CT venography combined with ultrasound-guided minimally invasive treatment for recurrent varicose veins: a pilot paired-design clinical trial

AIM

To compare 1-year outcomes of computed tomography venography (CTV) combined with ultrasound-guided minimally invasive treatment with ascending phlebography and ultrasound-guided treatment for recurrent varicose veins.

MATERIALS AND METHODS

Consecutive patients with unilateral recurrent varicose veins were matched by gender, age, C classification, and degree of obesity, and randomised in a 1:1 ratio to receive either CTV (CTV group) or ascending phlebography (control group) combined with ultrasound-guided minimally invasive treatment. Patients were followed up by clinical and ultrasound examination. Follow-up was scheduled at 1 week, and 3, 6, and 12 months. The primary outcome measure was the Venous Clinical Severity Score (VCSS) at 12 months. Measures of secondary outcome included Chronic Insufficiency Venous International Questionnaire-20 (CIVIQ-20) score, recurrence of varicose vein or ulcer during 12 months, ulcer healing time, detection and location of treated veins.

RESULTS

Eighty patients were enrolled. Median VCSS in the CTV group was lower than it in the control group (p=0.04) and the CIVIQ-20 score was higher than the control group (p=0.02). By 12 months, no symptomatically recurrent varicose veins or ulcers had occurred. The ulcer healing time in CTV group was shorter (p<0.01). A greater number of patients had treated veins detected using CTV than by ascending venography (p=0.01), especially among patients with recurrence reflux veins in the groin, perineum, and vulva (p<0.01).

CONCLUSION

CTV combined with ultrasound may be more helpful than ascending phlebography combined with ultrasound to improve treatment efficacy for recurrent varices. These results should be verified by an future study with more patients and long-term follow-up.

Clinical and radiographic outcomes of a combined surgery approach to treat peri-implantitis

Peri-implant infra-bony defects are difficult to treat, and data on the management of peri-implantitis are lacking. The aim of this study was to evaluate the effect of a combined surgical approach to manage peri-implantitis: implantoplasty with xenogeneic bone grafting and a concentrated growth factor membrane. Two independent examiners analysed the medical records and radiographs taken before surgery and at the last follow-up. Data were analysed at the implant level; some patient-level data (age, sex, smoking habit) were also considered. Linear regression analysis with generalized estimating equations (GEE) was used to explore the effect of variables of interest (including marginal bone level (MBL)) on implantitis treatment success and resolution rates. The effect of the prosthesis type on postoperative clinical and radiographic parameters was also explored by GEE, with adjustment for age, sex, tooth site, location, follow-up duration, and implant length (model IV including all). Thirty patients with 72 implants were investigated. The implant survival rate was 100% over a mean observation period of 3.3 years (range 2-11 years). The treatment success rate (bone loss <0.5 mm, no bleeding on probing (BOP), no suppuration, probing depth (PD) < 5 mm) was higher in females than males (50% vs 19.0%; P = 0.008). At the last postoperative follow-up, the MBL (1.51 ± 1.07 vs 4.01 ± 1.13 mm), PD (3.61 ± 0.84 vs 6.54 ± 1.01 mm), and BOP (23.38 ± 23.18% vs 79.17 ± 15.51%) were significantly reduced when compared to pre-surgery values (all P < 0.001). Furthermore, a significantly higher PD reduction (β = -1.10 mm, 95% confidence interval -1.97 to -0.23 mm, P = 0.014) was observed for implants with a single crown than a full-arch prosthesis (GEE model IV). Preliminary clinical and radiographic data indicate that implantoplasty in combination with surgery could be an effective treatment option for peri-implantitis.

Naples prognostic score as a predictor of outcomes in lung cancer: a systematic review and meta-analysis

OBJECTIVE

The Naples prognostic score (NPS) is a newly developed indicator of inflammation and nutritional status. However, its role in predicting the prognosis of lung cancer is unclear. We hereby reviewed the association between NPS and outcomes of lung cancer.

MATERIALS AND METHODS

PubMed, Web of Science, Embase, and Google Scholar were searched up to 15th April 2023 for studies assessing the predictive role of NPS for overall survival (OS) and disease-free survival (DFS) in lung cancer.

RESULTS

Seven studies were included. All were from China. One study was on small cell lung cancer, while the rest were on non-small cell lung cancer. Meta-analysis demonstrated that a high NPS score was a significant predictor of OS (HR: 3.21 95% CI: 2.27, 4.54 I2=62%) and disease-free survival (DFS) (HR: 3.81 95% CI: 2.57, 5.64 I2=65%) in lung cancer patients. Subgroup analysis based on different NPS reference values also showed similar results. The results remained significant on sensitivity analysis.

CONCLUSIONS

The NPS is a strong and independent prognostic indicator of lung cancer patients. Higher NPS scores are associated with worse OS and DFS. Further studies from non-Chinese populations are needed to supplement the results.

[The performance of digital chest radiographs in the detection and diagnosis of pulmonary nodules and the consistency among readers]

Objective: To investigate the detection and diagnostic efficacy of chest radiographs for ≤30 mm pulmonary nodules and the factors affecting them, and to compare the level of consistency among readers. Methods: A total of 43 patients with asymptomatic pulmonary nodules who consulted in Cancer Hospital, Chinese Academy of Medical Sciences from 2012 to 2014 and had chest CT and X-ray chest radiographs during the same period were retrospectively selected, and one nodule ≤30 mm was visible on chest CT images in the whole group (total 43 nodules in the whole group). One senior radiologist with more than 20 years of experience in imaging diagnosis reviewed CT images and recording the size, morphology, location, and density of nodules was selected retrospectively. Six radiologists with different levels of experience (2 residents, 2 attending physicians and 2 associate chief physicians independently reviewed the chest images and recorded the time of review, nodule detection, and diagnostic opinion. The CT imaging characteristics of detected and undetected nodules on X images were compared, and the factors affecting the detection of nodules on X-ray images were analyzed. Detection sensitivity and diagnosis accuracy rate of 6 radiologists were calculated, and the level of consistency among them was compared to analyze the influence of radiologists' seniority and reading time on the diagnosis results. Results: The number of nodules detected by all 6 radiologists was 17, with a sensitivity of detection of 39.5%(17/43). The number of nodules detected by ≥5, ≥4, ≥3, ≥2, and ≥1 physicians was 20, 21, 23, 25, and 28 nodules, respectively, with detection sensitivities of 46.5%, 48.8%, 53.5%, 58.1%, and 65.1%, respectively. Reasons for false-negative result of detection on X-ray images included the size, location, density, and morphology of the nodule. The sensitivity of detecting ≤30 mm, ≤20 mm, ≤15 mm, and ≤10 mm nodules was 46.5%-58.1%, 45.9%-54.1%, 36.0%-44.0%, and 36.4% for the 6 radiologists, respectively; the diagnosis accuracy rate was 19.0%-85.0%, 16.7%-6.5%, 18.2%-80.0%, and 0%-75.0%, respectively. The consistency of nodule detection among 6 doctors was good (Kappa value: 0.629-0.907) and the consistency of diagnostic results among them was moderate or poor (Kappa value: 0.350-0.653). The higher the radiologist's seniority, the shorter the time required to read the images. The reading time and the seniority of the radiologists had no significant influence on the detection and diagnosis results (P>0.05). Conclusions: The ability of radiographs to detect lung nodules ≤30 mm is limited, and the ability to determine the nature of the nodules is not sufficient, and the increase in reading time and seniority of the radiologists will not improve the diagnostic accuracy. X-ray film exam alone is not suitable for lung cancer diagnosis.

circIPO7 dissociates caprin-1 from ribosomes and inhibits gastric cancer cell proliferation by suppressing EGFR and mTOR

Circular RNA (circRNA) is a novel RNA molecule characterized by covalently closed loop structure. Since its discovery, researchers have shown that circRNA is not "splicing noise" but a participant of various pathophysiological processes through unique mechanisms. circIPO7, which was identified as an independent prognostic factor in gastric cancer (GC) patients, was downregulated in GC tissues and cells compared to paracarcinoma tissues and normal epithelial cells. circIPO7 overexpression significantly suppressed GC cell proliferation in vitro and in vivo. Mechanistically, circIPO7 directly binds with caprin-1, an RNA-binding protein involved in mRNA translation, sharing overlapping binding sites with G3BP1. Thus, the complex containing overexpressed circIPO7 blocked the caprin-1-G3BP1 interaction and dissociated caprin-1 and its target mRNAs (EGFR and mTOR) from ribosomes, resulting in their translational inhibition, followed by PI3K/AKT/mTOR pathway inactivation. We uncovered a novel molecular mechanism for circRNAs in GC development, identifying circIPO7 as a potential target for cancer treatment.

MiR-125b-5p modulates the function of regulatory T cells in tumor microenvironment by targeting TNFR2

BACKGROUND

Tumor necrosis factor receptor type 2 (TNFR2) is primarily expressed by CD4⁺FoxP3⁺ regulatory T cells (Tregs), especially those present in tumor microenvironment. There is compelling evidence that TNFR2 plays a crucial role in the activation, expansion, and phenotypic stability of Tregs and promotes tumor immune evasion. Understanding of epigenetic regulation of TNFR2 expression in Tregs may help device a novel strategy in cancer immunotherapy.

METHODS

MiR-125b-5p-overexpressing or knockdown murine CD4 T cells and Tregs were constructed, and the effect of miR-125b-5p on Tregs proliferation, suppressive function and TNFR2 expression were examined. In vivo antitumor efficacy of Ago-125b-5p (miR-125b-5p agomir) was evaluated in MC38 tumor bearing mice, and tumor-infiltrating Tregs and CD8⁺ cytotoxic T lymphocytes (CTLs) were analyzed. RNA-seq analysis was applied to reveal the genes and signaling pathways regulated by miR-125b-5p in Tregs.

RESULTS

In this study, we found that TNFR2 was a direct target of miR-125b-5p. Overexpression of miR-125b-5p decreased the proportion of Tregs and their expression of TNFR2 and consequently inhibited its proliferation and suppressive function by regulating the metabolism-related signaling pathways. Moreover, in colon cancer bearing mice, the administration of Ago-125b-5p markedly inhibited the tumor growth, which was associated with reduction of Tregs and increase of IFNγ⁺CD8⁺ T cells in tumor environment. Furthermore, in human colon adenocarcinoma patients, we verified that miR-125b-5p expression was downregulated, and low levels of miR-125b-5p were associated with poor prognosis. Interestingly, the expression of miR-125b-5p and TNFR2 were negatively correlated.

CONCLUSIONS

Our study for the first time found that the expression of TNFR2 by Tregs was regulated by miR-125b-5p. Our results showed that miR-125b-5p had the capacity to inhibit the expression of TNFR2 and immunosuppressive activity of Tregs and consequently enhanced the antitumor efficacy. This property of miR-125b-5p may be therapeutically harnessed in the treatment of human cancers.

HDAC6-dependent deacetylation of AKAP12 dictates its ubiquitination and promotes colon cancer metastasis

Aberrant expression of histone deacetylase 6 (HDAC6) is greatly involved in neoplasm metastasis, which is a leading cause of colon cancer related death. Thus, deep understanding of the regulatory mechanisms of HDAC6 in the metastasis of colon cancer is warranted. In this study, we firstly found that HDAC6 expression was highly expressed in metastatic colon cancer tissues and inhibition or knockdown of HDAC6 suppressed colon cancer metastasis. Next, based on proteomic analysis we uncovered A-kinase anchoring protein 12 (AKAP12) was a novel substrate of HDAC6. HDAC6 interacted with AKAP12 and deacetylated the K526/K531 residues of AKAP12. Moreover, deacetylation of AKAP12 at K531 by HDAC6 increased its ubiquitination level, which facilitated AKAP12 proteasome-dependent degradation. Importantly, we observed an inverse correlation between AKAP12 and HDAC6 protein levels with human colon cancer specimens. Further deletion of AKAP12 in HDAC6 knockdown cells restored the cell motility defects and reactivated the protein kinase C isoforms, repression of which were responsible for the inhibition of cancer metastasis of AKAP12. Our study identified AKAP12 was a new interactor and substrate of HDAC6 and uncovered a novel mechanism through which HDAC6-dependent AKAP12 deacetylation led to its ubiquitination mediated degradation and promoted colon cancer metastasis.

[Prevalence and risk factors of deep venous thrombosis of lower extremity in patients with stage and pressure ulcers on admission]

Objective: To investigate the incidence and risk factors of deep venous thrombosis (DVT) of lower extremity in patients with stage Ⅲ and Ⅳ pressure ulcer on admission. Methods: A retrospective case series study was conducted. A total of 241 patients with stage Ⅲ and Ⅳ pressure ulcers who met the inclusion criteria and were discharged from the Department of Wound Repair of the First People's Hospital of Zhengzhou from January 1, 2015 to December 31, 2019 were enrolled in this study, including 134 males and 107 females, aged 22 to 93 years, with a median age of 68 years; 37 patients were with stage Ⅲ pressure ulcers and 204 patients were with stage Ⅳ pressure ulcers. The DVT occurrence of patients was recorded. According to whether DVT of lower extremity veins was diagnosed by color Doppler ultrasound within 48 h after admission or not, the patients were divided into DVT group (n=37) and non-DVT group (n=204). Data of patients in the two groups were collected and compared, including gender, age, duration of pressure ulcer, time in bed, and combination with diabetes, hypertension, coronary heart disease, cerebral infarction, pneumonia, sepsis/septic shock, and paraplegia, and the plasma D-dimer level and Caprini score within 24 h after admission. Data were statistically analyzed with independent sample t test, Mann-Whitney U test, chi-square test, and Fisher's exact probability test. The indicators with statistically significant differences between the two groups were analyzed with multivariate logistic regression analysis to screen the independent risk factors influencing the DVT of lower extremity in 241 patients with stage Ⅲ and Ⅳ pressure ulcers on admission. Results: The incidence of DVT of lower extremity was 15.4% (37/241), of which 86.5% (32/37) were asymptomatic DVT. Among the DVT of 46 lower limbs, only 29 involved the inferior genicular veins, accounting for 63.0%. There were no statistically significant differences in gender, duration of pressure ulcer, combination with diabetes, hypertension, coronary heart disease, cerebral infarction, pneumonia, and sepsis/septic shock of patients between the two groups (P>0.05), while there were statistically significant differences in age, time in bed, combination with paraplegia, the plasma D-dimer level and Caprini score of patients between the two groups(t=-3.19, Z=-2.04, χ2=4.44, Z=-3.89, t=-2.14, respectively, P<0.05 or P<0.01). Multivariate logistic regression analysis showed that age and plasma D-dimer level were independent risk factors influencing the DVT of lower extremity in 241 patients with stage Ⅲ and Ⅳ pressure ulcers on admission (with odds ratios of 1.03 and 1.18, respectively, with 95% confidence intervals of 1.00-1.06 and 1.05-1.33, respectively, P<0.05 or P<0.01). Conclusions: The patients with stage Ⅲ and Ⅳ pressure ulcers have a higher incidence of DVT on admission, with age and plasma D-dimer level being the independent risk factors for DVT of lower extremity. It is necessary to pay attention to the targeted screening of DVT and education of its prevention.

The effects of TNF-α/TNFR2 in regulatory T cells on the microenvironment and progression of gastric cancer

TNFR2⁺ regulatory T cells preferentially accumulate in the tumor microenvironment, express high levels of immunosuppressive molecules and possess strong suppressive activity. Our study aimed to explore the characteristics and role of TNFR2⁺ Tregs in the microenvironment and progression of gastric cancer via polychromatic immunofluorescence, single-cell RNA sequencing and flow cytometry assays. The TNFR2⁺ Treg infiltration level in the tumor microenvironment increased significantly as gastric cancer progressed and was demonstrated to be a prognostic marker. Single-cell RNA sequencing revealed high levels of TNFR2 in tumor-infiltrating Tregs. The TNF-α/TNFR2 signaling pathway was activated, accompanied by the upregulation of costimulatory molecules. Unlike blood Tregs, tumor-infiltrating Tregs existed in activated and effector states. In addition to expressing costimulatory molecules such as TNFR2, 4-1BB, OX40 and GITR, tumor-infiltrating Tregs were also characterized by high expression levels of immune checkpoints such as CTLA-4 and TIGIT and chemokines such as CCR6. In vitro studies showed that the TNF-α/TNFR2 pathway increased the Foxp3 expression in CD4⁺ CD25⁺ T cells and the latent TGF-β production in Tregs as well as enhanced the immunosuppressive function of Tregs. In summary, our study revealed high infiltration levels of TNFR2⁺ Tregs that were in activated and effector states in the tumor microenvironment. The infiltration level of TNFR2⁺ Tregs is a prognostic marker and an independent risk factor for gastric cancer. Activation of the TNF-α/TNFR2 pathway promotes the immunosuppressive phenotype and function of Tregs. Our study provides a new theoretical basis for TNFR2⁺ Tregs as a therapeutic target in gastric cancer.

circEVI5 acts as a miR-4793-3p sponge to suppress the proliferation of gastric cancer

Circular RNAs (circRNAs) are a novel class of endogenous noncoding RNAs (ncRNAs) with a covalently closed loop structure. Accumulating evidence shows that circRNAs play vital roles in the growth, metastasis, treatment and prognosis of various cancers. However, the detailed functions and underlying mechanisms of circEVI5 (hsa_circ_0013162) in gastric cancer (GC) remain undocumented. In this study, the expression levels and prognostic value of circEVI5 were validated in GC tissue samples by using qRT-PCR. circEVI5 was significantly downregulated in GC tissues and cells, and low circEVI5 expression was correlated with poor prognosis. Next, in vitro CCK-8 assay, EdU incorporation assay, PI staining cell cycle assay, and in vivo xenograft mouse models were conducted to assess the functions of circEVI5. Gain of function experiments indicated that circEVI5 could inhibit GC cell proliferation and retard the cell cycle. Moreover, bioinformatics prediction showed that circEVI5 binds to miR-4793-3p, while FOXO1 may be a target of miR-4793-3p. Pull-down assays, RNA immunoprecipitation (RIP) assays, luciferase assays, and western blot were used to confirm the interactions between circEVI5, miR-4793-3p, and FOXO1. Functional assays demonstrated that circEVI5 suppressed the proliferation of GC by sponging miR-4793-3p and increasing FOXO1 expression levels. In conclusion, our study demonstrated that circEVI5 can bind miR-4793-3p as a ceRNA to eliminate the negative regulation of FOXO1, therefore suppressing GC proliferation.

Long noncoding RNA MGC27382 inhibits proliferation and metastasis of non-small cell lung cancer cells via down-regulating AKT/GSK3β pathway

PURPOSE

Persistent abnormal proliferation and long distant metastasis of tumors contribute to high mortality rate in non-small cell lung cancer (NSCLC) patients. Strategies that prevent NSCLC proliferation and/or metastasis have been studied but still need to be further explored. Numerous studies have proved the diversity functions of long noncoding RNAs (lncRNAs) exerted in cancer, including NSCLC. In this study, we aim to identify and investigate the role of novel lncRNAs in NSCLC progression.

METHODS

RNA sequence data were retrieved from the Cancer Genome Atlas (TCGA), differentially expressed lncRNAs (DElncRNAs) were screened out based on the R language, then real-time PCR experiment was introduced to detect the DElncRNA expression levels. A series of experiments including MTT, cell cycle, transwell, and wound healing assays were employed to explore the effect of DElncRNA MGC27382 on cell proliferation and invasion ability.

RESULTS

We detected that DElncRNA MGC27382 is down-regulated in NSCLC tissues and cells. Overexpression of MGC27382 prevented NSCLC cell proliferation via down-regulating cyclin D1 and cyclin E. Moreover, wound healing and transwell assays indicated that the ability of cell invasion and migration could be impaired when cells were treated with MGC27382 overexpression. Further studies demonstrated that MGC27382-mediated inhibition on NSCLC progression can be impaired by LY294002, which is a frequently used inhibitor of AKT/GSK3β pathway.

CONCLUSION

MGC27382 is down-regulated in NSCLC. It exerts an inhibitory role in NSCLC development through suppressing the AKT/GSK3β pathway. Our results indicate that the lncRNA MGC27382 might be a tumor-suppressor gene in NSCLC. Overexpression of MGC27382 is thought to be a potential strategy for overcoming NSCLC progression.

Total cholesterol affects the outcome of patients with anterior cerebral artery-occluded acute ischemic stroke treated with thrombolysis

OBJECTIVE

In this study, we investigated whether certain types of lipid profiles are major contributors of acute ischemic stroke (AIS).

PATIENTS AND METHODS

We screened 13,285 hospitalized patients in two stroke medical centers treated with thrombolysis, thrombectomy, or conventional care for anterior cerebral artery-occluded AIS, and found 266 patients. We examined their plasma lipid profiles using the cutoff values from a receiver operating characteristic (ROC) curve. We applied a multivariate logistic regression or Fisher's exact test to compare their outcomes and risk factors. We used the modified Rankin scale (mRS) score to assess the major clinical outcome of the patients 3 months after disease onset. Mortality and symptomatic intracranial hemorrhage (sICH) were both evaluated as risk factors. We analyzed symptoms' improvements at discharge as a disease outcome measure.

RESULTS

In the patients with anterior cerebral artery-occluded AIS (NIHSS ≥ 10) treated by intravenous (IV) thrombolysis, a total cholesterol (TC) level greater than 5.07 mmol/L predicted a poor outcome (OR 3.55, 95% CI 1.21,10.46, p=0.021).

CONCLUSIONS

In patients with anterior cerebral artery-occluded AIS, the TC level is a promising prognosis marker for the IV thrombolysis outcome.

Baicalin ameliorates Mycoplasma gallisepticum-induced lung inflammation in chicken by inhibiting TLR6-mediated NF-κB signalling

1. Mycoplasma gallisepticum (MG) causes severe lung inflammation and cell damage by activating toll-like receptor (TLR) signalling, the nuclear factor-kappaB (NF-κB) pathway and pro-inflammatory cytokine gene expression. Baicalin (BA) is a flavonoid extracted from Scutellaria baicalensis, which possesses anti-inflammatory and anti-bacterial properties. This study investigated the effect of BA in MG-induced lung inflammation and its potential mechanism in MG-infected chicken embryo lungs and DF-1 cells.2. The histopathological examination result showed that BA treatment alleviated MG-induced lung pathological changes. In addition, CCK-8 and cell cycle assays showed that BA treatment inhibited MG-induced cell proliferation and cell cycle progression in DF-1 cells.3. The ELISA and RT-qPCR results demonstrated that BA treatment decreased the expression of interleukin-1beta (IL-1β), IL-6, and tumour necrosis factor-alpha (TNF-α) both in MG-infected chicken embryo lungs and DF-1 cells.4. The results revealed that BA inhibited mRNA expression levels of toll-like receptor-6 (TLR6), myeloid differentiation primary response gene-88 (MyD88) and nuclear factor-κB (NF-κB), and the nuclear translocation of NF-κB-p655. In conclusion, the results showed that BA has a protective effect against MG-induced lung inflammation in chicken by inhibiting the TLR6-mediated NF-κB signalling.

Observation of the efficacy of naloxone combined with acyclovir in the treatment of children viral encephalitis and its impacts on IL-1 and IL-6

OBJECTIVE

To analyze the clinical efficacy of naloxone combined with acyclovir in the treatment of children viral encephalitis and the impacts on inflammatory factors IL-1 and IL-6.

PATIENTS AND METHODS

96 children with viral encephalitis were retrospectively analyzed. They were treated from July 2013 to January 2014 in our hospital. They were divided into control group (45 cases treated with acyclovir) and observation group (51 cases treated with acyclovir combined with naloxone). Both groups were treated with comprehensive measures. Changes of the content of serum IL-1 and IL-6 in the two groups before and after treatment were monitored by enzyme-linked immunosorbent assay (ELISA). Signs, recovery time of clinical symptoms, total effective rate, occurrence of adverse reactions and adverse reactions after treatment of children in the two groups were compared.

RESULTS

Levels of serum IL-1 and IL-6 of children in the control group and the observation group decreased after treatment, and the decrease was greater in the observation group (p<0.05). Signs and recovery time of clinical symptoms of the observation group were significantly shorter than that of the control group (p<0.05). Indexes of serum in the observation group were significantly lower than those of the control group after treatment (p<0.05). The total effective rate of the observation group was significantly higher than that of the control group (p<0.05). The prevalence of adverse reactions and sequelae in the observation group were lower than those in the control group (p<0.05).

CONCLUSIONS

In the treatment of children, viral encephalitis has naloxone combined with ganciclovir had a more significant effect on the decrease of levels of serum IL-1 and IL-6; naloxone combined with acyclovir in the treatment of children viral encephalitis had better effects, lower adverse reactions and lower prevalence of sequelae compared with sole medication, which is worth clinical promotion.

Abstract 1603: TNFR2+ regulatory T cells are key players in immune escape in gastric tumor microenvironment

BACKGROUND & AIMS: Regulatory T cells (Tregs) are potent immunosuppressive cells of the immune system. It is reported that the expression of TNFR2 identifies a subpopulation of Tregs with the maximally suppressive function. Thus, understanding the heterogeneity of human CD4+FOXP3+ Tregs and the function of TNFR2+ Tregs is of critical importance for moving Treg therapy into the clinics.

METHODS: The expression phenotype of TNFR2+ Tregs from gastric cancer patients and normal controls were detected by flow cytometry. Further, we quantified the infiltrated Foxp3+ Tregs and TNFR2+ Tregs of gastric cancer patients using multicolor immunofluorescence assay. Moreover, to generate a deep transcriptional map of the Tregs in human gastric cancer, we profiled 9058 Tregs from three gastric carcinomas, as well as 16769 Tregs from matched peripheral blood mononuclear cells (PBMCs), using single-cell RNA-seq.

RESULTS: In the peripheral blood of gastric cancer patients and healthy individuals, Tregs expressed markedly higher levels of TNFR2 than conventional T cells (Tconvs). The proportion of total FoxP3+ Tregs in the CD4+ cells and the percentage of TNFR2+ Tregs increased with tumor progression and lymphatic metastasis. Analysis of single-cell RNA sequencing data revealed that Tregs in gastric carcinomas microenvironment exhibited dissimilar phenotypes compared with Tregs in matched PBMCs. We observed lower phenotypic heterogeneity of tumor-derived Tregs. Tumor infiltrating Tregs expressed higher levels of immune checkpoint genes compared with peripheral blood Tregs, indicating they were in more activated states. Besides, we found the expression level of TNFR2 in two tumor-derived clusters was much higher compared with others. Treg biomarkers and immune checkpoint genes were also highly expressed in these two populations, suggesting that they were the main immunosuppressive Treg proportions in tumor microenvironment. Gene enrichment analysis indicated that the two Treg populations showed an overlap of gene expression signatures of Th1, Th2, and Th17 cells, which was consistent with the increasing evidence that Tregs can exhibit helper T cell-like phenotype to promote Tregs migrating and suppressing immune response.

CONCLUSIONS: Our findings revealed that TNFR2 could be a promising molecular marker associated with poor prognosis of patients baring gastric cancer. We also established the heterogeneity at the single-cell level of CD4+FOXP3+ Tregs, explaining the remarkable complexity and functional diversity of human Tregs. Finally, our work provide important clues for exploring the mechanism by which TNFR2 regulates the phenotype and activity of Tregs in the tumor microenvironment.

Citation Format: Liling Niu. TNFR2+ regulatory T cells are key players in immune escape in gastric tumor microenvironment [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 1603.

Elastohydrodynamic Scaling Law for Heart Rates

Animal hearts are soft shells that actively pump blood to oxygenate tissues. Here, we propose an allometric scaling law for the heart rate based on the idea of elastohydrodynamic resonance of a fluid-loaded soft active elastic shell that buckles and contracts axially when twisted periodically. We show that this picture is consistent with numerical simulations of soft cylindrical shells that twist-buckle while pumping a viscous fluid, yielding optimum ejection fractions of 35%-40% when driven resonantly. Our scaling law is consistent with experimental measurements of heart rates over 2 orders of magnitude, and provides a mechanistic basis for how metabolism scales with organism size. In addition to providing a physical rationale for the heart rate and metabolism of an organism, our results suggest a simple design principle for soft fluidic pumps.

Characterization of co-culture of Aeromonas and Pseudomonas bacterial biofilm and spoilage potential on refrigerated grass carp (Ctenopharyngodon idellus)

Aeromonas and Pseudomonas are important bacterial species involved in spoilage of refrigerated freshwater fish. In this study, 10 Aeromonas and seven Pseudomonas bacterial strains were isolated from spoiled grass carp and identified. Twelve of seventeen bacterial strains showed high potential of biofilm formation and 14 of 17 can produce extracellular protease. In order to explore the spoilage capacity of dual-species, the sterile grass carp fillets were inoculated with mono- and dual-species of Aeromonas salmonicida and Pseudomonas azotoformans strains. The results revealed significantly higher levels of the total viable count and total volatile basic nitrogen in dual-species as compared to mono-species from day 6. The higher contents of histamine, cadaverine and serious degradation in muscles tissue were also observed in dual-species after 10 days of storage. Results of in vitro experiments showed that the co-culture of A. salmonicida and P. azotoformans significantly increased the bacterial maximum growth rate, promoted the biofilm formation and improved the spoilage capacity of bacterial strains. This study has revealed that the co-culture of Aeromonas and Pseudomonas bacterial strains accelerated spoilage process of grass carp and increased biofilm formation. It indicates that the mixed-cultures of spoilage micro-organisms pose a huge threat to food industry.

STIM1 interacts with termini of Orai channels in a sequential manner

Store-operated Ca2+ entry (SOCE) is critical for numerous Ca2+-related processes. The activation of SOCE requires engagement between stromal interaction molecule 1 (STIM1) molecules on the endoplasmic reticulum and Ca2+ release-activated channel (CRAC) Orai on the plasma membrane. However, the molecular details of their interactions remain elusive. Here, we analyzed STIM1-Orai interactions using synthetic peptides derived from the N- and C-termini of Orai channels (Orai-NT and Orai-CT, respectively) and purified fragments of STIM1. The binding of STIM1 to Orai-NT is hydrophilic based, whereas binding to the Orai-CT is mostly hydrophobic. STIM1 decreases its affinity for Orai-CT when Orai-NT is present, supporting a stepwise interaction. Orai3-CT exhibits stronger binding to STIM1 than Orai1-CT, largely due to the shortness of one helical turn. The role of newly identified residues was confirmed by co-immunoprecipitation and Ca2+ imaging using full-length molecules. Our results provide important insight into CRAC gating by STIM1.

Atlastin-1 regulates morphology and function of endoplasmic reticulum in dendrites

Endoplasmic reticulum (ER) is characterized by interconnected tubules and sheets. Neuronal ER adopts specific morphology in axons, dendrites and soma. Here we study mechanisms underlying ER morphogenesis in a C. elegans sensory neuron PVD. In PVD soma and dendrite branch points, ER tubules connect to form networks. ER tubules fill primary dendrites but only extend to some but not all dendritic branches. We find that the Atlastin-1 ortholog, atln-1 is required for neuronal ER morphology. In atln-1 mutants with impaired GTPase activity, ER networks in soma and dendrite branch points are reduced and replaced by tubules, and ER tubules retracted from high-order dendritic branches, causing destabilized microtubule in these branches. The abnormal ER morphology likely causes defects in mitochondria fission at dendritic branch points. Mutant alleles of Atlastin-1 found in Hereditary Spastic Paraplegia (HSP) patients show similar ER phenotypes, suggesting that neuronal ER impairment contributes to HSP disease pathogenesis.

The molecular mechanisms that achieve ER morphology in neurites are not well understood. This study uses a forward genetic approach to demonstrate that atln-1 is required for neuronal ER morphology and that C. elegans atln-1 mutants exhibit defects in mitochondria fission at dendritic branch points and abnormalities in protein homeostasis.

Effects of chronic dexamethasone exposure on bile acid metabolism and cecal epithelia function in goats

Bile acids (BAs) are synthesized in the liver via the oxidation of cholesterol and further metabolized by microbiota in the gut, where they simultaneously impact gut function. In the present study, 10 goats were randomly divided into 2 groups; 1 group was injected with dexamethasone (Dex; 0.2 mg/kg), and the other group was injected with saline as the control (Con) for 21 d. Expression levels of key genes and proteins in the liver and gut mucosa were analyzed and compared to investigate the impact of chronic stress on BA metabolism and related functions in ruminants. The results revealed that Dex decreased plasma total BAs (TBAs) concentration (P < 0.05) but increased TBA concentration in the cecal digesta (P < 0.05). Total cholesterol in the liver decreased moderately in response to Dex. The protein expression of cytochrome P450 family 7 subfamily A member 1 and cytochrome P450 family 27 subfamily A member 1, 2 enzymes that control BA synthesis in the liver, remained unchanged by Dex administration (P > 0.05). The expression of several genes in the cecal mucosa encoding epithelial tight junction proteins, including occludin (P < 0.05), tight junction protein 1 (P < 0.01), and claudin 1 (P < 0.05), increased significantly in response to Dex, and expression of defensin beta 1, which can strengthen the innate immune system, was also upregulated (P < 0.05). In addition, BAs increased the expression of the Solute Carrier family 9 member A 2 (P < 0.01) that encodes a sodium hydrogen exchanger. These results suggest that the Dex-induced disruption of BA homeostasis might be mediated through a liver-independent pathway in goats, and the Dex-induced accumulation of TBAs in the cecal digesta may improve volatile fatty acid transportation and mucosal defense.

Analysis of the correlation between the neutrophil-lymphocyte ratio in peripheral blood and perioperative myocardial damage in pediatric patients with frequent ventricular premature beat

OBJECTIVE

The objective of the present study was to investigate the relationship between the neutrophil-lymphocyte ratio (NLR) in peripheral blood and myocardial damage in pediatric patients with frequent ventricular premature beat (FVPB), and provide a reference for myocardial preservation in these patients.

PATIENTS AND METHODS

A total of 212 pediatric patients who were treated in the Department of Cardiology, Xuzhou Children's Hospital between December 2014 and March 2016 for FVPB, were selected. The results of routine blood exam, and levels of cardiac troponin I (cTnI) and creatine kinase-MB (CK-MB) in patients after the onset of FVPB were analyzed, and NLR was calculated. According to NLR levels, patients were divided into four groups using quartiles.

RESULTS

With increases of NLR, the proportion of patients with a history of hypertension and ejection fraction < 50% increased gradually, and white blood cells (WBCs), the peaks of CK-MB and cTnI, and serum creatinine levels were significantly increased (p<0.05, p<0.01). There were no significant differences (p>0.05) in age, sex, body mass index, serum creatinine before treatment, fasting blood glucose, TG, TC, LDL-C, and HDL-C among the four groups. Multiple stepwise regression analysis showed that for patients with FVPB, NLR in peripheral blood was positively correlated with the peak of cTnI (r=0.538, p<0.05). NLR was positively correlated with levels of WBCs (r=0.661, p<0.05) and there was no correlation between NLR and history of hypertension, ejection fraction, and the laboratory results of creatinine peak and CK-MB. The differences were not statistically significant (p>0.05). However, the peak of cTnI was positively correlated with the levels of WBCs (r=0.189, p=0.003).

CONCLUSIONS

NLR and WBCs in patients with FVPB are positively related to the peak of cTnI. NLR may serve as an excellent marker that reflects myocardial damage in pediatric patients with FVPB.

Correlation between NFATC1 gene polymorphisms and congenital heart disease in children

OBJECTIVE

To analyze the links between NFATC1 gene polymorphism and congenital heart disease in children.

PATIENTS AND METHODS

In the present study, we selected 85 children patients with congenital heart disease who were hospitalized from February 2013 to February 2015 as research subjects (observation group), and 92 healthy subjects as control group. Restriction fragment length polymorphism (RFLP) was used for analysis of NFATC1 gene in samples from each group.

RESULTS

The distribution of NFATC1 genotype and allele between the observation group (children with congenital heart disease) and the control group showed no significant difference (p >0.05), but AA, GG genotypes, and allele frequency between pathological samples of children with congenital heart disease and the control group displayed significant difference (p <0.05) (X2 = 16.04, p <0.05; X2 = 16.29, p <0.05). Further analyses showed that AA, GG, AG genotype and allele frequency among children with congenital heart disease in observation group also showed a difference, i.e., homozygote (AA, GG) ratio in children with severe congenital heart disease is relatively high.

CONCLUSIONS

There is a correlation between NFATC1 genes and the incidence of congenital heart disease in children, and a correlation between different genotypes and allele frequency and the incidence of the disease.

Evolving safety practices in the setting of modern complex operating room: role of nurses

Operating room (OR) nursing previously referred to patient care provided during the intra-operative phase and the service provided within the OR itself. With the expansion of responsibilities of nurses, OR nursing now includes pre-operative and post-operative periods, therefore peri-operative nursing is accepted as a nursing process in OR in the contemporary medical literature. Peri-operative nurses provide care to the surgical patients during the entire process of surgery. They have several roles including those of manager or a director, clinical practitioner (scrub nurse, circulating nurse and nurse anesthetist), educator as well as researcher. Although, utmost priority is placed on insuring patient safety and well-being, they are also expected to participate in professional organization, continuing medical education programs and participating in research activities. A Surgical Patient Safety Checklist formulated by the World Health Organization serves as a major guideline to all activities in OR, and peri-operative nurses are key personnel in its implementation. Communication among the various players of a procedure in OR is key to successful patient outcome, and peri-operative nurses have a central role in making it happen. Setting up of OR in military conflict zones or places that suffering a widespread natural disaster poses a unique challenge to nursing. This review discusses all aspects of peri-operative nursing and suggests points of improvement in patient care.

Correlation analysis between GNAS2 gene polymorphisms in children with arrhythmia

OBJECTIVE

The objective of the present study was to analyze the correlation between GNAS2 gene polymorphisms and children with arrhythmia.

PATIENTS AND METHODS

We followed 89 children with arrhythmia treated in our hospital from April 2013 to April 2015, comprising the observation group, while 92 healthy subjects were taken as the control group. We analyzed polymorphisms of the GNAS2 gene from both groups by restriction fragment length polymorphism (RFLP).

RESULTS

There were no significant differences (p>0.05) in GNAS2 genotype or allelic distribution between the observation group and control group. However, there were significant differences in the gene frequency of homozygotes (TT and GG) and alleles between the control group and samples from children with arrhythmia (p<0.05) (X2=16.57, p<0.05; X2=17.48, p<0.05). Further study of samples from both groups indicate that gene frequency of homozygous (TT and GG) or heterozygous (TG) genes and alleles also had differences, indicating that homozygotes (TT and GG) are in relatively high proportion among patients with severe cases of arrhythmia.

CONCLUSIONS

Morbidity in patients with arrhythmia is related to GNAS2 gene polymorphisms. Differences in genotype and allele frequency are related to the severity of illness.

[Phosphatase and tensin homolog deleted on chromosome ten/phosphatidyl Inositol 3-kinase/vascular endothelial growth factor signaling pathway changes in the rabbit Kawasaki disease model]

OBJECTIVE

To observe the changes of phosphatase and tensin homolog deleted on chromosome ten(PTEN)/ phosphatidyl Inositol 3-kinase(PI3K)/ vascular endothelial growth factor(VEGF)signaling pathway in a rabbit Kawasaki disease model.

METHODS

Model of Kawasaki disease was established in weanling Japanese big-eared rabbits with 10% bovine serum venous injection (2.5 ml/kg, 2 times, and 2 week's interval) through the ear. Twenty four rabbits were divided into 4 groups: control group (without injection of 10% bovine serum albumin, six rabbits); 1 day group (sacrificed a the second day after the establishment of Kawasaki disease models, six rabbits); 7 day group (sacrificed at the seventh day after establishment of Kawasaki disease model, six rabbits); 30 day group (sacrificed at the thirtieth day after establishment of Kawasaki disease model, six rabbits). Pathological analysis was performed on coronary artery tissue samples. The express of PTEN and PI3K were detected by immunohistochemistry. The levels of VEGF and CK were also examined with ELISA and white blood cells were counted.

RESULTS

(1) Coronary artery of model groups was thinner, distorted and had enlarged lumen. (2) PTEN expression in 1 d group, 7 d group and 30 d group were 58.5 ± 12.9, 73.2±9.9 and 109.6 ± 24.4, respectively, significantly higher than in the control group (25.5 ± 6.9, P<0.01 or 0.05). (3) The express of PI3K was significantly upregulated in 1 d group(57.2±11.1)and 7 d group(39.9±4.8) compared to control group(19.1±3.5, P<0.01 or 0.05). The expression level of PI3K in 30 d group was 18.8 ± 7.5, which was similar as control group (P>0.05) and significantly lower than 1 d and 7 d group (both P<0.05). (4) Similarly, the level of VEGF in 1 d group, 7 d group ((89.1 ± 15.5) ng/L, (76.9±9.9) ng/L) were significantly higher while it was significantly lower in 30 d group ((19.8 ± 4.4)ng/L) compared with the control group ((33.9 ± 6.7) ng/L, P<0.01 or 0.05). The level of VEGF in 7 d group was significantly lower than in 1 d group (P<0.05) and the level of VEGF was significantly lower in 30 d group than in 7 d group (P<0.01). (5)Creatine kinase levels were significantly higher in 30 d group than in control group (P<0.05) and there were no significantly different between control group, 1 d group and 7 d group(all P>0.05). (6)White blood cell count were significantly higher in 1 d group, 7 d group and 30 d group than in control group (all P<0.01).

CONCLUSION

The level of PTEN/PI3K/VEGF signaling pathway change after establishment of rabbit Kawasaki disease model and the signaling pathway might be involved in this model.

A High-sugar High-fat Diet Induced Metabolic Syndrome Shows some Symptoms of Alzheimer's Disease in Rats

OBJECTIVES

Cases of sporadic Alzheimer's disease (SAD) are the predominant form of the age-related dementia. New evidence suggests that metabolic syndrome (MS), a metabolic disorder, is an initiating factor of some SAD cases. A high-sugar high-fat diet could cause MS, we aimed to investigate whether it could directly lead to SAD.

MEASUREMENTS

The characteristic molecules of AD (hippocampus Aβ and Tau) were tested by using ELISA and western blotting to confirm the happening hallmarks of AD in brain. MS and inflammation related biochemical indicators were measured using immunological method. Proteins associated with the insulin resistance signal pathway (JNK, PI-3K, AKT, GSK-3β, GLUT3) were evaluated using western blotting method. The levels of reactive oxygen species (ROS) were measured by immunofluorescence method.

RESULTS

Expressions of hippocampus Aβ, phosphorylation-Tau (p-Tau), inflammatory factors and p-JNK, Gsk-3βwere higher in the model rats than those in the control rats and expressions of p-PI3K, p-AKT and GLUT3 were reversed.

CONCLUSIONS

The MS model animals, which can induce the characteristics symptoms of AD, and therefore it may be preliminarily considered that the AD pertains to the MS-related diseases.

Paucity of Nanolayering in Resin-Dentin Interfaces of MDP-based Adhesives

Self-assembled nanolayering structures have been reported in resin-dentin interfaces created by adhesives that contain 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP). These structures have been hypothesized to contribute to bond durability. The objective of the present study was to determine the extent of nanolayering in resin-dentin interfaces after application of commercialized 10-MDP-containing self-etch and universal adhesives to human dentin. Seven commercialized adhesives were examined: Adhese Universal (Ivoclar-Vivadent), All-Bond Universal (Bisco, Inc.), Clearfil SE Bond 2, Clearfil S3 Bond Plus, Clearfil Universal Bond (all from Kuraray Noritake Dental Inc.), G-Premio Bond (GC Corp.), and Scotchbond Universal (3M ESPE). Each adhesive was applied in the self-etch mode on midcoronal dentin according to the respective manufacturer's instructions. Bonded specimens (n = 6) were covered with flowable resin composite, processed for transmission electron microscopy, and examined at 30 random sites without staining. Thin-film glancing angle X-ray diffraction (XRD) was used to detect the characteristic peaks exhibited by nanolayering (n = 4). The control consisted of 15%wt, 10%wt, and 5%wt 10-MDP (DM Healthcare Products, Inc.) dissolved in a mixed solvent (ethanol and water weight ratio 9:8, with photoinitiators). Experimental primers were applied to dentin for 20 s, covered with hydrophobic resin layer, and examined in the same manner. Profuse nanolayering with highly ordered periodicity (~3.7 nm wide) was observed adjacent to partially dissolved apatite crystallites in dentin treated with the 15% 10-MDP primer. Three peaks in the 2θ range of 2.40° (3.68 nm), 4.78° (1.85 nm), and 7.18° (1.23 nm) were identified from thin-film XRD. Reduction in the extent of nanolayering was observed in the 10% and 5% 10-MDP experimental primer-dentin interface along with lower intensity XRD peaks. Nanolayering and characteristic XRD peaks were rarely observed in specimens prepared from the commercialized adhesives. The sparsity of nanolayering in resin-dentin interfaces created by commercialized adhesives challenges its clinical effectiveness as a mechanism for improving bond longevity in dentin bonding.

Correlation between magnetic resonance perfusion weighted imaging of radiation brain injury and pathology

We used magnetic resonance perfusion weighted imaging and pathological evaluation to examine different stages of radiation-induced brain injury and to investigate the correlation between the relative cerebral blood volume (rCBV) ratio and vascular endothelial growth factor (VEGF). Thirty adult rats were randomly divided into 2 groups: control and radiation group. The control group was not subjected to irradiation. The irradiation group rats were examined by magnetic resonance imaging and magnetic resonance perfusion weighted imaging at 1, 3, 6, 9, and 12 months after radiation treatment. We measured the rCBV, mean transit time, and time to peak. Hematoxylin and eosin staining, immunohistochemical staining, and electron microscopy were performed. VEGF absorbance was evaluated by immunohistochemical staining. Compared with the control group, the differences in rCBV, mean transit time, time to peak, and VEGF absorbance after 3 months were statistically significant (P < 0.05). rCBV was positively correlated with VEGF (r = 0.94, P < 0.05). Magnetic resonance perfusion weighted imaging can reflect pathophysiological changes in brain tissue after irradiation. Decreased expression of VEGF plays a critical role in the pathogenesis of radiation-induced brain injury.

Observation of Kawasaki disease-related indexes and the study of relationship between myocardial enzyme changes and coronary artery lesions

OBJECTIVE

To discuss the significance of Kawasaki disease-related laboratory indicators and relationship between myocardial enzyme changes and myocardial enzyme changes in children with Kawasaki disease.

PATIENTS AND METHODS

Make an observation of C-reactive proteins and immune globulin changes in children with Kawasaki disease, and also a comparison about the myocardial enzyme changes between the children with myocardial enzyme changes and others without lesions.

RESULTS

Compare the study group before treatment with the control group of normal children, there are significant differences in the levels of CRP, IgG, and IgM, and the difference was statistically significant (p < 0.05); make a comparison about the levels of AST, LDH, CK, HB-DH, and CK-MB in the group with or without coronary artery lesions, the difference was not statistically significant (p > 0.05).

CONCLUSIONS

Relevant laboratory indices play an important role in the early diagnosis of Kawasaki disease. Myocardial injury and coronary artery lesions in children with Kawasaki disease have no correlation between each other, and there has an inconsistency characteristic.

High-speed measurement of rotational anisotropy nonlinear optical harmonic generation using position-sensitive detection

We present a method of performing high-speed rotational anisotropy nonlinear optical harmonic generation experiments at rotational frequencies of several hertz by projecting the harmonic light reflected at different angles from a sample onto a stationary position-sensitive detector. The high rotational speed of the technique, 10(3) to 10(4) times larger than existing methods, permits precise measurements of the crystallographic and electronic symmetries of samples by averaging over low frequency laser-power, beam-pointing, and pulse-width fluctuations. We demonstrate the sensitivity of our technique by resolving the bulk fourfold rotational symmetry of GaAs about its [001] axis using second-harmonic generation.

124 cases of clinical analysis of children with viral myocarditis

OBJECTIVE

A study on clinical characteristics, diagnostic methods of children's viral myocarditis (VMC) and analysis of the effect of VMC is carried out.

PATIENTS AND METHODS

A retrospective analysis of the clinical data of 124 cases of children with VMC from January 2008 to March 2011 in Xuzhou Children's Hospital is conducted.

RESULTS

The age of onset of 1 VMC is less than 1 year old with the majority, fever, precordial pain, and fatigue as the main manifestation, auxiliary examination of abnormal electrocardiogram (ECG) in 110 cases, accounting for 88.71%, the positive rate of dynamic ECG is 92.31%, and abnormal rate of myocardial enzyme examination is 96.77%. The effective rate of treatment is 94.35%, and the effective rate of treatment of creatine phosphate sodium is 100%.

CONCLUSIONS

For childhood, especially 1 year old children with viral infection in clinical, attention should be paid to the VMC performance, suspected children should be timely ECG, dynamic ECG and myocardial enzyme examined with diagnosis and early treatment. The myocardial protection of creatine phosphate sodium has definite therapeutic effect on VMC of children.