mtDNA regulates cGAS-STING signaling pathway in adenomyosis

In various hyperproliferative disorders, damaged mitochondria can release mitochondrial DNA (mtDNA) into the cytoplasm, activating the cGAS-STING signaling pathway and subsequent immune imbalances. Our previous research has demonstrated that hypoxia plays a role in the development of adenomyosis (AM) by inducing mitochondrial dysfunction. However, the precise involvement of the cGAS-STING signaling pathway and mtDNA in AM remains unclear. Therefore, this study aims to investigate the relationship between mtDNA secretion, changes in the cGAS-STING signaling pathway, and the abnormal cellular proliferation observed in AM. We found the cGAS, STING, TBK1, p-TBK1, IRF3, and p-IRF3 proteins levels were significantly elevated in the tissues of patients with AM compared to the control group. Additionally, there was an increase in the expression of the pro-inflammatory cytokines IL-6 and IFN-α in the AM tissues. Hypoxia-induced an increase in the proliferation and migration abilities of endometrial stromal cells (ESCs), accompanied by the activation of the cGAS-STING signaling pathway and elevated levels of IFN-α. Furthermore, hypoxia promoted the leakage of mtDNA into the cytoplasm in AM ESCs, and the deletion of mtDNA reduced the activation of the cGAS-STING pathway. Moreover, knockdown of the STING gene inhibited the expression of TBK1, p-TBK1, IRF3, and p-IRF3 and suppressed the secretion of the inflammatory cytokines IL-6 and IFN-α. Furthermore, the migration and invasion abilities of AM ESCs were significantly diminished after STING knockdown. These findings provide valuable insights into the role of mtDNA release and the cGAS-STING signaling pathway in the pathogenesis of AM.

Benefit and harm of low-dose aspirin in pregnancy: a balancing act

Linked article: This Correspondence comments on Souter et al. Click here to view the article.

Full sample analysis of cerebral venous sinus thrombosis in ophthalmology inpatients

PURPOSE

We hope that by analyzing the clinical features of cerebral venous sinus thrombosis (CVST), we can help ophthalmologists reduce misdiagnosis or delayed diagnosis.

DESIGN

We evaluated 47 patients with CVST in terms of clinical manifestations.

METHODS

All cases were analyzed in terms of risk factors, clinical symptoms, ophthalmic examination, imaging examination and lumbar puncture.

RESULTS

The body mass indices (BMIs) of 41 patients (87.2%; 95% CI, 77.7-96.8%) were≥24, which is overweight by Chinese standards. There were 22 patients (46.8%; 95% CI, 32.5-61.1%) with BMIs≥28, who were considered obese. Thirteen were hypertensive (27.7%; 95% CI, 14.9-40.5%). The initial symptoms included blurred vision (23, 48.9%; 95% CI, 34.6-63.2%), amaurosis fugax (13, 27.7%; 95% CI, 14.9-40.5%), headache (11 patients, 23.4%; 95% CI, 11.3-35.5%), dizziness (3, 6.4%; 95% CI, -0.6-13.4%), and bilateral diplopia (3, 6.4%; 95% CI, -0.6-13.4%). There were 9 patients (9, 19.2%; 95% CI, 7.9-30.4%) with blindness, 23 patients (48.9%; 95% CI, 34.6-63.2%) with pupillary abnormalities, and 40 patients (85.1%; 95% CI, 74.9-95.2%) with papilledema. Forty-three of the 45 patients who successfully underwent a routine lumbar puncture showed high intracranial pressure (91.7%; 95.6% CI, 89.6-101.6%). Finally, two cases are reported in greater detail for illustrative purposes.

CONCLUSION

The main reasons interfering with the diagnosis of CVST might be its nonspecific ocular symptoms and the physicians' clinical thought process being limited to the scope of common ophthalmological diseases.

Innovative association network of new energy vehicle charging stations in China: Structural evolution and policy implications

New energy vehicles (NEVs) can effectively reduce emissions and alleviate global climate problems, and are crucial to global sustainable development. China is the world's largest seller of NEVs, but charging stations have always been a major constraint to the development of NEVs. To clearly characterize the structural characteristics of an innovation association network of NEV charging stations, this study analyzes the structural characteristics of China's innovation association network of NEV charging stations with the patent data since 2007 in the Incopat Global Patent Database from the three perspectives of province, city and patent applicant using method of social network analysis (SNA). The findings show the following: (1) The innovation association network of NEV charging stations has been expanded constantly, with the association strength evidently increasing. (2) The innovation association network of NEV charging stations exhibits a typical core-periphery structure, with the quantity of nodes with high association strength varying little, and the quantity of nodes with low- and medium-association strengths exhibiting an evident increasing trend. (3) The effect of regional central cities is enhanced, with an evident group structure. There has been no information barrier caused by excessive small group formation in the province association network, whereas there are small group development trends in city and patent applicant cooperation networks. In addition, policy recommendations for further expanding technological innovation in charging stations to promote the development of the NEV industry are discussed based on the study results.

A study of the spatial network structure of ethnic regions in Northwest China based on multiple factor flows in the context of COVID-19: Evidence from Ningxia

As an underdeveloped and low-income region, the development of minority regions in Northwest China is crucial. As an important part of minority regions, Ningxia Hui Autonomous Region has insufficient endogenous power for stable economic development and high risk of returning to poverty. On the whole, the Ningxia county network shows a spatial pattern of high in the north and low in the south. However, there are great differences in the centrality of different factor flow networks. The factor connections between most counties are weak, and a close innovation network has not yet been formed. There is an obvious administrative clique structure, showing a certain degree of self-enclosure. The factor flows between counties are relatively uniform and greatly affected by geographic distance. From the perspective of integrated flow, the Ningxia county network presents a distinct core-periphery circle structure. Population size and GDP are the main factors affecting the spatial network. The policy implication of this study is that Ningxia Autonomous Prefecture should coordinate the planning of the region's economy, technology, and transportation, so as to reduce the development gap between counties by enhancing the closeness of the county spatial association network, and ultimately realize the region's high-quality development.

Assessing the role of robotic surgery versus laparoscopic surgery in patients with a diagnosis of endometriosis: A meta-analysis

BACKGROUND

Surgical management of endometriosis can be carried out with the traditional standard laparoscopic technique or the robotic surgery technique; however, it is not clear if there is a significant difference between techniques. This meta-analysis aims to evaluate and compare the impact of robotic and standard laparoscopic techniques in endometriosis regarding the clinical outcome.

METHODS

Studies comparing robotic surgery to laparoscopic surgery for endometriosis were among the studies from various languages that met the inclusion criteria. Using dichotomous and continuous random-effect models, the results of these investigations (surgery time, hospitalization time, blood loss, complications, and conversion rate) were examined, and the mean difference with 95% confidence intervals was computed.

RESULTS

Eight studies from 2013 to 2022 were selected for the current analysis including 1741 patients with endometriosis. The studied data revealed a statistically significant (P = .01) lower operation time related to laparoscopic surgery compared with the robotic technique. In addition, the hospitalization time of laparoscopic surgery is significantly (P = .03) lower than that of robotic surgery. On the other hand, blood loss, rehospitalization, postoperative and intraoperative complications, and conversion rates were not significantly different between both techniques. Heterogeneity values were variable according to the analysis factor, from 0% to 91%.

CONCLUSION

Both robotic and standard laparoscopic techniques have similar outcomes regarding blood loss, rehospitalization, conversion rate, and rate of complication. However, the substantial difference between techniques was in favor of standard laparoscopic surgery regarding operation and hospitalization time.

Comparative Efficacy and Safety of Chinese Patent Medicines for Cervical High-risk Human Papillomavirus Infection: A Bayesian Network Meta-analysis

Background: Many Chinese patent medicines have been reported to show anti-tumor cell effects on cervical cancer. To estimate the comparative effectiveness and safety of Chinese patent medicines for cervical high-risk human papillomavirus (HR-HPV) infection. Methods: Randomized controlled trials (RCTs) of Chinese patent medicines for HR-HPV infection were searched in eight databases until 31 August 2022, and two review authors independently extracted data and assessed the risk of bias. Outcomes concerning efficacy were evaluated as odds ratio (OR) and 95% credible intervals (CrI) utilizing R 4.1.2 and Stata 16.1. The protocol was registered on the International Prospective Register of Systematic Reviews (CRD42022351120). Results: We ultimately identified 60 RCTs that involved 5,951 participants and 8 interventions. Chinese patent medicines combined with recombinant human interferon (rhIFN) have better treatment effects than rhIFN alone. The results showed that Baofukang suppository (BFK) combined with rhIFN is greater for the rate of HR-HPV clearance follow-up at 6 months (SUCRA = 78.16%). Kushen gel (KS) combined with rhIFN ranked first for the rate of HR-HPV clearance after treatment (SUCRA = 90.77%). Furthermore, KS + rhIFN is most likely to be the best intervention for improving the clinical effectiveness rate (SUCRA = 87.39%). Adverse reactions were not statistically significant in BFK + rhIFN versus BFK, BFK + rhIFN versus rhIFN, and BFK versus rhIFN. Conclusion: The combination of Chinese patent medicines with rhIFN may demonstrate a higher efficacy than rhIFN alone in clearing the virus and improving cervical symptoms. Weighing with the clinical comprehensive efficacy, BFK + rhIFN and KS + rhIFN maybe the optimal treatments for cervical HR-HPV infection. However, more high-quality randomized controlled trials are needed in the future to further confirm the efficacy and safety of proprietary Chinese medicines for cervical HR-HPV infection.

Spatial network and driving factors of low-carbon patent applications in China from a public health perspective

Introduction

The natural disasters and climate anomalies caused by increasing global carbon emissions have seriously threatened public health. To solve increasingly serious environmental pollution problems, the Chinese government has committed itself to achieving the goals of peak carbon emissions and carbon neutrality. The low-carbon patent application is an important means to achieve these goals and promote public health.

Methods

This study analyzes the basic situation, spatial network, and influencing factors of low-carbon patent applications in China since 2001 at the provincial and urban agglomeration levels using social network analysis based on data from the Incopat global patent database.

Results

The following findings are established. (1) From the number of low-carbon patent applications, the total number of low-carbon patent applications in China increased year by year, while the number of applications in the eastern region was larger than those in the central and western regions, but such regional differences had been decreasing. (2) At the interprovincial level, low-carbon patent applications showed a complex and multithreaded network structure. In particular, the eastern coastal provinces occupied the core position in the network. The weighted degree distribution of China's interprovincial low-carbon patent cooperation network is affected by various factors, including economic development, financial support, local scientific research level, and low-carbon awareness. (3) At the urban agglomeration level, the eastern coastal urban agglomerations showed a radial structure with the central city as the core. Urban innovation capability, economic development, low-carbon development awareness, level of technology import from overseas, and informatization level are highly correlated with the weighted degree of low-carbon cooperation networks of urban agglomerations.

Discussion

This study provides ideas for the construction and governance of low-carbon technology innovation system and perspectives for theoretical research on public health and high-quality development in China.

Research on the evolution of the Chinese urban biomedicine innovation network pattern: An analysis using multispatial scales

This paper addresses the spatial pattern of urban biomedicine innovation networks by separately using four scales, i.e., the national scale, interregional scale, urban agglomeration scale, and provincial scale, on the basis of Chinese biomedicine patent data from the incoPat global patent database (GPD) (2001-2020) and using the method of social network analysis (SNA). Through the research, it is found that (1) on the national scale, the Chinese biomedicine innovation network becomes denser from west to the east as its complexity continuously increases. Its spatial structure takes the form of a radial network pattern with Beijing and Shanghai as its centers. The COVID-19 pandemic has not had an obvious negative impact on this network at present. (2) On the interregional scale, the strength of interregional network ties is greater than that of intraregional network ties. The eastern, central and western biomedicine innovation networks appear to be heterogeneous networks with regional central cities as the cores. (3) At the urban agglomeration scale, the strength of intraurban-agglomeration network ties is greater than that of interurban-agglomeration network ties. The three major urban agglomerations have formed radial spatial patterns with central cities as the hubs. (4) At the provincial scale, the intraprovincial networks have poor connectivity and low internal ties strength, which manifest as core-periphery structures with the provincial capitals as centers. Our research conclusion helps to clarify the current accumulation of technology and offer guidance for the development of China's biomedicine industry.

Impacts of menopause hormone therapy on mood disorders among postmenopausal women

OBJECTIVE

This study aimed to explore the modulatory effects of menopause hormone therapy (MHT) on mood disorders among postmenopausal women.

METHODS

A cross-sectional study was conducted to recruit postmenopausal women, including patients (arranged MHT for over 3 years as the medication group) and non-MHT controls. All participants were asked to respond to the Center for Epidemiological Studies Depression Scale (CES-D) and Generalized Anxiety Disorder Screener (GAD-7) questionnaires to assess their depression and anxiety status.

RESULTS

A total of 230 cases from the two groups were determined based on propensity score matching analysis by matching the menopausal age and menopausal durations. We found that MHT served as a favorable modulator in the depression status of postmenopausal women. Among the four factors of the CES-D questionnaire, our data indicated that the differences between the two groups fell primarily into two aspects: depressive emotion, and somatic symptoms or retarded activities. MHT was mainly involved in improving the depression of overweight women. However, no substantial effects of MHT were observed on the regulation of anxiety.

CONCLUSION

Postmenopausal women, especially the overweight population, who have experienced MHT exhibited an improved depressive status but not their anxiety condition.

Video-assisted superior mediastinal lymphadenectomy for papillary thyroid cancer: a case report

Superior mediastinal lymph node metastases in papillary thyroid cancer are uncommon. The clinical characteristics and surgical strategy of superior mediastinal lymph node metastases remain unclear. Superior mediastinal lymphadenectomy can be accomplished either by a transcervical or transsternal approach. Transsternal approach for superior mediastinal lymphadenectomy can cause great damage; transcervical approach sometimes results in inadequate exposure. Here we report our experience of a papillary thyroid cancer patient with superior mediastinal lymph node metastases who underwent video-assisted superior mediastinal lymphadenectomy. A 49-year-old woman diagnosed with papillary thyroid cancer in left thyroid underwent unilateral lobectomy and ipsilateral central and lateral node dissection in the local hospital 4 years ago. Currently lymph node metastases were found in mediastinum and the right neck, some of which were adjacent to the right innominate vein. Unilateral lobectomy, ipsilateral central and lateral node dissection, and video-assisted superior mediastinal lymphadenectomy were successfully performed by transcervical approach. Subsequently, the patient received thyroxine suppression therapy and adjuvant radioiodine treatment. Video-assisted superior mediastinal lymphadenectomy, providing adequate exposure for a complete superior mediastinal lymphadenectomy, is proved to be safe and feasible.

How Does Organizational Unlearning Influence Product Innovation Performance? Moderating Effect of Environmental Dynamism

Product innovation integrates technology, knowledge, management practices, and market innovation, making it essential to gain a competitive advantage. Effective management of dynamic knowledge, which is the foundation of and driving force for product innovation, is a powerful tool that allows a firm to successfully innovate, adapt to environmental changes, and improve its competitiveness. In the "nanosecond age," unlearning and learning in an organization is crucial to a firm's ability to promptly update its organizational knowledge and maintain innovation vitality. Based on the dynamic knowledge management perspective, this study integrates and constructs a theoretical model with environmental dynamism as the moderating variable, discusses the impact of organizational unlearning on product innovation performance, and empirically analyzes 208 valid questionnaires in the Yangtze River Delta using the multiple regression method. The results show that organizational unlearning shares a positive relationship with dynamic capabilities and product innovation performance. Dynamic capability is positively related to product innovation performance and has a partial mediating effect on the relationship between organizational unlearning and product innovation performance. Environmental dynamism shares a positive moderating effect on the relationship between organizational unlearning and product innovation performance. This study deepens the existing research on the factors that influence product innovation performance, which may help firms improve their dynamic knowledge management and product innovation performance.

Spatiotemporal evolution of online attention to vaccines since 2011: An empirical study in China

Since the outbreak of Coronavirus Disease 2019 (COVID-19), the Chinese government has taken a number of measures to effectively control the pandemic. By the end of 2021, China achieved a full vaccination rate higher than 85%. The Chinese Plan provides an important model for the global fight against COVID-19. Internet search reflects the public's attention toward and potential demand for a particular thing. Research on the spatiotemporal characteristics of online attention to vaccines can determine the spatiotemporal distribution of vaccine demand in China and provides a basis for global public health policy making. This study analyzes the spatiotemporal characteristics of online attention to vaccines and their influencing factors in 31 provinces/municipalities in mainland China with Baidu Index as the data source by using geographic concentration index, coefficient of variation, GeoDetector, and other methods. The following findings are presented. First, online attention to vaccines showed an overall upward trend in China since 2011, especially after 2016. Significant seasonal differences and an unbalanced monthly distribution were observed. Second, there was an obvious geographical imbalance in online attention to vaccines among the provinces/municipalities, generally exhibiting a spatial pattern of “high in the east and low in the west.” Low aggregation and obvious spatial dispersion among the provinces/municipalities were also observed. The geographic distribution of hot and cold spots of online attention to vaccines has clear boundaries. The hot spots are mainly distributed in the central-eastern provinces and the cold spots are in the western provinces. Third, the spatiotemporal differences in online attention to vaccines are the combined result of socioeconomic level, socio-demographic characteristics, and disease control level.

Global Trade Pattern of Medical Devices and China's Trade Position: Based on Data From 2001 to 2020

To depict the evolution of the global trade of medical devices, this study analyzes the spatiotemporal evolution characteristics of global and China's trade patterns of medical devices from 2001 to 2020 based on data from the World Bank and United Nations Commodity Trade Statistics Database, and thereby investigates the status quo of global and China's medical device trade, as well as changes in China's position in the global medical device trade. The findings are as follows. First, the total global trade volume of medical devices is generally on the rise, showing closer network connections. Despite some changes in trade position, the core countries in the global medical device trade network are relatively fixed. The intermediate position of core trading countries has been weakened on the whole, whereas exporting countries have generally assumed an enhanced central position. Communities with geographical proximity have been formed in the global medical device trade network, including two large communities, the Asian-European countries and the Pacific Rim countries, and one small community, the South American countries. Second, with its rapidly growing trade volume of medical devices with other countries, China has now become the fourth largest medical device trading country in the world. Its number of import and export partners has remained relatively stable and continued to increase. Its export markets are relatively concentrated, and a tripartite pattern of import sources has been formed. China has established extensive interdependent relations and almost no one-way dependent relations in the medical device trade. Among its major trading partners for medical devices, the interdependence of China with developed countries/regions, such as European and American countries and Japan, has generally deepened.

The associations between TMAO-related metabolites and blood lipids and the potential impact of rosuvastatin therapy

Background

Trimethylamine N-oxide (TMAO)-related metabolites are associated with the pathogenesis of atherosclerotic cardiovascular disease (ASCVD) and are known to disrupt lipid metabolism. The aims of this study were to evaluate the associations between TMAO-related metabolites and blood lipids and determine how lowering the lipid profile via rosuvastatin therapy influences TMAO-related metabolites.

Methods

A total of 112 patients with suspected ASCVD were enrolled in this study. The levels of plasma TMAO-related metabolites, including TMAO, choline, carnitine, betaine, and γ-butyrobetaine (GBB), were analyzed by stable isotope dilution liquid chromatography-tandem mass spectrometry (LC/MS/MS) before and after rosuvastatin therapy in all patients. Statistical methods were used to detect the associations between TMAO-related metabolites and blood lipids and determine how rosuvastatin therapy alters the levels of these metabolites.

Results

A significant positive correlation was found between TMAO and triglycerides (TG) (r = 0.303, P < 0.05). Furthermore, significant negative correlations were found between TMAO and high-density lipoprotein cholesterol (HDL-c) and between betaine and low-density lipoprotein cholesterol (LDL-c) (r = − 0.405 and − 0.308, respectively, both P < 0.01). Compared to baseline, significantly lower TMAO levels and higher carnitine, betaine and GBB levels were observed after rosuvastatin therapy, while the lipids decreased significantly (P < 0.05). The significant correlation between TMAO and TG or between betaine and LDL-c disappeared after rosuvastatin therapy (r = 0.050 and − 0.172, respectively, both P > 0.05). However, a significantly positive association between carnitine and TC and a negative association between carnitine and LDL-c or between betaine and TG were found after adjustment for sex, age, body mass index (BMI) and lipids (P < 0.05).

Conclusions

This study suggests that TMAO-related metabolites are significantly associated with blood lipids, although some of them are changed postrosuvastatin therapy. Lower TMAO and higher TMAO precursors were observed after rosuvastatin therapy compared to baseline. This study indicates that elevated TMAO precursors after rosuvastatin therapy and their potential impact on ASCVD should be considered in the clinic.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12944-022-01673-3.

CARBONATED BEVERAGES AFFECT LEVELS OF ANDROGEN RECEPTOR AND TESTOSTERONE SECRETION IN MICE

Objectives

This work aimed to study the influences of carbonated beverages (CBs) on the testis growth and the expression levels of androgen receptor (AR) of mice.

Methods

Two experimental groups of 30 mice each PEP-1 and PEP-2 drank 50% and 100% Pepsi-Cola, respectively for 15 days. Other 2 experimental groups of 30 mice each COC-1 and COC-2 drank 50% and 100% Coca-Cola, respectively for 15 days. The control group (CG) of 30 mice drank water. Bilateral testes were harvested aseptically on days 0, 5, 7, 10, 13 and 15. Real-time PCR and Western blot were implemented to detect levels of androgen receptor (AR) mRNA and protein in testis tissues.

Results

Testes masses of PEP-2, COC-1 and COC-2 were greater than those of PEP-1 and CG (P < 0.05). On day 15, testis longitudinal diameter (TLD) of CBs-treated mice was increased as compared to CG. TLD, testes transverse diameters (TTD) and AR proteins levels of PEP-2 and COC-2 were increased in comparison with CG (P<0.05). Serum testosterone concentrations of PEP-2 were higher than that of COC-1 and CG (P < 0.05). Levels of AR mRNAs of four CBs-treated mice were increased by 60.18%, 67.26%, 65.93% and 78.76%.

Conclusions

A high concentration of Coca-Cola and Pepsi-Cola could raise TLD and TDD, enhance testosterone secretion, and increase serum EGF concentrations.

The adaptation to freezing tolerance of hydrated lettuce seeds: effects of regional climate and of seed characteristics

BACKGROUND

With global warming, soil seed banks at high altitudes face dual challenges, excessive water absorption and thinner snow cover that increase underground temperature. A better understanding of freezing tolerance of hydrated seeds provides insights for conservation in natural soil seed banks.

OBJECTIVE

To understand the adaptation mechanisms of seed freezing tolerance under various climates, in relation to cooling rate and seed size.

MATERIALS AND METHODS

Twelve ecotypes of lettuce (Lactuca sativa) seeds were collected from different geographical locations around the world. Seeds were fully hydrated and tested for their freezing tolerance using programmed cooling methods.

RESULTS

The size of seeds from different climate regions varied, and was correlated with the freezing tolerance of the hydrated seeds (P < 0.05). Larger seeds showed poorer freezing tolerance. The local climates of maternal plants were also well correlated to seed freezing tolerance (P < 0.05), especially under slow cooling conditions. The seeds collected in regions with high spring rainfall exhibited greater freezing tolerance.

CONCLUSION

Freezing tolerance of hydrated seeds is affected by the climate of maternal plants and by seed size. Our data revealed the existence of an adaptation mechanism of freezing tolerance among various ecotypes of lettuce seeds. doi.org/10.54680/fr22410110412.

Global Trade Pattern of Traditional Chinese Medicines and China's Trade Position

To depict the evolution of the global trade of traditional Chinese medicine (TCM) products, this article analyzes the 2001-2020 trade data of TCM products in the World Bank and United Nations Commodity Trade Statistics Database to discern the spatial-temporal evolution characteristics of global and China's trade patterns of TCM products from 2001 to 2020 and thereby assess the changes in the global trade of TCM products and in the positions of various countries or regions in the global trade of TCM products. Research findings are as follows: First, on the whole, the total trade volume of TCM products and the number of participating economies and trade connections are on the rise. Second, in terms of topological structure, with higher network density and rising transmission efficiency, the global trade network of TCM products has typical small-world and scale-free network characteristics and has begun to be controlled by a few countries. Judging from the co-opetition between major trading countries, there are more diversified sources of imports for major trading countries, and there is competition between supplying countries. Third, For China, the trade volume of TCM products between China and various countries worldwide has grown rapidly and exhibits a trend of continuous increase followed by decline. China has established extensive trade partnerships and its position in the global trade network of TCM products has been continuously improved. China's participation has contributed to a closer connection among trading entities, but its network heterogeneity remains to be further improved. From the perspective of trade interdependence, the number of countries or regions maintaining high interdependence with China has been gradually increasing, and most of them are European and American countries, Japan, and Southeast Asian countries. The number of countries or regions maintaining low interdependence with China has gradually decreased, and countries or regions that are completely one-way dependent on China are nonexistent.

Has COVID-19 Changed China's Digital Trade?-Implications for Health Economics

Digital technologies have played a significant role in the defense against the COVID-19 pandemic. This development raises the question of whether digital technologies have helped Chinese exports recover quickly and even grow. To answer this question, we study monthly data on Chinese exports to 40 countries/regions from January 2019 to June 2020 and covering 97 product categories. The study takes the COVID-19 outbreak as a natural experiment and treats digital trade products as the treatment group. Using a generalized difference-in-differences (DID) approach, we empirically investigate how this major global public health crisis and digital trade have influenced Chinese exports. Our empirical analysis reveals that the COVID-19 pandemic has inhibited China's export trade overall, digital trade has significantly promoted trade, and the supply mechanism has played a significant role in promoting the recovery of exports. Heterogeneity tests on destination countries/regions reveal that digital trade has significantly promoted exports to countries/regions with different income levels, with a more significant effect on low-risk destinations than on high-risk destinations. The sector heterogeneity test demonstrates that digital trade has enhanced the export recovery of sectors dealing in necessities for pandemic prevention. Other robustness tests, including parallel trend and placebo tests, support the above conclusions. Finally, we extend the research conclusions and discuss their implication for health economics and the practice of fighting COVID-19.

Association of prenatal renal ultrasound abnormalities with pathogenic copy number variants in a large Chinese cohort

OBJECTIVES

To assess the clinical utility of prenatal chromosomal microarray analysis (CMA) in fetuses with abnormal renal sonographic findings, and to evaluate the association of pathogenic or likely pathogenic copy number variants (P/LP CNVs) with different types of renal abnormality.

METHODS

This was a retrospective study of fetuses at 14-36 weeks screened routinely for renal and other structural abnormalities at the Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region. We retrieved and analyzed data from fetuses with abnormal renal sonographic findings, examined between January 2013 and November 2019, which underwent CMA analysis using tissue obtained from chorionic villus sampling (CVS), amniocentesis or cordocentesis. We evaluated the CMA findings according to type of renal ultrasound anomaly and according to whether renal anomalies were isolated or non-isolated.

RESULTS

Ten types of renal anomaly were reported on prenatal ultrasound screening, at a mean ± SD gestational age of 24.9 ± 4.8 weeks. The anomalies were diagnosed relatively late in this series, as 64% of cases with an isolated renal anomaly underwent cordocentesis rather than CVS. Fetal pyelectasis was the most common renal ultrasound finding, affecting around one-third (34.32%, 301/877) of fetuses with a renal anomaly, but only 3.65% (n = 11) of these harbored a P/LP CNV (comprising: isolated cases, 2.37% (4/169); non-isolated cases, 5.30% (7/132)). Hyperechogenic kidney was found in 5.47% (n = 48) of fetuses with a renal anomaly, of which 39.58% (n = 19) had a P/LP CNV finding (comprising: isolated cases, 44.44% (16/36); non-isolated cases, 25.00% (3/12)), the highest diagnostic yield among the different types of renal anomaly. Renal agenesis, which accounted for 9.92% (n = 87) of all abnormal renal cases, had a CMA diagnostic yield of 12.64% (n = 11) (comprising: isolated cases, 11.54% (9/78); non-isolated cases, 22.22% (2/9); unilateral cases, 11.39% (9/79); bilateral cases, 25.00% (2/8)), while multicystic dysplastic kidney (n = 110), renal cyst (n = 34), renal dysplasia (n = 27), crossed fused renal ectopia (n = 31), hydronephrosis (n = 98), renal duplication (n = 42) and ectopic kidney (n = 99) had overall diagnostic rates of 11.82%, 11.76%, 7.41%, 6.45%, 6.12%, 4.76% and 3.03%, respectively. Compared with the combined group of CMA-negative fetuses with any other type of renal anomaly, the rate of infant being alive and well at birth was significantly higher in CMA-negative fetuses with isolated fetal pyelectasis or ectopic kidney, whereas the rate was significantly lower in fetuses with isolated renal agenesis, multicystic dysplastic kidney or severe hydronephrosis. The most common pathogenic CNV was 17q12 deletion, which accounted for 30.14% (22/73) of all positive CMA findings, with a rate of 2.51% (22/877) among fetuses with an abnormal renal finding. Fetuses with 17q12 deletion exhibited a wide range of renal phenotypes. Other P/LP CNVs in the recurrent region that were associated with prenatal renal ultrasound abnormalities included 22q11.2, Xp21.1, Xp22.3, 2q13, 16p11.2 and 1q21, which, collectively, accounted for 2.17% (19/877) of the fetuses with prenatal renal anomalies.

CONCLUSIONS

In this retrospective review of CMA findings in a large cohort of fetuses with different types of renal ultrasound abnormality, the P/LP CNV detection rate varied significantly (3.03-39.58%) among the different types of kidney anomaly. Our data may help in the decision regarding whether to perform prenatal genetic testing in fetuses with renal ultrasound findings. Specifically, prenatal CMA testing should be performed in cases of hyperechogenic kidney, regardless of whether or not the anomaly is isolated, while it should be performed postnatally rather than prenatally in cases of fetal pyelectasis. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

Autonomous robotic laparoscopic surgery for intestinal anastomosis

Autonomous robotic surgery has the potential to provide efficacy, safety, and consistency independent of individual surgeon's skill and experience. Autonomous anastomosis is a challenging soft-tissue surgery task because it requires intricate imaging, tissue tracking, and surgical planning techniques, as well as a precise execution via highly adaptable control strategies often in unstructured and deformable environments. In the laparoscopic setting, such surgeries are even more challenging because of the need for high maneuverability and repeatability under motion and vision constraints. Here we describe an enhanced autonomous strategy for laparoscopic soft tissue surgery and demonstrate robotic laparoscopic small bowel anastomosis in phantom and in vivo intestinal tissues. This enhanced autonomous strategy allows the operator to select among autonomously generated surgical plans and the robot executes a wide range of tasks independently. We then use our enhanced autonomous strategy to perform in vivo autonomous robotic laparoscopic surgery for intestinal anastomosis on porcine models over a 1-week survival period. We compared the anastomosis quality criteria-including needle placement corrections, suture spacing, suture bite size, completion time, lumen patency, and leak pressure-of the developed autonomous system, manual laparoscopic surgery, and robot-assisted surgery (RAS). Data from a phantom model indicate that our system outperforms expert surgeons' manual technique and RAS technique in terms of consistency and accuracy. This was also replicated in the in vivo model. These results demonstrate that surgical robots exhibiting high levels of autonomy have the potential to improve consistency, patient outcomes, and access to a standard surgical technique.

Digital Technology, Knowledge Level, and Food Safety Governance: Implications for National Healthcare System

Exploring the intrinsic relationship between digital technology and the efficiency of food safety supervision contributes to a better understanding of the role of digital technology in food safety supervision and how to maximize its influence. This study employed sample data from 31 regions in China between 2015 and 2017 for an empirical analysis of the correlation between the two and to examine the moderating effects of the knowledge levels of food producers and consumers. The results show that the development of digital technology contributes to enhancing the efficiency of food safety supervision. In this process, the higher the knowledge level of consumers, the greater the positive promotional effect of digital technology. On the contrary, when the knowledge level of producers is higher, it is not conducive to enhancing the effect of digital technology on the efficiency of food safety supervision. The author holds the view that this is related to the fact that employees in the food production and manufacturing industry have insufficient moral and legal knowledge. This not only limits the effect of digital technology on enhancing the efficiency of food safety supervision, but also opens the door to illegal production for some unprincipled producers. The policy implications are that digital technology should be used to improve food safety supervision, the moral and legal knowledge of food producers should be improved, and consumers should be encouraged to use digital technology more in the pursuit of food safety. Implications for national healthcare system would be also discussed in our paper.

Change of zinc mobilization and gene expression of key zinc transport proteins between the yolk sac membrane and liver of duck embryonic developing

Zinc (Zn) deposition in egg yolk is essential for the rapid growth and complete development of the avian embryo. Thus, it is crucial to obtain maximal Zn mobilization at an appropriate time during development in favor of the survival of avian embryos. The aim of this study was to study the developmental change of Zn mobilization and gene expression related to key Zn transport proteins between the yolk sac membrane and embryonic liver from the incubation d 17 (E17) to d 32 (E32) during duck embryonic developing. The weights of duck embryo, embryo without yolk sac, and embryonic liver increased as well as the yolk sac weight decreased linearly (P < 0.0001) when incubation day increased. The Zn concentration in the yolk sac did not change from E17 to E29 and only declined significantly from E29 to E32 of duck embryos, while hepatic Zn level decreased linearly as with the increased incubation time (P < 0.01). When the incubation day increased, the decreased Zn amount in the yolk sac and the increased Zn amount in the embryonic liver were observed (P < 0.0001). The calculated transfer-out rate of Zn in the yolk sac and transfer-in rate of Zn in livers were both increased from E23-26 to E29-32 (P < 0.01). Among E17, E23 and E29, the solute carrier family 39 member (ZIP) of ZIP10, ZIP13, and ZIP14 genes mRNA expressions were increased in yolk sac membrane but were decreased in the embryonic liver, while metallothionein 1 mRNA expression was increased both in the yolk sac membrane and liver (P < 0.05). In conclusion, yolk sac membrane and embryonic liver tissues displayed the similar developmental patterns of Zn mobilization and metallothionein 1 mRNA expression from E17 to E32 during duck embryonic developing. The appropriate time of the maximal rate of Zn mobilization were observed between E29 and E32 of duck embryo, associated with the significant changes of gene expression related to some key Zn transport proteins on E29 in yolk sac membrane and liver tissues.

Trial leadership by women is associated with racial diversity among heart failure clinical trial participants: a systematic bibliometric review 2000–2020

Background

For the results of randomized controlled trials (RCTs) to be generalizable, they should report on and include the broad range of patients who have the disease.

Purpose

We assessed temporal trends and trial factors associated with 1) the reporting of race or ethnicity data and 2) the enrolment of Black, Indigenous, and people of colour (BIPOC) in Heart Failure (HF) RCTs.

Methods

We searched MEDLINE, EMBASE, and CINAHL for RCTs that recruited adults with HF and were published in journals with an impact factor ≥10 between January 1, 2000 and June 17, 2020. We extracted data in duplicate and used the Cochran-Armitage and Jonchkeere-Terpstra tests to examine temporal trends. We used multivariable regression to assess the independent association between trial factors and the outcomes of interest.

Results

A total of 414 RCTs met inclusion criteria, of which a vast majority (90.6%; 95% CI 87.4–93.2%) were coordinated in either Europe or North America. Only 157 of the 414 RCTs (37.9%; 95% CI 33.2–42.8%) reported race/ethnicity data; among the 158,200 participants in these trials, only 29,512 (18.7%; 95% CI 18.5–18.9%) were BIPOC. There was a significant increase in the reporting of race or ethnicity data (from 26.9% in 2000–2001 to 54.2% in 2019–2020, p&lt;0.001) and in enrollment of BIPOC (from 16.5% in 2000–2001 to 23.9% in 2019–2020, p=0.038) between 2000–2020. Trial leadership by a woman was associated with twice the adjusted odds of reporting of race or ethnicity data (OR 2.0; 95% CI 1.1–3.8; p=0.028) and an 8.4% (95% CI 1.9–15.0%; p=0.012) adjusted increase in enrollment of BIPOC. The race/ethnicity of trial leaders was not available for analysis.

Conclusions

Among HF RCTs published between 2000–2020, &lt;38% reported data on race or ethnicity, although this increased over time. Among trials reporting such data, &lt;19% of participants were BIPOC, with modest increases in enrollment over time. Trials led by women had greater adjusted odds of reporting race/ethnicity data and enrollment of BIPOC.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): CIHR

Global representation of heart failure clinical trial leaders and collaborators: a systematic bibliometric review 2000–2020

Aims

Heart Failure (HF) has a disproportionate burden in low- and middle-income countries. The geographic representation of those who lead HF randomized clinical trials (RCTs) may not reflect the geographic burden of disease. We assessed temporal trends and trial characteristics associated with leadership outside Europe and North America, and explored whether there was a geographic association between trial leadership and participant enrolment.

Methods and results

We searched MEDLINE, EMBASE, and CINAHL for HF RCTs published in journals with an impact factor ≥10 between January 1, 2000, and June 17, 2020. We used the Jonckheere-Terpstra test to assess temporal trends and multivariable logistic regression models to determine associations between predictor and outcome variables.

There were 414 eligible RCTs. Only 80 of 828 trial leaders (9.7%; 95% CI: 7.8% to 11.8%), and 453 of 4656 collaborators (9.7%; 95% CI: 8.8% to 10.6%) were from regions outside Europe and North America, with no temporal change in geographic representation. The odds of trial leadership outside Europe and North America were significantly lower with industry versus public funding (OR: 0.33; 95% CI: 0.15 to 0.75; P=0.008). Trial leadership outside Europe and North America was associated with enrolment of patients outside Europe and North America (OR: 10.0; 95% CI 5.6–19.0; P&lt;0.001).

Conclusion

Trial leadership outside Europe and North America is rare, particularly in industry funded trials, and is associated with participant enrolment in regions with disproportionate disease burden. Building research capacity and networks in under-represented regions could increase generalizability of trial results.

Funding Acknowledgement

Type of funding sources: None.

Acupuncture for glucose and lipid metabolic disorders of polycystic ovarian syndrome: A systematic review protocol

BACKGROUND

Polycystic ovary syndrome (PCOS) is a common gynecological disease that is often accompanied by some metabolic abnormality such as insulin resistance and dyslipidemia. As a non-pharmacological therapy, acupuncture is widely used for the treatment of PCOS, but the effectiveness for insulin resistance and lipid metabolic disorder remains controversial.

OBJECTIVES

To assess the effectiveness and safety of acupuncture for insulin resistance and lipid metabolic disorder of women with PCOS.

SEARCH METHODS

Eight databases will be searched from inception to June 2021, three clinical trial registration platforms will be searched for relevant trials.

SELECTION CRITERIA

Randomized controlled trials (RCTs) of acupuncture therapy for insulin resistance and lipid metabolic of PCOS will be included.

DATA COLLECTION AND ANALYSIS

Study screening, data collection, and analysis will be performed by two or more reviewers independently. We will calculate mean difference (MD), standard mean difference (SMD) with 95% confidence intervals (CIs). Data synthesis will be performed with RevMan V.5.3 software and with Stata V.15.0 software when necessary.

PROSPERO REGISTRATION NUMBER

CRD42020177846.

Is Health Contagious?-Based on Empirical Evidence From China Family Panel Studies' Data

This study empirically analysed the contagion of health using data from China Family Panel Studies. We first controlled variables related to health behaviour, medical conditions, individual characteristics, household characteristics, group characteristics, and prefecture/county characteristics and then employed multiple methods for estimation. The estimates showed that the average health level of others in the community had a significant positive effect on individual self-rated health-health was contagious. The measurement results remained robust after the endogeneity of the core explanatory variables was controlled using two-stage least squares. Furthermore, by analysing the heterogeneity of health contagion, we found that the contagion effect of health varied with the level of medical care, household affiliation, gender, rural/urban areas, and age groups. The contagion effect of health was more pronounced in the elderly population and the rural areas of the central region, where the level of medical care is relatively low, whereas it did not differ significantly between genders. Finally, the learning or imitation mechanism and social interaction mechanism of health contagion were examined.

An Overview of Systematic Reviews of Acupuncture for Infertile Women Undergoing in vitro Fertilization and Embryo Transfer

Background: Currently, more and more subfertility couples are opting for combined acupuncture to improve the success rate of in vitro fertilization and embryo transfer (IVF-ET). However, the efficacy and safety of acupuncture in IVF-ET is still highly controversial.

Objectives: The purpose of this overview is to summarize evidence of essential outcomes of systematic reviews (SRs) of acupuncture in IVF-ET and evaluate their methodological quality.

Methods: We conducted a comprehensive literature search for relevant SRs in eight databases from inception to July 31, 2020, without language restriction. We evaluated the methodological quality of the included SRs by using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2), which was the latest available assessment tool. The Risk of Bias in Systematic Review (ROBIS) tool was used to assess the risk of bias in SRs. We assessed the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) score to determine the strength of evidence. We excluded the overlapping randomized controlled trials (RCTs) and performed a re-meta-analysis of the primary RCTs.

Results: This review included 312 original RCT studies and 65,388 participants. By using AMSTAR-2, we found that the methodological quality of 16 SRs was critically low, because they had more than one critical weakness. Our reviews showed that although the GRADE for quality of evidence profile was suboptimal, acupuncture seemed to be beneficial in increasing the pregnancy rate. Our re-meta-analysis suggested that acupuncture was superior to sham acupuncture in improving the clinical pregnancy rate (CPR) of IVF-ET with substantial heterogeneity (RR = 1.31, 95% CI: 1.13–1.52, p = 0.0004, I² = 66%). No statistical difference was observed regarding the outcomes of live birth rate (LBR), ongoing pregnancy rate (OPR), biochemical pregnancy rate (BPR), and miscarriage rate (MR) between two groups. When compared with no adjunctive treatment groups, acupuncture improved CPR (RR = 1. 25, 95% CI: 1.11–1.42, p = 0.0003) and OPR (RR = 1. 38, 95% CI: 1.04–1.83, p = 0.03). Acupuncture was more superior than no adjunctive treatment in reducing MR (OR = 1.42, 95% CI: 1.03–1.95, p = 0.03) and BPR (RR = 1.19, 95% CI: 1.02–1.37, p = 0.02).

Conclusions: Although the evidence of acupuncture in IVF-ET is insufficient, acupuncture appears to be beneficial to increase the clinical pregnancy rate in women undergoing IVF-ET. However, there are severe heterogeneity and methodological quality defects, which limit the reliability of results. Further, high-quality primary studies are still needed.

Triplex qRT-PCR with specific probe for synchronously detecting Bovine parvovirus, bovine coronavirus, bovine parainfluenza virus and its applications

Bovine parvovirus (BPV), bovine coronavirus (BCoV) and bovine parainfluenza virus (BPIV) are common etiologies causing gastrointestinal and respiratory diseases in dairy herds. However, there are few reports on the synchronous detection of BPV, BCoV and BPIV. The present article aimed to develop a quick and accurate RT-PCR assay to synchronously detect BPV, BCoV and BPIV based on their specific probes. One pair universal primers, one pair specific primers and one specific probe was designed and synthesized. After the concentrations of primer and probe and annealing temperature were strictly optimized, the specificity, sensitivity and repeatability of the established triplex probe qRT-PCR were evaluated, respectively. The results showed the recombinant plasmids of pMD18-T-BPV, pMD18-T-BCoV and pMD18-T-BPIV were 554bp, 699bp and 704bp, respectively. The optimal annealing temperature was set at 45.0°C for triplex qRT-PCR. The triplex probe qRT-PCR can only synchronously detect BPV, BCoV and BPIV. Detection sensitivities were 2.0×102, 2.0×102 and 2.0×101 copies/μL for BPV, BCoV and BPIV, being 1000-fold greater than that in the conventional PCR. Detection of clinical samples demonstrated that triplex probe qRT-PCR had a higher sensitivity and specificity. The intra-assay and inter-assay coefficient of variation were lower than 2.0%. Clinical specimens verified that the triplex qRT-PCR had a higher sensitivity and specificity than universal PCR. In conclusion, this triplex probe qRT-PCR could detect only BPV, BCoV and BPIV. Minimum detection limits were 2.0×102 copies/μL for BPV and BCoV, and 2.0×101 copies/μL for BPIV. The sensitivity of this triplex probe qRT-PCR was 1000-fold greater than that in the conventional PCR. The newly qRT-PCR could be used to monitor or differentially diagnose virus infection.

Acupuncture for chronic pelvic pain in patients with SPID: A protocol for systematic review and meta-analysis

BACKGROUND

Chronic pelvic pain (CPP) is one of the common sequela of pelvic inflammatory disease, the pathological factors are adhesions, scarring and pelvic congestion which caused by inflammation, often cause abdominal pain and lumbosacral soreness, and aggravated after fatigue, sexual intercourse and during menstruation. It is difficult to treat because special pathological changes. Although acupuncture has gained increased popularity for the management of CPP, evidence regarding its efficacy is lacking. Therefore, a systematic review of acupuncture for chronic pelvic pain in patients with SPID is required to provide available evidence for further study.

METHODS AND ANALYSIS

We will conduct a systematic review of randomized controlled trials (RCTs) that investigate the effect and safety of acupuncture for the treatment of chronic pelvic pain patients with SPID. We will electronically search the literature in the databases of PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, the Web of Science, China National Knowledge Infrastructure (CNKI), Wan-fang Digital Periodicals, Chinese Biomedical Literature Database (CBM), Chinese Scientific Journal Database (VIP) and select eligible articles. Data extraction will be conducted by 2 researchers independently, and risk of bias of the meta-analysis will be evaluated based on the Cochrane Handbook for Systematic Reviews of Interventions. The primary outcomes will be total effective rate and VAS pain score, and the secondary outcomes include the recurrence rate and adverse reaction. All data analysis will be conducted by software Review Manager V.5.3.

RESULTS

This study will provide the latest analysis of the currently available evidence for the efficacy of acupuncture for chronic pelvic pain in patients with SPID.

PROSPERO REGISTRATION NUMBER

CRD42020193826.

Primary Clear Cell Sarcoma of the Breast: A Case Report

Casestudy: Clear cell sarcoma (CCS), also known as malignant melanoma of soft parts, is a primary soft tissue neoplasm exhibiting evidence of melanocytic differentiation. It is an uncommon aggressive tumor that arises in tendons and aponeuroses of the distal extremities. Here, we report the first case of primary CCS of the breast.

The patient was a 43-year-old female who presented with a left breast mass and underwent surgical resection at an outside hospital. No history of melanoma or any other malignancies was reported. Grossly, it was described as a 2 x 1.5 x 1.5 cm, well-demarcated, white nodular mass. Microscopic examination showed a malignant neoplasm composed of short spindle cells with ill-defined, eosinophilic cytoplasm and ovoid nuclei with finely stippled chromatin and exhibiting moderate pleomorphism. The lesional cells were arranged in short interlacing fascicles with abundant collagen, with brisk mitotic activity (&gt;15/10 HPF). The differential diagnosis included spindle cell carcinoma, myoepithelial carcinoma and melanocytic neoplasm. The tumor cells were immunoreactive for S-100 protein, SOX10, Mart-1, HMB45 and MiTF, but negative for multiple cytokeratins (including high and low molecular weight keratins), p63, EMA, CEA, Caldesmon, smooth muscle myosin, calponin, desmin, ERG, and CD31, thus confirming melanocytic origin. EWSR1 gene rearrangement was detected by fluorescence in situ hybridization analysis using break-apart probes. Overall, the histomorphology combined with the immunophenotype and cytogenetic characteristics, was most consistent with a CCS. To our knowledge, no primary CCS of the breast has been previously reported in the English language literature.

miR-34b inhibits the migration/invasion and promotes apoptosis of non-small-cell lung cancer cells by YAF2

OBJECTIVE

Lung cancer is the leading cause of cancer death in the world and microRNAs (miRNA) have been found to be involved in the initiation and development of cancer by acting as potential oncogenes or tumor suppressor genes.

PATIENTS AND METHODS

In this study, we investigated the expression of miR-34b in non-small cell lung cancer (NSCLC) patients and discussed the molecular mechanism of miR-34b in the invasion and migration of A549 cells in vitro.

RESULTS

Our results showed that miR-34b was significantly down-regulated in primary cancer tissues when compared with the normal lung tissues. The over-expression of miR-34b inhibited migration and invasion, and promoted apoptosis of A549 lung cancer cells. Furthermore, Luciferase reporter assay validated YY1-associated factor 2 (YAF2) as a direct target of miR-34b and YAF2 expression was significantly increased in clinical NSCLC tissue samples. In addition, the over-expression of miR-34b inhibited YAF2, p-Jak2, p-STAT3 and MMP2 protein expression and promoted caspase 3 protein expression in cancer cells.

CONCLUSIONS

Our results suggest that miR-34b may inhibit migration and invasion of NSCLC cells by targeting YAF2. Thus, our findings provide new insight into the molecular mechanisms of lung cancer metastasis and miR-34b may serve as a potential target in the treatment of human lung cancer.

miR-18a expression in basal cell carcinoma and regulatory mechanism on autophagy through mTOR pathway

BACKGROUND

Basal cell carcinoma (BCC) is the most common form of skin carcinoma.

AIM

To investigate the function of key micro(mi)RNAs and to explore the potential molecular mechanisms involved in BCC.

METHODS

The microarray dataset GSE34535, which comprises seven BCC samples and seven control samples, was downloaded from the Gene Expression Omnibus database. Differentially expressed miRNAs (DE-miRNAs) were identified. We collected tissue samples from 20 patients with BCC and 20 healthy controls (HCs), to compare the miR-18a expression in their tissue samples. Expression of miR-18a in A431 and HaCaT cells was also assayed. Following this, we upregulated and downregulated miR-18a expression in A431 cells to examine the effects on cell proliferation, migration and apoptosis. To further investigate the relative mechanism, the proteins LC3, Beclin 1, Akt and mammalian target of rapamycin (mTOR) were examined by quantitative real-time PCR and Western blotting. For further verification, we examined the expression of LC3 in the 20 BCC and 20 HC tissue samples.

RESULTS

In total, 19 DE-miRNAs (13 upregulated and 6 downregulated) that were common to the BCC and HC groups were identified. Levels of miR-18a were about three-fold higher in BCC tissues and A431 cells compared with their respective control groups. In vitro, downregulation of miR-18a was shown to inhibit cell proliferation and activate autophagy via the Akt/mTOR signalling pathway, while upregulation of miR-18a promoted proliferation of these cells. LC3 was decreased in BCC compared with HC tissue samples.

CONCLUSIONS

Our data support an oncogenic role of miR-18a through a novel Akt/mTOR/Beclin 1/LC3 axis, and suggest that the antitumour effects of miR-18a inhibitor may make it suitable for BCC therapy.

[Analysis of emergency venous sinus stenting in the treatment of acute visual impairment caused by idiopathic cranial hypertension]

Objective: To investigate the efficacy and safety of emergency venous sinus stenting in the treatment of acute visual impairment caused by idiopathic intracranial hypertension (IIH). Methods: A descriptive cross-sectional study design was used to retrospectively analyze 38 patients undergoing venous sinus stenting in the First Affiliated Hospital of Zhengzhou University from January 2013 to October 2019. A total of 9 patients who had sudden short-term vision loss met the inclusion criteria. Routine visual field and fundus examination were performed. The venous sinus stenosis (CVSS) was confirmed by MR venography or DSA. The pressure gradient at both ends of CVSS was ≥10 mmHg(1 mmHg=0.133 kPa). All patients were treated with emergency venous sinus stenting. Six-month follow-up data were collected for comparison, evaluation of the therapeutic effect, and observation of adverse reactions. Results: All 9 patients were successfully treated with venous sinus stent. The pressure gradient at the distal and proximal ends of the stenosis after stent implantation decreased to (2.3±1.2) mmHg. After 6 months of follow-up, the papilledema was significantly improved or disappeared in all patients. The average grade of papilledema decreased from 2.44±0.73 before operation to 0.56±0.53 after treatment (t=6.314, P<0.001). The visual acuity of 9 patients recovered to the pre-onset level or improved significantly after 6 months. The average baseline value of preoperative visual acuity (logMAR) was 0.12±0.11, which increased to 0.74±0.13 on average 6 months after operation (t=-10.827, P<0.001). No recurrence of symptoms or serious adverse reactions occurred in all patients during the follow-up period. Conclusion: For patients with acute visual impairment caused by idiopathic cranial hypertension, emergency venous sinus stenting is a relatively safe and effective treatment that can effectively improve visual acuity.

Antimalarial agent artesunate induces G0/G1 cell cycle arrest and apoptosis via increasing intracellular ROS levels in normal liver cells

Artesunate (ARS) has been shown to be highly effective against chloroquine-resistant malaria. In vitro studies reported that ARS has anticancer effects; however, its detrimental action on cancer cells may also play a role in its toxicity toward normal cells and its potential toxicity has not been sufficiently researched. In this study, we investigated the possible cytotoxic effects using normal BRL-3A and AML12 liver cells. The results showed that ARS dose-dependently inhibited cell proliferation and arrested the G0/G1 phase cell cycle in both BRL-3A and AML12 liver cells. Western blotting demonstrated that ARS induced a significant downregulation of cyclin-dependent kinase-2 (CDK2), CDK4, cyclin D1, and cyclin E1 in various levels and then caused apoptosis when the Bcl-2/Bax ratio decreased. Conversely, the levels of intracellular reactive oxygen species (ROS) were increased. The ROS scavenger N-acetylcysteine can significantly inhibit cell cycle arrest and apoptosis induced by ARS. Thus, the data confirmed that ARS exposure impairs normal liver cell proliferation by inducing G0/G1 cell cycle arrest and apoptosis, and this detrimental action may be associated with intracellular ROS accumulation. Collectively, the possible side effects of ARS on healthy normal cells cannot be neglected when developing therapies.

Adjuvant therapy of Chinese herbal medicine for the treatment of adenomyosis: A protocol for systematic review

BACKGROUND

Adenomyosis is benign gynecologic condition with complex etiologies. Common symptoms associated with adenomyosis (AM) include menorrhagia, dysmenorrhea, chronic pelvic pain, metrorrhagia, and dyspareunia. Although Chinese herbal medicine (CHM) has often been utilized for managing AM in clinical practice in China, evidence regarding its efficacy is lacking. This systematic review protocol aims to describe a systematic review to assess the effectiveness and safety of CHM combined with Levonorgestrel-releasing intrauterine system for AM.

METHODS

The following 7 databases will be searched from the publishment to December 2019: the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, China National Knowledge Infrastructure (CNKI), Wanfang Digital Periodicals (WAN FANG), Chinese Biomedical Literature Database (CBM), Chinese Scientific Journal Database (VIP). The primary outcomes will be relief in pain and uterine bleeding. The secondary outcomes include the adverse effects, CA125 variation in peripheral blood, reduction in uterine volume, and endometrial thickness. We will use RevMan V.5.3 to conduct the meta-analysis, if possible. If it is not allowed, a descriptive analysis will be conducted. We will use risk ratio with 95% confidence interval for dichotomous data and the mean difference for continuous data.

RESULTS

This study will provide the latest analysis of the currently available evidence for the efficacy of the adjuvant therapy of CHM for the treatment of AM.

REGISTRATION NUMBER

OSF (DOI 10.17605/OSF.IO/A2GHY) ETHICS AND DISSEMINATION:: No ethical issues are required. The findings will be published in a peer-reviewed scientific journal.

0834 Different Neural Circuits Were Associated With Different Parts of Relationships Among Sleep, Pain and Anxiety in Women with Primary Dysmenorrhoea

Introduction

Although the relationships amongst sleep, pain and anxiety have been evidenced, the underlying neurological mechanisms remain elusive. Primary dysmenorrhea is a good model of spontaneous pain with clear painful (menstruation, state) and pain free (e.g., peri-ovulatory phase, trait) conditions. We sought to investigate the state- and trait-related neural signatures that link sleep and anxiety in primary dysmenorrhea.

Methods

Thirty female subjects with primary dysmenorrhea and 30 healthy female controls completed resting-state functional magnetic resonance imaging, the State-Trait Anxiety Inventory and sleep quality assessments during menstruation and peri-ovulatory phases. As we have reported that there was altered default mode network in the primary dysmenorrhea, posterior parietal cortex (PPC) was therefore chosen as the seed to elucidate the functional connectivity that may correlate with sleep and anxiety.

Results

The primary dysmenorrheic subjects exhibited sleep disturbances throughout the menstrual cycle with increased state anxiety. The primary dysmenorrheic subjects demonstrated significantly higher correlations between the sleep quality and the PPC-insula and -putamen functional connectivity during the peri-ovulatory phase. During menstruation, the primary dysmenorrheic subjects demonstrated significantly lower correlations between their state-anxiety scores and the PPC-occipital cortex functional connectivity.

Conclusion

After regressing out the effects of trait anxiety, the correlation between sleep quality and the PPC-putamen functional connectivity was not significant, indicating anxiety-mediated sleep-pain relationship. The PPC-insula functional connectivity, by contrast, was remained significant. Furthermore, state anxiety was associated with the PPC-occipital cortex functional connectivity that was significantly impaired in primary dysmenorrheic subjects. These findings hinted pain and anxiety mediating sleep quality in different neurological circuits.

Support

Taipei City Goverment(10401-62-046 and 10501-62-046)