Exosomes derived from microglia overexpressing miR-124-3p alleviate neuronal endoplasmic reticulum stress damage after repetitive mild traumatic brain injury

JOURNAL/nrgr/04.03/01300535-202409000-00033/figure1/v/2024-01-16T170235Z/r/image-tiff We previously reported that miR-124-3p is markedly upregulated in microglia-derived exosomes following repetitive mild traumatic brain injury. However, its impact on neuronal endoplasmic reticulum stress following repetitive mild traumatic brain injury remains unclear. In this study, we first used an HT22 scratch injury model to mimic traumatic brain injury, then co-cultured the HT22 cells with BV2 microglia expressing high levels of miR-124-3p. We found that exosomes containing high levels of miR-124-3p attenuated apoptosis and endoplasmic reticulum stress. Furthermore, luciferase reporter assay analysis confirmed that miR-124-3p bound specifically to the endoplasmic reticulum stress-related protein IRE1α, while an IRE1α functional salvage experiment confirmed that miR-124-3p targeted IRE1α and reduced its expression, thereby inhibiting endoplasmic reticulum stress in injured neurons. Finally, we delivered microglia-derived exosomes containing miR-124-3p intranasally to a mouse model of repetitive mild traumatic brain injury and found that endoplasmic reticulum stress and apoptosis levels in hippocampal neurons were significantly reduced. These findings suggest that, after repetitive mild traumatic brain injury, miR-124-3 can be transferred from microglia-derived exosomes to injured neurons, where it exerts a neuroprotective effect by inhibiting endoplasmic reticulum stress. Therefore, microglia-derived exosomes containing miR-124-3p may represent a novel therapeutic strategy for repetitive mild traumatic brain injury.

Floating-Point Approximation Enabling Cost-Effective and High-Precision Digital Implementation of FitzHugh-Nagumo Neural Networks

The study of neuron interactions and hardware implementations are crucial research directions in neuroscience, particularly in developing large-scale biological neural networks. The FitzHugh-Nagumo (FHN) model is a popular neuron model with highly biological plausibility, but its complexity makes it difficult to apply at scale. This paper presents a cost-saving and improved precision approximation algorithm for the digital implementation of the FHN model. By converting the computational data into floating-point numbers, the original multiplication calculations are replaced by adding the floating-point exponent part and fitting the mantissa part with piecewise linear. In the hardware implementation, shifters and adders are used, greatly reducing resource overhead. Implementing FHN neurons by this approximation calculations on FPGA reduces the normalized root mean square error (RMSE) to 3.5% of the state-of-the-art (SOTA) while maintaining a performance overhead ratio improvement of 1.09 times. Compared to implementations based on approximate multipliers, the proposed method achieves a 20% reduction in error at the cost of a 2.8% increase in overhead.This model gained additional biological properties compared to LIF while reducing the deployment scale by only 9%. Furthermore, the hardware implementation of nine coupled circular networks with eight nodes and directional diffusion was carried out to demonstrate the algorithm's effectiveness on neural networks. The error decreased to 60% compared to the single neuron of the SOTA. This hardware-friendly algorithm allows for the low-cost implementation of high-precision hardware simulation, providing a novel perspective for studying large-scale, biologically plausible neural networks.

Hypoxic Exosomal circPLEKHM1-Mediated Crosstalk between Tumor Cells and Macrophages Drives Lung Cancer Metastasis

Intercellular communication often relies on exosomes as messengers and is critical for cancer metastasis in hypoxic tumor microenvironment. Some circular RNAs (circRNAs) are enriched in cancer cell-derived exosomes, but little is known about their ability to regulate intercellular communication and cancer metastasis. Here, by systematically analyzing exosomes secreted by non-small cell lung cancer (NSCLC) cells, a hypoxia-induced exosomal circPLEKHM1 is identified that drives NSCLC metastasis through polarizing macrophages toward to M2 type. Mechanistically, exosomal circPLEKHM1 promoted PABPC1-eIF4G interaction to facilitate the translation of the oncostatin M receptor (OSMR), thereby promoting macrophage polarization for cancer metastasis. Importantly, circPLEKHM1-targeted therapy significantly reduces NSCLC metastasis in vivo. circPLEKHM1 serves as a prognostic biomarker for metastasis and poor survival in NSCLC patients. This study unveils a new circRNA-mediated mechanism underlying how cancer cells crosstalk with macrophages within the hypoxic tumor microenvironment to promote metastasis, highlighting the importance of exosomal circPLEKHM1 as a prognostic biomarker and therapeutic target for lung cancer metastasis.

Prevalence and Risk Factors of Urinary Retention in Patients With Cervical Cancer: A Meta-analysis and Systematic Review

BACKGROUND

The literature is inconsistent on the prevalence and risk factors of urinary retention in patients with cervical cancer.

OBJECTIVE

The aim of this study was to review the literature on the prevalence of urinary retention in patients with cervical cancer and consolidate the risk factors.

METHODS

For this meta-analysis, eligible articles published in English or Chinese by December 10, 2021, were systematically searched for and retrieved from PubMed, Cochrane Library, Ovid-Embase Medline, Web of Science, PsycINFO, CINAHL, and Scopus. Prevalence, odds ratios (ORs), and 95% confidence intervals (CIs) were used for meta-analysis.

RESULTS

Twenty-five studies were included in the analysis. The pooled overall prevalence was 0.26 (95% CI, 0.21-0.30, I2 = 95.0%). The identified risk factors were age (OR, 1.13; 95% CI, 1.08-1.19), urinary tract infection (UTI) (OR, 3.33; 95% CI, 1.48-7.49), surgical extent (OR, 2.95; 95% CI, 1.27-6.85), and catheter indwelling time (OR, 3.44; 95% CI, 2.43-3.87).

CONCLUSIONS

The prevalence of urinary retention in patients with cervical cancer is 0.26. Older age, UTI, longer catheter indwelling time, and a larger surgical extent may increase the risk of urinary retention. Clinicians should identify patients at risk and adopt interventions such as individualized catheter care.

IMPLICATIONS FOR PRACTICE

Nursing staff should assess the risk of urinary retention in a patient with cervical cancer according to her age, presence of UTI, surgical extent, and catheterization time. A carefully chosen surgical procedure and interventions such as individualized education, timely catheter removal, treatment of UTI, and rehabilitation should be offered.

Bronchiolar adenoma/ciliated muconodular papillary tumour: advancing clinical, pathological, and imaging insights for future perspectives

Bronchiolar adenoma/ciliated muconodular papillary tumour (BA/CMPT) is a benign peripheral lung tumour composed of bilayered bronchiolar-type epithelium containing a continuous basal cell layer; however, the similarities in imaging and tissue biopsy findings at histopathology between BA/CMPT and malignant tumours, including lung adenocarcinoma, pose significant challenges in accurately diagnosing BA/CMPT preoperatively. This difficulty in differentiation often results in misdiagnosis and unnecessary overtreatment. The objective of this article is to provide a comprehensive and systematic review of BA/CMPT, encompassing its clinical manifestations, pathological basis, imaging features, and differential diagnosis. By enhancing healthcare professionals' understanding of this disease, we aim to improve the accuracy of preoperative BA/CMPT diagnosis. This improvement is crucial for the development of appropriate therapeutic strategies and the overall improvement of patient prognosis.

Value of multi-center 18 F-FDG PET/CT radiomics in predicting EGFR mutation status in lung adenocarcinoma

BACKGROUND

Accurate, noninvasive, and reliable assessment of epidermal growth factor receptor (EGFR) mutation status and EGFR molecular subtypes is essential for treatment plan selection and individualized therapy in lung adenocarcinoma (LUAD). Radiomics models based on 18 F-FDG PET/CT have great potential in identifying EGFR mutation status and EGFR subtypes in patients with LUAD. The validation of multi-center data, model visualization, and interpretation are significantly important for the management, application and trust of machine learning predictive models. However, few EGFR-related research involved model visualization and interpretation, and multi-center trial.

PURPOSE

To develop explainable optimal predictive models based on handcrafted radiomics features (HRFs) extracted from multi-center 18 F-FDG PET/CT to predict EGFR mutation status and molecular subtypes in LUAD.

METHODS

Baseline 18 F-FDG PET/CT images of 383 LUAD patients from three hospitals and one public data set were collected. Further, 1808 HRFs were extracted from the primary tumor regions using Pyradiomics. Predictive models were built based on cross-combination of seven feature selection methods and seven machine learning algorithms. Yellowbrick and explainable artificial intelligence technology were used for model visualization and interpretation. Receiver operating characteristic curve, classification report and confusion matrix were used for model performance evaluation. Clinical applicability of the optimal models was assessed by decision curve analysis.

RESULTS

STACK feature selection method combined with light gradient boosting machine (LGBM) reached optimal performance in identifying EGFR mutation status ([area under the curve] AUC = 0.81 in the internal test cohort; AUC = 0.62 in the external test cohort). Random forest feature selection method combined with LGBM reached optimal performance in predicting EGFR mutation molecular subtypes (AUC = 0.89 in the internal test cohort; AUC = 0.61 in the external test cohort).

CONCLUSIONS

Explainable machine learning models combined with radiomics features extracted from multi-center/scanner 18 F-FDG PET/CT have certain potential to identify EGFR mutation status and subtypes in LUAD, which might be helpful to the treatment of LUAD.

Factors associated with nocturnal and diurnal glycemic variability in patients with type 2 diabetes: a cross-sectional study

PURPOSE

There is little information on factors that influence the glycemic variability (GV) during the nocturnal and diurnal periods. We aimed to examine the relationship between clinical factors and GV during these two periods.

METHODS

This cross-sectional study included 134 patients with type 2 diabetes. 24-h changes in blood glucose were recorded by a continuous glucose monitoring system. Nocturnal and diurnal GV were assessed by standard deviation of blood glucose (SDBG), coefficient of variation (CV), and mean amplitude of glycemic excursions (MAGE), respectively. Robust regression analyses were performed to identify the factors associated with GV. Restricted cubic splines were used to determine dose-response relationship.

RESULTS

During the nocturnal period, age and glycemic level at 12:00 A.M. were positively associated with GV, whereas alanine aminotransferase was negatively associated with GV. During the diurnal period, homeostatic model assessment 2-insulin sensitivity (HOMA2-S) was positively associated with GV, whereas insulin secretion-sensitivity index-2 (ISSI2) was negatively associated with GV. Additionally, we found a J-shape association between the glycemic level at 12:00 A.M. and MAGE, with 9.0 mmol/L blood glucose level as a cutoff point. Similar nonlinear associations were found between ISSI2 and SDBG, and between ISSI2 and MAGE, with ISSI2 value of 175 as a cutoff point.

CONCLUSION

Factors associated with GV were different between nocturnal and diurnal periods. The cutoff points we found in this study may provide the therapeutic targets for beta-cell function and pre-sleep glycemic level in clinical practice.

Explore the use of complementary and alternative medicine among Chinese gynaecological patients with cancer undergoing chemotherapy: a qualitative phenomenological study

OBJECTIVES

To explore the use of complementary and alternative medicine (CAM) by Chinese gynaecological oncology patients undergoing chemotherapy and discuss measures to address the existing gaps.

DESIGN

Qualitative phenomenology. Semistructured in-depth interview. Colaizzi's method data analysis.

SETTING

A tertiary general hospital.

PARTICIPANTS

16 gynaecological oncology patients (mean age 51.7) having undergone ≥1 chemotherapy cycle were recruited by purposive sampling.

RESULTS

Six themes were generated. The participants were under-informed about CAM concept and options. They were open to explore various modalities after chemotherapy as long as it could alleviate symptoms. The gynaecological patients with cancer sought information about CAM from diverse sources, with professional expertise being the most desirable way to seek information. They used CAM as a strategy to support continued chemotherapy and for symptom alleviation. Financial burden was not stressed but they had concerns about sustainability of some therapies. Their attitudes toward different CAM types varied. Some were sceptical about the efficacy.

CONCLUSIONS

The Chinese gynaecological oncology patients may be under-informed about CAM. They are open to use various CAM therapies for symptom relief and as a support strategy. However, their attitudes toward specific therapies may vary. Some may host scepticism about certain CAM modalities. The patients actively seek information on CAM and treatment resources but prefer professional expertise to other sources. Financial burden due to continued CAM use is inconclusive due to possible sampling bias. Sustainability of CAM therapies is a common concern because of limited resources and access. Education on CAM should be incorporated into the curriculum of healthcare professionals. Oncologists and nurses should educate gynaecological patients with cancer on the concept and options of CAM, preferably with information tailored to patient's individual needs. Health authorities should advocate provisions of diverse CAM services and develop the necessary technologies such as network of local care resources.

Achieving High Core Neuron Density in a Neuromorphic Chip Through Trade-off Among Area, Power Consumption, and Data Access Bandwidth

As a crucial component of neuromorphic chips, on-chip memory usually occupies most of the on-chip resources and limits the improvement of neuron density. The alternative of using off-chip memory may result in additional power consumption or even a bottleneck for off-chip data access. This article proposes an on- and off-chip co-design approach and a figure of merit (FOM) to achieve a trade-off between chip area, power consumption, and data access bandwidth. By evaluating the FOM of each design scheme, the scheme with the highest FOM (1.085× better than the baseline) is adopted to design a neuromorphic chip. Deep multiplexing and weight-sharing technologies are used to reduce on-chip resource overhead and data access pressure. A hybrid memory design method is proposed to optimize on- and off-chip memory distribution, which reduces on-chip storage pressure and total power consumption by 92.88% and 27.86%, respectively, while avoiding the explosion of off-chip access bandwidth. The co-designed neuromorphic chip with ten cores fabricated under standard 55 nm CMOS technology has an area of 4.4 mm 2 and a core neuron density of 4.92 K/mm 2, an improvement of 3.39  ∼ 30.56× compared with previous works. After deploying a full-connected and a convolution-based spiking neural network (SNN) for ECG signal recognition, the neuromorphic chip achieves 92% and 95% accuracy, respectively. This work provides a new path for developing high-density and large-scale neuromorphic chips.

A novel 3D printed type II silk fibroin/polycaprolactone mesh for the treatment of pelvic organ prolapse

Pelvic organ prolapse (POP) is one of the common diseases in middle-aged and elderly women, caused by weakened pelvic floor muscle ligament tissue support. Pelvic floor reconstruction with mesh implantation has been proven to be an effective treatment for POP. However, traditional non-degradable and inflexible pelvic floor implantation meshes have been associated with pain, vaginal infections, and the need for additional surgeries. In this study, novel meshes with pre-designed structures were fabricated with solution-based electrohydrodynamic printing (EHDP) technology, using a series of polycaprolactone/silk fibroin composites as bioinks. The PCL/SF mesh mechanical performances were particularly enhanced with the addition of silk II, leading it to obtain higher adaptability with soft tissue repair. The mesh containing SF showed more robust degradation performance in the in vitro degradation assay. Furthermore, biocompatibility tests conducted on mouse embryonic fibroblasts (NIH/3T3) revealed enhanced cell affinity. Finally, the biocompatibility and tissue repair properties of PCL/SF mesh were verified through the implantation of meshes in the muscle defect site of mice. The results demonstrated that the 3D printed PCL/SF mesh prepared by EHDP exhibits superior mechanical properties, biocompatibility, biodegradability, as well as ligament and muscle fiber repair ability. The novel implantable meshes are promising for curing POP.

[Construction of a schistosomiasis transmission risk assessment system in Wuhan City based on analytic hierarchy process]

OBJECTIVE

To construct a schistosomiasis transmission risk assessment system in Wuhan City and preliminary evaluate its application effect, so as to promote the rational allocation of schistosomiasis control resources and accelerate the progress towards schistosomiasis elimination.

METHODS

The schistosomiasis risk assessment indicators were collected through referring schistosomiasis surveillance data of Wuhan City from 2014 to 2020, literature review and expert interviews. Indicators within each criterion and sub-criterion were screened using the Delphi method, and a hierarchical structure model was created based on analytic hierarchy process. Quantitative assignment of each indicator was conducted according to relative importance, and the weight and combination weight of each criterion were calculated in each analytic hierarchy framework to create a schistosomiasis transmission risk assessment system, which was used for the schistosomiasis transmission risk assessment in 12 national schistosomiasis surveillance sites in Wuhan City.

RESULTS

A three-level schistosomiasis transmission risk assessment system was preliminarily constructed, which included a target layer, 5 criterion layers and 21 sub-criterion layers. Of all indicators in the criterion layer, transmission route had the highest weight (0.433), followed by source of Schistosoma japonicum infection (0.294); and among all indicators in the sub-criterion layer, S. japonicum infection in Oncomelania hupensis and sentinel mice had the highest combination weight (0.125), followed by prevalence of S. japonicum infection in humans (0.091) and bovines (0.053), snail control by chemical treatment (0.049), positive rate of inquiry examinations (0.048), allocation of schistosomiasis control professionals (0.045), and areas of submerged snail-infested settings (0.041). Of the 12 national schistosomiasis surveillance sites in Wuhan City, there were 5 sites with weights of > 0.8, 4 sites with weights of 0.6 to 0.8, and 3 sites with weights of < 0.6 in 2020.

CONCLUSIONS

A schistosomiasis transmission risk assessment system has been constructed based on analytic hierarchy process in Wuhan City, which may provide a evidence-based basis for health resource allocation and decision-making for schistosomiasis control.

A novel TOX3-WDR5-ABCG2 signaling axis regulates the progression of colorectal cancer by accelerating stem-like traits and chemoresistance

The eradication of cancer stem cells (CSCs) with drug resistance confers the probability of local tumor control after chemotherapy or targeted therapy. As the main drug resistance marker, ABCG2 is also critical for colorectal cancer (CRC) evolution, in particular cancer stem-like traits expansion. Hitherto, the knowledge about the expression regulation of ABCG2, in particular its upstream transcriptional regulatory mechanisms, remains limited in cancer, including CRC. Here, ABCG2 was found to be markedly up-regulated in CRC CSCs (cCSCs) expansion and chemo-resistant CRC tissues and closely associated with CRC recurrence. Mechanistically, TOX3 was identified as a specific transcriptional factor to drive ABCG2 expression and subsequent cCSCs expansion and chemoresistance by binding to -261 to -141 segments of the ABCG2 promoter region. Moreover, we found that TOX3 recruited WDR5 to promote tri-methylation of H3K4 at the ABCG2 promoter in cCSCs, which further confers stem-like traits and chemoresistance to CRC by co-regulating the transcription of ABCG2. In line with this observation, TOX3, WDR5, and ABCG2 showed abnormal activation in chemo-resistant tumor tissues of in situ CRC mouse model and clinical investigation further demonstrated the comprehensive assessment of TOX3, WDR5, and ABCG2 could be a more efficient strategy for survival prediction of CRC patients with recurrence or metastasis. Thus, our study found that TOX3-WDR5/ABCG2 signaling axis plays a critical role in regulating CRC stem-like traits and chemoresistance, and a combination of chemotherapy with WDR5 inhibitors may induce synthetic lethality in ABCG2-deregulated tumors.

Optimal 18F-FDG PET/CT radiomics model development for predicting EGFR mutation status and prognosis in lung adenocarcinoma: a multicentric study

Purpose

To develop and interpret optimal predictive models to identify epidermal growth factor receptor (EGFR) mutation status and subtypes in patients with lung adenocarcinoma based on multicentric ¹⁸F-FDG PET/CT data, and further construct a prognostic model to predict their clinical outcome.

Methods

The ¹⁸F-FDG PET/CT imaging and clinical characters of 767 patients with lung adenocarcinoma from 4 cohorts were collected. Seventy-six radiomics candidates using cross-combination method to identity EGFR mutation status and subtypes were built. Further, Shapley additive explanations and local interpretable model-agnostic explanations were used for optimal models' interpretation. Moreover, in order to predict the overall survival, a multivariate Cox proportional hazard model based on handcrafted radiomics features and clinical characteristics was constructed. The predictive performance and clinical net benefit of the models were evaluated via area under receiver operating characteristic (AUC), C-index and decision curve analysis.

Results

Among the 76 radiomics candidates, light gradient boosting machine classifier (LGBM) combined with recursive feature elimination wrapped LGBM feature selection method achieved best performance in predicting EGFR mutation status (AUC reached 0.80, 0.61, 0.71 in the internal test cohort and two external test cohorts, respectively). And extreme gradient boosting classifier combined with support vector machine feature selection method achieved best performance in predicting EGFR subtypes (AUC reached 0.76, 0.63, 0.61 in the internal test cohort and two external test cohorts, respectively). The C-index of the Cox proportional hazard model achieved 0.863.

Conclusions

The integration of cross-combination method and the external validation from multi-center data achieved a good prediction and generalization performance in predicting EGFR mutation status and its subtypes. The combination of handcrafted radiomics features and clinical factors achieved good performance in predicting prognosis. With the urgent needs of multicentric ¹⁸F-FDG PET/CT trails, robust and explainable radiomics models have great potential in decision making and prognosis prediction of lung adenocarcinoma.

Rural regional economic data management based on blockchain technology

In the process of continuous development of rural economy, big data management plays an important role. Rural economic data mainly include rural labor force, added value of agriculture, forestry, fishery and animal husbandry, agricultural product output and per capita net income. Using big data to manage economic data can not only integrate and analyze a large number of data, build an economic management analysis database, but also predict and warn related risks in time and provide reasonable and effective economic management suggestions, thus ensuring the smooth operation of the economy. However, there are some shortcomings in data reliability, data quality and data management efficiency in rural regional economic data management, which have a great impact on the long-term stable development of the economy. This paper makes a systematic analysis of rural regional economic data, uses the blockchain consensus mechanism to quickly manage and analyze different types of economy in rural areas, and improves the speed of economic data analysis through smart contracts. This paper makes a comparative analysis of rural regional economic data management before and after adopting blockchain technology. In view of this phenomenon, according to the development demand of data management, this paper uses blockchain technology to effectively analyze and study the big data management of rural regional economy, and makes a comparative analysis through the tests of data operation efficiency, data quality, data management security and sharing degree. The experimental data show that the efficiency of data operation is as high as 1100 times per minute after the combination of blockchain technology, and the minimum manual modification ratio of node data is 0.24. This shows that the data quality of technical means is guaranteed. The data leakage rate per hour is at least 66%, and the data sharing volume is maintained at about 8000 views/hour and 7000 references/hour. The improvement of quality and efficiency can ensure the effectiveness of data management and improve the speed of economic development in rural areas, thus promoting good economic development. This paper uses blockchain technology to manage rural economic data, which has certain reference value for rural economic development.

Infection pattern and immunological characteristics of Epstein-Barr virus latent infection in cervical squamous cell carcinoma

Previous studies reported the association between Epstein-Barr virus (EBV) and cervical squamous cell carcinoma (CSCC), but its infection pattern and clinical significance unclear. This study aimed to comprehensively investigate the infection pattern, clinicopathology, outcomes, and immunology of this entity in central China. We evaluated a total of 104 untreated CSCC tumor tissue specimens using in situ hybridization for EBV-encoded small RNAs (EBERs), and by employing flowcytometry fluorescence hybridization for human papillomavirus (HPV) genotyping. The expression of EBV latency proteins and immune biomarkers was evaluated and quantified by immunohistochemistry. EBERs transcripts were detected in 21 (20.2%) cases overall (in malignant epithelial cells of 13 cases and in lymphocytes of 8 cases). EBV belonged to latency type I infection in CSCC. The high-risk (HR)-HPV was detected in all of EBV-positive CSCC, and the difference of detection rate of HR-HPV was significant when compared with EBV-negative CSCC (p = 0.001). The specific clinicopathology with increased frequency of advanced clinical stages, tumor-positive lymph nodes, neural invasion, and increased infiltration depth (all p value < 0.05) were observed in cases with EBV. However, EBV infection was found to have no impact on prognosis of patients with CSCC. Increased densities of forkhead box P3 (FoxP3)⁺-tumor infiltrating lymphocytes (TILs) (p = 0.005) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4)⁺-TILs (p = 0.017) and higher expression of programmed cell death-1 (PD-1) (p = 0.002) and programmed cell death-1 ligand 1 (PD-L1) (p = 0.040) were associated with EBV latent infection in CSCC, and these immunological changes were more likely to be associated with the infection in lymphocytes rather than tumor cells. Moreover, in patients with HPV-positive CSCC, similar significant differences were still found. In conclusions, EBV-positive CSCC may have specific infection pattern and clinicopathology and can exhibit an immunosuppressive microenvironment dominated by Treg cells aggregation and immune checkpoint activation.

Pulmonary Infection in Patients with Severe Fever with Thrombocytopenia Syndrome: A Multicentre Observational Study

Co-infection in patients with severe fever with thrombocytopenia syndrome (SFTS) has been reported, posing a serious threat to survival and treatment. We aimed to systematically investigate the SFTS associated pulmonary infection, particularly invasive pulmonary fungal infection (IPFI). During April 2019 to October 2021, we conducted a multicentre observational study on adult hospitalized patients confirmed with SFTS from 3 tertiary hospital in central China. Demographic, clinical and laboratory data of patients were collected and re-assessed. A total of 443 patients (51.7% were male sex) were included for analysis with median age of 65 years old. Among them, 190 (42.9%) patients met the criteria for pulmonary infection. Pulmonary infection was associated with shorter survival time (p < 0.0001 by log-rank test), and adjusted hazard ratio was 1.729 [95% confidence interval, 1.076-2.780] (p = 0.024). Age (odds ratio (OR) 1.040 [1.019-1.062], p < 0.001), time from onset to admission (OR 1.163 [1.070-1.264], p < 0.001), having severe status (OR 3.166 [2.020-4.962], p < 0.001) and symptoms of skin change (OR 2.361 [1.049-5.316], p < 0.001) at admission and receiving intravenous immunoglobin (OR 2.185 [1.337-3.569], p = 0.002) were independent risk factors for the occurrence of pulmonary infection. After excluded false-positive/clinically irrelevant colonization, 70 (15.8%) patients were defined as IPFI. Multivariate analysis showed that time from onset to admission (OR 1.117 [1.016-1.229], p = 0.022), severe status (OR 5.737 [3.054-10.779], p < 0.001), having smoking history (OR 3.178 [1.251-8.070], p = 0.015) and autoimmunity disease (OR 7.855 [1.632-37.796], p = 0.010), receiving intravenous immunoglobin (OR 3.270 [1.424-7.508], p = 0.005) were independent risk factors for the occurrence of IPFI. In SFTS patients with pulmonary infection, white blood count < 2.09×10⁹ per L (OR 6.521 [2.615-16.265], p < 0.001) and CD3⁺ CD4⁺ T cell count < 104.0 per μL (OR 8.707 [3.453-21.955], p < 0.001) could independently predict IPFI. This study showed the high prevalence and poor outcomes of pulmonary infection and IPFI in patients with SFTS. These findings highlighted the need for active surveillance of fungal pathogens and early antifungal treatment in patients with SFTS. This article is protected by copyright. All rights reserved.

Management of Crown-root Fracture with 180-degree Rotation Replantation: a Report of 2 Cases

Intentional replantation involves a combination of periodontics, endodontics, prosthodontics and oral surgery. Crown-root fracture management is still complicated nowadays. A fracture line extending longitudinally to the subgingival area and intruding bioogical width could affect infection control, gingival health and crown restoration. In the present study, we present two cases. Case 1 involved a 23-year-old man who presented at our hospital with crown-root fracture of the maxillary left central incisor. A radiographic image of the tooth revealed a fracture line under the alveolar crest. The fractured tooth was treated with intentional replantation with 180-degree rotation, root canal treatment and veneer restoration. The patient was followed up for 60 months. The replanted tooth functioned well, and no symptoms of resorption or ankylosis were observed by radiographic examination. Case 2 involved a 20-year-old woman who was referred to our hospital for crown-root fracture of her maxillary teeth. A radiographic examination revealed complicated crown-root fracture of the maxillary right lateral incisor and both maxillary central incisors. The central incisors were treated with intentional replantation with 180-degree rotation. At the 48-month follow-up, the fractured teeth were found to have regained normal function based on clinical and radiographic examination. Limited case reports are available on a long-term follow-up of intentional replantation with 180-degree rotation. These two cases, particularly case 2, presented optimal healing after 4 years with unideal crown-root ratios. This case report suggests that this old method of preserving teeth with crown-root fractures can be used as a last resort to save teeth owing to its timesaving and microinvasive procedure.

The Wnt pathway protein Dvl1 targets Somatostatin receptor 2 for lysosome-dependent degradation

The Somatostatin receptor 2 (Sstr2) is a heterotrimeric G protein coupled receptor that is highly expressed in neuroendocrine tumors and is a common pharmacological target for intervention. Unfortunately, not all neuroendocrine tumors express Sstr2, and Sstr2 expression can be downregulated with prolonged agonist use. Sstr2 is rapidly internalized following agonist stimulation and, in the short term, is quantitatively recycled back to the plasma membrane. However, mechanisms controlling steady state expression of Sstr2 in the absence of agonist are less well described. Here we show that Sstr2 interacts with the Wnt pathway protein Dvl1 in a ligand-independent manner to target Sstr2 for lysosomal degradation. Interaction of Sstr2 with Dvl1 does not affect receptor internalization, recycling, or signaling to adenylyl cyclase, but does suppress agonist-stimulated ERK1/2 activation. Importantly, Dvl1-dependent degradation of Sstr2 can be stimulated by overexpression of Wnts, and treatment of cells with Wnt pathway inhibitors can boost Sstr2 expression in neuroendocrine tumor cells. Taken together, this study identifies for the first time a mechanism that targets Sstr2 for lysosomal degradation that is independent of Sstr2 agonist and can be potentiated by Wnt ligand. Intervention in this signaling mechanism has the potential to elevate Sstr2 expression in neuroendocrine tumors and enhance Sstr2-directed therapies.

Effect of clay supplementation on growth performance of broiler chickens: a systematic review and meta-analysis

1. This review assessed the effect of dietary clay supplementation as a drug and toxin adsorbent on broiler growth performance as a meta-analysis.2. A total of 33 eligible studies were included in the present study after identification and evaluation from online databases. Standardised mean differences (SMD) with corresponding 95% confidence intervals were computed with a fixed-effects model.3. The results indicated that clay supplementation significantly improved broiler daily gain (P < 0.001) and feed conversion ratio (P < 0.001), but did not affect feed intake (P = 0.954). Results of subgroup analysis showed that zeolite clay had the most stable medium improvement effect on FCR, while kaolin had a large effect. In addition, male broilers and Cobb or Ross broilers were more sensitive to the addition of clay, and the best supplemental levels, in general, were 10 g/kg to 30 g/kg.4. Meta-regression analysis showed that clay supplemental level and sex of broilers may be important factors in the effect of clay on ADG and FCR of broilers, respectively. The sensitivity analysis showed high stability of the results and no significant publication bias was found with funnel plot analysis and Egger's or Begg's test (P > 0.05).5. In conclusion, an appropriate addition level is a prerequisite for effective clay application. Kaolin and zeolite clays seem to be more suitable for enhancing broiler growth performance, and the value of clay is amplified in specific broiler breeds.

Ginsenoside Rg3 inhibits renal cell carcinoma cell migration, invasion, colony formation, and tube formation and enhances apoptosis through promoting the DNA demethylation and histone acetylation

OBJECTIVES

This study explored the effect and mechanism of Rg3 on renal cell carcinoma (RCC) progression.

METHODS

RCC cells were treated with different concentrations of Rg3, 5-Aza-dc (a methyltransferase inhibitor) or TSA (a deacetylase inhibitor). Rg3-induced cytotoxicity, migration, invasion, colony formation, tube formation and apoptosis of RCC cells were evaluated by CCK-8, wound healing, Transwell, colony formation, tube formation and flow cytometry assays, respectively. Methylation and expressions of p53, p21 and p16, and expressions of methylation-related genes and histone deacetylases and histone acetylation-related genes (H3 (acetyl K14), H3 (acetyl K9), H4 (acetyl K12), H4 (acetyl K5) and H4 (acetyl K16)) were analysed by qRT-PCR and western blot.

KEY FINDINGS

Rg3 dose-dependently decreased the viability, inhibited migration, invasion, colony formation and tube formation, and enhanced apoptosis of RCC cells. Rg3 enhanced the demethylation levels and expressions of p53, p21 and p16 as well as the expressions of histone acetylation-related genes, but repressed the expressions of methylation-related genes and histone deacetylases. Rg3 had the same effect as 5-Aza-dc and TSA did on the above-mentioned cellular changes.

CONCLUSION

Rg3 restrains RCC cell migration, invasion, colony formation and tube formation, yet enhances apoptosis through promoting demethylation of p53, p21 and p16, and histone acetylation.

Inhibition of neutrophil extracellular trap formation attenuates NLRP1-dependent neuronal pyroptosis via STING/IRE1α pathway after traumatic brain injury in mice

Introduction

Increased neutrophil extracellular trap (NET) formation has been reported to be associated with cerebrovascular dysfunction and neurological deficits in traumatic brain injury (TBI). However, the biological function and underlying mechanisms of NETs in TBI-induced neuronal cell death are not yet fully understood.

Methods

First, brain tissue and peripheral blood samples of TBI patients were collected, and NETs infiltration in TBI patients was detected by immunofluorescence staining and Western blot. Then, a controlled cortical impact device was used to model brain trauma in mice, and Anti-Ly6G, DNase, and CL-amidine were given to reduce the formation of neutrophilic or NETs in TBI mice to evaluate neuronal death and neurological function. Finally, the pathway changes of neuronal pyroptosis induced by NETs after TBI were investigated by administration of peptidylarginine deiminase 4 (a key enzyme of NET formation) adenovirus and inositol-requiring enzyme-1 alpha (IRE1α) inhibitors in TBI mice.

Results

We detected that both peripheral circulating biomarkers of NETs and local NETs infiltration in the brain tissue were significantly increased and had positive correlations with worse intracranial pressure (ICP) and neurological dysfunction in TBI patients. Furthermore, the depletion of neutrophils effectively reduced the formation of NET in mice subjected to TBI. we found that degradation of NETs or inhibition of NET formation significantly inhibited nucleotide-binding oligomerization domain (NOD)-like receptor pyrin domain containing 1 (NLRP1) inflammasome-mediated neuronal pyroptosis after TBI, whereas these inhibitory effects were abolished by cyclic GMP-AMP (cGAMP), an activator of stimulating Interferon genes (STING). Moreover, overexpression of PAD4 in the cortex by adenoviruses could aggravate NLRP1-mediated neuronal pyroptosis and neurological deficits after TBI, whereas these pro-pyroptotic effects were rescued in mice also receiving STING antagonists. Finally, IRE1α activation was significantly upregulated after TBI, and NET formation or STING activation was found to promote this process. Notably, IRE1α inhibitor administration significantly abrogated NETs-induced NLRP1 inflammasome-mediated neuronal pyroptosis in TBI mice.

Discussion

Our findings indicated that NETs could contribute to TBI-induced neurological deficits and neuronal death by promoting NLRP1-mediated neuronal pyroptosis. Suppression of the STING/ IRE1α signaling pathway can ameliorate NETs-induced neuronal pyroptotic death after TBI.

A Novel Method for Growing α-Ga2O3 Films Using Mist-CVD Face-to-face Heating Plates

In this paper, the method for growing α-Ga₂O₃ films on c-plane sapphire substrates using an inexpensive fine-channel mist-CVD face-to-face heating plate was investigated. Because high temperatures can result in reactor deformation, expensive AlN ceramics resistant to deformation are used as the reactor fabrication material in traditional fine-channel mist-CVD equipment, which limits its use for promotion and research purposes. In this work, we used a face-to-face heating method to replace the traditional single-sided heating method which will reduce the requirement for equipment sealability. Therefore, cheap quartz can be used to replace expensive AlN ceramics to make reactors, which can greatly reduce the cost of mist-CVD equipment. We also investigated the effects of substrate temperature and carrier gas on the crystalline quality and surface morphology of α-Ga₂O₃ films. By optimizing the fabrication conditions, we obtained triangular grains with edges that were clearly visible in atomic force microscopy images. Using absorption spectrum analysis, we also found that the optical bandgap of the film reached 5.24 eV. Finally, we recorded a value of 508 arcsec for the full width at half maximum of the α-Ga₂O₃ (0006) diffraction peak in the X-ray diffraction pattern.

KRAS Inhibitor that Simultaneously Inhibits Nucleotide Exchange Activity and Effector Engagement

We describe a small molecule ligand ACA-14 (2-hydroxy-5-{[(2-phenylcyclopropyl) carbonyl] amino} benzoic acid) as an initial lead for the development of direct inhibitors of KRAS, a notoriously difficult anticancer drug target. We show that the compound binds to KRAS near the switch regions with affinities in the low micromolar range and exerts different effects on KRAS interactions with binding partners. Specifically, ACA-14 impedes the interaction of KRAS with its effector Raf and reduces both intrinsic and SOS-mediated nucleotide exchange rates. Likely as a result of these effects, ACA-14 inhibits signal transduction through the MAPK pathway in cells expressing mutant KRAS and inhibits the growth of pancreatic and colon cancer cells harboring mutant KRAS. We thus propose compound ACA-14 as a useful initial lead for the development of broad-acting inhibitors that target multiple KRAS mutants and simultaneously deplete the fraction of GTP-loaded KRAS while abrogating the effector-binding ability of the already GTP-loaded fraction.

Supplier-base concentration and efficiency: the moderating roles of R&D expenditure and market share

Purpose

This study addresses an important research question regarding how supplier-base concentration affects buyer efficiency. Drawing on the contradicting views of transaction cost theory (TCT) and resource dependence theory (RDT), the authors explore the main effect of supplier-base concentration on buyer efficiency and how this effect is contingent on buyers' characteristics (i.e. research and development (R&D) expenditure and market share).

Design/methodology/approach

Based on data collected from the Chinese manufacturing firms listed on National Equities Exchange and Quotations (NEEQ) between 2015 and 2019, the authors use a fixed-effect model as well as a two-stage least squares model to test the predictions.

Findings

The authors find that supplier-base concentration has a positive effect on buyer efficiency. In addition, when a buyer has higher levels of R&D expenditure and market share, the positive relationship between supplier-base concentration and buyer efficiency is strengthened.

Originality/value

This study contributes to a better understanding of the effect of supplier-base concentration. First, the authors provide theoretical and empirical evidence of the positive effect of supplier-base concentration on buyer efficiency. Second, the authors reveal the underlying mechanism of how to counter the potential drawbacks and benefit more from supply base reduction by introducing R&D expenditure and market share as contingencies.

Self-compression of stimulated Raman backscattering by a flying focus

The regime of self-compression has been proposed for plasma-based backward Raman amplification upon a flying focus. By using a pumping focus moving with a speed equal to the group velocity of stimulated Raman backscattering (SRBS), only a short part of SRBS which always synchronizes with the flying focus can be amplified. Therefore, instead of a short pulse, plasma noise or a long pulse can seed the BRA amplifiers. Here we demonstrate the regime by 2D particle-in-cell simulations, showing that the pump pulse is compressed from 26 ps to 116 fs, with an output amplitude comparable with the case of a well-synchronized short seed. As only one laser pulse is used in the simulation, the results present a significant path to simplify the Raman amplifiers.

[Critical quality attribute characterization of big brand TCM: taste formulation optimization strategy and application of Xiaoer Ganmao Oral Liquid based on taste quality attribute]

The taste is the quality attribute for the development and production of traditional Chinese medicine(TCM). To improve the medication compliance of the big brand TCM, Xiaoer Ganmao Oral Liquid, a correlation model between the electronic tongue sensor signal value and human sensory evaluation score was established, and an optimization strategy of taste improvement for Xiaoer Ganmao Oral Liquid was developed with the key techniques of statistical experimental design. Based on the above model, the optimal formulation was determined as follows: aspartame content of 1-2 mg·mL~(-1), acesulfame-K content of 1.5-3 mg·mL~(-1), and steviol glycoside content of 1-2 mg·mL~(-1). Furthermore, the optimal formulation was verified by human sensory evaluation. Therefore, the taste of Xiaoer Ganmao Oral Liquid was improved. Taking Xiaoer Ganmao Oral Liquid as an example, the present study developed the taste formulation optimization method based on the correlation between the electronic tongue and human sensory evaluation, which is expected to provide an important reference to improve the taste of oral liquid of TCM.

Predictors of Occurrence and 30-Day Mortality for Co-Infection of Carbapenem-Resistant Klebsiella pneumoniae and Carbapenem-Resistant Acinetobacter baumannii

Background

The phenomenon of co-infection with multiple carbapenem-resistant bacteria is growing, which pose a great challenge for infection control and treatment. This study aimed to analyze predictors of occurrence and 30-day mortality for carbapenem-resistant Klebsiella pneumoniae and carbapenem-resistant Acinetobacter baumannii co-infection.

Methods

From June 2018 to June 2021, clinical data of 103 patients co-infected with carbapenem-resistant Acinetobacter baumannii (CRAB) and carbapenem-resistant Klebsiella pneumoniae (CRKP) were collected from a tertiary teaching hospital in Anhui Province, China. The clinical characteristics and predictors of mortality were analyzed. Meanwhile, the bacterial isolates were characterized for drug susceptibility, multi-locus sequence typing, and drug resistance genes.

Results

The multivariate analysis revealed that fiberoptic bronchoscopy (p = 0.005, OR=2.72), repeat transfusions (p = 0.008, OR= 2.23) and exposure to tigecycline (p = 0.002, OR = 6.58) were independent risk factors for CRKP and CRAB co-infection. Neutrophil ≥11.9*10⁹ (p = 0.035, adjusted HR = 3.12) and C-reactive protein ≥ 149 mg/L (p = 0.009, adjusted HR = 4.41) were found associated with 30-day mortality. Combined neutrophil with C-reactive protein could predict 30-day mortality, of which AUC value was 0.791 (95%CI: 0.661-0.921). KPC (46/51, 90.2%) was the most common carbapenemase in CRKP. 33 isolates of CRKP belong to ST11 (33/51, 64.7%), and three new ST types ST5882, ST5883, ST5885 were detected.

Conclusions

Invasive operations and antibiotics exposure can lead to CRKP and CRAB co-infection. Combined neutrophil with C-reactive protein could predict 30-day mortality.

Exploring lived experiences of informal caregivers for pregnant women seeking scheduled antenatal care during the COVID-19 lockdown in China: A phenomenological study

OBJECTIVE

We aimed to explore the lived experiences of informal caregivers for pregnant women seeking scheduled antenatal care during the early stage of China's COVID-19 lockdown and potential measures to address the challenges.

DESIGN

This is a phenomenological qualitative study.

SETTING

The study was carried out in a leading teaching hospital in Southwest China.

PARTICIPANTS

We recruited 15 informal caregivers for healthy pregnant women on routine antenatal visits about six months after China launched the city-wide lockdown and other control measures for COVID-19, including 10 males and 5 females with diverse demographic backgrounds.

MEASURES AND FINDINGS

The research team developed a demographic form and an interview outline with key questions, conducted semi-structured interviews with the informal caregivers, and analyzed the data using the Colazzie's method. Five themes of lived experiences were revealed, i.e., increased caregiving burdens, disruption of routines in family life, lack of accurate information and knowledge, active role adjustment, and positive attitudes and coping in a difficult time. Some caregivers reacted positively to the lockdown experience and saw it as an opportunity to rethink their lives and improve family relations.

KEY CONCLUSIONS

The informal caregivers experienced increased physical and psychological burdens. Strategies such as adoption of a less frequent prenatal visit schedule, use of tele-medicine technologies, and provision of accurate information and knowledge may help to ease the increased informal caregiving burdens. Psychological counseling, community services and disaster response policies specially targeting pregnant women and their informal caregivers may also be valuable resources.

IMPLICATIONS FOR PRACTICE

Attention should be drawn to the group of informal caregivers for pregnant women during a COVID-19 lockdown, including professional assistance delivered by nursing and other related professionals. Measures are called for to minimize exposure opportunities such as adoption of a new prenatal care schedule and tele-medicine technologies. Patient education with reliable information should be provided, preferably by nursing staff and physicians. Social support efforts including professional mental counseling may added and work with other resources such as community services and policy makers.

[A multi-center, randomized controlled study on the effect of Saccharomyces boulardii combined with triple therapy for the initial eradication of Helicobacter pylori infection]

Objective: To assess the efficacy and safety of Saccharomyces boulardii (S. boulardii) in combination with triple therapy as a first-line regimen for the eradication of Helicobacter pylori (H. pylori) in non-ulcer dyspepsia (NUD) patients. Methods: A total of 497 Helicobacter pylori-positive patients who underwent gastroscopy and diagnosed with NUD were enrolled from June 2018 to January 2020 in 9 medical centers across China. Participants were segmentedly randomly divided into 3 groups. Patients in group A received S. boulardii for 14 days and triple therapy for 10 days, while patients in group B received bismuth quadruple group for 10 days, and patients in group C received triple therapy for 10 days. The H. pylori status was determined by the ¹³C-urea breath test on the 44th day of the treatment. Symptom improvement and adverse reactions were assessed on the 14th and 44th day. Results: There were 229 males and 268 females in all 497 patients enrolled. They were aged 18-69 (46.1±11.8) years and 472 of them (158 cases in group A, 159 cases in group B, and 155 cases in group C) completed the trial. The intention-to-treat (ITT) eradication rates in patients in patients A, B and C were 77.8% (126/162), 80.1% (137/171) and 65.2% (107/164) respectively, and per protocol-based (PP) eradication rates were 79.7% (126/158), 86.2% (137/159) and 69.0% (107/155) respectively. The differences were statistically significant in ITT and PP analysis among 3 groups (ITT: χ²=11.14, P<0.01; PP: χ²=13.86, P<0.01). There was no significant difference between eradication rates of two quadruple therapys(all P>0.05), but both of them were significantly higher than that of standard triple therapy (both P<0.05). Statistics revealed that both quadruple therapys led to significantly higher symptom improvement of belching compared with that of standard triple therapy in day 14 (P<0.05). The relief of abdominal distension and belching symptom scores of group A were significantly higher than those of group C in day 44(all P<0.05). There was no serious adverse event reported. The incidence of diarrhea in group A was significantly lower than those in the other two groups (both P<0.05). Conclusions: The combination of S. boulardii and triple therapy can achieve a better eradication effect on H. pylori infection with NUD, and has advantages in symptom relief and safety.

[Progress in pulmonary enteric adenocarcinoma]

Pulmonary enteric adenocarcinoma (PEAC), as a rare histologic subtype of primary lung adenocarcinoma, is defined as an adenocarcinoma in which the enteric component exceeds 50%. It is named after its shared morphological and immunohistochemical features with colorectal cancer. While with such similarity, the differential diagnosis of PEAC and lung metastatic colorectal cancer is a great challenge in the clinic. PEAC may originate from the intestinal metaplasia of respiratory basal cells stimulated by risk factors such as smoking. Current studies have found that KRAS is a relatively high-frequency mutation gene, and other driver gene mutations are rare. In terms of immunohistochemistry, in pulmonary enteric adenocarcinoma, the positive rate was 88.2% (149/169) for CK7, 78.1% (132/169) for CDX2, 48.2% (82/170) for CK20 and 38.8% (66/170) for TTF1. As for clinical features, the average age of onset for pulmonary enteric adenocarcinoma was 62 years, male patients accounted for 56.5% (35/62), smokers accounted for 78.8% (41/52), and 41.4% (24/58) of the primary lesion was located in the upper lobe of the right lung. In terms of treatment, conventional non-small cell lung cancer (NSCLC) regimens rather than colorectal cancer regimens are now recommended. There is still an urgent need for more basic and clinical research, in-depth exploration of its molecular feature and pathogenesis from the level of omics and other aspects, to help diagnosis and differential diagnosis, and find the optimal chemotherapy regimen, possibly effective targeted therapy and even immunotherapy.

Modafinil Reduces Neuronal Pyroptosis and Cognitive Decline After Sleep Deprivation

Sleep deprivation (SD) induces systemic inflammation that promotes neuronal pyroptosis. The purpose of this study was to investigate the effect of an antioxidant modafinil on neuronal pyroptosis and cognitive decline following SD. Using a mouse model of SD, we found that modafinil improved learning and memory, reduced proinflammatory factor (IL-1β, TNF-α, and IL-6) production, and increased the expression of anti-inflammatory factors (IL-10). Modafinil treatment attenuated inflammasome activity and reduced neuronal pyroptosis involving the NLRP3/NLRP1/NLRC4-caspase-1-IL-1β pathway. In addition, modafinil induced an upregulation of brain-derived neurotrophic factor (BDNF) and synaptic activity. These results suggest that modafinil reduces neuronal pyroptosis and cognitive decline following SD. These effects should be further investigated in future studies to benefit patients with sleep disorders.

MiR-4282 is a tumor-suppressor gene for preventing metastasis of epithelial ovarian cancer by negatively regulating MIER1

OBJECTIVE

To elucidate the biological role of miR-4282 in influencing metastasis of epithelial ovarian cancer (EOC) by regulating MIER1.

PATIENTS AND METHODS

MiR-4282 expressions in 45 cases of EOC specimens and normal controls were detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The relationship between miR-4282 and clinical features in EOC patients, including pathological indicators and overall survival, was analyzed. After intervening miR-4282 level in SKOV3 and 3AO cells by plasmid transfection, changes in migratory and invasive abilities were determined by transwell assay and wound healing assay. The target gene of miR-4282 was observed by Dual-Luciferase reporter assay, followed by exploration of its involvement in EOC progression via rescue experiments.

RESULTS

MiR-4282 was downregulated in EOC specimens than normal controls. EOC patients expressing low level of miR-4282 had higher incidences of lymphatic metastasis and distant metastasis, as well as worse prognosis than those overexpressing miR-4282. Overexpression of miR-4282 in SKOV3 cells weakened metastatic ability, and conversely, knockdown of miR-4282 in 3AO cells yielded the promotive trends. MIER1 was confirmed to be the target gene binding miR-4282, which was highly expressed in EOC specimens. MIER1 was able to reverse the regulatory effect of miR-4282 on EOC cell metastasis.

CONCLUSIONS

Lowly expressed miR-4282 in EOC specimens is closely linked to the incidence of metastasis and overall survival. MiR-4282 prevents EOC metastasis by a negative regulation on MIER1.

Limbic Inducted and Delocalized Effects of Diazole in Carbon Nitride Skeleton for Propelling Photocatalytic Hydrogen Evolution

Skeleton modification on carbon nitride (g-C₃N₄) via organic molecules is a recognized effective strategy to improve photocatalytic performance because it can powerfully improve charge separation in the skeleton plane. Herein, a diazole with a unique conjugated structure is bonded on edge of the g-C₃N₄ skeleton through a moderate polymerization of urea with 4-aminoantipyrine (4AAP). Meanwhile, the Pt nanoparticles selectively deposit on edge of the g-C₃N₄-4AAP₁₅ nanosheet. It reveals that the robust limbic inducted and delocalized effects of diazole not only facilitate photogenerated electrons aggregation toward skeleton edge to promote in-plane carrier separation but also effectively stabilize and delocalize photogenerated electrons to improve carrier lifetime for propelling the photocatalytic hydrogen evolution (PHE) reaction. Specifically, the PHE rate over optimal g-C₃N₄-4AAP₁₅ (284.2 μmol h^-1) is 10 times that of pure g-C₃N₄ (27.6 μmol h^-1) and the apparent quantum efficiency (AQE) at 420 nm reaches up to 24.2%. Through insights into the functionalized effect of small nitrogenous heterocycles introduced into the skeleton edge of g-C₃N₄, this work opens a new design thought for exploiting high-efficiency g-C₃N₄-based photocatalysts for photocatalytic application.

The risk factors of gestational diabetes mellitus in patients with polycystic ovary syndrome: What should we care

ABSTRACT

The influencing factors of gestational diabetes mellitus (GDM) in the polycystic ovary syndrome (PCOS) patients remain unclear, we aimed to investigate the risk factors of GDM in patients with PCOS, to provide reliable evidence for the prevention and treatment of GDM in PCOS patients.PCOS patients treated in our hospital from January 1, 2019 to October 31, 2020 were included. The personal and clinical treatment details of GDM and no GDM patients were analyzed. Logistic regressions were performed to analyze the factors influencing the occurrence of GDM.A total of 196 PCOS patients were included, the incidence of GDM in patients with PCOS was 23.98%. There were significant differences in the age, body mass index, insulin resistance index, fasting insulin, testosterone, androstenedione, and sex hormone-binding protein between GDM and no GDM patients with PCOS (all P < .05), and no significant differences in the family history of GDM, the history of adverse pregnancy, and multiple pregnancies were found (all P > .05). Age ≥30 years (odds ratio (OR) 2.418, 95% confidence interval (CI) 1.181-3.784), body mass index ≥24 kg/m2 (OR 1.973, 95%CI 1.266-3.121), insulin resistance index ≥22.69 (OR 2.491, 95%CI 1.193-4.043), fasting insulin ≥22.71 mIU/L (OR 2.508, 95%CI 1.166-5.057), testosterone ≥2.85 nmol/L (OR 1.821, 95%CI 1.104-2.762), androstenedione ≥6.63 nmol/L (OR 1.954, 95%CI 1.262-2.844), sex hormone-binding protein <64.22 nmol/L (OR 1.497, 95%CI 1.028-2.016) were the independent risk factors of GDM in patients with PCOS (all P < .05). The incidence of preeclampsia, premature delivery, premature rupture of membranes, polyhydramnios, and postpartum hemorrhage in the GDM group was significantly higher than that of the no-GDM group (all P < .05). There was no significant difference in the incidence of oligohydramnios between the 2 groups (P = .057).The incidence of GDM in PCOS patients is high, and the measures targeted at the risk factors are needed to reduce the occurrence of GDM in patients with PCOS.

The correlation of serum Vaspin, S100A12 and PCT levels with the severity of ulcerative colitis and its clinical significance

OBJECTIVE

This study aimed to investigate the correlation between Vaspin, S100A12 and PCT levels and ulcerative colitis (UC).

METHODS

This study included 104 patients with UC from November 2018 to June 2020 as the experimental group, including 37 cases in remission and 67 cases in an active phase; patients in an active phase were classified into 17 cases of mild, 37 cases of moderate and 13 cases of severe according to Modified Mayo Endoscopic Score (MMES). There were 104 patients as healthy controls during the same period who were enrolled as the control group. Serum levels of Vaspin, S100A12, PCT, inflammatory factors and immunoglobulins were compared between two groups and the correlation between serum levels of each index and the severity of UC was analyzed.

RESULTS

Compared with the control group, serum Vaspin, S100A12, and PCT levels were higher in the experimental group, and serum Vaspin, S100A12, and PCT levels were higher in the active phase than in the remission phase (P < 0.05). Serum Vaspin, S100A12, PCT, IL-6, IL-17, TNF-α levels: Severe patients > moderate patients > mild patients; Serum IgA, IgG levels: Severe < moderate < mild (P < 0.05). As shown by Spearman analysis, serum Vaspin, S100A12, PCT, IL-6, IL-17, and TNF-α levels were positively correlated with (r=0.317, P=0.021) while serum IgA and IgM were negatively correlated with the severity of UC disease (r=-0.418, P=0.007).

CONCLUSION

Serum Vaspin, S100A12, PCT and inflammatory factor levels were positively correlated with the severity of UC disease, and they showed significance in the assessment of the severity and prognosis of UC.

Risk factors of postpartum stress urinary incontinence in primiparas: What should we care

Stress urinary incontinence (SUI) is a common clinical postpartum complication. It is necessary to explore the risk factors of postpartum SUI in primiparas to provide evidence support for preventing and reducing the occurrence of SUI.Primiparas who were delivered in our hospital from March 2019 to October 2020 were identified, the personal information and related treatment details of SUI and no-SUI primiparas were collected and analyzed. Logistic regression analyses were conducted to identify the risk factors of postpartum SUI in primiparas.A total of 612 primiparas were included, the incidence of SUI in primiparas was 32.03%. There were significant differences in the body mass index (BMI) before pregnancy, diabetes, abortion, delivery method, newborn's weight, epidural anesthesia, and duration of second stage of labor (all P < .05) between SUI and no-SUI group, and there were no significant differences in the age, BMI at admission, hypertension and hyperlipidemia SUI and no-SUI group (all P > .05). Logistic regression analyses indicated that BMI before pregnancy ≥24 kg/m2 (odds ratio [OR]: 2.109, 95% confidence interval [CI]: 1.042-4.394), diabetes (OR: 2.250, 95% CI: 1.891-3.544), abortion history (OR: 3.909, 95% CI: 1.187-5.739), vaginal delivery (OR: 2.262, 95% CI: 1.042-4.011), newborn's weight ≥3 kg (OR: 1.613, 95% CI: 1.095-2.316), epidural anesthesia (OR: 2.015, 95% CI: 1.226-3.372), and duration of second stage of labor ≥90 minutes (OR: 1.726, 95% CI: 1.084-2.147) were the risk factors of postpartum SUI in primiparas (all P < .05).The clinical incidence of SUI in primiparas is relatively high. In clinical practice, medical staff should conduct individualized early screening for those risk factors, and take prevention measures to reduce the occurrence of SUI.

Ni2P QDs decorated in the multi-shelled CaTiO3 cube for creating inter-shelled channel active sites to boost photocatalytic performance

Control and insight into the abundance of inter-shelled channel active sites and charge transport mechanism are the long-term challenges for enhancing photocatalytic activity. Herein, the Ni₂P quantum dots (QDs) are decorated in the multi-shelled CaTiO₃ cube for creating the abundance of inter-shelled channel active sites, which greatly improve the photocatalytic performances for generating H₂ and degrading tetracycline (TC) relative to pure CaTiO₃ and Ni₂P. Moreover, the Z-scheme mechanism and the quantum effect of the Ni₂P in multi-shelled CaTiO₃ cube play a crucial role for enhancing photocatalytic performance. Furthermore, the photoelectric researches demonstrate that the Ni₂P/CaTiO₃ heterostructure possesses more abundant active sites, smaller interface transmission resistance and faster photo-generated charge transfer efficiency. This work provides a meaningful model to research other materials with creating the abundance of inter-shelled channel active sites for the photo-electrocatalytic field.

[Effect of levothyroxine treatment on pregnancy outcomes in euthyroid women with thyroid autoantibody positive: a Meta-analysis]

Objective: To conduct a systematic review of the association of levothyroxine treatment with pregnancy outcomes in euthyroid women who are thyroid autoantibody positive. Methods: Medline, Excerpta Medica (EMBASE), Cochrane Library, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), Wanfang data and VIP database were searched from inception until Jan. 28, 2020. All published randomized controlled trials assessing the association of levothyroxine treatment with pregnancy outcomes in euthyroid women with thyroid autoantibody-positive were included. STATA 11.0 and RevMan 5.3 softwares were used to perform this Meta-analysis. Results: A total of 6 studies met the inclusion criteria, with 2 188 women randomized. Meta-analysis showed that there was no significantly association between miscarriage (OR=0.85, 95%CI: 0.65-1.11, P=0.234) and preterm birth (OR=0.79, 95%CI: 0.54-1.16, P=0.224) with levothyroxine treatment. Conclusions: Levothyroxine therapy could not reduce the risk of miscarriage and preterm birth in euthyroid women with thyroid autoantibody-positive. Therefore, levothyroxine should be used with caution for these pregnant women.

Functional connectivity patterns of the subgenual anterior cingulate cortex in first-episode refractory major depressive disorder

Although accumulating evidence has been elucidating the neuronal basis of refractory/nonrefractory major depressive disorder (rMDD/nrMDD), the results are inconsistent, and little is known about the distinct neural mechanisms underlying rMDD. Here, we explored the convergent/divergent brain networks between first-episode MDD subtypes using the resting-state functional connectivity (RSFC) approach. In total, 33 healthy controls (HCs), 31 first-episode rMDD patients and 33 first-episode nrMDD patients were enrolled and underwent MRI scanning. The left subgenual anterior cingulate cortex (sgACC) was selected as the seed region, and RSFC was employed to evaluate associations between the seed and other regions in the whole brain. Both MDD subtypes exhibited convergent left sgACC-based neural networks, including increased RSFC with the dorsal prefrontal cortex (DPFC) and decreased RSFC with the bilateral orbitofrontal cortex (OFC) and right parahippocampus. rMDD patients exhibited increased left sgACC-OFC RSFC relative to nrMDD patients, and RSFC with the bilateral OFC in rMDD patients was negatively correlated with HAMD scores. These findings confirmed our speculation that convergent and divergent neural networks exist between rMDD and nrMDD. Cortical-limbic circuits, especially the prefrontal-limbic circuit, may serve as the convergent dysfunctional neural circuitry in MDD subtypes. As an important biomarker, a unique OFC-sgACC circuit abnormality was identified in rMDD patients, which might help elucidate the underlying mechanism regarding treatment responses in rMDD patients.

SPT6 recruits SND1 to co-activate human telomerase reverse transcriptase to promote colon cancer progression

Human telomerase reverse transcriptase (hTERT) plays an extremely important role in cancer initiation and development, including colorectal cancer (CRC). However, the precise upstream regulatory mechanisms of hTERT in different cancer types remain poorly understood. Here, we uncovered the candidate transcriptional factor of hTERT in CRC and explored its role and the corresponding molecular mechanisms in regulating hTERT expression and CRC survival with an aim of developing mechanism-based combinational targeting therapy. The possible binding proteins at the hTERT promoter were uncovered using pull-down/mass spectrometry analysis. The regulation of SPT6 on hTERT expression and CRC survival was evaluated in human CRC cell lines and mouse models. Mechanistic studies focusing on the synergy between SPT6 and staphylococcal nuclease and Tudor domain containing 1 (SND1) in controlling hTERT expression and CRC progression were conducted also in the above two levels. The expression correlation and clinical significance of SPT6, SND1, and hTERT were investigated in tumor tissues from murine models and patients with CRC in situ. SPT6 was identified as a possible transcriptional factor to bind to the hTERT promoter. SPT6 knockdown decreased the activity of hTERT promoter, downregulated the protein expression level of hTERT, suppressed proliferation, invasion, and stem-like properties, promoted apoptosis induction, and enhanced chemotherapeutic drug sensitivity in vitro. SPT6 silencing also led to the delay of tumor growth and metastasis in mice carrying xenografts of human-derived colon cancer cells. Mechanistically, SND1 interacted with SPT6 to co-control hTERT expression and CRC cell proliferation, stemness, and growth in vitro and in vivo. SPT6, SND1, and hTERT were highly expressed simultaneously in CRC tissues, both from the murine model and patients with CRC in situ, and pairwise expression among these three factors showed a significant positive correlation. In brief, our research demonstrated that SPT6 synergized with SND1 to promote CRC development by targeting hTERT and put forward that inhibiting the SPT6-SND1-hTERT axis may create a therapeutic vulnerability in CRC.

Cancer-Induced Muscle Wasting Requires p38β MAPK Activation of p300

Cancer-associated cachexia, characterized by muscle wasting, is a lethal metabolic syndrome without defined etiology or established treatment. We previously found that p300 mediates cancer-induced muscle wasting by activating C/EBPβ, which then upregulates key catabolic genes. However, the signaling mechanism that activates p300 in response to cancer is unknown. Here, we show that upon cancer-induced activation of Toll-like receptor 4 in skeletal muscle, p38β MAPK phosphorylates Ser-12 on p300 to stimulate C/EBPβ acetylation, which is necessary and sufficient to cause muscle wasting. Thus, p38β MAPK is a central mediator and therapeutic target of cancer-induced muscle wasting. In addition, nilotinib, an FDA-approved kinase inhibitor that preferentially binds p38β MAPK, inhibited p300 activation 20-fold more potently than the p38α/β MAPK inhibitor, SB202190, and abrogated cancer cell-induced muscle protein loss in C2C12 myotubes without suppressing p38α MAPK-dependent myogenesis. Systemic administration of nilotinib at a low dose (0.5 mg/kg/day, i.p.) in tumor-bearing mice not only alleviated muscle wasting, but also prolonged survival. Therefore, nilotinib appears to be a promising treatment for human cancer cachexia due to its selective inhibition of p38β MAPK. SIGNIFICANCE: These findings demonstrate that prevention of p38β MAPK-mediated activation of p300 by the FDA-approved kinase inhibitor, nilotinib, ameliorates cancer cachexia, representing a potential therapeutic strategy against this syndrome.

Informal caregiver burden and influencing factors in gynaecological oncology patients hospitalized for chemotherapy: a cross-sectional study

OBJECTIVE

To determine the level and influencing factors of informal caregiver burden in gynaecological oncology inpatients receiving chemotherapy.

METHODS

This cross-sectional study enrolled gynaecological oncology patients and their informal caregivers between May 2018 and November 2018 and measured the caregivers' burden using the Caregiver Burden Inventory. The influencing factors were evaluated with univariate regression analysis and multivariate linear stepwise regression analysis.

RESULTS

A total of 138 patients and their informal caregivers completed the questionnaire. The mean ± SD total informal caregiver burden score was 53.18 ± 10.97. The highest mean ± SD score was recorded in the dimension of time-dependent burden (14.28 ± 2.74), followed by developmental burden (13.65 ± 2.15), physical burden (10.52 ± 2.07), social burden (7.61 ± 2.58) and emotional burden (7.12 ± 1.43). Multivariate analysis showed that the informal caregiver's sex, relationship to the patient, daily duration of care, presence of chronic health problems and the duration of the patient's disease were factors influencing the level of caregiver burden.

CONCLUSIONS

The informal caregivers of gynaecological cancer patients hospitalized for chemotherapy experience a moderate level of burden. Nursing measures should be considered to reduce informal caregiver burden and improve the quality of lives of both patients and their caregivers.

Regional cerebral activity abnormality in pregnant women with antenatal depression

BACKGROUND

Antenatal depression (ATDP) is one of the most common mental disorders that occur during the antenatal period. As a serious problem in households around the world, ATDP has adverse consequences for both mothers and offspring and heavily burdens their families and society. However, until recently, the neurobiological mechanisms underlying ATDP remained unclear, which impeded early detection and intervention for this disorder.

METHODS

To explore the intrinsic cerebral activity alternations in ATDP, we investigated fractional amplitude of low-frequency fluctuation (fALFF) differences in 20 treatment-naïve ATDP patients and 22 healthy pregnant women (HPW) using voxel-based whole-brain analysis by resting-state functional magnetic resonance imaging. The correlation between the regional functional abnormalities and clinical variables in ATDP patients was also examined.

RESULTS

Compared with HPW, ATDP patients showed increased fALFF in the left medial prefrontal cortex, dorsolateral prefrontal cortex and anterior cingulate cortex, as well as decreased fALFF in the bilateral orbitofrontal cortex, the right insula, the cluster covering the right ventral temporal cortex (VTC) and the parahippocampus (PHP). The Edinburgh Postnatal Depression Scale scores of ATDP patients were negatively correlated with fALFF values in the right VTC and PHP.

LIMITATIONS

The study is limited by a small sample size and the fact that only antenatal maternal women in the second and third trimesters were assessed.

CONCLUSION

The aberrant regional functional activities of ATDP patients were mainly located within the prefrontal-limbic circuit related to multiple neural system abnormalities. This finding provides insight into the potential psychopathology of ATDP.