LINC01094 promotes human nasal epithelial cell epithelial-to-mesenchymal transition and pyroptosis via upregulating HMGB1

BACKGROUND

Excessive epithelial-to-mesenchymal transition (EMT) of nasal epithelial cells (NECs) play a prominent role in chronic rhinosinusitis with nasal polyps (CRSwNP) pathogenesis. Long intergenic non-coding RNA 01094 (LINC01094) was previously reported to be overexpressed in CRSwNP, while the regulatory mechanism by which LINC01094 regulates CRSwNP progression remains unclear. Our study aimed to investigate the role of LINC01094 in CRSwNP development.

METHODS

hNEC were isolated from tissues of controls and CRSwNP patients and stimulated with interleukin (IL)-13. 3-(4, 5-Dimethylthiazolyl2)-2, 5-diphenyltetrazolium bromide (MTT) assay was employed to analyze hNEC viability. Flow cytometry was employed to analyze pyroptosis. Immunofluorescence was employed to analyze Snail nuclear translocation. The interactions between LINC01094, fused in sarcoma (FUS) and high mobility group box-1 (HMGB1) were analyzed by RNA immunoprecipitation (RIP) and RNA pull-down assays.

RESULTS

LINC01094 and EMT-related proteins were markedly upregulated in nasal polyp tissues of CRSwNP. LINC01094 knockdown inhibited IL-13-induced hNEC EMT and pyroptosis. LINC01094 promoted HMGB1 expression in CRSwNP by binding with FUS. HMGB1 promoted Snail nuclear import in GSK-B phosphorylation-dependent manner.

CONCLUSION

LINC01094 facilitated hNEC EMT and pyroptosis in CRSwNP by activating the HMGB1/GSK-B Snail axis, which suggested that LINC01094 might serve as a biomarker and therapeutic target in CRSwNP.

New insights into the key role of node I in thallium accumulation in seed of coix (Coix lacryma-jobi L.)

The mechanisms underlying the distribution of many toxic metal(loid)s in shoots and metal(loid) transport to grains have been well documented in the quest for food safety but there remains a lack of knowledge on thallium (Tl) accumulation in food crops. Here, field investigations combined with a glasshouse pot experiment were conducted to investigate the characteristics of Tl distribution and accumulation in coix, a major food crop in south Guizhou province, China, and the role of node I in restricting Tl transport to the seed. Fourteen percent of coix seed samples collected from the Lanmuchang Tl-As-Hg mine contained higher Tl concentrations than the recommended limit for foods and feedstuffs in Germany (0.5 mg kg-1), with the highest exceedance rate of the metal(loid)s determined, when grown in soils surrounding the mine with a very high Tl concentration of 0.07-89.5 mg kg-1 and a general low pH of 4.19-6.48. Thallium concentrations were higher in coix nodes than in internodes, followed by roots and grains. The Tl translocation factors from node I to grains were 0.01-0.21 and were the lowest of any translocation factors between different tissues. Node I is therefore the key tissue restricting Tl transport to coix grains. Thallium was localized mainly in the diffuse vascular bundles (DVBs) in node I. The co-localization of Tl and sulfur in the DVBs and Tl contamination-induced phytochelatin (PC) accumulation indicate that Tl storage in the DVBs involving complexation with PCs in node I is an important process in Tl accumulation in coix grains. Moreover, the area of DVBs in node I increased with increasing soil Tl pollution level, providing more channels for Tl transport to the panicles and grains and thereby acting as a key factor restricting Tl transport to the grains. These results provide new insights into the key role of node I in Tl accumulation in coix grains and indicate key points to minimize Tl accumulation in grains for food safety.

Root-associated bacterial microbiome shaped by root selective effects benefits phytostabilization by Athyrium wardii (Hook.)

The root-associated microbiome assembly substantially promotes (hyper)accumulator plant growth and metal accumulation and is influenced by multiple factors, especially host species and environmental stress. Athyrium wardii (Hook.) is a phytostabilizer that grows in lead (Pb)-zinc (Zn) mine tailings and shows high root Pb accumulation. However, there remains little information on the assembly of the root-associated microbiome of A. wardii and its role in phytostabilization. A field study investigated the structural and functional variation in the root-associated bacterial microbiome of Athyrium wardii (Hook.) exposed to different levels of contamination in Pb-Zn mine tailings. The root compartment dominated the variation in the root-associated bacterial microbiome but the levels of contaminants showed less impact. Bacterial co-occurrence was enhanced in the rhizosphere soil and rhizoplane but tended to be much simpler in the endosphere in terms of network complexity and connectivity. This indicates that the microbial community assembly of A. wardii was non-random and shaped by root selective effects. Proteobacteria, Chloroflexi, Actinobacteria, Cyanobacteria, and Acidobacteriota were generally the dominant bacterial phyla. The genera Crossiella and Bradyrhizobium were enriched in the rhizosphere and cyanobacterial genera were enriched in the endosphere, demonstrating substantial advantages to plant survival and adaptation in the harsh mine environment. Functional categories involved in amino acid and carbohydrate metabolism were abundant in the rhizosphere soil, thus contributing to metal solubility and bioavailability in the rhizosphere. Membrane transporters, especially ATP-binding cassette transporters, were enriched in the endosphere, indicating a potential role in metal tolerance and transportation in A. wardii. The study shows substantial variation in the structure and function of microbiomes colonizing different compartments, with the rhizosphere and endophytic microbiota potentially involved in plant metal tolerance and accumulation during phytostabilization.

Depletion of macrophages with clodronate liposomes partially attenuates renal fibrosis on AKI-CKD transition

Clodronate liposomes are bisphosphonates encapsulated by liposomes that are known to induce macrophage depletion in vivo. In a previous study, clodronate liposomes improved renal ischemia/reperfusion (I/R) injury in mice, which may be due to effects on macrophage phenotypes. However, how inflammatory cytokines secretion participates is unknown. In this study, we investigated the effect of macrophages in the I/R kidney by depleting macrophages with clodronate liposomes and changing inflammatory cytokines. C57BL/6 mice underwent I/R injury with or without clodronate liposomes administration on Days 5 and 15. Tubular injury, collagen deposition, and fibrosis were detected and analyzed by histological staining, immunocytochemistry (IHC), flow cytometry (FACS), and reverse transcription-polymerase chain reaction (RT-PCR). Inflammatory cytokines were detected and analyzed by Western blotting and RT-PCR. We found that clodronate liposomes alleviated renal fibrosis and tissue damage on both Days 5 and 15. KIM-1, IL-10, and TGF-β were reduced significantly in the clodronate liposomes treatment group. However, TNF-α was not different between the clodronate liposomes treatment group and the phosphate-buffered saline treatment group on either Day 5 or Day 15. Thus, clodronate liposomes can alleviate renal fibrosis and tissue damage and reduce the inflammatory cytokines IL-10 and TGF-β, suggesting that clodronate liposomes alleviate renal fibrosis may because of M1/M2 polarization.

Clinical characteristics of bloodstream infections in adult patients with solid tumours and a nomogram for mortality prediction: a 5-year case-controlled retrospective study in a tertiary-level hospital

Background

Bloodstream infections (BSIs) are one of the leading causes of death in cancer patients. Nevertheless, the risk factors of BSIs in solid tumors have rarely been ascertained adequately.

Methods

We conducted a single-center case-controlled retrospective study from 2017 to 2021 among adults with solid tumors in a tertiary-level hospital. The BSIs and control group were matched by the propensity score matching method. We found independent risk factors of occurrence and death of BSIs using univariate and multivariate regression analysis. Additionally, a nomogram was constructed to predict the risk of mortality in BSIs.

Results

Of 602 patients with solid tumors in the study period, 186 had BSIs and 416 had non-BSIs. The incidence of BSIs was 2.0/1,000 admissions (206/102,704), and the 30-day mortality rate was 18.8% (35/186). Compared to the control group, the BSIs had longer hospital stays (24.5 days vs. 20.0 days), and higher frequency complicating with organ failure (10.5% vs. 2.4%), nephropathy (19.6% vs. 3.8%), comorbidities≥3 (35.5% vs. 20.0%), and liver-biliary-pancreatic infections (15.6% vs. 5.3%) (all P<0.001). Among the 186 patients with BSIs, 35 died within 30 days after BSIs. Gram-negative bacteria were the most frequent microorganisms (124/192, 64.6%). Liver cancer, organ failure, a high level of lactate dehydrogenase and septic shock were the independent hazardous factors for death of BSIs. What's more, a nomogram was constructed to predict the 30-day survival rate of BSIs, which was proved to have good accuracy (AUC: 0.854; 95% confidence interval: 0.785~0923) and consistency.

Conclusion

Being aware of the risk factors of BSIs redounds to take preventive measures to reduce the incidence and death of BSIs.

Role of Root Exudates in Cadmium Accumulation of a Low-Cadmium-Accumulating Tobacco Line (Nicotiana tabacum L.)

Root exudates are tightly linked with cadmium (Cd) uptake by the root and thus affect plant Cd accumulation. A hydroponic experiment was carried out to explore the role of root exudates in Cd accumulation of a low-Cd-accumulating tobacco line (RG11) compared with a high-Cd- accumulating tobacco line (Yuyan5). Greater secretion of organic acids and amino acids by the roots was induced by an exogenous Cd addition in the two tobacco lines. The concentration of organic acid secreted by RG11 was only 51.1~61.0% of that secreted by Yuyan5. RG11 roots secreted more oxalic acid and acetic acid and less tartaric acid, formic acid, malic acid, lactic acid, and succinic acid than Yuyan5 under Cd stress. Oxalic acid accounted for 26.8~28.8% of the total organic acids, being the most common component among the detected organic acids, and was significantly negatively correlated with Cd accumulation in RG11. Propionic acid was only detected in the root exudates of RG11 under Cd stress. Lactic acid was positively linked with Cd accumulation in Yuyan5, being less accumulated in RG11. Similarly, RG11 secreted more amino acids than Yuyan5 under Cd stress. Aspartic acid, serine, and cysteine appeared in RG11 when it was exposed to Cd. Lysine was the most secreted amino acid in RG11 under Cd stress. RG11 roots secreted less lysine, histidine, and valine, but more phenylalanine and methionine than Yuyan5 under Cd stress. The results show that organic acids and amino acids in root exudates play a key role in Cd uptake by the root, and this contribution varied with cultivar/genotype. However, further research is still needed to explore the mechanisms underlying low Cd translocation to the leaf, which may be the key contribution of low Cd accumulation in RG11 to the security of tobacco leaf.

Indigenous rhizosphere microbial community characteristics of the phytostabilizer Athyrium wardii (Hook.) grown in a Pb/Zn mine tailing

Plant rhizosphere microbiome usually changes dramatically in adaptation to the mine environment to endure high heavy metal concentration, which in turn improves the process of revegetation and phytostabilization of mine tailing and deserves deep investigation. A field study was conducted to investigate the indigenous microbial community of a mining ecotype (ME) of the phytostabilizer Athyrium wardii (Hook.) grown in a Pb/Zn mine tailing and a corresponding non-mining ecotype (NME) grown in an uncontaminated adjacent site. Our study found a slight difference in microbial α-diversity between the ME and NME, and no significant difference between the rhizosphere and bulk soil. Both bacterial and fungal community compositions differed between the ME and NME, for which the differences were mainly driven by pH and metal contaminants. The ME harbored a unique microbial community in the rhizosphere soils different from the bulk soil and NME counterparts. The dominant phyla in the ME rhizosphere were Proteobacteria, Chloroflexi, Actinobacteria, Nitrospirae, and Ascomycota. Several genera from Proteobacteria, Acidobacteria, and Ascomycota were more abundant in the ME rhizosphere than in the NME rhizosphere. Network analysis revealed that keystone taxa were different in the two sites. Some keystone taxa from Gemmatimonadaceae, and Burkholderiaceae and Ascomycota played a critical role in microbial interactions within the mine tailing network. The unique microbial community with high tolerance in the rhizosphere soils of ME may show great benefit for plant growth and metal tolerance of the ME and thereby contributing to the process of revegetation and phytostabilization of mine tailings.

The investigation of construction and clinical application of image recognition technology assisted bronchoscopy diagnostic model of lung cancer

Background

The incidence and mortality of lung cancer ranks first in China. Bronchoscopy is one of the most common diagnostic methods for lung cancer. In recent years, image recognition technology(IRT) has been more and more widely studied and applied in the medical field. We developed a diagnostic model of lung cancer under bronchoscopy based on deep learning method and tried to classify pathological types.

Methods

A total of 2238 lesion images were collected retrospectively from 666 cases of lung cancer diagnosed by pathology in the bronchoscopy center of the Third Xiangya Hospital from Oct.01 2017 to Dec.31 2020 and 152 benign cases from Jun.01 2015 to Dec.31 2020. The benign and malignant images were divided into training, verification and test set according to 7:1:2 respectively. The model was trained and tested based on deep learning method. We also tried to classify different pathological types of lung cancer using the model. Furthermore, 9 clinicians with different experience were invited to diagnose the same test images and the results were compared with the model.

Results

The diagnostic model took a total of 30s to diagnose 467 test images. The overall accuracy, sensitivity, specificity and area under curve (AUC) of the model to differentiate benign and malignant lesions were 0.951, 0.978, 0.833 and 0.940, which were equivalent to the judgment results of 2 doctors in the senior group and higher than those of other doctors. In the classification of squamous cell carcinoma (SCC) and adenocarcinoma (AC), the overall accuracy was 0.745, including 0.790 for SCC, 0.667 for AC and AUC was 0.728.

Conclusion

The performance of our diagnostic model to distinguish benign and malignant lesions in bronchoscopy is roughly the same as that of experienced clinicians and the efficiency is much higher than manually. Our study verifies the possibility of applying IRT in diagnosis of lung cancer during white light bronchoscopy.

The Global, Regional, and National Burden and Trends of Infective Endocarditis From 1990 to 2019: Results From the Global Burden of Disease Study 2019

Introduction

Infective endocarditis (IE) presents with increasing incidence and mortality in some regions and countries, as well as serious socioeconomic burden. The current study aims to compare and interpret the IE burden and temporal trends globally and in different regions from 1990 to 2019.

Methods

Data on the incidence, deaths and disability-adjusted life years (DALYs) caused by IE were extracted and analyzed from the Global Burden of Disease Study 2019. Estimated annual percentage changes (EAPC) were adopted to quantify the change trends of age-standardized rates (ASRs). Besides, potential contributors of serious IE burden were also evaluated including age, gender, social-demographic index (SDI), and age-standardized incident rate (ASIR) in 1990.

Results

Globally, the number of IE cases and deaths has increased sharply during the past 30 years from 478,000 in 1990 to 1,090,530 in 2019 and from 28,750 in 1990 to 66,320 in 2019, and both presented an upward temporal trend annually (EAPC:1.2 for incidence and 0.71 for death). However, the EAPC of age-standardized DALYs demonstrated a negative temporal trend despite increasing DALYs from 1,118,120 in 1990 to 1,723,590 in 2019. Moreover, older patients and men were more severely affected. Meanwhile, different SDI regions had different disease burdens, and correlation analyses indicated that SDI presented a positive association with ASIR (R = 0.58, P < 0.0001), no association with age-standardized death rate (R = −0.06, P = 0.10), and a negative association with age-standardized DALYs (R = −0.40, P < 0.0001). In addition, the incidence of IE increased in most countries during the past 30 years (190 out of 204 countries). However, the change trends of deaths and DALYs were heterogeneous across regions and countries. Finally, we discovered positive associations of the EAPC of ASRs with the SDI in 2019 among 204 countries and territories but few associations with the ASIR in 1990.

Conclusion

Generally, the global burden of IE is increasing, and there is substantial heterogeneity in different genders, ages and regions, which may help policy-makers and medical staff respond to IE and formulate cost-effective interventional measures.

A composite amendment benefits rice (Oryza sativa L.) safety and production in cadmium-contaminated soils by unique characteristics after oxidation modification

In-situ immobilization is an effective strategy for Cd remediation and food safety, while some modifications are necessary to improve immobilization efficiency. In this study, a composite amendment (RFW) derived from rice straw biochar (RSB), fly ash (FA), and white marble (WM) was modified by oxidization (RFW-O) and pyrolysis (RFW-P). The RFW-O showed stronger Cd²⁺ sorption ability than RFW and RFW-P due to larger BET surface area and more oxygen containing-functional groups. Complexation and iron exchange were the two main processes of Cd²⁺ sorption on RFW-O. As a result, the application of RFW-O significantly reduced Cd availability in soils by 10.11-26.24% along with increased soil pH. It was found to be optimal to apply the RFW-O at a dosage of 2.5 wt% for 15 days before transplantation. After RFW-O application, Cd concentrations in brown rice decreased by 40.49% and 41.59% for pot and field experiment, respectively, and were less than 0.2 mg kg^-1. The catalase, dehydrogenase, acid phosphatase and alkaline phosphatase activities in soils increased significantly. Moreover, RFW-O showed no significant effect on rice yield and quality. The RFW-O is thereby considered to be an ideal amendment for in-situ immobilization of Cd-contaminated soils for rice safety and production in practice.

[MYC and BCL-2 protein co-expression and prognosis of patients with diffuse large B-cell lymphoma: a propensity score matching analysis]

目的

探究MYC/BCL-2蛋白双表达对弥漫大B细胞淋巴瘤（DLBCL）患者预后的影响，观察纳入DA-EPOCH-R（利妥昔单抗+依托泊苷+泼尼松+长春新碱+环磷酰胺+表阿霉素）、中枢神经系统预防治疗、移植等治疗因素后，双表达是否仍是DLBCL的独立预后不良因素。

方法

回顾性收集2015−2018年在北京协和医院血液科治疗且具有可用病理结果的223例初治DLBCL患者，75例MYC/BCL-2高表达的患者归为双表达组，从148例非双表达的患者中，应用倾向性评分（PSM），根据年龄、国际预后指数（IPI）评分、治疗选择等因素进行1∶1匹配，筛选出75例作为对照组，比较两组患者总生存（OS）及无进展生存（PFS）等方面的差异。

结果

PSM后双表达组和非双表达组的3年OS率分别为（69.8±5.5）％及（77.0±4.9）％（P＝0.225），3年PFS率分别为（60.7±5.8）％及（65.3±5.5）％（P＝0.390），差异均无统计学意义。R-CHOP方案（利妥昔单抗+环磷酰胺+阿霉素+长春新碱+泼尼松）治疗的亚组分析显示，双表达和非双表达患者的3年OS率分别为（61.3±7.5）％及（77.2±5.6）％（P＝0.027），3年PFS率分别为（52.1±7.5）％及（70.6 ± 6.0）％（P＝0.040），差异均具有统计学意义。多因素Cox回归分析显示年龄、Ann Arbor分期、细胞起源（COO）分型、是否进行中枢神经系统预防、是否进行移植是DLBCL患者预后的独立影响因素（P值均<0.05），而MYC/BCL-2蛋白双表达不是预后的影响因素。

结论

MYC/BCL-2蛋白双表达在R-CHOP方案治疗下与不良预后显著相关，但在DA-EPOCH-R、移植等治疗方案下，双表达对DLBCL的不良预后影响在一定程度上得到消除。

The changes of rhizosphere characteristics contributed to enhanced Pb accumulation in Athyrium wardii (Hook.) Makino after nitrilotriacetic acid application

Chelant-assisted phytoremediation may modify plant rhizosphere, which is closely related to heavy metal (HM) accumulation in plants. This work focused on the effects of nitrilotriacetic acid (NTA) on rhizosphere characteristics to investigate the mechanisms of lead (Pb) accumulation in Athyrium wardii (Hook.) Makino with exposure to 800 mg kg^-1 Pb. After NTA application, Pb accumulation in the underground part of A. wardii increased by 14.3%, accompanying with some changes for the rhizosphere soils. Soil pH decreased by 0.37 units, and the dissolved organic carbon (DOC) content in the rhizosphere soils significantly increased by 7.6%. The urease, acid phosphatase, and catalase activities in the rhizosphere soils significantly increased by 104.8%, 19.7%, and 27.1%, respectively. However, a slight inhibition on microbial activities was observed in the rhizosphere of A. wardii after NTA application. Soil respiration decreased by 8.9%, and microbial biomass carbon decreased by 8.9% in the rhizosphere soils, indicating that NTA addition might recruit some microorganisms to maintain rhizosphere functions in Pb-contaminated soils while inhibiting others with low tolerance to Pb. Results suggest that lower pH, more DOC exudation, and higher soil enzyme activities after NTA application contributed to the increase of Pb accumulation in A. wardii. This study gave some preliminary evidence for NTA-assisted Pb remediation by A. wardii by modifying rhizosphere characteristics.

Interplay of structural fluctuations and charge carrier dynamics is key for high performance of hybrid lead halide perovskites

Interplay of organic cation rotation and inorganic lattice fluctuation maintains the high performance of hybrid organic–inorganic perovskites.

MiR-3130-5p is an intermediate modulator of 2q33 and influences the invasiveness of lung adenocarcinoma by targeting NDUFS1

Genome‐wide association studies (GWAS) have reported a handful of loci associated with lung cancer risk, of which the pathogenic pathways are largely unknown. We performed cis‐expression quantitative trait loci (eQTL) mapping for 376 lung cancer related GWAS loci in 227 TCGA lung adenocarcinoma (LUAD) and reported two risk loci as eQTL of miRNA. Among the miRNAs in association with lung cancer risk, we further predicted and validated miR‐3130‐5p as an intermediate modulator of risk loci 2q33 and the tumor suppressor NDUFS1. We assessed the phenotypic impacts of the interaction between miR‐3130‐5p and NDUFS1 in both lung cancer cell lines and mice xenograft models. As a result, miR‐3130‐5p directly regulates the expression of NDUFS1 and the corresponding tumor invasiveness, migration and epithelial‐mesenchymal transition (EMT). Our findings provide important clues for the pathogenic mechanism of 2q33 in lung carcinogenesis which informs clinical diagnosis and prognosis of LUAD.

We performed a cis‐eQTL analysis for 376 lung cancer risk loci based on the expression profiles of 251 miRNAs in a cohort of 227 TCGA lung adenocarcinoma. We report a novel pathogenic pathway of 2q33 via miR‐3130‐5p and NDUFS1.

Machine learning-based radiomic evaluation of treatment response prediction in glioblastoma

AIM

To investigate machine learning based models combining clinical, radiomic, and molecular information to distinguish between early true progression (tPD) and pseudoprogression (psPD) in patients with glioblastoma.

MATERIALS AND METHODS

A retrospective analysis was undertaken of 76 patients (46 tPD, 30 psPD) with early enhancing disease following chemoradiotherapy for glioblastoma. Outcome was determined on follow-up until 6 months post-chemoradiotherapy. Models comprised clinical characteristics, O⁶-methylguanine-DNA methyltransferase (MGMT) promoter methylation status, and 307 quantitative imaging features extracted from enhancing disease and perilesional oedema masks on early post-chemoradiotherapy contrast-enhanced T1-weighted imaging, T2-weighted imaging (T2WI), and apparent diffusion coefficient (ADC) maps. Feature selection was performed within bootstrapped cross-validated recursive feature elimination with a random forest algorithm. Naive Bayes five-fold cross-validation was used to validate the final model.

RESULTS

Top selected features included age, MGMT promoter methylation status, two shape-based features from the enhancing disease mask, three radiomic features from the enhancing disease mask on ADC, and one radiomic feature from the perilesional oedema mask on T2WI. The final model had an area under the receiver operating characteristics curve (AUC) of 0.80, sensitivity 78.2%, specificity 66.7%, and accuracy of 73.7%.

CONCLUSION

Incorporating a machine learning-based approach using quantitative radiomic features from standard-of-care magnetic resonance imaging (MRI), in combination with clinical characteristics and MGMT promoter methylation status has a complementary effect and improves model performance for early prediction of glioblastoma treatment response.

Early fibroproliferative signs on high-resolution CT are associated with mortality in COVID-19 pneumonia patients with ARDS: a retrospective study

Objectives:

To investigate the chest high-resolution computed tomography (HRCT) findings in coronavirus disease 2019 (COVID-19) pneumonia patients with acute respiratory distress syndrome (ARDS) and to evaluate its relationship with clinical outcome.

Materials and methods:

In this retrospective study, 79 COVID-19 patients with ARDS were recruited. Clinical data were extracted from electronic medical records and analyzed. HRCT scans, obtained within 3 days before clinical ARDS onset, were evaluated by three independent observers and graded into six findings according to the extent of fibroproliferation. Multivariable Cox proportional hazard regression analysis was used to assess the independent predictive value of the computed tomography (CT) score and radiological fibroproliferation. Patient survival was determined by Kaplan–Meier analysis.

Results:

Compared with survivors, non-survivors showed higher rates of lung fibroproliferation, whereas there were no significant differences in the area of increased attenuation without traction bronchiolectasis or bronchiectasis. A HRCT score <230 enabled the prediction of survival with 73.5% sensitivity and 93.3% specificity, 100% negative predictive value (NPP), 83.3% positive predictive value (PPV) and 88.6% accuracy (Area Under the Curve [AUC] = 0.9; 95% confidence Interval [CI] 0.831–0.968). A multivariate Cox proportional hazards model showed that the HRCT score is a significant independent risk factor for mortality (Hazard Ratio [HR] 9.94; 95% CI 4.10–24.12). Kaplan–Meier analysis revealed that a HRCT score ⩾230 was associated with a higher fatality rate. Organ injury occurred less frequently in patients with a HRCT score <230 compared to those with a HRCT score ⩾230.

Conclusion:

Early pulmonary fibroproliferative signs on HRCT are associated with increased mortality and susceptibility to organ injury in COVID-19 pneumonia patients with early ARDS.

Global, regional, and national dengue burden from 1990 to 2017: A systematic analysis based on the global burden of disease study 2017

BACKGROUND

Dengue is one of the most common vector-borne diseases globally, however, its burden is poorly quantified. Hence, we aimed to report the dengue burden in 195 countries and territories between 1990 and 2017, using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017.

METHODS

Following the methodology framework and analytical strategies used in the Global Burden of Disease Study 2017, we analysed the incidence, mortality, and disability-adjusted life years (DALYs) of dengue in geographically defined populations worldwide between 1990 and 2017. We also determined the association between development levels and dengue burden. All estimates were reported as numbers and rates per 100 000 population, with 95% uncertainty intervals.

FINDINGS

Globally, the total number of dengue cases increased from 23 283 274 (95% UI 453 180.7-51 840 670) in 1990 to 104 771 911 (95% UI 63 759 019-158 870 031) in 2017. The age-standardised incidence rate increased from 431.6 (8.4-961.0) per 100 000 population in 1990 to 1371.3 (834.5-2079.3) per 100 000 population in 2017. In addition, the number of deaths due to dengue increased from approximately16 957 (7 613-30 091) in 1990 to 40 467 (17 620-49 778) in 2017. Meanwhile, the global age-standardised death rate increased from 0.31 (0.14-0•56) per 100 000 population in 1990 to 0.53 (0.23-0•65) per 100 000 population in 2017. Overall, there were 2 922 630 DALYs (1 629 424-3 967 492) attributed to dengue in 2017 globally, an increase of 107.6% since 1990 (1 407 571 DALYs [624 016.4-2 510 025]), and the age-standardised DALY rate increased from 26.10 (11.57-46.53) per 100 000 population to 38.25 (21.33-51.93) per 100 000 population between 1990 and 2017. The association between socio-demographic index (SDI) and dengue-related DALYs suggested that the lowest age-standardised DALY rates were found in countries in the low and high-SDI quintile in 2017, and from 1990 to 2017, the age-standardized DALY rate tended to increase in regions with the lowest SDI but declined in regions with the highest SDI. There was a nonlinear association between the socio-demographic index and the healthcare access and quality index and age-standardised DALY rates.

INTERPRETATION

Dengue is a major public health challenge worldwide. While there is remarkable international variation in its incidence, the dengue burden is increasing globally. The results of this study could be useful for policy makers to implement cost-effective interventions and reduce the dengue burden, particularly in countries with high incidence or increasing burden.

FUNDING

This work was supported by a grant from the National Natural Science Foundation of China (NSFC) (grant numbers 81,800,041 and 82,000,078).

The predominant role of pectin in binding Cd in the root cell wall of a high Cd accumulating rice line (Oryza sativa L.)

Cell wall (CW) plays an important role in Cd accumulation in roots of metal-tolerant plants, including rice. The role of CW polysaccharides, especially pectin, in binding Cd in roots of a high Cd accumulating (HA) rice line of Lu527-8 and a non-high Cd accumulating (NHA) rice line of Lu527-4 was investigated in this study. About 59%-63% of Cd in roots of the two rice lines was bound to CWs, indicating that CW was the main site for Cd accumulation in roots of the two rice lines. Cd adsorbed on the root CWs of the HA was 1.1-1.2 times more than that of the NHA, demonstrating the root CWs of the HA showed greater Cd binding ability. Cd exposure induced more Cd accumulation in pectin and hemicellulose in the HA. In particular, up to 65% of Cd accumulation in root CWs of the HA was observed in pectin. The removal of pectin lead to a 50% decrease for the amounts of Cd adsorption on root CWs of the HA, indicating that pectin was the major binding site for Cd in root CWs of the HA. The HA showed greater pectin methylesterase activities, resulting in lower degree of pectin methylesterification along with more low-methylesterified pectins in root CWs than the NHA. The more accumulation of low-methylesterified pectins in CWs induced by Cd contributed greatly to the high Cd accumulation in roots of the HA rice line of Lu527-8.

Characterization of dissolved organic matter in the rhizosphere of phytostabilizer Athyrium wardii (Hook.) involved in enhanced metal accumulation when exposed to Cd and Pb co-contamination

The characterization of DOM and its effect on heavy metal solubility in soils have been widely concerned, while few concerns on the phytostabilization of multi-metal contaminated soils. A pot experiment was performed to characterize dissolved organic matter (DOM) in the rhizosphere of the mining ecotype (ME) and non-mining ecotype (NME) of Athyrium wardii (Hook.) when exposed to Cd and Pb simultaneously, and investigate its effect on Cd and Pb solubility in soils. The ME presented more DOM in the rhizosphere when exposed to Cd and Pb simultaneously than that exposed to single Cd or Pb, and also than the NME. The acid fractions (hydrophilic acid, hydrophobic acid) and hydrophilic fractions (hydrophilic acid, hydrophilic neutral, and hydrophilic base) were the dominant parts of DOM in the ME rhizosphere. The ME presented more acid and hydrophilic fractions in the rhizosphere when exposed to Cd and Pb simultaneously. Meanwhile, there were more O-H, C-O, N-H and C-H, assigned to carboxylic groups, phenolic groups, hydroxyl groups, and/or amino groups, present in DOM from the rhizosphere of ME when exposed to Cd and Pb simultaneously. These results highlighted the acid characteristics of DOM in the rhizosphere of ME when exposed to Cd and Pb simultaneously. DOM in the rhizosphere of ME thereby showed greater complexation degree for Cd (68%) and Pb (77%), thus showing greater ability to enhance Cd and Pb solubility in soils when exposed to Cd and Pb simultaneously. This is thereby considered to be one of the key processes for enhancing Cd and Pb uptake by the ME when exposed to Cd and Pb simultaneously.

Nilpotent fuzzy lie ideals

In this paper, we introduce a new definition for nilpotent fuzzy Lie ideal, which is a well-defined extension of nilpotent Lie ideal in Lie algebras, and we name it a good nilpotent fuzzy Lie ideal. Then we prove that a Lie algebra is nilpotent if and only if any fuzzy Lie ideal of it, is a good nilpotent fuzzy Lie ideal. In particular, we construct a nilpotent Lie algebra via a good nilpotent fuzzy Lie ideal. Also, we prove that with some conditions, every good nilpotent fuzzy Lie ideal is finite. Finally, we define an Engel fuzzy Lie ideal, and we show that every Engel fuzzy Lie ideal of a finite Lie algebra is a good nilpotent fuzzy Lie ideal. We think that these notions could be useful to solve some problems of Lie algebras with nilpotent fuzzy Lie ideals.

Medical students mental health, professional pride, and intention to work in the frontline during coronavirus disease 2019 pandemic

OBJECTIVES

To understand medical students' mental health, professional pride, and intention to work in the front-line during coronavirus disease 2019 (COVID-19) pandemic, and provide a reference for psychological intervention.

METHODS

We used the depression-anxiety-stress scale and self-designed questionnaire on professional pride, intention to work in the front-line and the extent of family support. Medical students from 4 medical schools in Fujian and Hunan were investigated. Their mental health status, professional pride and first-line work willingness with different characteristics were compared, and the influential factors for professional pride and first-line work willingness were analyzed.

RESULTS

A total of 266 valid questionnaires were collected. During the pandemic, there were significant differences in the proportion of depressed students among different college and universities, majors and stages (P<0.05), and the professional pride was significantly different (P<0.001). Medical students with different mental health status showed significant differences in professional pride (P<0.01). Marriage, pressure and extent of family support were the influential factors for their professional pride (P<0.05). The latter two were also influential factors for their intention to work in the front-line (P<0.05).

CONCLUSIONS

During the pandemic, students from college and nursing have relatively better mental health and higher professional pride. The professional pride is low in medical students who married, with abnormal stress or low family support. The intention to work in front-line is decreased in students with abnormal stress or low family support.

NTA-enhanced Pb remediation efficiency by the phytostabilizer Athyrium wardii (Hook.) and associated Pb leaching risk

Nitrilotriacetic acid (NTA), a biodegradable chelant, has been promoted to effectively assist Pb phytoextraction, while a few researches available on the phytostabilizer of Athyrium wardii (Hook.). In this study, two incubation experiments and a subsequent column experiment were conducted to investigate the effects of application of NTA on Pb availability in soils and Pb accumulation in A. wardii and associated leaching risk. The application of NTA significantly increased the exchangeable Pb and Pb bound to carbonates along with a decreased pH, leading to enhanced Pb availability in soils. It was more effective in enhancing Pb availability in soils by adding 2 mmol kg^-1 NTA into soils at once for 7 d, thus demonstrating potential for enhancing Pb uptake by A. wardii. After the addition of 2 mmol kg^-1 NTA for 7 d, Pb concentrations in roots of A. wardii was enhanced by 23.8%, along with 10.6% of increase for Pb accumulation in roots. No significant changes were observed for the biomass of A. wardii. Meanwhile, the available Pb and TCLP-extractable Pb in 0-20 cm soils increased by 11.1-23.4% and 7.1-31.2%, thus promoting Pb leaching in 0-20 cm soils. However, there were no changes for Pb leaching risk levels of 20-40 cm soils. No Pb was detected in the leachates from all columns. The application of 2 mmol kg^-1 NTA at once for 7 d is therefore proved to show greater potential in enhancing Pb remediation efficiency by the phytostabilizer of A. wardii without increasing Pb leaching risk into groundwater.

The combined effects of Cd and Pb enhanced metal binding by root cell walls of the phytostabilizer Athyrium wardii (Hook.)

Cell wall acts as a major metal sink in plant roots, while a few studies focused on root cell wall binding in plants for the phytostabilization of multi-metal contaminated soils. A pot experiment was performed to characterize root cell wall properties of the mining ecotype (ME) and non-mining ecotype (NME) of Athyrium wardii (Hook.) in response to Cd and Pb. The cell wall was found to be the major sink for Cd (41.3-54.3%) and Pb (71.4-73.8%) accumulation in roots of the ME when exposed to Cd and/or Pb. The ME showed more Cd and Pb accumulation in root cell walls when exposed to Cd and Pb simultaneously, compared with those exposed to single Cd or Pb as well as the NME, suggesting some modifications for cell walls. The uronic acid contents of pectin and hemicellulose 1 (HC1) in root cell walls of the ME increased significantly when exposed to Cd and Pb simultaneously, suggesting enhanced cell wall binding capacity, thus resulting in more Cd and Pb bound to pectin and HC1. In particular, pectin was found to be the predominant binding site for Cd and Pb. Greater pectin methylesterase activity along with a lower degree of methylesterification were observed in the cell walls of the ME when exposed to Cd and Pb simultaneously. Furthermore, the ME present more O-H, N-H, C-OH, C-O-C, C-C and/or Ar-H in root cell walls when exposed to Cd and Pb simultaneously. These changes of root cell wall properties of the ME lead to enhanced cell wall binding ability in response to the co-contamination of Cd and Pb, thus could be considered a key process for enhanced Cd and Pb accumulation in roots of the ME when exposed to Cd and Pb simultaneously.

GSPE alleviates renal fibrosis by inhibiting the activation of C3/ HMGB1/ TGF-β1 pathway

Grape seed proanthocyanidin extract (GSPE) has been reported to exhibit a variety of protective effects, such as antioxidant, anti-atherosclerosis and other pharmacological effects. As a member of the complement system, complement component 3 (C3) deposition in the glomerulus is recognized as an important causative mediator of various kidney diseases. In this study, we aimed to identify the effect of GSPE on C3 in the chronic kidney fibrosis and evaluate the possible mechanism. We observed that administration of GSPE relieves inflammation and chronic renal fibrosis in mouse models of UUO. GSPE inhibited C3 secreted by macrophages to relieve renal interstitial inflammation. In vitro, we found that C3 stimulated HMGB1 translocation form nucleus to cytoplasm and promote the expression of pro-inflammatory cytokines including TGF-β1 in primary renal tubular epithelial cells (PTEC), which could be inhibited by GSPE. Meanwhile, GSPE could also decreased HMGB1-induced EMT of PTEC through suppresses the HMGB1/TLR4/p65/TGF-β1 pathway. In addition, the myofibroblast activation was inhibited by GSPE via TGF-β1/Smad2/3 signaling pathways in normal rat kidney fibroblast (NRK-49F) cells. Overall, these observations provide that GSPE alleviates renal fibrosis by inhibiting the C3/HMGB1/TGF-β1 pathway and could thus lead to find the potential therapy for the suppression of renal fibrosis.

Lead accumulation and soil microbial activity in the rhizosphere of the mining and non-mining ecotypes of Athyrium wardii (Hook.) Makino in adaptation to lead-contaminated soils

Better understanding of microbial activity in the rhizosphere soils associated with lead (Pb) uptake by plants may help with the phytoremediation of Pb-contaminated soils. In this work, the effects of Pb exposure (0, 200, 400, 600, 800 mg kg^-1) on Pb accumulation and soil microbial activity in the rhizosphere of the mining ecotype (ME) and corresponding non-mining ecotype (NME) of Athyrium wardii (Hook.) Makino were investigated through a pot experiment. Although the plant growth of the two ecotypes was inhibited under Pb stress, the ME showed a less biomass decrease (12.6-44.0%) for aboveground than the NME, showing a greater tolerance to Pb stress. Pb concentrations as well as Pb accumulation in the two ecotypes showed an increasing trend with increasing soil Pb concentrations. The ME presented greater Pb accumulation ability than the NME, especially in underground parts. Pb availability in the rhizosphere soils of the two ecotypes after harvest decreased compared with those before transplantation. Available Pb in the rhizosphere of the ME was 1.4-4.8 times higher than that of the NME under exposure to 200-800 mg kg^-1 Pb. The ME shows a greater ability to mobilize Pb in the rhizosphere soils. Pb exposure resulted in an inhibition of microbial activity in the rhizosphere of the two ecotypes. The ME demonstrated greater soil respiration and microbial biomass carbon (MBC) in the rhizosphere than the NME when treated with 200-800 mg kg^-1 Pb. The ME showed a less decrease for MBC and a less increase for metabolic quotient in the rhizosphere soils than the NME when exposed to Pb generally. Microorganisms in the rhizosphere soils of the ME seem to be much more adapted to Pb stress, thus showing a great benefit for Pb accumulation and the phytostabilization of Pb-contaminated soils by the ME.

[Analysis of infection status and recombination types of norovirus in patients with acute gastroenteritis in the Ningxia Hui Autonomous Region from 2016 to 2017]

Objective: To analyze the infection status and recombination of Norovirus in patients with acute gastroenteritis in Ningxia. Methods: The specimens of 10 sentinel hospitals in Ningxia were collected from 2016 to 2017. Real-time quantitative PCR was used for nucleic acid detection. GⅡ-positive samples were amplified by RT-PCR for the RdRp and Capsid regions, then sequenced and genotyped. Evolution analysis was performed using software such as MEGA-X, and recombination analysis was performed using Simplot 3.5.1 and RDP4. Results: The age of the 2 334 cases was 1.42 (0.68, 7.69) years old, 1 133 cases in 2016 and 1 201 cases in 2017, 1 343 and 991 cases for males and females respectively. The positive rate of Norovirus GⅠ genogroup was 0.86% (20/2 334), and GⅡ genogroup was 14.82% (346/2 334). A total of 78 recombinant strains were sequenced and 12 recombinant types were found. GⅡ.Pe/GⅡ.4Sydney_2012 and GⅡ.P12/GⅡ.3 were the main epidemic strains, accounting for 35.90% (28 strains) and 32.05% (25 strain) respectively, followed by GⅡ.P16/GⅡ.2 accounting for 12.82% (10 strains). Among them,GⅡ.P7/GⅡ.6 (2 strains), GⅡ.P12/GⅡ.3 (6 strains), GⅡ.P16/GⅡ.1 (2 strains), GⅡ.P16/GⅡ.2 (5 strains), GⅡ.Pe/GⅡ.4 (7 strains) were detected for the first time in Ningxia. Recombinant strains were all intergenotype recombination, and the recombination breakpionts were all located within ORF1. Conclusion: Norovirus infection in Ningxia area was mainly in GⅡ genogroup from 2016 to 2017, and most of them were recombinant strains. GⅡ.Pe/GⅡ.4Sydney_2012 and GⅡ.P12/GⅡ.3 were the main epidemic strains, followed by GⅡ.P16/GⅡ. 2.

Multi-modular engineering for renewable production of isoprene via mevalonate pathway in Escherichia coli

AIMS

To establish the biotechnology platforms for production of bio-based chemicals in various micro-organisms is considered as a promising target to improve renewable production of isoprene.

METHODS AND RESULTS

In this study, we heterologously expressed the mevalonate (MVA) isoprene biosynthesis pathway, and explored three strategies of increasing isoprene production in Escherichia coli. We first manipulated the expression levels of the MVA pathway genes through changing the gene cassettes and promoters. To introduce cofactor engineering, we then overexpressed NADP-dependent glyceraldehyde-3-phosphate dehydrogenase gene from Clostridium acetobutylicum to supply available NADPH. To reduce the inhibitory by-product accumulation, we finally knocked out acetate-producing genes, phosphate acetyl transferase and pyruvate oxidase B in E. coliJM109 (DE3), decreasing acetate accumulation 89% and increasing isoprene production 39%. The strategies described here finally increased the isoprene titre to 92 mg l^-1 in two-gene deletion strain JMAB-4T7P1Trc, increasing 2·6-fold comparing to strain JM7T7.

CONCLUSION

The multimodularly engineering approaches including promoter engineering, cofactor engineering and by-product reducing could be used to improve isoprene production in E. coli.

SIGNIFICANCE AND IMPACT OF THE STUDY

The metabolic strategies in this study show us directions for further studies to promote transformation of renewable sources to isoprene.

Cd and Pb accumulation characteristics of phytostabilizer Athyrium wardii (Hook.) grown in soils contaminated with Cd and Pb

Interactions between heavy metals in soil could affect soil heavy metal availability and plant uptake. Thus, in this study, Cd and Pb accumulation as well as plant growth of the mining ecotype (ME) and non-mining ecotype (NME) of Athyrium wardii (Hook.) in response to the exposure of Cd and Pb was investigated by a pot experiment. Although the exposure of Cd in combination with Pb further inhibited the growth of the two ecotypes in comparison with the exposure of single Cd or Pb, the ME presented lower biomass decline for the whole plant (22.0%-70.0%) than the NME among most treatments. The presence of Pb promoted Cd accumulation both in above-ground and under-ground parts of the ME. Cd concentrations in under-ground parts of the ME decreased when exposed to higher concentrations of Pb (> 600 mg kg^-1). Meanwhile, the presence of Cd inhibited Pb accumulation in above-ground parts of the ME and promoted Pb accumulation in under-ground parts of the ME. Pb concentrations in under-ground parts of the ME decreased when soil Cd concentrations were more than 25 mg kg^-1. The partial correlation analysis further demonstrated that the interactions between Cd and Pb stimulated Cd accumulation both in above-ground and under-ground parts of the ME and Pb accumulation in under-ground parts of the ME, while inhibited Pb accumulation in above-ground parts of the ME, showing great benefit for Pb phytostabilization by the ME. Among treatments, the bioaccumulation coefficients for Cd and Pb of the ME, varying from 2.71-31.05 and 20.09-78.06, were much higher than those of the NME. The translocation factors for Cd and Pb of the ME, varying from 0.26-0.52 and 0.01-0.10, were lower than those of the NME. These results indicate that the ME presented greater potential for the phytostabilization of soil contamination with Cd and Pb, especially for Pb.

GSPE Inhibits HMGB1 Release, Attenuating Renal IR-Induced Acute Renal Injury and Chronic Renal Fibrosis

Grape seed proanthocyanindin extract (GSPE) is a polyphenolic bioflavonoid derived from grape seeds and has been widely studied for its potent antioxidant, anti-inflammatory and antitumor activities. HMGB1 is a newly discovered danger-associated molecular pattern (DAMP) that has potent proinflammatory effects once released by necrotic cells. However, the effect of GSPE on the HMGB1, and the relationship of those two with acute kidney injury and chronic kidney fibrosis are unknown. This study aimed to investigate the impact of GSPE on acute kidney injury and chronic fibrosis. C57bl/6 mice were subjected to bilateral ischemia/reperfusion (I/R) and unilateral I/R with or without GSPE administration. After bilateral I/R, mice administered GSPE had a marked improvement in renal function (BUN and Cr), decreased pathological damage and reduced inflammation. In unilateral I/R, mice subjected GSPE showed reduced tubulointerstitial fibrosis and decreased inflammatory reaction. The renoprotection of GSPE on both models was associated with the inhibition of HMGB1 nucleocytoplasmic shuttling and release, which can amplify the inflammation through binding to its downstream receptor TLR4 and facilitated P65 transcription. Thus, we have reason to believe that GSPE could be a good alternative therapy for the prevention and treatment of IR-induced renal injury and fibrosis in clinical practice.

The influence of humic substance on Cd accumulation of phytostabilizer Athyrium wardii (Hook.) grown in Cd-contaminated soils

The application of organic amendments into heavy metal contaminated soil is considered as an environmentally friendly technique to promote the potential of phytoremediation. A pot experiment was carried out to evaluate the effect of humic substances on growth, cadmium (Cd) accumulation and phytostabilization potential of the mining ecotype (ME) and the corresponding non-mining ecotype (NME) of Athyrium wardii (Hook.) grown in Cd-contaminated soils. The addition of the humic substances demonstrated great promotion for the growth and Cd uptake of ME. Both plant biomass and Cd concentration significantly increased with the increasing application of the humic substances up to 100 g kg(-1), beyond which no significant change of underground part biomass and Cd concentrations in underground part of A. wardii was observed. The maximum Cd concentration in underground part of ME was 180 mg kg(-1) when 150 g kg(-1) humic substances were applied. The ME showed greater Cd accumulation capability in underground part (0.47-0.68 mg plant(-1)) than that of NME (0.27-0.45 mg plant(-1)). Increasing bioaccumulation coefficient (BCF) values of A. wardii was observed with increasing application of the humic substances. The BCF values of ME were higher than those of NME. However, the use of the humic substances exhibited little impact on translocation factors (TFs) of ME, and the TF values of ME were less than NME. Furthermore, the application of the humic substances improved the remediation factors (RFs) of A. wardii. The RF values in underground part of ME ranging from 0.73 to 0.91 % were apparently higher than those of NME. These results indicated that the humic substances can be a potential candidate for enhancing the phytostabilization of A. wardii grown in Cd-contaminated soils.

Adaptive behaviour of Chinese boys with fragile X syndrome

BACKGROUND

Adaptive behaviour is closely related to quality of life in children with intellectual disability (ID), but little is known about the adaptive behaviour of children with fragile X syndrome (FXS) in China.

METHOD

In boys with FXS, the adaptive behaviours in six domains, including self-dependence, locomotion, work skills, communication, socialisation and self-management, were assessed by the Infants-Junior Middle School Students Social-life Abilities Scale. In addition, we compared the adaptive skills of boys with FXS to those of three control groups of boys, including boys with Down syndrome (DS) and typically developing (TD) boys matched by chronological age (CA) or mental age (MA). The profile of the adaptive behaviour of boys with FXS is discussed in detail.

RESULTS

Compared to boys with DS, boys with FXS obtained lower scores in three domains in adaptive behaviour, including work skills, socialisation and self-management skills; boys with FXS had better scores in self-dependence and locomotion skills than boys matched for MA; as expected, boys with FXS had significantly poorer adaptive skills in all six domains assessed compared to CA boys.

CONCLUSION

The development of adaptive skills in boys with FXS was worse than that of boys with DS. The profile of the adaptive behaviour of boys with FXS establishes a basis for the development of targeted interventions to promote social development in this population.

An increased ratio of serum miR-21 to miR-181a levels is associated with the early pathogenic process of chronic obstructive pulmonary disease in asymptomatic heavy smokers

Heavy smoking is associated with the development of chronic obstructive pulmonary disease (COPD). However, there is no valuable biomarker for evaluating COPD development in heavy smokers because they are usually asymptomatic. This study is aimed at evaluating whether the levels of serum miRNAs can serve as biomarkers for predicting the occurrence of COPD. A rat model of emphysema was induced by enforced smoking, and the dynamic miRNAs expression profile at different stages of emphysema with varying periods of smoking were analyzed by microarray and quantitative real-time polymerase chain reaction (qRT-PCR). The differentially expressing miRNAs were analyzed using Gene Ontology and the KEGG PATHWAY database. The levels of three serum candidate miRNAs were measured by qRT-PCR in 41 healthy controls (HC), 40 asymptomatic heavy smokers, and 49 COPD patients. Following smoking for varying periods, different severities of lung emphysema were observed in different groups of rats, accompanied by altered levels of some serum miRNAs associated with regulating some pathways. Furthermore, the levels of miR-21 were significantly higher in the COPD patients and asymptomatic heavy smokers than in the HC (P < 0.001), while the levels of miR-181a were significantly lower in the COPD patients and asymptomatic heavy smokers than in the HC (P < 0.001). Accordingly, the levels of serum miR-21 and miR-181a as well as their ratios had a high sensitivity (0.854) and specificity (0.850) for evaluating the development of COPD. Our data suggest that the levels of serum miR-21 and miR-181a may be valuable for evaluating the development of COPD in heavy smokers.

Effect of penehyclidine hydrochloride on β-arrestin-1 expression in lipopolysaccharide-induced human pulmonary microvascular endothelial cells

β-arrestins are expressed proteins that were first described, and are well-known, as negative regulators of G protein-coupled receptor signaling. Penehyclidine hydrochloride (PHC) is a new anti-cholinergic drug that can inhibit biomembrane lipid peroxidation, and decrease cytokines and oxyradicals. However, to date, no reports on the effects of PHC on β-arrestin-1 in cells have been published. The aim of this study was to investigate the effect of PHC on β-arrestin-1 expression in lipopolysaccharide (LPS)-induced human pulmonary microvascular endothelial cells (HPMEC). Cultured HPMEC were pretreated with PHC, followed by LPS treatment. Muscarinic receptor mRNAs were assayed by real-time quantitative PCR. Cell viability was assayed by the methyl thiazolyl tetrazolium (MTT) conversion test. The dose and time effects of PHC on β-arrestin-1 expression in LPS-induced HPMEC were determined by Western blot analysis. Cell malondialdehyde (MDA) level and superoxide dismutase (SOD) activity were measured. It was found that the M3 receptor was the one most highly expressed, and was activated 5 min after LPS challenge. Furthermore, 2 μg/mL PHC significantly upregulated expression of β-arrestin-1 within 10 to 15 min. Compared with the control group, MDA levels in cells were remarkably increased and SOD activities were significantly decreased in LPS pretreated cells, while PHC markedly decreased MDA levels and increased SOD activities. We conclude that PHC attenuated ROS injury by upregulating β-arrestin-1 expression, thereby implicating a mechanism by which PHC may exert its protective effects against LPS-induced pulmonary microvascular endothelial cell injury.

Two-port laparoscopic cholecystectomy with modified suture retraction of the fundus: A practical approach

CONTEXT

Although transumbilical single incision laparoscopic cholecystectomy (SILC) has been demonstrated to be superior cosmetic, it is only limited to simple cases at present. In complex cases, the standard four- or three-port LC is still the treatment of choice.

AIM

To summarize the clinical effect of a modified technique in two-port LC.

SETTINGS AND DESIGN

A consecutive series of patients with benign gallbladder diseases admitted to the provincial teaching hospital who underwent LC in the past 4 years were included. A modified two-port LC was the first choice except for those requiring laparoscopic common bile duct exploration (LCBDE).

MATERIALS AND METHODS

The operation was done with suture retraction of the fundus by a needle-like retractor. The patients' data, including the operative time, time consumed by gallbladder retraction, operative bleeding, conversion rate, rate of adding trocars, and postoperative complications were recorded.

STATISTICAL ANALYSIS

Data were expressed as percentage and mean with standard deviation.

RESULTS

Total 107 patients with chronic calculous cholecystitis (N = 61), acute calculous cholecystitis (N = 43), and cholecystic polyps (N = 3) received two-port LC. The procedure was successful in 99 out of 107 cases (success rate, 92.5%), and a third trocar was added in the remaining 8 cases (7.5%) due to severe pathological changes. The operative time was 47.2 (±13.21) min. There was no conversion to open surgery.

CONCLUSION

Two-port LC using a needle-like retractor for suture retraction of the gallbladder fundus is a practical approach when considering the safety, convenience, and indications as well as relatively minimal invasion.