Bisphenol Z exposure inhibits oocyte meiotic maturation by rupturing mitochondrial function

The use of bisphenol A (BPA) has been restricted due to its endocrine-disrupting effects. As a widely used alternative to BPA today, environmental levels of bisphenol Z (BPZ) continue to rise and accumulate in humans. Oocyte quality is critical for a successful pregnancy. Nevertheless, the toxic impacts of BPZ on the maturation of mammalian oocytes remain unexplored. Therefore, the impacts of BPZ and BPA on oocyte meiotic maturation were compared in an in vitro mouse oocyte culture model. Exposure to 150 μM of both BPZ and BPA disrupted the assembly of the meiotic spindle and the alignment of chromosomes, and BPZ exerted stronger toxicological effects than BPA. Furthermore, BPZ resulted in aberrant expression of F-actin, preventing the formation of the actin cap. Mechanistically, BPZ exposure disrupted the mitochondrial localization pattern, reduced mitochondrial membrane potential and ATP content, leading to impaired mitochondrial function. Further studies revealed that BPZ exposure resulted in oxidative stress and altered expression of genes associated with anti-oxidative stress. Moreover, BPZ induced severe DNA damage and triggered early apoptosis in oocytes, accompanied by impaired lysosomal function. Overall, the data in this study suggest that BPZ is not a safe alternative to BPA. BPZ can trigger early apoptosis by affecting mitochondrial function and causing oxidative stress and DNA damage in oocytes. These processes disrupt cytoskeletal assembly, arrest the cell cycle, and ultimately inhibit oocyte meiotic maturation.

Triphenyltin chloride exposure inhibits meiotic maturation of mouse oocytes by disrupting cytoskeleton assembly and cell cycle progression

Triphenyltin chloride (TPTCL) is widely used in various industrial and agricultural applications. This study aimed to elucidate the mechanisms underlying the toxicological effects of TPTCL on oocytes. The obtained findings revealed that TPTCL exposure reduced polar body extrusion (PBE) and induced meiotic arrest. Mechanistically, TPTCL disrupted meiotic spindle assembly and chromosome alignment. Further analysis indicated a significant decrease in p-MAPK expression, and disturbances in the localization of Pericentrin and p-Aurora A in TPTCL exposed oocytes, which suggesting impaired microtubule organizing center (MTOC)function. Moreover, TPTCL exposure enhance microtubule acetylation and microtubule instability. Therefore, the spindle assembly checkpoint (SAC) remained activated, and the activity of the anaphase-promoting complex (APC) was inhibited, thereby preventing oocytes from progressing into the entering anaphase I (AI) stage. TPTCL exposure also augmented the actin filaments in the cytoplasm. Notably, mitochondrial function appeared unaffected by TPTCL, as evidenced indicated by stable mitochondrial membrane potential and ATP content. Furthermore, TPTCL treatment altered H3K27me2, H3K27me3 and H3K9me3 levels, suggesting changes in epigenetic modifications in oocytes. Taken together, our results suggest that TPTCL disrupts cytoskeleton assembly, continuously activates SAC, inhibits APC activity, and blocks meiotic progression, ultimately impair oocyte maturation.

[Dosimetric analysis of different optimization algorithms for three-dimensional brachytherapy for gynecologic tumors]

OBJECTIVE

To investigate the dosimetric difference between manual and inverse optimization in 3-dimensional (3D) brachytherapy for gynecologic tumors.

METHODS

This retrospective study was conducted among a total of 110 patients with gynecologic tumors undergoing intracavitary combined with interstitial brachytherapy or interstitial brachytherapy. Based on the original images, the brachytherapy plans were optimized for each patient using Gro, IPSA1, IPSA2 (with increased volumetric dose limits on the basis of IPSA1) and HIPO algorithms. The dose-volume histogram (DVH) parameters of the clinical target volume (CTV) including V200, V150, V100, D90, D98 and CI, and the dosimetric parameters D2cc, D1cc, and D0.1cc for the bladder, rectum, and sigmoid colon were compared among the 4 plans.

RESULTS

Among the 4 plans, Gro optimization took the longest time, followed by HIPO, IPSA2 and IPSA1 optimization. The mean D90, D98, and V100 of HIPO plans were significantly higher than those of Gro and IPSA plans, and D90 and V100 of IPSA1, IPSA2 and HIPO plans were higher than those of Gro plans (P < 0.05), but the CI of the 4 plans were similar (P > 0.05). For the organs at risk (OARs), the HIPO plan had the lowest D2cc of the bladder and rectum; the bladder absorbed dose of Gro plans were significantly greater than those of IPSA1 and HIPO (P < 0.05). The D2cc and D1cc of the rectum in IPSA1, IPSA2 and HIPO plans were better than Gro (P < 0.05). The D2cc and D1cc of the sigmoid colon did not differ significantly among the 4 plans.

CONCLUSION

Among the 4 algorithms, the HIPO algorithm can better improve dose coverage of the target and lower the radiation dose of the OARs, and is thus recommended for the initial plan optimization. Clinically, the combination of manual optimization can achieve more individualized dose distribution of the plan.

Neddylation inhibition affects early embryonic development by disrupting maternal-to-zygotic transition and mitochondrial function in mice

Post-translational modifications (PTMs) are critical for early development in mice because early cleavage-stage embryos are characterized by transcriptional inactivity. Neddylation is an important ubiquitin-like PTM that regulates multiple biophysical processes. However, the exact roles of neddylation in regulating early embryonic development remain largely unknown. In the present study, we found that inhibition of neddylation by specific inhibitor MLN4924 led to severe arrest of early embryonic development. Transcriptomic analysis showed that neddylation inhibition changed the expression of 3959 genes at the 2-cell stage. Importantly, neddylation inhibition blocked zygotic genome activation and maternal mRNA degradation, thus disrupting the maternal-to-zygotic transition. Moreover, inhibition of neddylation induced mitochondrial dysfunction including aberrant mitochondrial distribution, decreased mitochondrial membrane potential, and reduced ATP content. Further analysis showed that inhibition of neddylation resulted in the accumulation of reactive oxygen species and superoxide anion, thereby resulting in oxidative stress and severe DNA damage at the 2-cell stage. Overall, this study demonstrates that neddylation is vital for early embryonic development in mice. Our findings suggest that proper neddylation regulation is essential for the timely inter-stage transition during early embryonic development.

Carbendazim exposure inhibits mouse oocytes meiotic maturation in vitro by destroying spindle assembly

Successful fertilization and early embryonic development heavily depend on the quality of the oocytes. Carbendazim (CBZ), a broad-spectrum fungicide, is widely available in the environment and has adverse effects on organisms. The present study focused on exploring the potential reproductive toxicity of CBZ exposure by investigating its effects on the maturation of mouse oocytes. The results demonstrated that although no disruptions were observed in the G2/M stage transition for meiosis resumption, CBZ did hinder the polar body extrusion (PBE) occurring during oocyte maturation. Cell cycle distribution analysis revealed that CBZ exposure interfered with the meiotic process, causing oocytes to be arrested at the metaphase I (MI) stage. The subsequent investigation highlighted that CBZ exposure impeded the spindle assembly and chromosomal alignment, which was linked to a decline in the level of p-MAPK. Additionally, CBZ exposure adversely affected the kinetochore-microtubule (K-MT) attachment, leading to the persistent activation of the spindle-assembly checkpoint (SAC). The study further noticed a substantial rise in the acetylation of α-tubulin and a reduction in spindle microtubule stability in CBZ-treated oocytes. In addition, the distribution pattern of estrogen receptor alpha (ERα) was altered in oocytes treated with CBZ, with abnormal aggregation on the spindles. CBZ exposure also resulted in altered histone modifications. A notable finding from this research was that the meiotic maturation of some oocytes remained unaffected even after CBZ treatment. However, during the ensuing metaphase II (MII) stage, these oocytes displayed anomalies in their spindle morphology and chromosome arrangement and diminished ability to bind to the sperm. The observations made in this study underscore the potential for CBZ to disrupt the meiotic maturation of oocytes, leading to a decline in the overall quality of oocytes.

[Electroencephalographic microstates in vestibular schwannoma patients with tinnitus]

OBJECTIVE

To explore the biomarkers of tinnitus in vestibular schwannoma patients using electroencephalographic (EEG) microstate technology.

METHODS

The EEG and clinical data of 41 patients with vestibular schwannoma were collected. All the patients were evaluated by SAS, SDS, THI and VAS scales. The EEG acquisition time was 10-15 min, and the EEG data were preprocessed and analyzed using MATLAB and EEGLAB software package.

RESULTS

Of the 41 patients with vestibular schwannoma, 29 patients had tinnitus and 12 did not have tinnitus, and their clinical parameters were comparable. The average global explanation variances of the non-tinnitus and tinnitus groups were 78.8% and 80.1%, respectively. The results of EEG microstate analysis showed that compared with those without tinnitus, the patients with tinnitus had an increased frequency (P=0.033) and contribution (P=0.028) of microstate C. Correlation analysis showed that THI scale scores of the patients were negatively correlated with the duration of microstate A (R=-0.435, P=0.018) and positively with the frequencies of microstate B (R=0.456, P=0.013) and microstate C (R=0.412, P=0.026). Syntax analysis showed that the probability of transition from microstate C to microstate B increased significantly in vestibular schwannoma patients with tinnitus (P=0.031).

CONCLUSION

EEG microstate features differ significantly between vestibular schwannoma patients with and without tinnitus. This abnormality in patients with tinnitus may reflect the potential abnormality in the allocation of neural resources and the transition of brain functional activity.

Lactational exposure to Deoxynivalenol causes mammary gland injury via inducing inflammatory response and impairing blood-milk barrier integrity in mice

Lactation is a unique physiological process to produce and secrete milk. Deoxynivalenol (DON) exposure during lactation has been demonstrated to affect adversely the growth development of offspring. However, the effects and potential mechanism of DON on maternal mammary glands remain largely unknown. In this study, we found the length and area of mammary glands were significantly reduced after DON exposure on lactation day (LD) 7 and LD 21. RNA-seq analysis results showed that the differentially expressed genes (DEGs) were significantly enriched in acute inflammatory response and HIF-1 signaling pathway, which led to an increase of myeloperoxidase activity and inflammatory cytokines. Furthermore, lactational DON exposure increased blood-milk barrier permeability by reducing the expression of ZO-1 and Occludin, promoted cell apoptosis by upregulating the expression of Bax and cleaved Caspase-3 and downregulating the expression of Bcl-2 and PCNA. Additionally, lactational DON exposure significantly decreased serum concentration of prolactin, estrogen, and progesterone. All these alterations eventually resulted in a decrease of β-casein expression on LD 7 and LD 21. In summary, our findings indicated that lactational exposure to DON caused lactation-related hormone disorder and mammary gland injury induced by inflammatory response and blood-milk barrier integrity impairment, ultimately resulting in lower production of β-casein.

[Treatment of orbital vascular malformations with intralesional bleomycin injection and N-butyl-2-cyanoacrylate glue embolization]

Objective: To evaluate the clinical efficacy of bleomycin lavage combined with N-butyl-2-cyanoacrylate glue embolization and resection in the treatment of orbital vascular malformations. Methods: It was a retrospective case series study. Patients with orbital vascular malformations diagnosed at the Ophthalmology Division of Chinese PLA General Hospital from January 2018 to October 2021 were included and divided into exophthalmos group and non-exophthalmos group based on whether the patients had postural exophthalmos. Intralesional bleomycin injection and N-butyl-2-cyanoacrylate glue embolization were performed. The preoperative and postoperative visual acuity, the dosages of bleomycin and isobutyl cyanoacrylate glue, pathological results, imaging findings and remission rate were recorded and analyzed. The Chi-square test, Wilcoxon signed rank analysis and Mann-Whitney U test were used for statistical analysis. Results: A total of 58 patients (58 eyes)were included, and there were 22 males (37.9%)　and 36 females (62.1%). Nineteen (32.8%) patients had postural exophthalmos, and 39 (67.2%) patients did not suffer postural exophthalmos. The patient's age of the two groups was 39.0 (28.0, 54.5) years vs. 14.0 (5.7, 26.5) years, with a statistically significant difference (Z=-3.96, P<0.001). There was no significant difference in gender, eye laterality, follow-up time and the disease course between the two groups (all P>0.05). During the operation, the dosage of bleomycin was 15 000 (13 500, 15 000) U in the exophthalmos group, and 15 000 (9 000, 16 500) U in the non-exophthalmos group (Z=-0.70, P=0.944). The dosages of N-butyl-2-cyanoacrylate glue were 2.8 (1.0, 3.0) ml and 1.7 (1.0, 2.2) ml, respectively, in the two groups, with no significant difference (Z=-1.11, P=0.268). There was no visual impairment in both groups, while the visual acuity in 5 patients without postural exophthalmos was improved postoperatively. The imaging examination results showed no difference in the malformed vascular area before and after the treatment in the exophthalmos group [384.0 (329.0, 458.0) mm² vs. 330.5 (271.6, 356.7) mm²; Z=-1.26, P=0.208], but a significantly decreased area after the treatment in the non-exophthalmos group [960.8 (822.1, 1058.3) mm² vs. 311.6 (164.6, 361.6) mm²; Z=-2.67, P=0.008]. All patients had no obvious local or systemic adverse reactions during the follow-up. The pathology reports showed vascular malformations in all 15 specimens obtained from the exophthalmos group, as well as vascular malformations in 41.0% (16/39) of specimens and venous lymphatic malformations in 59.0% (23/39) of specimens from the non-exophthalmos group. Thirty-nine patients had complete remission (67.2%), 19 patients had partial remission (32.8%), and the effective treatment rate was 100%. Conclusion: Bleomycin lavage combined with N-butyl-2-cyanoacrylate glue embolization can achieve good therapeutic effects on orbital vascular malformations.

Protective Effect and Mechanism of Melatonin on Cisplatin-Induced Ovarian Damage in Mice

Chemotherapeutics' development has enhanced the survival rate of cancer patients; however, adverse effects of chemotherapeutics on ovarian functions cause fertility loss in female cancer patients. Cisplatin (CP), an important chemotherapeutic drug for treating solid tumors, has adversely affected ovarian function. Melatonin (MT) has been shown to have beneficial effects on ovarian function owing to its antioxidative function. In this research, an animal model was established to explore the effect of MT on CP-induced ovarian damage. Immunohistochemical analysis and Western blot were also used to explore its mechanism. This study reported that MT protects mouse ovaries from CP-induced damage. Specifically, MT significantly prevented CP-induced ovarian reserve decline by maintaining AMH and BMP15 levels. We also found that MT ameliorated CP-induced cell cycle disorders by up-regulating CDC2 expression, and inhibited CP-induced ovarian inflammation by decreasing IL-1β and IL-18 levels. Moreover, MT protected the ovary from CP-induced mitochondrial damage, as reflected by restoring mitochondria-related protein expression. Furthermore, CP caused ovarian apoptosis, as indicated by up-regulated BAX expression. MT was also shown to activate the MAPK pathway. Our results showed that MT could ameliorate ovarian damage induced by CP, implying that MT may be a viable alternative to preserve female fertility during CP chemotherapy.

[Comparison of time series and case-crossover analyses in environmental epidemiology]

Time-series and case-crossover are two main study designs in environmental epidemiology. However, due to the differences in design principles and model construction between the two analyses, the results of the two analyses may not be consistent. Herein, we examined the short-term effect of cold spells on cardiovascular mortality in Nanjing using both time series and case-crossover analyses, aiming to provide a basis for the selection of appropriate research design in environmental epidemiology.

Deoxynivalenol exposure inhibits biosynthesis of milk fat and protein by impairing tight junction in bovine mammary epithelial cells

Deoxynivalenol (DON) is one of the most common feed contaminants, and it poses a serious threat to the health of dairy cows. The existing studies of biological toxicity of DON mainly focus on the proliferation, oxidative stress, and inflammation in bovine mammary epithelial cells, while its toxicity on the biosynthesis of milk components has not been well documented. Hence, we investigated the toxic effects and the underlying mechanism of DON on the bovine mammary alveolar cells (MAC-T). Our results showed that exposure to various concentrations of DON significantly inhibited cell proliferation, induced apoptosis, and altered the cell morphology which was manifested by cell distortion and shrinkage. Moreover, the transepithelial electrical resistance (TEER) values of MAC-T cells exposed to DON were gradually decreased in a time- and concentration- dependent manner, but lactate dehydrogenase (LDH) leakage was significantly increased with the maximum increase of 2.4-fold, indicating the cell membrane and tight junctions were damaged by DON. Importantly, DON significantly reduced the synthesis of β-casein and lipid droplets, along with the significantly decreases of phospho-mTOR, phospho-4EBP1, phospho-JAK2, and phospho-STAT5. Gene expression profiles showed that the expressions of several genes related to lipid synthesis and metabolism were changed, including acyl-CoA synthetase short-chain family member 2 (ACSS2), fatty acid binding protein 3 (FABP3), 3-hydroxy-3-methylglutaryl-CoA synthase 1 (HMGCS1), and insulin-induced gene 1 (INSIG1). GO and KEGG enrichment analyses revealed that the differentially expressed genes (DEGs) were significantly enriched in ribosome, glutathione metabolism, and lipid biosynthetic process, which play important roles in the toxicological process induced by DON. Taken together, DON affects the proliferation and functional differentiation of MAC-T cells, which might be related to the cell junction disruption and morphological alteration. Our data provide new insights into functional differentiation and transcriptomic alterations of MAC-T cells after DON exposure, which contributes to a comprehensive understanding of DON-induced toxicity mechanism.

Model Selection for the Preclinical Development of New Drug-Radiotherapy Combinations

Radiotherapy plays an essential role in the treatment of more than half of all patients with cancer. In recent decades, advances in devices that deliver radiation and the development of treatment planning software have helped radiotherapy attain precise tumour targeting with minimal toxicity to surrounding tissues. Simultaneously, as more targeted drug therapies are being brought into the market, there has been significant interest in improving cure rates for cancer by adding drugs to radiotherapy to widen the therapeutic window, the difference between normal tissue toxicity and treatment efficacy. The development of new combination therapies will require judicious adaptation of preclinical models that are routinely used for traditional drug discovery. Here we highlight the strengths and weaknesses of each of these preclinical models and discuss how they can be used optimally to identify new and clinically beneficial drug-radiotherapy combinations.

Analysis of risk factors and prognosis of post-stroke pulmonary infection in integrated ICU

OBJECTIVE

The incidence of SAP (stroke-associated pneumonia) is high in integrated ICU (Intensive Care Unit), and it might result in sepsis, which exacerbates the clinical outcome and increases mortality. It is necessary to investigate the epidemiological features of post-stroke infection and sepsis, identify the risk factors and analyze the prognosis.

PATIENTS AND METHODS

We retrospectively analyzed the data of 329 patients with cerebral infarction or cerebral hemorrhage, from seven tertiary university hospitals in Suzhou, Jiangsu Province, between January 1, 2016, and December 31, 2016. Basic demographic and clinical data including common health evaluation, stroke severity, microbiological parameters, surgical interventions and treatments were recorded for the analysis. SAP was diagnosed according to the criteria and recommendation from American Heart Association (AHA).

RESULTS

188 (66.4%) patients suffered pneumonia, 124 patients were diagnosed as SAP. Compared with SAP, patients with non-SAP pulmonary infection had prolonged mechanical ventilation time, prolonged central venous catheter indwelling time, and higher incidence of sepsis (17.7% vs. 48.4%). 53 patients (18.7%) developed sepsis during hospitalization, whose mortality rate during hospitalization and the occurrence of neurologic dysfunction at 3 months were significantly increased (p<0.05). 130 positive results of sputum cultures were found. The detected pathogens were mainly gram-negative bacteria. The pathogenic detection rate of non-SAP patients with pulmonary infection was higher (78.1%). The in-hospital mortality was 16.3% and the related risk factors were higher NIHSS score at admission, lower GCS score at admission, pulmonary infection (especially non-SAP pulmonary infection) and sepsis during hospitalization.

CONCLUSIONS

The incidence of pulmonary infection after stroke in the integrated ICU is high, and it is easy to be complicated with sepsis, prolonging the mechanical ventilation time, central venous catheter indwelling time and hospitalization time, and the prognosis of long-term neurological function is relatively poor. The definition of stroke-associated pneumonia has implications for the classification of clinical infections, the prediction of possible pathogenic pathogens, and the guidance of anti-infective treatment.

MiR-16 inhibits proliferation of cervical cancer cells by regulating KRAS

OBJECTIVE

The aim of this study was to explore the effects of micro ribonucleic acid (miR)-16 on the proliferation and apoptosis of cervical cancer (CC) cells and its related regulatory mechanism.

MATERIALS AND METHODS

The downstream regulatory targets of miR-16 were analyzed based on the miRNA online database. HCC94 cells were selected as experimental objects. Subsequently, the cells were transfected with miR-16 mimic (miR-16 mimic group), miR-16 small interfering RNA (siRNA) (miR-16 siRNA group) and only Lipofectamine 2000 transfection reagent [blank control group and miR-16 normal control (NC) group]. The expression level of miR-16 in HCC94 cells was measured via quantitative reverse transcription-polymerase chain reaction (qRT-PCR). Cell counting kit-8 (CCK-8) assay, 5-Ethynyl-2'-deoxyuridine (EdU) staining assay and flow cytometry were then conducted to detect the effects of miR-16 on the viability, proliferation and apoptosis of HCC94 cells, respectively. Additionally, the effect of miR-16 on the protein expression level of Kirsten rat sarcoma viral oncogene homolog (KRAS) in HCC94 cells was determined via Western blotting.

RESULTS

MiRNA online database analysis showed that KRAS was the downstream target of miR-16. Compared with miR-16 NC group, the viability and proliferation ability of HCC94 cells increased significantly in miR-16 siRNA group but decreased significantly in miR-16 mimic group (p<0.05). However, the apoptosis rate evidently declined in miR-16 siRNA group while increased remarkably in miR-16 mimic group (p<0.05). In addition, the protein expression level of KRAS in HCC94 cells was significantly higher in miR-16 siRNA group but significantly lower in miR-16 mimic group when compared with miR-16 NC group (p<0.05).

CONCLUSIONS

MiR-16 is lowly expressed in HCC94 cells. Moreover, highly expressed miR-16 represses the viability and proliferation of HCC94 cells and promotes their apoptosis by targeted regulation on KRAS.

A184 INCIDENCE OF VENOUS THROMBOTIC EVENTS AND RISK FACTORS IN CHILDREN HOSPITALIZED WITH INFLAMMATORY BOWEL DISEASE: A RETROSPECTIVE, CASE-CONTROL STUDY

Background

Limited research has been published to describe the incidence of venous thromboembolism (VTE) and relevant risk factors in Canadian children with inflammatory bowel disease (IBD).

Aims

The present study aimed to investigate the incidence of VTE amongst hospitalized pediatric IBD patients over a 10-year period and identify risk factors for the development of VTE.

Methods

A retrospective, matched case-control study was performed at McMaster Children’s Hospital. Hospitalized pediatric patients with IBD (&lt;18 years old) from September 2009 to August 2020 were selected. Inpatient data was extracted from the medical record database, including baseline demographic data, thromboembolic events and potential risk factors for VTE.

Results

There were 890 hospitalizations of IBD patients during the study period. 15 (1.69%) were diagnosed with a VTE, including 4 males and 11 females (mean age 13.4±2.9 years old). 12 ulcerative colitis (UC) (80%) and 3 Crohn’s disease (CD) (20%) hospitalizations were comprised in the VTE group. There was a significant difference in VTE rate between females (2.7%) and males (0.8%) (P = 0.03). The VTE rate in the UC group (4.2%) was significantly higher than in the CD group (0.6%) (P = 0.001). The incidence of VTE amongst hospitalized IBD patients did not vary over the 10-year period (P = 0.496). Length of stay in hospital, albumin level and central venous catheter were shown to be significantly different, although they were not identified as independent risk factors (P &gt;0 .05). Of the 15 hospitalizations with VTE, 6/15 (40%) were superficial VTEs in the extremities and 9/15 (60%) had a deep vein thrombosis (DVT) including 6 in the extremities and 3 in the abdomen. VTEs were associated with a peripheral line in 7 patients and with a PICC line in 4 hospitalizations. 2 of 9 (22%) with extremity DVT developed symptomatic pulmonary embolism. An inherited thrombotic condition was identified in 2 of 15 with VTEs. 12/15 (80%) with VTEs were symptomatic and all VTE related symptoms happened in patients with extremity thrombosis and pulmonary embolism. 7 of 15 (47%) VTEs were treated with anticoagulation therapy for 1–6 months. VTE related symptoms and repeat imaging tests significantly improved, and no patient developed a bleeding complication as a result of treatment.

Conclusions

The VTE rate in pediatric IBD patients was relatively low at McMaster Children’s hospital. Children with VTE were disproportionately females with ulcerative colitis compared with children with no VTE. Central venous line insertion may be correlated with the risk for VTE in children with IBD. Most VTEs and related symptoms happened in patients with extremity thrombosis and secondary pulmonary embolus. Anticoagulation therapy in children with IBD with active disease appears to be safe.

Funding Agencies

Kids Dig Health Funding from McMaster Children’s Hospital, McMaster University

Supplemental iodine-containing prenatal multivitamins use and the potential effects on pregnancy outcomes in a mildly iodine-deficient region

PURPOSE

The use and contribution of prenatal multivitamins (PMV) as iodine source for pregnant women in China, especially in mildly iodine-deficient region, have not been well studied. This study aimed to explore the association between PMV intake during pregnancy and thyroid function in mothers and newborns.

METHODS

We performed a study involving women with a history of taking PMV during pregnancy between January 2013 and October 2015, in Shanghai, a mildly iodine-deficient region. Maternal thyroid function in early and late pregnancy, and neonatal TSH on postnatal d 3 were obtained from medical records. We compared the outcomes in pregnant women who took exclusively iodine-containing PMV (I + PMV) with those who took exclusively non-contained PMV (I- PMV). Propensity score matching (PSM) was used to identify women with similar baseline characteristics.

RESULTS

After PSM, 1280 women in I + PMV and 2560 in I- PMV had similar propensity scores and were included in the analyses. Introduction of I + PMV to women was associated with slightly higher maternal thyroid hormone production (higher maternal FT4, p = 0.01, non-significantly lower TSH, p = 0.79) and lower neonatal TSH levels (p < 0.0001). The frequency of adverse pregnancy outcomes or thyroid dysfunctions did not differ between groups in late pregnancy. Mothers received I + PMV (0.2 SD) had a stronger association of maternal TSH with neonatal TSH than those who received I- PMV (0.1 SD). These effects were only shown in TPOAb-negative mothers, not in TPOAb-positive mothers.

CONCLUSION

TPOAb-positive women display an impaired iodine transport in thyroid and placenta, and this may explain the lack of changes in maternal and neonatal thyroid parameters with I + PMV supplementation in these women. This phenomenon might suggest that these women require different iodine doses or treatment approach in comparison with TPOAb-negative women.

[Consistency of effective orifice area of prosthetic mitral valve estimated using 2-dimensional and 3-dimensional transesophageal echocardiography]

OBJECTIVE

To analyze the consistency of effective orifice area (EOA) of prosthetic mitral valve estimated using 2- dimensional (2D) and 3-dimensional (3D) transesophageal echocardiography (TEE).

OBJECTIVE

This study was conducted among 34 patients undergoing mitral valve replacement surgery in Nanjing First Hospital between March and June in 2019. The diameter of the left ventricular outflow tract (LVOT) measured by 2D-TEE was used to calculate the cross sectional area of LVOT (CSALVOT). In 3D-TEE method, LVOT area was measured directly by planimetry on an enface view. The EOAs of the prosthetic mitral valve were calculated for both methods using the continuity equation. Bland-Altman plot consistency test was used to analyze the consistency between the two sets of EOA results, and linear regression analysis was used to analyze their correlation.

OBJECTIVE

The EOA of the prosthetic mitral valve differed significantly between 2D method and 3D method (2.22±0.71 cm² vs 2.35±0.70 cm², P < 0.001) with a mean difference of -0.14±0.20 cm² and 95% coherence boundaries of (-0.53, 0.25 cm²). The regression equation for EOA-3D and EOA-2D is y=0.27 + 0.94x, showing a good correlation between the two methods.

OBJECTIVE

EOA estimation of the prosthetic mitral valve using 2D and 3D TEE has a good consistency, and the results estimated by the 2D method are slightly lower by about 6% than those by the 3D method.

The Predictive Value of d-Dimer Test for Venous Thromboembolism During Puerperium: A Prospective Cohort Study

The aim of this study was to investigate the d-dimer for prediction of venous thromboembolism (VTE) events in puerperium and to identify other risk factors associated with the occurrence of VTE. This was a prospective observational cohort study, which included 16 127 women who gave birth after 28 weeks of gestation at Women’s Hospital of Zhejiang University, School of Medicine, from January 2016 to December 2016. Data including basic maternal and fetal characteristics, pregnancy complications, and predictive biomarkers within postpartum 24 hours including d-dimer, platelet, and fibrinogen were collected for analyses. In the cohort study, 19 (0.12%) women were identified as VTE, including 1 pulmonary embolism event and 18 deep venous thrombosis events. The receiver operating characteristic curve analysis suggested the best cutoff point for d-dimer level within postpartum 24 hours was 3.695 mg/L, with a specificity of 75.5% and a sensitivity of 73.7%, and there was no statistical correlation between fibrinogen and VTE, as well as between platelets and VTE. On multivariate analysis, age ≥35 years (odds ratio [OR] = 2.895, 95% confidence interval [CI]: 1.079-7.773), scarred uterus (OR = 3.894, 95% CI: 1.234-12.282), intrauterine infection (OR = 7.214, 95% CI: 1.519-34.262), antiphospholipid syndrome (OR = 199.530, 95% CI: 15.152-2627.529), d-dimer ≥3.70 mg/L (OR = 7.573, 95% CI: 2.699-21.247), and emergency cesarean delivery (OR = 23.357, 95% CI: 2.819-193.508) were independently associated with VTE in puerperium. We concluded that d-dimer ≥3.70 mg/L was an independent predictor of VTE during puerperium and d-dimer testing was necessary for perinatal women.

Hsa_circ_0005075 predicts a poor prognosis and acts as an oncogene in colorectal cancer via activating Wnt/β-catenin pathway

OBJECTIVE

Emerging evidence has demonstrated vital regulation of circular RNAs (circRNAs) on tumorigenesis and progression of tumors. Abnormally expressed circRNAs hsa_circ_0005075 (circ_0005075) has been reported in several tumors. In this study, we aimed to explore the expression profiles, prognostic value, and potential function of circ_0005075 in colorectal cancer (CRC) PATIENTS AND METHODS: RT-PCR was used to detect the expression of circ_0005075 in both CRC tissues and cell lines. The associations between circ_0005075 expression and clinicopathological features and clinical prognosis were statistically analyzed. The effects of circ_0005075 on CRC cells were evaluated by Cell Counting Kit-8 (CCK-8), colony formation assays, Flow cytometer, and transwell assays. Western blot was performed to explore whether circ_0005075 modulated the Wnt/β-catenin pathway.

RESULTS

We observed that circ_0005075 expression was significantly up-regulated in both CRC tissues and cell lines. Then, clinical assays indicated that high circ_0005075 expression was significantly associated with histology/differentiation, depth of invasion, advanced TNM stage, and shorter overall survival and disease-free survival of CRC patients. Cellular studies indicated that circ_0005075 can enhance the proliferation, migration, and invasion capacities of CRC cells, thereby promoting tumor progression. Further mechanistic investigation showed that circ_0005075 displayed its tumor-promotive roles through activating Wnt/β-catenin pathway.

CONCLUSIONS

Our present data revealed circ_0005075 as a potential molecular marker and target for the prognosis and treatment of CRC patients.

Comparison of contrast-enhanced ultrasound and contrast-enhanced computed tomography for the diagnosis of cervical lymph node metastasis in squamous cell carcinoma of the oral cavity

Early detection of cervical lymph node metastasis (CLNM) from squamous cell carcinoma (SCC) of the oral cavity remains challenging. This prospective study was performed to evaluate the ability of contrast-enhanced ultrasound (CEUS) to detect CLNM from oral cavity SCC. Additionally, its diagnostic value was compared with that of contrast-enhanced computed tomography (CECT). Forty-eight consecutive patients with SCC of the oral cavity were enrolled. All subjects were examined preoperatively with both CEUS and CECT. Subsequently, neck dissections were performed for these patients, and cervical lymph nodes separated from the surgical specimens were assessed histologically. The diagnostic performance of these two examinations was compared based on the results of histopathology. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and Youden index for CEUS and CECT were 69.39% vs. 44.90%, 94.71% vs. 97.12%, 89.88%% vs. 87.16%, 75.56% vs. 78.57%, 92.92% vs. 88.21%, and 64.10% vs. 42.02%, respectively. A significant difference was observed in terms of sensitivity (P=0.024) and Youden index (rate difference 22.08%, 95% confidence interval 2.72-41.44%). Therefore, CEUS appears to be a promising diagnostic tool that is superior to CECT for detecting CLNM from SCC of the oral cavity, with a higher sensitivity.

Sex modulates the apolipoprotein E ε4 effect on white matter and cortical functional connectivity in individuals with amnestic mild cognitive impairment

BACKGROUND AND PURPOSE

Recent studies from the Alzheimer's Disease Neuroimaging Initiative show that, in the USA, 75% of patients with Alzheimer's disease are female. To date, there have rarely been any attempts to analyze data by sex or gender, which limits the potential for discovering the effects of sex or gender on disease. Little evidence is available regarding the effect of gender and apolipoprotein E (APOE) ε4 on white matter (WM) connection from the functional perspective due to the lack of appropriate techniques for detecting blood-oxygen-level-dependent signals in WM.

METHODS

We took advantage of a new framework known as functional tensor imaging to investigate the effect of sex and APOEε4 on WM cortical functional connectivity throughout the brain.

RESULTS

In a group of female patients with amnestic mild cognitive impairment, we found a significantly reduced functional connectivity in the left posterior limb of the internal capsule, left superior fronto-occipital fasciculus, bilateral temporopolar area and right somatosensory association cortex in APOEε4 carriers in contrast to non-carriers. We also found a significant APOEε4 by sex interaction effect on the right somatosensory association cortex, left temporopolar area and left superior temporal gyrus. The clinical Montreal Cognitive Assessment score was significantly negatively associated with the right somatosensory association cortex with APOEε4 by sex interaction in males.

CONCLUSIONS

These results indicate that increased APOE-related risk in women may be associated with decreased activity in both gray matter and WM in patients with amnestic mild cognitive impairment compared with men. The finding suggests accounting for sex differences in neuroimaging biomarkers, diagnostics and treatment strategy.

MiR-203 over-expression promotes prostate cancer cell apoptosis and reduces ADM resistance

The article "MiR-203 over-expression promotes prostate cancer cell apoptosis and reduces ADM resistance, by Chen LZ, Ding Z, Zhang Y, He ST, Wang XH, published in Eur Rev Med Pharmacol Sci. 2018 Jun;22(12):3734-3741. DOI: 10.26355/eurrev_201806_15253. PMID: 29949147" has been withdrawn from the authors. The Publisher apologizes for any inconvenience this may cause.

The toxic effects of Fluorene-9-bisphenol on porcine oocyte in vitro maturation

Fluorene-9-bisphenol (9,9-bis(4-hydroxyphenyl)-fluorene [BHPF]) is a bisphenol A (BPA) substitute used in the production of "BPA-free" plastics, now has been identified is harmful to living organisms. Our previous study showed that BHPF impaired mouse denuded oocyte in vitro maturation. However, there is a question that whether BHPF is still able to affect oocyte maturation in the presence of dense cumulus cells. In the present study, we checked the toxic effects of BHPF on porcine oocyte maturation which is derived from COCs in vitro culture. Our results showed that BHPF (50 μM) inhibited the expansion of cumulus cells, led to a significant decrease in polar body extrusion (PBE). Importantly, BHPF resulted in abnormal spindle assembly, ATP level decrease, reactive oxygen species (ROS) accumulation and early apoptosis in porcine oocytes, which are all negative to oocyte maturation. Furthermore, BHPF also declined porcine oocyte quality by disturbing the cortical granules (CGs) distribution. In conclusion, our study showed that BHPF still inhibited oocyte maturation even in the presence of cumulus cells leading to abnormal spindle assembly, ATP decrease, increased ROS level, early apoptosis, and disturbed CGs distribution in porcine oocytes, and also indicates that BHPF has a wide range toxic effects on oocyte in different species.

MiR-203 over-expression promotes prostate cancer cell apoptosis and reduces ADM resistance

OBJECTIVE

Extra-cellular signal regulated kinase (ERK)/mitogen activated protein kinase (MAPK) signaling pathway is widely involved in cell proliferation, apoptosis, and drug resistance. MAPK kinase 1 (MEK1) is the upstream protein kinase of ERK that can activate ERK/MAPK signaling pathway. microRNA 203 (MiR-203) down-regulation is found to be associated with prostate cancer pathogenesis. Bioinformatics analysis showed the complementary targeted relationship between miR-203 and the 3'-UTR of MEK1 mRNA. This study explored the role of miR-203 in regulating prostate cancer cell proliferation, apoptosis, and ADM resistance through affecting MEK1 expression.

MATERIALS AND METHODS

Dual luciferase assay confirmed the targeted relationship between miR-203 and MEK1. MiR-203, MEK1, p-ERK1/2, and B cell lymphoma 2 (Bcl-2) expressions were compared in normal prostate epithelial cells PrEC, prostate cancer cells PC-3M, and drug resistance cells PC-3M/ADM. PC-3M, PC-3M/ADM cell apoptosis and proliferation were detected by using flow cytometry under ADM treatment at IC50 concentration of PC-3M cells. PC-3M cells were cultured in vitro and divided into four groups, including microRNA-normal control (miR-NC), miR-203 mimic, small interfere NC (si-NC), and si-MEK1.

RESULTS

MiR-203 targeted and inhibited MEK1 expression. MiR-203 levels and cell apoptosis were significantly lower, while MEK1, p-ERK1/2, Bcl-2, and cell proliferation were significantly higher in PC-3M/ADM cells compared to the PC-3M cells. MiR-203 mimic and/or si-MEK1 transfection significantly reduced MEK1, p-ERK1/2, and Bcl-2 levels, attenuated cell proliferation, induced cell apoptosis, and decreased drug resistance.

CONCLUSIONS

MiR-203 elevation suppressed prostate cancer PC-3M cell proliferation, promoted apoptosis, and weakened ADM resistance through targeted inhibiting MEK1 expression to alleviate ERK/MAPK signaling pathway and Bcl-2 expression.

The role of a semi-automated NanoVelcro system in capturing circulating tumor cells and evaluating their prognostic value for gestational choriocarcinoma

To investigate whether circulating tumor cells (CTCs) are detectable in patients with gestational choriocarcinoma (GC) and evaluate the prognostic value of CTC enumeration. In this multicenter study, the presence of CTCs was examined in 180 GC patients using a semi-automated NanoVelcro system, among whom 106 patients underwent CTC re-evaluation after one cycle of chemotherapy. Approximately 96% of the GC patients contained ≥2 CTCs in 7.5 mL of blood. The number of CTCs per 7.5 mL of blood was much higher in patients with distant metastases (n = 95; range, 0 to 104) than in patients without distant metastases (n = 85; range, 0 to 6). Applying a 90-patient training and 90-patient validation cohort, a cutoff value of ≥6 CTCs was defined as the prognostic threshold for progression-free survival (PFS) and overall survival (OS). The presence of ≥6 CTCs was significantly associated with worse PFS and OS (both P < 0.001). A multivariate analysis showed that the CTC number (≥6 CTCs) was the strongest predictor of OS (hazard ratio [HR], 15.8; 95% confidence interval [CI], 4.3-57.9; P < 0.001). The number of CTCs decreased after one cycle of chemotherapy; univariate analyses demonstrated that the CTC count after the first chemotherapy cycle was a strong predictor of OS (HR, 36.1; 95% CI, 4.8-271.5; P < 0.001). CTCs are a promising prognostic factor for GC. The absolute CTC count after one cycle of chemotherapy in the context of this disease is a strong predictor of chemotherapy response.

Observation of second sound in graphite at temperatures above 100 K

Wavelike thermal transport in solids, referred to as second sound, is an exotic phenomenon previously limited to a handful of materials at low temperatures. The rare occurrence of this effect restricted its scientific and practical importance. We directly observed second sound in graphite at temperatures above 100 kelvins by using time-resolved optical measurements of thermal transport on the micrometer-length scale. Our experimental results are in qualitative agreement with ab initio calculations that predict wavelike phonon hydrodynamics. We believe that these results potentially indicate an important role of second sound in microscale transient heat transport in two-dimensional and layered materials in a wide temperature range.

Imaging features of metanephric adenoma and their pathological correlation

AIM

To analyse the imaging features of metanephric adenoma (MA) and their pathological correlation.

MATERIALS AND METHODS

The imaging findings in 11 patients with MA were studied retrospectively. Ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) findings were studied in seven, 11, and six patients, respectively. The enhancement pattern, attenuation, lesion location, size, cystic or solid appearance, capsule sign, and presence of calcifications were evaluated.

RESULTS

On ultrasonography, MA presented as hypoechoic (4/7), slightly hyperechoic (1/7), isoechoic (2/7), and with a clear boundary. Unenhanced CT showed unclear boundaries (11/11), homogeneous isodensity (8/11), with calcification (1/11), necrosis (1/11), and heterogeneous hyperattenuation (1/11). Mean CT attenuation values on unenhanced and enhanced CT (cortical phase, corticomedullary phase, and excretory phase) were 38.87±6.66, 55.71±17.74, 67.77±16.86, and 65.62±15.99 HU, respectively. The degree of enhancement of the lesions in each phase was statistically significantly lower than that of the surrounding normal renal parenchyma (p=0.00). The pattern of enhancement of the solid component was slight and gradual enhancement (9/11). The tumour was located entirely within the renal medulla in nine cases, and two cases demonstrated an exophytic pattern. All tumours showed a clear boundary on enhanced CT, but capsules were not found. The mean greatest tumour diameter was 3.5 cm. MA showed markedly hyperintense on the diffusion-weighted MRI sequence (DWI) and delayed enhancement of the tumour capsule on enhanced MRI.

CONCLUSIONS

Imaging features of MA are usually solid and hypovascular, and show prolonged, and homogeneous mild enhancement that is less than that of the surrounding normal renal parenchyma in all phases. MA is markedly hyperintense on DWI.

Physcion 8-O-β-glucopyranoside prevents hypoxia-induced epithelial-mesenchymal transition in colorectal cancer HCT116 cells by modulating EMMPRIN

Epithelial-mesenchymal transition (EMT) is considered as the most important mechanism that underlies the initiation of cancer metastasis. Here we report that Physicon 8-O-β-glucopyranoside (PG), a major active ingredient from a traditional Chinese herbal medicine Rumex japonicus Houtt, is capable of preventing human colorectal cancer cells from hypoxia-induced EMT. The treatment of the cells with PG reversed the EMT-related phenotype that has the morphological changes, down-regulation of E-cadherin, and hypoxia-induced cell migration and invasion. The effect was mediated at least in part by inhibiting the mRNA and protein expressions of EMMPRIN via modulation of PTEN/Akt/HIF-1α pathway. In addition, we found that PG-mediated prevention of EMT involved blockade of the hypoxia-induced up-regulation of Snail, Slug and Twist. In summary, this study showed that PG can prevent EMT induced by hypoxia, the environment that commonly exists in the center of a solid tumor. Given the low toxicity of PG to the healthy tissues, our study suggests that PG can serve as a safe therapeutic agent for suppressing cancer metastasis.

Long-term immunogenicity and immune persistence of live attenuated and inactivated hepatitis a vaccines: a report on additional observations from a phase IV study

Both live attenuated (HA-L) and inactivated (HA-I) hepatitis A vaccine were licensed for routine use in China. Although phase 1, 2 and 3 clinical studies of both vaccines have been completed, further systematic evaluation of their immunogenicity and immunological persistence under phase 4 clinical studies in a wide range of conditions and involving large populations is necessary. A phase IV clinical trial (NCT02601040) was performed in 9000 participants over 18 months of age. Geometric mean concentrations (GMCs) and seroconversion rates (SRs) were compared at five time points during 3 years for 1800 individuals among them. The SRs of HA-L and HA-I were 98.08% (95% CI 95.59%-99.38%) and 99.64% (95% CI 98.93%-100.00%) respectively 28 days after administration of the first dose, and remained at 97.07% (95% CI 94.31%-98.73%) or above and 96.73% (95% CI 94.07%-98.42%) or above respectively during the following 3 years. The GMCs for both the HA-L and HA-I groups showed that both vaccines elicited high anti-HAV titres, considerably more than the threshold of protection needed against HAV infection in humans, and these titres were sustained. Hence, both HA-I and HA-L vaccines could provide an excellent long-term protective effect, and supported the routine use of both vaccines.

Clinical and molecular insights into Glanzmann's thrombasthenia in China

Glanzmann's thrombasthenia (GT) is a rare bleeding disorder characterized by spontaneous mucocutaneous bleeding. The disorder is caused by quantitative or qualitative defects in integrin αIIbβ3 (encoded by ITGA2B and ITGB3) on the platelet and is more common in consanguineous populations. However, the prevalence rate and clinical characteristics of GT in non-consanguineous populations have been unclear. We analyzed 97 patients from 93 families with GT in the Han population in China. This analysis showed lower consanguinity (18.3%) in Han patients than other ethnic populations in GT-prone countries. Compared with other ethnic populations, there was no significant difference in the distribution of GT types. Han females suffered more severe bleeding and had a poorer prognosis. We identified a total of 43 different ITGA2B and ITGB3 variants, including 25 previously unidentified, in 45 patients. These variants included 14 missense, 4 nonsense, 4 frameshift, and 3 splicing site variants. Patients with the same genotype generally manifested the same GT type but presented with different bleeding severities. This suggests that GT clinical phenotype does not solely depend on genotype. Our study provides an initial, yet important, clinical and molecular characterization of GT heterogeneity in China.

A circulating microRNA signature as noninvasive diagnostic and prognostic biomarkers for nonalcoholic steatohepatitis

BACKGROUND

Noninvasive biomarkers are urgently needed for patients with nonalcoholic steatohepatitis (NASH) to assist in diagnosis, monitoring disease progression and assessing treatment response. Recently several exploratory studies showed that circulating level of microRNA is associated with NASH and correlated with disease severity. Although these data were encouraging, the application of circulating microRNA as biomarkers for patient screening and stratification need to be further assessed under well-controlled conditions.

RESULTS

The expression of circulating microRNAs were profiled in diet-induced NASH progression and regression models to assess the diagnostic and prognostic values and the translatability between preclinical mouse model and men. Since these mice had same genetic background and were housed in the same conditions, there were minimal confounding factors. Histopathological lesions were analyzed at distinct disease progression stages along with microRNA measurement which allows longitudinal assessment of microRNA as NASH biomarkers. Next, differentially expressed microRNAs were identified and validated in an independent cohorts of animals. Thirdly, these microRNAs were examined in a NASH regression model to assess whether they would respond to NASH treatment. MicroRNA profiling in two independent cohorts of animals validated the up-regulation of 6 microRNAs (miR-122, miR-192, miR-21, miR-29a, miR-34a and miR-505) in NASH mice, which was designated as the circulating microRNA signature for NASH. The microRNA signature could accurately distinguish NASH mice from lean mice, and it responded to chow diet treatment in a NASH regression model. To further improve the performance of microRNA-based biomarker, a new composite biomarker was proposed, which consists of miR-192, miR-21, miR-505 and ALT. The new composite biomarker outperformed the microRNA signature in predicting NASH mice which had NAS > 3, and deserves further validations in large scale studies.

CONCLUSION

The present study supported the translation of circulating microRNAs between preclinical models and humans in NASH pathogenesis and progression. The microRNA-based composite biomarker may be used for non-invasive diagnosis, clinical monitoring and assessing treatment response for NASH.

Estrogen-dependent association of HDAC4 with fear in female mice and women with PTSD

Women are at increased risk of developing post-traumatic stress disorder (PTSD) following a traumatic event. Recent studies suggest that this may be mediated, in part, by circulating estrogen levels. This study evaluated the hypothesis that individual variation in response to estrogen levels contributes to fear regulation and PTSD risk in women. We evaluated DNA methylation from blood of female participants in the Grady Trauma Project and found that serum estradiol levels associates with DNA methylation across the genome. For genes expressed in blood, we examined the association between each CpG site and PTSD diagnosis using linear models that adjusted for cell proportions and age. After multiple test correction, PTSD associated with methylation of CpG sites in the HDAC4 gene, which encodes histone deacetylase 4, and is involved in long-term memory formation and behavior. DNA methylation of HDAC4 CpG sites were tagged by a nearby single-nucleotide polymorphism (rs7570903), which also associated with HDAC4 expression, fear-potentiated startle and resting-state functional connectivity of the amygdala in traumatized humans. Using auditory Pavlovian fear conditioning in a rodent model, we examined the regulation of Hdac4 in the amygdala of ovariectomized (OVX) female mice. Hdac4 messenger RNA levels were higher in the amygdala 2 h after tone-shock presentations, compared with OVX-homecage control females. In naturally cycling females, tone-shock presentations increased Hdac4 expression relative to homecage controls for metestrous (low estrogen) but not the proestrous (high estrogen) group. Together, these results support an estrogenic influence of HDAC4 regulation and expression that may contribute to PTSD in women.

Co-occurrence of DSM-IV mental disorders and alcohol use disorder among adult Chinese males

BACKGROUND

Studies from high-income countries report moderate-to-strong positive associations between alcohol use disorder (AUD) and other mental disorders, but there is little evidence about the comorbidity of AUD from low-and-middle-income countries.

METHODS

A sample of 74 752 adults from five provinces that account for >12% of China's adult population was screened using the General Health Questionnaire, and the Structured Clinical Interview for DSM-IV was administered by psychiatrists to a subsample of 9619 males. The associations between AUD and other mental disorders at each site and the characteristics of men with AUD with and without comorbid mental disorders were estimated using logistic regression and summarized across sites using meta-analysis. Generalized estimation equations estimated the associations between the clinical features of alcohol dependence and comorbidity.

RESULTS

Robust inverse associations were found between current AUD and any mood disorder (adjusted OR = 0.6, 95% CI = 0.4-0.8) and any anxiety disorder (OR = 0.5, 95% CI = 0.3-1.0). Compared with men without AUD, men with AUD without comorbid disorders were more likely to be middle-aged, to be currently married, and to have higher family incomes. Men with comorbid AUD and other disorders were more likely to have the clinical features of alcohol dependence than men with AUD without comorbid disorders.

CONCLUSIONS

Inverse associations between AUD and other mental disorders and the higher social status of men with AUD than men without AUD found in this large, representative sample of community-dwelling Chinese males highlight the importance of considering the local substance-use culture when designing clinical or preventive interventions for addictive conditions.

Forkhead Box M1 positively regulates UBE2C and protects glioma cells from autophagic death

Ubiquitin-conjugating enzyme E2C (UBE2C) is characterized as a crucial molecule in cancer cell growth that plays an essential role in the development of gliomas, but the detailed mechanisms have not been fully elucidated. In this study, we found that Forkhead box transcription factor M1 (FoxM1) overexpression increased UBE2C expression, whereas FoxM1 suppression inhibited UBE2C expression in glioma cells. In addition, high FoxM1/UBE2C expression was significantly correlated with poor prognosis in glioma. We subsequently demonstrated that UBE2C was a direct transcriptional target of FoxM1, and site-directed mutations markedly down-regulated UBE2C promoter activity. Moreover, UBE2C siRNA (si-UBE2C) significantly induced glioma cell autophagy and increased both mCherry-LC3 punctate fluorescence and LC3B-II/LC3-I expression. Notably, the si-UBE2C-induced decrease in cell viability was markedly inhibited by the autophagy inhibitor bafilomycin A1. The silencing of UBE2C resulted in a distinct inhibition of the PI3K-Akt-mTOR pathway, which functions in the negative modulation of autophagy. Collectively, our findings provide clinical and molecular evidence that FoxM1 promotes glioma progression by enhancing UBE2C transcription and that the inhibition of UBE2C partially induces autophagic glioma cell death. Thus, targeting the FoxM1-UBE2C axis has therapeutic potential in the treatment of gliomas.