miRNA-137-5p improves spatial memory and cognition in Alzheimer's mice by targeting ubiquitin-specific peptidase 30

BACKGROUND

Alzheimer's disease (AD) is a prevalent neurodegenerative disorder causing progressive dementia. Research suggests that microRNAs (miRNAs) could serve as biomarkers and therapeutic targets for AD. Reduced levels of miR-137 have been observed in the brains of AD patients, but its specific role and downstream mechanisms remain unclear. This study sought to examine the therapeutic potential of miR-137-5p agomir in alleviating cognitive dysfunction induced in AD models and explore its potential mechanisms.

METHODS

This study utilized bioinformatic analysis and a dual-luciferase reporter assay to investigate the relationship between miR-137-5p and ubiquitin-specific peptidase 30 (USP30). In vitro experiments were conducted using SH-SY5Y cells to assess the impact of miR-137-5p on Aβ1-42 neurotoxicity. In vivo experiments on AD mice evaluated the effects of miR-137-5p on cognition, Aβ1-42 deposition, Tau hyperphosphorylation, and neuronal apoptosis, as well as its influence on USP30 levels.

RESULTS

It was discovered that miR-137-5p mimics efficiently counteract Aβ1-42 neurotoxicity in SH-SY5Y cells, a protective effect that is negated by USP30 overexpression. In vivo experiments demonstrated that miR-137-5p enhances the cognition and mobility of AD mice, significantly reducing Aβ1-42 deposition, Tau hyperphosphorylation, and neuronal apoptosis within the hippocampus and cortex regions. Mechanistically, miR-137-5p significantly suppresses USP30 levels in mice, though USP30 overexpression partially buffers against miR-137-5p-induced AD symptom improvement.

CONCLUSION

Our study proposes that miR-137-5p, by instigating the downregulation of USP30, has the potential to act as a novel and promising therapeutic target for AD.

Dosimetric Validation of 3D-Printed Bolus at Different Printing Infill Percentage in VMAT Plan

PURPOSE/OBJECTIVE(S)

The 3D printed bolus technology is rapidly evolving in external beam radiotherapy and printing parameters can have a significant impact on absorbed dose. In this study, a novel 3D printed bolus was designed to evaluate the time and material cost effects, dosimetry differences, and surface dose modulation capabilities in the volumetric-modulated arc therapy (VMAT) plan at different print filling percentages.

MATERIALS/METHODS

A hollow-type bolus, the middle 2.36 mm of 5 mm thickness infilled with different ratio, was designed and printed with polylactic acid (PLA). The ratio of printed material was defined by the infill percentage parameter ranging from 10% to 90%. For each bolus, two treatment plans were designed with AAA algorithm, considering the real computed tomography (CT) scan of the 3D printed bolus and modeling the 3D printed bolus as a virtual bolus structure. Percentage depth dose (PDD) profiles were calculated to build up the mapping equivalent CT value in treatment plan system (TPS). Measurement dose was performed by radiographic films. The PDD profiles were then compared between measured and calculated. A simulation VMAT treatment plan with planning target volume (PTV) close to the body surface was designed on a water-equivalent phantom, and the modulation capabilities of epidermal dose under different filling percentage was compared.

RESULTS

Compared with 100% percent infill 3D printed bolus, The maximum printing time could be reduced by 47.8% and material consumption could be reduced by 42.5%. The surface dose at single field irradiation can reach 69.6% to 85.8% of the maximum dose in different filling boluses. The PDD measurement and mapping equivalent CT calculation deviation was less than 3% when the infill percentage of the middle region is greater than 30%. The dose distribution of the VMAT plan is satisfying for infill percentages greater than 30%.

CONCLUSION

Using the 3D printing technology is possible to modulate the amount of shift of the build-up region by tuning the infill percentage of the 3D printed bolus. Patients could undergo CT simulation without bolus. Appropriate bolus could be selected according to the location of the PTV region and dose requirement.

First Demonstration of the Commissioning of a New Multi-Modality Radiotherapy Platform

PURPOSE/OBJECTIVE(S)

A new multi-modality radiotherapy platform was developed and introduced into clinical application, which has received US FDA 510k(K210921) and National Medical Products Administration (NMPA) clearance in China (20223050973). This study, for the first time, presents the technological characteristics and commissioning results of the new platform.

MATERIALS/METHODS

The platform consists of 3 modules: linear accelerator, rotating gamma system, and a kV imaging system within an O-ring gantry. The O-ring gantry can rotate continuously achieved by using a slip ring. The Linac delivers a 6 MV FFF photon beam with a variable dose rate of 50 to 1400 MU/min. The delivery techniques include 3D-CRT, IMRT, and VMAT. The rotating gamma system utilizes 18 Co-60 sources with a reference dose rate of 350 cGy/min. The image-guided techniques consist of kV-kV pairs and kV-CBCT. The X-ray intensity-modulated radiotherapy and γ-ray stereotactic radiotherapy can be delivered on the same platform. The acceptance test and commissioning were performed following the vendor's customer acceptance tests (CAT) and several AAPM Task Group reports/guidelines. Regarding the Linac, all applicable validation tests recommended by the MPPG 5.a (basic photon beam model validation, IMRT/VMAT validation, E2E tests, and patient-specific QA) were performed. For the rotating gamma system, the absorbed doses were measured using a PTW31014 and PTW60016. EBT3 films were employed to measure the relative output factors (ROFs). The E2E tests were performed using a PTW31014 and EBT3 films. The coincidence between the imaging isocenter and the Linac/gamma treatment isocenter was investigated using EBT3 films. The image quality was evaluated regarding the contrast-to-noise ratio (CNR), spatial resolution, and uniformity.

RESULTS

All tests included in the CAT met the vendor's specifications. All MPPG 5.a tests complied with the tolerances. The confidence limits for IMRT/VMAT validation were achieved according to TG-119. The point dose differences were below 1.68% and gamma pass rates (3%/2 mm) were above 95.9% for the Linac E2E tests. All plans of patient-specific QA had point dose differences below 1.79% and gamma pass rates (3%/2 mm) above 96.1% suggested by TG-218. For the rotating gamma system, the differences between the calculated and measured absorbed doses were below 1.86%. The ROFs calculated by the TPS were independently confirmed within 2% using EBT3 films. The point dose differences were below 2.57% and gamma pass rates (2%/1 mm) were above 95.3% for the E2E tests. The coincidence between the imaging isocenter and the Linac/gamma treatment isocenter was within 0.5 mm. The image quality fully complied with the vendor's specifications regarding the CNR, spatial resolution, and uniformity.

CONCLUSION

This is the first report about the commissioning of a new multi-modality radiotherapy platform. The platform has been successfully commissioned and exhibits good performance in mechanical and dosimetry accuracy.

[Clinical research progress of selective laser trabeculoplasty]

Selective Laser Trabeculoplasty (SLT) is an effective laser treatment modality for controlling intraocular pressure (IOP) in open-angle glaucoma (OAG). Compared to other laser techniques targeting the trabecular meshwork, SLT has demonstrated favorable efficacy and safety. This article aims to summarize the application and advancements of SLT in Chinese OAG patients, focusing on its effectiveness in reducing IOP and postoperative adverse reactions that may influence OAG. By examining SLT from these perspectives, we aim to provide insights for the standardized promotion of SLT and enhancement of clinical glaucoma management in China.

Identifying a prognostic model and screening of potential natural compounds for acute myeloid leukemia

Background

Acute myeloid leukemia (AML) is one of the most common hematologic malignancies with a poor prognosis and high recurrence rate. The discovery of new predictive models and therapeutic agents plays a crucial role.

Methods

The differentially expressed gene that was explicitly highly expressed in The Cancer Genome Atlas (TCGA) and GSE9476 transcriptome databases were screened and included in the least absolute shrinkage and selection operator (LASSO) regression model to derive risk coefficients and build a risk score model. Functional enrichment analysis was conducted on the screened hub genes to explore the potential mechanisms. Subsequently, critical genes were incorporated into a nomogram model based on risk scores to analyze prognostic value. Finally, this study combined network pharmacology to find potential natural compounds for hub genes and used molecular docking to verify the binding ability of molecular structures to natural compounds to explore drug development for possible efficacy in AML.

Results

A total of 33 highly expressed genes may be associated with poor prognosis of AML patients. After LASSO and multivariate Cox regression analysis of 33 critical genes, Rho-related BTB domain containing 2 (RHOBTB2), phospholipase A2 (PLA2G4A), interleukin-2 receptor-α (IL2RA), cysteine and glycine-rich protein 1 (CSRP1), and olfactomedin-like 2A (OLFML2A) were found to played a significant role in the prognosis of AML patients. CSRP1 and OLFML2A were independent prognostic factors of AML. The predictive power of these 5 hub genes in combination with clinical features was better than clinical data alone in predicting AML in the column line graphs and had better predictive value at 1, 3, and 5 years. Finally, through network pharmacology and molecular docking, this study found that diosgenin in Guadi docked well with PLA2G4A, beta-sitosterol in Fangji docked well with IL2RA, and OLFML2A docked well with 3,4-di-O-caffeoylquinic acid in Beiliujinu.

Conclusions

The predictive model of RHOBTB2, PLA2G4A, IL2RA, CSRP1, and OLFML2A combined with clinical features can better guide the prognosis of AML. In addition, the stable docking of PLA2G4A, IL2RA, and OLFML2A with natural compounds may provide new options for treating AML.

[Clinical features and prognostic factors of elderly patients with mantle cell lymphoma]

Objective: To examine the clinical characteristics and prognostic factors of elderly patients with mantle cell lymphoma (MCL) and the impact of nutrition and underlying diseases on the prognosis of elderly patients with MCL. Methods: retrospectively analyzed 255 elderly patients with MCL from 11 medical centers, including Peking University Third Hospital between January 2000 and February 2021. We analyzed clinical data, such as age, gender, Mantle Cell Lymphoma International Prognostic Index score, and treatment options, and performed univariate and multivariate prognostic analysis. We performed a comprehensive geriatric assessment on elderly MCL patients with medical records that included retraceable underlying disease and albumin levels, and we investigated the impact of basic nutrition and underlying disorders on MCL prognosis in the elderly. Results: There were 255 senior individuals among the 795 MCL patients. Elderly MCL was more common in males (78.4%), with a median age of 69 yr (ages 65-88), and the majority (88.6%) were identified at a late stage. The 3-yr overall survival (OS) rate was 42.0%, with a 21.2% progression-free survival (PFS) rate. The overall response rate (ORR) was 77.3%, with a 33.3% total remission rate. Elderly patients were more likely than younger patients to have persistent underlying illnesses, such as hypertension. Multivariate analysis revealed that variables related with poor PFS included age of ≥80 (P=0.021), Ann Arbor stage Ⅲ-Ⅳ (P=0.003), high LDH level (P=0.003), involvement of bone marrow (P=0.014). Age of ≥80 (P=0.001) and a high LDH level (P=0.003) were risk factors for OS. The complete geriatric assessment revealed that renal deficiency was associated with poorer OS (P=0.047) . Conclusions: Elderly MCL patients had greater comorbidities. Age, LDH, renal function, bone marrow involvement, and Ann Arbor stage are all independent risk factors for MCL in the elderly.

[Clinical analysis of inflatable video-assisted mediastinoscopic transhiatal esophagectomy combined with laparoscopy]

Objective: To examine the safety and effectiveness of inflatable video-assisted mediastinoscopic transhiatal esophagectomy (IVMTE). Methods: Totally 269 patients admitted to the Anhui Provincial Hospital of Anhui Medical University who underwent IVMTE (IVMTE group, n=47) or thoracoscopy combined with minimally invasive Mckeown esophageal cancer resection (MIME group, n=222) from September 2017 to December 2021 were analyzed retrospectively. There were 31 males and 16 females in IVMTE group, aged (68.6±7.5) years (range: 54 to 87 years). There were 159 males and 63 females in MIME group, aged (66.8±8.8) years (range: 42 to 93 years). A 1∶1 match was performed on both groups by propensity score matching, with 38 cases in each group. The intraoperative conditions and postoperative complication rates of the two groups were compared by t test, Wilcoxon rank, χ² test, or Fisher exact probability method. Results: Patients in IVMTE group had less intraoperative bleeding ((96.0±39.2) ml vs. (123.8±49.3) ml, t=-2.627, P=0.011), shorter operation time ((239.1±47.3) minutes vs. (264.2±57.2) minutes, t=-2.086, P=0.040), and less drainage 3 days after surgery (85(89) ml vs. 675(573) ml, Z=-7.575, P<0.01) compared with that of MIME group. There were no statistically significant differences between the two groups in terms of drainage tube-belt time, postoperative hospital stay, and lymph node dissection stations and numbers (all P>0.05). The incidence of Clavien-Dindo grade 1 to 2 pulmonary infection (7.9%(3/38) vs. 31.6%(12/38), χ²=6.728, P=0.009), total complications (21.1%(8/38) vs. 47.4%(18/38), χ²=5.846, P=0.016) and total lung complications (13.2%(5/38) vs. 42.1%(16/38), χ²=7.962, P=0.005) in the IVMTE group were significantly lower. Conclusion: Inflatable video-assisted mediastinoscopic transhiatal esophagectomy combined with laparoscopic esophagectomy is safe and feasible, which can reach the same range of oncology as thoracoscopic surgery.

Mechanism of Procyanidin B2 in the Treatment of Chronic Myeloid Leukemia Based on Integrating Network Pharmacology and Molecular Docking

OBJECTIVE

To study the pharmacological mechanism of procyanidin B2 (PCB2) on chronic myeloid leukemia (CML) by integrating network pharmacological methods systematically.

METHODS

Firstly, the potential target genes of PCB2 were predicted by the pharmacological database and analysis platform (TCMSP and Pharmmapper). Meanwhile, the relevant target genes of CML were collected from GeneCards and DisGene. Pooled data were collected to screen for common target genes. Furthermore, the above intersection genes were imported into the String website to construct a protein-protein interaction (PPI) network, and the Gene Ontology (GO) functional annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway were further analyzed. Besides, molecular docking was performed to verify the possible binding conformation between PCB2 and candidate targets. Finally, MTT and RT-PCR experiments of K562 cells were performed to verify the above results of network pharmacology.

RESULTS

A total of 229 PCB2 target genes were retrieved, among which 186 target genes had interaction with CML. The pharmacological effects of PCB2 on CML were related to some important oncogenes and signaling pathways. The top ten core targets predicted by Network Analysis were as follows: AKT1, EGFR, ESR1, CASP3, SRC, VEGFA, HIF1A, ERBB2, MTOR, and IGF1. Molecular docking studies confirmed that hydrogen bonding was the main interaction force of PCB2 binding targets. According to the molecular docking score, the following three target proteins were most likely to bind to PCB2: VEGFA (-5.5 kcal/mol), SRC (-5.1 kcal/mol), and EGFR (-4.6 kcal/mol). After treatment of PCB2 for 24h, mRNA expression levels of VEGFA and HIF1A decreased significantly in K562 cells.

CONCLUSION

Through integrating network pharmacology combined with molecular docking, the study revealed the potential mechanism of PCB2 anti-chronic myeloid leukemia.

[The study of the correlation between age and the pathogenic factors of primary glaucoma: a review]

Age is an important risk factor for primary glaucoma. While the specific mechanism of primary glaucoma remained unclear, the change of ocular anatomy, the disturbance of aqueous humor balance, the change of ocular biomechanics and the disorder of neurometabolism contribute to the occurrence and development of primary glaucoma. This paper reviewes the latest studies on the correlation between age and the risk factors of glaucoma in the above four aspects, so as to provide some references for the in-depth discussion of the pathophysiology of primary glaucoma, and advancement on diagnosis, treatment and research of primary glaucoma.

[Strengthening the clinical research of minimally invasive glaucoma surgery]

Glaucoma is a leading cause of irreversible blindness in the world. The reduction of intraocular pressure is the main clinical treatment. Due to the limitations of traditional filter surgery, a variety of minimally invasive glaucoma surgery (MIGS) procedures have been applied in clinical practice in recent years. Quite a few of them have been carried out in China and achieved good results. At the same time, domestic technology enterprises are actively engaged in the development, innovation and localization of the MIGS equipment. However, there are still some problems in MIGS in China, which need to be paid attention to and require corresponding clinical research, so as to make it a new highlight in the clinical diagnosis and treatment of glaucoma.

Localized ablative immunotherapy drives de novo CD8+ T-cell responses to poorly immunogenic tumors

BACKGROUND

Localized ablative immunotherapies hold great promise in stimulating antitumor immunity to treat metastatic and poorly immunogenic tumors. Tumor ablation is well known to release tumor antigens and danger-associated molecular patterns to stimulate T-cell immunity, but its immune stimulating effect is limited, particularly against metastatic tumors.

METHODS

In this study, we combined photothermal therapy with a potent immune stimulant, N-dihydrogalactochitosan, to create a local ablative immunotherapy which we refer to as laser immunotherapy (LIT). Mice bearing B16-F10 tumors were treated with LIT when the tumors reached 0.5 cm³ and were monitored for survival, T-cell activation, and the ability to resist tumor rechallenge.

RESULTS

We found that LIT stimulated a stronger and more consistent antitumor T-cell response to the immunologically 'cold' B16-F10 melanoma tumors and conferred a long-term antitumor memory on tumor rechallenge. Furthermore, we discovered that LIT generated de novo CD8⁺ T-cell responses that strongly correlated with animal survival and tumor rejection.

CONCLUSION

In summary, our findings demonstrate that LIT enhances the activation of T cells and drives de novo antitumor T-cell responses. The data presented herein suggests that localized ablative immunotherapies have great potential to synergize with immune checkpoint therapies to enhance its efficacy, resulting in improved antitumor immunity.

[Practice of Palliative Care:Experience of a Patient with Advanced Lung Cancer at the End of Life]

Palliative care refers to the prevention and relief of physical and mental suffering through early recognition,active assessment,and management of pain and other painful symptoms to improve quality of life for both the patients with severe diseases and their families.A successful case of palliative care requires not only the establishment of correct concepts but also the team work and the improvement of the medical system.This paper introduced the end-of-life care experience for a patient with advanced lung cancer,showing the gains and deficiencies in the practice of palliative care.

The divergence between T cell and innate lymphoid cell fates controlled by E and Id proteins

T cells develop in the thymus from lymphoid primed multipotent progenitors or common lymphoid progenitors into αβ and γδ subsets. The basic helix-loop-helix transcription factors, E proteins, play pivotal roles at multiple stages from T cell commitment to maturation. Inhibitors of E proteins, Id2 and Id3, also regulate T cell development while promoting ILC differentiation. Recent findings suggest that the thymus can also produce innate lymphoid cells (ILCs). In this review, we present current findings that suggest the balance between E and Id proteins is likely to be critical for controlling the bifurcation of T cell and ILC fates at early stages of T cell development.

Single-cell RNA sequencing reveals localized tumour ablation and intratumoural immunostimulant delivery potentiate T cell mediated tumour killing

Background

Metastatic breast cancer poses great challenge in cancer treatment. N‐dihydrogalactochitosan (GC) is a novel immunoadjuvant that stimulates systemic immune responses when administered intratumourally following local tumour ablation. A combination of photothermal therapy (PTT) and GC, referred to as localized ablative immunotherapy (LAIT), extended animal survival and generates an activated B cell phenotype in MMTV‐PyMT mouse mammary tumour microenvironment (TME). However, how T cell populations respond to LAIT remains to be elucidated.

Methods

Using depletion antibodies, we studied the contributions of CD8⁺ and CD4⁺ T cells to the therapeutic effect of LAIT. Using single‐cell RNA‐sequencing (scRNAseq), we analysed tumour‐infiltrating T cell heterogeneity and dissected their transcriptomes upon treatments of PTT, GC, and LAIT (PTT+GC).

Results

Loss of CD8⁺ T cells after LAIT abrogated the therapeutic benefits of LAIT. Ten days after treatment, proportions of CD8⁺ and CD4⁺ T cells in untreated TME were 19.2% and 23.0%, respectively. Upon LAIT, both proportions were increased to 25.5% and 36.2%, respectively. In particular, LAIT increased the proportions of naïve and memory cells from a resting state to an activated state. LAIT consistently induced the expression of co‐stimulatory molecules, type I IFN responsive genes, and a series of antitumor cytokines, Ifng, Tnf, Il1, and Il17 in CD8⁺ and CD4⁺ T cells. LAIT also induced immune checkpoints Pdcd1, Ctla4, and Lag3 expression, consistent with T cell activation. Relevant to clinical translation, LAIT also upregulated genes in CD8⁺ and CD4⁺ T cells that positively correlated with extended survival of breast cancer patients.

Conclusions

Overall, our results reveal that LAIT prompts immunological remodelling of T cells by inducing broad proinflammatory responses and inhibiting suppressive signalling to drive antitumour immunity.

Mitochondrial Dysfunction in Parkinson’s Disease: From Mechanistic Insights to Therapy

Parkinson’s disease (PD) is one of the most common neurodegenerative movement disorders worldwide. There are currently no cures or preventative treatments for PD. Emerging evidence indicates that mitochondrial dysfunction is closely associated with pathogenesis of sporadic and familial PD. Because dopaminergic neurons have high energy demand, cells affected by PD exhibit mitochondrial dysfunction that promotes the disease-defining the loss of dopaminergic neurons in the substantia nigra pars compacta (SNpc). The mitochondrion has a particularly important role as the cellular “powerhouse” of dopaminergic neurons. Therefore, mitochondria have become a promising therapeutic target for PD treatments. This review aims to describe mitochondrial dysfunction in the pathology of PD, outline the genes associated with familial PD and the factors related to sporadic PD, summarize current knowledge on mitochondrial quality control in PD, and give an overview of therapeutic strategies for targeting mitochondria in neuroprotective interventions in PD.

Nano Sized Hydroxyapatite-Polylactic Acid-Vancomycin in Alleviation of Chronic Osteomyelitis

Background

Objective

Methods

Results

Conclusion

E-Protein Inhibition in ILC2 Development Shapes the Function of Mature ILC2s during Allergic Airway Inflammation

E-protein transcription factors limit group 2 innate lymphoid cell (ILC2) development while promoting T cell differentiation from common lymphoid progenitors. Inhibitors of DNA binding (ID) proteins block E-protein DNA binding in common lymphoid progenitors to allow ILC2 development. However, whether E-proteins influence ILC2 function upon maturity and activation remains unclear. Mice that overexpress ID1 under control of the thymus-restricted proximal Lck promoter (ID1^tg/WT) have a large pool of primarily thymus-derived ILC2s in the periphery that develop in the absence of E-protein activity. We used these mice to investigate how the absence of E-protein activity affects ILC2 function and the genomic landscape in response to house dust mite (HDM) allergens. ID1^tg/WT mice had increased KLRG1^- ILC2s in the lung compared with wild-type (WT; ID1^WT/WT) mice in response to HDM, but ID1^tg/WT ILC2s had an impaired capacity to produce type 2 cytokines. Analysis of WT ILC2 accessible chromatin suggested that AP-1 and C/EBP transcription factors but not E-proteins were associated with ILC2 inflammatory gene programs. Instead, E-protein binding sites were enriched at functional genes in ILC2s during development that were later dynamically regulated in allergic lung inflammation, including genes that control ILC2 response to cytokines and interactions with T cells. Finally, ILC2s from ID1^tg/WT compared with WT mice had fewer regions of open chromatin near functional genes that were enriched for AP-1 factor binding sites following HDM treatment. These data show that E-proteins shape the chromatin landscape during ILC2 development to dictate the functional capacity of mature ILC2s during allergic inflammation in the lung.

PPAR-α Agonist GW7647 Protects Against Oxidative Stress and Iron Deposit via GPx4 in a Transgenic Mouse Model of Alzheimer's Diseases

Alzheimer's disease (AD) is a neurodegenerative disease caused by lipid peroxidation and iron hemostasis of the brain. PPAR-α is regarded as the most encouraging therapeutic approach of several neurodegenerative and metabolic disorders, due to its potent regulatory effects. In this study, we examined the ameliorative effect and the mechanisms of a PPAR-α agonist, GW7647, on the established AD models using APP/PS1 mice and APPsw/SH-SY5Y cells. Through Aβ quantification and behavioral test, we found that GW7647 reduced Aβ burden and improved cognitive defect in APP/PS1 mice. Liquid chromatography-mass spectrometry analysis indicated that GW7647 could enter the brain after oral administration. Neuronal cell death and iron deposit were inhibited, accompanied by decreased lipid peroxidation and inflammation. In an in vitro study of APPsw cells, we found that PPAR-α directly bound with GPx4 intron3 to promote GPx4 transcription and reduced the iron transport capability. Our data suggested that activation of PPAR-α by GW7647 improved the disruption of iron homeostasis in the brain of APP/PS1 mice and alleviated neuronal inflammation and lipid peroxidation, which was possibly related to the upregulated transcription of GPx4 mediated by the interaction of GPx4 noncoding region and the PPAR-α.

[Relative factors analysis of visual field defect in advanced primary glaucoma]

Objective: To explore the relative factors of visual field defect in advanced primary glaucoma. Methods: A retrospective case-control study. The data of patients with primary advanced glaucoma who had the central 5 to 10 degrees of the visual field or the temporal peripheral field and were treated at Eye & ENT Hospital of Fudan University from January 2014 to December 2019 were reviewed. The patients were divded into the central visual field group and the temporal peripheral field group according to the type of visual field defect. Statistical analyses of single-factor (Chi square test or independent sample t test) and multivariate logistic regression were performed to analyze the correlation between the remaining visual field and the risk factors including age, gender, left/right eye, type of glaucoma, baseline glaucoma stage, peak intraocular pressure (IOP), mean IOP, number of operations, family history, high myopia, diabetes, hypertension, hypotension and migraine. Results: A total of 287 patients (287 eyes) were included. There were 101 patients [mean age, (61±15) years; 48 males, 53 females] with the central 5 to 10 degrees of the visual field and 186 patients [mean age, (59±17) years; 107 males, 79 females] with the temporal peripheral field. There was no statistically significant difference between the two groups with respect to age, gender, left/right eye, age of onset, number of operations, family history and history of combined systemic diseases (all P>0.05). Primary open-angle glaucoma, chronic primary angle-closure glaucoma (CPACG) and acute primary angle-closure glaucoma were found in 26, 34 and 41 patients, respectively, in the central visual field group, and in 61, 78 and 47 patients, respectively, in the temporal peripheral field group. The baseline glaucoma was in the moderate stage in 30 and 32 patients, and in the advanced stage in 71 and 154 patients, respectively, in the two groups. The peak IOP was (31.94±4.11) mmHg (1 mmHg=0.133 kPa) and (34.58±6.47) mmHg, and the mean IOP was (22.48±3.99) mmHg and (24.01±4.30) mmHg, respectively, in the two groups. High myopia occurred in 5 and 28 patients, respectively, in the two groups. The differences in the type of glaucoma (χ²=7.24), baseline glaucoma stage (χ²=6.04), peak IOP (t=4.22), mean IOP (t=2.96) and high myopia (χ²=6.57) between the two groups were statistically significant (all P<0.05). In the multivariable model, CPACG (OR=2.021, 95%CI: 1.020 to 4.001), higher peak IOP (OR=1.128, 95%CI: 1.038 to 1.226) and high myopia (OR=5.090, 95%CI: 1.556 to 16.651) increased the risks for the progression to the temporal peripheral field. Conclusion: CPACG, higher peak IOP and concurrent high myopia are all relative factors for the progression to the temporal peripheral field in advanced primary glaucoma.

Antigen presentation and interferon signatures in B cells driven by localized ablative cancer immunotherapy correlate with extended survival

Rationale: B cells have emerged as key regulators in protective cancer immunity. However, the activation pathways induced in B cells during effective immunotherapy are not well understood. Methods: We used a novel localized ablative immunotherapy (LAIT), combining photothermal therapy (PTT) with intra-tumor delivery of the immunostimulant N-dihydrogalactochitosan (GC), to treat mice bearing mouse mammary tumor virus-polyoma middle tumor-antigen (MMTV-PyMT). We used single-cell RNA sequencing to compare the transcriptional changes induced by PTT, GC and PTT+GC in B cells within the tumor microenvironment (TME). Results: LAIT significantly increased survival in the tumor-bearing mice, compared to the treatment by PTT and GC alone. We found that PTT, GC and PTT+GC increased the proportion of tumor-infiltrating B cells and induced gene expression signatures associated with B cell activation. Both GC and PTT+GC elevated gene expression associated with antigen presentation, whereas GC elevated transcripts that regulate B cell activation and GTPase function and PTT+GC induced interferon response genes. Trajectory analysis, where B cells were organized according to pseudotime progression, revealed that both GC and PTT+GC induced the differentiation of B cells from a resting state towards an effector phenotype. The analyses confirmed upregulated interferon signatures in the differentiated tumor-infiltrating B cells following treatment by PTT+GC but not by GC. We also observed that breast cancer patients had significantly longer survival time if they had elevated expression of genes in B cells that were induced by PTT+GC therapy in the mouse tumors. Conclusion: Our findings show that the combination of local ablation and local application of immunostimulant initiates the activation of interferon signatures and antigen-presentation in B cells which is associated with positive clinical outcomes for breast cancer. These findings broaden our understanding of LAIT's regulatory roles in remodeling TME and shed light on the potentials of B cell activation in clinical applications.

[The Current Status and Research Progress of Antiviral Therapy in HCV-Associated Lymphoma --Review]

Hepatitis C virus (HCV) is one of the leading causes of chronic liver disease. HCV is not only related to hepatic malignancies but may also promote lymphoid neoplasms. Currently, research has confirmed HCV-related lymphoma, including marginal zone lymphoma (MZL), lymphoplasmacytic lymphoma (LPL), follicular lymphoma (FL), diffuse large B-cell lymphoma (DLBCL), and Burkitt lymphoma (BL). Many types of research have shown that antiviral therapy can improve or even remission several HCV-related lymphomas. The direct-acting antiviral agents (DAAs) (such as NS5A protease inhibitors, NS4/4A protease inhibitors and viral polymerase inhibitors) have shown clinical advantages of high efficacy and low side effects for both virus elimination and tumor regression in several HCV-related lymphomas, which may make the selected HCV-related lymphoma patients treated without chemotherapy. In this review the research progress and development direction of antiviral therapy in treating HCV-related lymphoma has summarized briefly.

[Importance and practice of standardized children's refractive development records]

The prevalence of myopia in China is increasing. The early onset and rapid progression of myopia in younger children have attracted more attention. The establishment of standardized children's refractive development records is the basis of myopic prevention and control. It would be helpful to follow the refractive status and pay more attention to the refractive development of potential myopic children, so as to reduce the prevalence of myopia. (Chin J Ophthalmol, 2021, 57: 724-726).

[Risk factors and nutritional status analysis in patients with liver cirrhosis and concomitant chronic periodontitis]

Objective: To study and explore the prevalence, characteristics, preliminary risk factors, as well as their relationship with nutritional scores in liver cirrhotic patient with chronic periodontitis. Methods: 163 patients with liver cirrhosis who were hospitalized in the Hepatology Division, Department of Internal Medicine at Tianjin Third Central Hospital from June to September 2018 were enrolled as the case group, while the control group consisted 140 healthy individuals enrolled during the same period. Periodontal examination, biochemical examination and oral hygiene habits were investigated. The prevalence of periodontitis in the two groups was compared, and the risk factors of severe periodontitis were conducted by multivariate regression analysis. Results: The prevalence of chronic periodontitis was significantly higher in patients with liver cirrhosis than healthy control population, and the differences were statistically significant (P < 0.05). The prevalence of severe periodontitis and full edentulous jaws was significantly higher in patients with liver cirrhosis than healthy control group, and the differences were statistically significant (P < 0.05 and P < 0.001). Compared with the healthy control group, the depth of periodontal pocket and the degree of attachment loss were significantly increased in the liver cirrhosis group (P < 0.001). Multivariate regression analysis showed that liver cirrhosis was the independent risk factors for both groups of patients with severe periodontitis (χ (2) = 11.046, P < 0.001). Univariate and multivariate regression analysis showed that toothbrushing frequency, nutritional risk score, prealbumin level and Child-Pugh grade were independent risk factors for occurrence of severe periodontitis in liver cirrhotic patient (χ (2) = 5.252, P = 0.022; χ (2) = 24.162, P < 0.001; χ (2) = 4.159, P = 0.041; χ (2) = 9.249, P = 0.002). Conclusion: The prevalence of periodontitis is significantly higher in patients with liver cirrhosis than healthy individuals, and liver cirrhosis is an independent risk factor for the occurrence of severe periodontitis. Toothbrushing frequency, nutritional risk score, prealbumin level and Child-Pugh grade are risk factors for severe periodontitis in patients with liver cirrhosis.

Modified Xiaochaihu Decoction for gastroesophageal reflux disease: A randomized double-simulation controlled trial

BACKGROUND

Gastroesophageal reflux disease (GERD) has a high prevalence worldwide, and its incidence is increasing annually. Modified Xiaochaihu Decoction (MXD) could relieve the symptoms of GERD, but the effects of MXD on GERD manifestations and relapse prevention need to be further explained. Therefore, we performed a prospective, double-blind, and double-simulation study.

AIM

To verify the efficacy of MXD for GERD and its effect on esophageal motility.

METHODS

Using randomization, double-blinding, and a simulation design, 288 participants with GERD were randomized to the treatment group and control group and received herbs (MXD) plus omeprazole simulation and omeprazole plus herbs simulation, respectively, for 4 wk. The GERD-Q scale score and esophageal manometry were measured at baseline, after treatment, and at 1 mo and 3 mo follow-up visits when medication was complete to evaluate recurrence indicators.

RESULTS

The GERD-Q scale score in both groups decreased significantly compared to those before treatment (P < 0.01). However, no significant difference was observed between the two groups (P > 0.05). Esophageal manometry showed that participants with lower esophageal sphincter pressure reduction and the proportion of ineffective swallowing (more than 50%) improved in both groups from baseline (P < 0.01), especially in the treatment group (P < 0.05). The percentage of small intermittent contractions, large intermittent contractions, and increased pre-phase contractions in the treatment group significantly improved compared with baseline (P < 0.05) but did not improve in the control group (P > 0.05). There was no significant difference between the groups after treatment (P > 0.05). The percentage of weak esophageal contractility (distal contractile integral < 450 mmHg·s·cm), improved in both groups (P < 0.01), but no significant difference was observed between the groups after treatment (P > 0.05). The relapse rate in the treatment group was lower than that in the control group at the 1 mo (P < 0.01) and 3 mo follow-up (P < 0.05).

CONCLUSION

MXD has a similar therapeutic effect to omeprazole in mild-to-moderate GERD. The therapeutic effect may be related to increased pressure in the lower esophageal sphincter and reduced ineffective swallowing.

Type 2 innate lymphoid cells from Id1 transgenic mice alleviate skin manifestations of graft-versus-host disease

Background

Acute graft-versus-host disease (aGVHD) is one of the most common causes of morbidity for patients undergoing allogeneic stem cell transplantation. There is preliminary evidence that activated Group 2 innate lymphoid cells (ILC2s) from wild type (WT) mice reduces the lethality of aGVHD and is effective in treating lower gastrointestinal (GI) tract manifestations of aGVHD. This raises the prospect that ILC2s may be used for cell-based therapy of aGVHD but vigorous investigation is necessary to assess their impacts on different aspects of aGVHD. Genetically engineered mice which either express Id1 protein (Id1^tg/tg), an inhibitor of E protein transcription factors or have E protein genes knocked out (dKO) in the thymus produce massive numbers of ILC2s, thus allowing extensive evaluation of ILC2s. We investigated whether these ILC2s have protective effects in aGVHD as WT ILC2s do using an established mouse model of aGVHD.

Results

bone marrow transplant was performed by irradiating BALB/c strain of recipient mice and transplanting with bone marrow and T cells from the MHC-disparate C57BL/6 strain. We isolated ILC2s from Id1^tg/tg and dKO mice and co-transplanted them to study their effects. Our results confirm that activated ILC2s have a protective role in aGVHD, but the effects varied depending on the origin of ILC2s. Co-transplantation of ILC2s from Id1^tg/tg mice were beneficial in aGVHD and are especially helpful in ameliorating the skin manifestations of aGVHD. However, ILC2s from dKO mice were less effective at the protection and behaved differently depending on if the cells were isolated from dKO mice were pre-treated with IL-25 in vivo.

Conclusion

These findings support the notion that thymus-derived ILC2s from Id1^tg/tg mice are protective against aGVHD, with a significant improvement of skin lesions and they behave differently from dKO mice in the setting of aGVHD.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12865-021-00432-w.

USP9X deubiquitinates connexin43 to prevent high glucose-induced epithelial-to-mesenchymal transition in NRK-52E cells

Epithelial-to-mesenchymal transition (EMT) plays an important role in diabetic nephropathy (DN). Ubiquitin-specific protease 9X (USP9X/FAM) is closely linked to TGF-β and fibrosis signaling pathway. However, it remains unknown whether USP9X is involved in the process of EMT in DN. Our previous study has shown that connexin 43 (Cx43) activation attenuated the development of diabetic renal tubulointerstitial fibrosis (RIF). Here, we showed that USP9X is a novel negative regulator of EMT and the potential mechanism is related to the deubiquitination and degradation of Cx43. To explore the potential regulatory mechanism of USP9X, the expression and activity of USP9X were studied by CRISPR/Cas9-based synergistic activation mediator (SAM) system, short hairpin RNAs, and selective inhibitor. The following findings were observed: (1) Expression of USP9X was down-regulated in the kidney tissue of db/db diabetic mice; (2) overexpression of USP9X suppressed high glucose (HG)-induced expressions of EMT markers and extra cellular matrix (ECM) in NRK-52E cells; (3) depletion of USP9X further aggravated EMT process and ECM production in NRK-52E cells; (4) USP9X deubiquitinated Cx43 and suppressed its degradation to regulate EMT process; (5) USP9X deubiquitinated Cx43 by directly binding to the C-terminal Tyr²⁸⁶ of Cx43. The current study determined the protective role of USP9X in the process of EMT and the molecular mechanism clarified that the protective effects of USP9X on DN were associated with the deubiquitination of Cx43.

[Characteristics of esophageal motility and clinical presentation in gastroesophageal reflux disease patients of different age groups]

Objective: To explore the characteristics of esophageal motility and clinical presentation in gastroesophageal reflux disease (GERD) patients of different age groups. Methods: This was a case-control study. Confirmed GERD patients in the Department of Gastroenterology of Peking Union Medical College Hospital from January 2015 to September 2018 were enrolled and divided into two groups: elderly group (≥60 years old) and young and middle-aged group (<60 years old). Characteristics of gender, disease course, clinical symptoms, esophageal motility, gastroscopic manifestations and esophageal hiatus function of patients in the two groups were analyzed. Results: A total of 250 patients met the inclusion criteria, with 61 patients in elderly group and 189 in young and middle-aged group. There were no significant differences in gender ((male/female: 24/37 vs 78/111, P>0.05) and disease course((4.9±4.2) years vs(4.5±3.8)years, P>0.05) between the two groups. However, there were significant differences in typical symptoms (acid regurgitation and heartburn) and atypical symptoms (chest pain, cough, foreign body sensation in pharynx, etc.) (typical/atypical symptoms: 35/26 vs 146/43, P<0.01) between the two groups. Compared with young and middle-aged group, upper esophageal sphincter (UES) resting pressure was lower ((65±28) mmHg (1 mmHg=0.133 kPa)vs (74±28) mmHg, P<0.05), but the percentage of ineffective esophageal motility (IEM) (78.7%(48/61) vs 65.1%(123/189),P<0.05) and DeMeester score (16.3(6.0,36.3) vs 6.4(2.5,18.0), P<0.05) were higher in elderly group. There were no significant differences in lower esophageal sphincter (LES) resting pressure and distal contractile integral (DCI) between the two groups. Higher proportion of grade C and D reflux esophagitis,and grade C and D reflux esophagitis complicated with esophageal hiatus dysfunction was observed in elderly group compared with young and middle-aged group (2.04%(8/49) vs 0.65%(1/155); 14.29%(7/49) vs 0(0/155); both P<0.01). Pearson correlation analysis showed that there was a negative correlation between UES resting pressure and age(r=-0.145, P<0.05), while there was a positive correlation between the LES length and age (r=0.129, P<0.05). Conclusion: Compared with young and middle-aged GERD patients, the atypical symptoms, lower LES resting pressure, increased incidence of ineffective esophageal motility and acid exposure were more prominent in the elderly. Considering that anti-reflux function was weakened, long-term acid suppressants may be needed in elderly patients.

[Retinal vessel density in primary open-angle glaucoma with a hemifield defect]

Objective: To evaluate the retinal vessel density in eyes with primary open-angle glaucoma (POAG) with single-hemifield visual field (VF) defects and its relationship to retinal nerve fiber layer (RNFL) thickness and visual field indices. Methods: Cross-sectional study. Twenty-eight POAG patients with single-hemifield VF defects and 31 normal controls were recruited from October 2015 to October 2018 in the Eye, Ear, Nose and Throat Hospital of Fudan University. All subjects underwent complete ophthalmological examinations, including RNFL, retinal ganglion cell complex (GCC) thickness and visual field tests, and the general information was collected. The peripapillary radial peripapillary capillaries (RPC) and macular superifical retinal capillary plexus (SCP) were derived from optical coherence tomography angiography. The retinal vessel density, structural values, and VF values were compared among the corresponding hemifields of POAG and healthy eyes using the Rank Sum test. Results: There were 16 males and 12 females in POAG patients, with the age of (47±12) years; there were no significant differences in gender distribution, age, intraocular pressure, central corneal thickness, axial length and intraocular perfusion pressure between POAG patients and the normal controls (all P>0.05). Among POAG patients, there were 19 cases with upper and 9 cases with lower visual field defect. In the POAG eyes, the vascular density of peripapillary RPC and macular SCP were 45.86% (34.92%-52.78%) and 39.31% (32.55%-46.79%), respectively. In the normal eyes, the vascular density of peripapillary RPC and macular SCP were 56.90% (51.69%-60.84%) and 47.48% (37.95%-52.25%), respectively. The difference was statistically significant (Z=-6.56, -5.86; both P<0.01). The RNFL and GCC thicknesses in the POAG group were 84.4 (62.1-97.1), 76.4 (60.3-92.5) μ m, respectively, which were smaller than those in normal controls [110.6 (95.7-131.6), 98.1 (84.0-109.2) μm; Z=-6.57, -6.36; both P<0.01]. In the POAG eyes, the peripapillary RPC [44.12% (34.73%-53.20%) vs. 51.85% (38.64%-61.02%); Z=-4.62; P<0.01] and macular SCP [36.81% (29.73%-47.82%) vs. 41.78% (33.93%-49.22%); Z=-4.12; P<0.01] vessel densities were reduced in the abnormal hemisphere compared with the opposite hemisphere. Compared with the normal eyes, the normal hemisphere of the POAG eyes had lower peripapillary RPC and macular SCP vessel densities (Z=-5.08, -4.95; both P<0.01), a thinner RNFL and a thinner retinal GCC [93.0 (61.9-116.5) μm vs. 110.6 (95.7-131.6) μm, Z=-5.15; 86.3 (67.2-98.2) μm vs. 98.1 (84.0-109.2) μm, Z=-5.35; both P<0.01]. But the mean deviation and pattern standard deviation values of the VF were not significantly different between them (both P>0.05). Conclusions: The retinal vessel density reduce in eyes with POAG with single-hemifield VF defects. The normal hemisphere of POAG eyes have a reduced retinal microcirculation along with the thinning of the RNFL and GCC, suggesting that vascular dysfunction and structural changes preceded VF loss in POAG. (Chin J Ophthalmol, 2021, 57: 201-206).

[A new analysis method for 24-hour intraocular pressure data]

The study aimed to introduce a new analysis method of 24-hour intraocular pressure (IOP) and to propose the concept of overall IOP. Data of 24-hour IOP of a patient with a confirmed diagnosis of normal tension glaucoma was selected. Based on the present indexes including peak IOP, trough IOP, maximum difference, and mean IOP, new indexes were proposed, which included main IOP, duration of main IOP, and rate of IOP increase. A radar chart was drawn, and overall IOP was calculated. Overall IOP value = IOP distribution (sum of IOP value multiplied by the corresponding duration) × IOP fluctuation (standard deviation) × rate of IOP increase/100. By comparing two series of IOP data, the advantages of the new IOP indexes were demonstrated. The introduction of the concept of overall IOP expands the description of IOP from a single static state to a comprehensive dynamic state, which enables us to analyze the results of 24-hour IOP monitoring more thoroughly. (Chin J Ophthalmol, 2021, 57: 228-231).

[Analysis of liver cancer screening results and influencing factors of urban residents in Zhejiang Province from 2013 to 2018]

Objective: To analyze the results of liver cancer screening for urban residents in Zhejiang Province from 2013 to 2018 and explore the influencing factors of the detection rate. Methods: From September 2013 to August 2019, six urban communities in Hangzhou (Jianggan District and Gongshu District), Ningbo (Haishu District, Yinzhou District and Jiangbei District), and Quzhou (Kecheng District) were selected as study sites. All permanent residents aged 40-74 (with local household registration and living in the local area for more than 3 years) were selected as the research subjects by using cluster sampling method. Patients with confirmed cancers and other serious medical and surgical diseases were excluded. A total of 166 293 research subjects were included. Basic demographic characteristics and risk factors of subjects were obtained through questionnaire surveys. The cancer risk assessment system was used to evaluate the liver cancer risk of subjects. Clinical screening participation and screening results for subjects at high risk of liver cancer were obtained from participating hospitals. The high-risk rate of liver cancer, clinical screening rate, detection rate of positive lesions, and detection rate of suspected liver cancer were analyzed. Poisson regression was used to analyze the influencing factors of detection rate. Results: The age of 166 293 subjects was (56.01±8.40) years, of which 41.36% (68 777) were males. A total of 23 765 high-risk subjects for liver cancer were screened (the high-risk rate was 14.29%). Among them, a total of 12 375 subjects participated in clinical screening for liver cancer, with a screening rate of 52.07% (12 375/23 765). A total of 297 cases of positive lesions were detected and the detection rate was 2.40% (297/12 375). A total of 8 cases of suspected liver cancer were detected, with a detection rate of 0.06% (8/12 375). The results of multivariate Poisson regression model analysis showed that compared with men, people who never smoked, never ate pickled food, had low oil content, and had no history of hepatobiliary disease, female, people who were smoking or had smoked, sometimes ate pickled food, ate higher oil content, and had a history of hepatobiliary disease had a higher detection rate of positive lesions. The incidence rate ratio (IRR) (95%CI) values were 1.98 (1.45-2.70), 2.23 (1.61-3.09)/2.08 (1.31-3.28), 1.82 (1.22-2.70), 1.44 (1.08-1.91), and 1.45 (1.05-2.00), respectively. Compared with those aged from 40 to 49 years old and without HBsAg test, the IRR (95%CI) of suspected liver cancer in people aged 70 to 74 years old and HBsAg positive were 16.30 (1.32-200.74) and 6.43 (1.24-33.22), respectively. Conclusion: The urban cancer early diagnosis and early treatment project in Zhejiang Province has good compliance in clinical screening of liver cancer. Abdominal ultrasound examination and serum alpha-fetoprotein detection are helpful to detect liver cancer and its precancerous lesions in the high-risk population of liver cancer.

The Short-Term Effects of Ambient Air Pollutants are Associated With Daily Mortality in Northeast China From 2014 to 2018: A Time Series Analysis

OBJECTIVE

We aimed to examine the associations between ambient air pollutants and daily mortality in Northeast China from 2014 to 2018.

METHODS

A two-stage approach was used to estimate particulate matter with an aerodynamic diameter of 10 μm (PM10), nitrogen dioxide (NO2), and sulfur dioxide (SO2) exposure and daily mortality.

RESULTS

An increase of 10 μg/m3 of PM10 exposure and NO2 at lag of 0 to16 days was associated with the cumulative relative risk of 1.011 (95% confidence interval [CI]: 1.004, 1.019) and 1.026 (95% CI: 1.004, 1.049), respectively, in non-accident mortality. Meanwhile, significant association was observed in people aged under 60 years between SO2 exposure and respiratory mortality at lag of 0 to 9 days.

CONCLUSIONS

Our findings strengthen the evidence of PM10 and NO2 exposures were independent risk for daily mortality.

Stabilizing a laser frequency by the Pound-Drever-Hall technique with an acousto-optic modulator

We develop and demonstrate a method of optical phase modulation in the Pound-Drever-Hall (PDH) technique. The phase modulation in this paper is realized by an acousto-optic modulator (AOM) operating in the Bragg diffraction regime. In this process, a light beam separated from a laser (780 nm) is sent through the AOM twice and coupled to a high finesse Fabry-Perot cavity. Then, the light power coupling into the cavity is stabilized by modulating the optical amplitude with this AOM. The coupling light power is stabilized to a level of 10^-3. In the meantime, the PDH error signal is obtained by modulating the optical phase with the same AOM. After the error signal is fed back to the laser current, the laser linewidth is suppressed to approximately 907.91 Hz. This method of phase modulation is simple and convenient, and we believe it can be widely used in modulation transfer spectroscopy and frequency-modulation sideband spectroscopy.

[Results and cost-effectiveness of colorectal cancer screening program among urban residents in Zhejiang province, 2013-2018]

Objective: To analyze the results and cost-effectiveness of colorectal cancer (CRC) screening program among Zhejiang urban residents so as to provide evidence for further optimization of CRC screening strategies. Methods: Based on the Cancer Screening Program in Urban China which was conducted in Zhejiang province from 2013-2018, data related to the rates on compliance and detection through the CRC screening program among the 40-74 year-old residents were analyzed. Chi-square tests were used to compare the differences among groups, and multivariate logistic regression models were applied to explore the potential risk factors. Cost-effectiveness ratio (CER) was calculated by using the cost per lesion detected as the indicator. Results: Among all the 166 285 participants who completed the risk assessment questionnaire, 21 975 (13.2%) were recognized as under the high risk of CRC and 4 389 (20.0%) of them received the colonoscopy. The detection rates of CRC, advanced adenoma, and non-advance adenoma were 0.3% (11 cases), 2.7% (119 cases), and 5.2% (229 cases), respectively. Results from the multivariate logistic regression analyses showed that factors as age, gender, education level, smoking, drinking alcohol, previous fecal occult blood test (FOBT), polyp history, and family history of CRC were significantly associated with the compliance rate of colonoscopy while age, smoking and polyp history were significantly associated with the detection rate of advanced neoplasms (CRC and advanced adenoma). The costs were ￥22 355.74 Yuan for every CER advanced neoplasm detection and ￥264 204.18 Yuan per CRC detection, respectively. The CER decreased along with ageing. Sensitivity analysis showed that CERs were expected to decrease when the compliance rate of colonoscopy was increasing. Conclusions: The current screening program seems effective in detecting the precancerous colorectal lesions, but the relatively low compliance rate of colonoscopy restricting both the diagnostic yields and economic benefits. It is necessary to improve the awareness and acceptance of colonoscopy among the high-risk CRC population.

Comparison of Three Frailty Scales for Prediction of Adverse Outcomes among Older Adults: A Prospective Cohort Study

OBJECTIVES

To compare the ability of Frailty Phenotype (FP), FRAIL and Frailty Index (FI) to predict adverse outcomes.

DESIGN

A prospective cohort study.

SETTING

A senior community in Beijing, China.

PARTICIPANTS

A total of 188 older adults aged 65 years or older (mean age 84.0 ± 4.4 years, 58.5% female).

MEASUREMENTS

Frailty was evaluated by FP, FRAIL and FI. The agreement between scales was assessed by Cohen kappa coefficient. The predictive value of the three scales for adverse outcomes during one-year follow-up period were analyzed using decision curve analysis(DCA) and receiver operating characteristic curve (ROC) analysis.

RESULTS

Frailty ranged from 25% (FRAIL) to 42.6% (FI). The agreement between scales was moderate to good (Cohen's kappa coefficient 0.44~0.61). DCA showed though the curves of the scales overlapped across all relevant risk thresholds, clinical treating had a higher net benefit than "treat all" and "treat none" when risk of unplanned hospital visits ≥30%, risk of functional decline or falls ≥15%. The three scales had similar predictive value for unplanned hospital visits (area under ROC, AUC 0.63, 0.64 and 0.69). FRAIL and FI had similar predictive value for functional decline (AUC 0.63,0.65). FI had predictive value for falls (AUC 0.65).

CONCLUSIONS

All three scales showed clinical utility but FRAIL may be best in practice because it is simple. Multidimensional measures of frailty are better than unidimensional for prediction of adverse outcomes among older adults.

Augmenting E Protein Activity Impairs cDC2 Differentiation at the Pre-cDC Stage

Dendritic cell (DC) specification and differentiation are controlled by a circuit of transcription factors, which regulate the expression of DC effector genes as well as the transcription factors themselves. E proteins are a widely expressed basic helix-loop-helix family of transcription factors whose activity is suppressed by their inhibitors, ID proteins. Loss-of-function studies have demonstrated the essential role of both E and ID proteins in different aspects of DC development. In this study, we employed a gain-of-function approach to illustrate the importance of the temporal control of E protein function in maintaining balanced differentiation of conventional DC (cDC) subsets, cDC1 and cDC2. We expressed an E protein mutant, ET2, which dimerizes with endogenous E proteins to overcome inhibition by ID proteins and activate the transcription of E protein targets. Induction of ET2 expression at the hematopoietic progenitor stage led to a dramatic reduction in cDC2 precursors (pre-cDC2s) with little impact on pre-cDC1s. Consequently, we observed decreased numbers of cDC2s in the spleen and lung, as well as in FLT3L-driven bone marrow-derived DC cultures. Furthermore, in mice bearing ET2, we detected increased expression of the IRF8 transcription factor in cDC2s, in which IRF8 is normally down-regulated and IRF4 up-regulated. This aberrant expression of IRF8 induced by ET2 may contribute to the impairment of cDC2 differentiation. In addition, analyses of the transcriptomes of splenic cDC1s and cDC2s revealed that ET2 expression led to a shift, at least in part, of the transcriptional profile characteristic of cDC2s to that of cDC1. Together, these results suggest that a precise control of E protein activity is crucial for balanced DC differentiation.

Polydatin attenuates renal fibrosis in diabetic mice through regulating the Cx32-Nox4 signaling pathway

We previously found that polydatin could attenuate renal oxidative stress in diabetic mice and improve renal fibrosis. Recent evidence shows that NADPH oxidase 4 (Nox4)-derived reactive oxygen species (ROS) contribute to inflammatory and fibrotic processes in diabetic kidneys. In this study we investigated whether polydatin attenuated renal fibrosis by regulating Nox4 in vitro and in vivo. In high glucose-treated rat glomerular mesangial cells, polydatin significantly decreased the protein levels of Nox4 by promoting its K48-linked polyubiquitination, thus inhibited the production of ROS, and eventually decreasing the expression of fibronectin (FN) and intercellular adhesion molecule-1 (ICAM-1), the main factors that exacerbate diabetic renal fibrosis. Overexpression of Nox4 abolished the inhibitory effects of polydatin on FN and ICAM-1 expression. In addition, the expression of Connexin32 (Cx32) was significantly decreased, which was restored by polydatin treatment. Cx32 interacted with Nox4 and reduced its protein levels. Knockdown of Cx32 abolished the inhibitory effects of polydatin on the expression of FN and ICAM-1. In the kidneys of streptozocin-induced diabetic mice, administration of polydatin (100 mg·kg-1·d-1, ig, 6 days a week for 12 weeks) increased Cx32 expression and reduced Nox4 expression, decreased renal oxidative stress levels and the expression of fibrotic factors, eventually attenuating renal injury and fibrosis. In conclusion, polydatin promotes K48-linked polyubiquitination and degradation of Nox4 by restoring Cx32 expression, thereby decreasing renal oxidative stress levels and ultimately ameliorating the pathological progress of diabetic renal fibrosis. Thus, polydatin reduces renal oxidative stress levels and attenuates diabetic renal fibrosis through regulating the Cx32-Nox4 signaling pathway.

E proteins orchestrate dynamic transcriptional cascades implicated in the suppression of the differentiation of group 2 innate lymphoid cells

Group 2 innate lymphoid cells (ILC2s) represent a subset of newly discovered immune cells that are involved in immune reactions against microbial pathogens, host allergic reactions, as well as tissue repair. The basic helix-loop-helix transcription factors collectively called E proteins powerfully suppress the differentiation of ILC2s from bone marrow and thymic progenitors while promoting the development of B and T lymphocytes. How E proteins exert the suppression is not well understood. Here we investigated the underlying molecular mechanisms using inducible gain and loss of function approaches in ILC2s and their precursors, respectively. Cross-examination of RNA-seq and ATAC sequencing data obtained at different time points reveals a set of genes that are likely direct targets of E proteins. Consequently, a widespread down-regulation of chromatin accessibility occurs at a later time point, possibly due to the activation of transcriptional repressor genes such as Cbfa2t3 and Jdp2 The large number of genes repressed by gain of E protein function leads to the down-regulation of a transcriptional network important for ILC2 differentiation.

Determination of Strong-Phase Parameters in D→K_{S,L}^{0}π^{+}π^{-}

We report the most precise measurements to date of the strong-phase parameters between D^{0} and D[over ¯]^{0} decays to K_{S,L}^{0}π^{+}π^{-} using a sample of 2.93  fb^{-1} of e^{+}e^{-} annihilation data collected at a center-of-mass energy of 3.773 GeV with the BESIII detector at the BEPCII collider. Our results provide the key inputs for a binned model-independent determination of the Cabibbo-Kobayashi-Maskawa angle γ/ϕ_{3} with B decays. Using our results, the decay model sensitivity to the γ/ϕ_{3} measurement is expected to be between 0.7° and 1.2°, approximately a factor of three smaller than that achievable with previous measurements, based on the studies of the simulated data. The improved precision of this work ensures that measurements of γ/ϕ_{3} will not be limited by knowledge of strong phases for the next decade. Furthermore, our results provide critical input for other flavor-physics investigations, including charm mixing, other measurements of CP violation, and the measurement of strong-phase parameters for other D-decay modes.

Correlation of the levels of DNA-binding inhibitor Id3 and regulatory T cells with SLE disease severity

E proteins, a subset of basic helix-loop-helix (bHLH) proteins, are transcription activators and their functions are inhibited by DNA-binding inhibitor (Id) 1-4. Studies have shown that Treg levels are decreased in Id3 knockout mice. Mice over-expressing Id1 in CD4 T cells possessed a greater number of regulatory T cells (Treg) and exhibited attenuated experimental autoimmune encephalomyelitis (EAE). The significance of Id proteins in human systemic lupus erythematosus (SLE) remains unclear. In this study, we systematically analyzed Id transcription in naïve, memory CD4 cells and regulatory T cells in peripheral blood mononuclear cells (PBMCs) in patients with active or inactive SLE. In parallel, Treg subsets in PBMCs were analyzed using different strategies. Id expression levels were correlated with Treg numbers as well as clinical indicators. We found that Id genes expressed in human peripheral CD4 cells were mainly Id2 and Id3. Id3 levels were significantly elevated in CD4⁺CD25^hi T cells of patients with active SLE. Likewise, Id3 levels were positively correlated with increased CD4⁺FoxP3⁺ and CD4⁺Helios⁺FoxP3⁺ Treg cells in these patients. Id3 levels were found to be positively correlated with erythrocyte sedimentation rate (ESR), lupus anticoagulant (LAC), ribosomal antibody and SLE Disease Activity Index (SLEDAI) in patients with active SLE. Mice overexpressing Id1 in CD4⁺ T cells possessed significantly higher Treg levels in spleen and lower autoantibody concentrations in serum. Our results suggest that during the pathogenesis of SLE, up-regulation of Id3 can promote Treg differentiation to play an inhibitory effect on autoimmune responses.

Positive-Parity Linear-Chain Molecular Band in ^{16}C

An inelastic excitation and cluster-decay experiment ^{2}H(^{16}C,^{4}He+^{12}Be or ^{6}He+^{10}Be)^{2}H was carried out to investigate the linear-chain clustering structure in neutron-rich ^{16}C. For the first time, decay paths from the ^{16}C resonances to various states of the final nuclei were determined, thanks to the well-resolved Q-value spectra obtained from the threefold coincident measurement. The close-threshold resonance at 16.5 MeV is assigned as the J^{π}=0^{+} band head of the predicted positive-parity linear-chain molecular band with (3/2_{π}^{-})^{2}(1/2_{σ}^{-})^{2} configuration, according to the associated angular correlation and decay analysis. Other members of this band were found at 17.3, 19.4, and 21.6 MeV based on their selective decay properties, being consistent with the theoretical predictions. Another intriguing high-lying state was observed at 27.2 MeV which decays almost exclusively to ^{6}He+^{10}Be(∼6  MeV) final channel, corresponding well to another predicted linear-chain structure with the pure σ-bond configuration.

Recovery of innate lymphoid cells after allogeneic stem cell transplant: A single institution pilot study

The response of Innate Lymphoid Cells (ILCs) to conditioning regimens and subsequent recovery in the setting of allogeneic hematopoietic stem cell transplant (aHSCT) in pediatric patients is not known. The impact of this recovery pattern on graft versus host disease (GVHD) has not been prospectively studied. We aim to study the recovery of ILCs after aHSCT in children and discover its role in GVHD. Pediatric patients undergoing aHSCT were enrolled in a prospective translational study since May 2019. Patients blood were analysed by flow cytometry at following time points: prior to the conditioning regimen, weekly starting on day 0 until +30 (+/− 3 days), then +60, +90 and +180 days. Ten patients have been enrolled to date - demographics: median age 9.5 years; 4 malignant, 6 non-malignant; haploidentical donor (n=1), matched sibling (n=3), unrelated (n= 6). Graft source was bone marrow for all patients. Most common conditioning regimen was fludarabine, busulfan and rabbit antithymocyte globulin (40%). GVHD prophylaxis for most patients was tacrolimus with mini-methotrexate (90%). We saw substantial drop in number of ILCs in response to conditioning regimen in all patients, with nadir on +14 that plateaued through +30, followed by a spike on +60 and return to normal levels by +90. Similar trend was seen in type 1 ILCs (Lin− CD127+ CRTH2− CD117−) but showed a slower drop, reaching nadir on +21 with slow recovery by +60. Type 2 ILCs (Lin− CD127+ CRTH2+) and Type 3 ILCs (Lin− CD127+ CRTH2-ve CD117+) however showed a small increase on +7 compared to day 0 with both cell types recovering by +60. We showed that it is feasible to prospectively study the recovery of ILCs after aHSCT. Continued enrollment will allow us to evaluate the correlation between ILCs and GVHD.

The effect of Chinese wild blueberry fractions on the growth and membrane integrity of various foodborne pathogens

The objective of this study was to evaluate the antibacterial effect of Chinese wild blueberry extract and its fractions against Listeria monocytogenes, Staphylococcus aureus, Salmonella Enteritidis, and Vibrio parahaemolyticus. Chinese wild blueberry (Vaccinium uliginosum) crude extract (BBE) was obtained using methanol extraction, and sugars plus organic acids (F1), phenolics fraction (F2), and anthocyanins plus proanthocyanidins (F3) fractions were separated using C-18 Sep-Pak columns. The minimal inhibitory concentration and minimal bactericidal concentration of each fractional component were determined using a two-fold-serial dilution method. Nucleic acid leakage (OD_{260 nm} ) and protein release (Bradford protein assay) were determined by spectrophotometry, to evaluate the permeability of the cell membrane. F3 was found to exhibit the greatest antimicrobial activity against the four tested strains, followed by F2, F1, and BBE. V. parahaemolyticus was the most sensitive to the all fractions, followed by S. Enteritidis, L. monocytogenes, and S. aureus. Survival curve analysis showed that the number of bacteria decreased from six log colony-forming units (CFU) to less than 10 CFU after bacteria were treated with fractions for 12 hr, which demonstrated the bactericidal effect of blueberry fractions. Furthermore, when the pathogens were treated with fractions for 2 hr, the OD_{260 nm} and OD_{595 nm} values increased significantly (P < 0.01), which indicated the significant release of nucleic acid and protein. The results from this study indicated that blueberry fractions, especially F3, inhibited the growth of foodborne pathogens by damaging their cell membrane, and may be developed as a natural preservative to prevent and control foodborne pathogens. PRACTICAL APPLICATION: A blueberry crude extract and its sugars plus organic acids, phenolics, and anthocyanins plus proanthocyanidins fractions, inhibited the growth of foodborne pathogens by destroying their cell membrane. Therefore, Chinese wild blueberries have potential as a natural preservative to prevent and control foodborne pathogens.