A non-invasive 25-Gene PLNM-Score urine test for detection of prostate cancer pelvic lymph node metastasis

BACKGROUND

Prostate cancer patients with pelvic lymph node metastasis (PLNM) have poor prognosis. Based on EAU guidelines, patients with >5% risk of PLNM by nomograms often receive pelvic lymph node dissection (PLND) during prostatectomy. However, nomograms have limited accuracy, so large numbers of false positive patients receive unnecessary surgery with potentially serious side effects. It is important to accurately identify PLNM, yet current tests, including imaging tools are inaccurate. Therefore, we intended to develop a gene expression-based algorithm for detecting PLNM.

METHODS

An advanced random forest machine learning algorithm screening was conducted to develop a classifier for identifying PLNM using urine samples collected from a multi-center retrospective cohort (n = 413) as training set and validated in an independent multi-center prospective cohort (n = 243). Univariate and multivariate discriminant analyses were performed to measure the ability of the algorithm classifier to detect PLNM and compare it with the Memorial Sloan Kettering Cancer Center (MSKCC) nomogram score.

RESULTS

An algorithm named 25 G PLNM-Score was developed and found to accurately distinguish PLNM and non-PLNM with AUC of 0.93 (95% CI: 0.85-1.01) and 0.93 (95% CI: 0.87-0.99) in the retrospective and prospective urine cohorts respectively. Kaplan-Meier plots showed large and significant difference in biochemical recurrence-free survival and distant metastasis-free survival in the patients stratified by the 25 G PLNM-Score (log rank P < 0.001 and P < 0.0001, respectively). It spared 96% and 80% of unnecessary PLND with only 0.51% and 1% of PLNM missing in the retrospective and prospective cohorts respectively. In contrast, the MSKCC score only spared 15% of PLND with 0% of PLNM missing.

CONCLUSIONS

The novel 25 G PLNM-Score is the first highly accurate and non-invasive machine learning algorithm-based urine test to identify PLNM before PLND, with potential clinical benefits of avoiding unnecessary PLND and improving treatment decision-making.

An endoplasmic reticulum stress-related signature featuring ASNS for predicting prognosis and immune landscape in prostate cancer

Prostate cancer (PRAD) is one of the common malignant tumors of the urinary system. In order to predict the treatment results for PRAD patients, this study proposes to develop a risk profile based on endoplasmic reticulum stress (ERS). Based on the Memorial Sloan-Kettering Cancer Center (MSKCC) cohort and the Gene Expression Omnibus database (GSE70769), we verified the predictive signature. Using a random survival forest analysis, prognostically significant ERS-related genes were found. An ERS-related risk score (ERscore) was created using multivariable Cox analysis. In addition, the biological functions, genetic mutations and immune landscape related to ERscore are also studied to reveal the underlying mechanisms related to ERS in PRAD. We further explored the ERscore-related mechanisms by profiling a single-cell RNA sequencing (scRNA-seq) dataset (GSE137829) and explored the oncogenic role of ASNS in PRAD through in vitro experiments. The risk signature composed of eight ERS-related genes constructed in this study is an independent prognostic factor and validated in the MSKCC and GSE70769 data sets. The scRNA-seq data additionally revealed that several carcinogenic pathways were noticeably overactivated in the group with high ERS scores. As one of the prognostic genes, ASNS will significantly inhibit the proliferation, migration and invasion abilities of PRAD cells after its expression is interfered with. In conclusion, this study developed a novel risk-specific ERS-based clinical treatment strategy for patients with PRAD.

Effect of discharge opioid on persistent postoperative opioid use: a retrospective cohort study comparing tapentadol with oxycodone

Opioid harm can vary by opioid type. This observational study examined the effect of opioid type (oxycodone vs. tapentadol) on rates of persistent postoperative opioid use ('persistence'). We linked hospital and community pharmacy data for surgical patients who were dispensed discharge opioids between 1 January 2016 and 30 September 2021. Patients were grouped by opioid experience ('opioid-naive' having received no opioids in the 3 months before discharge) and formulation of discharge opioid (immediate release only or modified release ± immediate release). Mixed-effects logistic regression models predicted persistence (continued use of any opioid at 90 days after discharge), controlling for key persistence risk factors. Of the 122,836 patients, 2.31% opioid-naive and 27.24% opioid-experienced patients met the criteria for persistence. For opioid-naive patients receiving immediate release opioids, there was no significant effect of opioid type. Tapentadol modified release was associated with significantly lower odds of persistence compared with oxycodone modified release, OR (95%CI) 0.81 (0.69-0.94) for opioid-naive patients and 0.81 (0.71-0.93) for opioid-experienced patients. Among patients who underwent orthopaedic surgery (n = 19,832), regardless of opioid experience or opioid formulation, the odds of persistence were significantly lower for those who received tapentadol compared with oxycodone. This was one of the largest and most extensive studies of persistent postoperative opioid use, and the first that specifically examined persistence with tapentadol. There appeared to be lower odds of persistence for tapentadol compared with oxycodone among key subgroups, including patients prescribed modified release opioids and those undergoing orthopaedic surgery.

[Autophagy promotes recurrence of nasopharyngeal carcinoma via inducing the formation of dormant polyploid giant cancer cells]

Objective: To explore the effect of dormant polyploid giant cancer cells (PGCC) on nasopharyngeal carcinoma (NPC) recurrence and to clarify the role of inhibition of autophagy in inhibiting NPC-PGCC formation and preventing NPC recurrence. Methods: NPC cells-derived PGCC (NPC-PGCC) were induced by paclitaxel (PTX), and the morphology, polyploid characteristics and cell activity of PGCC were identified by light microscopy, immunofluorescence and Live/Dead cell double staining assays. RNA-seq was used to analyze the differentially expressed genes between NPC-PGCC and diploid nasopharyngeal carcinoma cells CNE2. Functional enrichment and pathway annotation analysis of differentially expressed genes were performed using Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG). The level of autophagy in NPC-PGCC cells was assessed by Western Blot and transmission electron microscopy analysis. The role of autophagy in the formation of NPC-PGCC and the effect of NPC-PGCC on the recurrence of nasopharyngeal carcinoma were studied using a highly clinically relevant mouse nasopharyngeal carcinoma recurrence model. Statistical analysis was performed using GraphPad Prism 6 and P-values<0.05 were considered statistically significant. Results: NPC-PGCC induced by paclitaxel had the characteristics of burst-like division after dormancy. GO enrichment and KEGG pathway analyses identified the significant biological processes and pathways mainly concentrated in autophagy and related pathways involving the differentially expressed genes between NPC-PGCC and diploid nasopharyngeal carcinoma cells CNE2. The autophagy level was significantly enhanced in NPC-PGCC cells. In a highly clinically relevant mouse nasopharyngeal carcinoma recurrence model, the number of PGCC in the primary tumor of the nude mice treated with cisplatin were higher than those of the other groups. In nude mice pretreated with autophagy inhibitor and then co-treatment with autophagy inhibitor and cisplatin, the number of PGCC in primary tumors was less and the recurrence rate was significantly lower than in other groups. Conclusions: The mechanism of dormant polyploid giant cancer cells formation is related to autophagy. Inhibition of autophagy can inhibit the formation of PGCC and thus prevent the recurrence of nasopharyngeal carcinoma.

Measurement of the Electric Dipole Moment of ^{171}Yb Atoms in an Optical Dipole Trap

The permanent electric dipole moment (EDM) of the ^{171}Yb (I=1/2) atom is measured with atoms held in an optical dipole trap. By enabling a cycling transition that is simultaneously spin-selective and spin-preserving, a quantum nondemolition measurement with a spin-detection efficiency of 50% is realized. A systematic effect due to parity mixing induced by a static E field is observed, and is suppressed by averaging between measurements with optical dipole traps in opposite directions. The coherent spin precession time is found to be much longer than 300 s. The EDM is determined to be d(^{171}Yb)=(-6.8±5.1_{stat}±1.2_{syst})×10^{-27}  e cm, leading to an upper limit of |d(^{171}Yb)|<1.5×10^{-26}  e cm (95% C.L.). These measurement techniques can be adapted to search for the EDM of ^{225}Ra.

Comprehensive analysis of the endoplasmic reticulum stress-related long non-coding RNA in bladder cancer

Background

Bladder cancer is ranked the second most frequent tumor among urological malignancies. The research strived to establish a prognostic model based on endoplasmic reticulum stress (ERS)-related long non-coding RNA (lncRNA) in bladder cancer.

Methods

We extracted the ERS-related genes from the published research and bladder cancer data from the Cancer Genome Atlas database. ERS-related lncRNAs with prognostic significance were screened by univariate Cox regression, least absolute shrinkage and selection operator regression analysis and Kaplan-Meier method. Multivariate Cox analysis was leveraged to establish the risk score model. Moreover, an independent dataset, GSE31684, was used to validate the model’s efficacy. The nomogram was constructed based on the risk score and clinical variables. Furthermore, the biological functions, gene mutations, and immune landscape were investigated to uncover the underlying mechanisms of the ERS-related signature. Finally, we employed external datasets (GSE55433 and GSE89006) and qRT-PCR to investigate the expression profile of these lncRNAs in bladder cancer tissues and cells.

Results

Six ERS-related lncRNAs were identified to be closely coupled with patients’ prognosis. On this foundation, a risk score model was created to generate the risk score for each patient. The ERS-related risk score was shown to be an independent prognostic factor. And the results of GSE31684 dataset also supported this conclusion. Then, a nomogram was constructed based on risk scores and clinical characteristics, and proven to have excellent predictive value. Moreover, the gene function analysis demonstrated that ERS-related lncRNAs were closely linked to fatty extracellular matrix, cytokines, cell adhesion, and tumor pathways. Further analysis revealed the association of the 6-lncRNAs signature with gene mutations and immunity in bladder cancer. Finally, the external datasets and qRT-PCR verified high expressions of the ERS-related lncRNAs in bladder cancer tissues and cells.

Conclusions

Overall, our findings indicated that ERS-related lncRNAs, which may affect tumor pathogenesis in a number of ways, might be exploited to assess the prognosis of bladder cancer patients.

[Imaging features of developmental stenosis of atlas with degenerative cervical myelopathy]

Objective: To investigate the imaging features of patients with developmental stenosis of atlas (small atlas) complicated with degenerative cervical myelopathy and to explore the diagnostic criteria of small atlas. Methods: The clinical data of patients with degenerative cervical myelopathy treated by posterior cervical laminoplasty and resection of posterior arch of atlas from 2006 to 2020 in the Department of Orthopedics, Peking University Third Hospital were retrospectively analyzed. Sixteen cases had spinal cord compression at C₁ level after the exclusion of ossification of cervical posterior longitudinal ligament (OPLL) and other pathology. These cases were suspected small atlas (small atlas group). Forty-six cases without posterior arch resection in the same period were selected as control group. The middle sagittal diameter of atlas and the vertical distance from posterior tubercle of atlas to occipitoaxial line under CT in both groups were compared. The sagittal diameter of the spinal canal at the atlas level under MRI, the Japanese Orthopaedic Association (JOA) score for functional state of cervical spine before operation and at last follow-up were also measured. Results: There were 9 males and 7 females in the small atlas group, aged (63±12) years. There were 21 males and 25 females in the control group, aged (57±10) years. The patients in both group were followed-up for at least one year. The sagittal diameter of atlas in the small atlas group was (26.4±3.1) mm, which was significantly smaller than that in the control group [(29.6±2.2) mm, P=0.010]. The vertical distance from the posterior tubercle of atlas to the occipitoaxial line in the small atlas group was larger than that in the control group[(6.79±1.17) mm vs (5.57±1.29) mm, P=0.001]. The diameter of atlas canal in the small atlas group was (8.25±1.44) mm which was significantly smaller than that in the control group [(13.00±1.66) mm, P<0.001]. The JOA score of the small atlas group before operation and at the last follow-up were both slightly lower than that in the control group (both P<0.05), but there was no significant difference in the recovery rate of JOA score between the two groups (61.9% vs 66.0%, P=0.066). Among the 16 cases in the small atlas group, 5 cases of occipital-axial connection were located at the posterior 1/3 of the posterior arch of atlas, and 11 cases of occipital-axial connection were completely located at the posterior arch of atlas. Conclusions: The effective sagittal diameter of atlas is smaller in small atlas group which can lead to more severe cervical myelopathy. The presence of a small atlas should be highly suspected when the sagittal diameter of atlas canal is less than 26 mm under CT. The existence of the small atlas should be alert when the occipitalaxial line is located at the dorsal 1/3 or behind of the posterior arch of atlas.

Tislelizumab versus chemotherapy as second-line treatment of advanced or metastatic esophageal squamous cell carcinoma (RATIONALE 302): impact on health-related quality of life

Background

RATIONALE 302 (NCT03430843) an open-label, phase III study of second-line treatment of advanced/metastatic esophageal squamous cell carcinoma (ESCC), reported that tislelizumab, relative to investigator-chosen chemotherapy (ICC), was associated with improvements in overall survival and a favorable safety profile. This study assessed the health-related quality of life (HRQoL) and ESCC-related symptoms of patients in RATIONALE 302.

Methods

Adults with advanced/metastatic ESCC whose disease progressed following prior systemic therapy were randomized 1 : 1 to receive either tislelizumab or ICC (paclitaxel, docetaxel, or irinotecan). HRQoL was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 items (EORTC QLQ-C30), the EORTC Quality of Life Questionnaire Oesophageal Cancer Module 18 items (QLQ-OES18), and the EuroQoL Five-Dimensions Five-Levels (EQ-5D-5L) visual analogue scale. Mixed effect modeling for repeated measurements examined changes from baseline to weeks 12 and 18. The Kaplan–Meier method was used to examine time to deterioration.

Results

Overall, 512 patients were randomized to tislelizumab (n = 256) or ICC (n = 256). The tislelizumab arm maintained QLQ-C30 global health status/quality whereas the ICC arm worsened at week 12 {difference in least square (LS) mean change: 5.8 [95% confidence interval (CI): 2.0-9.5], P = 0.0028} and week 18 [difference in LS mean change: 8.1 (95% CI: 3.4-12.8), P = 0.0008]. Physical functioning (week 18) and fatigue (weeks 12 and 18) worsened less in the tislelizumab compared with the ICC arm. The tislelizumab arm improved in reflux symptoms, whereas the ICC worsened at week 12 [difference in LS mean change: −4.1 (95% CI: −7.6 to −0.6), P = 0.0229]. The visual analogue scale remained consistent in the tislelizumab arm whereas it worsened in the ICC arm. The hazard of time to deterioration was lower in tislelizumab patients compared with ICC for physical functioning and reflux.

Conclusions

HRQoL, including fatigue symptoms and physical functioning, was maintained in patients with advanced or metastatic ESCC receiving tislelizumab compared with ICC-treated patients. These results provide additional support for the benefits of tislelizumab in this patient population.

•

Global health status and HRQoL remained consistent in the tislelizumab arm whereas the ICC arm experienced worsening.

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Fatigue and physical functioning worsened in both arms; however, the worsening was greater in the ICC arm.

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The tislelizumab arm was at lower risk of reaching the threshold for worsening in physical functioning and reflux.

Effect of dietary protein and energy intake on embryonic survival and gene expression in the uterine endometrium of early pregnant gilts

Porcine embryonic loss during early gestation is a serious problem in swine production. Improving embryonic survival can be achieved by maternal manipulation. Protein and energy are two major components of the diet, which play decisive roles in embryonic survival. This study was performed to evaluate the effects of enhancing maternal protein or energy intake on embryonic survival during early gestation in gilts and to explore the underlying mechanism. From day (d) 0 to 30 of gestation, 40 gilts (Landrace × York) were randomly allocated to 5 diets according to daily intake of low (L, National Research Council (NRC) recommendation for gestation gilts), medium (M, 20% higher than NRC) or high (H, 40% higher than NRC) CP or metabolisable energy (ME) (L_CPL_ME, M_CPL_ME, H_CPL_ME, L_CPH_ME, H_CPH_ME). Gilts were sacrificed on d 30 of gestation, and number of foetuses and corpora lutea, embryonic survival rate, uterine weight, and total volume of allantoic fluid were recorded or calculated. Gene expression was determined by Quantitative Real-time PCR (qPCR), western blot or immunohistochemistry. Results showed that increasing protein or ME intake significantly increased embryonic survival rate. Compared with diet L_CPL_ME, plasma progesterone (P4) concentration in diet L_CPH_ME increased at d 14 and d 30 of gestation. Progesterone receptor (PGR) was found not to be expressed in the epithelia but was strongly expressed in the stroma of the endometrium. Increasing protein or ME intake did not alter PGR expression in the endometrium. There was also no change in the amount of P4, hepatocyte growth factor, and fibroblast growth factor-7 in the endometrium. The mRNA abundance of cationic amino acid transporter 1 in the endometrium in diet L_CPH_ME and H_CPH_ME was significantly lower than in diet L_CPL_ME. Diet H_CPL_ME showed a tendency to increase neutral amino acid transporter 1 mRNA expression in the endometrium compared to diet L_CPL_ME (P = 0.087). In conclusion, increasing maternal protein or ME intake had a positive effect on the embryonic survival. Increased protein intake by 20 or 40% did not alter plasma P4 level, but increasing ME intake by 40% improved plasma P4 concentration at d 14 and 30 of gestation. Increasing maternal protein or ME intake did not induce PGR expression in the endometrium. Maternal protein and energy intake likely mediate transportation of cationic and neutral amino acids from mother to foetus to affect embryonic survival and development.

[The application value of plasma heterogeneous nuclear ribonucleoprotein A2/B1, Aβ42 and P-tau in the preoperative diagnosis of mild cognitive dysfunction]

Objective: To explore the application value of plasma heterogeneous nuclear ribonucleoprotein A2/B1(hnRNP A2B1), β-amyloid 42(Aβ₄₂) and phosphorylated tau protein(P-tau) levels in elderly patients in the preoperative diagnosis of mild cognitive impairment(MCI). Methods: A total of 200 patients who underwent elective surgery at Tianjin Third Central Hospital from June 2020 to March 2021were Enrolled, regardless of gender, age 65-80 years old. According to the international MCI working group standards and the European Alzheimer's Disease Federation working group standards, patients were divided into MCI group and control group. There were 58 males and 42 females in each group. The patient's plasma hnRNP A2/B1, Aβ₄₂ and P-tau levels were detected before operation. The sensitivity, specificity and accuracy of the diagnosis of MCI were calculated. The receiver operating characteristic curve were drew to evaluate the diagnostic value of each index. Results: The plasma levels of hnRNP A2/B1, Aβ₄₂ and P-tau in the MCI group were 310.0 (275.1, 344.2), 34.5 (24.9, 42.5), 190.4 (150.4, 301.7) ng/L, respectively, which were significantly higher than those of the control group [272.7 (239.6, 291.5), 18.7 (14.7, 26.6), 140.0 (101.8, 217.5) ng/L]. The differences were statistically significant (all P<0.05). Taking the international MCI working group standard as the gold standard, the sensitivity, specificity and area under the ROC curve (AUC) of plasma hnRNP A2/B1 for predicting MCI were 80%, 61%, and 0.781, respectively. The sensitivity, specificity and AUC of plasma Aβ₄₂ for predicting MCI were 78%, 73%, and 0.744. The sensitivity, specificity, and AUC of P-tau for predicting MCI were 51%, 79%, and 0.675, respectively. The sensitivity, specificity and AUC of hnRNP A2/B1 and Aβ₄₂ in predicting MCI were not statistically significant (all P>0.05), but the sensitivity of both were higher than P-tau (all P<0.001). Compared with P-tau, the AUC of plasma hnRNP A2/B1 was higher when predicting MCI (P<0.05). When the three indicators were combined, the sensitivity was 82%, and the AUC was 0.842, both of which were the highest, but the specificity reduced (71%) (all P<0.05). Conclusions: Plasma hnRNP A2/B1 combined with Aβ₄₂ and P-tau levels can improve the sensitivity and accuracy of MCI diagnosis in elderly MCI patients before surgery, and have the greatest diagnostic efficiency. It has certain application value.

[Clinical effect of minimally invasive duodenum preserving pancreatic head resection for benign and pre-malignant lesions of pancreatic head]

Objective: To examine the clinical effect of minimally invasive duodenum preserving pancreatic head resection(DPPHR) for benign and pre-malignant lesions of pancreatic head. Methods: The clinical data of patients with diagnosis of benign or pre-malignant pancreatic head tumor were retrospectively collected and analyzed,all of them underwent laparoscopic or robotic DPPHR between October 2015 and September 2021 at Division of Gastrointestinal and Pancreatic surgery,Zhejiang Provincial People's Hospital. Thirty-three patients were enrolled with 10 males and 23 females. The age(M(IQR)) was 54(32) years old(range: 11 to 77 years old) with body mass index of 21.9(2.9)kg/m²(range: 18.1 to 30.1 kg/m²). The presenting symptoms included abdominal pain(n=12), Whipple triad(n=2), and asymptomatic(n=19), among them there were 7 patients with hypertension and 1 patient with diabetes mellitus. There were 19 patients diagnosed as American Society of Anesthesiologists class Ⅰ and 14 patient as class Ⅱ. The student t test,U test, χ² test or Fisher exact test was used to compare continuous data or categorized data,respectively. All the perioperative data and metabolic morbidity were analyzed and experiences on minimally invasive DPPHR was concluded. Results: Fourteen patients underwent laparoscopic DPPHR,while the rest of 19 patients received robotic DPPHR. Indocyanine green fluorescence imaging was used in 19 patients to guide operation. Five patients were performed pancreatico-gastrostomy and the rest 28 patients underwent pancreaticojejunostomy. Pathological outcomes confirmed 9 solid pseudo-papillary neoplasms, 9 intraductal papillary mucinous neoplasms, 7 serous cystic neoplasms, 6 pancreatic neuroendocrine tumors, 1 mucous cystic neoplasm, 1 chronic pancreatitis. The operative time was (309.4±50.3) minutes(range:180 to 420 minutes),and the blood loss was (97.9±48.3)ml(range:20 to 200 ml). Eighteen patients suffered from postoperative complications,including 3 patients experienced severe complications(Clavien-Dindo Grade ≥Ⅲ). Pancreatic fistula occurred in 16 patients,including 8 patients with biochemical leak,7 patients with grade B pancreatic fistula and 1 patient with grade C pancreatic fistula. No one suffered from the duodenal necrosis and none perioperative death was occurred. The length of hospital stay was 14(7) days (range:6 to 87 days). The follow-up was 22.6(24.5)months(range:2 to 74 months). None suffered from recurrence or metastasis. During the follow-up,all the patients were free of refractory cholangitis. Moreover,in the term of endocrine dysfunction,no postoperative new onset of diabetes mellitus were observed in the long-term follow-up. However,in the view of exocrine insufficiency,pancreatic exocrine insufficiency and non-alcoholic fatty liver disease (NAFLD) was complicated in 2 and 1 patient,respectively,with the supplement of pancreatic enzyme,steatorrhea and weight loss relieved,but NAFLD was awaited to be seen. Conclusions: Minimally invasive DPPHR is feasible and safe for benign or pre-malignant lesions of pancreatic head. Moreover,it is oncological equivalent to pancreaticoduodenectomy with preservation of metabolic function without refractory cholangitis.

Androgen receptor suppresses inflammatory response of airway epithelial cells in allergic asthma through MAPK1 and MAPK14

BACKGROUND

Dysfunction of airway epithelial cells in patients with asthma is closely with the occurrence and development of allergic asthma. Finding the differences of airway epithelium between asthmatic patients and normal patients is helpful to find out new treatment strategies.

METHODS

First, three original microarray datasets (GSE89809, GSE41861, GSE104468) from the Gene Expression Omnibus (GEO) dataset were used to assess differentially expressed genes in the epithelial tissues between patients with allergic asthma and healthy controls. Then, 10 ng/mL TGF-β1 treated BEAS-2B cells and rats with ovalbumin induced allergic asthma were performed to confirm our assumption from the gene expression analysis with microarrays.

RESULTS

Top ten hub significant difference genes were obtained by Cytohubba plug-in from GSE41861, and found that androgen receptor (AR) was closely associated with the mitogen-activated protein kinase (MAPK) pathway, especially MAPK1 and MAPK14. After treated with the TGF-β1 treated BEAS-2B cells and rats with allergic asthma, we found that 5α-dihydrotestosterone (5α-DHT), AR agonist, significantly decreased the Th2 inflammation (IL-25 and IL-33), MAPK1 and MAPK14 proteins expression in vitro and in vivo. The roles of 5α-DHT were similar with the results of chicanine (a p38 MAPK and ERK1/2 inhibitor), but the roles of 5α-DHT were masked by the C16-PAF (a MAPK and MEK/ERK activator) treatment.

CONCLUSION

Androgen receptor limits the secretion of Th2 inflammatory factors by downregulating MAPK1 and MAPK14 in the TGF-β1 treated BEAS-2B cells and rats with ovalbumin induced allergic asthma, which plays a critical role for the therapeutics of patients with asthma.

Non-invasive Urine Test for Molecular Classification of Clinical Significance in Newly Diagnosed Prostate Cancer Patients

Objective: To avoid over-treatment of low-risk prostate cancer patients, it is important to identify clinically significant and insignificant cancer for treatment decision-making. However, no accurate test is currently available.

Methods: To address this unmet medical need, we developed a novel gene classifier to distinguish clinically significant and insignificant cancer, which were classified based on the National Comprehensive Cancer Network risk stratification guidelines. A non-invasive urine test was developed using quantitative mRNA expression data of 24 genes in the classifier with an algorithm to stratify the clinical significance of the cancer. Two independent, multicenter, retrospective and prospective studies were conducted to assess the diagnostic performance of the 24-Gene Classifier and the current clinicopathological measures by univariate and multivariate logistic regression and discriminant analysis. In addition, assessments were performed in various Gleason grades/ISUP Grade Groups.

Results: The results showed high diagnostic accuracy of the 24-Gene Classifier with an AUC of 0.917 (95% CI 0.892–0.942) in the retrospective cohort (n = 520), AUC of 0.959 (95% CI 0.935–0.983) in the prospective cohort (n = 207), and AUC of 0.930 (95% 0.912-CI 0.947) in the combination cohort (n = 727). Univariate and multivariate analysis showed that the 24-Gene Classifier was more accurate than cancer stage, Gleason score, and PSA, especially in the low/intermediate-grade/ISUP Grade Group 1–3 cancer subgroups.

Conclusions: The 24-Gene Classifier urine test is an accurate and non-invasive liquid biopsy method for identifying clinically significant prostate cancer in newly diagnosed cancer patients. It has the potential to improve prostate cancer treatment decisions and active surveillance.

[Analysis on the difference between life expectancy and healthy life expectancy in Shanghai]

Objective: To analyze the difference of life expectancy and healthy life expectancy among Shanghai residents of different gender and age groups. Methods: Compare the trends of life expectancy among Shanghai and other longevity countries/regions. With the disability weights of GBD, Sullivan method was applied to calculate the healthy life expectancy in Shanghai and analyze the loss of healthy life years among the population of different age groups and genders. Results: In the past 40 years, life expectancy had increased by 10.86 years in Shanghai. In 2016, the life expectancy of Shanghai residents was 83.18 years old, and 80.83 years old for males and 85.61 years old for females. The healthy life expectancy of Shanghai residents was 69.46 years, and 68.68 years for males and 70.23 years old for females. The gap with life expectancy was 13.72 years old, 12.15 years old and 15.38 years old, respectively. They account for 16.49%, 15.02% and 17.97% of life expectancy, respectively. The healthy life expectancy of women in all age groups is higher than that of men with the average gap of 1.76 years. The difference between the two is as small as 1.36 years at 20-24 years old, and as large as 2.24 years at 70-74 years old. The loss rate of healthy life expectancy increases with age, with women higher than men before age 65 and vice versa after age 65 years old. Conclusions: The life expectancy in Shanghai has reached the world leading level, but the healthy life loss is still large. It is necessary to further improve the life quality with the reducing mortality rate, especially for women and men over 65 years old.

[Analysis on adult health life expectancy in Shanghai]

Objective: To investigate health status and calculate health life expectancy (HE) of residents in Shanghai, analyze health related factors and provided foundation of health policy. Methods: A multi-stage stratified random sampling was used to obtain self-reported health survey in Shanghai. WHO questionnaire was used to evaluate the health quality of life which was designed for the world health survey, Sullivan's method was used to calculate HE. Results: The self-assessment disability measure for adults over 18 years old in Shanghai was 0.25, higher for women (0.28) than for men (0.23). LE was 65.76 years for adults over 18 years old, higher for women (68.22) than for men (63.39). HE for adults over 18 years old was 47.99 years old, higher for men (49.05) than women (47.14). HE's proportion in LE gradually decreases with age. It accounts for 72.97% in the 18 years old and 39.00% in the 85 years old. Conclusions: The health of adult male in Shanghai is higher than that of female, and the proportion of HE loss of elderly is higher than young people. It is necessary to focus on the aging problem and strengthen the long-term care and health support system for the elderly. Improve the prevention and control of major diseases such as chronic diseases,which affect the quality of life expectancy seriously. Promotes the health level and quality of life in Shanghai.

Estrogen enhances the expression of a growth-associated long noncoding RNA in chicken liver via ERα

1. The long noncoding RNA lncGLM is significantly differentially expressed in the livers of peak-laying hens compared with that in the livers of pre-laying hens, but its potential biological role and expression regulation are unclear.2. To explore the potential biological function of lncGLM, single nucleotide polymorphism (SNP) detection and association analysis were carried out in the Gushi×Anka F₂ resource population.3. The tissues and spatiotemporal expression characteristics of lncGLM were analysed by real-time quantitative PCR. The effects of 17β-oestradiol on the expression of lncGLM expression were analysed through in vitro and in vivo experiments.4. The results showed that a g.19069338 T > C SNP was present in lncGLM. Association analysis revealed that lncGLM was significantly associated with body slanting length at 12 weeks, body weight at 12 weeks, shank length at four weeks, chest depth at eight weeks, pelvic width at 12 weeks, eviscerated weight, head weight, pancreas weight, pectoralis weight, leg muscle weight, muscular stomach weight rate, pancreas weight rate, carcase weight, aspartate aminotransferase, creatinine and pectoral muscle water loss rate.5. The expression of lncGLM in the liver was higher than that in other sampled tissues. In addition, the expression of lncGLM in the liver was significantly higher in the peak-laying period than at the pre-laying period. Both in vitro and in vivo experiments showed that lncGLM expression was regulated by 17β-oestradiol via oestrogen receptor alpha (ER-α). These results demonstrated that the chicken lncGLM gene is highly expressed in liver tissue and regulated by oestrogen through ER-α.

CT phenotypes in mild-to-moderate chronic obstructive pulmonary disease: difference before and after the age of 60 years

AIM

To investigate the pulmonary phenotype of mild-to-moderate chronic obstructive pulmonary disease (COPD) using quantitative computed tomography CT analysis techniques.

MATERIALS AND METHODS

Sixty-three patients with stable-phase mild-to-moderate COPD and 78 healthy controls, categorised as those aged <60 (28 and 40 patients, respectively) and ≥60 years (35 and 38, respectively), underwent chest low-dose respiratory dual-phase CT and pulmonary function test. Automatic software was used to measure the proximal airway parameters, and the emphysema and air-trapping indices were recorded. The intergroup differences in each parameter were assessed by one-way analysis of variance.

RESULTS

At <60 years of age, the mean Pi10WA (Wall area of a hypothetical airway with an internal perimeter of 10 mm) was greater in the mild-to-moderate COPD group than in the healthy control group (17.04 ± 1.63 versus 16.03 ± 1.16 mm²; p=0.004). Mild or moderate air-trapping was observed in the mild-to-moderate COPD group aged <60 years. There was no significant difference in the proximal airway parameters and inspiratory VI_-950 (percent voxels less than -950 HU) between the two groups at age ≥60 years (all p>0.05); however, the expiratory VI_-856 (percent voxels less than -856 HU) and mean lung density expiratory/inspiratory ratio (MLD_E/I) were higher in the mild-to-moderate COPD group than those in the healthy control group (26.02 [30.23] versus 6.45 [11.16]; 0.88 ± 0.05 versus 0.84 ± 0.04; p<0.001 and p=0.024).

CONCLUSION

For patients with mild-to-moderate COPD, the CT phenotype was predominantly the "airway remodelling" type at <60 years of age, and the "air-trapping" type at ≥60 years of age. Thus, pulmonary CT phenotypes of mild-to-moderate COPD patients of different age groups are different.

[The correlation between the severity of uncovertebral joints degeneration and heterotopic ossification after single-level artificial cervical disc replacement]

Objective: To investigate the correlation between the severity of uncovertebral joints degeneration and heterotopic ossification (HO) after single-level artificial cervical disc replacement (ACDR). Methods: From January 2005 to January 2016, 70 patients who had undergone single-level ACDR in Peking University Third Hospital and had at least 5 years follow-up were included in this study. There were 35 males and 35 females with an average age of (42±8) years (range, 25-62 years). Cervical spine A-P X-rays were taken to assess the degeneration of uncovertebral joints and lateral X-rays were taken to assess the degeneration of intervertebral space. Cervical spine lateral and the flexion-extension X-rays at 5 years follow up were taken to assess HO. Degeneration of uncovertebral joints were evaluated by the classification system set-up in Peking University Third Hospital. Kellgren&Lawrence grading system was used to evaluate the degeneration of intervertebral space. HO was evaluated by the McAfee grading standards. The data were collected before surgery and at 5-years follow-up, then the correlation between degeneration of uncovertebral joints, degeneration of intervertebral space and HO was analyzed with Spearman non-parametric test. Results: The average follow-up time of 70 patients was (62.7±4.8) years (range, 52-74 months). There was a significant positive correlation between preoperative uncovertebral joints degeneration and HO after ACDR (r=0.585, P<0.01). There was a significant positive correlation between preoperative intervertebral space degeneration and HO (r=0.557, P<0.01). There was a significant positive correlation between preoperative intervertebral space degeneration and preoperative uncovertebral joints degeneration (r=0.727, P<0.01). Conclusion: There is a significant positive correlation between preoperative uncovertebral joints degeneration and HO after ACDR.

Development and validation of a 25-Gene Panel urine test for prostate cancer diagnosis and potential treatment follow-up

BACKGROUND

Heterogeneity of prostate cancer (PCa) contributes to inaccurate cancer screening and diagnosis, unnecessary biopsies, and overtreatment. We intended to develop non-invasive urine tests for accurate PCa diagnosis to avoid unnecessary biopsies.

METHODS

Using a machine learning program, we identified a 25-Gene Panel classifier for distinguishing PCa and benign prostate. A non-invasive test using pre-biopsy urine samples collected without digital rectal examination (DRE) was used to measure gene expression of the panel using cDNA preamplification followed by real-time qRT-PCR. The 25-Gene Panel urine test was validated in independent multi-center retrospective and prospective studies. The diagnostic performance of the test was assessed against the pathological diagnosis from biopsy by discriminant analysis. Uni- and multivariate logistic regression analysis was performed to assess its diagnostic improvement over PSA and risk factors. In addition, the 25-Gene Panel urine test was used to identify clinically significant PCa. Furthermore, the 25-Gene Panel urine test was assessed in a subset of patients to examine if cancer was detected after prostatectomy.

RESULTS

The 25-Gene Panel urine test accurately detected cancer and benign prostate with AUC of 0.946 (95% CI 0.963-0.929) in the retrospective cohort (n = 614), AUC of 0.901 (0.929-0.873) in the prospective cohort (n = 396), and AUC of 0.936 (0.956-0.916) in the large combination cohort (n = 1010). It greatly improved diagnostic accuracy over PSA and risk factors (p < 0.0001). When it was combined with PSA, the AUC increased to 0.961 (0.980-0.942). Importantly, the 25-Gene Panel urine test was able to accurately identify clinically significant and insignificant PCa with AUC of 0.928 (95% CI 0.947-0.909) in the combination cohort (n = 727). In addition, it was able to show the absence of cancer after prostatectomy with high accuracy.

CONCLUSIONS

The 25-Gene Panel urine test is the first highly accurate and non-invasive liquid biopsy method without DRE for PCa diagnosis. In clinical practice, it may be used for identifying patients in need of biopsy for cancer diagnosis and patients with clinically significant cancer for immediate treatment, and potentially assisting cancer treatment follow-up.

[Clinical analysis of minimal invasive surgical treatment for pancreatic neuroendocrine tumors]

Objective: To analyze the safety and effectiveness of minimal invasive surgery treating pancreatic neuroendocrine tumors (pNETs), and to summarize surgical characteristics and share experience. Methods: The clinical data of 80 pNETs treated by a single hospital from January 2015 to December 2019 were retrospectively analyzed. The patients were divided into laparoscopic group and robot group. And surgical procedures included pancreaticoduodenectomy (PD), distal pancreatectomy (DP), central pancreatectomy (CP), and tumor enucleation. Results: Of 80 patients, 76 cases (95%) underwent minimal invasive surgery and 4 cases (5%) changed to open surgery. There were 38 females, with median age of 54.4 (20-80) years and median BMI (17.0-38.0) kg/m(2). Among them, 24 patients (31.6%) underwent PD, 36 patients (47.4%) underwent DP, 8 patients (10.5%) underwent CP and 8 patients (10.5%) received tumor enucleation. The postoperative incidence of grade B/C pancreatic fistula was 35.5%, the incidence of abdominal infection was 10.5%, the postoperative bleeding was 7.9%, and the reoperation rate was 6.6%, without perioperative deaths. There was no significant difference in postoperative complications among different surgical methods, including postoperative pancreatic fistula (P=0.396), postoperative bleeding (P=0.297), postoperative abdominal infection (P=0.339) and reoperation (P=0.396). Conclusions: Surgical resection is an effective treatment for pNETs. pNETs are suitable for minimally invasive surgery with earlier stage and smaller tumor diameter. Minimally invasive surgery for pNETs is safe and feasible, and functional preserving surgery could take into consideration.

MiR-21 promotes fracture healing by activating the PI3K/Akt signaling pathway

OBJECTIVE

This study aims to elucidate the potential mechanism of micro ribonucleic acid (miR)-21 in promoting fracture healing.

MATERIALS AND METHODS

30 male Sprague-Dawley rats were randomly divided into group A (phosphate-buffered saline, PBS, n=10), group B (AntagomiR-21, n=10) and group C (AntagomiR-NC, n=10) according to the different treatments. The femoral fracture operation was performed in every rat, which was pathologically diagnosed via X-ray. After the successful modeling, 50 μL (2 nmoL) PBS, 50 μL AntagomiR-21 or 50 μL AntagomiR-NC was intraperitoneally injected into rats in group A, B or C, respectively. The above agents were injected once a week for 6 weeks. At 6 weeks, 3 rats were executed in each group, and the tissue at the fracture end was observed via hematoxylin-eosin (HE) staining. The fracture healing of rats was evaluated via imaging at 1 and 7 weeks. At the same time, the expression of miR-21 in the three groups was detected via Reverse Transcription-Polymerase Chain Reaction (RT-PCR), and the expression of phosphatidylinositol 3-hydroxy kinase (PI3K) and phosphorylated-serine/threonine-protein kinase B (p-Akt) in the three groups was detected via Western blotting.

RESULTS

According to the histological staining, the bone repair at the fracture end of rats in group B was not significant with fracture and poor continuity compared with those in group A and group C. The imaging evaluation revealed that in group B, the callus tissues were significantly reduced, the fracture line had undesirable healing. There were no displacement and loosening of internal fixation compared with group A and group C. Besides, RT-PCR showed that the miR-21 expression declined markedly in group B compared with that in group A and group C, and the differences were statistically significant (p<0.05). Western blotting manifested that the protein levels of PI3K and p-Akt also declined in group B compared with those in group A and group C, and there were statistically significant differences (p<0.05).

CONCLUSIONS

MiR-21 promotes the fracture healing in fractured rats by activating the PI3K/Akt signaling pathway.

[Early experience of minimal invasive surgery for adolescent with pancreatic head tumor: a report of 15 cases]

Objective: To summarize the characteristics and difficulties of minimal invasive surgery for adolescent with pancreatic head tumor. Methods: The data of adolescent younger than 28 years old with pancreatic head tumor treated at Department of Gastroenterology and Pancreatic Surgery, Zhejiang Province People's Hospital from January 2014 to December 2019 were analyzed retrospectively. Fifteen cases were enrolled, included 5 males and 10 females. The median age was 20 years(range: 11 to 27 years) and the body mass index was (19.8±2.3)kg/m(2)(range: 17.3 to 21.6 kg/m(2)). Results: Standard pancreaticoduodenectomy was performed in 12 cases, including 9 cases of laparoscopic surgery and 3 cases of robotic-assisted surgery, and laparoscopic pancreaticoduodenectomy with resection of hepatic flexure of colon was performed on 1 case, and robotic-assisted duodenum-preserving pancreatic head resection with pancreatogastrostomy was performed on other 2 cases. The operative time was (269.0±65.1)minutes(range: 150 to 410 minutes), and the blood loss was (135.6±52.7)ml(range: 50 to 400 ml). Six patients got postoperative complications with gastrointestinal bleeding biochemical leakage and intestinal obstruction(n=1), pancreatic biochemical leakage(n=1), bile leakage(n=1), chylous leakage(n=1), wound infection(n=1), hepatic injury(n=1). The median postoperative hospital stay was 13 days(range: 9 to 22 days).The pathologic findings were solid pseudopapillary neoplasms(n=8), neuroendocrine neoplasms(n=3), introductal papillary mucinous neoplasm(n=1), cystic fibroma(n=1), serous cystadenoma(n=1), Ewing sarcoma(n=1).The median follow-up was 37 months(range: 2 to 75 months).The patient with Ewing sarcoma was diagnosed as liver metastasis at 41 months after surgery and died at 63 months after surgery.All the other patients survived without tumor.Three patients got the long-term complication of bile duct. Conclusions: Most of pancreatic head tumors for adolescent are benign or low malignant. Minimally invasive surgery be the first choice, and function-preserving surgery should be taken into account as much as possible.Perioperative management and communication is essential as the parents pay much attention to the quality of life after surgery.

Inactivation of airborne porcine reproductive and respiratory syndrome virus (PRRSv) by a packed bed dielectric barrier discharge non-thermal plasma

Porcine reproductive and respiratory syndrome virus (PRRSv) is one of the most significant airborne viruses impacting the pork industry in the US. Non-thermal plasmas (NTPs) are electrical discharges comprised of reactive radicals and excited species that inactivate viruses and bacteria. Our previous experiments using a packed bed NTP reactor demonstrated effective inactivation of bacteriophage MS2 as a function of applied voltage and power. The present study examined the effectiveness of the same reactor in inactivating aerosolized PRRSv. A PRRSv solution containing ∼10⁵ TCID₅₀/ml of PRRSv VR2332 strain was aerosolized at 3 ml/min by an air-jet nebulizer and introduced into 5 or 12 cfm air flow followed by NTP exposure in the reactor. Twin impingers upstream and downstream of the reactor collected samples of the virus-laden air flow for subsequent TCID₅₀ assay and qPCR analyses. An optical particle sizer measured upstream and downstream aerosol size distributions, giving estimates of aerosol filtration by the reactor. The results showed that PRRSv was inactivated to a similar degree as MS2 at the same conditions, with the maximum 1.3-log inactivation of PRRSv achieved at 20 kV and 12 cfm air flow rate. The results demonstrate the potential of properly optimized NTPs in controlling PRRSv transmission.

[Laparoscopic gastroduodenostomy with manual suture for Billroth Ⅰ anastomosis: a report of 36 cases]

Objective: To examine the clinical efficiency of laparoscopic gastroduodenostomy with BillrothⅠanastomosis with manual suture. Methods: The clinic data of 36 patients with gastric cancer who underwent laparoscopic gastroduodenostomy with Billroth Ⅰ anastomosis from November 2017 to September 2019 in Department of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People's Hospital were analyzed retrospectively.There were 22 males and 14 females, aged (64.3±9.3) years(range: 43 to 80 years), underwent complete laparoscopic gastroduodenostomy. The laparoscopic manual suture was used for Billroth Ⅰ anastomosis. Results: All the laparoscopic radical gastrectomy and manual suturing gastroduodenostomy were successfully performed. The operation time was (226.7±40.4) minutes (range: 180 to 320 minutes), including (24.8±7.1) minutes (range: 15 to 48 minutes) for gastroduodenostomy.There was (3.8±0.9) days (range: 2 to 6 days) for anal exhaust, (5.7±2.0) days (range: 3 to 13 days) for extubation of gastric tube, and (10.3±3.1) days (range: 7 to 19 days) for hospitalization. There was no death in perioperative period. Postoperative pathological report showed 3 cases of highly differentiated adenocarcinoma, 5 cases of moderately differentiated adenocarcinoma, 22 cases of poorly differentiated adenocarcinoma and 6 cases of signet ring cell carcinoma, including 27 cases in T1 stage and 9 cases in T2 stage. The number of lymph nodes harvested was 36.4±8.9 (range: 23 to 60). Lymph node metastasis was positive in 7 cases and negative in 29 cases. TNM stage included 24 cases in ⅠA stage, 8 cases in ⅠB stage and 4 cases in Ⅱ stage. After the operation, the upper digestive tract radiography showed that the anastomosis opening was unobstructed without complications such as anastomotic stenosis. Conclusion: Laparoscopic gastroduodenostomy with Billroth Ⅰ anastomosis with manual suture is safe and feasible, has a good short-term effect.

[The role of abnormal mitochondrial fusion and fission in PBDE-47-induced change in mitochondrial mass in PC12 cells]

Objective: To investigate the effect of 2, 2', 4, 4'-tetrabromodiphenyl ether (PBDE-47) on the mitochondrial mass in rat adrenal pheochromocytoma (PC12) cells and the potential mechanisms. Methods: Highly differentiated PC12 cells were divided into control, 1, 10 or 20 μmol/L PBDE-47-treated groups and cultured for 24 h. Transmission electron microscopy was employed to observe the changes in mitochondrial morphology and quantity in PC12 cells. Flow cytometry was used to measure the fluorescence intensity of Nonyl Acridine Orange (NAO) , a fluorescent indicator of mitochondrial membrane cardiolipin, to reflect mitochondria mass. Western blotting was used to determine the expression levels of Mitofusion 1 (Mfn1) and Fission 1 (Fis1) proteins. To further explore the role of abnormal mitochondrial fusion and fission in PBDE-47-induced mitochondrial mass changes, PC12 cells were divided into control group, 5 μmol/L M1 treatment group, 20 μmol/L PBDE-47 treatment group and 5 μmol/L M1+20 μmol/L PBDE-47 combined treatment group and cultured for 24 h, then the fluorescence intensity of NAO and expression levels of Mfn1 and Fis1 proteins were detected. Results: The control group showed numerous mitochondria with normal morphology, while the number of mitochondria decreased after PBDE-47 treatment. Especially, the disappeared cristae, swelling and vacuoles of mitochondria and decreased fluorescence intensity of NAO (P<0.05) were observed in 10 and 20 μmol/L PBDE-47-treated groups. Meanwhile, the expression levels of Mfn1 and Fis1 proteins in the 10 and 20 μmol/L PBDE-47-treated groups were significantly decreased compared with control group (P<0.05) . However, 5 μmol/L M1 co-treatment with 20 μmol/L PBDE-47 significantly increased the levels of Mfn1 and Fis1 proteins and fluorescence intensity of NAO compared with the 20 μmol/L PBDE-47 group (P<0.05) . Conclusion: PBDE-47 can inhibit the mitochondrial fusion and fission process, thus leading to damage of mitochondria mass in PC12 cells.

Inactivation of airborne viruses using a packed bed non-thermal plasma reactor

Outbreaks of airborne infectious diseases such as measles or severe acute respiratory syndrome can cause significant public alarm. Where ventilation systems facilitate disease transmission to humans or animals, there exists a need for control measures that provide effective protection while imposing minimal pressure differential. In the present study, viral aerosols in an airstream were subjected to non-thermal plasma (NTP) exposure within a packed-bed dielectric barrier discharge reactor. Comparisons of plaque assays before and after NTP treatment found exponentially increasing inactivation of aerosolized MS2 phage with increasing applied voltage. At 30 kV and an air flow rate of 170 standard liters per minute, a greater than 2.3 log reduction of infective virus was achieved across the reactor. This reduction represented ~2 log of the MS2 inactivated and ~0.35 log physically removed in the packed bed. Increasing the air flow rate from 170 to 330 liters per minute did not significantly impact virus inactivation effectiveness. Activated carbon-based ozone filters greatly reduced residual ozone, in some cases down to background levels, while adding less than 20 Pa pressure differential to the 45 Pa differential pressure across the packed bed at the flow rate of 170 standard liters per minute.

Characterization of fungal microbiota on normal ocular surface of humans

OBJECTIVES

Our objective was to characterize the fungal microbiota on normal ocular surface of humans with the culture-based method and high-throughput sequencing approach.

METHODS

A total of 45 adults were recruited from an urban community, and 90 conjunctival swabs were obtained, one from each eye of each participant. One of the two swabs from each participant was randomly chosen and allocated to internal transcribed spacer (ITS) sequencing, and the other was subjected to conventional fungal cultivation.

RESULTS

Four filamentous fungi were isolated from the 45 samples using the culture-based method, Penicillium citrinum, Aspergillus niger, Phialophora and Trichoderma. In the other 45 samples, 18 samples were positive for PCR amplification and sent for subsequent ITS sequencing. A total of 518 703 valid reads were generated and assigned into 467 operational taxonomic units. Overall, 4 phyla and 94 genera were identified. Two phyla, Basidiomycota (78.67%) and Ascomycota (19.54%), and five genera, Malassezia (74.65%), Rhodotorula (1.93%), Davidiella (1.89%), Aspergillus (1.25%) and Alternaria (0.61%), which accounted for >80% of the fungal microbiome and presented in >80% of the individuals tested, constituted the possible 'core fungal taxa' on normal ocular surface.

CONCLUSIONS

The fungal microbiome on normal ocular surface of humans was identified using the high-throughput sequencing method, providing a basis for further investigations on the potential role of the fungal microbiota in ocular health and disease.

Plasma cell-free DNA integrity plus circulating tumor cells: a potential biomarker of no distant metastasis breast cancer

Cell-free DNA integrity (cfDI) is a promising diagnostic and prognostic biomarker in breast cancer. However, no specific study has evaluated the diagnostic ability of cfDI in patients with no distant metastasis breast cancer (no-MBC) and benign breast tumor (BBT) to date. We assessed the plasma cfDI of 84 patients with no-MBC and 30 patients with BBT using quantitative PCR and compared it with circulating tumor cells (CTCs) and carbohydrate antigen 153 (CA153). The no-MBC group had significantly lower mean cfDI (0.58) than the BBT group (0.74, p = 0.004). Subgroup analysis showed that decreased cfDI seem to be associated with risk factors such as age 14% (mean cfDI = 0.57), tumor size > 2 cm (mean cfDI = 0.58), and positive lymph node status (mean cfDI = 0.56), but had no statistical significance. McNemar's test suggested that cfDI had stronger diagnostic power than CTCs, cfDNA concentration, or CA153 (p < 0.001). Spearman's rho showed that the correlation coefficient between cfDI and CTCs was 0.278 (p = 0.04) in the no-MBC group. Receiver operating characteristic curve analysis also suggested that cfDI was superior to CTCs or CA153. Combined with CTCs, cfDI reduced the false positive rate from 50% to 10.71% and increased the area under the curve value from 0.66 to 0.68. Our results suggest that cfDI is a potential diagnostic biomarker of no-MBC. Using cfDI and CTCs as a combined diagnostic tool for no-MBC could improve diagnostic sensitivity and specificity but more samples will be needed.

[Predictive value of cytokines and procalcitonin on infection in children with hematological malignancies]

Objective: To explore the value of cytokines and procalcitonin (PCT) in predicting the potential pathogen and the severity of infection in children with hematological malignancies. Methods: This was a prospective cohort study. A total of 1 543 children (3 912 episodes) with hematological malignancies admitted to the Department of Hematology/Oncology in Children's Hospital of Zhejiang University School of Medicine from November 2010 to June 2018 were prospectively enrolled in this study. According to the pathogen, the patients were divided into sepsis group with positive blood culture (380 patients/608 episodes), sepsis group with negative blood culture (539/1 484), non-septic infection group (549/1 709), viral infection group (18/21) and fungal infection group (57/90). The patients were also divided into two groups in either shock group (171/187) or non-shock group (1 372/3 725). Meanwhile, 89 children (112 episodes) with matched hematological malignancies without fever were enrolled as the control group. The levels of PCT and cytokines were measured for detecting the potential relationship between these markers and infection severity. Mann-Whitney U test or Kruskal-Wallis H test was used to compare the differences between groups. The Receiver Operator Characteristic curve analysis was used to explore the predictive value. Results: (1) There were significantly higher levels of interleukin (IL) 6 (H=210.002, P<0.01), IL-10 (H=223.045, P<0.01), and PCT (H=76.799, P<0.01) in the infection group, with area under curre (AUC) of 0.67 (95%CI 0.64-0.69), 0.69 (95%CI 0.66-0.71) and 0.59 (95%CI 0.56-0.61), respectively. (2) Among the patients in the shock group, IL-6 (Z=11.460, P<0.01), IL-10 (Z=14.242, P<0.01) and PCT (Z=10.813, P<0.01) were significantly higher than those in the non-shock group, with the AUC of 0.75 (95%CI 0.70-0.79), 0.81 (95%CI 0.77-0.84) and 0.73 (95%CI 0.69-0.77), respectively. (3) In patients with septic shock, the incidence of Gram negative bacteria (GNB) infection (60 episodes) was significantly higher than Gram positive bacteria (GPB) infection (22 episodes) (χ(2)=29.665, P<0.01). The AUC of IL-6, IL-10 and PCT for predicting GNB infection were 0.75 (95%CI 0.72-0.78), 0.82 (95%CI 0.79-0.85) and 0.67 (95%CI 0.63-0.70), respectively. (4) The predictive power of IL-6, IL-10 and PCT combination (AUC=0.994) was superior to IL-10 alone (AUC=0.810) in predicting septic shock (Z=10.211, P<0.01). Conclusions: IL-6 and IL-10 are better predictors of GNB infection than PCT in hematology-oncology children. Furthermore, the combination of these two cytokines and PCT is more valuable in predicting the severity of infection.

Comparative analysis of the blood transcriptomes between wolves and dogs

Dogs were domesticated by human and originated from wolves. Their evolutionary relationships have attracted much scientific interest due to their genetic affinity but different habitats. To identify the differences between dogs and wolves associated with domestication, we analysed the blood transcriptomes of wolves and dogs by RNA-Seq. We obtained a total of 30.87 Gb of raw reads from two dogs and three wolves using RNA-Seq technology. Comparisons of the wolf and dog transcriptomes revealed 524 genes differentially expressed genes between them. We found that some genes related to immune function (DCK, ICAM4, GAPDH and BSG) and aerobic capacity (HBA1, HBA2 and HBB) were more highly expressed in the wolf. Six differentially expressed genes related to the innate immune response (CCL23, TRIM10, DUSP10, RAB27A, CLEC5A and GCH1) were found in the wolf by a Gene Ontology enrichment analysis. Immune system development was also enriched only in the wolf group. The ALAS2, HMBS and FECH genes, shown to be enriched by the Kyoto Encyclopedia of Genes and Genomes analysis, were associated with the higher aerobic capacity and hypoxia endurance of the wolf. The results suggest that the wolf might have greater resistance to pathogens, hypoxia endurance and aerobic capacity than dogs do.

Three-vessel-trachea view in the diagnosis of fetal cardiac great vessel malformation

Fetal cardiac great vessel malformation is attracting increasing attention in the prenatal ultrasonic diagnosis of fetal congenital heart disease. To investigate the clinical diagnostic values of three-vessel-trachea view (3VT view) in the ultrasonic diagnosis of this malformation, the present study analyzed the echocardiographic examination results of 77 fetuses with great vessel malformation, retrospectively analyzed the echocardiographic characteristics in the three-vessel-trachea view, and followed up the enrolled cases. The results suggest that great vessel malformation had characteristic manifestations, such as abnormal arrangement order, inner diameter, blood flow direction and branch. Color Doppler flow imaging found V, O, C, U, Ioo and oVo structures. There were 20 cases of blood vessel position abnormality, 38 cases of abnormal blood vessel diameter, and 19 cases of abnormal number of blood vessels. The detection rate of abnormal blood vessel diameter was 95%, which was the highest; the detection rate of abnormal blood vessel position was 97.4%, and that of abnormal number of blood vessels was 84.2%. It is concluded that the 3VT view can indicate fetal cardiac great vessel malformation. The 3VT view is beneficial to timely prenatal diagnosis, relief of body pain and improvement of quality of birth.

Available energy content, nutrients digestibility of chili meal and effects on performance of growing pigs

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Chili meal is classified as a roughage due to its high dietary fiber content.

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Chili meal has moderate DE, ME and nutrients digestibility for growing pigs.

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Addition of chili meal have adverse effect on ADG and ATTD of nutrients.

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The combination of 50 g/kg chili meal and proper soybean has no significant negative effects for growing pigs.

The objective of this study was to evaluate the digestible energy (DE), metabolizable energy (ME) content, apparent total tract digestibility (ATTD) of nutrients in chili meal (CM), and to determine the effects of CM on the performance of growing pigs. In Exp. 1, 12 barrows (Duroc x Landrace x Yorkshire) with an initial body weight (BW) of 50.9 ± 1.8 kg were allocated to one of two treatments, corn-soybean meal basal diet or diet containing 194.2 g/kg CM, which replaced corn and soybean meal in the basal diet. Pigs were placed in metabolism crates for a 7-d adaptation period followed by a 5-d total collection of feces and urine to detect DE, ME and ATTD of nutrients in CM. Exp. 2 was conducted for 4 wk. to evaluate the effect of CM on performance of growing pigs. 150 growing pigs (58.4 ± 1.2 kg BW) were allocated to 1 of 5 treatments. Treatment 1 was a corn-soybean meal basal diet met the DE requirement for growing pigs recommended by NRC (2012). Treatment 2 or 3 were diets containing 50 g/kg or 100 g/kg CM respectively. Treatment: 4 or 5 were based on treatment 2 or 3, while soybean oil (SBO) was added to improve the DE content to that in treatment 1. In Exp. 1, the DE and ME content of CM were 9.08 and 8.48 MJ/kg. The ATTD of dry matter (DM), gross energy (GE), organic matter (OM) and neutral detergent fiber (NDF) were 0.60, 0.54, 0.66 and 0.38, respectively. In Exp. 2, addition of CM linearly decreased (P < 0.05) average daily gain (ADG) and the ATTD of DM, GE and OM while ATTD of crude protein (CP) had a quadratic (P < 0.05) change. When SBO was supplemented in diets containing CM, greater values (P < 0.05) of ATTD of most nutrients were observed. With the dietary inclusion of CM, the albumin/globulin ratio in serum had a quadratic change (P < 0.05), and the level of low-density cholesterol linearly (P < 0.05) increased. In treatments with 50 g/kg CM, a significant reduction (P < 0.05) of total antioxidant capacity was found in diet formulated with SBO. In treatments with 100 g/kg CM, the level of total cholesterol was lower (P < 0.05) in the diet with SBO. In conclusion, CM had moderate energy density and nutrients digestibility in pig diets. 50 g/kg CM with SBO in diets could be fed to growing pigs with no significant negative effects.

A monoclonal antibody targeting ErbB2 domain III inhibits ErbB2 signaling and suppresses the growth of ErbB2-overexpressing breast tumors

The anti-ErbB2 antibodies trastuzumab and pertuzumab in combination have recently been approved for the treatment of patients with ErbB2-positive metastatic breast cancer. Pertuzumab, which binds to ErbB2 near the center of domain II, and trastuzumab, which binds to the juxtamembrane region of ErbB2 domain IV, directly interfere with domain II- and domain IV-mediated heterodimerization contacts, respectively. In this study, we report a novel anti-ErbB2 antibody, 3E10, which binds to an epitope in domain III that appears to be located opposite to the dimerization interfaces in domain II and domain IV of ErbB2. Our data show that the 3E10 antibody inhibits ErbB2 heterodimerization via a mechanism that strikingly differs from trastuzumab and pertuzumab. It could be speculated that the 3E10 antibody may affect ErbB2 heterodimerization by causing major conformational changes of ErbB2. Furthermore, 3E10 provides synergistic inhibition of ErbB2 heterodimerization and signaling in combination with either trastuzumab or pertuzumab. The combination of these three anti-ErbB2 antibodies that have complementary mechanisms of action appears to be an extremely potent ErbB2 heterodimerization blocker. Compared with trastuzumab plus pertuzumab, the combination of trastuzumab, pertuzumab and 3E10 provides a more potent blockade of ErbB2 signaling. Consistent with this, trastuzumab plus pertuzumab plus 3E10 results in greater in vitro and in vivo antitumor activity in ErbB2-overexpressing breast tumor models, suggesting its potential use for treating ErbB2-overexpressing breast cancer.