Ultra-early electroacupuncture rehabilitation for intravenous thrombolysis-induced cerebral infarction

OBJECTIVE

The purpose of this research was to investigate whether it is possible to perform ultra-early interventional electroacupuncture on individuals who had experienced intravenous thrombolysis prior to receiving therapy for acute cerebral infarction.

PATIENTS AND METHODS

Patients who have undergone intravenous thrombolysis between July 2019 and March 2021 were eligible for participation in this study. The participants were divided into two groups; one group received electroacupuncture therapy 24 hours after their condition became stable, while the other group received treatment 48 hours after their condition became stable. Both groups received the same therapy for their respective forms of rehabilitation. The Fugl-Meyer Motion Assessment Scale (FMA) was used to assess the patients' motor function before and after therapy, as well as two weeks and one month after treatment. The scores of the FMA were recorded before and after treatment.

RESULTS

After therapy, the FMI scores were higher in both groups (p<0.05), and the researchers found that the ultra-early electroacupuncture intervention was related to higher FMI ratings 2 weeks and 1 month after treatment (p<0.05). In neither of the two study groups was there any sign of a major adverse response or consequence (p>0.05).

CONCLUSIONS

This research offers evidence that ultra-early interventional electroacupuncture rehabilitation therapy may be an effective and safe method of treatment for individuals who have had a cerebral infarction after receiving intravenous thrombolysis. The results lend credence to the notion that this kind of therapy should be taken into consideration as an adjunctive model for rehabilitation in patients of this type.

Recombinant Treponema pallidum protein Tp47 promoted the phagocytosis of macrophages by activating NLRP3 inflammasome induced by PKM2-dependent glycolysis

BACKGROUND

Glycolysis is a critical pathway in cellular glucose metabolism that provides energy and participates in immune responses. However, whether glycolysis is involved in NOD-like receptor family protein 3 (NLRP3) inflammasome activation and phagocytosis of macrophages in response to Treponema pallidum infection remains unclear.

OBJECTIVES

To investigate the role of glycolysis in activating the NLRP3 inflammasome for regulating phagocytosis in macrophages in response to T. pallidum protein Tp47 and its associated mechanisms.

METHODS

Interactions between activation of the NLRP3 inflammasome and phagocytosis and the role of glycolysis in Tp47-treated macrophages were investigated through experiments on peritoneal macrophages and human monocytic cell line-derived macrophages.

RESULTS

Activation of phagocytosis and NLRP3 inflammasome were observed in Tp47-treated macrophages. Treatment with NLRP3 inhibitor MCC950 or si-NLRP3 attenuated Tp47-induced phagocytosis. Glycolysis and glycolytic capacity were enhanced by Tp47 stimulation in macrophages, and a change in the levels of glycolytic metabolites (phosphoenolpyruvate, citrate and lactate) was induced by Tp47 in macrophages. Inhibition of glycolysis with 2-deoxy-D-glucose, a glycolysis inhibitor, decreased the activation of NLRP3. Expression of M2 isoform of pyruvate kinase (PKM2), an enzyme catalysing a rate-limiting reaction in the glycolytic pathway, was upregulated in Tp47-stimulated macrophages. Inhibition of PKM2 with shikonin or si-PKM2 decreased glycolysis and NLRP3 activation.

CONCLUSION

Tp47 promotes phagocytosis in macrophages by activating the NLRP3 inflammasome, which is induced by the enhancement of PKM2-dependent glycolysis.

[The Origin and Academic Characteristics of Xujiang School]

Xujiang School of acupuncture and moxibustion has a long history with distinctive academic characteristics and regional influence. Xujiang School, originated from Xi Hong in Song Dynasty, is the oldest acupuncture and moxibustion school recorded in Chinese history. Later, it was passed down from family to family for more than ten generations. The tenth generation Xi Xinqing passed it on to Chen Honggang and gradually evolved into a school of acupuncture and moxibustion with regional characteristics and a certain national influence. In terms of academic characteristics, doctors in Xujiang School kept innovating based on the Classics.Its acupuncture and moxibustion academic ideas including reinforcement and reduction , point selection and searching for the primary cause of disease in treatment have had an important impact on contemporary acupuncture in clinic.

[Immune function and research progress of pentraxin 3 in pulmonary infectious diseases]

Pentraxins3 (PTX3) is an acute-phase protein of the pentraxin family that is synthetized and stored in a variety of cells. As an important mediator of innate immunity, PTX3 is rapidly released during microbial invasion and inflammatory response. It promotes the recognition of pathogens by myeloid cells through regulating complement activation. Recent studies have indicated that PTX3 concentrations in peripheral blood or tissues increase rapidly after infection, and the increased level is associated with the severity of the disease. Thus, PTX3 appears to be a vital clinical biomarker in the diagnosis and prognosis of pulmonary infectious diseases.

[The directionality of measurement bias: a directed acyclic graph-based structural perspective]

Measurement bias (MB) has been described in causal structures but is still not entirely clear. In practice, the correctness of substitution estimate (SE) of effect is a prerequisite for causal inference, usually based on a bidirectionally non-differential misclassification between the measured exposure and the measured outcome. Based on a directed acyclic graph (DAG), this paper proposes a structure for the single-variable measure, where its MB is derived from the choice of an imperfect, "input/output device-like" measurement system. The MB of the SE is influenced both by the measurement system itself and by factors outside the measurement system: while the independence or dependence mechanism of the measurement system still ensures that the MB of the SE is bidirectionally non-differential; however, the misclassification can be bidirectionally non-differential, unidirectionally differential, or bidirectionally differential resulted from the factors outside the measurement system. In addition, reverse causality should be defined at the level of measurement, where measured exposures can influence measured outcomes and vice versa. Combined with temporal relationships, DAGs help elucidate MB's structures, mechanisms, and directionality.

[Application and clinical efficacy of ultrasound debridement method in residual burn wounds]

Objective: To investigate the application and clinical efficacy of ultrasound debridement method in residual burn wounds. Methods: A retrospective cohort study was conducted. From August 2017 to August 2021, 64 patients with residual burn wounds who met the inclusion criteria were admitted to the 980th Hospital of the Joint Logistic Support Force of PLA. According to the debridement method adopted for the residual wounds, the patients were divided into ultrasound debridement group (34 cases, 22 males and 12 females, aged (31±13) years) and traditional debridement group (30 cases, 19 males and 11 females, aged (32±13) years). After the corresponding debridement, the wounds of patients in the two groups were selected for stamp skin grafting or large skin grafting according to the wound site and skin donor status. For unhealed wounds after stage Ⅰ surgery, secondary debridement and skin grafting were be performed, with the wound debridement methods in the 2 groups being the same as those of stage Ⅰ, respectively. On postoperative day 3, drug-sensitive test was used to detect the bacteria in the wound and the positive rate of bacteria was calculate. On postoperative day 7, the survival rate of skin slices in wound and the incidence of subcutaneous hematoma were calculated. At discharge, wound healing time and debridement times of patients were counted, and the secondary debridement rate was calculated. Data were statistically analyzed with independent sample t test or chi-square test. Results: On postoperative day 3, the wounds in ultrasound debridement group were infected with Staphylococcus aureus in 2 cases and Pseudomonas aeruginosa in 2 cases, and the wounds in traditional debridement group were infected with Staphylococcus aureus in 5 cases, Pseudomonas aeruginosa in 3 cases, Acinetobacter baumannii in 1 cases, Klebsiella pneumoniae in 1 cases, and Enterobacter cloacae in 1 cases. The positive rate of bacteria of wound in ultrasound debridement group was significantly lower than that in traditional debridement group (χ2=5.51, P<0.05). On postoperative day 7, the survival rate of skin grafts in ultrasound debridement group was (92±5) %, which was significantly higher than (84±10) % in traditional debridement group (χ2=6.78, P<0.01); the incidence of subcutaneous hematoma in ultrasound debridement group was 17.6% (6/34), which was significantly lower than 40.0%( 12/30) in traditional debridement group, χ2=3.94, P<0.05. At discharge, the wound healing time in ultrasound debridement group was (11.0±2.0) d, which was significantly shorter than (13.0±3.1) d in traditional debridement group (t=3.81, P<0.01); the secondary debridement rate of wounds in ultrasound debridement group was 2.9% (1/34), which was significantly lower than 20.0% (6/30) in traditional debridement group (χ2=4.76, P<0.05). Conclusions: Ultrasound debridement method can significantly reduce the bacterial load of residual burn wounds, reduce postoperative hematoma formation, and promote the survival of skin grafts to shorten the course of disease of patients.

[A case of GM1 gangliosidoses]

This article describes a case which seek medical advice for 2 months due to retrogressive development, The discovery of the characteristic fundus of the macular cherry-red spot is a key clue for further genetic analysis, GLB compound heterozygous mutations is detected, and enzymology results show that the acid B-galactose glucoside enzyme significantly decrease, fundus inspection help diagnosis GM1 gangliosidoses.

[Smith-Kingsmore syndrome caused by MTOR gene variation: 2 cases and literature review]

Objective: To investigate the clinical manifestations and genetic features of 2 children with Smith-Kingsmore syndrome caused by MTOR gene variation and review the literature. Methods: The clinical data of 2 children carrying MTOR gene variant, diagnosed at Xi'an Children's Hospital from April 2018 to April 2021, were retrospectively summarized."MTOR"and"Smith-Kingsmore syndrome"were used as key words to search at China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, PubMed and OMIM up to August 2021. The characteristics of MTOR gene variation and the clinical phenotype of children with Smith-Kingsmore syndrome were summarized. Results: Two children were both females, aged 1.5 years and 2 years respectively, the onset age were both in infancy. They both had developmental delay, megalencephaly and abnormal face. Both whole exome sequencing revealed a de novo heterozygous missense variant in MTOR gene. One case carried c.5395G>A (p.Glu1799Lys) and the other case carried c.7234G>C (p.Asp2412His). There was no literature of MTOR gene variation in Chinese. So far, a total of 45 cases were reported worldwide with detailed clinical information. Eleven variations in MTOR gene were involved, which were all heterozygous missense mutations. Among them, p.Glu1799Lys was the most common sites (28 cases,62%). Another case carried c.7234G>C (p.Asp2412His) was not reported before. Summarizing the 47 cases (including these 2 cases), 46 cases had developmental delay or intellectual disability, 9 cases had developmental regression,42 cases had megalencephaly, 30 cases had facial malformation,16 cases had hypotonia, 17 cases had autism spectrum disorders, 3 cases had hyperactivity, 3 cases had obsessive compulsive disorder, 13 cases had eye diseases, 11 cases had cutaneous vascular malformation, and 9 cases had hypoglycemia. Conclusions: The main clinical features of Smith-Kingsmore syndrome include megalencephaly, developmental delay or intellectual disability, and facial malformation, which can be combined with epilepsy, autism spectrum disorder, hypotonia, hypoglycemia and so on. The variation of MTOR gene is the cause of Smith-Kingsmore syndrome.

Diagnostic accuracy of ultrasonography for detecting gastric tube placement: an updated meta-analysis

OBJECTIVE

This study aimed at reviewing the diagnostic accuracy of ultrasonography for detecting correct nasogastric tube placement compared with X-ray imaging as the reference standard.

MATERIALS AND METHODS

This was a systematic review and meta-analysis of observational studies published between 1961 and 2022. We included studies that compared the diagnostic accuracy of ultrasound detection for nasogastric tube placement with that of X-ray imaging in adult patients who were undergoing nasogastric tube placement for any reason. We searched for published studies in the following electronic databases: Cochrane Library, PubMed, EMBASE, and Web of Science. The risk of bias was assessed using a standard procedure according to the Quality Assessment of Diagnostic Accuracy Studies-2 criteria. The results were analyzed using RevMan or Meta-Disc software to determine the adequacy and conclusiveness of the available evidence.

RESULTS

Fourteen studies met our inclusion criteria. Overall, 1,812 patients were included in these studies. The results included a pooled sensitivity of 0.96 (95% confidence interval [CI] 0.94-0.97), specificity of 0.91 (95% CI 0.85-0.96), positive likelihood ratio of 5.08 (95% CI 1.49-17.39), and negative likelihood ratio of 0.08 (95% CI 0.06-0.10). This was confirmed through a summary receiver operating characteristic curve, which showed that the area under the curve was 0.96.

CONCLUSIONS

We found evidence about validity of ultrasound as an efficient method for verifying nasogastric tube placement, although there is insufficient evidence to suggest that it can be used as a diagnostic tool for incorrect gastric tube placement.

[Progress in the clinical treatment of alcoholic hepatitis]

Alcoholic hepatitis is a severe and life-threatening systemic inflammatory response syndrome, which has a high incidence and mortality rate worldwide. The severity ranges from asymptomatic liver biochemical disturbances to fulminant liver failure or death; however, there are few effective therapeutic interventions. Maddrey discriminant function not only predicts short-term mortality, but it also guides clinicians to choose appropriate alcoholic hepatitis-specific treatments. Alcohol abstinence, nutritional support, psychological counseling, and infection prevention remain the cornerstones for alcoholic hepatitis treatment. Corticosteroids remain the mainstay of treatment when patients have a good appetite and normal serum creatinine levels, but early liver transplantation is the only life-saving option for steroid-unresponsive patients. New studies have found that gut microbiota is an important therapeutic targets in patients with alcohol hepatitis, and N-acetylcysteine, granulocyte colony-stimulating factor, and metadoxine as adjunctive therapy have a positive effect on patient survival.

Neuroprotective effects of visnagin on cerebral ischemia-reperfusion injury rats and the underlying mechanisms

OBJECTIVE

Cerebral ischemia-reperfusion (I/R), caused by the treatments of ischemic stroke, usually leads to brain injury. Inflammation, oxidative stress, and autophagy play pivotal roles in the pathology. Visnagin presents a protective effect on I/R injured animal models of the heart, liver, kidney, and other organs. In our research, we identified the neuroprotective effects and the underlying mechanisms of visnagin in cerebral I/R injured models.

MATERIALS AND METHODS

We constructed rat models of cerebral I/R injury and categorized them into 5 groups: sham operation group, I/R model group, and visnagin treatment I/R group (10, 30, 60 mg/kg). The neurological deficits of the rats were analyzed after 24 hours of reperfusion, then, the contents of glutathione peroxidase, malondialdehyde, superoxide dismutase catalase, caspase-3, nuclear factor kappa-B p65 unit, tumor necrosis factor-α, interleukin-1β, and interleukin6 were measured in rat models. The expressions of Bcl-2 and Bax were detected by Western blot analysis.

RESULTS

Our results suggested that the administration of visnagin alleviated the cognitive dysfunction, reduced the activities of inflammatory factors, promoted the protein expression of Bcl-2, and downregulated the expression of Bax in the I/R injured rat model.

CONCLUSIONS

Visnagin exerts a neuroprotective effect during I/R injury in rats, the underlying mechanisms may be the effect of attenuating neuroinflammation, anti-oxidative and inhibition of apoptosis.

[Magnetic resonance imaging quantitative analysis of knee joint injury and cartilage before and after long-distance march and training for college students]

Objective: To assess the effects of long-distance march and training on acute knee injury and knee cartilage sub-regions of college students using quantitatively magnetic resonance imaging analysis. Methods: Twenty-seven young male students from freshman classes in the Army Military Medical University were enrolled in September 2019, aged from 17 to 20 (19.48±0.14) years, participated in the whole 8-day, 240 km long-distance march and training. Three-dimensional quantitative MRI was performed on the right knee using high-field MRI before (baseline) and 1 day after (follow-up) march. The assessment indexes included: meniscus and cartilage injury(5-point scale), bone marrow and ligament injury, and joint effusion(3-point scale). Using semi-automatic cartilage segmentation and 3D data post-processing techniques, a total of 21 sub-regions of cartilage volume and thickness were measured in the medial and lateral femur, medial and lateral tibia. Paired-samples t-test was used to compare the changes in quantitative cartilage indices of the knee joint before and after march. Results: In terms of acute knee injuries, medial and lateral meniscus injuries (grade 1-3) occurred in 8 and 9 college students, respectively compared with those before march. Anterior cruciate ligaments injury occurred in 4 college students and developed from grade 0 to grade 1. Bone marrow edema occurred in 10 students and developed from grade 0 to grade 2, and in 5 students from grade 0 to grade 1. Joint effusion occurred in 5 college students and developed from grade 1 to grade 2 (all P<0.05). In terms of quantitative analysis of cartilage subregion of knee joint, the volume of central region of femoral pulley increased [(1.84±0.32) mm³ vs (1.67±0.29) mm³] and the volume of central region of medial femoral condyle decreased [(1.18±0.21) mm³ vs (1.26±0.17) mm³] compared with that before march (all P<0.05); The cartilage thickness of 11 cartilage subregion [(1.37±0.27) mm vs (1.53±0.18) mm], [(1.42±0.25) mm vs (1.54±0.17) mm], [(1.53±0.20) mm vs (1.62±0.20) mm], [(1.72±0.28) mm vs (1.83±0.28) mm], [(1.84±0.45) mm vs (2.04±0.42) mm], [(2.20±0.58) mm vs (2.46±0.50) mm], [(1.74±0.19) mm vs (1.85±0.21) mm] [(1.45±0.21) mm vs (1.58±0.16) mm], [(1.81±0.22) mm vs (1.91±0.15) mm], [(1.44±0.13) mm vs (1.53±0.15) mm] was thinner than that before march (all P<0.05). The T₂ values of 7 cartilage subregion [(40.57±26.23) ms vs (67.10±47.46) ms], [(80.10±20.56) ms vs (98.42±23.58) ms], [(87.92±24.95) ms vs (108.84±29.24) ms], [(50.49±19.18) ms vs (76.97±37.16) ms], [(38.89±15.82) ms vs (69.70±40.16) ms] [(55.84±24.53) ms vs (106.35±50.01) ms] and [(72.38±36.64) ms vs (105.31±39.34) ms] were lower than those before march, while the T₂ values of the two subregions of patellar cartilage [(102.13±44.47) ms vs (72.20±28.37) ms], [(97.42±44.86) ms vs (76.67±51.64) ms] were higher than those before march (P<0.05). There was no significant difference in other cartilage subareas (P>0.05). Conclusions: Long distance hiking will lead to acute injury of knee joint of young college students. The thickness of cartilage subregion of knee joint showed a thinning trend as a whole, while the volume and T₂ values showed different trends.

[Acute respiratory distress syndrome caused by quetiapine poisoning: a case report]

Quetiapine is a psychotropic drug. Excessive use of quetiapine may lead to drowsiness, blurred vision, respiratory depression, hypotension and extrapyramidal reactions. Acute respiratory distress syndrome (ARDS) is rare due to overdose of quetiapine. On 14 February 2020, a patients with coma, respiratory arrest and hypotension due to overdose of quetiapine were admitted to our hospital. After receiving mechanical ventilation、plasma adsorption and anti-inflammatory treatment, the patient's consciousness turned clear, the machine was successfully removed and extubated, and the patient's condition was improved and discharged from hospital. We analyzed the clinical data of the patient with quetiapine poisoning, and discussed the clinical symptoms and chest CT characteristics of ARDS caused by quetiapine poisoning, in order to improve the understanding of quetiapine poisoning and improve the success rate of rescue.

[Scoping review on prevention of central venous catheter-related bloodstream infection in burn patients]

Objective: To investigate the research trend and scope of prevention of central venous catheter-related bloodstream infection (CRBSI) in burn patients. Methods: The scoping review method was adopted. Pre-retrieval was carried out with search terms of ", , " and "central venous catheter, infection, catheter-related bloodstream infection, burn". On the basis of pre-retrieval, different retrieval formulas were formulated to retrieve researches related to central venous CRBSI in burn patients in China National Knowledge Internet, Wanfang Database, VIP Database, PubMed, Embase, CINAHL, and Cochrane Library from the establishment of each database to August 2020. Data were extracted from the included literature, including the first author, research publication time, research country, research type, diagnosis basis and intervention measures of central venous CRBSI, research sample selection, incidence related to infection, and research conclusion. Results: A total of 20 randomized controlled trials, quasi-experimental studies, case-control studies, cohort studies, and implementation researches published in 1990-2020 were included in this study with the first authors from China, the United States of America, or Argentina. The diagnostic bases for central venous CRBSI in burn patients were not uniform in the included literature, including adopting the Guidelines of American Centers for Disease Control and Prevention, Diagnostic Criteria for Nosocomial Infection, and other diagnostic criteria without specifying the source. The intervention measures included the use of new materials such as antibiotics coated catheter and ethanol impregnated port protectors, multidisciplinary cooperation, and comprehensive preventive measures. The sample size in the included literature was small, and the sample selection was different, including the number of patients and the the number of placement of central venous catheter. The outcome indicators for infection in the included literature were diversified. The incidence per 1 000 days of central venous CRBSI was 20.41‰-29.1‰ of patients in control group in China, the incidence per 1 000 days of central venous CRBSI was mostly <16.6‰ in control group in foreign countries, and the incidence of central venous CRBSI was decreased to varying degrees after implementing the corresponding intervention measures. Related research conclusions showed that new materials, multidisciplinary cooperation, and comprehensive preventive measures had good effects on prevention of central venous CRBSI in burn patients. Conclusions: The researches on prevention of central venous CRBSI in burn patients in China start early and the research types are diversified. The diagnostic criteria of central venous CRBSI in burn patients are not uniform, intervention measures have shifted from standardizing relevant operational measures to exploring the prevention effects of new materials, multidisciplinary cooperation, and multiple measures, and the latter has good effects on preventing central venous CRBSI in burn patients.

[The risk prediction models for occurrence of cervical cancer: a systematic review]

Objective: To systematically summarize and assess risk prediction models for occurrence of cervical cancer and to provide evidence for selecting the most reliable model for practice, and guide cervical cancer screening. Methods: Two groups of keywords related to cervical cancer and risk prediction model were searched on Chinese databases (CNKI, and Wanfang) and English databases (PubMed, Embase, and Cochrane Library). Original articles that developed or validated risk prediction models and published before November 21, 2019, were selected. Information form was created based on the CHARMS checklist. The PROBAST was used to assess the risk of bias. Results: 12 eligible articles were identified, describing 15 prediction models, of which five were established in China. The predicted outcomes included multiple stages from cervical precancerous lesions to cancer occurrence, i.e., abnormal Pap smear (1), occurrence or recurrence of CIN (9), and occurrence of cervical cancer (5), etc. The most frequently used predictors were HPV infection (12), age (7), smoking (5), and education (5). There were two models using machine learning to develop models. In terms of model performance, the discrimination ranged from 0.53 to 0.87, while only two models assessed the calibration correctly. Only two models were externally validated in Taiwan of China, using people in different periods. All of the models were at high risk of bias, especially in the analysis domain. The problems were concentrated in the improper handling of missing data (13), preliminary evaluation of model performance (13), improper use of internal validation (12), and insufficient sample size (11). In addition, the problems of inconsistency measurements of predictors and outcomes (8) and the flawed report of the use of blindness for outcome measures (8) were also severe. Compared with the other models, the Rothberg (2018) model had relatively high quality. Conclusions: There are a certain number of cervical cancer risk prediction models, but the quality is poor. It is urgent to improve the measurement of predictors and outcomes, the statistical analysis details such as handling missing data and evaluation of model performance and externally validate existing models to better guide screening.

[Clinicopathological and molecular features of small round cell sarcoma of bone and soft tissue: a study of 72 cases]

Objective: To investigate the clinicopathological, immunohistochemical and molecular features of small round cell sarcoma (SRCS) of the bone and soft tissue, and to compare the diagnostic value of different techniques. Methods: Seventy-two cases of SRCS of the bone and soft tissue diagnosed at People's Hospital, Peking University from January 2016 to March 2020 were recruited and retrospectively analyzed for pathological morphology, immunophenotype and fluorescence in situ hybridization (FISH) data. Next generation sequencing (NGS) was performed on 13 difficult cases. Results: In the study cohort, the patients ranged in age from 4-55 years, with a male predominance. The most Ewing's sarcomas and osteosarcomas occurred in the bone, while CIC-rearranged sarcomas, BCOR-rearranged sarcoma, synovial sarcoma, extraskeletal myxoid chondrosarcoma and FUS-NFATc2 rearranged sarcoma occurred in soft tissue. Histologically, all cases were composed predominantly of small round cells. Most cases were positive for vimentin and CD99, and showed a variable reactivity for neurogenic markers. Muscle marker and epithelial marker were negative for most cases. Combined with clinical features, histopathologic findings, immunophenotype, FISH and NGS, we diagnosed 46 Ewing sarcomas, 14 osteosarcomas, 3 CIC-rearranged sarcomas, 1 BCOR-rearranged sarcoma, 1 synovial sarcoma, 1 clear cell soft tissue sarcoma, 1 extraskeletal myxoid chondrosarcoma, 1 FUS-NFATc2 rearranged sarcoma, and 4 undifferentiated small round cell sarcomas. Conclusions: SRCS of bone and soft tissue is a group of malignant mesenchymal tumors based on morphological features. Most cases can be diagnosed with a combination of clinical characteristics, morphological features and immunohistochemical phenotype, while some cases require such further tests as FISH and NGS technologies, and NGS can be useful in diagnosing and categorizing SRCS.

[Four cases of acute diquat poisoning with prominent epileptoid seizure and literature review]

Objective: To further improve the awareness of the clinical feature of acute diquat poisoning. Methods: A retrospective analysis was performed on 4 cases of acute diquat poisoning with epileptoid seizure as the main clinical manifestation, which were admitted and diagnosed by the Characteristic Medical Center of Chinese People's Armed Police Force from January 1, 2017 to December 31, 2019. Take "Diquat" or "Deiquat" or "Reward" as keyword search for CNKI, Pubmed, and EMbase in both Chinese and English. The date of literature retrieval was from the database founding to December 31, 2019. Results: Of the 4 patients, 3 were male and 1 female, with an average age of 28 years (22-33 years) . The estimated dose was 8-20 g. All patients were treated with gastric lavage, catharsis, fluid replacement, blood perfusion, and in the early stage of treatment of epileptic seizures, the initial routine antiepileptic drugs had poor effect. Then propofol and midazolam were injected into the treatment. The epilepsy was relieved, but the condition deteriorated rapidly, and the patients died eventually. The literature search retrieved 3 patients in the 3 literatures included in the study were analyzed, and their clinical course was similar to that of 4 cases in the center. Necropsy was performedon all 3 patients, and the results were cerebral edema, diffuse cerebral edema, and hemorrhage around the basal ganglia. Conclusion: Acute diquat poisoning can cause epileptic seizures. Once it occurs, the disease progresses rapidly and the prognosis is poor. The combination of large dose of sedative drugs can be used to treat epilepsy in order to improve the prognosis.

LncRNA KCNQ1OT1 contributes to the cisplatin resistance of tongue cancer through the KCNQ1OT1/miR-124-3p/TRIM14 axis

OBJECTIVE

Tongue cancer is a common malignant tumor in the oral and maxillofacial region, most of which is squamous cell carcinoma. Cisplatin (DDP) is one of the chemotherapy drugs for patients with tongue squamous cell carcinoma (TSCC). However, DDP resistance has become a major obstacle to its clinical application. Our study aimed to investigate the effects of long non-coding RNA (lncRNA) KCNQ1 overlapping transcript 1 (KCNQ1OT1) on DDP resistance of tongue cancer and the underlying mechanism.

PATIENTS AND METHODS

The levels of KCNQ1OT1, miR-124-3p, and tripartite motif containing 14 (TRIM14) were detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The maximum size of tumor (MTS) assay was used to detect the cell survival rates. Furthermore, the cell proliferation was detected by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) assay. Transwell assay was performed to detect the cell migration and invasion. Western blot assay was used to detect the protein levels of Vimentin, N-cadherin, E-cadherin, and TRIM14. The functional targets of KCNQ1OT1 and miR-124-3p, miR-124-3p and TRIM14 were predicted by starBase 3.0 and TargetScan. The relationship between KCNQ1OT1 and miR-124-3p was confirmed by Dual-Luciferase reporter assay, RNA immunoprecipitation (RIP) and RNA pull-down. Further, the relationship between miR-124-3p and TRIM14 was verified by Dual-Luciferase reporter assay. Animal experiment revealed the effect of KCNQ1OT1 on DDP resistance of tongue cancer cells in vivo.

RESULTS

KCNQ1OT1 was upregulated in DDP-resistant tongue cancer tissues and cells, and mainly expressed in cytoplasm. Functionally, the knockdown of KCNQ1OT1 inhibited the survival rate, proliferation, migration, invasion, and EMT of the DDP-resistant tongue cancer cells. Of note, miR-124-3p acted as a target of KCNQ1OT1 and KCNQ1OT1 could reduce the expression of miR-124-3p. Moreover, miR-124-3p targeted TRIM14 and the downregulation of TRIM14 reduced the DDP resistance of tongue cancer cells. Importantly, KCNQ1OT1 regulated the TRIM14 expression by targeting miR-124-3p. Furthermore, KCNQ1OT1 knockdown reduced the DDP-resistant tumor growth and weight through the miR-124-3p/TRIM14 axis in vivo.

CONCLUSIONS

LncRNA KCNQ1OT1 promotes the DDP resistance of tongue cancer by sponging miR-124-3p to regulate TRIM14 expression.

[Analysis of Correlation between Gene Polymorphisms of CRHBP in Yunnan Han Population and Schizophrenia and Aggressive Behavior]

Objective To explore the correlation between 4 tag single nucleotide polymorphisms （Tag SNP） sites （rs7721799, rs32897, rs7718461, rs10062367） of corticotropin releasing hormone binding protein （CRHBP） and schizophrenia and aggressive behavior in the Yunnan Han population. Methods Case-control correlation analysis was used to establish a complex amplification system. Improved multiplex ligase detection reaction （iMLDR） technology was used to detect the genotypes of 4 SNP sites of CRHBP gene of 163 Han schizophrenic patients （including 81 patients with aggressive behavior, 82 patients without aggressive behavior） and 345 healthy Han individuals, which were analyzed statistically by SPSS 19.0, Haploview 4.2 and PHASE 2.1 software. Results There was no correlation between the 3 SNP sites of CRHBP gene and the onset of schizophrenia except for the rs7718461 site （P>0.05）. The relative risk of aggressive behavior of patients carrying GG or GA genotype at rs7718461 site were 4.903 times higher than those carrying AA genotype （P<0.05）. Conclusion The CRHBP gene may not be associated with the occurrence of schizophrenia in Yunnan Han population, but AA genotype of rs7718461 may reduce the risk of aggressive behavior in schizophrenia patients.

Long non-coding RNA LINC01287 promotes breast cancer cells proliferation and metastasis by activating Wnt/ß-catenin signaling

OBJECTIVE

Long noncoding RNA (lncRNAs) frequently exhibited abnormal levels in numerous tumors and other diseases in current biological researches. LINC01287, a newly discovered lncRNA, has been found to act as an oncogene in hepatocellular carcinoma. The aim of this research was to explore the expressions and functions of LINC01287 in breast cancer (BC).

PATIENTS AND METHODS

The relative expressions of LINC01287 in BC tissues and cells were determined using RT-PCR. The associations between the LINC01287 expression, the clinicopathological factors, and the overall survival of BC patients were statistically examined. The apoptosis and proliferation abilities of MCF-7 and MDA-MB-468 cells were analyzed by MTT and flow cytometry assay after LINC01287 knockdown. The effects of LINC01287 in migration and invasion were determined using wound-healing and transwell assays. The protein expressions of the Wnt/β-catenin pathway were determined using Western blot.

RESULTS

We showed that the levels of LINC01287 were significantly upregulated in BC tissues and BC cell lines, and the abnormal expressions of LINC01287 were correlated with TNM stage and lymph node metastasis. A distinct difference was observed and indicated that BC patients with higher LINC01287 expressions had significantly shorter overall survival than patients with lower LINC01287 expressions. The multivariate analysis demonstrated that LINC01287 expression was independently correlated with the overall survival. Si-LINC01287 transfection significantly inhibited the proliferation and metastasis of BC cells, and further promoted apoptosis. Besides, the knockdown of LINC01287 suppressed Wnt/β-catenin activation and affected the expressions of β-catenin, cyclin D1, and c-myc.

CONCLUSIONS

Our findings indicated that the new lncRNA LINC01287 was correlated with poor clinical outcome and may function as a novel prognostic biomarker and therapeutic target in the development of antineoplastic therapies for BC.

[The clinical significance of plasma PTX3 in patients with secondary hemophagocytic lymphohistiocytosis]

Objective: To investigate the significance of plasma pentraxin 3 (PTX3) in patients with secondary hemophagocytic lymphohistiocytosis (sHLH). Methods: Plasma PTX3 levels were tested by ELISA in 48 newly diagnosed sHLH patients, 18 healthy volunteers and 9 lymphoma controls in the First Affiliated Hospital of Nanjing Medical University from January 2017 to July 2019. Clinical parameters were collected, and the correlations with PTX3 levels were analyzed. Results: PTX3 level in newly diagnosed group was significantly higher than that of healthy control group [16.29(1.17-66.00) vs. 0.76(0.01-7.86) μg/L, P<0.01]. Patients with lymphoma-associated HLH(LHLH) had higher plasma level of PTX3 than Fhose with infection-associated HLH (IHLH) [24.29(3.36-66.00) vs. 9.56(1.17-36.50)μg/L, P<0.05]. Plasma PTX3 levels in 48 sHLH patients were positively correlated with serum ferritin (P<0.05). Receiver operating characteristic (ROC) curve for plasma PTX3 levels of sHLH and healthy controls produced a cutoff value at 3.9 μg/L, with its 86.7% sensitivity and 94.4% specificity. And ROC analysis showed that PTX3 17.5 μg/L was the critical value for diagnosis of LHLH from non-LHLH group, that the sensitivity and specificity were 63.0% and 76.2% respectively. The 1-year overall survival (OS) rate in patients with PTX3≥17.5 μg/L was significantly lower in those with PTX3<17.5 μg/L (18.5% vs. 75.8%, P<0.01). Conclusion: These results indicate the potential of PTX3 as a biomarker for diagnosis and prognosis in patients with sHLH.

[Calculation of the prevalence of progressive muscular atrophy among adults in China based on urban medical insurance data from 15 provinces]

OBJECTIVE

To analyze the characteristics of patients with progressive muscular atrophy (PMA) and calculate the prevalence of PMA in China in 2016.

METHODS

A retrospective analysis based on China's urban employee basic medical insurance data and the urban residence basic medical insu-rance data from January 1, 2016 to December 31, 2016 was carried out. Children under 18 years old were excluded. Patients with progressive muscular atrophy were identified by disease names and codes. Subgroup analyses by gender, region and age were carried out to calculate the gender-specific, region-specific and age-specific prevalences. Age-adjusted national prevalence was estimated based on 2010 Chinese census data. Sensitivity analyses were done by only considering the observed cases and by excluding the top 10% provinces regarding the missing rate of diagnostic information, respectively.

RESULTS

A total of 996.09 million person-years were included in this study, with 518.41 million person-years in males and 477.67 million person-years in females. The age and gender distribution of the study population was similar to that of the 2010 Chinese census data, therefore the study population was nationally representative. The prevalence of PMA in China in 2016 was 0.28 per 100 000 person-years (95%CI: 0.24-0.33), with 0.21 per 100 000 person-years (95%CI: 0.16-0.26) and 0.35 per 100 000 person-years (95%CI: 0.28-0.42) for females and males, respectively. Regional disparity existed in the Chinese PMA prevalence, with the lowest prevalence in Southwest region (0.11 per 100 000 person-years, 95%CI: 0.07-0.15) and the highest prevalence in Northwest region (3.47 per 100 000 person-years, 95%CI: 0.80-7.99). Age trend in the PMA prevalence was not obvious, but the prevalence among those aged 70 years and older was relatively higher. The age-adjusted prevalence based on 2010 Chinese census data was 0.29 per 100 000 person-years (95%CI: 0.27-0.31). The national prevalences calculated by only considering the observed cases and by excluding the top 10% provinces regar-ding the missing rate of diagnostic information were 0.17 per 100 000 person-years (95%CI: 0.14-0.20) and 0.24 per 100 000 person-years (95%CI: 0.20-0.28), respectively.

CONCLUSION

This study is to calculate the prevalence of PMA among adults in urban China, which can provide basic statistics for the enactment of PMA related medical policies, and clues for the studies on the mechanisms of PMA.

[A cross-sectional study on current status of rare disease related health information based on WeChat official accounts in China]

Objective: To understand the current status of rare disease related health information release in WeChat official accounts in China. Methods: We used a series of key words containing "rare diseases" and the names of the top 30 rare diseases in hospitalizations in China to search WeChat official accounts. Eligible articles were selected by systematic sampling. All including WeChat official accounts and articles were evaluated to extract the basic information. Results: No relevant WeChat official accounts were found for 14 rare diseases (46.67%). Most of the WeChat official accounts (52.17%) were initiated by patients and patient groups. No significant difference was detected in the total number of articles between the official accounts related with Traditional Chinese Medicine (TCM) and non-TCM related ones, however, the frequency of the monthly information release was significantly higher in TCM related official accounts (P<0.001), while the average reading number of articles was significantly higher in non-TCM related official accounts (P<0.001). Nearly 80% of the WeChat official accounts had navigation menu, and the average reading number of official accounts with menus was larger than those without menus. The top three topics were rare disease diagnosis and treatment knowledge (46.00%), public welfare activity for rare diseases (12.81%) and uncorrelated things (8.65%), while the first three leading topics were cutting-edge information, public welfare activity and patient story, respectively. Conclusions: The scale for rare disease related health information release based on WeChat official accounts in China has been basically formed, but it is still in development stage. Many improvements should be made in their coverage of rare diseases, release frequency, topic and form. It is urgent to establish or recreate some high-quality WeChat official accounts in order to provide precise information and effectively facilitate the prevention and treatment of rare diseases.

Recombinant Treponema pallidum protein Tp0136 promotes fibroblast migration by modulating MCP-1/CCR2 through TLR4

BACKGROUND

Chancre self-healing is an important clinical feature in the early stages of syphilis infection. Wound healing may involve an important mechanism by the migration of fibroblasts filling the injured lesion. However, the specific mechanism underlying this process is still unknown.

OBJECTIVES

We aimed to analyse the role of Tp0136 in the migration of fibroblasts and the related mechanism.

METHODS

The migration ability of fibroblasts was detected by a wound-healing assay. RT-PCR and ELISA detected the expression of MCP-1, IL-6 and MMP-9. TLR4 expression was detected by RT-PCR. The protein levels of CCR2 and relevant signalling pathway molecules were measured by Western blotting.

RESULTS

Tp0136 significantly promoted fibroblast migration. Subsequently, the levels of MCP-1 and its receptor CCR2 were increased in this process. The migration of fibroblasts was significantly inhibited by an anti-MCP-1 neutralizing antibody or CCR2 inhibitors. Furthermore, studies demonstrated that Tp0136 could activate the ERK/JNK/PI3K/NF-κB signalling pathways through TLR4 activity and that signalling pathways inhibitors could weaken MCP-1 secretion and fibroblast migration.

CONCLUSIONS

These findings demonstrate that Tp0136 promotes the migration of fibroblasts by inducing MCP-1/CCR2 expression through signalling involving the TLR4, ERK, JNK, PI3K and NF-κB signalling pathways, which could contribute to the mechanism of chancre self-healing in syphilis.

WHITE STRIPE LEAF8, encoding a deoxyribonucleoside kinase, is involved in chloroplast development in rice

WSL8 encoding a deoxyribonucleoside kinase (dNK) that catalyzes the first step in the salvage pathway of nucleotide synthesis plays an important role in early chloroplast development in rice. The chloroplast is an organelle that converts light energy into chemical energy; therefore, the normal differentiation and development of chloroplast are pivotal for plant survival. Deoxyribonucleoside kinases (dNKs) play an important role in the salvage pathway of nucleotides. However, the relationship between dNKs and chloroplast development remains elusive. Here, we identified a white stripe leaf 8 (wsl8) mutant that exhibited a white stripe leaf phenotype at seedling stage (before the four-leaf stage). The mutant showed a significantly lower chlorophyll content and defective chloroplast morphology, whereas higher reactive oxygen species than the wild type. As the leaf developed, the chlorotic mutant plants gradually turned green, accompanied by the restoration in chlorophyll accumulation and chloroplast ultrastructure. Map-based cloning revealed that WSL8 encodes a dNK on chromosome 5. Compared with the wild type, a C-to-G single base substitution occurred in the wsl8 mutant, which caused a missense mutation (Leu 349 Val) and significantly reduced dNK enzyme activity. A subcellular localization experiment showed the WSL8 protein was targeted in the chloroplast and its transcripts were expressed in various tissues, with more abundance in young leaves and nodes. Ribosome and RNA-sequencing analysis indicated that some components and genes related to ribosome biosynthesis were down-regulated in the mutant. An exogenous feeding experiment suggested that the WSL8 performed the enzymic activity of thymidine kinase, especially functioning in the salvage synthesis of thymidine monophosphate. Our results highlight that the salvage pathway mediated by the dNK is essential for early chloroplast development in rice.

MiR-1271 negatively regulates AKT/MTOR signaling and promotes apoptosis via targeting PDK1 in pancreatic cancer

OBJECTIVE

Pancreatic cancer (PC) possesses a very poor prognosis, and its pathogenesis is not fully understood. Evidence has suggested that microRNAs play important roles in cancer development and progression, the present study was designed to study the function of miR-1271 in PC.

PATIENTS AND METHODS

PC tissues and adjacent normal tissues were collected from 17 patients. MiR-1271 and PDK1 expression were quantified by quantitative reverse-transcriptional polymerase chain reaction (RT-PCR). AKT/MTOR signaling activity and PDK1 protein expression were determined by Western blot. Cell viability and apoptosis were assessed by MTT assay and enzyme-linked immunosorbent assay (ELISA). Luciferase assay was used to verify whether miR-1271 directly targets PDK1.

RESULTS

MiR-1271 was significantly down-regulated in PC tissues compared with that in the paired normal adjacent tissue, and its expression was up-regulated dose-dependently upon cisplatin treatment in PC cells. Overexpression of miR-1271 in these cells produced a pro-apoptotic effect, similar to what caused by cisplatin treatment. Moreover, overexpression of miR-1271 inhibited AKT/MTOR signaling, which was due to the targeting relationship between miR-1271 and PDK1. Finally, knockdown of PDK1 exerted a similar effect on apoptosis to that of miR-1271 overexpression.

CONCLUSIONS

MiR-1271 is a potent tumor suppressor in PC, its pro-apoptotic function was partially mediated by reduced AKT/MTOR signaling. Targeting miR-1271 may represent an effective strategy for PC treatment.

Activities of key enzymes in the C4 pathway and anatomy of sugarcane infected by Leifsonia xyli subsp. xyli

AIMS

Ratoon stunting disease caused by Leifsonia xyli subsp. xyli (Lxx) is a bacterial disease that has plagued sugarcane-planting countries for a long time. This study mainly analysed Lxx localization and its effects on sugarcane leaf.

METHODS AND RESULTS

Badila were inocultated by bacteria of Lxx. It was noted that the number of Lxx cells were rapidly enriched in sugarcane leaves from the 150th to the 210th days of post inoculation (dpi). Lxx infection disrupted the integrity of vascular bundle sheath cells (BSC) in the 'Kranz anatomy' of leaves, resulting in irregular accumulation of starch in vascular BSC of leaves. In situ PCR showed that the Lxx localized in the xylem vessels, mesophyll cell (MC) and BSC as described before in sugarcane leaf, a new niche within the host tissues in the phloem of sugarcane stem. The gene expression and activities of phosphoenolpyruvate carboxylase (PEPC), pyruvate, orthophosphate dikinase (PPDK) and NADP-malic enzyme (NADP-ME) enzymes were lower in Lxx-inoculated sugarcane plants as compared to the MI group.

CONCLUSION

Lxx infection not only disrupted the structure of vascular BSC in the C4 'Kranz anatomy' of sugarcane leaves, but also affected the activities and gene expression of the key enzymes PEPC, PPDK and NADP-ME in the C4 cycle of sugarcane suggesting a reduction in CO₂ fixation.

SIGNIFICANCE AND IMPACT OF THE STUDY

The effect of Leifsonia xyli subsp. xyli (Lxx) infection on the photosynthetic physiology of sugarcane is currently limited to the evaluation of photosynthetic parameters. This study assessed the impact of Lxx infection on the mechanism of C4 cycle CO₂ fixation and to accompanying plant anatomy.

[Clinical analysis of secondary hemophagocytic lymphohistiocytosis complicated with capillary leak syndrome]

目的

探讨继发性噬血细胞性淋巴组织细胞增多症（sHLH）合并毛细血管渗漏综合征（CLS）的临床特征。

方法

回顾性分析2015年1月至2017年12月江苏省人民医院收治的87例sHLH患者的临床及实验室资料，其中21例合并CLS（CLS-sHLH组），66例未合并CLS（非CLS-sHLH组）。比较两组的临床表现、实验室检查、治疗及预后差异。

结果

比较CLS-sHLH组和非CLS-sHLH组患者引起sHLH的病因，差异无统计学意义（P>0.05）。CLS-sHLH组患者ANC、血清纤维蛋白原、白蛋白较非CLS-sHLH组降低，而甘油三酯较非CLS-sHLH组升高（P值均<0.05）。CLS-sHLH组患者均有不同程度水肿、体重增加、低血压、低蛋白血症、少尿及多浆膜腔积液。其中15例患者CLS症状消失，CLS中位好转时间为7（5~14）d。6例患者CLS症状未消失，并于15（6~30）d死亡。CLS-sHLH组中位OS时间低于非CLS-sHLH组（75 d对未达到，P=0.031）。

结论

在sHLH患者中，CLS的发生可能与sHLH的原发病无明显相关。严重的ANC、纤维蛋白原及白蛋白减低，甘油三酯升高，可能是sHLH发生CLS的伴随症状。sHLH合并CLS时预后差。

Are nontreponemal tests suitable for monitoring syphilis treatment efficacy? Evidence from rabbit infection models

OBJECTIVES

We aimed to characterize kinetics of non-treponamal antibody titres during the natural course of syphilis and explore their roles in monitoring syphilis treatment efficacy.

METHODS

Sixty New Zealand white male rabbits were challenged with Nichols or Amoy Treponema pallidum strains, and the rapid plasma reagin (RPR) test was performed to quantify non-treponemal antibody titres during the infection course. Viable T. pallidum in the challenged rabbits was assessed with rabbit infectivity tests.

RESULTS

The RPR titres of the Nichols or Amoy strain between no benzathine penicillin G (BPG) and BPG treatment subgroups displayed a similar trend: first ascending and then descending. Compared with baseline, the proportions of fourfold decline in RPR titres in the Nichols or Amoy group presented a similar result on days 30, 60 and 180 between the no BPG and BPG treatment subgroups (0%, 0/5; 80%, 4/5; 100%, 5/5; vs. 0%, 0/5; 80%, 4/5; 100%, 5/5; p 0.999; 0%, 0/5; 80%, 4/5; 80%, 4/5; vs. 40%, 2/5; 100%, 5/5; 100%, 5/5; p 0.098, respectively). Compared with the maximum baseline titre, the proportion of fourfold decline in PRR titre also showed a similar result in the two groups on days 30, 60 and 180 between the no BPG and the BPG treatment subgroups (0%, 0/5; 100%, 5/5; 100%, 5/5, vs. 40%, 2/5; 100%, 5/5; 100%, 5/5; p 0.129; 0%, 0/5; 100%, 5/5; 100%, 5/5, vs. 80%, 4/5; 100%, 5/5; 100%, 5/5; p 0.091, respectively. Moreover, regardless of whether the RPR titres presented a fourfold decline, viable T. pallidum could be detected in untreated rabbits' lymph nodes at 30, 60 and 180 days post infection, while viable T. pallidum was not detected in any of the treated rabbits' lymph nodes.

CONCLUSIONS

The RPR titre increased and then decreased (even became negative) during the natural course of syphilis, similar to that seen after BPG treatment. The RPR tetre is thus a questionable indicator of syphilis treatment efficacy.

Analysis of serum metabolite profiles in syphilis patients by untargeted metabolomics

BACKGROUND

Global metabolomics analysis can provide substantial information on energy metabolism, physiology, possible diagnostic biomarkers and intervention strategies for pathogens.

OBJECTIVE

To gain a better understanding of the mechanisms of syphilis and analysis of serum metabolite profiles in syphilis patients.

METHODS

We conducted an untargeted metabolomics analysis of serum from 20 syphilis patients and 20 healthy controls.

RESULTS

A total of 2890 molecular features were extracted from each sample, and the peak intensity of each feature was obtained. Distinct differential metabolites were identified by principal component analysis, partial least squares-discriminant analysis and hierarchical clustering analysis. Furthermore, five metabolites were identified as significantly different by Student's t-test, including trimethylamine N-oxide, l-arginine, lysoPC(18:0), betaine and acetylcarnitine. KEGG analysis showed that these differential metabolites were in various pathways, including Chagas disease, fatty acid biosynthesis, primary bile acid biosynthesis, Salmonella infection, ABC transporters, glycerophospholipid metabolism and choline metabolism. Among them, trimethylamine N-oxide was 3.922 times in patients with syphilis than healthy controls.

CONCLUSION

Trimethylamine N-oxide may be used as an indicator to distinguish between syphilis patients and healthy controls. The changes in these metabolites suggest that Treponema pallidum affects the normal metabolic activity of host cells, providing some clues for elucidating the pathogenesis of T. pallidum.

Long noncoding RNA HOXD-AS1 regulates proliferation of cervical cancer cells by activating Ras/ERK signaling pathway

OBJECTIVE

To investigate the effects of HOXD cluster antisense RNA 1 (HOXD-AS1) in cervical cancer and its underlying mechanism.

PATIENTS AND METHODS

Real-time quantitative polymerase chain reaction (RT-qPCR) was used to examine the expression of HOXD-AS1 in human cervical cancer tissues. x2-test was used for analyzing the association of HOXD-AS1 expression and clinical parameters. Cell viability, colony formation capacity, and phosphorylation of extracellular regulated protein kinases 1/2 (ERK1/2) in treated HeLa and CaSki cells were detected by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) assay, colony formation assay, and Western blot analysis, respectively.

RESULTS

The results indicated that HOXD-AS1 was upregulated in cervical cancer cells significantly. Meanwhile, HOXD-AS1 expression was involved in tumor-node-metastasis stages, lymphovascular invasion, lymph node metastasis, as well as recurrence. HOXD-AS1 knockdown remarkably suppressed cervical cancer cell proliferation, colony formation capacity, and the Ras/ERK signaling pathway in vitro. Furthermore, xenograft assays confirmed the results in vivo.

CONCLUSIONS

Our data elucidate that silencing HOXD-AS1 remarkably suppresses cell growth by inactivating the Ras/ERK pathway in cervical cancer, providing a more detailed understanding of cervical cancer pathogenesis and providing a possible theoretical foundation for long non-coding RNA for the diagnosis and therapy for cervical cancer.

[A cohort study on body mass index and risk of all-cause mortality among hypertensive population]

Objective: To investigate the relationship between body mass index (BMI) and all-cause mortality in hypertensive population. Methods: All participants were selected from a prospective cohort study based on a rural population from Henan province, China. Cox proportional hazards regression models were used to estimate the associations of different levels of BMI stratification with all-cause mortality. Restricted cubic spline models were used to detect the dose-response relation. Results: Among the 5 461 hypertensive patients, a total of 31 048.38 person-years follow-up was conducted. The median of follow-up time was 6 years, and 589 deaths occurred during the follow-up period. Compared to normal weight group (18.5 kg/m(2)<BMI<24.0 kg/m(2)) the multivariate-adjusted hazard ratios for all-cause mortality associated with BMI levels (<18.5 kg/m(2), 24-28 kg/m(2), and ≥28 kg/m(2)) were 0.83 (95%CI: 0.37-1.87), 0.81 (95%CI: 0.67-0.97), and 0.72 (95%CI: 0.56-0.91), respectively. The dose-response analysis showed a nonlinear, reverse "S" shaped relationship (non-linearity P<0.001). Conclusion: Overweight or obese might have a protective effect on all-cause mortality in hypertensive population, which supports the "obesity paradox" phenomenon.

[Exposure-preceding-outcome regarding time sequence among cohort studies in real world]

One of the commonly accepted merits of cohort studies (CSs) refers to the exposure precedes outcome superior to other observational designs. We use Directed Acyclic Graphs to construct a causal graph among research populations under CSs. We notice that the substitution of research population in place of a susceptible one can be used for effect estimation. Its correctness depends on the outcome-free status of the substituted population and the performance of both screening and diagnosis regarding the outcomes under study at baseline. The temporal precedence of exposure over outcome occurs theoretically, despite the opposite happens in realities. Correct effect estimate is affected by both the suitability of population substitution and the validities of outcome identification and exclusion.

Comparison of gefitinib and platinum-based chemotherapy and only platinum-based chemotherapy to treat lung adenocarcinoma

To study the curative effects and safety for patients who adopt both gefitinib and platinum-based chemotherapy or only platinum-based chemotherapy in the treatment of lung adenocarcinoma, 80 EGFR mutation-positive lung adenocarcinoma patients in stage IIIB/IV were divided into two groups. Half of them received both gefitinib and standard chemotherapy (group A), and the others (group B) received only standard chemotherapy. Overall response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and the related toxicities of both groups were recorded in order to take certain nursing measures for a variety of toxicities. Next, statistical methods were used to analyze the curative effects and safety of the two treatments. The results showed that ORR, DCR and median progression-free (mPFS) survival of the two groups of patients showed no statistical difference (P >0.05). However, group A (18.56 months) had a longer median overall survival (mOS) than group B (14.87 months), which was of statistical significance (P less than 0.05). Nausea and loss of appetite were common mild adverse reactions, and anemia and leukocytopenia were moderate common adverse reactions. The difference between these two groups of patients regarding adverse reactions was not statistically significant (P>0.05). In conclusion, the two treatments have similar safety, but lung adenocarcinoma patients with drug resistance during stage IIIB/IV after using first-line gefitinib therapy have lower survival benefits than patients who take both gefitinib and platinum-based chemotherapy.

Arsenic and five metal concentrations in the muscle tissue of bigeye tuna (Thunnus obesus) in the Atlantic and Indian Oceans

White muscle concentrations of As, Cd, Cu, Fe, Se, and Zn were investigated in Atlantic- and Indian-bigeye tuna (BET) (Thunnus obesus) from 6 regions. As and Cd muscle concentrations were significantly higher in the Indian-BET than in the Atlantic-BET, whereas the Indian-BET caught in the waters off South Africa revealed the highest As, Se, and Zn muscle concentrations. Accordingly, multidimensional scaling separated them into two oceanic groups. Positive linear relationships between muscle Cd concentration and fork length (FL) were established in both oceans. For the other elements, only muscle-Fe and FL relationship was found in the Atlantic-BET. 10.3% of BET > 145 cm FL from both oceans possessed muscle Cd concentrations exceeding the food safety limit (0.1 μg g^-1 wet weight) set by the European Commission. Increased Cd, Cu and Zn pollution was found in the Atlantic Ocean compared with previous data, with higher levels found in the Indian Ocean.

Sponge Prokaryote Communities in Taiwanese Coral Reef and Shallow Hydrothermal Vent Ecosystems

Previously, it was believed that the prokaryote communities of typical 'low-microbial abundance' (LMA) or 'non-symbiont harboring' sponges were merely subsets of the prokaryote plankton community. Recent research has, however, shown that these sponges are dominated by particular clades of Proteobacteria or Cyanobacteria. Here, we expand on this research and assess the composition and putative functional profiles of prokaryotic communities from LMA sponges collected in two ecosystems (coral reef and hydrothermal vent) from vicinal islands of Taiwan with distinct physicochemical conditions. Six sponge species identified as Acanthella cavernosa (Bubarida), Echinodictyum asperum, Ptilocaulis spiculifer (Axinellida), Jaspis splendens (Tetractinellida), Stylissa carteri (Scopalinida) and Suberites sp. (Suberitida) were sampled in coral reefs in the Penghu archipelago. One sponge species provisionally identified as Hymeniacidon novo spec. (Suberitida) was sampled in hydrothermal vent habitat. Each sponge was dominated by a limited set of operational taxonomic units which were similar to sequences from organisms previously obtained from other LMA sponges. There was a distinct bacterial community between sponges collected in coral reef and in hydrothermal vents. The putative functional profile revealed that the prokaryote community from sponges collected in hydrothermal vents was significantly enriched for pathways related to DNA replication and repair.

[Differential expression and clinical significance of calretinin in total colonic aganglionosis]

Objective: To evaluate the differential calretinin immunostaining in different segments of total colonic aganglionosis and its utility in the diagnosis. Methods: Nine specimens including ileum and colon segments were obtained from 9 patients with total colonic aganglionosis (TCA), from 2010 to 2016 year, in Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology. Another 9 ganglionic specimens including the same segments from patients with non-Hirschsprung disease (non-HD) patients were collected as control. All cases were immunostained with calretinin. The patterns of calretinin immunostaining were observed, and morphometric analysis of each sample was performed by image analysis program (Image-Pro-Plus). The mean absorbance was evaluated by calculating the areas of the lamina propria occupied by the positively stained area of the calretinin at high power field. Results: The same pattern of calretinin immunostaining was seen in ganglionic ileum and ganglionic colon segments, with staining seen in intrinsic nerves fibers (INF), and in granular aggregates in the lamina propria and muscularis mucosae. There was no significant difference in the numbers of calretinin-positive INF from the ganglionic segments. In contrast, the number of calretinin-positive INF and granular aggregates in aganglionic segments were significantly lower than those in the ganglionic group (P<0.01). In the ileum transitional zone, scattered calretinin staining was observed, and the amount of calretinin-positive INF was significantly lower than those in the proximal segment of ganlionic ileum (P<0.01). Conclusions: Since there is significant different expression of calretinin among the different segments from TCA, calretinin immunostaining has potential value in detecting TCA. It could be an important adjunctive method in detecting TCA in the future.

[The prognostic analysis of hepatocellular carcinoma based on the tumor neo-vessels, macrophages and α-SMA in tumor microenvironment]

Objective: To analyze the quantitative expression and prognostic significance of tumor neo-vessels, macrophages and fibroblasts in tumor microenvironment of hepatocellular carcinoma (HCC). Methods: The clinic-pathological features and tissue samples for 101 HCC cases were collected. Immunohistochemistry was used to stain the tumor neo-vessels, macrophages and fibroblasts on tumor tissue. The distribution results and quantitative data of above key components were acquired by inverted microscopy equipped with CRi Nuance multispectral analysis system. The number of tumor neo-vessels and macrophages on HCC tissue were counted and the thickness of cancer stroma based on the expression of fibroblasts was measured. The clinic-pathological characteristics and overall survival were analyzed. Results: The median disease free survival (DFS) of 101 HCC cases was 5 month. The quantitative analysis of tumor neo-vessels, macrophages and fibroblasts showed that the expression range was 51-429 with median 218, 110-555 with median 259, 35.61-555.35 with median 246.98, respectively. To take the median as cutoff, all the cases could be classified into high and low expression group. The survival analysis demonstrated that the high density group of macrophages (P=0.022) and fibroblasts (P<0.001) has shorter DFS than low density group, with statistical significance. The high tumor neo-vessels group has shorter DFS with median 5 month than low density group with median 7 month. However, there was no statistical significance between these two group (P=0.197). Combined with above the three stromal components, all the cases could be classified into low, middle and high group. The survival analysis demonstrated that the high density group of stromal components has shorter DFS than the other two groups with median 3 month (P=0.001). Multivariate analysis by Cox regression indicated that cirrhosis, metastasis status, macrophages and fibroblasts density were the independent prognostic factors. Conclusion: The key elements in tumor microenvironment including tumor neo-vessels, macrophages and fibroblasts were heterogenic in HCC tissues and played significant roles in HCC invasion and metastasis.

Tangeretin has anti-asthmatic effects via regulating PI3K and Notch signaling and modulating Th1/Th2/Th17 cytokine balance in neonatal asthmatic mice

Asthma is a chronic allergic disease characterized by airway inflammation, airway hyper-responsiveness (AHR), and mucus hypersecretion. T-lymphocytes are involved in the pathogenesis of asthma, mediating airway inflammatory reactions by secreting cytokines. The phosphoinositide 3-kinase (PI3K) and Notch signaling pathways are associated with T cell signaling, proliferation, and differentiation, and are important in the progression of asthma. Thus, compounds that can modulate T cell proliferation and function may be of clinical value. Here, we assessed the effects of tangeretin, a plant-derived flavonoid, in experimental asthma. BALB/c mice at postnatal day (P) 12 were challenged with ovalbumin (OVA). Separate groups of mice (n=18/group) were administered tangeretin at 25 or 50 mg/kg body weight by oral gavage. Dexamethasone was used as a positive control. Tangeretin treatment reduced inflammatory cell infiltration in bronchoalveolar lavage fluid (BALF) and also restored the normal histology of lung tissues. OVA-specific IgE levels in serum and BALF were reduced. AHR, as determined by airway resistance and lung compliance, was normalized. Flow cytometry analyses revealed a reduced Th17 cell population. Tangeretin reduced the levels of Th2 and Th17 cytokines and raised IFN-γ levels. PI3K signaling was inhibited. The expressions of the Notch 1 receptor and its ligands Jagged 1 and 2 were downregulated by tangeretin. Our findings support the possible use of tangeretin for treating allergic asthma.

Sibelium in combination with dibazole in the treatment of angioneurotic headache

Angioneurotic headache is a common nerve headache featured by intermittence, repetition, paroxysm and aggravation, which can severely affect the sufferer’s quality of life. Currently, there are multiple drugs which can be used for relieving this type of headache, and the effectiveness and safety of drugs have been a subject of interest in clinical practice. To observe the effects of sibelium in combination with dibazole and offer a basis for the clinical treatment, 136 patients with angioneurotic headache who were admitted to hospital between February and September 2015 were selected and randomly divided into a test group and a control group, 68 in each. Patients in the test group were treated with sibelium in combination with dibazole, while patients in the control group were given sibelium only. The effects, adverse reactions, complications and toxic and side effects of the treatment in the two groups were observed. Furthermore, the blood flow speed and hemodynamic changes before and after treatment were compared. The results demonstrated that the hemodynamic indexes and cerebral blood flow speed of the patients in the test group showed obvious changes after treatment, and the difference was statistically significant (P<0.05); the improvement of the above indexes of the test group was superior to that of the control group, and the difference had statistical significance (P<0.05); the overall effective rate of the test group was higher than that of the control group (94.12% vs 76.47%) (P<0.05); the medication safety of the test group was higher than that of the control group (all P<0.05). It can be concluded that sibelium in combination with dibazole has a remarkable effect in treating angioneurotic headache as it can significantly improve hemodynamic indexes and cerebral blood flow speed. Moreover, the therapy seldom induces toxic and side effects, adverse reactions or complications.

Down-expression of miR-373 predicts poor prognosis of glioma and could be a potential therapeutic target

OBJECTIVE

MicroRNAs (miRNAs) are epigenetic regulators of gene expression, and their deregulation plays an important role in human cancer, including glioma. The main objective of this work was to investigate the expression level of miR-373 and its clinical significance in glioma.

PATIENTS AND METHODS

The expression levels of miR-373 in glioma tissues and non-neoplastic brain tissues were measured by the qRT-PCR assay. Patients were divided into two groups based on the median miR-373 expression. The probability of differences in overall and progression-free survival as a function of time was ascertained by use of the Kaplan-Meier method. Cox regression analysis of factors potentially associated with survival was conducted to identify independent factors.

RESULTS

In clinical gastric cancer samples, we found that miR-373 expression was significantly down-regulated in glioma tissues compared with non-neoplastic brain tissues (p<0.01). Reduced expression of miR-373 was associated with serum WHO grade (p=0.015) and KPS score (p=0.001). Kaplan-Meier analysis indicated that patients with low level of miR-373 expression had poorer overall survival (OS) and progression-free survival (PFS). Multivariate survival analysis verified that miR-373 expression level was an independent predictor of both OS and PFS for glioma patients.

CONCLUSIONS

Our study showed miR-373 was associated to progression in glioma, and suggested it as a potential predictive factor for the prognosis of glioma.

[Study on the health effect of the occupational stress in aircrew]

Objective: To explore the relationship between occupational stress and physiological and biochemical indexes, to research the health effect of the occupational stress in aircrew. Methods: 450 aircrews were conducted with the OSI-R questionnaire survey, examine the level of blood pressure, blood routine, ALT and UA. Results: The concentration of HB was positively related with task conflict and entertainment and leisure (β=0.262 and 0.106, both P<0.05) , while heavy task, task discomfort and psychological stress reactions were negatively related with HB (β=-0.163, -0.102, and -0.137, all P<0.05) ; task conflict and self-care were positively related with RBC (β=0.221 and 0.159, both P<0.01) , heavy task, psychological stress reactions and social support were negatively related with RBC (β=-0.157, -0.119, and -0.113, all P<0.05) ; task ambiguity and self-care had a positive relationship with ALT (β=0.144 and 0.159, both P<0.01) while heavy task, psychological stress reactions and social support had a negative relationship with ALT (β=-0.176, -0.096, and -0.102, all P<0.05) ; self-care was positively related with SBP (β=0.170, P<0.01) , task discomfort, interpersonal stress reactions and social support were negatively related with SBP (β=-0.093, -0.103, and -0.111, all P<0.05) ; while self-care was positively related with DBP (β=0.139, P<0.01) , social support was negatively related with DBP (β=-0.114, P<0.05) . Conclusion: Occupational stress of the aircrew is significantly related with blood pressure, RBC, ALT and UA, occupational stress can make effects on the health of aircrew.

[Establishment of multiplex PCR method for rapid detection of nontuberculous mycobacteriums infection in the hand]

OBJECTIVE

To establish a multiplex polymerase chain reaction (mPCR) method with high sensitivity and specificity for rapid detection of common nontuberculous mycobacterium(NTM) infection in the hand.

METHODS

Application of primer design software to the mycobacterium marinum, mycobacterium avium, mycobacterium kansasii and mycobacterium fortuitum, the specific gene sequences were used to design construction of multiplex PCR and detection of DNA from the non tuberculous mycobacterial standard strains of each bacterium of single PCR and multiplex DNA accuracy and sequence contrast evaluation to verify the specificity of multiple PCR primers.26 clinical specimens were identified by this method.

RESULTS

Detection of 26 cases of clinical samples, positive detection of more than 7/8, the identification time is shorter than the traditional method.

CONCLUSION

The research method can be rapid, specific, sensitive and effective to detect the common hand of mycobacterium tuberculosis infection, can be used for clinical identification of mycobacterium tuberculosis infection.

Overexpression of maelstrom promotes bladder urothelial carcinoma cell aggressiveness by epigenetically downregulating MTSS1 through DNMT3B

We have recently identified and characterized a novel oncogene, maelstrom (MAEL) from 1q24, in the pathogenesis of hepatocellular carcinoma. In this study, MAEL was investigated for its oncogenic role in urothelial carcinoma of the bladder (UCB) tumorigenesis/aggressiveness and underlying molecular mechanisms. Here, we report that overexpression of MAEL in UCB is important in the acquisition of an aggressive and/or poor prognostic phenotype. In UCB cell lines, knockdown of MAEL by short hairpin RNA is sufficient to inhibit cell growth, invasiveness/metastasis and suppressed epithelial-mesenchymal transition (EMT), whereas ectopic overexpression of MAEL promoted cell growth, invasive and/or metastatic capacity and enhanced EMT both in vitro and in vivo. We further demonstrate that MAEL could induce UCB cell EMT by downregulating a critical downstream target, the metastasis suppressor 1 (MTSS1) gene, ultimately leading to an increased invasiveness of cancer cells. Notably, overexpression of MAEL in UCB cells substantially enhanced the enrichment of DNA methyltrans-ferase (DNMT)3B and histone deacetylase (HDAC)1/2 on the promoter of the MTSS1, and thereby epigenetically suppressing the MTSS1 transcription. Downregulation of MTSS1 by MAEL in UCB cells is partially dependent on DNMT3B. Furthermore, we identify that beside the gene amplification of MAEL, miR-186 is a key negative regulator of MAEL and downregulation of miR-186 is another important mechanism for MAEL overexpression in UCBs. These data suggest that overexpression of MAEL, caused by gene amplification and/or decreased miR-186, has a critical oncogenic role in UCB pathogenesis by downregulation of MTSS1, and MAEL could be used as a novel prognostic marker and/or effective therapeutic target for human UCB.