A Novel Bifunctional Fusion Protein (Anti-IL-17A-sST2) Protects against Acute Liver Failure, Modulating the TLR4/MyD88 Pathway and NLRP3 Inflammasome Activation

Acute liver failure (ALF) is a serious inflammatory disorder with high mortality rates, which poses a significant threat to human health. The IL-33/ST2 signal is a crucial regulator in inflammation responses associated with lipopolysaccharide (LPS)-induced macrophages. The IL-17A signaling pathway promotes the release of chemokines and inflammatory cytokines, recruiting neutrophils and T cells under LPS stimulation, thus facilitating inflammatory responses. Here, the potential therapeutic benefits of neutralizing the IL-17A signal and modulating the IL-33/ST2 signal in ALF were investigated. A novel dual-functional fusion protein, anti-IL-17A-sST2, was constructed, which displayed high purity and biological activities. The administration of anti-IL-17A-sST2 resulted in significant anti-inflammatory benefits in ALF mice, amelioration of hepatocyte necrosis and interstitial congestion, and reduction in TNF-α and IL-6. Furthermore, anti-IL-17A-sST2 injection downregulated the expression of TLR4 and NLRP3 as well as important molecules such as MyD88, caspase-1, and IL-1β. The results suggest that anti-IL-17A-sST2 reduced the secretion of inflammatory factors, attenuated the inflammatory response, and protected hepatic function by regulating the TLR4/MyD88 pathway and inhibiting the NLRP3 inflammasome, providing a new therapeutic approach for ALF.

A potential strategy for bladder cancer treatment: inhibiting autophagy to enhance antitumor effects of Nectin-4-MMAE

Research and development on Nectin-4 antibody-drug conjugates (ADC) have been greatly accelerated since the approval of enfortumab vedotin to treat uroepithelial cancer. During the course of this study, we identified that autophagy serves as a cytoprotective mechanism during Nectin-4-MMAE treatment and proposed a strategy to enhance the antitumor effects of Nectin-4-MMAE in bladder cancer. Nectin-4-MMAE rapidly internalized into bladder cancer cells in 30 minutes and released MMAE, inducing the onset of caspase-mediated apoptosis and leading to the inhibition of tumor cell growth. Transcriptomics showed significant alterations in autophagy-associated genes in bladder cancer cells treated with Nectin-4-MMAE, which suggested autophagy was activated by Nectin-4-MMAE. Furthermore, autophagy activation was characterized by ultrastructural analysis of autophagosome accumulation, immunofluorescence of autophagic flux, and immunoblotting autophagy marker proteins SQSTM1 and LC3 I/II. Importantly, inhibiting autophagy by LY294002 and chloroquine significantly enhances the cytotoxicity effects of Nectin-4-MMAE in bladder cancer cells. Additionally, we detected the participation of the AKT/mTOR signaling cascade in the induction of autophagy by Nectin-4-MMAE. The combination of Nectin-4-MMAE and an autophagy inhibitor demonstrated enhanced antitumor effects in the HT1376 xenograft tumor model. After receiving a single dose of Nectin-4-MMAE, the group that received the combination treatment showed a significant decrease in tumor size compared to the group that received only one type of treatment. Notably, one mouse in the combination treatment group achieved complete remission of the tumor. The combination group exhibited a notable rise in apoptosis and necrosis, as indicated by H&E staining and immunohistochemistry (cleaved caspase-3, ki67). These findings demonstrated the cytoprotective role of autophagy during Nectin-4-MMAE treatment and highlighted the potential of combining Nectin-4-MMAE with autophagy inhibitors for bladder cancer treatment.

[Efficacy and safety analysis of bupivacaine liposome for pericapsular nerve group block for postoperative analgesia in elderly patients with hip replacement]

Objective: To investigate the efficacy and safety of bupivacaine liposome for pericapsular nerve group block (PENGB) for postoperative analgesia in elderly patients with total hip replacement. Methods: A total of 42 elderly patients underwent total hip replacement were selected in the Second Affiliated Hospital of Wenzhou Medical University from May to July in 2023, including 19 males and 23 females, aged (68.8±6.3) years, the American Society of Anesthesiologists (ASA) grade Ⅰ to Ⅲ. They were divided into bupivacaine liposome group (observation group) and levobupivacaine hydrochloride group (control group) according to random number table, with 21 cases in each group. All the patients were anesthetized by lumbar anesthesia combined with PENGB. During PENGB, the observation group was injected with 10 ml (133 mg) bupivacaine liposome+5 ml normal saline, and the control group was injected with 10 ml (75 mg) levobupivacaine hydrochloride+5 ml normal saline. The primary outcome measures included the rest and movement visual analogue scale (VAS) scores at 6, 12, 24, 36, 48, 60, and 72 h after operation, the sufentanil consumption in analgesic pump, the numbers of analgesic pump compressions, and the rates of additional parexib sodium use in ward. The secondary outcome measures were the changes in lower limb muscle strength, the length of hospital stay and the occurrence of adverse reactions. Results: There was no significant difference in the rest and movement VAS scores between the two groups at pre-operation and at 6 h after operation (P>0.05);but the rest and movement VAS scores at 12, 24, 36, 48, 60 and 72 h after operation in observation group were significantly lower than those in control group (P<0.05); the rest and movement VAS scores at 6, 12, 24, 36, 48, 60 and 72 h after operation were lower than those at pre-operation in two group (P<0.05). The consumption of sufentanil in analgesic pump and parexib sodium usage in observation group were lower than those in control group at 12, 24, 36 and 48 h after operation (P<0.05). The total number of analgesic pump compressions, the number of effective compressions and the number of ineffective compressions in 48 h in observation group were lower than those in control group (P<0.05). The muscle strength of the lower limbs of all patients were able to move against gravity at 12 h after operation. The incidence of nausea in 48 h after operation in observation group was 9.5% (2/21), which was lower than 42.9% (9/21) in control group (P=0.014). No postoperative vomiting occurred in all patients. The length of the hospital stay was (9.3±2.2) d in observation group and (8.9±1.9) d in control group, and there was no significant difference between the two groups (P=0.500). Conclusion: Compared with levobupivacaine hydrochloride, liposomal bupivacaine in PENGB provides analgesic effects for up to 72 h after total hip replacement in elderly patients, reduces postoperative opioid and other analgesics usage, decreases the incidence of postoperative nausea, and has a minor effect on lower limb movement without prolonging hospitalization.

Inhibition of Hedgehog signaling ameliorates foam cell formation by promoting autophagy in early atherosclerosis

Macrophages are the origin of most foam cells in the early stage of atherosclerotic plaques. However, the mechanism involved in the formation of macrophage-derived foam cell formation remains unclear. Here, we revealed that the hedgehog (Hh) signaling is critical in autophagy-lysosome pathway regulation and macrophage-derived foam cell formation. Inhibition of Hh signaling by vismodegib ameliorated lipid deposition and oxidative stress level in atherosclerotic plaques in high-fat diet-fed apoE-/- mice. For mechanistic study, how the Hh signaling modulate the process of foam cell formation were accessed afterward. Unexpectedly, we found that suppression of Hh signaling in apoE-/- mice had no significant impact on circulating cholesterol levels, indicating that Hh pathway modulate the procession of atherosclerotic plaque not through a traditional lipid-lowing mechanism. Instead, vismodegib was found to accelerate autophagosomes maturation as well as cholesterol efflux in macrophage-derived foam cell and in turn improve foam cell formation, while autophagy inhibitors (LY294002 or CQ) administration significantly attenuated vismodegib-induced cholesterol efflux and reversed the effect on foam cell formation. Therefore, our result demonstrated that inhibition of the Hh signaling pathway increases cholesterol efflux and ameliorates macrophage-derived foam cell formation by promoting autophagy in vitro. Our data thus suggested a novel therapeutic target of atherosclerosis and indicated the potential of vismodegib to treat atherosclerosis.

Innate Immunity in Cancer Biology and Therapy

Immunotherapies including adaptive immune checkpoint inhibitors (ICIs) and chimeric antigen receptor (CAR) T cells, have developed the treatment of cancer in clinic, and most of them focus on activating T cell immunity. Although these strategies have obtained unprecedented clinical responses, only limited subsets of cancer patients could receive long-term benefits, highlighting the demand for identifying novel targets for the new era of tumor immunotherapy. Innate immunity has been demonstrated to play a determinative role in the tumor microenvironment (TME) and influence the clinical outcomes of tumor patients. A thorough comprehension of the innate immune cells that infiltrate tumors would allow for the development of new therapeutics. In this review, we outline the role and mechanism of innate immunity in TME. Moreover, we discuss innate immunity-based cancer immunotherapy in basic and clinical studies. Finally, we summarize the challenges in sufficiently motivating innate immune responses and the corresponding strategies and measures to improve anti-tumor efficacy. This review could aid the comprehension of innate immunity and inspire the creation of brand-new immunotherapies for the treatment of cancer.

[Association of sleep duration and risk of frailty among the elderly over 80 years old in China: a prospective cohort study]

Objective: To explore the association between sleep duration and the risk of frailty among the elderly over 80 years old in China. Methods: Using the data from five surveys of the China Elderly Health Influencing Factors Follow-up Survey (CLHLS) (2005, 2008-2009, 2011-2012, 2014, and 2017-2018), 7 024 elderly people aged 80 years and above were selected as the study subjects. Questionnaires and physical examinations were used to collect information on sleep time, general demographic characteristics, functional status, physical signs, and illness. The frailty state was evaluated based on a frailty index that included 39 variables. The Cox proportional risk regression model was used to analyze the correlation between sleep time and the risk of frailty occurrence. A restricted cubic spline function was used to analyze the dose-response relationship between sleep time and the risk of frailty occurrence. The likelihood ratio test was used to analyze the interaction between age, gender, sleep quality, cognitive impairment, and sleep duration. Results: The age M (Q₁, Q₃) of 7 024 subjects was 87 (82, 92) years old, with a total of 3 435 (48.9%) patients experiencing frailty. The results of restricted cubic spline function analysis showed that there was an approximate U-shaped relationship between sleep time and the risk of frailty. When sleep time was 6.5-8.5 hours, the elderly had the lowest risk of frailty; Multivariate Cox proportional risk regression model analysis showed that compared to 6.5-8.5 hours of sleep, long sleep duration (>8.5 hours) increased the risk of frailty by 13% (HR: 1.13; 95%CI: 1.04-1.22). Conclusion: There is a nonlinear association between sleep time and the risk of frailty in the elderly.

Targeting CD47 enhanced the antitumor immunity of PD-L1 blockade in B-cell lymphoma

Background: Only a subset of B-cell lymphoma (BCL) patients can benefit from immune checkpoint inhibitors targeting PD-1/PD-L1. Materials & methods: In the A20 model, SIRPα-Fc and anti-PD-L1 were employed to target CD47 and PD-L1 simultaneously. Flow cytometry, immunofluorescence and quantitative polymerase chain reaction were used to unravel the potential mechanisms. Results: Simultaneously targeting CD47 and PD-L1 activated CD8⁺ T cells with an increased release of effector molecules. Furthermore, infiltration of F4/80⁺iNOS⁺ M1 macrophages was enhanced by the dual therapy. Conclusion: Anti-CD47 therapy could sensitize BCL tumors to anti-PD-L1 therapy in a CD8⁺ T-cell- and M1-macrophage-dependent manner by promoting cytotoxic lymphocyte infiltration, which may provide a potential strategy for BCL treatment by simultaneously targeting CD47 and PD-L1.

Simultaneous blockade of VEGF-B and IL-17A ameliorated diabetic kidney disease by reducing ectopic lipid deposition and alleviating inflammation response

The pathogenesis of diabetic kidney disease (DKD) is complicated. Current clinical treatments fail to achieve satisfactory efficacy in the prevention of DKD progression, it urgently needs novel and effective treatment for DKD. In this study, we firstly demonstrated that renal lipid metabolism abnormality and inflammation significantly changed in DKD conditions by mining public transcriptomic data of DKD patient samples. KEGG analysis further exhibited the critical role of vascular endothelial growth factor B (VEGF-B) and interleukin 17A (IL-17A) signal pathways in DKD progression, indicating that VEGF-B and IL-17A might be the promising targets for DKD treatment. Then the potential of a novel combination therapy, anti-VEGF-B plus anti-IL-17A antibody, was evaluated for DKD treatment. Our results demonstrated that simultaneous blockade of VEGF-B and IL-17A signaling with their neutralizing antibodies alleviated renal damage and ameliorated renal function. The therapeutic effectiveness was not only related to the reduced lipid deposition especially the neutral lipids in kidney but also associated with the decreased inflammation response. Moreover, the therapy alleviated renal fibrosis by reducing collagen deposition and the expression of fibronectin and α-SMA in kidney tissues. RNA-seq analysis indicated that differential expression genes (DEGs) in db/db mice were significantly clustered into lipid metabolism, inflammation, fibrosis and DKD pathology-related pathways, and 181 of those DEGs were significantly reversed by the combinatory treatment, suggesting the underlying mechanism of administration of anti-VEGF-B and anti-IL-17A antibodies in DKD treatment. Taken together, this study identified that renal lipid metabolism abnormality and inflammation were critically involved in the progression of DKD, and simultaneous blockade of VEGF-B and IL-17A signaling represents a potential DKD therapeutic strategy.

Targeting 4-1BB and PD-L1 induces potent and durable antitumor immunity in B-cell lymphoma

Introduction

Although PD-1/L1 mAb has demonstrated clinical benefits in certain cancer types, low response rate and resistance remain the main challenges for the application of these immune checkpoint inhibitors (ICIs). 4-1BB is a co-stimulator molecule expressed in T cells, which could enhance T cell proliferation and activation. Herein, the synergetic antitumor effect and underlying mechanism of 4-1BB agonist combined with PD-1/PD-L1 blockade were determined in B-cell lymphoma (BCL).

Methods

Subcutaneous transplantation BCL tumor models and metastasis models were established to evaluate the therapeutic effect of PD-L1 antibody and/or 4-1BB agonist in vivo. For the mechanistic study, RNA-seq was applied to analyze the tumor microenvironment and immune-related signal pathway after combination treatment. The level of IFN-γ, perforin, and granzyme B were determined by ELISA and Real-time PCR assays, while tumor-infiltrating T cells were measured by flow cytometry and immunohistochemical analysis. CD4/CD8 specific antibodies were employed to deplete the related T cells to investigate the role CD4+ and CD8+ T cells played in combination treatment.

Results

Our results showed that combining anti-PD-L1 ICI and 4-1BB agonists elicited regression of BCL and significantly extended the survival of mice compared to either monotherapy. Co-targeting PD-L1 and 4-1BB preferentially promoted intratumoral cytotoxic lymphocyte infiltration and remodeled their function. RNA-sequence analysis uncovered a series of up-regulated genes related to the activation and proliferation of cytotoxic T lymphocytes, further characterized by increased cytokines including IFN-γ, granzyme B, and perforin. Furthermore, depleting CD8+ T cells not CD4+ T cells totally abrogated the antitumor efficacy, indicating the crucial function of the CD8+ T cell subset in the combination therapy.

Discussion

In summary, our findings demonstrated that 4-1BB agonistic antibody intensified the antitumor immunity of anti-PD-1/PD-L1 ICI via promoting CD8+ T cell infiltration and activation, providing a novel therapeutic strategy to BCL.

A novel fusion protein consisting of anti-ANGPTL3 antibody and interleukin-22 ameliorates diabetic nephropathy in mice

Introduction

The pathogenic mechanisms of diabetic nephropathy (DN) include podocyte injury, inflammatory responses and metabolic disorders. Although the antagonism of Angiopoietin-like protein 3 (ANGPTL3) can alleviate proteinuria symptoms by inhibiting the activation of integrin αvβ3 on the surface of podocytes, it can not impede other pathological processes, such as inflammatory responses and metabolic dysfunction of glucolipid. Interleukin-22 (IL-22) is considered to be a pivotal molecule involved in suppressing inflammatory responses, initiating regenerative repair, and regulating glucolipid metabolism.

Methods

Genes encoding the mIL22IgG2aFc and two chains of anti-ANGPTL3 antibody and bifunctional protein were synthesized. Then, the DN mice were treated with intraperitoneal injection of normal saline, anti-ANGPTL3 (20 mg/kg), mIL22Fc (12 mg/kg) or anti-ANGPTL3 /IL22 (25.3 mg/kg) and irrigation of positive drug losartan (20mg/kg/d) twice a week for 8 weeks.

Results

In this research, a novel bifunctional fusion protein (anti-ANGPTL3/IL22) formed by the fusion of IL-22 with the C-terminus of anti-ANGPTL3 antibody exhibited favorable stability and maintained the biological activity of anti-ANGPTL3 and IL-22, respectively. The fusion protein showed a more pronounced attenuation of proteinuria and improved dysfunction of glucolipid metabolism compared with mIL22Fc or anti-ANGPTL3. Our results also indicated that anti-ANGPTL3/IL22 intervention significantly alleviated renal fibrosis via inhibiting the expression of the inflammatory response-related protein nuclear factor kappa light-chain enhancer of activated B cells (NF-κB) p65 and NOD-like receptor family pyrin domain-containing protein 3 (NLRP3) inflammasome. Moreover, transcriptome analysis revealed the downregulation of signaling pathways associated with injury and dysfunction of the renal parenchymal cell indicating the possible protective mechanisms of anti-ANGPTL3/IL22 in DN.

Conclusion

Collectively, anti-ANGPTL3/IL22 bifunctional fusion protein can be a promising novel therapeutic strategy for DN by reducing podocyte injury, ameliorating inflammatory response, and enhancing renal tissue recovery.

Characterization of light chain c-terminal extension sequence variant in one bispecific antibody

Protein modifications such as post-translational modifications (PTMs) and sequence variants (SVs) occur frequently during protein biosynthesis and have received great attention by biopharma industry and regulatory agencies. In this study, an aberrant peak near light chain (LC) was observed in the non-reduced capillary electrophoresis sodium dodecyl sulfate (nrCE-SDS) electrophoretogram during cell line development of one bispecific antibody (BsAb) product, and the detected mass was about 944 Da higher than LC. The corresponding peak was then enriched by denaturing size-exclusion chromatography (SEC-HPLC) and further characterized by nrCE-SDS and peptide mapping analyses. De novo mass spectra/mass spectra (MS/MS) analysis revealed that the aberrant peak was LC related sequence variant, with the truncated C-terminal sequence “SFNR” (“GEC”deleted) linked with downstream SV40 promotor sequence “EAEAASASELFQ”. The unusual sequence was further confirmed by comparing with the direct synthetic peptide “SFNREAEAASASELFQ”. It was demonstrated by mRNA sequencing of the cell pool that the sequence variant was caused by aberrant splicing at the transcription step. The prepared product containing this extension variant maintained well-folded structure and good functional properties though the LC/Heavy chain (HC) inter-chain disulfide was not formed. Several control strategies to mitigate the risk of this LC related sequence variant were also proposed.

[Quit intention and smoking cessation behavior of current smokers aged 15 years and above in China, 2018]

Objective: To describe the current situation on quit intention and quit attempts among current smokers aged 15 years and above in China and explore the main factors affecting their smoking cessation behaviors. Methods: The subjects were people aged 15 years and above in China. A stratified multi-phased randomized cluster sampling method was used. The survey covered 200 districts/counties in 31 provinces (autonomous regions and municipalities directly under the central government), including 19 376 people under investigation. The data were weighted with SAS 9.4 for complex sampling analysis, and the frequency and weighted component ratio were used for description. The influencing factors were studied using the Rao Scott χ² test and unconditional multivariate logistic regression. Results: Among current smokers, 6.63% reported that they planned to quit smoking in the next month, 5.44% for men and 8.49% for women. 17.96% of the current smokers made quit attempts in the past 12 months, with 17.80% men and 22.15% women. People who smoke occasionally (OR=3.42, 95%CI: 2.09-5.59) made quit attempts in the past (OR=4.91, 95%CI: 0.33-0.52) and knew that smoking would lead to three diseases (OR=2.24, 95%CI: 1.48-3.40) had higher quit intention. People who occasionally smoke (OR=1.68, 95%CI: 1.20-2.34) received smoking cessation suggestions from medical staff (OR=1.96, 95%CI: 1.62-2.37), were a ware of that smoking causes three diseases (OR=1.63, 95%CI: 1.32-2.02) and had smoking prohibition regulations in indoor areas of their homes, had a higher rate of quit attempts. Conclusion: Providing effective smoking cessation intervention services and creating a supportive tobacco control environment are significant in promoting smoking cessation behavior.

[Study on smoking behavior and its changes among Chinese people aged 15 years and above in 2018]

Objective: To describe the current status of smoking among Chinese people aged 15 and above and analyze its epidemic evolution. Methods: A stratified multi-phased randomized cluster sampling design of the Global Adult Tobacco Survey was used. The cross-sectional survey was conducted from July to December 2018, covering 200 districts/counties in 31 provinces of China. Field data was collected through in-house face-to-face interviews by trained investigators using a tablet computer. 19 376 individual questionnaires were completed, with an overall response rate of 91.50%. The data were weighted for complex sampling and analyzed with SAS 9.4. Results: In 2018, the current smoking prevalence of adults aged 15 and above was 26.59%, with that higher among males (50.47%) than among females (2.07%) and higher among those in rural (28.87%) than among those in urban areas (25.05%). The quitting rate was 20.10%, with a higher rate among females (30.22%) than males (19.64%). However, there was no significant difference between rural and urban areas (P=0.864). Compared with the previous data, the smoking rate tends to drop, with a substantial decrease among the 25-44 age groups and 45-64 age groups. The most significant decline occurs among those with higher education (Junior college and above). In addition, in 2018, current daily smokers aged 15 and above in China started to smoke daily at an average age of 20.95 years old. For current smokers, 16.00 cigarettes were consumed each day on average. Conclusion: Although the current smoking prevalence among the Chinese population aged 15 and above tends to decrease, the decreasing speed is too slow to achieve the target set in the Healthy China Action (2019-2030). Consequently, much more effective efforts to control tobacco need to be enforced.

[Analysis of exposure to tobacco advertisement and promotion among Chinese adults aged 15 years and above, 2010 and 2018]

Objective: To investigate the exposure to tobacco advertisements and promotions among Chinese adults aged 15 and above, identify the publicity channels and forms of tobacco advertising and promotion in 2010 and 2018, and implicate further tobacco control measures in China. Methods: A multistage, stratified, randomized cluster sampling design was used in 2010 and 2018 China Adult Tobacco Survey, with national representativeness. 13 354 and 19 376 permanent residents were selected in the 2010 and 2018 surveys. SAS 9.4 software was applied for data analysis, and all the data were weighted based on a complex sampling design. Rao Scott χ2 test was used for group comparison of a single factor. Results: In 2010 and 2018, 19.61% and 18.14% of the survey respondents did see tobacco advertising and promotion. From 2010 to 2018, there was no significant change in the situation of tobacco advertisements and promotions. Among those who had gone to a cigarette shop, the proportion of seeing tobacco advertisements increased from 29.28% in 2010 to 43.28% in 2018. Among those who had seen tobacco advertisements on TV, the rate fell from 50.93% in 2010 to 28.58% in 2018. Among those who had gone to movie theaters, the proportion of seeing tobacco advertisements increased from 2.17% in 2010 to 9.89% in 2018. Among those who had used the Internet, the proportion of seeing tobacco advertisements online rose from 19.20% in 2010 to 42.30% in 2018. In terms of tobacco promotion, the percentages of people who had seen tobacco promotions, cigarette price discounts, cigarette discount coupons, gifts, and other preferential activities in various places in the past 30 days were 4.99% vs. 9.30%, 0.78% vs. 4.09%, 0.04% vs. 0.33% and 0.98% vs. 3.33% in 2010 and 2018, respectively (P<0.001). Conclusions: Tobacco advertising and promotion are still prevalent in China, with no significant change in 2010 and 2018. Tobacco advertising and promotion have been with the constant changes and development of media platforms. It is necessary to improve the implementation of relevant policies, comprehensively ban tobacco advertisements and promotions, and strengthen the supervision of ads and promotions.

[Secondhand smoke exposure and its influencing factors among Chinese people aged 15 years and above in 2010 and 2018]

Objective: To investigate secondhand smoke (SHS) exposure among non-current smokers aged 15 and over and its influencing factors in China in 2010 and 2018. Methods: The 2010 and 2018 China Adult Tobacco Surveys used multistage stratified cluster random sampling methods to obtain national representative samples across 31 provinces (autonomous regions and municipalities) in China. This study selected non-current smokers aged 15 and over as the research subjects to describe the general demographic characteristics, perceptions of SHS hazards, attitudes towards smoking bans in indoor areas in public places, and SHS exposure and the smoking restriction regulations in different places. The Rao-Scott χ2 test was used to compare the rates, and the unconditional logistic regression was used to analyze the influencing factors of SHS exposure. All the subjects in the analysis were weighted based on a complex sampling design. Results: Among non-current smokers aged 15 and over, from 2010 to 2018, the percentage of indoor smokers had decreased from 84.7% to 71.9%. The rates of people who saw smoking in various places declined with a statistically significant difference (P<0.001). The exposure to SHS for females, people aged 45-64, teachers, medical staff, workers in enterprises, businesses, waiters, and people who live in rural and central areas declined. The differences were statistically significant (P<0.05). In 2018, the percentage of SHS exposure for those who reported a comprehensive smoking ban in households or allowed smoking in certain areas was lower than for those who reported allowed or without a smoking ban. Among those aged 25-44, SHS exposure for those who reported complete smoking prohibition in workplaces was lower than those who reported allowed or without smoking prohibition (OR=0.65, 95%CI: 0.49-0.87). The proportion of SHS exposure for those who believe that smoking should not be allowed in indoor areas of 0-5 public places is higher than that smoking should not be allowed in the indoor spaces of 8 public places (OR=2.13, 95%CI: 1.35-3.36). Among people aged 45-64, the proportions of SHS exposure for teachers (OR=0.37, 95%CI: 0.17-0.78) and medical staff (OR=0.35, 95%CI: 0.16-0.76) and staff working in agriculture, forestry, animal husbandry, fishery, and water conservancy were lower than governmental staff (OR=0.49, 95%CI: 0.29-0.84). Conclusions: Data from the decreased exposure of Chinese non-current smokers aged 15 and over to SHS suggests the initial achievement through constructing a smoke-free environment, but continued efforts are needed. It is necessary to actively advocate for smoke-free families, strengthen publicity and education on the hazards of tobacco and SHS, and improve the skills of non-smokers in rejecting SHS exposure.

A novel nanobody-heavy chain antibody against Angiopoietin-like protein 3 reduces plasma lipids and relieves nonalcoholic fatty liver disease

Background

Nonalcoholic fatty liver disease (NAFLD) is a metabolic disease mainly on account of hypercholesterolemia and may progress to cirrhosis and hepatocellular carcinoma. The discovery of effective therapy for NAFLD is an essential unmet need. Angiopoietin-like protein 3 (ANGPTL3), a critical lipid metabolism regulator, resulted in increased blood lipids and was elevated in NAFLD. Here, we developed a nanobody-heavy chain antibody (VHH-Fc) to inhibit ANGPTL3 for NAFLD treatment.

Results

In this study, we retrieved an anti-ANGPTL3 VHH and Fc fusion protein, C44-Fc, which exhibited high affinities to ANGPTL3 proteins and rescued ANGPLT3-mediated inhibition of lipoprotein lipase (LPL) activity. The C44-Fc bound a distinctive epitope within ANGPTL3 when compared with the approved evinacumab, and showed higher expression yield. Meanwhile, C44-Fc had significant reduction of the triglyceride (~ 44.2%), total cholesterol (~ 36.6%) and LDL-cholesterol (~ 54.4%) in hypercholesterolemic mice and ameliorated hepatic lipid accumulation and liver injury in NAFLD mice model.

Conclusions

We discovered a VHH-Fc fusion protein with high affinity to ANGPTL3, strong stability and also alleviated the progression of NAFLD, which might offer a promising therapy for NAFLD.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s12951-022-01456-z.

Design, Synthesis and Biological Evaluation of Novel 1,2,5-Oxadiazol-3- Carboximidamide Derivatives as Indoleamine 2, 3-Dioxygenase 1 (IDO1) Inhibitors

BACKGROUND AND OBJECTIVE

Indoleamine-2,3-dioxygenase 1 (IDO1), which catalyzes the degradation of L-tryptophan (L-Trp) to N-formyl kynurenine (NFK) in the first and rate-limiting step of Kynurenine (KYN) pathway has been identified as a promising therapeutic target for cancer immunotherapy. The small molecule Epacadostat developed by Incyte Corp is the most advanced IDO1 inhibitor in clinical trials.

METHODS

In this study, various amidine derivatives were individually installed as the polar capping group onto the amino ethylene side chain to replace the sulfamoylamino moiety of Epacadostat to develop novel IDO1 inhibitors. A series of novel 1,2,5-oxadiazol-3-carboximidamide derivatives were designed, prepared, and evaluated for their inhibitory activities against human IDO1 enzyme and cellular IDO1.

RESULTS

In vitro human IDO1 enzyme and cellular IDO1 assay results demonstrate that the inhibitory activities of compound 13a and 13b were comparable to Epacadostat, with the enzymatic IC50 values of 49.37nM and 52.12nM and cellular IC50 values of 12.34nM and 14.34nM, respectively. The anti-tumor efficacy of 13b is slightly better than Epacadosta in Lewis Lung Cancer (LLC) tumor-bearing mice model.

CONCLUSION

13b is a potent IDO1 inhibitor with therapeutic potential in tumor immunotherapy.

Discovery of novel hydroxyamidine derivatives as indoleamine 2,3-dioxygenase 1 inhibitors with in vivo anti-tumor efficacy

Indoleamine 2,3-dioxygenase 1 (IDO1) is closely associated with immune escape in many tumor tissues, and is considered to be a valuable therapeutic target in cancer immunotherapy. In this study, the modification of amino sidechain was performed with the hydroxyamidine core kept intact to optimize lead compound Epacadostat. 19 new compounds with hydrazide, thietane or sulfonamide moiety as polar capping group in sidechain were prepared and their IDO1 inhibitory activities were evaluated. Sulfonamide 3a showed potent IDO1 inhibition in both enzymatic and cellular assays with the IC₅₀ value of 71 nM and EC₅₀ value of 11 nM, respectively. Furthermore, in vivo Lewis lung cancer (LLC) allograft studies of 3a indicated that it handicapped the tumor growth with similar efficacy to Epacadostat. Molecular docking demonstrated that the change of polar capping group affords influence on the orientation of amino ethylene side chain and forms new hydrogen bonding.

IKBKE enhances TMZ-chemoresistance through upregulation of MGMT expression in glioblastoma

PURPOSE

Glioblastoma multiforme (GBM) is the most common and aggressive malignant type of brain tumor. Despite advances in diagnosis and therapy, the prognosis of patients with GBM has remained dismal. Multidrug resistance and high recurrence are two of the major challenges in successfully treating brain tumors. IKBKE (inhibitor of nuclear factor kappa-B kinase subunit epsilon) is a major oncogenic protein in tumors and can inhibit glioblastoma cell proliferation, migration, and tumorigenesis. Our study aimed to investigate the mechanism of IKBKE enhancing the resistance of glioma cells to temozolomide.

METHODS

For the in vitro experiments, LN18 and U118 glioblastoma cells were treated with a combination of sh/oe-IKBKE lentivirus and TMZ. Cell proliferation was determined by the EdU assay and colony formation assays. Apoptosis was analyzed by the TUNEL assay. In vivo, LN18 NC and LN18 sh-IKBKE cells were implanted into the cerebrums of nude mice to detect the effect of combination therapy. The protein and mRNA levels were assayed by western blot, immunohistochemistry, and qRT-PCR.

RESULTS

In this study, we demonstrated that IKBKE enhances the resistance of glioblastoma cells to temozolomide (TMZ) by activating the AKT/NF-κB signaling pathway to upregulate the expression of the DNA repair enzyme o6-methylguanine-dna methyltransferase (MGMT). In glioblastoma cells, IKBKE knockdown enhances apoptosis and suppresses cell proliferation, clone formation, and tumor development in vivo induced by TMZ. However, overexpression of IKBKE reduces the effects of TMZ.

CONCLUSION

Our studies suggest that inhibition of IKBKE can enhance the therapeutic effect of TMZ on GBM in vitro and in vivo, providing new research directions and therapeutic targets for the treatment of GBM.

[Relationship between the choroid plexus cyst and the aneuploidy]

Objective: Using the method of the ultrasound and the noninvasive DNA to find the relationship between the choroid plexus cyst and the aneuploidy, and to provide the meaningful data for prenatal consultant. Methods: A total of 112 cases, that the gestational age were between 13 and 20 weeks, which were diagnosed with choroid plexus cyst in the Department of Gynecology and Obstetrics of the Second Hospital of Jilin University from January. 2016 to July. 2017 were tested by ultrasonography. They all accepted the noninvasive DNA. At the same time, a total of 100 normal fetuses were randomly involved in the control group by the combination of gestational age and the age of the pregnant woman, all of them had taken the non-invasive DNA examination and followed up until the birth. Those fetuses who combined with other malformations were induced labor in the two groups. If the results of noninvasive DNA indicated the high-risk, invasive examination for karyotype analysis were recommended. If the results were aneuploidy, they chose induced labor. The rest cases followed up until the birth. Results: Five cases of the 112 fetuses in the case group were found with obvious malformation (3 of them were found in the early trimester, 2 of them were found in the middle trimester). The numbers of high risk results of noninvasive DNA were 7, and 5 of them underwent the invasive karyotype analysis. When the aneuploidy had diagnosed definitely, induced labor had been taken. One case was found to be the aneuploidy in the control group, and took the induced labor. One case was diagnosed as right side aortic arch by ultrasound in the control group, with a good prognosis. The other cases were followed up until the birth with a good prognosis. Conclusions: (1)In the early trimester, the fetus with choroid plexus cyst has an increasing risk of aneuploidy. (2)When the maximum diameter of choroid plexus cyst is less than 1 cm and the cyst was single, most of them could disappear in the middle trimester, it has no effect on the fetus. (3)Noninvasive DNA test has a high accuracy, which can improve the positive rate of invasive examination.

[Correlation between fetal intracardiac echogenic foci and chromosome and heart function]

Objective: To study the relationship between the intracardiac echogenic foci and the abnormal chromosome and the changes of Cardiac function. Methods: A total of 2645 cases with the gestational age between 14 to 22 weeks were tested in the department of gynecology and obstetrics of the Second Hospital of Jilin University from Jan.2016 to Dec.2017.Seventy-nine of them existed the intracardiac echogenic foci, and the patient's imaging data in details were recorded.All of them have taken the non-invasive DNA examination.Fetal echocardiography was performed at 22-24 weeks.Karyotype analysis was performed using amniocentesis and umbilical cord blood puncture.Inducing labor was performed for fetuses that has been identified as a haploid or had a severely malformation during pregnancy.The other fetuses were followed up to the birth.Echocardiography was performed on neonates. Results: The detection rate of intracardiac echogenic focus was 3.0% in early pregnancy, 92% in the left ventricle, 4% in the right ventricle, and 4% in double ventricle.There were 5 cases of haploid fetus induced labor, 2 cases of induced labor due to fatal malformation.Fetal echocardiography revealed tricuspid regurgitation in 7 cases.One of them was induced labor in consideration of heart failure. Conclusions: 1.The risk of chromosomal abnormality in the fetus of isolated left intracardiac echogenic focus is lower.Non-invasive DNA examination has a high reliability that could be an important reference before an invasive antenatal diagnosis.2.A higher rate of fetal malformation will be found when the foci located in the right or double ventricle.3.The relationship between fetal intracardiac echogenic foci and fetal cardiac dysfunction needs to be further clarified.

[Relationship between sonographic markers and fetal chromosome abnormality during 16-18 weeks of pregnancy]

Objective: To analysis of fetal ultrasound soft index positive cases during 16-18 weeks of pregnancy, and to explore the relationship with chromosomal abnormalities in order to increase the positive rate of invasive prenatal diagnosis and reduce the rate of missed diagnosis. Methods: A total of 569 cases which were diagnosed with positive soft markers in the department of gynecology and obstetrics of the Second Hospital of Jilin University from Jan.2016 to Jan.2017 were studied by ultrasonography. Twenty-five cases were lost in follow-up and finally 544 cases were included as group A. Those fetuses who combined with other malformations were induced labor. Non-invasive DNA examination was recommended for continued pregnant women, and those pregnant women whose results were high risk underwent the amniotic cavity puncture. When the fetal aneuploidy was confirmed, they chose induced labor. We followed the rest of those patients until postnatal half year. Randomly selected 544 cases during 16-18 weeks of pregnancy without obvious abnormalities into group B, followed up to half a year after birth. Results: In group A, 7 of the 544 cases were combined with other severe malformation in the beginning, among the remaining 537 patients, 273 of them received non-invasive DNA examination. Ten cases were high risk results, all of them underwent the amniotic cavity puncture with the result of chromosome abnormality, and they chose induced labor. Six cases were found other malformation in the second trimester who chose induced labor, and the rest 521 cases followed until the fetuses was born after half year had a favorable prognosis. In group B, 1 cases of severe deformities and 1 cases of haploid fetuses were found in 544 fetuses. The incidence of haploid fetus in group A and group B were 1.8% and 0.2%, respectively, with statistically significant (P<0.05). The incidence of severe malformation in group A and group B were 2.3% and 0.2%, respectively, with statistically significant (P<0.05). Conclusions: During 16-18 weeks of pregnancy, sonographic markers may indicate an increased risk in fetal chromosomal abnormalities. The risk of serious malformation was increased in the fetuses with ultrasonic soft marker positive, but there was no specificity.

In vivo hepatocellular expression of interleukin-22 using penetratin-based hybrid nanoparticles as potential anti-hepatitis therapeutics

Hepatocellular injury is the pathological hallmark of hepatitis and a crucial driver for the progression of liver diseases, while the treatment options are commonly restricted. Interleukin-22 (IL-22) has attracted special attention as a potent survival factor for hepatocytes that both prevents and repairs the injury of hepatocytes through activation of STAT3 signaling pathway. We hypothesized that the ability to generate potent expression of IL-22 locally for the treatment of severe hepatocellular injury in hepatitis was a promising strategy to enhance efficacy and overcome off-target effects. Accordingly, we developed a polypeptide penetratin-based hybrid nanoparticle system (PDPIA) carrying IL-22 gene by a self-assembly process. This nanocomplex modified with penetratin featured direct translocation across the cellular or endosomal membrane but mild zeta-potential to facilitate the high cellular internalization and endosomal escape of the gene cargos as well as scarcely Kupffer cells uptake. More importantly, PDPIA afforded preferential liver accumulation and predominant hepatocytes internalization following systemic administration, which showed pharmacologically suitable organ and sub-organ-selective properties. Subsequent studies confirmed a considerable protective role of PDPIA in a model of severe hepatitis induced by concanavalin A, evidenced by reduced hepatocellular injury and evaded immune response. The locally expressed IL-22 by PDPIA activated STAT3/Erk signal transduction, and thus promoted hepatocyte regeneration, inhibited reactive oxygen species (ROS) accumulation as well as prevented the dysfunction of mitochondrial. In addition, this system did not manifest side effects or systemic toxicity in mice. Collectively, the high versatility of PDPIA rendered its promising applications might be an effective agent to treat various hepatic disorders.

Activating Autophagy Enhanced the Antitumor Effect of Antibody Drug Conjugates Rituximab-Monomethyl Auristatin E

Background

Antibody drug conjugate (ADC) showed potent therapeutic efficacy in several types of cancers. The role of autophagy in antitumor effects of ADC remains unclear.

Methods

In this study, the ADC, Rituximab-monomethyl auristatin E (MMAE) with a Valine–Citrulline cleavable linker, was designed to investigate its therapeutic efficacy against non-Hodgkin lymphoma (NHL) as well as the underlying mechanisms. Methylthiazolyldiphenyl-tetrazolium bromide (MTT) was used to detect growth inhibition in B-cell lymphoma cell lines, Ramos and Daudi cells, which were treated by Rituximab-MMAE alone or combined with autophagy conditioner. Apoptosis was detected by flow cytometry and immunohistochemistry, and apoptosis inhibitor was employed to discover the relationship between autophagy and apoptosis during the Rituximab-MMAE treatment. Autophagy was determined by three standard techniques which included confocal microscope, transmission electron microscope, and western blots. Ramos xenograft tumors in BALB/c nude mice were established to investigate the antitumor effect of combination use of Rituximab-MMAE and autophagy conditioner in B-NHL therapy.

Results

Our results showed that Rituximab-MMAE elicited caspase-3-dependent apoptosis in NHL cells and exhibited potent therapeutic efficacy in vivo. Autophagy, which was characterized by upregulated light chain 3-II expression, and accumulation of autophagosomes, was triggered during the Rituximab-MMAE treatment. Meanwhile, inactivation of Akt/mTOR pathway was shown to be involved in the autophagy triggered by Rituximab-MMAE, indicating a probable mechanism of the ADC-initiated autophagy. Importantly, inhibition of autophagy by chloroquine suppressed the Rituximab-MMAE-induced apoptosis, while activating autophagy by rapamycin significantly enhanced the therapeutic effect of Rituximab-MMAE both in vitro and in vivo.

Conclusion

Our data elucidated the critical relationship between autophagy and apoptosis in Rituximab-MMAE-based therapy and highlighted the potential approach for NHL therapy by combined administration of the ADC and autophagy activator.

Mesoporous silica nanoparticles induced hepatotoxicity via NLRP3 inflammasome activation and caspase-1-dependent pyroptosis

Increased biomedical applications of mesoporous silica nanoparticles (MSNs) raise considerable attention concerning their toxicological effects; the toxicities of MSNs are still undefined and the underlying mechanisms are unknown. We conducted this study to determine the hepatotoxicity of continuous administration of MSNs and the potential mechanisms. MSNs caused cytotoxicity in hepatic L02 cells in a dose- and time-dependent manner. Then, MSNs were shown to elicit NOD-like receptor protein 3 (NLRP3) inflammasome activation in hepatocytes, leading to caspase-1-dependent pyroptosis, a novel manner of cell death. In vivo MSN administration triggered hepatotoxicity as indicated by increased histological injury, serum alanine aminotransferase and serum aspartate aminotransferase. Notably, NLRP3 inflammasome and pyroptosis were also activated during the treatment. Meanwhile, in NLRP3 knockout mice and caspase-1 knockout mice, MSN-induced liver inflammation and hepatotoxicity could be abolished. Furthermore, experiments indicated that MSNs induced mitochondrial reactive oxygen species (ROS) generation, and the ROS scavenger could attenuate the MSN-activated NLRP3 inflammasomes and pyroptosis in the liver. Collectively, these data suggested that MSNs triggered liver inflammation and hepatocyte pyroptosis through NLRP3 inflammasome activation, which was caused by MSN-induced ROS generation. Our study provided novel insights into the hepatotoxicity of MSNs and the underlying mechanisms, and facilitated the potential approach to increase the biosafety of MSNs.

Inhibition of autophagy potentiated the anti-tumor effects of VEGF and CD47 bispecific therapy in glioblastoma

Glioblastoma, characterized by extensive microvascular proliferation and invasive tumor growth, is one of the most common and lethal malignancies in adults. Benefits of the conventional anti-angiogenic therapy were only observed in a subset of patients and limited by diverse relapse mechanism. Fortunately, recent advances in cancer immunotherapy have offered new hope for patients with glioblastoma. Herein, we reported a novel dual-targeting therapy for glioblastoma through simultaneous blockade of VEGF and CD47 signaling. Our results showed that VEGFR1D2-SIRPαD1, a VEGF and CD47 bispecific fusion protein, exerted potent anti-tumor effects via suppressing VEGF-induced angiogenesis and activating macrophage-mediated phagocytosis. Meanwhile, autophagy was activated by VEGFR1D2-SIRPαD1 through inactivating Akt/mTOR and Erk pathways in glioblastoma cells. Importantly, autophagy inhibitor or knockdown of autophagy-related protein 5 potentiated VEGFR1D2-SIRPαD1-induced macrophage phagocytosis and cytotoxicity against glioblastoma cells. Moreover, suppression of autophagy led to increased macrophage infiltration, angiogenesis inhibition, and tumor cell apoptosis triggered by VEGF and CD47 dual-targeting therapy, thus eliciting enhanced anti-tumor effects in glioblastoma. Our data revealed that VEGFR1D2-SIRPαD1 alone or in combination with autophagy inhibitor could effectively elicit potent anti-tumor effects, highlighting potential therapeutic strategies for glioblastoma through disrupting angiogenetic axis and CD47-SIRPα anti-phagocytic axis alone or in combination with autophagy inhibition.

[Evaluation of pelvic floor function of postpartum pelvic floor ultrasound in pregnant women with multiple pregnancies]

Objective: To probe the effect of multiple pregnancy on pelvic floor function of pregnant women, Pelvic floor ultrasonography was performed on the 42 day postpartum women.And the bladder neck mobility, bladder and urethral posterior angle and pelvic diaphragmatic hiatus area were measured. Methods: Collect 200 cases 42 day postpartum women who visited the second hospital of Jilin University from July 2015 to June 2017, of which 100 cases of primipara belong to group A, 100 cases of multiple pregnancy belong to group B, and 100 cases without maternal at the same age belong to the control group, ultrasound measurement of the bladder neck mobility, bladder and urethral posterior angle and pelvic diaphragmatic hiatus area were measured.t test were proformed respectively between the three groups, P<0.05 was considered statistically significant difference. Results: In the control group, the bladder neck mobility is (2.59±0.51) cm , the bladder neck mobility in A group is (2.99±0.69) cm, the bladder neck mobility in B group is (3.36±0.71) cm; the bladder and urethral posterior angle in the control group is (112.56±13.61)°, the bladder and urethral posterior angle in the control group after Valsalva action angle is(135.37±12.17)°, the bladder and urethral posterior angle in A group is(119.26±15.80)°, the bladder and urethral posterior angle in group A after Valsalva action is(141.79±12.08)°, the bladder and urethral posterior angle in B group is(123.62±16.20)°, the bladder and urethral posterior angle in group B after Valsalva action is (148.92±13.60)°; the pelvic diaphragmatic hiatus area in the control group is (13.35±2.86) cm(2,) the pelvic diaphragmatic hiatus area in the control group after Valsalva action is(15.28±3.15) cm(2,) the pelvic diaphragmatic hiatus area in A group is(17.52±3.19) cm(2,) the pelvic diaphragmatic hiatus area in A group ater Valsalva action is (18.06±5.13_the pelvic diaphragmatic hiatus area) cm(2,) the pelvic diaphragmatic hiatus area in B group is (18.26±4.18) cm(2,) the pelvic diaphragmatic hiatus area in B group after Valsalva action is (20.3±3.53) cm(2).In group A, group B and the control group, the measured value of the bladder neck mobility, bladder and urethral posterior angle and pelvic diaphragmatic hiatus area were examined by t test, and P<0.05, which means the difference was statistically significant. Conclusion: Pregnancy can affect the function of female pelvic floor, and the effect of parturient is more significant than that of the primipara.

[Application of ultrasound guidance for fascia iliaca compartment block in pediatric femoral surgery]

Objective: To evaluate the efficacy of ultrasound guidance for fascia iliaca compartment block in pediatric femoral surgery. Methods: This study was a prospective study, thirty children who were American Society of Anesthesiologists (ASA) statusⅠ with 5-10 years old scheduled for femoral surgery were selected in orthopedics department in Second Affiliated Hospital of Wenzhou Medical University from May to December in 2014. After induction of general anesthesia, all the children were inserted the laryngeal mask. Then they were received fascia iliaca compartment block using ultrasound guidance under sevoflurane inhalation anesthesia. The indicators including heart rate(HR), mean arterial pressure(MAP), oxygen saturation(SpO(2)) and exhaled sevoflurane concentration were recorded before skin incision(T(1)), at 1, 5, 10 min after incision(T(2)-T(4))and at the end of the surgery(T(5)). Postoperative pain were assessed using the pain behavior assessment scale at awake time, 2 h and 4 h after surgery. The efficacy of postoperative analgesia and the satisfaction of parents at 2 h and 4 h after surgery were recorded. Results: The differences between HR、MAP and SpO(2) in children at T(1)-T(5) were no statistical significance (all P>0.05). Exhaled sevoflurane concentration at T(1)-T(5) were(2.50±0.51)%, (2.51±0.42)%, (2.50±0.41)%, (2.54±0.31)% and(0.61±0.20)%, respectively, the differences were statistically significant(F=13.503, P<0.05), among them that at T(5) was significantly lower than at T(1)-T(4)(all P<0.05). The pain score at awake time, 2 h and 4 h after surgery were (1.6±0.7), (3.3±1.4) and (3.9±1.3) scores, respectively. The parents satisfaction were 87% and 73% at 2 h and 4 h afer surgery respectively. Conclusion: The way of ultrasound guidance for fascia iliaca compartment block combined with general anesthesia can be safely and effectively used in pediatric femoral surgery. Using the technique of ultrasonic imaging, the fascia iliaca compartment can be directly observed and then the local anesthetics is injected, therefore the efficacy of block is improved.

[The Study of relationship between fetal radius loss and chromosomal abnormality]

Objective: To explore the relationship between fetal radius loss and chromosomal abnormalities. Methods: Collect data of 3 100 cases pregnant women who had been checked in the second hospital of Jilin University from 2012 to 2015.There were 8 cases of absent radius, except 1 case of fetal lost follow-up, the remaining 7 cases had complete ultrasound, chromosome examination and the result of induction.The relationship between fetal radius loss and chromosomal abnormalities were analysed. Results: There were 1 case of 21 trisomy syndrome, 1 case of trisomy 13 syndrome, 2 cases of trisomy 18, 2 cases of chromosome translocation, 1 case of normal chromosome result and 1 case was lost to follow-up of the 8 absent radius fetuses. Conclusion: Through a comparison between the chromosome and ultrasonic characteristics of fetuses who have absent radius, we had indicated the relationship of fetal radius deletion and chromosomal anomaly, improved the positive rate of chromosome invasion examination, and provided the reference for eugenics.

[Prenatal ultrasound diagnosis, prognosis and chromosome analysis of fetal bowel dilatation]

Objective: To investigate the relationship among the prenatal ultrasound, prognosis and chromosome results of fetal bowel dilatation. And in order to further improve the positive rate of prenatal chromosome examination operation, and reduce the risk of missed diagnosis. Methods: Ninety fetuses who were diagnosed as fetal bowel dilatation by prenatal ultrasound from June 2013 to December 2015 in the Second hospital of Jilin University were enrolled. Chromosomes were examined by amniotic cavity puncture or umbilical cord blood puncture. The change of fetus's bowel was monitored periodically by prenatal ultrasound. The normal bowel movement of newborns was a good prognosis. The abdominal X ray or barium contrast radiography was performed in the newborns who did not have normal bowel movement after delivery. Patients underwent surgery or conservative treatment after diagnosis. Fetal karyotype analysis of aborted fetus was carried out by amniotic cavity puncture and umbilical cord blood before induction of labor. Autopsy was performed after induced labor. Patients who were not continued examination in our hospital were followed up by telephone. Results: Among the 90 fetuses, there are 11 cases of duodenum dilatation, 38 cases of jejunum and ileum dilatation, 41 cases of colorectal dilatation. Ten cases of duodenum dilatation were confirmed by autopsy after induced labor, and one case was lost in follow-up. Chromosome examination revealed 3 cases of 21- three body syndrome, 1 case of 18- three body syndrome, 1 case of chromosomal translocation. In 38 cases of jejunum and ileum dilatation, bowel dilatation of 26 cases had decrease or no obvious increase with good prognosis. Six cases of induced labor, 3 cases of receive surgery after birth, 2 cases of postoperative survival, and 3 cases of loss of follow-up. Chromosome examination revealed 1 case of 21- three body syndrome and 1 case of chromosomal translocation. In 41 cases of colorectal dilatation, 29 cases had good prognosis. Five cases were aborted, 1 case of fetal death, 2 cases died within 1 month after birth, 2 cases received surgery after birth and survived after operation, and 2 cases of loss of follow-up. Conclusions: Clinical prognosis and the associated risk of chromosome abnormalities in patients with fetal bowel dilatation are different in terms of its expansion location and extent of the different, which need to a specific analysis of specific situations.

[The 2015 China Adult Tobacco Survey: exposure to second-hand smoke among adults aged 15 and above and their support to policy on banning smoking in public places]

OBJECTIVE

To understand the situation on exposure to second-hand smoke among Chinese adults aged 15 and above and their support to policy on banning smoking in public places in 2015.

METHODS

A cross-sectional survey was conducted based on the protocol on Global Adult Tobacco Survey. Stratified multi-stage cluster sampling was used to select 16 800 households in China. Data were collected through household survey, using the electronic devices. One eligible respondent was selected by random sampling in each household. Standardized questionnaire was used from Global Tobacco Surveillance System. Data were weighted and analyzed by SAS 9.3 and SUDAAN 10.0.1 complex survey data analysis program.

RESULTS

93.1% (60 128×10(3)/64 575×10(3)), 76.3% (455 473×10(3)/596 782×10(3)), 57.1% (621 793×10(3)/1 089 582×10(3)), 54.3% (218 792×10(3)/402 732×10(3)), 38.1% (61 208×10(3)/160 574×10(3)), 26.9% (119 783×10(3)/444 679×10(3)), 23.8%(17 598×10(3)/73 993×10(3)), 17.2% (41 099×10(3)/239 022×10(3)) and 16.4% (102 153×10(3)/623 015×10(3)) of the respondents reported that smoking did exsit in the following places as: inside of bars or night clubs, in the restaurants, households homes, working places, government buildings, health care facilities, universities, primary and high schools (both indoor and outdoor areas), and on public transportation, respectively. Compared with those data in 2010, the proportions of exposure to indoor areas of restaurants, government buildings, health care facilities, primary and high schools (both indoor and outdoor areas), public transportation, and homes all significantly decreased after standardization of data. RESULTS also showed that most respondents were supportive to the policy on banning smoking in public and working places. However, the proportions of exposure to indoor areas of restaurants were still high but almost 70% of the respondents thought smoking should not be allowed in indoor areas of restaurants.

CONCLUSION

From 2010 to 2015, proportions of exposure to indoor areas of public places, working places, public transportation and homes were obviously declining in China. The Chinese public seemed supportive to the policy on banning smoking in public places.

Degesting the remodeled cardiovascular wall: role of cysteinyl cathepsins in cardiovascular disease

Cardiovascular disease (CVD) is characterized by extensive remodeling of the extracellular matrix (ECM) architecture of the cardiovascular system. Among the many extracellular proteolytic enzymes present in cardiovascular cells and inflammatory cells and involved in ECM remodeling, members of the matrix metalloproteinase family and serine protease family have received the most attention. However, recent findings from laboratory and clinical studies have indicated that lysosomal cysteinyl cathepsins also participate in pathogenesis of CVD. This review summarizes recent knowledge on discoveries regarding the relationship between cysteinly cathepsins and CVD.

Effect of angiotensin II on STAT3 mediated atrial structural remodeling

OBJECTIVE

Atrial fibrillation (AF) has been identified to contribute significantly to the morbidity and mortality of cardiovascular disease patients. The atrial structural remodeling is a hallmark of AF and the molecular mechanisms underlying this remain unclear. Hence the objective of the present study is to determine the role of angiotensin II (Ang-II)/Ang-II type 1 (AT1) receptor--STAT3 signaling pathway on--atrial structural remodeling.

MATERIALS AND METHODS

The method of this study involves incubation of atrial myocytes, with Ang-II, to increase the level of apoptosis expressions by Tunel assay and the expression of apoptosis related factors like caspase 3 and 8 release of cytochrome C from mitochondria to cytosol by western blot test after OGD pre-treatment.

RESULTS

Atrial myocytes were shown to simulate the ischemia, hypoxia and atrial fibrillation. When incubated with Ang-II, (inhibited by losartan) the improvement was observed in the expression of caspase-3 and caspase-8. Ang-II also significantly promoted the transfer of cytochrome C levels from the mitochondria to the cytoplasm and this transfer was observed to be inhibited by losartan and WP1066. Ang-II incubation showed improved transcriptions of collagens and MMP expressions in atrial fibroblasts. In cultured atrial myocytes and fibroblasts, Ang-II induced tyrosine and serine phosphorylation of STAT3 showing interaction with MMP1 and MMP2 and DNA promoter sequences in atrial fibroblasts. The complete sequence was observed to have an affinity to be inhibited by losartan and WP1066.

CONCLUSIONS

Ang-II/AT1 receptor/STAT3 is an important signaling pathway in the atrial structural remodeling, Ang-II enhances the apoptosis of atrial parenchyma and deposition of atrial ECM, which might contributes to atrial fibrillation.

Icariin stimulates the proliferation of rat Sertoli cells in an ERK1/2-dependent manner in vitro

Icariin (ICA), a major constituent of flavonoids from the Chinese medical herb Epimedium brevicornum Maxim, is found to be protective for male reproductive ability, with the underlying mechanism largely unknown. Our study here investigated the effects of ICA on Sertoli cells, which act as nurse cells for the germ cells developing. Icariin was found to stimulate Sertoli cell proliferation in a dose-dependent manner. Further study revealed that Icariin induced an obvious phosphorylation of ERK in Sertoli cells. Inhibition of activation of ERK by the ERK inhibitor U0126 nearly blocked the Icariin-induced proliferation of Sertoli cells. Taken together, our results suggest that Icariin promotes the proliferation of Sertoli cells in vitro by activating the ERK1/2 signal pathway, which might at least partially, explain the protective role of Icariin on male reproductive ability.

A cross-sectional study on levels of second-hand smoke in restaurants and bars in five cities in China

OBJECTIVES

To assess indoor second-hand smoke (SHS) exposure in restaurants and bars via PM(2.5) (fine particles 2.5 μm in diameter and smaller) level measurements in five cities in China.

METHODS

The study was conducted from July to September in 2007 in Beijing, Xi'an, Wuhan, Kunming and Guiyang. Portable aerosol monitors were used to measure PM(2.5) concentrations in 404 restaurants and bars. The occupant density and the active smoker density were calculated for each venue sampled.

RESULTS

Among the 404 surveyed venues, 23 had complete smoking bans, 9 had partial smoking bans and 313 (77.5%) were observed to have allowed smoking during sampling. The geometric mean of indoor PM(2.5) levels in venues with smoking observed was 208 μg/m(3) and 99 μg/m(3) in venues without observed smoking. When outdoor PM(2.5) levels were adjusted, indoor PM(2.5) levels in venues with smoking observed were consistently significantly higher than in venues without smoking observed (F=80.49, p<0.001). Indoor PM(2.5) levels were positively correlated with outdoor PM(2.5) levels (partial rho=0.37 p<0.001) and active smoker density (partial rho=0.34, p<0.001).

CONCLUSIONS

Consistent with findings in other countries, PM(2.5) levels in smoking places are significantly higher than those in smoke-free places and are strongly related to the number and density of active smokers. These findings document the high levels of SHS in hospitality venues in China and point to the urgent need for comprehensive smoke-free laws in China to protect the public from SHS hazards, as called for in Article 8 of the Framework Convention on Tobacco Control, which was ratified by China in 2005.

A cross-sectional study on levels of secondhand smoke in restaurants and bars in five cities in China

OBJECTIVES

To assess indoor secondhand smoke (SHS) exposure in restaurants and bars via PM(2.5) level measurements in five cities in China.

METHODS

The study was conducted from July to September in 2007 in Beijing, Xi'an, Wuhan, Kunming and Guiyang. PM(2.5) concentrations were measured in 404 restaurants and bars using portable aerosol monitors. The occupant density and the active smoker density were calculated for each venue sampled.

RESULTS

Among the 404 surveyed venues, 23 had complete smoking bans, nine had partial smoking bans and 313 (77.5%) had smoking observed during sampling. The geometric mean of indoor PM(2.5) levels in venues with smoking observed was 208 μg/m(3) and 99 μg/m(3) in venues without smoking observed. When outdoor PM(2.5) levels were adjusted, indoor PM(2.5) levels in venues with smoking observed were consistently significantly higher than those in venues without smoking observed (F=80.49, p<0.001). Indoor PM(2.5) levels were positively correlated with outdoor PM(2.5) levels (partial ρ=0.37 p<0.001) and active smoker density (partial ρ=0.34, p<0.001).

CONCLUSIONS

Consistent with findings in other countries, PM(2.5) levels in smoking places are significantly higher than those in smoke-free places and are strongly related to the number and density of active smokers. These findings document the high levels of SHS in hospitality venues in China and point to the urgent need for comprehensive smoke-free laws in China to protect the public from SHS hazards, as called for in Article 8 of the Framework Convention on Tobacco Control, which was ratified by China in 2005.

Reverse transcription-polymerase chain reaction and western blotting analysis for detection of p63 isoforms in uterine cervical cancers

The aim of this study was to investigate the role of TAp63 and DeltaNp63 isoforms in uterine cervical cancers. The messenger RNA (mRNA) and protein expressions of TA and DeltaN forms as well as alpha, beta, and gamma isoforms of p63 were studied in seven SiHa, ME-180, SNU17, SNU902, SNU1160, SNU703, and SNU1299 human papillomavirus (HPV)-positive uterine cervical squamous cell carcinoma (SCC) cell lines, one HT3 HPV-negative SCC cell line, and one HeLa adenocarcinoma cell line using reverse transcription-polymerase chain reaction (RT-PCR) and western blotting. Fresh nonneoplastic and neoplastic tissues of uterine cervical and endometrial cancers were also studied. RT-PCR for TA and DeltaN form and three isoforms of p63 showed positive bands for both TA and DeltaN forms and for all three isoforms in cervical cancer cell lines but weak band for alpha isoform in HPV-negative HT3 SCC cell line and no band for beta isoform in HeLa adenocarcinoma cell line. RT-PCR for TA and DeltaN and three isoforms of p63 mRNA in tissue samples showed positive bands in almost all samples, except for gamma isoform, the expression was weak or absent in nonneoplastic tissues compared with neoplastic tissues. In western blotting, cancer cell lines and both nonneoplastic and neoplastic tissue samples showed expression of TA and DeltaN, and gamma isoform but beta isoform expression with or without alpha isoform was only found in cancer cell lines and neoplastic tissues. beta isoform, possibly of DeltaNp63, may be considered as an important isoform in uterine cervical squamous cell carcinogenesis.

[A computer-aided analysis system for counting the synaptic numerical density based on disector technique]

The change in the numbers of synapse is of importance in various kinds of physiological and pathological processes. The numerical density is the structural parameter measuring up the numbers of the particles in the space. A new stereological technique, the disector technique, has been described to count the number of particles in a given volume of tissue. It is a technique for counting the number of arbitrary particles in 3-dimensional space using adjacent parallel sections at known distance apart. In this article also discussed is the software for computer assisted count of the synaptic numerical density based on the physical director technique with Visual Basic 4.0.

A new complex of palladium-thiourea and carbon tetrabromide catalyzed carbonylative annulation of o-hydroxylarylacetylenes: efficient new synthetic technology for the synthesis of 2,3-disubstituted benzo[b]furans

[reaction: see text] A highly effective cocatalysis system (PdI2-thiourea and CBr4) was developed for carbonylative cyclization of both electron-rich and electron-deficient o-hydroxylarylacetylenes to the corresponding methyl benzo[b]furan-3-carboxylates.

[The effect of serum TGFb1 of patients with chronic hepatitis B in liver fibrosis formation]

OBJECTIVES

To observe the relation between serum transforming growth factor beta 1(TGF beta 1) and level of PCIII, LN, HA, proliferation of hepatic fibrotic tissue.

METHODS

Serum TGF beta 1 was detected by ELISA in 58 patients with chronic hepatitis B(CHB) and 18 patients with liver cirrhosis(LC). 20 healthy persons served as normal control(NC). Liver puncture was performed in 29 patients with CHB. Diagnosis of pathological histology and quantitative analysis of collagenous and reticular fibers were made.

RESULTS

(1)Serum TGF beta 1 levels in CHB and LC were notably higher than in NC (P < 0.01) and increased successively in mild, moderate and severe degrees of CHB and LC(P < 0.01/0.05). (2)Serum TGF beta 1 was correlated with serum levels of PCIII, LN, HA(P < 0.01/0.05)positively. The quantity of hepatic collagenous and reticular fibers went up in mild, moderate and severe degrees of CHB(P < 0.01/0.05). Meanwhile serum TGF beta 1 rose at the same degree.

CONCLUSION

Serum TGF beta 1 levels increase in CHB and LC. With hepatic pathological change worsening, serum TGF beta 1 and the quantity of hepatic collagenous and reticular fibers increased to the same degree. This suggests that TGF beta 1 is a crucial factor in accelerating liver fibrosis and plays a decisive role in liver fibrosis.

Effects of some 7-arylidene and 7-heteroarylidene morphinan-6-ones on the antinociceptive activity of [D-Pen2, D-Pen5]enkephalin and [D-Ala2, Glu4]deltorphin II and on multiple opioid receptors

The in vivo and functional effects of several 7-arylidene and 7-heteroarylidene morphinan-6-ones were determined at the mu-, delta-, and kappa-opioid receptors using the guinea pig brain membranes, guinea pig ileum (GPI), and mouse vas deferens (MVD). In vivo effects included the antagonism by these compounds given subcutaneously on the antinociceptive actions of intracerebroventricularly injected [D-Pen2, D-Pen5]enkephalin (DPDPE) and [D-Ala2, Glu4]deltorphin II (deltorphin II), the highly selective putative delta 1- and delta 2-opioid receptor agonists. Finally, the partition coefficients of these compounds were estimated (CLOGP) and determined experimentally at pH 7.4 in the 1-octanol/water system. Compared with E-7-benzylidenenaltrexone (BNTX), most compounds except for E-7-(4-chlorobenzylidene)naltrexone, were more potent at delta-opioid receptors than at the mu-opioid receptor, whereas, in comparison to the kappa-opioid receptor, the activities of the E-7-arylidene or E-7-heteroarylidene naltrexone derivatives at the delta-receptor were in the following order, where the 7-substituents were: 4-fluorobenzylidene- > benzylidene > 3-pyridylmethylene- > 4-pyridylmethylene- > 1-methyl-2-imidazolylmethylene > 4-chlorobenzylidene. In the MVD preparation, the potencies at the delta-opioid receptor, in comparison to BNTX, were in the following order, where the 7-substituents were: benzylidene = 1-methyl-2-imidazolylmethylene- > 4-fluorobenzylidene- = 3-pyridylmethylene- = 4-pyridylmethylene-. All compounds antagonized delta 1, and delta 2-opioid receptor agonist-induced analgesia. The antagonist potencies at the delta 1-opioid receptor were in the following order, where the 7-substituents were: benzylidene- > 4-chlorobenzylidene- > 4-fluorobenzylidene- > 3-pyridylmethylene- > 1-methyl-2-imidazolymethylene- approximately 4-pyridylmethylene-, whereas at the delta 2-opioid receptor, the order was benzylidene- > 4-chlorobenzylidene- > 4-fluorobenzylidene- > 3-pyridylmethylene- > 1-methyl-2-imidazolymethylene- > 4-pyridylmethylene. In general, all compounds exhibited greater potency at the delta 2- than delta 1-opioid receptor. The computed partition coefficients were, as expected, greater than the apparent log P values, which were determined experimentally. Generally, the lipophilicity values in decreasing order were: 4-chlorobenzylidene- > 4-fluorobenzylidene- > benzylidene > 3-pyridylmethylene- = 4-pyridylmethylene- > 1-methyl-2-imidazolylmethylene-. In general, the benzylidene and 4-pyridylmethylene derivatives, which have medium lipophilicities, were equally effective at the delta 1- and delta 2-receptors; the 3-pyridylmethylene and 1-methyl-2-imidazolylmethylene derivatives had lower lipophilicities and were more selective for the delta 2- than delta 1-receptor; the 4-chlorobenzylidene and 4-fluorobenzylidene derivatives were more lipophilic and had intermediate activity. The plot of pED50 values for the in vivo tests for the delta 1- and delta 2-receptors showed that the two receptors are not independent with respect to this series of compounds.

A dietary survey of the Chinese population in urban and rural areas of Tianjin

OBJECTIVES

A survey was carried out to assess the food pattern and of nutrient intakes of 15-64 year old Chinese in Tianjin.

DESIGN

The survey was randomised and the diet assessed by weighing household food items and by individual food records over 3 consecutive days.

SETTING

The survey was carried out in Tianjin; the third largest city in China (population about 8 million).

SUBJECTS

A random stratified multi-level cluster sampling technique was used. Of the 5233 eligible subjects, 207 dropped out, and the response rate was 96%.

RESULTS

Distinct differences in dietary patterns and nutrient intakes were found between subjects living in urban and rural areas. The diet of urban people was richer in fat and high quality protein compared with that of rural people. Energy intake from fat was about 31% in the urban diet and about 21% in the rural diet. Low intakes of vitamin A, riboflavin, calcium and zinc were found in both areas, with the situation being worse in the rural areas. Sodium intake was found to be high in both areas. Cholesterol intake was much higher among urban people.

CONCLUSION

The present survey revealed that the intake of some nutrients was lower than recommended and that total sodium intake was very high in Tianjin. An integrated nutrition intervention program would appear necessary for such a population.

Dietary sodium and potassium, socioeconomic status and blood pressure in a Chinese population

The average total intake of sodium was 6.11 g in a Chinese urban diet and 6.49 g in the rural sample in China. Discretionary use of salt provided 53% of the total sodium intake in the urban and 63% in the rural diet. Sodium intakes derived from processed foods, soy sauce and monosodium glutamate were 17%, 16% and 6% respectively in the urban diet, and 4%, 16%, 2% respectively in the rural diet. The mean intake of potassium was 1.95 g in the urban and 1.83 g in the rural diet. Cereals and vegetables were the major sources of dietary potassium. The intakes of total sodium, salt and soy sauce decreased as educational level increased. Similar results were found in white-collar workers and blue-collar workers or farmers. Nevertheless, an inverse association between blood pressure and education was found. The results suggest that reduction in sodium intake, especially cooking salt, and increased potassium intake are needed for nutritional control of hypertension in population-based interventions aimed at all social classes.