Detecting pulmonary malignancy against benign nodules using noninvasive cell-free DNA fragmentomics assay

BACKGROUND

Early screening using low-dose computed tomography (LDCT) can reduce mortality caused by non-small-cell lung cancer. However, ∼25% of the 'suspicious' pulmonary nodules identified by LDCT are later confirmed benign through resection surgery, adding to patients' discomfort and the burden on the healthcare system. In this study, we aim to develop a noninvasive liquid biopsy assay for distinguishing pulmonary malignancy from benign yet 'suspicious' lung nodules using cell-free DNA (cfDNA) fragmentomics profiling.

METHODS

An independent training cohort consisting of 193 patients with malignant nodules and 44 patients with benign nodules was used to construct a machine learning model. Base models using four different fragmentomics profiles were optimized using an automated machine learning approach before being stacked into the final predictive model. An independent validation cohort, including 96 malignant nodules and 22 benign nodules, and an external test cohort, including 58 malignant nodules and 41 benign nodules, were used to assess the performance of the stacked ensemble model.

RESULTS

Our machine learning models demonstrated excellent performance in detecting patients with malignant nodules. The area under the curves reached 0.857 and 0.860 in the independent validation cohort and the external test cohort, respectively. The validation cohort achieved an excellent specificity (68.2%) at the targeted 90% sensitivity (89.6%). An equivalently good performance was observed while applying the cut-off to the external cohort, which reached a specificity of 63.4% at 89.7% sensitivity. A subgroup analysis for the independent validation cohort showed that the sensitivities for detecting various subgroups of nodule size (<1 cm: 91.7%; 1-3 cm: 88.1%; >3 cm: 100%; unknown: 100%) and smoking history (yes: 88.2%; no: 89.9%) all remained high among the lung cancer group.

CONCLUSIONS

Our cfDNA fragmentomics assay can provide a noninvasive approach to distinguishing malignant nodules from radiographically suspicious but pathologically benign ones, amending LDCT false positives.

Study on the correlation between dietary structure and sleep in patients with insomnia disorder

OBJECTIVE

Insomnia disorder (ID) is a persistent difficulty sleeping, often accompanied by anxiety and depression, which seriously reduces a person's quality of life. Dietary changes in insomnia patients have been a concern. To explore the rationality of diet in patients with ID and its correlation with insomnia in ID patients.

PATIENTS AND METHODS

This study included 216 patients diagnosed with ID and 197 individuals as the healthy control (HC) group who attended the neurology outpatient clinic or sleep clinic at Henan Provincial People's Hospital between September 2018 and November 2019. Through the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD), sleep and mental conditions were assessed in the ID and HC groups. The dietary intake structure of both groups was observed using the food frequency table. Meanwhile, the relationship between dietary intake and sleep quality was analyzed based on the logistics regression.

RESULTS

Individuals in the ID group had significantly higher age, weight, and body mass index compared to the HC group (p<0.01). Individuals within the ID category demonstrated a heightened daily consumption of carbohydrates, grains, tubers, and legumes relative to the healthy control group. In contrast, the intake levels of vegetables, fruits, and nuts were diminished compared to the HC group, with this difference being statistically significant (p<0.01). A positive correlation was observed between the daily consumption of grains, tubers, and legumes and PSQI scores. Conversely, a negative association was found between daily consumption of vegetables and fruits.

CONCLUSIONS

ID patients exhibit an elevated intake of carbohydrates, whereas the consumption of vegetables, fruits, and nuts is deficient in comparison to the healthy cohort, implying that a distorted dietary structure might be a contributing factor to ID onset. Sensible and scientific dietary guidance is of considerable significance in preventing the onset of ID and facilitating its management. However, the derived conclusions warrant further extensive research.

Standard Therapy vs. Individualized Therapy in Elderly Locally Advanced Nasopharyngeal Carcinoma: A Real-World Study

PURPOSE/OBJECTIVE(S)

Concurrent chemoradiotherapy (CRT) with/without induction chemotherapy has been the standard therapy (ST) for locally advanced nasopharyngeal carcinoma (LA-NPC). However, most patients supporting these clinical trials were younger than 65 years of age. For the toxicity of CRT and the poor tolerance of elderly patients, it is still controversial whether ST could bring the most promising survival benefits for elderly NPC compared with individualized therapy (IT). Thus, in this real-world study we compared the survival and safety of ST with IT in elderly LA-NPC to explore an effective and tolerable treatment strategy for elderly LA-NPC.

MATERIALS/METHODS

A total of 109 newly diagnosed elderly LA-NPC (>65 years old) from Jan. 2013-Jul. 2020 were retrospectively enrolled and divided into the ST group and IT group according to the original treatment tendency. ST refers to CRT with/without induction chemotherapy. IT group included patients not suitable for CRT and were given individualized treatment fully discussed by at least two oncologists from our head and neck team. A 1:1 propensity score matching (PSM) generated a matched cohort of ST and IT. The survivals and treatment related toxicities were compared between the two groups.

RESULTS

There were 46 cases in the ST group and 63 cases in the IT group. The 5-year overall survival (OS) rate, cancer-specific survival (CSS) rate, progression- free survival (PFS) rate, local recurrence-free survival (LRFS) rate and distant metastasis-free survival (DMFS) rate were 68.64%, 76.42%, 73.69%, 85.67% and 86.82%, respectively. By 1:1PSM, 35 cases in each group were matched. No significant differences of OS, CSS, PFS, LRFS and DMFS were found between ST and IT groups in the PSM-matched cohorts (P = 0.87, P = 0.79, P = 0.51, P = 0.81 and P = 0.24, respectively). Compared with patients in the ST group, cases received IT were associated with less severe acute toxicities including anemia, leucopenia, neutropenia, and thrombocytopenia.

CONCLUSION

For elderly LA-NPC, IT had similar survivals while less severe toxicities compared with ST, which revolutionarily challenged the role of ST for elderly LA-NPC. In the future, more studies are need to explore a less toxic treatment modality with noninferior efficacy for elderly LA-NPC.

Accurate Calibration of a Large Field of View Camera with Coplanar Constraint for Large-Scale Specular Three-Dimensional Profile Measurement

In the vision-based inspection of specular or shiny surfaces, we often compute the camera pose with respect to a reference plane by analyzing images of calibration grids, reflected in such a surface. To obtain high precision in camera calibration, the calibration target should be large enough to cover the whole field of view (FOV). For a camera with a large FOV, using a small target can only obtain a locally optimal solution. However, using a large target causes many difficulties in making, carrying, and employing the large target. To solve this problem, an improved calibration method based on coplanar constraint is proposed for a camera with a large FOV. Firstly, with an auxiliary plane mirror provided, the positions of the calibration grid and the tilt angles of the plane mirror are changed several times to capture several mirrored calibration images. Secondly, the initial parameters of the camera are calculated based on each group of mirrored calibration images. Finally, adding with the coplanar constraint between each group of calibration grid, the external parameters between the camera and the reference plane are optimized via the Levenberg-Marquardt algorithm (LM). The experimental results show that the proposed camera calibration method has good robustness and accuracy.

Temperature management of intraoperative cardiopulmonary bypass in valve replacement surgery: a retrospective analysis of the impact on postoperative organ function

OBJECTIVE

This study aimed to systematically analyze the effects of cardiopulmonary bypass (CPB) at different temperatures on the function of different organs in patients after heart valve replacement and to investigate its safety and feasibility.

PATIENTS AND METHODS

The data of 275 heart valve replacement surgery patients who underwent static suction compound anesthesia under CPB between February 2018 and October 2019 were retrospectively analyzed and divided into normothermic CPB anesthesia group (group 0), shallow hypothermic CPB anesthesia group (group 1), medium hypothermic CPB anesthesia group (group 2), and deep hypothermic CPB anesthesia group (group 3) according to the different intraoperative CPB temperatures. The basic preoperative conditions, cardiac resuscitation, number of defibrillations, postoperative ICU stay, postoperative hospital stay, and postoperative evaluation of different organ functions, such as heart, lung, and kidney functions, were analyzed and studied in each group.

RESULTS

The comparison of preoperative and postoperative pulmonary artery pressure and left ventricular internal diameter (LVD) was statistically significant in each group (p < 0.05), and the postoperative pulmonary function pressure was statistically significant in group 0 compared with groups 1 and 2 (p < 0.05). The preoperative glomerular filtration rate (eGFR) and the eGFR on the first postoperative day were statistically significant in all the groups (p < 0.05), and the eGFR on the first postoperative day in groups 1 and 2 were statistically significant (p < 0.05).

CONCLUSIONS

The control of appropriate temperature during CPB was associated with the recovery of organ function in patients after valve replacement. Intravenous compound general anesthesia with superficial hypothermic CPB might be more beneficial in recovering cardiac, pulmonary, and renal functions.

[microRNA let-7g-3p regulates proliferation, migration, invasion and apoptosis of bladder cancer cells by targeting HMGB2]

OBJECTIVE

To explore the molecular mechanism by which microRNA let-7g-3p regulates biological behaviors of bladder cancer cells.

METHODS

The expression levels of let-7g-3p in bladder cancer and adjacent tissues, normal bladder epithelial cells (HUC cells) and bladder cancer cells (T24, 5637 and EJ cells) were detected using qRT- PCR. T24 cells were transfected with let-7g-3p mimic or inhibitor, and the changes in cell proliferation, migration, invasion, and apoptosis were examined. Transcriptome sequencing was carried out in cells overexpressing let-7g-3p, and the results of bioinformatics analysis, double luciferase reporter gene assay, qRT-PCR and Western blotting confirmed that HMGB2 gene was the target gene of let-7g-3p. The expression of HMGB2 was examined in HUC, T24, 5637 and EJ cells, and in cells with HMGB2 knockdown, the effect of let-7g-3p knockdown on the biological behaviors were observed.

RESULTS

qRT-qPCR confirmed that let-7g-3p expression was significantly lower in bladder cancer tissues and cells (P < 0.01). Overexpression of let-7g-3p inhibited cell proliferation, migration and invasion, and promoted cell apoptosis, while let-7g-3p knock-down produced the opposite effects. Bioinformatics and transcriptome sequencing results showed that HMGB2 was the key molecule that mediate the effect of let-7g-3p on bladder cancer cells. Luciferase reporter gene assay, qRT-PCR and Western blotting all confirmed that HMGB2 was negatively regulated by let-7g-3p (P < 0.01). Knocking down HMGB2 could partially reverse the effect of let-7g-3p knockdown on the biological behaviors of the bladder cancer cells.

CONCLUSION

The microRNA let-7g-3p can inhibit the biological behavior of bladder cancer cells by negatively regulating HMGB2 gene.

Initial Clinical Characteristics of 146 Patients with COVID-19 Reported in Guizhou Province, China: A Survival Analysis

INTRODUCTION

Coronavirus disease 2019 (COVID-19) has caused an outbreak around the world. Early detection of severe illness is crucial for patients' survival. We analysed initial clinical characteristics of 146 patients with COVID-19 reported in Guizhou province, China to explore risk factors for transforming mild illness to severe.

METHODOLOGY

Data of 146 laboratory-confirmed cases were collected and evaluated by the survival analysis of univariate and multivariate Cox proportional hazards model.

RESULTS

On initial presentation, patients had fever (51.05%), dry cough (45.45%), headache (16.08%), shortness of breath (7.75%) and gastrointestinal symptoms (13.99%). Among 146 laboratory-confirmed cases, 30 patients (20.55%) had severe illness and needed Intensive Care Unit care for supportive treatment. The remaining patients (116, 79.45%) were non-severe cases. Nineteen (19/146, 13.01%) of 30 patients in the Intensive Care Unit had comorbidities, including hypertension (12, 40.00%), diabetes (5, 16.67%), cardiovascular disease (5, 16.67%) and pulmonary disease (4, 13.33%). For survival analysis, patients who had fever (HR = 3.30, 95% CI = 1.31, 8.29) and comorbidities (HR = 9.76, 95% CI = 4.28, 22.23) at baseline were more likely to be admitted into the Intensive Care Unit. Few variables were not related to the survival time of discharge from baseline to discharge and from Intensive Care Unit care to discharge.

CONCLUSIONS

Severe patients with COVID-19 should be paid more attention. On initial symptoms, many patients did not have fever, but those with fever were more likely to be admitted to the Intensive Care Unit. Comorbidities were likewise a risk factor of severe COVID-19.

Associations between severe pulmonary function and residual CT abnormalities in rehabilitating COVID-19 patients

OBJECTIVE

Coronavirus disease 2019 (COVID-19) spread around the world in 2020. Abnormal pulmonary function and residual CT abnormalities were observed in COVID-19 patients during recovery. Appropriate rehabilitation training is around the corner. The correlation between spirometric impairment and residual CT abnormality remains largely unknown.

PATIENTS AND METHODS

A cross-sectional study conducted on the pulmonary function of 101 convalescent COVID-19 patients before discharge. Multivariate analysis was used to establish a scoring system to evaluate the spirometric abnormality based on residual chest CT.

RESULTS

Lung consolidation area >25% and severe-type COVID-19 were two independent risk factors for severe pulmonary dysfunction. Besides, a scoring system was established. People scoring more than 12 points have more chances (17 times) to get severe pulmonary function impairment before discharge.

CONCLUSIONS

For the first time, a chest CT characteristics-based grading system was suggested to predict the pulmonary dysfunction of COVID-19 patients during convalescence in this study. This study may provide suggestions for pulmonary rehabilitation.

[Modulatory effect of 2-arachidonoylglycerol on voltage-gated sodium currents in rat caudate nucleus neurons with kainic acid-induced injury]

OBJECTIVE

To investigate the modulatory effect of 2-arachidonoylglycerol (2-AG) on voltage-gated sodium currents(VGSCs) in rat caudate nucleus (CN) neurons with kainic acid (KA)-induced injury and explore the molecular mechanism underlying the neuroprotective effect of 2-AG.

METHODS

Primary cultures of CN neurons isolated from neonatal SD rats were treated with KA, 2-AG+KA, RIM (a CB1 receptor antagonist) +2-AG+KA, or vehicle only (as control).After 7 days in primary culture, the neurons were treated with corresponding agents for 12 h (RIM and 2-AG were added at the same time; KA was added 30 min later) before recording of current density changes, current-voltage characteristics, activation and inactivation kinetics of VGSCs (I_Na) using whole-cell patch clamp technique.

RESULTS

In cultured CN neurons, KA significantly increased current density of VGSCs (P=0.009) as compared with vehicle treatment.KA also produced a hyperpolarizing shift in the activation curve of I_Na and significantly increased the absolute value of V_1/2 for activation (P=0.008).Addition of 2-AG in the culture medium obviously prevented KA-induced increase of I_Na (P=0.009) and hyperpolarizing shift in the activation curve of I_Na, and significantly reduced the value of V_1/2 for activation(P=0.009)in a CB1 receptor-dependent manner.2-AG alone did not affect the density, activation or deactivation of VGSCs in rat CN neurons.

CONCLUSION

In excitotoxic events, endogenous 2-AG can offer neuroprotection by modulating VGSCs in the CN neurons through a CB1 receptor-dependent pathway.

Whole exome sequencing in molecular diagnostics of cancer decreases over time: evidence from a cost analysis in the French setting

OBJECTIVES

Although high-throughput sequencing is revolutionising medicine, data on the actual cost of whole exome sequencing (WES) applications are needed. We aimed at assessing the cost of WES at a French cancer institute in 2015 and 2018.

METHODS

Actual costs of WES application in oncology research were determined using both micro-costing and gross-costing for the years 2015 and 2018, before and after the acquisition of a new sequencer. The entire workflow process of a WES test was tracked, and the number and unit price of each resource were identified at the most detailed level, from library preparation to bioinformatics analyses. In addition, we conducted an ad hoc analysis of the bioinformatics storage costs of data issued from WES analyses.

RESULTS

The cost of WES has decreased substantially, from €1921 per sample (i.e. cost of €3842 per patient) in 2015 to €804 per sample (i.e. cost of €1,608 per patient) in 2018, representing a decrease of 58%. In the meantime, the cost of bioinformatics storage has increased from €19,836 to €200,711.

CONCLUSION

This study suggests that WES cost has decreased significantly in recent years. WES has become affordable, even though clinical utility and efficiency still need to be confirmed.

Epidemiologic Characteristics of COVID-19 in Guizhou Province, China

INTRODUCTION

At the end of 2019, the COVID-19 broke out, and spread to Guizhou province in January of 2020.

METHODOLOGY

To acquire the epidemiologic characteristics of COVID-19 in Guizhou province, we collected data from 169 laboratory-confirmed COVID-19 related cases. We described the demographic characteristics of the cases and estimated the incubation period, serial interval and the effective reproduction number. We also presented two representative case studies in Guizhou province: Case Study 1 was an example of the asymptomatic carrier; while Case Study 2 was an example of a large and complex infection chain that involved four different regions, spanning three provinces and eight families.

RESULTS

Two peaks in the incidence distribution associated with COVID-19 in Guizhou province were related to the 6.04 days (95% CI: 5.00 - 7.10) of incubation period and 6.14±2.21 days of serial interval. We also discussed the effectiveness of the control measures based on the instantaneous effective reproduction number that was a constantly declining curve.

CONCLUSIONS

As of February 2, 2020, the estimated effective reproduction number was below 1, and no new cases were reported since February 26. These showed that Guizhou Province had achieved significant progress in preventing the spread of the epidemic. The medical isolation of close contacts was consequential. Meanwhile, the asymptomatic carriers and the super-spreaders must be isolated in time, who would cause a widespread infection.

Circ-DONSON promotes malignant progression of glioma through modulating FOXO3

OBJECTIVE

The aim of this study was to investigate the expression level of circ-DONSON in glioma and to explore its effect on glioma metastasis and the underlying mechanism.

PATIENTS AND METHODS

Quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) was performed to examine circ-DONSON expression in 40 paired glioma tumor tissues and adjacent tissues. Meanwhile, the relation between circ-DONSON level and clinical parameters of glioma and the prognosis of patients was analyzed. The expression of circ-DONSON in glioma cell lines was analyzed by qRT-PCR as well. In addition, circs-DONSON silencing model was constructed in glioma cell lines. Cell counting kit-8 (CCK-8), cell scratch, and transwell migration assays were performed to investigate the effect of circ-DONSON on biological functions of glioma cells. Finally, the interplay between FOXO3 and circ-DONSON was explored.

RESULTS

QRT-PCR results revealed that the expression level of circ-DONSON in glioma tumor tissues was remarkably higher than that of adjacent tissues, and the difference was statistically significant (p<0.05). Compared with patients with low expression of circ-DONSON, significantly higher prevalence of lymph node or distant metastasis and worse prognosis were observed in patients with high expression of circ-DONSON (p<0.05). The proliferation and migration abilities of glioma cells in circ-DONSON silenced group were remarkably suppressed when compared with NC group (p<0.05). Additionally, FOXO3 expression was remarkably down-regulated in glioma cell lines and tissues. FOXO3 expression was negatively correlated with circ-DONSON expression. In addition, cell reverse experiment demonstrated that circ-DONSON and FOXO3 can regulate each other, thereby together affecting the malignant progression of glioma.

CONCLUSIONS

Circ-DONSON was remarkably associated with lymph node or distant metastasis, as well as poor prognosis of patients with glioma. Furthermore, it promoted the metastasis of glioma cells via regulating FOXO3.

Discharge of a silo through a lateral orifice: Role of the bottom inclination versus friction

In this work we propose to identify the relative role of the inclination of gravitational acceleration and friction on the discharge flow rate of a granular media from a rectangular silo by varying the silo geometry thanks to an inclined bottom which ends up at a lateral outlet. The study is motivated by a nuclear safety problem: a fuel rod (modeled by an elongated silo) accidentally releases fuel fragments (modeled by grains). We performed experiments where we independently measured the mass flow rate and the velocity profiles, together with discrete particle simulations and continuum simulations with a frictional rheology described by a μ(I) constitutive law and taking into account the wall friction. We study monolayer flows and three-dimensional flows, and we propose an analytical model that predicts the discharge flow rate of particles from a rectangular silo with an inclined bottom according to its outlet aspect ratio and the bottom inclination angle.

[Efficacy comparison between robot-assisted and laparoscopic surgery for mid-low rectal cancer: a prospective randomized controlled trial]

Objective: To compare the short- and long-term outcomes of robot-assisted and laparoscopic radical resection for mid-low rectal cancer. Methods: A prospective randomized controlled trial was conducted. A total of 130 patients with mid-low rectal cancer (inclusion criteria: age > 18 or ≤80 years old; pathological diagnosis of rectal adenocarcinoma by colonoscopy; distance from tumor to the anal verge ≤12 cm; no distant metastasis; cT1-3N0-1 or ycT1-3 after neoadjuvant radiotherapy and chemotherapy; suitable for laparoscopic and robotic surgery) at the Department of Colorectal Surgery of the First Affiliated Hospital of Nanchang University from October 2016 to September 2018 were prospectively enrolled. According to computer-generated random number method, patients were randomly divided into the robot group (n=66) and laparoscopy group (n=64), and underwent robot-assisted surgery or laparoscopic surgery respectively. Clinicopathological data of all the patients were collected and analyzed. The demographic parameters, short- and long-term outcomes were compared between two groups. Results: One patient in robot group whose postoperative sample was diagnosed as rectal adenoma by pathology was excluded. There were no statistically significant differences in age, sex, BMI, ASA classification, distance from tumor to the anal verge, serum CEA level, CA199 level between two groups (all P>0.05). Operations were successfully performed in all the patients without conversion to open operation. Robotic surgery was found to be associated with less intraoperative blood loss than laparoscopic surgery [(73.4±49.7) ml vs. (119.1±65.7) ml, t=-4.461, P<0.001], while there were no statistically significant differences in surgical procedures, operation time, time to first flatus, time to first liquid intake, time to removal of catheter or postoperative hospital stay between two groups (all P>0.05). Besides, there was no significant difference in the morbidity of postoperative complication between two groups [10.8% (7/65) vs. 12.5 (8/64), χ(2)=4.342, P=0.720]. The median number of harvested lymph node in the robot group and the laparoscopy group was 15.7±6.2 and 13.8±6.1 (t=1.724, P=0.087). There were no significant differences between two groups in tumor sample length, distance between proximal and distal resection margin, integrity grade of TME specimen, number of positive lymph nodes, postoperative pathological stage and tumor differentiation (all P>0.05). The distal resection margin of samples in two groups was all negative. One case in the robot group was found to have positive circumferential resection margin. The median follow up was 24 (9 to 31) months. In the robot group and the laparoscopy group, the 2-year overall survival rate was 95.4% and 90.6% respectively; the 2-year disease-free survival rate was 90.8% and 85.9% respectively, whose differences were not significant (both P>0.05). Conclusion: Robot-assisted radical resection for mid-low rectal cancer can achieve similar short-term and long-term outcomes of laparoscopic resection, while robot-assisted surgery can decrease blood loss during operation, leading to more precise practice in minimally invasive surgery.

[Application of multiple nucleotide polymorphism analysis in chimerism detection after allogeneic hematopoietic stem cell transplantation]

目的

建立一种利用多核苷酸多态性高通量测序（MNPseq）分析异基因造血干细胞移植后嵌合状态的新方法，并探讨其可行性及优越性。

方法

筛选100个MNP片段，采用高通量测序技术，通过模拟嵌合样本和临床移植后样本，与STR法、融合基因定量检测和流式细胞术微小残留病检测进行对比，验证方法的准确性和敏感性。

结果

MNPseq的准确性和敏感性均优于STR法，其中敏感性为0.01%，较STR法敏感约100倍；MNPseq可以进一步区分STR完全嵌合的42份样本，且经Cutoff值校正后，与融合基因定量检测结果相关；MNPseq可以纠正因为影子峰所造成的STR法的假阳性，并且可以用于检测缺乏供者和（或）患者移植前信息的嵌合体标本。

结论

基于高通量测序的MNPseq分析是一种更加准确和敏感的嵌合体检测方法，而且解决了缺乏移植前信息无法检测嵌合体的问题，具有极高的临床应用价值。

miR-191 is involved in renal dysfunction in arsenic-exposed populations by regulating inflammatory response caused by arsenic from burning arsenic-contaminated coal

Chronic exposure to arsenic may result in the manifestation of damage in multiple organs or systems of the body. Arsenic-induced renal dysfunction has been determined, but their pathogenesis has not been fully examined. In this study, we measured the expression levels of miR-191 in plasma, the contents of pro-inflammatory (interleukin (IL)-6 and tumor necrosis factor alpha) and anti-inflammatory (IL-2 and transforming growth factor beta) cytokines, and renal dysfunction indicators (blood urea nitrogen, blood creatinine, uric acid, and cystatin C) in serum from control and arsenic poisoning populations and analyzed the relationship between the miR-191, cytokines, and renal dysfunction indicators. The results clearly show the alteration of miR-191 expression was significantly associated with arsenic-induced renal dysfunction. Overall, the association of miR-191, inflammatory response and renal dysfunction, is clearly supported by the current findings. In other words, miR-191 is involved in renal dysfunction in exposed populations by regulating inflammatory response caused by coal-burning arsenic. The study provides a scientific basis for further studies of the causes of the arsenic-induced renal dysfunction, the biological role of miR-191, and targeted prevention strategies.