantly decreased under ABP sufficiency (P < 0.05). The proliferation function of peripheral blood T cells increased (P < 0.05) in ABP-sufficient piglets. Percentages of CD3 (+) and CD3 (+)CD4 (+) ratios (d 39, 46, and 53) and CD4 (+)CD8 (+) ratios (d 32, 39, 46, and 53) increased remarkably (P < 0.05) under ABP sufficiency compared with NC. These results suggest that ABP sufficiency could increase the T cell population and proliferation function of T cells and could induce decreased percentages of apoptotic cells. Overall, the cellular immune function was evidently improved in weaned piglets. We suggest optimal dosages of 500 mg/kg ABP for 4-wk addition and 1,000 mg/kg ABP for 2-wk addition.

High expression of p21 increases killing effect of 5-Fu on gastric cancer cells

AIM: To investigate the effect of p21 expression on the sensitivity of gastric cancer cells to 5-fluorouracil (5-Fu) and the possible mechanisms involved.

METHODS: A p21 expression plasmid was transfected into two gastric cancer cell lines, BGC803 and SGC7901, using liposomes, and Western blot was used to detect the expression of p21. After transfection, the CCK8 colorimetric method was used to detect the proliferation of the two gastric cancer cell lines treated with 5-Fu. Flow cytometry was used to test the change of the cell cycle.

RESULTS: After transfection, p21 expression was significantly up-regulated in the SGC7901 and BGC803 cells compared with control cells (P < 0.05). The cells with p21 overexpression were highly sensitive to 5-Fu (P < 0.05). Cell cycle analysis showed that the cells with p21 overexpression had a significantly increased G₀/G₁ population (P < 0.01). Western blot assay showed down-regulation of expression of CDK2 and Cyclin E (P < 0.01).

CONCLUSION: Overexpression of p21 protein increases the sensitivity of gastric cancer cells to 5-Fu, possibly via mechanisms associated with inducing G₀/G₁ arrest and down-regulation of CDK2 and Cyclin E expression.

ERCC1 and TS expression and prognosis in colon cancer after postoperative adjuvant chemotherapy

AIM: To explore the relationship between excision repair cross-complementing group 1 (ERCC1) expression, thymidylate synthase (TS) expression and the prognosis in colon cancer after postoperative adjuvant chemotherapy.

METHODS: Seventy-six patients who were diagnosed with colon cancer for the first time were enrolled in our study. All the patients received radical operation, were pathologically diagnosed with stage Ⅱ or Ⅲ disease, accepted FOLFOX4 (L-OHP+5-Fu+CF) chemotherapy and were followed at least 3 years. Immunohistochemistry was used to detect ERCC1 and TS expression levels in colon cancer. The relationship between the expression of ERCC1 and TS and postoperative survival was analyzed retrospectively.

RESULTS: The positive expression rates of ERCC1 and TS in colon cancer were 36.8% and 43.4%, respectively. There were a negative correlation between the positive expression of ERCC1 and TS and tumor differentiation (P = 0.019 and 0.024). The median survival time was significantly longer in patients with negative ERCC1 expression than in those with positive expression (P < 0.05), and in patients with negative TS expression than in those with positive expression (P < 0.05). Cox multivariate regression analysis revealed that patients with positive ERCC1 and TS expression did not benefit from chemotherapy (HR = 3.50, 95%CI: 1.59-7.73, P = 0.002; HR = 0.52, 95%CI: 0.35-0.87, P = 0.010).

CONCLUSION: ERCC1 and TS may be biomarkers for predicting the prognosis of colon cancer patients receiving chemotherapy.

Energy, amino acid, and phosphorus digestibility of phytase transgenic corn for growing pigs

Three experiments were conducted to evaluate energy, AA, and P digestibility in a phytase transgenic corn (PTC) containing a phytase gene (phyA2) isolated from Aspergillus niger compared with a nontransgenic near-isoline conventional corn (CC) grown in the same environmental conditions for growing pigs. Experiment 1 was an energy balance experiment conducted to measure DE and ME in PTC and CC. Eighteen growing barrows (initial BW 25.8±0.3 kg) from 9 litters were allotted by BW and litter to 1 of 2 dietary treatments with 9 pigs per treatment in a randomized complete block design. Pigs were individually placed in metabolism cages and fed diets based on the 2 corns. The DE and ME in PTC (3,967 and 3,941 kcal/kg of DM, respectively) were greater (P<0.05) than those in CC (3,917 and 3,848 kcal/kg of DM, respectively). Experiment 2 was conducted to measure apparent ileal digestibility (AID) and standardized ileal digestibility (SID) values of CP and AA in the 2 corns. Eighteen growing barrows (initial BW 41.8±0.7 kg) were equipped with a T-cannula in the distal ileum. Pigs were placed in metabolism cages in a completely randomized design with 3 dietary treatments of 6 pigs each. An N-free diet was used to estimate basal endogenous losses of CP and AA. The AID and SID values for CP and all AA did not differ between the 2 corns. Experiment 3 was conducted to measure apparent total tract digestibility (ATTD) and standardized total tract digestibility (STTD) values of P in the 2 corns. Eighteen growing pigs (initial BW 30.5±0.5 kg) from 6 litters were placed in metabolism cages in a randomized complete block design with 3 dietary treatments of 6 pigs each based on BW and litter. Two diets were based on the 2 corns, and a P-free diet was used to measure endogenous P losses. The ATTD and STTD values of P were greater (P<0.05) in the PTC diet (71.4% and 76.9%, respectively) than those in the CC diet (27.6% and 33.4%, respectively). Pigs fed the PTC diet had a greater (P<0.05) P retention (70.7%) than those fed the CC diet (27.1%). It was concluded that PTC had a greater digestibility of energy and P than CC for growing pigs. As a consequence, if PTC replaces CC in a pig diet, the DE and ME in the diet will increase, and less inorganic P will need to be supplemented to the diet, and thus P excretion in manure will be decreased.

Effects of zearalenone on calcium homeostasis of splenic lymphocytes of chickens in vitro

Zearalenone (ZEA) is an estrogenic mycotoxin. It is produced by several Fusarium species and can contaminate food and feed. To investigate the role of calcium homeostasis in ZEA-induced toxicity of poultry and elucidate its cytotoxic mechanism, splenic lymphocytes isolated from chickens were exposed to ZEA (0-25 μg/mL) for 48 h. The intracellular calcium concentration ([Ca2+]i), pH, calmodulin (CaM) mRNA levels, and Na+/K+-ATPase activities and Ca2+-ATPase activities were detected by the fluorescent dyes Fluo-3/AM and BCECF/AM, quantitative real-time PCR, and chromatometry. Supernatant CaM concentrations were simultaneously detected by ELISA. As the ZEA exposure concentration increased, the [Ca2+]i and CaM mRNA levels gradually increased, while intracellular pH, CaM concentrations of supernatants, and intracellular Na+,K+-ATPase and Ca2+-ATPase activities gradually decreased in a dose-dependent manner. There were significant differences (P<0.05 or P<0.01) between the treatment groups and the control group. These results indicate that ZEA cytotoxicity arises by causing an imbalance in calcium homeostasis and intracellular acidification in lymphocytes.

Studies on gastrin in duodenal ulcer

By immunocytochemical method and radioimmunoassay, the gastrin secreting cells (G cells) and gastrin concentration in antral mucosa, gastric juice and serum in 20 patients with duodenal ulcer (DU) were studied. The number of G cells and gastrin concentration in antral mucosa showed no significant difference as compared with normal control. The number of G cells in patients with DU and antral atrophy was much higher than those with antral atrophy but with DU. It indicated that G cells were increased in number in DU, and the gastrin concentration in gastric juice (271.11 +/- 255.25 pg/ml) was much higher than in sera (74.71 +/- 43.07 pg/ml). G cells were distributed in different parts of pyloric glands, showing that gastrin in gastric juice should come directly from G cells. The disturbance of feedback mechanism in regulating gastric acidity might be an important role in hypersecretion of gastric acid in DU. The increase of gastrin concentration in gastric juice might be closely related to hyperplasia of parietal cells.

[Pericardial puncture under linear array real time ultrasound guidance]

This article reported 14 cases of pericardial puncture under ultrasound guidance with total success and without any complications. This technique is safer and more accurate than conventional method. The localization of puncture site and the technique were introduced. A common linear array transducer coupled with a self-made end-entering guide is the instrument needed which is simple and effective.