Homotherapy-for-heteropathy of Bupleurum Chinense DC.-Scutellaria baicalensis Georgi in treating depression and colorectal cancer: A network pharmacology and animal model approach

ETHNOPHARMACOLOGICAL RELEVANCE

Bupleurum chinense DC.-Scutellaria baicalensis Georgi (BS) is a classic drug pair that has good clinical effects on depression and many tumors. However, the concurrent targeting mechanism of how the aforementioned drug pair is valid in the two distinct diseases, has not been clarified yet.

AIM OF THE STUDY

The components of BS were detected by LC-MS, combined with network pharmacology to explore the active ingredients and common targeting mechanism of its multi-pathway regulation of BS in treating depression and CRC, and to validate the dual effects of BS using the CUMS mice model and orthotopic transplantation tumor mice model of CRC.

RESULTS

Twenty-nine components were screened, 84 common gene targets were obteined, and the top 5 key targets including STAT3, PIK3R1, PIK3CA, AKT1, IL-6 were identified by PPI network. GO and KEGG analyses revealed that PI3K/AKT and JAK/STAT signaling pathways might play a crucial role of BS in regulating depression and CRC. BS significantly modulated CUMS-induced depressive-like behavior, attenuated neuronal damage, and reduced serum EPI and NE levels in CUMS model mice. BS improved the pathological histological changes of solid tumors and liver tissues and inhibited solid tumors and liver metastases in tumor-bearing mice. BS significantly decreased the proteins' expression of IL-6, p-JAK2, p-STAT3, p-PI3K, p-AKT1 in hippocampal tissues and solid tumors, and regulated the levels of IL-2, IL-6 and IL-10 in serum of two models of mice.

CONCLUSION

BS can exert dual antidepressant and anti-CRC effects by inhibiting the expression of IL-6/JAK2/STAT3 and PI3K/AKT pathway proteins and regulating the release of inflammatory cytokines.

[Role of liver sinusoidal endothelial cell damage in the developmental process of hepatic sinusoidal obstruction syndrome: a focus on the research progress of immune inflammatory mechanisms]

Hepatic sinusoidal obstruction syndrome (HSOS) is a type of secondary vascular disease of the liver that is mainly associated with the ingestion of pyrrole alkaloids (PAs) and hematopoietic stem cell transplantation (HSCT) treatment, resulting in severe liver dysfunction, multiple organ failure, and even death. Hepatic sinusoidal dilatation and obstruction, hepatocyte coagulative necrosis, and hepatic lobular inflammation are the main pathological manifestations of HSOS. The key initiating process for the pathogenesis of HSOS is damage to liver sinusoidal endothelial cells (LSECs). Currently, it is believed that LSECs are damaged by the involvement of multiple etiologies and mechanisms, and secondary coagulation and fibrinolysis disorders, oxidative stress, and inflammatory responses are the occurrence contributors to HSOS; however, the mechanism has not been fully elucidated. Therefore, the role of immune-inflammatory mechanisms has received increasing attention in LSEC damage. This article provides an overview of the epidemiology, etiology, and pathological changes of HSOS and reviews the physiological functions, common etiological damage mechanisms, and the key role of LSEC damage in the pathogenesis of HSOS, with a special focus on the role and research progress of immune-inflammatory mechanisms for LSEC damage in recent years. Furthermore, we believe that in-depth study and elucidation of the role of immune-inflammatory mechanisms in LSEC damage and the pathogenesis of HSOS and diagnosis will provide feasible research and development ideas for the screening and identification of new markers and drug treatment targets for HSOS.

Chronic brain functional ultrasound imaging in freely moving rodents performing cognitive tasks

BACKGROUND

Functional ultrasound imaging (fUS) is an emerging imaging technique that indirectly measures neural activity via changes in blood volume. Chronic fUS imaging during cognitive tasks in freely moving animals faces multiple exceptional challenges: performing large durable craniotomies with chronic implants, designing behavioral experiments matching the hemodynamic timescale, stabilizing the ultrasound probe during freely moving behavior, accurately assessing motion artifacts, and validating that the animal can perform cognitive tasks while tethered.

NEW METHOD

We provide validated solutions for those technical challenges. In addition, we present standardized step-by-step reproducible protocols, procedures, and data processing pipelines. Finally, we present proof-of-concept analysis of brain dynamics during a decision making task.

RESULTS

We obtain stable recordings from which we can robustly decode task variables from fUS data over multiple months. Moreover, we find that brain wide imaging through hemodynamic response is nonlinearly related to cognitive variables, such as task difficulty, as compared to sensory responses previously explored.

COMPARISON WITH EXISTING METHODS

Computational pipelines in fUS are nascent and we present an initial development of a full processing pathway to correct and segment fUS data.

CONCLUSIONS

Our methods provide stable imaging and analysis of behavior with fUS that will enable new experimental paradigms in understanding brain-wide dynamics in naturalistic behaviors.

A novel ferroptosis-related gene signature for overall survival prediction in patients with gastric cancer

The global diagnosis rate and mortality of gastric cancer (GC) are among the highest. Ferroptosis and iron-metabolism have a profound impact on tumor development and are closely linked to cancer treatment and patient's prognosis. In this study, we identified six PRDEGs (prognostic ferroptosis- and iron metabolism-related differentially expressed genes) using LASSO-penalized Cox regression analysis. The TCGA cohort was used to establish a prognostic risk model, which allowed us to categorize GC patients into the high- and the low-risk groups based on the median value of the risk scores. Our study demonstrated that patients in the low-risk group had a higher probability of survival compared to those in the high-risk group. Furthermore, the low-risk group exhibited a higher tumor mutation burden (TMB) and a longer 5-year survival period when compared to the high-risk group. In summary, the prognostic risk model, based on the six genes associated with ferroptosis and iron-metabolism, performs well in predicting the prognosis of GC patients.

A centromere-derived retroelement RNA localizes in cis and is a core element of the transcriptional landscape of Drosophila centromeres

Centromeres are essential chromosomal landmarks that dictate the point of attachment between chromosomes and spindle microtubules during cell division. The stable transmission of the centromere site through generations is ensured by a unique chromatin containing the histone H3 variant CENP-A. Previous studies have highlighted the impact of transcription on promoting CENP-A deposition. However, the specific sequences undergoing this transcription and their contribution to centromere function in metazoan systems remain elusive. In this study, we unveil the centromeric transcriptional landscape and explore its correlation with CENP-A in D. melanogaster, currently the only in vivo model with assembled centromeres. We find that the centromere-enriched retroelement G2/Jockey-3 (hereafter referred to as Jockey-3) is a major driver of centromere transcription, producing RNAs that localize to all mitotic centromeres, with the Y centromere showing the most transcription. Taking advantage of the polymorphism of Jockey-3, we show that these RNAs remain associated with their cognate DNA sequences in cis. Using a LacI/lacO system to generate de novo centromeres, we find that Jockey-3 transcripts do not localize to ectopic sites, suggesting they are unlikely to function as non-coding RNAs with a structural role at centromeres. At de novo centromeres on the lacO array, the presence of CENP-A augments the detection of exogenous lacO-derived transcripts specifically in metaphase. We propose that Jockey-3 contributes to the epigenetic maintenance of the centromere by promoting chromatin transcription, while inserting in a region that permits its continuous transmission. Given the conservation of retroelements as centromere components across taxa, our findings have broad implications in understanding this widespread association.

Preservation effect of Lactobacillus plantarum O2 fermentation supernatant on postharvest pepper and its induced resistance to Phytophthora capsici

Research of lactic acid bacteria and its metabolites on biological preservatives becomes a hot topic. Lactobacillus plantarum O2, with good inhibition on Phytophthora capsici (P. capsici), was isolated from the pickle. In this study, the effects of L. plantarum O2 fermentation supernatant (FS) on pepper postharvest preservation and its induced resistance to P. capsici were studied. Results showed that weight loss rate, rot index, respiration rate, relative electrical conductivity, loss of chlorophyll content and VC of pepper in FS treatment group were decreased by 18 %, 64 %, 15 %, 26 %, 33 % and 20 % compared with blank control (BC) after 20 d storage. L* and b*-value of pepper in FS group were lower than those in the BC group. In addition, the damage-induced resistance test found that the infection rate in the FS group was reduced by 39 %, compared with CK2 after 12 d storage. Moreover, phenylalanine ammonia-lyase activity, peroxidase activity, polyphenol oxidase activity, proline content, total phenol content and flavonoid content increased by 14 %, 9 %, 30 %, 8 %, 8 % and 9 %, respectively, while malondialdehyde content decreased by 13 %. These results indicated that FS treatment showed good fresh-keeping effects on postharvest pepper. It could enhance the tolerance of pepper under stress by improving defensive enzyme activities, slowing down the damage caused by P. capsici, and inducing pepper resistance to P. capsici. Therefore, FS can be used as a microbial source bio-preservative for postharvest pepper.

The Effect of MDSC-Derived Exosomes Played in Esophageal Squamous Carcinoma Cells after Ionizing Radiation

PURPOSE/OBJECTIVE(S)

Radiotherapy is the main treatment for esophageal cancer. Previous studies have shown that radiotherapy not only kills tumor cells directly, but also reshapes the immune microenvironment of the tumor. It has been reported an increase in the recruitment of myeloid-derived suppressor cells (MDSC) can occur in tumor tissue after ionizing radiation. Exosomes are mediators of intercellular information exchange and are also involved in the regulation of the tumor microenvironment. In this study, we wanted to understand whether MDSC in esophageal cancer tissue are involved in the regulation of tumor cell response to ionizing radiation via exosomes.

MATERIALS/METHODS

KYSE-150 was used to construct a subcutaneous transplantation tumor model in nude mice. And then mice irradiated with 5 Gy×5fx and 0 Gy×5fx respectively. After irradiation, the spleens of the mice were used to isolate MDSC, and collect the cell supernatants to extract the exosomes. Based on the exosomes, we divided the experiment into three groups (control, exosomes, exosomes+radiation). Exosomes were injected into a nude mouse model of esophageal cancer via the tail vein or co-cultured with KYSE-150 cells. Mice were irradiated with a 5 Gy×5fx after completion of injection, and KYSE-150 cells were irradiated with a single dose 4 Gy. After radiation, KYSE-150 cells were used to detect cell cloning, apoptosis and cell cycle by flow cytometry, cell proliferation by CCK 8. XRCC4,XRCC5,XRCC6,γH2AX,ATM expression in cells and tumor tissue were measured by Western blot and RT-PCR.

RESULTS

The tumor volume was significantly reduced after 5 Gy x 5fx radiation. When exosomes co-cultured with KYSE-150 cells, decrease in apoptosis and increase in cell cloning and cell proliferation were found in the exosomes+radiation group and exosomes group after radiation when compared with the control group, with this change being more pronounced in the exosome+radiation group. The results of the cell cycle assay showed that after ionizing radiation, the proportion of cells in the G0/G1 phase was significantly lower, and the proportion of cells in the S and G2/M phases were significantly higher in the exosomes+radiation group and exosomes group when compared to the Control group. The protein and mRNA expression of XRCC4,XRCC5,XRCC6,γH2AX,ATM in cells were increased in exosomes+radiation group and exosomes group after radiation when compared with the control group, with this change being more obvious in the exosome+radiation group. After irradiation, tumor volumes were measured in nude mice and the results showed that exosomes+radiation group tumors were the largest in volume, while the control group regressed most significantly after irradiation.

CONCLUSION

MDSC-derived exosomes have a tumor growth-promoting effect in esophageal squamous carcinoma, which is enhanced by ionizing radiation, and this may be related to the accelerated repair of damage in tumor tissue after radiation.

Revealing abrupt transitions from goal-directed to habitual behavior

A fundamental tenet of animal behavior is that decision-making involves multiple 'controllers.' Initially, behavior is goal-directed, driven by desired outcomes, shifting later to habitual control, where cues trigger actions independent of motivational state. Clark Hull's question from 1943 still resonates today: "Is this transition abrupt, or is it gradual and progressive?"1 Despite a century-long belief in gradual transitions, this question remains unanswered2,3 as current methods cannot disambiguate goal-directed versus habitual control in real-time. Here, we introduce a novel 'volitional engagement' approach, motivating animals by palatability rather than biological need. Offering less palatable water in the home cage4,5 reduced motivation to 'work' for plain water in an auditory discrimination task when compared to water-restricted animals. Using quantitative behavior and computational modeling6, we found that palatability-driven animals learned to discriminate as quickly as water-restricted animals but exhibited state-like fluctuations when responding to the reward-predicting cue-reflecting goal-directed behavior. These fluctuations spontaneously and abruptly ceased after thousands of trials, with animals now always responding to the reward-predicting cue. In line with habitual control, post-transition behavior displayed motor automaticity, decreased error sensitivity (assessed via pupillary responses), and insensitivity to outcome devaluation. Bilateral lesions of the habit-related dorsolateral striatum7 blocked transitions to habitual behavior. Thus, 'volitional engagement' reveals spontaneous and abrupt transitions from goal-directed to habitual behavior, suggesting the involvement of a higher-level process that arbitrates between the two.

[Safety and feasibility of right colectomy via a transvaginal approach: early experience from a single center]

Objective: To investigate the safety and feasibility of performing right colectomy via a transvaginal approach. Methods: This was a retrospeltive cohort study. Data of 30 patients who had undergone transvaginal laparoscopic right colectomy (transvaginal group) and 23 women who had undergone laparoscopic right colectomy (laparoscopic group) from January 2019 to March 2022 in the Division of Colorectal Surgery, Department of General Surgery, Peking Union Medical College Hospital were collected retrospectively. The inclusion criteria for the transvaginal group were as follows: (1) post-menopausal woman; (2) transverse diameter of the tumor < 6 cm; and (3) diagnosis of benign polyps that were unresectable by endoscopy, mucinous tumors of the appendix, or confirmed right colon cancer not requiring D3 lymphadenectomy. The inclusion criteria for the laparoscopic group were as follows: (1) pathologically confirmed adenocarcinoma or high-grade intraepithelial neoplasia; (2) lesion located from the cecum to the right third of the transverse colon; and (3) clinically stage T1-4NanyM0. The exclusion criteria for the laparoscopic group were as follows: (1) distant metastasis discovered during surgical exploration; (2) multiple organ resection required or R0 resection not possible; or (3) conversion to open surgery required. Safety was evaluated on the basis of intra- and post-operative complications. Feasibility was assessed by postoperative recovery and quality of operative specimen. The body mass index was lower in the transvaginal than the laparoscopic group (22.0±3.1 kg/m2 vs. 24.1±2.6 kg/m2, t=2.617, P=0.012). Results: Among the 30 transvaginal laparoscopic right colectomies, 26 were pure transvaginal surgeries, three required laparoscopic assistance because of difficulties with anastomosis (n=2) or abdominal adhesions (n=1), and one required conversion to laparoscopic surgery because of vascular injury. Compared with the laparoscopic group, the transvaginal group had a longer surgery time (175.0 [147.5, 216.3] minutes vs. 120.0 [100.0, 120.0] minutes, U=63.000, P<0.001) and more blood loss (30.0 [10.0, 50.0] ml vs. 23.0 [10.0, 20.0] ml, U=208.000, P=0.011). The incidence of intraoperative complications (16.7% [5/30) vs. 0, P=0.061] was comparable between the two groups. In the transvaginal group, the sites of intraoperative injuries were bladder (n=3), ileocecal artery (n=1), and right uterine artery (n=1). The incidence of postoperative complications (20.0% [6/30] vs. 17.4% [4/23], χ2<0.001,P>0.999) was also comparable between the two groups. Clavien-Dindo grade III postoperative complications occurred in two patients in the transvaginal group (one patient had a pelvic hematoma that required embolization; the other had a vesico-vaginal fistula that required surgery). Postoperative visual analogue scale scores were significantly lower (P<0.001) in the transvaginal group. Times to first flatus, ambulation, and first intake and duration of postoperative hospital stay were comparable between the two groups (P>0.05). The proportion of specimens of moderate quality was 83.3% (25/30) in the transvaginal group and 100% (23/23) in the laparoscopic group; this difference is not significant (P=0.061). Among patients who underwent D2 lymph node dissection, the number of lymph nodes examined was comparable between the transvaginal (n=23) and laparoscopic groups (n=7) (18 [15, 27] vs. 20 [16, 29], U=69.500, P=0.589). Conclusion: Transvaginal right colon surgery is associated with less postoperative pain than laparoscopic surgery, but is not yet the preferred alternative because of the incidence of surgical complications.

Stent pretreatment for internal carotid artery exposed to necrotic lesions in nasopharyngeal carcinoma

BACKGROUND

Post radiation nasopharyngeal necrosis (PRNN) invading the internal carotid artery (ICA) contributes to the death of 69.2-72.7% of PRNN patients. ICA occlusion is an effective treatment to avoid fatal bleeding, while some patients are intolerant. We present a novel method that allows for these patients without interrupting blood flow through the ICA.

METHODOLOGY

This study enrolled patients with PRNN-invaded ICA who were not suitable for ICA occlusion from April 2020 to November 2022. ICA stent pretreatment was performed in the 36 patients and followed the endoscopic nasopharyngectomy (ENPG) or conservative treatment for PRNN. We report the survival outcome and incidence of complications after stent implantation and compare the survival outcomes of ENPG and conservative treatment for PRNN followed by stent implantation.

RESULTS

ICA stent pretreatment was performed in the 36 enrolled patients, among which 14 underwent ENPG, and 22 received conservative treatment. 27.8% patients died after a median follow-up of 15 months. The Kaplan-Meier estimates of overall survival were higher in the ENPG group than in the conservative treatment group. Karnofsky performance status (KPS) was significantly higher in the ENPG group than in the non-ENPG group.

CONCLUSIONS

The innovative application of ICA stents is a promising treatment to improve outcomes in patients with PRNN invading the ICA who are unsuitable for ICA embolization, especially when followed by endoscopic surgery. However, methods to avoid postoperative cerebral ischemia and nasopharyngeal hemorrhage still require further study.

Immune-related gene-based prognostic index for predicting survival and immunotherapy outcomes in colorectal carcinoma

Introduction

Colorectal cancer shows high incidence and mortality rates. Immune checkpoint blockade can be used to treat colorectal carcinoma (CRC); however, it shows limited effectiveness in most patients.

Methods

To identify patients who may benefit from immunotherapy using immune checkpoint inhibitors, we constructed an immune-related gene prognostic index (IRGPI) for predicting the efficacy of immunotherapy in patients with CRC. Transcriptome datasets and clinical information of patients with CRC were used to identify differential immune-related genes between tumor and para-carcinoma tissue. Using weighted correlation network analysis and Cox regression analysis, the IRGPI was constructed, and Kaplan-Meier analysis was used to evaluate its predictive ability. We also analyzed the molecular and immune characteristics between IRGPI high-and low-risk subgroups, performed sensitivity analysis of ICI treatment, and constructed overall survival-related receiver operating characteristic curves to validate the IRGPI. Finally, IRGPI genes and tumor immune cell infiltration in CRC model mice with orthotopic metastases were analyzed to verify the results.

Results

The IRGPI was constructed based on the following 11 hub genes: ADIPOQ, CD36, CCL24, INHBE, UCN, IL1RL2, TRIM58, RBCK1, MC1R, PPARGC1A, and LGALS2. Patients with CRC in the high-risk subgroup showed longer overall survival than those in the low-risk subgroup, which was confirmed by GEO database. Clinicopathological features associated with cancer progression significantly differed between the high- and low-risk subgroups. Furthermore, Kaplan-Meier analysis of immune infiltration showed that the increased infiltration of naïve B cells, macrophages M1, and regulatory T cells and reduced infiltration of resting dendritic cells and mast cells led to a worse overall survival in patients with CRC. The ORC curves revealed that IRGPI predicted patient survival more sensitive than the published tumor immune dysfunction and rejection and tumor inflammatory signature.

Discussion

Thus, the low-risk subgroup is more likely to benefit from ICIs than the high-risk subgroup. CRC model mice showed higher proportions of Tregs, M1 macrophages, M2 macrophages and lower proportions of B cells, memory B cell immune cell infiltration, which is consistent with the IRGPI results. The IRGPI can predict the prognosis of patients with CRC, reflect the CRC immune microenvironment, and distinguish patients who are likely to benefit from ICI therapy.

Recurrent atherosclerotic cardiovascular disease events preventable with guideline recommended lipid-lowering treatment following myocardial infarction

Background

The 2018 American Heart Association/American College of Cardiology (AHA/ACC) cholesterol guideline provides recommendations for lipid-lowering therapy (LLT) including statins, ezetimibe and proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9i) to prevent recurrent atherosclerotic cardiovascular disease (ASCVD) events in adults with established ASCVD. Many adults with ASCVD who are recommended to take statins, ezetimibe and/or PCSK9i do not receive these medications.

Purpose

To estimate the number of recurrent ASCVD events potentially prevented by population-wide use of guideline recommended LLT following a myocardial infarction (MI).

Methods

We simulated the population-wide impact of receipt of 2018 AHA/ACC cholesterol guideline recommended LLT over 3 and 5 years among US adults with government health insurance through Medicare or commercial health insurance following hospital discharge for MI. We used data from patients with an MI hospitalization in 2018–2019 to estimate the percentage receiving guideline recommended LLT defined by having the medications available to take in the 30 days after their discharge date. We used data from patients with an MI hospitalization in 2013–2016 to estimate the 3 and 5-year cumulative incidence of recurrent ASCVD events (i.e., MI, coronary revascularization or ischemic stroke). The reduction in ASCVD events associated with guideline recommended LLT was estimated from a meta-analysis by the Cholesterol-Lowering Treatment Trialists Collaboration. We conducted a sensitivity analysis estimating the number and percentage of ASCVD events prevented if LLT recommendations from the 2019 European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) cholesterol guideline were followed. We repeated all analyses with recurrent coronary heart disease (i.e., MI or coronary revascularization) and ischemic stroke events as separate outcomes.

Results

Among 279,395 adults with an MI hospitalization in 2018–2019 (mean age 75 years, 54% men, mean low-density lipoprotein cholesterol 92 mg/dL), 27% were receiving guideline recommended LLT. With current lipid-lowering medication use, we estimated that 70,698 (95% CI: 70,311–71,077) and 89,255 (95% CI: 88,841–89,730) ASCVD events would occur in 3 and 5 years, respectively, after MI hospital discharge (Table, top panel). If all patients were to receive 2018 AHA/ACC guideline recommended LLT, the number of ASCVD events was estimated to be reduced by 21.6%, representing 15,264 (95% CI: 14,451–16,679) events prevented over 3 years and 19,271 (95% CI: 18,245–21,055) events prevented over 5 years. A higher number of recurrent ASCVD events were estimated to be averted following the LLT recommendations of the 2019 ESC/EAS cholesterol guideline (Table, bottom panel).

Conclusions

Population-wide implementation of guideline recommended LLT in adults with an MI hospitalization could prevent a substantial number of recurrent ASCVD events.

Funding Acknowledgement

Type of funding sources: Private company. Main funding source(s): Amgen Inc.

[Efficacy and safety of adalimumab in patients with Crohn's disease]

Objective: To assess the effectiveness and safety of adalimumab in Crohn's disease (CD) patients. Methods: We retrospectively reviewed the charts of 41 CD patients who received adalimumab in Zhongda Hospital Southeast University from January 2020 to August 2021. General clinical data, laboratory results, endoscopy and radiologic findings were collected, meanwhile, disease activity and safety events were evaluated at baseline and at 12, 24 and 48 weeks of administration. Adalimumab was given subcutaneously once every 2 weeks in doses of 160 mg for the first time, 80 mg for the second time, and 40 mg for each subsequent time. Results: The clinical remission rates at 12, 24, and 48 weeks of treatment were 43.9% (18/41), 60.6% (20/33), 60.9% (14/23), and the clinical response rates were 75.6% (31/41), 69.7% (23/33), and 56.5%( 13/23), respectively. The proportion of endoscopic remission at 12, 24 and 48 weeks were 4/14, 2/6, 1/4 in patients undergoing endoscopy, and 1/14 patients achieved mucosal healing at 24 weeks. Primary nonresponse rate (PNR) was 17.1% (7/41), loss of response (LOR) rate was 14.6% (6/41). The incidence of adverse reactions was 9.8%(4/41). Conclusion: Adalimumab can effectively relieve the clinical symptoms and intestinal disease activities of Crohn's disease, and deserves to be popularized clinically. Patients with disease course <2 years, first-line biologics, low baseline HBI score, and longer duration of medication may have better results.

Astragalus mongholicus Bunge and Curcuma aromatica Salisb. inhibits liver metastasis of colon cancer by regulating EMT via the CXCL8/CXCR2 axis and PI3K/AKT/mTOR signaling pathway

BACKGROUND

One of the most challenging aspects of colon cancer (CC) prognosis and treatment is liver-tropic metastasis. Astragalus mongholicus Bunge-Curcuma aromatica Salisb. (AC) is a typical medication combination for the therapy of many malignancies. Our previous studies found that AC intervention inhibits liver metastasis of colon cancer (LMCC). Nevertheless, the comprehensive anti-metastasis mechanisms of AC have not been uncovered.

METHODS

In bioinformatics analysis, RNA-seq data of CC and LMCC patients were collected from TCGA and GEO databases, and differentially expressed genes (DEGs) were identified. The biological processes and signaling pathways involved in DEGs were enriched by GO and KEGG. The protein-protein interaction (PPI) network of DEGs was established and visualized using the Cytocape software, followed by screening Hub genes in the PPI network using Degree value as the criterion. Subsequently, the expression and survival relevance of Hub gene in COAD patients were verified. In the experimental study, the effects of AC on the inhibition of colon cancer growth and liver metastasis were comprehensively evaluated by cellular and animal models. Finally, based on the results of bioinformatics analysis, the possible mechanisms of AC inhibition of colon cancer EMT and liver metastasis were explored by in vivo and in vitro pharmacological experiments.

RESULTS

In this study, we obtained 2386 DEGs relevant to LMCC from the COAD (colon adenocarcinoma) and GSE38174 datasets. Results of GO gene function and KEGG signaling pathway enrichment analysis suggested that cellular EMT (Epithelial-mesenchymal transition) biological processes, Cytokine-cytokine receptor interaction and PI3K/Akt signaling pathways might be closely related to LMCC mechanism. We then screened for CXCL8, the core hub gene with the highest centrality within the PPI network of DEGs, and discovered that CXCL8 expression was negatively correlated with the prognosis of COAD patients. In vitro and in vivo experimental evidence presented that AC significantly inhibited colon cancer cell proliferation, migration and invasion ability, and suppressed tumor growth and liver metastasis in colon cancer orthotopic transplantation mice models. Concomitantly, AC significantly reduced CXCL8 expression levels in cell supernatants and serum. Moreover, AC reduced the expression and transcription of genes related to the PI3K/AKT pathway while suppressing the EMT process in colon cancer cells and model mice.

CONCLUSIONS

In summary, our research predicted the potential targets and pathways of LMCC, and experimentally demonstrated that AC might inhibit the growth and liver metastasis in colon cancer by regulating EMT via the CXCL8/CXCR2 axis and PI3K/AKT/mTOR signaling pathway, which may facilitate the discovery of mechanisms and new therapeutic strategies for LMCC.

Astragalus mongholicus Bunge-Curcuma aromatica Salisb. suppresses growth and metastasis of colorectal cancer cells by inhibiting M2 macrophage polarization via a Sp1/ZFAS1/miR-153-3p/CCR5 regulatory axis

Colorectal cancer (CRC) is regarded as one of the commonest cancer types around the world. Due to the poor understanding on the causes of CRC formation and progression, this study sets out to investigate the physiological mechanisms by which Astragalus mongholicus Bunge-Curcuma aromatica Salisb. (ARCR) regulates CRC growth and metastasis, and the role in which M2 macrophage polarization plays in this process. An orthotopic-transplant model of CRC was established to evaluate the influence of ARCR on the polarization of M2 macrophage and the growth and metastasis of tumors. Next, the binding affinity among Sp1, ZFAS1, miR-153-5p, and CCR5 was identified using multiple assays. Finally, after co-culture of bone marrow-derived macrophages (BMDM) with CRC cell line CT26.WT, the cell proliferative, invasive, and migrated abilities were assessed in gain- or loss-of-function experiments. ARCR inhibited the infiltration of M2 macrophages into tumor microenvironment to suppress the CRC growth and metastasis in vivo. Additionally, ARCR inhibited the transcription of ZFAS1 by reducing Sp1 expression to repress M2 macrophage polarization. Moreover, ZFAS1 competitively binds to miR-153-3p to upregulate the CCR5 expression. Finally, ARCR suppressed the polarization of M2 macrophages to inhibit the tumor growth and tumor metastasis in CRC by mediating the Sp1/ZFAS1/miR-153-3p/CCR5 regulatory axis. Collectively, ARCR appears to suppress the CRC cell growth and metastasis by suppressing M2 macrophage polarization via Sp1/ZFAS1/miR-153-3p/CCR5 regulatory axis. 1. ARCR suppress the CRC cell growth and metastasis 2. ZFAS1 promotes CCR5 expression by competitively binding to miR-153-3p. 3. Sp1 promotes M2 macrophage polarization by activating ZFAS1 via miR-153-3p/CCR5. 4. The study unveiled a protective target against CRC.

[Safety and prognosis analysis of transanal total mesorectal excision versus laparoscopic mesorectal excision for mid-low rectal cancer]

Objective: To compare the short-term and long-term outcomes between transanal total mesorectal excision (taTME) and laparoscopic total mesorectal excision (laTME) for mid-to-low rectal cancer and to evaluate the learning curve of taTME. Methods: This study was a retrospective cohort study. Firstly, consecutive patients undergoing total mesorectal excision who were registered in the prospective established database of Division of Colorectal Diseases, Department of General Surgery, Peking Union Medical College Hospital during July 2014 to June 2020 were recruited. The enrolled patients were divided into taTME and laTME group. The demographic data, clinical characteristics, neoadjuvant treatment, intraoperative and postoperative complications, pathological results and follow-up data were extracted from the database. The primary endpoint was the incidence of anastomotic leakage and the secondary endpoints included the 3-year disease-free survival (DFS) and the 3-year local recurrence rate. Independent t-test for comparison between groups of normally distributed measures; skewed measures were expressed as M (range). Categorical variables were expressed as examples (%) and the χ(2) or Fisher exact probability was used for comparison between groups. When comparing the incidence of anastomotic leakage, 5 variables including sex, BMI, clinical stage evaluated by MRI, distance from tumor to anal margin evaluated by MRI, and whether receiving neoadjuvant treatment were balanced by propensity score matching (PSM) to adjust confounders. Kaplan-Meier curve and Log-rank test were used to compare the DFS of two groups. Cox proportional hazard model was used to analyze and determine the independent risk factors affecting the DFS of patients with mid-low rectal cancer. Secondly, the data of consecutive patients undergoing taTME performed by the same surgical team (the trananal procedures were performed by the same main surgeon) from February 2017 to March 2021 were separately extracted and analyzed. The multidimensional cumulative sum (CUSUM) control chart was used to draw the learning curve of taTME. The outcomes of 'mature' taTME cases through learning curve were compared with laTME cases and the independent risk factors of DFS of 'mature' cases were also analyzed. Results: Two hundred and forty-three patients were eventually enrolled, including 182 undergoing laTME and 61 undergoing taTME. After PSM, both fifty-two patients were in laTME group and taTME group respectively, and patients of these two groups had comparable characteristics in sex, age, BMI, clinical tumor stage, distance from tumor to anal margin by MRI, mesorectal fasciae (MRF) and extramural vascular invasion (EMVI) by MRI and proportion of receiving neoadjuvant treatment. After PSM, as compared to laTME group, taTME group showed significantly longer operation time [(198.4±58.3) min vs. (147.9±47.3) min, t=-4.321, P<0.001], higher ratio of blood loss >100 ml during surgery [17.3% (9/52) vs. 0, P=0.003], higher incidence of anastomotic leakage [26.9% (14/52) vs. 3.8% (2/52), χ(2)=10.636, P=0.001] and higher morbidity of overall postoperative complications [55.8%(29/52) vs. 19.2% (10/52), χ(2)=14.810, P<0.001]. Total harvested lymph nodes and circumferential resection margin involvement were comparable between two groups (both P>0.05). The median follow-up for the whole group was 24 (1 to 72) months, with 4 cases lost, giving a follow-up rate of 98.4% (239/243). The laTME group had significantly better 3-year DFS than taTME group (83.9% vs. 73.0%, P=0.019), while the 3-year local recurrence rate was similar in two groups (1.7% vs. 3.6%, P=0.420). Multivariate analysis showed that and taTME surgery (HR=3.202, 95%CI: 1.592-6.441, P=0.001) the postoperative pathological staging of UICC stage II (HR=13.862, 95%CI:1.810-106.150, P=0.011), stage III (HR=8.705, 95%CI: 1.104-68.670, P=0.040) were independent risk factors for 3-year DFS. Analysis of taTME learning curve revealed that surgeons would cross over the learning stage after performing 28 cases. To compare the two groups excluding the cases within the learning stage, there was no significant difference between two groups after PSM no matter in the incidence of anastomotic leakage [taTME: 6.7%(1/15); laTME: 5.3% (2/38), P=1.000] or overall complications [taTME: 33.3%(5/15), laTME: 26.3%(10/38), P=0.737]. The taTME was still an independent risk factor of 3-year DFS only analyzing patients crossing over the learning stage (HR=5.351, 95%CI:1.666-17.192, P=0.005), and whether crossing over the learning stage was not the independent risk factor of 3-year DFS for mid-low rectal cancer patients undergoing taTME (HR=0.954, 95%CI:0.227-4.017, P=0.949). Conclusions: Compared with conventional laTME, taTME may increase the risk of anastomotic leakage and compromise the oncological outcomes. Performing taTME within the learning stage may significantly increase the risk of postoperative anastomotic leakage.

Pulse chirp enhances the laser acceleration of neutral particles

Accelerating neutral atoms is challenging because such particles are not directly manipulated by electric and magnetic fields as charged particles. In our acceleration scheme, the excited atom requires a sufficiently high gradient acceleration force. The key challenge in laser acceleration experiments is that not only must the photon energy excite atoms to the Rydberg state, but also atoms must not be ionized in an intense laser field. In this Letter, we propose using a chirped laser pulse to achieve the objectives above. The enhancement effect of the pulse chirp on the laser acceleration of neutral particles is investigated via numerical simulation and analytical analysis.

[Analysis of hemagglutinin-neuraminidase gene characteristics of human parainfluenza virus type 3 among children with acute respiratory tract infection in Qingdao city]

The purpose was to discuss the infection status of human parainfluenza virus type 3 (HPIV-3) in children with acute respiratory tract infection(ARTI) in Qingdao, Shandong province, and to analyze the gene characteristics of HPIV-3 hemagglutinin-neuraminidase protein (HN). This study was a cross-sectional study. A total of 1 674 throat swab samples were collected randomly from children with ARTI, in the three hospitals (Qingdao Women and Children's Hospital, West Coast Branch of Affiliated Hospital of Qingdao University, Laoshan Branch of Affiliated Hospital of Qingdao University) from January 2018 to December 2019. Multiplex real-time fluorescence RT-PCR was performed to screen HPIV-3 positive specimens. For HPIV-3 positive specimens, nested PCR was used to amplify the full-length HN gene of HPIV-3. The HN gene was sequenced and compared with the representative strains of HPIV-3 in GenBank, and the phylogenetic tree was established. As results, this study collected 1 674 samples, in which there were 90 HPIV-3 positive samples showed and the detection rate was 5.37%. Among positive specimens, the number of samples from children under 6 years old was 88, accounting for 97.78%. HPIV-3 positive cases were mainly distributed in spring and summer. The full-length sequences of 44 HPIV-3 HN genes were obtained by nested PCR method. Sequence alignment and evolutionary analysis showed that the HPIV-3HN gene belonged to the C3a and C3b branches of C3 genotype, with 30 strains of subtype C3a and 14 strains of subtype C3b. The nucleotide and amino acid homology of the amplified 44 strains of the HPIV-3 HN gene in Qingdao were 97.0%-100.0% and 98.5%-100.0%, respectively. In conclusion, from 2018 to 2019, the C3a and C3b branches of HPIV-3 C3 genotype were circulating prevalent in Qingdao, Shandong province. HN gene variation rate was low, but showed certain regional characteristics in evolution.

Brain functional changes in individuals with bulimia nervosa: a protocol for systematic review and meta-analysis

INTRODUCTION

Bulimia nervosa (BN) is a disorder with high health and socioeconomic burdens that typically arises in late adolescence and early adulthood. Previous neuroimaging studies have found functional brain changes in patients with BN. This study aims to review the latest neurobiological evidence from studies of individuals with BN, examine the consistency of these findings and evaluate the food addiction hypothesis of the disease.

METHODS AND ANALYSIS

A systematic search will be performed using the Cochrane Library, PubMed, Embase and Web of Science databases, covering the period from database inception to 30 November 2021. Two researchers will be responsible for study selection, quality assessment and data extraction. The anisotropic effect size version of the signed differential mapping method will be used to conduct a coordinate-based meta-analysis. Publication bias will be examined with the Egger test. The quality of studies will be evaluated using the Newcastle-Ottawa Scale.

ETHICS AND DISSEMINATION

No ethics approval is required for this is a systematic review protocol and does not require the collection of primary data. Findings will be disseminated through peer-reviewed journal or related conferences.

PROSPERO REGISTRATION NUMBER

CRD42022307233.

[Risk factors of postoperative surgical site infection in colon cancer based on a single center database]

Objective: To explore the incidence and risk factors of postoperative surgical site infection (SSI) after colon cancer surgery. Methods: A retrospective case-control study was performed. Patients diagnosed with colon cancer who underwent radical surgery between January 2016 and May 2021 were included, and demographic characteristics, comorbidities, laboratory tests, surgical data and postoperative complications were extracted from the specialized prospective database at Department of General Surgery, Peking Union Medical College Hospital. Case exclusion criteria: (1) simultaneously multiple primary colon cancer; (2) segmental resection, subtotal colectomy, or total colectomy; (3) patients undergoing colostomy/ileostomy during the operation or in the state of colostomy/ileostomy before the operation; (4) patients receiving natural orifice specimen extraction surgery or transvaginal colon surgery; (5) patients with the history of colectomy; (6) emergency operation due to intestinal obstruction, perforation and acute bleeding; (7) intestinal diversion operation; (8) benign lesions confirmed by postoperative pathology; (9) patients not following the colorectal clinical pathway of our department for intestinal preparation and antibiotic application. Univariate analysis and multivariate analysis were used to determine the risk factors of SSI after colon cancer surgery. Results: A total of 1291 patients were enrolled in the study. 94.3% (1217/1291) of cases received laparoscopic surgery. The incidence of overall SSI was 5.3% (69/1291). According to tumor location, the incidence of SSI in the right colon, transverse colon, left colon and sigmoid colon was 8.6% (40/465), 5.2% (11/213), 7.1% (7/98) and 2.1% (11/515) respectively. According to resection range, the incidence of SSI after right hemicolectomy, transverse colectomy, left hemicolectomy and sigmoid colectomy was 8.2% (48/588), 4.5% (2/44), 4.8% (8 /167) and 2.2% (11/492) respectively. Univariate analysis showed that preoperative BUN≥7.14 mmol/L, tumor site, resection range, intestinal anastomotic approach, postoperative diarrhea, anastomotic leakage, postoperative pneumonia, and anastomotic technique were related to SSI (all P<0.05). Multivariate analysis revealed that anastomotic leakage (OR=22.074, 95%CI: 6.172-78.953, P<0.001), pneumonia (OR=4.100, 95%CI: 1.546-10.869, P=0.005), intracorporeal anastomosis (OR=5.288, 95%CI: 2.919-9.577,P<0.001) were independent risk factors of SSI. Subgroup analysis showed that in right hemicolectomy, the incidence of SSI in intracorporeal anastomosis was 19.8% (32/162), which was significantly higher than that in extracorporeal anastomosis (3.8%, 16/426, χ(2)=40.064, P<0.001). In transverse colectomy [5.0% (2/40) vs. 0, χ(2)=0.210, P=1.000], left hemicolectomy [5.4% (8/148) vs. 0, χ(2)=1.079, P=0.599] and sigmoid colectomy [2.1% (10/482) vs. 10.0% (1/10), χ(2)=2.815, P=0.204], no significant differences of SSI incidence were found between intracorporeal anastomosis and extracorporeal anastomosis (all P>0.05). Conclusions: The incidence of SSI increases with the resection range from sigmoid colectomy to right hemicolectomy. Intracorporeal anastomosis and postoperative anastomotic leakage are independent risk factors of SSI. Attentions should be paid to the possibility of postoperative pneumonia and actively effective treatment measures should be carried out.

Efficacy and safety of HDL/apoA-1 mimetics on human and mice with atherosclerosis: a systematic review and meta-analysis

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): the National Natural Science Foundation of China

Background

Low high-density lipoprotein cholesterol (HDL-C) level as a residual risk factor of cardiovascular disease (CVD) is still causing concern, although using chemical drugs for raising HDL-C level failed. The effect of high-density lipoprotein/ apolipiproteinA-1(HDL/apoA-1) mimetics on atherosclerosis is controversial.

Aim

In this meta-analysis we analyzed the effect of high-density lipoprotein/ apolipiproteinA-1(HDL/apoA-1) mimetics on atherosclerotic lesion both in human and mice.

Methods

We systematically searched PubMed, Cochrane, Web of Science and EMBASE databases up to June 6, 2020 for eligible studies using wide search terms and included all the publications meet the including criteria. The methodological quality of the human studies was assessed using Review Manager (RevMan) software (version 5.3.). The methodological quality of the mice studies was assessed by using stair list. WMD(SMD) with 95% CI was used as a measure of the association between HDL/apoA-1 mimetics and plaque regression in human (in mice), after pooling data across trials in a random effect model. Sensitivity and subgroup analyses were used to explore sources of heterogeneity and the effect of potential confounders. STATA (version 14.0) was used to conduct all statistical analyses.

Results

We identified 15 randomized controlled trials in which 6 trails including 754 ACS (HDL/apoA-1 mimetics = 414, placebo = 340) patients used for efficacy analysis and all of 15 trails used for safety analysis and 17 controlled trials for animal study. The pooled results showed that the use of HDL/apoA-1 mimetics did not significant decreased the percent atheroma volume(p = 0.494) and total atheroma volume(p = 0.560) in patients with acute coronary syndrome (ACS). However, HDL/apoA-1 mimetics (or gene transfection) was significant associated with all of final percent lesion area, final lesion area and changes in lesion area (SMD, -1.75; 95% CI: -2.21∼-1.29, p = 0.000; SMD, -0.78; 95% CI: -1.18∼-0.38, p = 0.000; SMD: -2.06; 95% CI, -3.92∼-0.2, p = 0.03) in mice.

Conclusions

In human, HDL/apoA-1 mimetics cannot significantly improve atheroma volume in artery, although it is safe. However, in animal, the results suggest HDL/apoA-1 mimetics (or gene transfection) can decrease lesion area. So additional studies are needed to further investigate and explain the different efficacy of HDL/apoA-1 mimetic peptides between human and animal. Abstract Figure. Forest plots of human studies

Optical coherence tomography-defined vulnerable plaque characteristics in relation to functional severity of coronary stenoses stratified by quantitative flow ratio

Background

The functional severity and morphological features of epicardial lesions are both related to plaque vulnerability and adverse coronary events. However, their relationship remains controversial, especially in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS).

Purpose

This study aimed to examine whether quantitative flow ratio (QFR), an angiography-based computation of fractional flow reserve, was associated with optical coherence tomography (OCT)-defined vulnerable plaques such as thin-cap fibroatheromas (TCFAs) in a board spectrum of population, including patients presenting stable angina and NSTE-ACS.

Methods

We identified patients who underwent OCT examinations from 2 prospective cohorts and then assessed interrogated vessels with QFR. Lesions were divided into tertiles: QFR-T1 (QFR &lt;0.85)&lt;qfr),&gt;, QFR-T2 (0.85 to 0.93) and QFR-T3 (QFR &gt;0.93).

Results

This post-hoc analysis included 83 lesions from 79 patients (mean age: 61.5±9.8 years, males: 58%). Patients with NSTE-ACS accounted for the majority of the population (67%). The median % diameter stenosis and median QFR value were 42% (36 to 49%) and 0.88 (0.83 to 0.95), respectively. The prevalence of OCT-TCFA was significantly higher in QFR-T1 (50%) than in QFR-T2 (14%) and QFR-T3 (19%) (p=0.003 and 0.018, respectively). Overall significant differences were observed among tertiles in maximum lipid arc, thinnest fibrous cap thickness (FCT), and minimal lumen area (MLA) (p=0.017, 0.040, and &lt;0.001, respectively). The Spearman's correlation analysis showed that QFR was significantly related to MLA (ρ = 0.537, p&lt;0.001), % area stenosis (ρ = –0.512, p&lt;0.001), maximum lipid arc (ρ = –0.360, p=0.002), lipid length (ρ = –0.242, p=0.038), lipid index (ρ = –0.333, p=0.004), and thinnest FCT (ρ = 0.315, p=0.006). In the multivariable analysis, QFR ≤0.80 remained as a significant determinant of TCFAs regardless of the presence of NSTE-ACS and the level of low-density lipoprotein cholesterol (adjusted odds ratio = 4.387, 95% confidence interval: 1.297 to 14.839, p=0.017). In addition, QFR demonstrated moderate predictive ability for OCT-TCFA (area under the curve = 0.72, 95% confidence interval: 0.58 to 0.86, p=0.003) with the best cutoff of ≤0.86 (sensitivity: 65%; specificity: 73%; negative predictive value: 85%; accuracy: 71%).

Conclusions

Lower QFR was related to OCT-TCFA and other vulnerable plaque characteristics in angiographically mild-to-intermediate stable lesions and culprit lesions from NSTE-ACS. The QFR might be a useful tool for ruling out high-risk, rupture-prone plaques without using any pressure wires or vasodilators.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): The Jiangsu Provincial Key Research and Development Program Flow diagram of patient selectionOCT findings according to QFR tertiles

Standardized Astragalus Mongholicus Bunge-Curcuma Aromatica Salisb. Extract Efficiently Suppresses Colon Cancer Progression Through Gut Microbiota Modification in CT26-Bearing Mice

Altered gut microbiota and a damaged colon mucosal barrier have been implicated in the development of colon cancer. Astragalus mongholicus Bunge-Curcuma aromatica Salisb. (ACE) is a common herbal drug pair that widely used clinically to treat cancer. However, whether the anti-cancer effect of ACE is related to gut microbiota remains unclear yet. We standardized ACE and investigated the effects of ACE on tumour suppression and analyze the related mechanisms on gut microbiota in CT26 colon cancer-bearing mice in the present study. Firstly, four flavonoids (calycosin-7-glucoside, ononin, calycosin, formononetin) and three astragalosides (astragaloside A, astragaloside II, astragaloside I) riched in Astragalus mongholicus Bunge, three curcumins (bisdemethoxycurcumin, demethoxycurcumin, curcumin) and four essential oils (curdione, curzerene, germacrone and β-elemene) from Curcuma aromatica Salisb., in concentrations from 0.08 to 2.07 mg/g, were examined in ACE. Then the results in vivo studies indicated that ACE inhibited solid tumours, liver and spleen metastases of colon cancer while simultaneously reducing pathological tissue damage. Additionally, ACE regulated gut microbiota dysbiosis and the short chain fatty acid content in the gut, repaired intestinal barrier damage. ACE treatment suppressed the overgrowth of conditional pathogenic gut bacteria, including Escherichia-Shigella, Streptococcus and Enterococcus, while the probiotic gut microbiota like Lactobacillus, Roseburia, Prevotellaceae_UCG-001 and Mucispirillum were increased. More interestingly, the content level of SCFAs such as propionic acid and butyric acid was increased after ACE administration, which further mediates intestinal SDF-1/CXCR4 signalling pathway to repair the integrity of the intestinal barrier, decrease Cyclin D1 and C-myc expressions, eventually suppress the tumor the growth and metastasis of colon cancer. To sum up, the present study demonstrated that ACE could efficiently suppress colon cancer progression through gut microbiota modification, which may provide a new explanation of the mechanism of ACE against colon cancer.

Manganese promoted wheat straw decomposition by regulating microbial communities and enzyme activities

AIMS

This study investigated the dose-effect of manganese (Mn) addition on wheat straw (WS) decomposition, and explored the potential mechanisms of Mn involved in the acceleration of WS decomposition in regards to the soil microbial communities and enzyme activities.

METHODS AND RESULTS

A 180-day incubation experiment was performed to examine the decomposition of WS under four Mn levels, that is, 0, 0.25, 1 and 2 mg g^-1 . The effects of microbial communities and enzyme activities were evaluated using control (0 mg g^-1 ) and Mn (0.25 mg g^-1 ) treatments. Our results revealed that Mn (0.25 mg g^-1 ) addition significantly increased WS decomposition, and enhanced the release of carbon and nitrogen. Optimal Mn addition (0.25 mg g^-1 ) also caused significant increases in the activity of neutral xylanase (NEX), laccase (Lac), manganese peroxidase (MnP) and lignin peroxidase (LiP) within the incubation period. Mn (0.25 mg g^-1 ) addition also enriched some operational taxonomic units (OTUs) that, in turn, had the potential ability to decompose crop straw, such as secreting lignocellulolytic enzymes.

CONCLUSIONS

Mn (0.25 mg g^-1 ) could promote WS decomposition through enrichment of the microbial species involved in biomass decomposition, which enhanced the lignocellulose-degrading enzyme activity.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study provides evidence for Mn to promote WS biodegradation after Mn application, opening new windows to improve the utilization efficiency of crop residues.

[Artificial intelligence, radiomics and pathomics to predict response and survival of patients treated with radiations]

Artificial intelligence approaches in medicine are more and more used and are extremely promising due to the growing number of data produced and the variety of data they allow to exploit. Thus, the computational analysis of medical images in particular, radiological (radiomics), or anatomopathological (pathomics), has shown many very interesting results for the prediction of the prognosis and the response of cancer patients. Radiotherapy is a discipline that particularly benefits from these new approaches based on computer science and imaging. This review will present the main principles of an artificial intelligence approach and in particular machine learning, the principles of a radiomic and pathomic approach and the potential of their use for the prediction of the prognosis of patients treated with radiotherapy.

Metastatic small bowel adenocarcinoma: role of metastasectomy and systemic chemotherapy

Background

Metastatic small bowel adenocarcinoma (SBA) has a poor prognosis. Due to its rarity, high-quality data are lacking to guide treatment. This retrospective analysis was conducted to help characterize the treatment options for patients with metastatic SBA while providing clinically meaningful prognostic information.

Patients and methods

In total, 437 patients who initially presented with or developed metastatic SBA between September 1977 and September 2019 were identified from the MD Anderson Tumor Registry. Clinical data were collected from review of the medical record. Overall response rates (ORR), time to progression (TTP), and overall survival (OS) were assessed across various treatments and treatment lines.

Results

The median OS from diagnosis of metastatic disease was 15.9 months [95% confidence interval (CI): 14.3-17.9]. Seventy-five patients (17.1%) underwent metastasectomy, which was associated with a median OS of 34.5 versus 17.1 months among patients who received chemotherapy alone (P < 0.001). Fluoropyrimidine plus platinum (n = 164) was the most common first-line chemotherapy, associated with an ORR of 59% and TTP of 8.1 months. Irinotecan with 5-FU (n = 101) was the most common second-line therapy associated with an ORR of 31% and TTP of 4.0 months. Twenty-two patients received immunotherapy; 5 of 6 patients with deficient mismatch repair (dMMR) responded, while 0 of 16 with proficient mismatch repair (pMMR) responded. Taxane-based chemotherapy was given to 34 patients with an ORR of 21% and a median TTP of 2.4 months. Among 11 patients who received anti-epidermal-growth-factor-receptor (EGFR) monotherapy, the best response was stable disease (SD) in 1 patient.

Conclusions

In well-selected patients with SBA, metastasectomy appears to be associated with improved OS. This improvement was seen across metastasectomy sites, including liver, lung and peritoneal. Anti-programmed cell death protein 1 (PD-1) based immunotherapy was active for dMMR SBA but not pMMR SBA. While taxane-based chemotherapy demonstrates therapeutic activity, the activity of anti-EGFR therapy was limited.

•

Metastasectomy for well-selected metastatic SBA patients was associated with improved OS.

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Anti-PD1-based immunotherapy was active for dMMR SBA but not pMMR SBA.

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Taxane-based chemotherapy demonstrated clinical activity in refractory SBA.

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Anti-EGFR therapy demonstrated minimal activity in SBA.

Contributions of epiphytic microbiota on the fermentation characteristics and microbial composition of ensiled six whole crop corn varieties

AIMS

The present study is aimed to reveal the variations in epiphytic microbial composition among six whole crop corn (WCC) varieties and their contributions on ensiling characteristics and microbial composition of WCC silage.

METHODS AND RESULTS

Six WCC varieties (JS06, YS23, BS20, JS39, JS40 and JS26) were ensiled for 90 days. All WCC varieties were well fermented with low pH value (<4·0) and high LA (73·6-124 g kg^-1 DM, dry matter) concentration. Of six varieties, JS40 had the highest LA (124 g kg^-1 DM) concentration, which was supported by highest relative abundance of Lactobacillus. Pantoea was the most dominant epiphytic bacteria in all fresh WCC varieties; however, the secondary dominant genera among six WCC were absolutely difference. Lactobacillus became predominant genus in 90-day silages except YS23. YS23 kept the more bacterial genus from fresh to 90-day silages than other silages, meanwhile Acinetobacter and Enterobacter were the dominant bacteria in YS23 silages.

CONCLUSIONS

Among six WCC varieties, JS40 silage had the highest LA. The variations in epiphytic microbiomes among fresh WCC affected terminal microbial community of 90-day silages. There were differences in fermentation characteristics among six WCC varieties, which might be partly attributed to variations in epiphytic microbiomes among fresh WCC.

SIGNIFICANCE AND IMPACT OF THE STUDY

The study not only enriches the research on microbial communities of plant phyllosphere but also provides theoretical basis for selecting WCC varieties and inoculants for the forage production.

Split-course hypofractionated radiotherapy for aged and frail patients with head and neck cancers. A retrospective study of 75 cases

PURPOSE

To assess the efficacy and the tolerance of a split course hypofractionated (SCH) radiotherapy (RT) protocol in head and neck cancer (HNC) for eldery and/or unfit patients (pts).

PATIENTS AND METHODS

Pts with HNC treated by SCH-RT in two institutions were included retrospectively. The main SCH RT regimen was two courses of 30 grays (Gy)/10 fractions separated by 2-4 weeks, without any systemic therapy.

RESULTS

Between February 2012 and January 2019, 75 consecutive patients were analyzed. The median age was 80 years (range: 45.7-98.2) and 53 (70.7%) were men. Sixty-one (81.3%) pts had stage III/IV disease and 54 (72%) had at least two comorbidities. All of them were treated with intensity-modulated radiotherapy. Median follow-up was 10.6 months (range: 3.1-58.3). Local control at 12 and 24 months was 72.8% IC95%[62-85.5] and 51.7% IC95%[38.1-70.1] respectively. Progression free survival (PFS) at 12 and 24 months were 47.7% IC95%[37.4-60.8] and 41% IC95%[15-36.4] respectively, with a median of 11.5 months IC95%[8.9-17]. OS at 12 and 24 months were 60.4% IC95%[50-73.1] and 41% IC95%[30.6-54.9] respectively, with a median of 19.3 months IC95%[11.9-25.8]. Acute and late grade 3 or higher toxicities occurred for 6 (8%) and 3 (4%) pts.

CONCLUSION

The present SCH-RT regimen seems effective, well-tolerated and could represent an alternative to palliative strategies for pts deemed unfit for standard exclusive RT.

[Investigation and analysis of reproductive health status of female street cleaners in a district]

Objective: To explore the reproductive health status of the female street cleaners in Chaoyang district of Beijing and its influencing factors. Methods: In July 2018, a total of 647 questionnaires were sent out to female road cleaning and sanitation workers in the whole district, 613 of which were valid, with an effective rate of 94.7%. Frequency or percentage (%) is used for statistical description of counting data, and mean standard deviation is used for measurement data. The influencing factors were analyzed by 2 test. Results: The average age of 613 female road sweepers in Chaoyang District of Beijing was 42.01 (SD=6.69) years old, including 535 married female workers (87.28%) , 356 middle school and below educated (58.08%) , 292 non Beijing registered (47.63%) , accounting for (/613) , (/613) female workers working hours >8 hours per day 110 (17.94%) , weekly rest <2 days 341 (55.63%) . 144 (23.49%) women workers did not have regular gynecological examination, 119 (19.41%) had reproductive tract infections, 177 (28.87%) had abnormal menstruation in recent 6 months. Drinking, sexual behavior outside marriage, night shift and job satisfaction were all the influencing factors (P<0.05) . The increasing age, working years, drinking, household registration in other places and the decreasing satisfaction of women workers＇ rights and interests protection were all the influencing factors (P<0.05) . Conclusion: The reproductive health status of female road sweepers in Chaoyang District of Beijing is not optimistic.

Metabonomics study on orthotopic transplantion mice model of colon cancer treated with Astragalus membranaceus-Curcuma wenyujin in different proportions via UPLC-Q-TOF/MS

Metabolomics, an important part of systems biology, can reveal the complex pathogenesis of many diseases and mechanism of Chinese materia medica (CMM). Astragalus membranaceus-Curcuma wenyujin (AC) was a classic drug pair that has a good clinical effect on gastrointestinal inflammation and many tumors. Our previous research proved that AC can inhibit tumor growth and metastasis especially the colorectal cancer (CRC), also promote the normalization of tumor blood vessels, but its optimal ratio and the specific mechanism is still not clear. In this study, colon cancer mice of orthotopic transplantion model was used to screen the best proportion, UPLC-Q-TOF/MS metabolomics analysis method was established to explore the pathogenesis of colon cancer and the molecular mechanism of AC. The correlation analysis of metabolite changes and tumor growth was analyzed by R language. The result showed that AC at the ratio of 2:1 showed the best effect on inhibiting tumor growth, also the liver and spleen metastasis rate. A total of 23 potential biomarkers were detected in the serum of colon cancer mice by the analysis of Progenesis QI (Version 2.4) software. Among this, 11 metabolites including purines, steroids, phytosphingosine and l-palmitoylcarnitine were up-regulated in CC mice, while 12 metabolites like amino acids, deoxyribose and dihydrobiopterin were down-regulated in CC mice. After the treatment of AC for 15 days, 8 biomarkers were up-regulated, and 9 biomarkers down-regulated. Especially, AC at the ratio of 2:1 showed a significant callback effect on metabolic biomarkers, such as hypoxanthine, xanthosine, 7-methylxanthine, all-trans-retinoic acid, dihomo-γ-linolenic acid. 8 metabolic pathways: Aminoacyl-tRNA biosynthesis, Nicotinate and nicotinamide metabolism, Phenylalanine, tyrosine and tryptophan biosynthesis, Valine, leucine and isoleucine biosynthesis, Phenylalanine metabolism, Caffeine metabolism, Retinol metabolism, Alanine, aspartate and glutamate metabolism were selected as the model group disturbed metabolic pathways after the enrichment of MetaboAnalyst 4.0 online analysis software. And compared with the model group, Valine, leucine and isoleucine biosynthesis, Aminoacyl-tRNA biosynthesis, Caffeine metabolism pathway and Retinol metabolism pathways were altered after the intervention of AC. The correlation analysis results showed that various endogenous metabolites in serum have a strong correlation with tumor weight, such as hypoxanthine, which provides a basis for the selection of clinical markers. The results showed that AC can partially regulate metabolic disorder of CC mice by reversing the changes of metabolites, so as to inhibit the growth and metastasis of colon cancer, especially at the ratio of 2:1. These findings can provide a scientific basis for exploring the diagnostic biomarkers of colon cancer, and for clinical application of AC in the treatment of CRC program.

Area postrema syndrome as initial manifestation in neuromyelitis optica spectrum disorder patients: A retrospective study

BACKGROUND

Area postrema syndrome (APS) is recognized as a core feature in neuromyelitis optica (NMO) diagnosis. Isolated APS can occur at NMO onset and frequently results in a delay of diagnosis, along with devastating secondary neurologic deficits. To date, few studies have characterized APS-onset neuromyelitis optica spectrum disorder (APSO-NMOSD).

OBJECTIVE

We aimed to describe the clinical and radiologic features of patients with APSO-NMOSD who are initially misdiagnosed in a cohort of patients from Zhengzhou, China.

MATERIALS AND METHODS

We identified 15 patients who presented with APS as an initial manifestation, based on the 2015 international consensus diagnostic criteria for NMOSD, and reviewed their demographic, clinical, laboratory, and magnetic resonance imaging (MRI) data.

RESULT

Fifteen patients (3 men, 12 women) aged 14-50 years old were included in our study. All patients presented with APS that included intractable nausea, vomiting, or hiccups (INVH) as the initial manifestation; many experienced a delay in diagnosis. Serum AQP4 was positive in eleven patients and myelin oligodendrocyte glycoprotein (MOG) in one patient. All patients had a linear medullary lesion or a linear medulla-spinal lesion on sagittal MRI. An "inverted V sign" on axial medulla oblongata images, representing a lesion involving the area postrema, was noted in seven patients in this study.

CONCLUSIONS

APS can occur as a sole and initial manifestation of NMOSD, often leading to misdiagnosis in the early process of disease. Identifying patients with an "inverted V" sign and a linear medullary lesion upon MRI examination can help to quickly identify APS patients and avoid further diagnostic delays.

Evaluation of DNA methylation in matched oral swab and tissue specimens from Chinese patients with oral squamous cell carcinoma

The DNA methylation statuses of the paired box 1 (PAX1) and zinc finger protein 582 (ZNF582) genes have shown promise in the detection of oral squamous cell carcinoma (OSCC). The aim of this study was to investigate the ability of PAX1 and ZNF582 methylation to distinguish OSCC and the adjacent normal tissue among cancer patients. This study included 67 patients with OSCC. The methylation levels of these two genes were analysed in tissue specimens (lesion site and adjacent normal site) and in oral swabs (lesion site and contralateral normal site). Levels of DNA methylation were higher at lesion sites than at the corresponding normal sites. According to receiver operating characteristics curve analysis, the area under the curve for PAX1 and ZNF582 methylation ranged from 0.73 to 0.82. No significant difference was observed between tissue specimens and oral swabs (PAX1, P= 0.41; ZNF582, P=0.28). For the oral swab, PAX1 methylation was more pronounced in bone invasion (Z=1.988, P= 0.047), and ZNF582 methylation was more pronounced in early-stage (Z=2.354, P= 0.02) and well-differentiated tumours (Z=3.731, P= 0.0002). Hypermethylated PAX1 and ZNF582 are effective biomarkers to distinguish lesion sites and corresponding normal sites in tissue specimens and oral swabs from OSCC patients.